Paper
Family project: a demonstration project of family therapy for neglectful families
- issue: Issue 1 / 2010
- authors: Michèle Brousseau, Madeleine Beaudry and Marie-Claude Simard
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abstract
Introduction
Neglectful families represent a challenge for child welfare services. Research on family functioning and child neglect have remained separate fields, although recent research has identified family functioning problems (Gaudin and Dubowitz 1997, Brousseau 2000) that could be harmful to the security and development of children. Studies on child welfare intervention also indicate that services, including family therapies, generate modest positive changes and that we have to find out what works and what does not, with whom, and in what situations (Dufour and Chamberland 2004). This paper describes the family therapy model, the implementation process and the changes observed on families.
Purpose
The objectives of Family Project were to develop and experiment a family therapy programme for neglectful families. An ecosystemic family intervention with a focus on family functioning (Ryan et al. 2005) was designed and experimented with families. The McMaster model of family therapy focuses on a comprehensive evaluation, an active collaboration of family members and on family strengths. One assumption underlying the research action process is that collaboration between researchers and practitioners would improve the model implementation and the understanding of family outcomes. Four social workers in youth protection and first line services in Quebec (Canada) were engaged in the development and implementation process with families, including the monitoring of family changes. Those social workers received training in family therapy, and supervision was provided by the research team. They were consulted by the research team on the relevance of the family therapy model for neglectful and at risk families and on specific inclusion and exclusion criteria. The family sample included neglectful and at risk families (N = 13). Analyses were based on qualitative and quantitative data (self report and observation). Parents answered the Family Assessment Device (FAD) (Ryan et al. 2005) and other measurements before and after intervention. Social workers filled the McMaster Clinical Rating Scale (MCRS) (Ryan et al. 2005) after the family evaluation and at the end of intervention; they also kept a notebook of their interventions and observations throughout the project. Tape recordings of follow-up and supervision sessions also help to monitor the implementation process and changes in the families.
Key findings
An important finding was that the model has not been equally applied to all the families as shown by three implementation indicators: 1) application of the whole family therapy process, 2) level of implementation of the model basic principles as perceived by the social workers, and 3) percentage of family meetings that included all the significant members of the family.
In regard to family change, some families showed improvement in their family functioning while no changes were observed for others. These changes appear to be related to the level of model implementation. Families who showed improvement were the ones whose members all participate in family meetings and followed all the model steps. The family meetings percentage was also higher than in the other groups. These cases were closed, except one, where a long term occasional support was needed. Some other families stopped the family therapy after the evaluation process and they did not engaged in treatment. The implementation degree of the basic principles of the model was very low for those families. Lastly, some families showed no improvement and persistent problems. In this group, some did not get involved in family therapy and social workers went back to the usual individual intervention with only one family member, in other cases the family therapy was still going on at the end of the project. Findings point out to promising outcomes although the model was experimented with a small number of families and that social workers were using a new model. Also it should be noted that family therapy should be one specific strategy within an ecosystemic approach for helping neglectful families to protect their children and meet their needs.
Implications
The field experimentation and the collaboration with practitioners help to test the model feasibility in practice, to clarify eligibility criteria for families and to identify organisational issues for further implementation; it is also an important step for designing programmes or models for practice. Training and especially supervision are key issues for successful implementation of a new approach and should not be skipped, even if administrators and policy makers could consider that they are too time-consuming. Training and supervision are important for social workers in child welfare and child protection who used to work with an individual family member (more often the mothers) (Brousseau, 2006), and need to be supported to change their practices and operate a «paradigm shift». Lastly, it is highly relevant to monitor the degree of implementation of a model or programme in practice before trying to evaluate family outcomes. This would surely help to a better understanding of «what works, with whom, and in what situations».
Key references
Brousseau, M. (2000) La perception du fonctionnement familial de parents négligents et non négligents et les facteurs familiaux, parentaux et environnementaux associés. Thèse de doctorat. Québec : Laboratoire de recherche, École de service social, Université Laval.
Brousseau, M. and Morel, E. (2006) Le fonctionnement familial. Représentations du fonctionnement familial et pratiques centrées sur la famille en négligence. Rapport de recherche, Québec : Centre jeunesse de Québec - Institut universitaire.
Dufour, S. and Chamberland, C. (2004) 'The effectiveness of selected interventions for previous maltreatment: enhancing the well-being of children who live at home.' Child and Family Social Work 9, 39-56.
Gaudin, J.M. and Dubowitz, H. (1997) 'Family Functioning in neglectful families: Recent research.' Child Welfare Research Review 2 (eds. J.D. Berrick, R.P. Barth and N. Gilbert), 28-62.
Ryan, C.E., Epstein, N.B., Keitner, G.I., Miller, I.W. and Bishop, D.S. (2005) Evaluating and Treating Families: The McMaster Approach. Routledge, New York and Hove.
Contact details
Dr Michèle Brousseau, Centre jeunesse de Québec - Institut universitaire and Université Laval, 2915, avenue du Bourg-Royal, Québec (Qc), CANADA.
Email: Michele_Brousseau@ssss.gouv.qc.ca
Madeleine Beaudry and Dr Marie Simard, Université Laval, address as above.