Manitoba to Spend More Money on Child Welfare

The province of Manitoba says it will spend more money to keep children who are wards of the province within their communities. There is an excellent interview on CBC's As It Happens (click on Part 2 to listen). I would be interested to know if you think this is a good use of money for child welfare in the province.

A Violently Divided City

Last week, I spent two days in Hebron, interviewing families and children about their experiences living under occupation and specifically with Israeli settlements throughout the city, which according to the UN under the Fourth Geneva Convention are considered to be illegal. I have written about Hebron before, when I last visited in 2010, and unfortunately things are still extremely difficult for the Palestinians who live here.

Hebron is a surreal place, especially H2, which is the area of the city where over 500 Israeli settlers are living alongside 30,000 Palestinians. Despite the population imbalance, the Israeli settlers hold the power in H2, often commanding the Israeli soldiers stationed in the area. There are few people on the streets and all of the stores along Shuhada Street--once a bustling part of the Palestinian city center--are closed up and abandoned (see photo below) after the settlers moved into the area and forced Palestinian businesses to leave. Settlers freely walk around the streets, as they are guarded closely by the Israeli military. However, the statistics point to more violence directed towards Palestinians than settlers, so this "protection" is misplaced. In fact, the settlers frequently use the Israeli army to further oppress the Palestinians, which was reaffirmed in stories I heard from families. The Palestinians who are out on the streets are usually hurrying towards the safety of home. The Palestinians' fear is palpable, especially throughout my interviews. One family does not let their children (ranging in ages from 5-18) leave the house unless they are accompanied by an adult. Another family has installed multiple security cameras, which keep getting stolen by the settlers. Another family told me a story about their six-year-old son who was kidnapped by Israeli settler youth. One child-participant was scared to open up her front door to me, because she said that the settlers (who are her neighbors) might see her. The settler's power is seen clearly in all the Stars of David that are drawn on the walls and doors throughout the neighborhood, laying claim to the territory.

When I revisited Hebron a few days ago, I met members of the Ecumenical Accompaniment Programme in Palestine and Israel (EAPPI). These international volunteers--or Ecumenical Accompaniers (EA's)--"provide protective presence to vulnerable communities, monitor and report human rights abuses and support Palestinians and Israelis working together for peace" (see photo to the right). They invited me to observe them in their daily activities, including accompanying Palestinian children as they walk to and from school (as they are the frequent target of violence from Israeli settlers) and monitoring settler activity within Hebron.

On the day that I visited EAPPI, an EA and I waited at the bottom of some stairs where the children would pass by on their way from school to home. The schoolchildren were friendly (see photo below left), though cautious, especially with presence of so many settlers, who had gathered at the settlement just across the street from the stairs. (The number of settlers increased dramatically at this time of year, because of the Jewish passover.) Even when one of the Israeli settlers came up and yelled for us to leave, the children did not flinch; they just continued on their way, jostling and joking with one another, along Shuhada Street and home. At one point they squealed when they spotted a lizard.

One infamous settler named Anat Cohen, who, along with her husband and 14 children, lives in the Beit Hadassa settlement in the middle of H2. The house belongs to a Palestinian, Mr. Abu Ribhi Dies who was thrown out of the home in 1975 after a military order was issued claiming that the home did not belong to him. In addition to being the head of education for the settler children in H2, Anat Cohen is known for encouraging settler violence against Palestinians. She has also been known to be violent with internationals who visit H2 in support of Palestinians. I actually saw this with my own eyes, when I noticed an older woman with a taut and weathered face approach us, yell in Hebrew, and point at us. I was told that she was shouting at the nearby Israeli soldiers to arrest us, though there was obviously no legal reason for this. About five minutes later, I saw her throw water (along with some young female settlers) at an international visiting from Germany and then kick another international visiting from the US. After witnessing this, the EA and I encouraged the Israeli police to file a report about Ms. Cohen's violent behavior towards internationals. But instead, we were thrown out of H2 by the Israeli soldiers and police, a perfect example of how the settlers utilize the Israeli military to further their own goals. It also illustrates how difficult it is for Palestinians to see true justice.

At the end of my day in Hebron, I went along with another EA to monitor settler activity in H1. many settlers and their Israeli guests entered the Old City of Hebron to take historic tours of the area. According to the 1997 Hebron Agreement, H1 is under the Palestinian Authority's control, and therefore off-limits to Israelis. Despite this, the Israeli settlers--accompanied by dozens of Israeli soldiers (see photo to the left)--regularly visit the area to "sight see." When I asked one settler what the tour guide was saying, he told me, "We are learning that this city belongs to us."

