Journal Issue: Protecting Children from Abuse and Neglect Volume 8 Number 1 Spring 1998
A Continuum of Family and Children's Services
As any parent knows, raising children is a challenging and sometimes overwhelming responsibility. Most parents tap a broad range of informal and formal supports for help in fulfilling their responsibilities, looking to family, friends, and neighbors, as well as to child care, health, education, and social service providers. Over the years, social service professionals have developed many kinds of programs for families and children, although social services for families and children sometimes seem more like a hodgepodge than a system. Table 1 illustrates the broad array of services that families may need, showing that all families may need services at some points in their children's lives. While the categories of family types listed on the left are not exhaustive or exclusive, they suggest how family situations lead to different service needs.
Not all of the services mentioned in Table 1 would be classified as "family-centered" services. For instance, housing, child care, education, drug treatment, and mental health services do not necessarily focus on the whole family (a key element of family-centered services). Many of these services have operated with such separate funding, facilities, staff, and training approaches that they are almost separate worlds.
Certain services, such as family therapy and help with concrete needs, have long been available to abusive and neglectful families. However, the delivery of these services has been flawed: funding has been fragmented, inconsistent, and inadequate; access to services has been limited; programs have emphasized problems and family weaknesses rather than prevention and family strengths; and interventions have seldom focused on the family as a unit. These service delivery problems have increased the likelihood that children will be placed outside their homes, when they might have been well served within their families and home communities.
Recently, however, the philosophy and principles of family-centered services have begun to influence even traditional program arenas. More and more social service programs are responding to the new emphasis on family-centered, community-based, culturally competent, outcome-oriented care.4,6,7Comparing Family Support and Family Preservation
The two major types of family-centered services, family support and family preservation, are designed to serve families in different ways. Family support services are intended for families who are coping with the normal stresses of parenting, to provide reassurance, strengthen a family facing child-rearing problems, or prevent the occurrence of child maltreatment. By contrast, family preservation services are designed to help families at serious risk or in crisis, and are typically available only to families whose problems have brought them to the attention of child protective services, the juvenile justice system, or the mental health system.8,9 A major goal of these services is to prevent foster care placement, or help reunify families after a child has entered placement by improving parenting skills and providing follow-up services.10
Families enter these two service systems in very different ways. Most enroll voluntarily in family support services, while participation in family preservation services may be required of families whose children are under public agency supervision. Thus, while families in voluntary service programs seek services because they recognize that they need information or help, families in mandatory service programs may not recognize deficiencies in their child-rearing abilities, may resent receiving "help" that they do not want, and may fear having their children removed from home.
As discussed later in this article, funding for family support and preservation services is complex, mixing federal, state, local, and private resources for social services. Private foundations have played an important role in bolstering the development of both family preservation11 and family support programs. Federal laws have stimulated widespread interest in family-centered services and have provided modest funding to support them. (See the article by Courtney in this journal issue for further discussion of federal funding streams.)
Growth in family preservation programs can be traced to the Adoption Assistance and Child Welfare Act of 1980 (Public Law 96-272), which required states to make "reasonable efforts" to keep families together and avoid the placement of children in substitute care. The first federal attention to family support came in 1993, when legislation was passed that earmarked federal funds specifically for family support services and increased the funds available for family preservation services (Public Law 103-66). The regulations for the 1993 Family Preservation and Support Services Program recommended that states target services to the areas of greatest need and leverage funds from multiple funding streams by creating crosscutting community-based strategies.12
Funding for this initiative totaled approximately $930 million over five years. Ten percent of these funds could be used for administrative costs; the remaining funds were to be divided between family support services and family preservation services, with no less than 25% of these monies going to either service.12 The majority of states have invested more of this money in family support than in family preservation, with approximately three-fifths of the allocated funds being used for family support services.13
In November 1997, another key piece of child welfare legislation, the Adoption and Safe Families Act of 1997 (Public Law 105-89), was enacted. This law reaffirms the federal commitment to the two types of family-centered services discussed in this article by reauthorizing them through the year 2001 and increasing their funding level by about $20 million per year. It clarifies congressional intent by changing the name of the program from "Family Support and Family Preservation Services" to "Promoting Safe and Stable Families," and thus shifts focus away from specific models of service delivery toward two key outcomes for children and families—safety and stability. Through its provisions, which include shorter time frames for permanency hearings, adoption incentive payments, and modification of the reasonable efforts provisions of earlier laws, Public Law 105-89 reaffirms the importance of timely, goal-directed, family-centered approaches within the broader continuum of child welfare services designed to protect the safety of children, support families, and promote permanency and adoption.
Attempts by child protective services staff to keep abused or neglected children at home while providing services to their families have not been universally embraced, and some of the concerns of these critics are reflected in this new legislation. Some observers have argued that the emphasis on family preservation in the child welfare system works against the best interests of children.14 For example, one observer wrote that "Family preservation . . . stands for the proposition that nearly all families, no matter how dysfunctional or abusive, can be put right with the proper mixture of therapy and social services."15 Another argued that attempts to preserve families at all costs ignore "the uncomfortable truth that some parents are beyond the reach of even the best treatment programs."16
In fact, not every family can or should be preserved; children must be removed when families cannot assure their safety. The debate need not be framed in "either/or" terms that imply one must choose between the goal of saving children and that of preserving families. The true challenge is one of finding a better balance between competing priorities to maximize not only children's safety but their long-term well-being. A varied and adequately funded array of family-centered services gives child welfare agencies additional options to use as they work toward the sometimes competing goals of protecting children, supporting and preserving families, and building communities. To further explain what these service strategies offer child welfare agencies, the characteristics and effectiveness of family support and family preservation are described below.