New York Times
Fragile Families Are Guided Past Crisies
By CATHY CORMAN
TRYING to shepherd her four boys out of a social worker’s office at the Milford Mental Health Clinic, a 26-year-old mother asked one of her 4-year-old twins to put down the “Star Trek” doll that he had been grasping for more than an hour. The boy stubbornly refused to give up his toy, alternately waving, it in the air and clutching it to his chest. Taking cues from their brother, the other three grabbed dolls and clamored to play.
Drawing on her recent lessons about composure and patience, the mother tried to reason with her children, using a newly discovered inner reserve.
“I used to tell them, ‘Leave me alone,’ ” she said. “But I’m learning that it’s better to talk to them and punish them than to hit them.”
Last summer, before she agreed to participate in a new intensive family-preservation program, the woman risked losing her four boys and her older daughter to foster care.
An unemployed single mother with a ninth-grade education, few job prospects and no family or community support, she had been labled “notorious” by socialservice officials for her unwillingness to accept conventional forms of assistance. Withdrawn and deeply depressed, she was increasingly identified by her inability to care for and discipline her children.
Expensive and Ineffective
Most youngsters who are placed in foster care come from families similar to her’s. These children are not victims of incest or unrelenting physical violence, experts says, but suffer a far more common kind of abuse: neglect.
In the past two decades, child-welfare experts have realized that placement in foster care is expensive and often ineffective. In Connecticut, 60 to 70 percent of the budget of the Department of Child and Youth Services is devoted to paying for children to live apart from their families, said Brenda McGavran, the agency’s regional director who supervises the New Haven area.
Once fostet care begins, officials said, it tends to become a revolving door, as children are repeatedly sent away and sent back home.
“Once you’ve made the awful step, it’s easier to do the next time,” said Judy Burger-Gossart, director of services for families and children at the Milford Mental Heaith Clinic. For example, she said, of 200 cases in which the Department of Child and Youth Services removed children from their families and placed them in foster care, less than a dozen were placed only once.
“It’s not unusual to see kids in four to six foster homes,” Ms. Burger-Gossart said. “It becomes chronic.”
Struggling to put an end to the vicious circle that it supports and monitors, the state department is spending $2 million on seven family-preservation programs at private, nonprofit clinics, including the one in Milford.
Since July, these clinics have provided in-home counseling and crisis intervention to families at risk of losing children to placement in foster care. The state is also providing funds for an experimental program at the Milford clinic that provides help for parents and children after the youngsters return home from foster placement.
“We’re making a commitment to work with biological families first,” said Beverly Burke, family-preservation specialist for the Department of Child and Youth. Services, who supervises the seven programs. “We should be willing to invest as much in a kid“s own family as we would invest in placement.”
The first family-preservation program began in 1974 in Tacoma, Washington, where social workers were sent to help troubled families for short periods to avoid foster placement. Today, some 30 states offer one or more services based on the Tacoma model.
Two of Connecticut’s seven programs started as experiments in 1988. Based at the Yale Child Study Center in New Haven and at the Klingberg Family Center in New Britain, the two programs were financed by the state agency and a matching grant from the Edna McConnell Clark Foundation, a charitable organization in New York City that provides start-up support for family-preservation services throughout the country.
The programs in New Haven and New Britain were able to avoid foster placement in about 70 percent of the families they worked with; without the programs, all the children would have been placed. The state department was so impressed with the success rate that it asked the legislature in 1989 to finance five more programs.
Though there are minor variations among the programs in Connecticut, all share a similar approach. They were intended to serve children who, without further intervention, would be removed from their families within 72 to 96 hours. They rely on social workers who take on no more than two cases at a time and spend up to 20 hours a week with families in their homes. In Milford, caseworkers spend six to eight weeks with families; other programs have funds to extend the involvement.
Most of the state agency’s social workers manage 40 to 60 cases at once and rarely have time for a home visit. The family-preservation caseworkers, chosen for flexibility and tenacity, are on call 24 hours a day, seven days a week. They provide families with food stamps, clothing, household goods, cleaning supplies and transportation as well as offering psychotherapy and lessons in parental skills. “Going into the home is where the action is,” said Dr. John Leventhal, associate professor of Pediatrics at Yale University School of Medicine and medical director of the Child Abuse Committee at Yale New Haven Hospital.
Having worked with the pilot program at Yale, Dr. Leventhal said, he heartily supports the family-preservation efforts. Indeed, critics of the concept are hard to find, which is as it should be, said Edward Zigler, professor of psychology at Yale and director of the Bush Center in Child Development and Social Policy.
For the single mother at the Milford clinic, the program is giving her a chance to raise all five of her children herself, while she explores employment options. Her boys are starting to settle down and follow instruction, she said, and her daughter, who is 7, is showing more interest in school work and reading. “They hug and kiss each other all the time.”
She said she now realizes that she had been severely depressed for four years before her involvement with the family-preservation program. Others had tried to get her into counseling, she said, but her current caseworker, Adelaida Egan, was the first person who broke through the barrier.
“It was just me in this dark closet,” the mother said, until Ms. Egan “came in and opened it up, and the sun came in.”
Taking ‘Time Out’
She said that Ms. Egan was on hand at times when the family was most susceptible to crisis, like the children’s bedtime, when tempers were likely to flare. The caseworker demonstrated techniques like taking a “time-out,” which allowed the mother to control her temper and remain firmly authoritative, she said. Ms. Egan even helped provide transportation to counseling sessions and offered help setting up a household budget.
Ms. Egan and her colleagues in the family-preservation program are “an unusual breed of sharpshooters,” said the executive director of the Milford clinic, Barry Kasdan. They can assess a situation quickly, he said, and can help create environments in which families are able to begin functioning.
For their part, the caseworkers said that they were relieved to be working in a program where they do not have to worry about burnout. Carmen Martinez, director of the Milford program, said the group is so effective because the workers communicate well with clients and with each other. The caseworkers said they can watch their clients change, no matter how gradually, and they feel they can avert crises.
“The common perception is that these families are not workable,” said Mr. Kasdan. “The healthiest families do go into crisis. It“s a large, loud statement. They are exposing themselves to the community.”
Those who work in the program said these troubled parents are not bad people but often are people to whom bad things have been done. The children, even when they have been neglected, are probably not unwanted, the social workers said.
“Children, no matter how abused, they love their parents, and they will fight to get their parents back,” said Ms. Egan. “No matter if the foster home is beautiful and all their needs are met, they want to go back.”