Questioning Family-Centered Child Welfare Practice

Is family-centered practice in the best interest of children? Child welfare practice has certainly embraced a family-centered paradigm so it must not only be in the best interest of children, it must be the only appropriate practice paradigm. The implication, at least by innuendo, is that any other approach may be unethical if not immoral. If this were not the case, we would easily find alternative paradigms and advocates for those paradigms.

To this point, I have not discovered any serious proponents of an alternative point of view. I am left to the conclusion that family-centered practice is axiomatic and that alternative perspectives are not worthy of consideration. Even so, letís suppose that an alternative paradigm is possible and explore how it might operate.
Assume that there is a report of a childís being abused or neglected and that investigation shows that the report is valid: there is abuse or neglect of the child. Further, assume that the abuse or neglect took place in the childís home and is attributable to the actions (or lack of action) of the childís parent. The conclusion is that the parent abused or neglected the child.

For discussion purposes, the decision point is reduced to a single choice. Does the child stay connected to the parent or is that connection permanently broken? Of course, the child and the parent staying connected would involve many sub-decisions and choices but letís focus here only on the single decision of staying/not staying connected.

Using the family-centered paradigm, focus shifts nearly exclusively to the parent, once the childís safety is reasonably assured. Assessment and intervention are directed to the parentís history of successful and unsuccessful functioning, to the parentís strengths and weaknesses, to the parentís capacities and incapacities, to the probability of recurring abuse or neglect, and to the parentís ongoing commitment to caring for and about the child. For the most part, the family-centered paradigm is parent-centered.

Focus on the child is primarily deficit oriented. If the child is experiencing developmental, health, educational, or other deficiencies, attention will be given to related, child-level interventions; but if there are no deficiencies, intervention focuses nearly exclusively on the parent. The requirement is to make reasonable efforts to enable the parent to remain connected to the child without further abusing or neglecting the child. The goal is the parentís sustained success as a parent who does not abuse or neglect the child. Family-centered practice is, then, largely a process of parent rehabilitation and the decision to leave the child connected or to break that connection is based on the relative success of the rehabilitation effort.

Using this approach, it is the responsibility of the child welfare practitioner to provide or arrange for those services and resources necessary to reasonably assure the success of the rehabilitation effort. Additionally, the practitioner is responsible for assuring that all reasonable effort has been made to facilitate the parentís participation in and success with the rehabilitation process. During this parent rehabilitation process, the practitioner is additionally responsible for assuring the safety and care of the child, compensating for parent deficiencies and inadequacies while the parent rehabilitation proceeds. This may include providing health care and other services for the child, foster care or daycare, educational services, supervised visitation, and so on. The child welfare practitioner fills the gap between adequate and inadequate parent functioning as parent rehabilitation progresses.

Federal and state legislation shows signs of questioning the family-centered paradigm. For example, there are a range of situations where no effort has to be made to rehabilitate the parent. These are primarily related to the parentís past abuse of children. Also, the time limits for rehabilitation success have been contracted, especially when the child is in foster care. The intervention efforts have to succeed within fairly firm time limits or the parent/child connection may be permanently broken.

Suppose instead of a family-centered paradigm, child welfare practitioners used a child-centered paradigm. Given the same abuse/neglect circumstance, what would a child welfare intervention look like? First, the practitioner would consider available knowledge and theory related to childrenís development and well being. Among other points, the practitioner would likely conclude that children normally fair best when living with parents. If that is not possible, they normally fair best living with members of their extended family, e.g., grandparents. If that is not possible, children normally fair best living with caring, supportive families who are not related to them. Also, children fair best when their living arrangements are stable and permanent.

Given this knowledge, the practitioner first determines whether the child can remain with the parent with no changes in the parentís functioning and relationship with the child. If so, no further intervention is necessary. If not, the parent is clearly notified that the current circumstance is unacceptable and that the child will be ďremoved.Ē This intervention may or may not be conditional, given the severity of the abuse or neglect. In most situations, the intervention will be conditional on the parent taking defined corrective action, on a timely basis.

Using the family-centered paradigm, the practitioner is there to protect the child by helping the parent, with the emphasis on helping the parent. Using the child-centered paradigm, the practitioner is there to protect the child by establishing conditions (if there are any such conditions) with which the parent must comply in order for the child not to be removed. It is then the parentís responsibility to comply with the defined conditions.

The practitioner may also assist the parent in compliance but that is simply an additional service and is not integral to the child-centered intervention. Whether the parent complies with the conditions is up to the parent. Resources available for help with complying are a function of the parentís personal resources and those available in the community. The decision to remove the child is simply based on whether the parent complies with the conditions.

Practitioners might also use a community-centered paradigm. They would still intervene to protect the child but the approach would shift. Conditions would be established for the child staying with the parent. These conditions would be developed through an extended family, neighborhood, or community group process. The practitioner would assess the childís ďsafetyĒ situation and then would take any concerns to the group. Based on a group decision process, conditions would be established, possible assistance would be agreed on, and a process for oversight would be arranged. The role of the child welfare practitioner would be to facilitate and to serve as an expert resource to the group. Many agencies are using a family decision making model that includes aspects of a community-centered approach but even those efforts are an outgrowth of the family-centered paradigm and do not represent a shift to an alternative paradigm.

The above exploration, at a minimum, shows that alternative paradigms are definitely possible. Current child welfare practice is at a crisis point. One only has to be familiar with the popular media, review government studies, and discuss the state of child welfare with practitioners to know that change is coming, either at the hand of child welfare professionals or at the hand of Congress and state legislatures. It is also clear that that change will be sweeping and fundamental. I suspect that it will be at the paradigm level over the next few years. Given that likely reality, we need to seriously question our practice paradigms, including the family-centered paradigm.
By Gary A. Crow, Ph.D. January 2017