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When is Reunification Safe? — November 2012 Sounding Board

30 Nov

 by Dee Wilson

Some reunification decisions are straighforward and uncomplicated; most of these decisions happen within a few days,weeks or months following out- of- home placement of children. For example, law enforcement officers often place children in receiving care or foster care after arresting their parents. CPS caseworkers may quickly return children to  parents following their release from jail, or they locate relatives where children can stay as long as necessary without legal action. Other children may be quickly returned home after parents have taken care of a specific problem or condition, for example by cleaning up and safety proofing a home, requiring an alleged sexual offender to leave the home or making child care arrangements. In these types of cases, caseworkers believe that children will be safe in a parent’s home once a specific safety threat has been removed. However, brief stays in out- of- home care are associated with comparatively high rates of re-entry because, in some of these cases, parents have underlying conditions such as substance abuse or mental health problems which have not been assessed and which continue to endanger children.

When children are placed out of the home as part of a dependency action, parents usually have substance abuse and/or mental health problems (often co-occurring) and frequently a history of domestic violence as well. A small percentage of parents have severe cognitive impairments as well as psychiatric problems. Children have often been chronically abused and/or neglected and experienced multiple forms of maltreatment, including emotional abuse or neglect. In these cases, caseworkers, judicial officers and CASAs typically have more difficulty informing parents clearly and concisely what changes in parental functioning, living arrangements and conditions in the home are necessary before children can be returned to their care and custody. Parents’ attorneys and parent advocates frequently complain that caseworkers and courts “raise the bar” for reunification as parents complete service programs and tasks mandated in court orders; but they may frequently be underestimating the extent to which decision makers are genuinely uncertain regarding what it will take in multi-problem families for children to be be reasonably safe from further harm. 

The legal formulation that children must be returned to parents when the conditions that led to their involuntary removal are corrected does not offer decision makers much guidance since, in most cases, children were placed out of the home due to severe or chronic abuse or neglect; and the question decision makers must answer is whether parents have made changes that significantly reduce the likelihood of future maltreatment. Furthermore, by the time reunification is seriously considered for legally dependent children, children have usually been separated from their parents for many months or (possibly) years. Caseworkers, judges and CASAs cannot make reunification decisions based on recent parenting behavior; instead, they must utilize proxy measures of change as indicators of safety and risk to children following reunification.

The longer children have been living out of the home, the less reasonable it is for decision makers to depend solely on comparisons of parental functioning/ family relationships at the time of children’s removal from the home with current parental and family functioning. In the year or two it often takes for parents to complete treatment programs, a parent may have remarried or begun living with a new romantic partner who may or may not constitute a risk to a child he hardly knows. The mother may have a new baby, and the children of a step parent may be living in the home. In addition, separation of parents and children for long periods of time changes parent – child relationships. For example, many babies enter foster care shorly after birth. These infants will usually become atttached to kin or non- kin foster parents regardless of the frequency of parent- child visitation.  When these children are reunified with a birth parent after a lengthy placement, they are likely to be cranky and difficult to care for. If a birth parent is not prepared to cope with a toddler’s grief at separation from his/ her foster parents, a dangerous parent- child conflict may ensue when parents with troubled early histories interpret their child’s cranky behavior as rejection or disapproval.  

Research studies conducted in other states (e.g., Smith and Donovan, 2003) have found that caseworkers and courts utilize compliance with court ordered treatment plans as a proxy measure of change. Caseworkers and judicial officers in this state have stated during presentations I’ve done on reunification that most of them do the same. However, participation in and completion of treatment programs is a means to an end, not the goal itself. Parents may comply with court orders without benefiting from mandated services; and parents may occasionally become clean and sober, less depressed, more dependable and affectionate with their children without engaging in services or completing treatment programs. When parents have co –occurring substance abuse and mood disorders, there is a serious question whether a clean and sober parent will become more (rather than less) depressed during the early stages of a recovery process and less responsive to young children.

Reunification Criteria – Motivation, Experience, Enjoyment, Efficacy, Resources and Skills ( MEEERS)

I offer the following criteria as a framework for discussion and debate. These criteria are a distillation of practice wisdom, not research studies, and as such, their usefulness as indicators of child safety and risk needs to be rigorously evaluated. These criteria are not intended to apply to all reunification decisions. Some children (per the discussion above) can be quickly reunited with parents after a specific safety threat has been removed from the home. However, for children who have been severly or chronically maltreated by parents with substance abuse and/ or mental health problems, and/or whose families are periodically impacted by family violence, more is needed to protect children from future maltreatment.

Motivation – A parent seeking reunification is fully committed to her/ his children’s safety and well being. A child or sibling group’s safety and welfare is more important to the parent than feeding a drug habit, maintaining a relationship with a dangerous partner or controlling difficult child behavior.

 Motivation becomes evident when parents are forced to choose among or between competing values. A parent’s motivation to ensure the safety of her/ his children is often confused with motivation to regain the custody of children or motivation for recovery from substance abuse. However, these are different goals that can be disentangled during parents’ frequent interactions with children in out- of- home care and with helping professionals.

