DETERMINING THE NEED FOR PLACEMENT

What is the impact of relocating a child to another family for foster placement compared with arranging for the child to move in with a grandparent or other relative? With tongue in cheek, Mishne (1983) points out that many wealthy parents voluntarily send their children to boarding school, with no expectation that the young people will be harmed by the experience of separation from home. Obviously, it is not primarily the separation that threatens a child but the circumstances that precipitated the separation in the first place. If, as previously indicated, the main reason for involuntary placement is parental abuse or neglect, a separation can be viewed as the culmination of many past experiences of emotional and/or physical distress because of the adults’ behavior. The separation is frequently the outcome of a long, sad history, which often leads the child to mistrust adults. These life experiences of abuse or neglect also contribute to the child’s poor ego development and reduced ability to deal with even the everyday difficulties of life, let alone situations of extreme stress. Because every placement decision is different, the interacting influence of many factors must be weighed in determining the specific meaning of the placement to each individual child and family and in outlining a realistic treatment plan. Evaluating Placement as Crisis: The Use of Tripartite Assessment In several previous publications (Webb, 1991, 1993, 1999, 2001, 2007, 2010), I have presented the use of tripartite assessment as a method of evaluating the impact of a specific crisis or traumatic experience on a child. As noted also in Chapter 4 of this book, tripartite assessment looks at the interaction of three groups of factors: those related to (1) the individual, (2) the situation, and (3) the support system of family and community. When used by child welfare practitioners, tripartite assessment will assist in evaluating the need for the placement and in weighing the prospects for returning the child to his or her family. It is essential that child welfare workers become aware of the neurological effects on the child’s brain of early trauma such as abuse or erratic parenting behavior. These experiences can compromise the child’s later ability to trust adults and to cope with stress (Perry, 2006; Webb, 2006b). A “crisis” is defined by Gilliland and James (2001, p. 3) as “a perception of an event or situation as an intolerable difficulty that exceeds the resources and coping mechanisms of the person.” The out-of-home involuntary placement of a child provokes many feelings in the child and the family, including varying degrees of shame, guilt, and anger. The parents have been publicly exposed as unfit to care for their own child, with the result that the family may experience a loss of face and accompanying loss of self-respect. The child, in turn, may feel guilty about his or her perceived role in precipitating the placement. This form of loss generates a state of “disenfranchised grief” (Doka, 1989, 2002), because the stigma associated with the child’s placement can be neither openly acknowledged nor mourned. These suppressed, complicated feelings must be recognized and understood by child welfare professionals who work with the child and family. The use of tripartite assessment facilitates this understanding, especially of the complex factors that precipitated the placement decision. Workers who recognize the importance of the multiple factors that culminate in the child’s placement will be better able to help the child and the family acknowledge the loss experience that the placement represents as the basis for planning realistically for the future. Figure 10.1 diagrams the various factors that apply to the out-of-home placement of a child.
Determining the Factors Precipitating Placement The decision to move a child from his or her own home to another setting merits the utmost deliberation and review of all relevant facts. As previously mentioned, the majority of children in foster care enter the child welfare system because of family problems related to abuse and neglect. In many instances, this has been chronic. The form in Figure 10.2 allows the child welfare practitioner to record in detail the key factors contributing to the placement, based on the tripartite conceptualization.
Factors related to the family itself and to its ability to nurture the child are often critical in precipitating placement. Some children (e.g., those with autism or ADHD) make excessive demands on their families because of their special needs and the difficulty they have in controlling their emotions and behavior. Other children may have the misfortune to be born at a difficult time in their parents’ relationship or when the added demands of child care may prove too much for immature or overwhelmed parents who themselves feel needy and unfulfilled and who may take out their frustrations on their dependent children. For example, a father who has recently lost his job and whose wife has been diagnosed with cancer may vent his fury on his innocent 9-year-old son, who reminds the father of everything he hoped for in his own life that he now believes has been taken away from him. When the boy asks for money to buy a baseball mitt, the father tells him scornfully that money doesn’t grow on trees and that he’d better begin to think about ways to obtain his own money for the things he wants. One isolated episode like this is not likely to propel a boy into a life of crime. However, when it and others like it are combined with pressure from older neighborhood youngsters who serve as drug runners and decoys for drug dealers, it is comprehensible how the boy could become involved in a life of petty crime—one that later could result in placement in a foster home or a residential treatment facility. Evaluation of significant influences in child placement often hinges on an understanding of interacting individual and family factors. Figure 10.3 is a form for recording these specific influences on the placement decision.
