Improving outcomes for babies and toddlers in child welfare: A model for infant mental health intervention and collaboration.

Children under three comprise a sizable and growing proportion of foster care placements. Very young children who enter the child welfare system experience disruptions of critical attachments that are essential to this formative stage of brain development, as well as other traumatic events, leaving them at great risk for lifelong impairments. To reverse these concerning outcomes, babies who have been removed from their homes require intensive, relationship-based interventions that promote secure attachment to a primary caregiver and holistic attention the child's developmental needs. Child welfare decision-makers must be informed of infant brain development and knowledgeable about the particular needs and circumstances of each child. This article describes a model with these features that has been developed and tested in the Bronx, New York, one of the nation's poorest urban counties with high rates of foster care. The Project utilizes evidence-based Child-Parent Psychotherapy (CPP) as its core intervention, and emphasizes collaboration and information sharing- driven by the CPP clinician- with judges, child welfare workers, attorneys and other social service and mental health providers, thereby encouraging developmentally and relationally informed case planning and permanency decisions. The model is evaluated using pre and post treatment psychosocial measures and program outcome data. Results indicate improvement in parenting interactions, positive child welfare outcomes (including increased rates of reunification, fewer returns to foster care), and improved safety and wellbeing. Results highlight the need for child welfare practices to be more closely aligned with the current science of infant brain development, and to incorporate a specialized approach to address the unique needs of infants.

Residential care for abandoned children and their integration into a family-based setting in Uganda: lessons for policy and programming.

This article describes a model of care for abandoned and neglected infants in need of urgent physical, social, and medical support as implemented by the Child's i Foundation, an international, nongovernmental organization operating in Uganda. The model discounts the need for long-term care of young children within institutions and challenges the basis for intercountry adoption. Underpinned by the essentials of care continuum provided under the Uganda National Alternative Care Framework (Ministry of Gender, Labour and Social Development, 2012), the model emphasizes the need to effect the reintegration of the separated child within the family of his or her birth, or locally organize foster care or adoption. Highlighting policy and programming lessons, the model showcases a holistic approach to the problem and puts emphasis on interventions that are protective, promotional, and transformational and the use of a community-oriented approach. The model offers guidance to both government and nongovernment actors in addressing the problems of child neglect and abandonment through the implementation of the alternative care framework.

Out of home care in France and Switzerland / Las medidas de protección a la infancia con separación familiar en Francia y Suiza

Este artículo se centra en las semejanzas y diferencias entre los sistemas de protección a la infancia de Francia y Suiza, de acuerdo con la evolución del último decenio. La falta de un sistema integrado, holístico, y la enorme diversidad de prácticas entre territorios en ambos países crea una realidad que plantea un desafío tanto para la investigación como para los profesionales. Además, la legislación y Francia y en Suiza es bastante parecida en el hecho de que no hay un apoyo definido ni un cuerpo de legislación sobre el bienestar en niños y jóvenes. En ambos países es la necesidad de una mejor comprensión de esta realidad lo que impulsa el desarrollo de mejores procesos de recogida de datos y una nueva investigación en profundidad en este campo (AU)

This article focuses on the structural similarities and dissimilarities that exist between child protection systems in France and Switzerland, as exemplified by the evolutions of the last decade. The absence of an integrated holistic system and the great diversity of practices between territories in both countries creates a reality that is a challenge for research and practitioners alike. Furthermore, legislation in France and Switzerland is quite similar in that there is no single defined support or welfare body of legislation for children and youth. In both countries, the need for a better understanding of this reality drives the development of better data collection processes and of new in-depth research on these issues (AU)

Moving toward reconciliation in indigenous child welfare.

The Touchstones of Hope reconciliation movement consists of principles (culture and language, self-determination, structural interventions, non discrimination, and holistic approach) that guide a reconciliation process of truth-telling, acknowledging, restoring and relating to reshape indigenous child welfare led by indigenous peoples and supported by their non-indigenous counterparts. This article describes a reconciliation movement in Canada grounded in Touchstones of Hope principles, involving a reconciliation process between indigenous and non-indigenous individuals, which has enabled culturally relevant concepts of child welfare and plans for child safety to emerge.

Multi-agency and specialist working to meet the mental health needs of children in care and adopted.

Many of the children and young people who are looked after in foster and residential care or are adopted have complex mental health needs that are not well met by traditional mental health services. These vulnerabilities stem from an interaction between pre- and post-care experience, and often include trauma, attachment and developmental difficulties. It is now widely recognized that these children are best served by dedicated services provided by professionals with expertise in meeting the needs of looked after and adopted children. This involves effective joint working between health, education and social care services and requires supportive policies and structures at all levels of the organizations. This paper will explore the strengths, challenges and barriers of multi-agency and specialist working to meet the needs of these vulnerable children and young people.This will be illustrated with case examples drawn from a multi-agency service in Worcestershire, UK.

Qualitative study on the role of nurses as health case managers of children in foster care in California.

This qualitative study on nurses who provide health case management for children in foster care examined their vision for the care needed to improve health outcomes. A purposive sample of eight public health nurses was selected to participate in semistructured interviews. Data were analyzed using content analysis to formulate a narrative description of the nurses' vision. Two themes emerged from the data: (1) the desire to give holistic care with an emphasis on mental health care and (2) the difficulty with providing preventive care as a result of multiple causes of health problems.

Promoting the health of looked after children in Scotland.

Looked after children and young people represent one of the most vulnerable groups within our society and experience significant health inequalities compared with their counterparts who are not looked after by the local authorities. Tackling these health disparities and improving their health is a multiagency responsibility involving local authorities, health professionals, education and many other agencies. By recognising the potential benefits of collaborative working and incorporating it into everyday practice, it is anticipated that professionals will acknowledge that sharing their skills and expertise is pivotal to the maintenance of an equitable and holistic service for looked after children. This paper aims to raise awareness of the complex needs of these children and examines factors contributing to their poor health outcomes. It will also explore the emerging role of specialist nurses in Scotland in leading and facilitating a service to identify and address the health needs of this vulnerable population.