Children

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Childrens Forum, Dec. 2003

• Children in Institutions Prevention and
  Alternative Care

Bragi Guðbrandsson General Director, The
Government Agency for Child Protection, Iceland
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Outline

• The child's right to grow up in a family
• Harmful effects of institutionalization on
  children and society
• Residential care in Europe
• Prevention and preventive strategies
• Examples of Best practices
• Alternative care
• Leaving care - pathways
• The role of the professionals in the placement
  process

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The preamble to the Convention on the Rights of
the Child

• The family is the fundamental group of society
  and the natural environment of growth and well
  being of all its members and particularly
  children .The child should grow up in a family
  environment, in an atmosphere of happiness, love
  and understanding.

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Harmful effects of institutionalization on
children

• contributes to social exclusion and
  stigmatization
• deprivation of emotional nourishment and
  development of social skills
• hampers intellectual development and lasting
  relationship
• causes anxiety, personal uncertainty and
  passivity
• increases aggressiveness and inclination to
  antisocial behavior
• Russian research on orphans leaving care every
  fifth develops criminal career, every seventh
  becomes prostitute and ten percent commits
  suicide

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Harmful effects of institutionalization on
society

• Message from UNICEF
• We are also coming to realize what institutional
  care does to societies. It perpetuates
  discrimination, by providing tacit approval for
  the idea that certain groups of children, whether
  orphaned, abandoned, living with disabilities,
  from families affected by AIDS or by poverty
  should live apart from society.the use of
  institutional care also impedes the healthy
  development of communities and society as a
  whole.

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Harmful effects of institutionalization on
society, cont.

• The Stockholm Declaration of the Second
  International Conference on Children and
  Residential Care, May, 2003
• There is indisputable evidence that
  institutional care has negative consequence for
  both individual children and society at large.

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Residential care in Europe

• Existing data on the scope of residential care is
  
  fragmented and difficult to interpret
• At the risk of some oversimplification, three
  distinct categories of states can be identified,
  based on the rate of institutionalization, size
  and quality of institutional care, reasons for
  placement, alternative out-of-home placement and
  family support

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Central- and Eastern Europe

• High level of institutionalization 6 to 20
  children per 1000
• Large institutions, up to few hundred children
  per unit
• High number of orphans and infants in
  institutional care
• Long duration of placement
• Quality of care often poor
• Poverty the most significant cause for placement
• Low level of alternative care
• Family support limited

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South-Eastern Europe (incl. the Caucasus states)

• Low level of institutionalization typically 1 to
  3 children per 1000
• Large institutions, up to several hundred
  children
• High ratio of infants and orphans in care
• Long duration of placement
• Quality of care often poor
• Poverty and family breakdown significant cause
  for placement
• Low level of alternative care
• Family support undeveloped

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The more Affluent states in Europe (esp. Western
Europe)

• Varied level of institutionalization less than 1
  up to 7 per 1000
• Significant progress in de-institutionalization
• Small, family-type residential care is common
• Low rates of orphans and infant care
• Short-term placement common
• Quality of care often satisfactory or good
• Complex reasons for placement, conduct and
  substance abuse treatment a significant cause
• Generally a high level of alternative care,
  especially foster care
• Range of services for families

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Evolution of institutional care three stages

• the specialization paradigm
• the normalization paradigm
• the paradigm of childrens rights

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Defining Prevention

• Primary prevention to stop significant harm to
  children before it occurs
• Secondary prevention intervention to minimize
  the effects of significant harm once it has
  occurred
• Tertiary prevention to prevent the reoccurrence
  of harm and further deterioration

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Prevention strategies

• Evidence of correlation between lack of family
  support and high rates of out-of-home placement
• Strengthening the basic provisions and services
  on the state level health, education, housing,
  employment and social security
• Empowering local government - enhancing family
  support on the local level day care services
  etc.
• Targeting vulnerable groups single parent
  families, multiple children families, poor
  families, the disabled etc.
• Education, training, research and awareness
  raising child abuse, sexual exploitation,
  substance abuse etc.
• Public family policy