DIFFERENT LEVELS OF CARE Although it is beyond the scope of this chapter to analyze the wide range of child welfare programs for children, it is important to recognize that there is a continuum of services for children who are dependent and/or who have emotional or behavioral difficulties. These include foster care, residential treatment centers, group homes, day treatment programs, shelters, family and psychiatric clinics, and crisis/respite services. Because of space limitations, I focus here primarily on grandparent and foster placement, with case vignettes to demonstrate the varied circumstances that can lead to child placement. Selected methods for helping children in placement to cope with their feelings about their life situations are presented later in the chapter. Foster Care Foster care consists of a temporary arrangement for child care in a substitute home when the parents cannot take care of their own child because of some serious difficulty. The expectation is that the child will return to the parents’ home when the conditions precipitating the foster placement have been corrected. The intent of the Adoption Assistance and Child Welfare Reform Act (Public Law 96-272, 1980) is to provide permanent homes for children who are in the foster care system, either by returning them to their biological parents or by placing them with relatives. The third best alternative is a legally permanent adoptive family, and the fourth best placement is a reasonably permanent foster family (University of Kentucky College of Social Work, 1989; Whittaker, 1987). It is important to note that this law requires that “a variety of placement prevention services. . . ensure that ‘reasonable efforts’ have been made to preserve the family before a child [is] placed in substitute care” (Pecora, Reed-Ashcraft, & Kirk, 2001, p. 15). Therefore, we can speculate that children who are placed with nonrelatives probably come from families with fewer supports and resources. In 2015 there were approximately 408,000 children in foster care, with a median age of 7.8 years (Child Welfare Information Gateway, 2017). Although foster care is supposed to be temporary (limited to 18 months), it is often much longer. Frequently, children have difficulty adjusting in the new home, where they may not be able to trust the foster parent or conform to a new routine and expectations. Unable to adapt, many children act out; then they are moved from one foster placement to another, with increasingly negative effects on their sense of security and self-esteem. The length of a child’s stay in foster care varies greatly, from a few days to a few years. The average length is approximately 2 years. Whenever possible, siblings are kept together. The longer a child stays in foster care, the smaller the child’s chances are of obtaining a permanent home, according to Brieland et al. (1985). Kinship Foster Care * The fastest growing form of out-of-home placement in the United States is kinship foster care. In 2016, more than 2.7 million grandparents in the United States were raising their own grandchildren because the children’s own parents were unavailable or unable to care for them (Annie E. Casey Foundation, 2017). About one-fifth of these grandparents live below the poverty line; many are over 60 years old, and about a quarter of these have a disability. Therefore, this arrangement can come with its own problems. Grandparents provide at least half of the kinship care in this country, and estimates suggest that the great majority of these arrangements are made informally between family members in response to emergencies or other situations of need. Other times, grandparents or other relatives are recruited to take care of children of their relatives, and they may enter the formal child welfare system with reimbursement as approved foster parents. Although kinship care is viewed as preferable to placement in a home of nonrelatives because it preserves the family, children in kinship foster care are less likely to return to their biological parents and are less likely to be adopted than are children in placements with nonrelated foster parents (Barth, Courtney, Berrick, & Albert, 1994). There is a long tradition of kinship care in African American and Hispanic families, in which family and kin networks are utilized when child care is needed (Bean, McAllister, & Hudgins, 2001; Patterson & Marsiglia, 2000). However, the tremendous growth of grandparent-headed households between 1990 and 1997 was not just an African American or Hispanic phenomenon, as might be believed. The growth of European American grandparent-headed households was the most dramatic during this period (Bean et al., 2001). As reported by AARP, based on a Metropolitan Life Report and the U.S. Census of 2010, 2.7 million grandparents were raising their grandchildren at that time. Even when the care of children by grandparents is culturally supported and frequent, they may find it burdensome because of health and economic worries of their own. According to Casper and Bryson (1998; quoted in Shapiro et al., 2001b, p. 126), “children who live in grandparent-maintained households, with or without a parent, are more likely to be without health insurance, living in families below the poverty line, and receiving public assistance.” Other stresses in these families can include ongoing family conflicts regarding the custody of the child, especially when the child’s mother has a substance abuse problem and the grandparent doubts that her rehabilitation will last. This was the situation in the case of Ricky, discussed later in the chapter. Other difficulties can occur when the child still longs for the mother and wants to return to her despite the grandparent’s love and good care. This situation creates a loyalty conflict for the child similar to that felt by many children in divorcing families who feel torn between their parents (Tonning, 1999; Edelstein, Burge, & Waterman, 2002).