I occasionally hear the argument from parents’ attorneys, and sometimes from caseworkers and judicial officers, that there is no objective test of parental motivation, or that motivation is inherently ambiguous or conflicted. My view is that parental commitment to children – or its lack – becomes increasingly apparent in lengthy dependency actions during which parents reveal their values and goals in the consistency and quality of visitation with children, through active participation in treatment programs and the choices they make in their personal lives. As a rule, the reliability of judgments regarding motivation increases over time through frequent contact between professionals and parents. It’s easy to be mistaken about others’ motivations when contact with them is infrequent or superficial. Judgments regarding motivation become more accurate and reliable when there is a large sample of behavior to “read”,  and when these judgments are made by several well informed persons rather than one.

Experience – Parents have had lengthy visitations with children, including overnights and weekends, prior to reunification and have maintained a reasonable standard of care during these visitations.

Babies and toddlers in out- of- home care have frequently spent most of their lives in the care of kin or non – kin foster parents or unlicensed relatives. Parents must be able to cope with young children’s reactions to separation from caregivers to whom they are strongly attached. Transition plans will usually reduce the emotional impact of moves, as well as allowing helping professionals assist parents in understanding and adjusting to their child’s response to the loss of substitute caregivers.

Foster parents will frequently want to abbreviate transition plans because a child’s impending departure from their home is emotionally painful and difficult to manage when a child’s behavior problems increase following extended visits with birth parents. Caseworkers must be able to explain to foster parents why a gradual transition plan is essential for child safety and well being.

Enjoyment – Parent- child interactions during visits include periods of mutually enjoyable activities and reciprocal affectionate behavior. Parents are able to sensitively respond to a child’s non – verbal cues, to demonstrate spontaneous affection in ways that are evident to children and able and wiling to praise and reward positive child behavior. A child is not fearful in the presence of the parents.

Mutually satisfying parent- child interactions create a nurturing intimate environment in which children feel loved and protected. It is extremely dangerous to to reunite a legally dependent child with a parent who consistently experiences interactions with the child as painful, frustrating, irritating or infuriating, or as a sign of their own inadequacy. Most parents are likely to occasionally have negative feelings about their children, but also have a large reservoir of positive experiences that inhibit aggressive or distancing responses to children’s difficult behavior. Absent periodic positive interactions between parents and children that strengthen affectionate bonds, power struggles within a family may easily escalate into physically and emotionally abusive behavior.

Efficacy – A parent is able to take reasonable actions to meet her needs and her childen’s needs; in addition, a parent takes initiative to improve her family’s life.

A key dynamic in chronic neglect is parental loss of self efficacy due to substance abuse, severe depression, a history of trauma and despair. The measure of the success of treatment programs for neglecting parents who initially present as hopeless/ helpless is not abstinence from drugs and alcohol, or the reduction of depressive symptoms, but the energy, initiative and hope to take on day to day challenges with a determined and persistent attitude. 

Resources – A parent has the resources needed to house, feed, clothe, supervise and educate her/ his children. Other resources such as child care, mental health treatment, specialized medical care and access to public transportation are also important.

Children can be safely returned to birth parents more quickly in communities that offer a wide range of resources, including family support services, to low income families. When there are few, if any, community resources available to support low income families, parents need to be firmly established in recovery from substance abuse, and/ or mental health problems and able to function independently before children are returned to their care and custody.

 

Skills – Parents have the ability to manage their children’s behavior in non- abusive ways and know how to initiate positive interactions with their children.

 

An important question in case planning is “at what point can a parent with a history of substance abuse and mental health problems benefit from a skill based program”? Evidenced based parenting programs are usually skill based, hands on programs designed to reduce children’s oppositional behavior by increasing parents’ use of praise and other rewards with their children. Some parents cannot acquire new more effective parenting skills until they are clean and sober or less depressed and anxious; others can benefit from parenting programs during the course of substance abuse and mental health treatment programs. Parents who can benefit early on from skill based programs are usually good candidates for early reunification.

It cannot be emphasized too strongly that lengthy out- of- home placements create uncertainty and tensions in parent – child relationships, issues that may not have been evident at the time of children’s removal from the parent’s home. In addition, school age children  are frequently intensely angry at birth parents whose parenting deficiencies led to the child’s removal from the home, and may be unwilling to initially accept the authority of their parents. Birth parents, in turn, may be tempted to reassert their authority over children in the home through harsh or abusive means. Caseworkers and other helping professionals need to be aware of these risks, and ready to intervene to prevent normal tensions fom escalting into dangerous power struggles that endanger children and lead to re-entry into out- of- home care.

 

In Take Me Home (2009) , Jill Berrick refers to reunification as a lonely compliance driven process for birth parents. Child welfare agencies should develop post – reunification services with the understanding that the first year following reunification after a lengthy stay in foster care is likely to be highly stressful and challenging for both parents and children. Leaving parents to cope with the challenges of reunification without emotional support and timely concrete assistance invites a recurrence of maltreatment and re-entry into care. Families with a history of substance abuse and mental health problems should receive services and the support of a family team for at least a year following their children’s return to the home; and parents with severe cognitive impairments may require case management services until all children in the home have started school. 

 

References

Berrick, Jill, Take Me Home: Protecting America’s Vulnerable Children and Families , Oxford University Press, 2009.

Smith, Brenda, Donovan, Stella, “Child Welfare practice in Organizational and Institutional Context,” Social Service Review, December 2003.

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Posted by on November 30, 2012 in Uncategorized

 

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