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Public Family Policy

• Family Policy as a Perspective
• Latent and Explicit family policy
• Assessing policies in terms of their family
  consequences
• Definition of responsibilities, coordination and
  collaboration

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Child Protection Systems

• Vulnerable children and social intervention
• The Child Rescue Model investigatory,
  policing and procedurally driven focus
• The Family Support Model supportive
  intervention and partnership with families
• CPS Comparative analysis in Europe

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CPS Comparative analysis in Europe

• Comments on the UK System
• Limited understanding of family dynamic
• Tension investigation vs. theraphy
• Conflict between families and professionals
• Comments on the Continental System
• Risks with respect to the childs safety
• Lack of planning for course of action
• Actions without evidence of harm or abuse

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CPS Cross Cultural Differences

• The Priciple of Subsidiarity
• Welfare pluralism
• The Concept of rights

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Examples of Best Practices

• Gatekeeping
• Partnership with families
• Family Group Conferences - CFC
• Parent Management Training - PMT
• Multi-systematic Treatment (MST)
• Developing competence and family services

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Gatekeeping 

• To ensure that services are provided only to
  those who meet specified eligibility criteria
• To ration and make effective use of scarce
  resources
• To focus on the child needs and targeting
  services
• Should raise thresholds for institutional or
  other out-of-home placement

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Partnership with Families

• Empowerment deprofessionalization,
  decentralization and anti oppressive practices
• Consumerism power of choice, quality assurance
  and rights of the individual
• ATD Fourth World
• Talk with us not at us
• Work with families rather than work on families
• Dont judge by crisis behaviour alone

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Family Group Conferences

• Radical alternative to traditional methods
• Engages the wider family in decision-making with
  regard to children at risk
• Principle Every family is unique a valuable
  resource
• Four steps
• Referral
• Preparation
• The Meeting
• Reviewing the plan

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Parent Management Training

• Adresses serious behavioural disturbances of
  children from a very early age
• Attempts to break a vicious circle of negative
  interaction between parent and child
• PMT consists of
• Directions and skill encouragement
• Setting limits
• Anger control and problem solving
• Positive involvement

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Multisystematic Treatment

• Community-based treatment of high risk young
  offenders, substance abusers and adolescents with
  anti-social behaviour
• A treatment package that focuses on
• Family theraphy and parental techniqes
• Interaction within the home, in school, with
  peers and neighbours
• Implemented nationwide in Norway promising
  results

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Developing Competence and Family Services

• Families with multi-problems can become
  multi-agency families
• The danger of compartmentalisation of
  professional intervention and of family life
• The importance of Multiagency and
  Interdiciplinary approach

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Alternative Care Foster families

• Foster family care most nurturing out-of-home
  placement for children
• Regulating foster care services by establishing
  guidlines accreditation, monitoring etc.
• The right of the child to
• Be listened to
• Maintain contact to the biological family
• Have his/her developmental needs met

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Foster Pride an example of best practices

• Parent Resources for Information, Development and
  Education
• A Comprehensive Framework for Competence Building
• Pre-service recruitment, preparation and
  assessment
• In-service training, enhancing general skills
  and children with special needs

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Existing Forms of Alternative Care Eastern
Europe

• Family-type ophanages and family like boarding
  schools
• Family upbringing groups, replacement
  families, patronage families
• Guardianship
• SOS Childrens Villages
• Adoptions

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Leaving Care - Pathways

• Post placement care is crucial for the well-being
  of the child
• The Pathway plan, based on assessment of needs
• Family and social relationship
• Skills for independent living
• Accomodation
• Education, training and employment
• Health and development
• Financial arrangement

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The Role of the Professional in the Placement
Process

• Professional roles as articulation of values,
  perceptions, knowledge and ethical beliefs
• Important ground rules
• The rights of the Child
• Family support and respect
• Care Plans the childs development and autonomy
• Social intergration
• Minority Ethnic Groups
• Code of Ethics