I watched the Israeli settlers, accompanied by heavily armed soldiers, walked through the narrow streets of the Old City. The settlers also watched me, and found it amusing to take photos of me. (At one point, I felt like a tourist attraction.) Palestinian children also watched the settlers curiously, but also took time to skirmish with a soccer ball. Though it was extremely strange to see these large groups of settlers accompanied by heavily-armed Israeli soldiers moving through a Palestinian city, it was just another day for the Palestinian children, who seemed eager for the Israeli settlers and soldiers to leave, so they could get on with their football match.

Pushing Past 'No': The New York Times and Journalistic Ethics

I read this article from New York Times reporter Graham Bowley, which details his attempts to interview Sahar Gul, a fifteen-year old Afghani girl who was tortured by her husband and in-laws after refusing to go into prostitution. I was interested in The New York Times coverage of this horrifying incident, but was shocked with Bowley's reporting. What follows is the subsequent letter I wrote to the editor:

To the Editor:
I was dismayed to read Graham Bowley's (“In One Girl’s Story, a Test of Women’s Rights in Afghanistan”, January 10, 2012) article describing his interview with Sahar Gul, the Afghan teenager who was the victim of gruesome abuse by her husband and in-laws. I believe the manner in which Mr. Bowley attempted to gain access to Ms. Gul while she was recovering in the hospital is unprofessional and unethical. Yet, The New York Times felt it was appropriate to publish these details. He took great pride describing how he “pushed past ‘no’” when hospital workers repeatedly told him that Ms. Gul did not wish to speak to reporters because she was too emotionally fragile to revisit her story. Mr. Bowley notes that Ms. Gul had already been interviewed by another news organization (the Associated Press), and therefore, the goal of disseminating her story with a broader audience—indeed, an important goal for journalism—was already achieved. However, Mr. Bowley’s persistence in interviewing Ms. Gul seemed to be more of an attempt to advance his professional career rather than to share an important story with the world. I see no need for a The New York Times reporter to subject a child to a additional questions and potentially retraumatize her in the process just to enhance a newspaper’s credibility. There is nothing to be gained in this process, and journalists such as Mr. Bowley must remember that they have an ethical responsibility when reporting in volatile settings such as Afghanistan.
Regards,
Bree Akesson

I shortly received the following response from The New York Times public editor, Arthur S. Brisbane, who "works outside of the reporting and editing structure of the newspaper and receives and answers questions or comments from readers and the public, principally about articles published in the paper":

Thanks for your message about Graham Bowley's coverage of Sahar Gul, the young Afghan girl. I am concerned about the girl's privacy as well and have raised the question with the Foreign Desk. I do concur that news organizations should be careful to respect the privacy of crime victims. This is a case where, I believe, the benefits of doing a story were outweighed by the potential harm to the girl.

Best,
Art Brisbane public editor

Arthur Brisbane wrote an-ed piece about this topic, addressing many of the concerns in my letter (which reflected many other readers' views), along with a response from the foreign editor. You can view the article here.

Methods of Policy Analysis

Dror (1984) calls policymaking “a very presumptuous activity” (p.13). Though the same might be said about research. In comparing the two activities, Edwards (2005) describes the “uneasy relationship” between research and policymaking. Whereas policymakers believe that research doesn’t concern itself with issues that are relevant to the lived realities of the studied populations and is often “driven by ideology” masked as intellectual inquiry, researchers believe that there is a lack of government interest in research and that there are roadblocks put in place by policymakers to make research more difficult to carry out. Furthermore, Edwards describes a general anti-intellectualism embraced by policymakers, in that they are wary about critical analysis because it could make certain policies embarrassing or irrelevant. Similarly, researchers note that there is a lack of incentives for researchers to create policy-relevant research. To Edwards (2005), all of this bickering illustrates two distinct cultures, but more significantly, two distinct ways of communicating.

Stone (as cited in Edwards, 2005) outlines twelve perspectives that encompass the many reasons that there is a gap between research and policy. Though all of Stone’s supply side, demand side, and socio-cultural factors are insightful and accurate, the ones that I see as being the most striking are:

• Comprehension: Researchers don’t understand what the policy process is and how research fits into the policy process.
• Communication: Researchers don’t have the adequate tools to convey messages about their research to policymakers.
• Anti-intellectualism in government: Government ideology is driven by an inherent distrust in using pure science to base policy decisions.
• Politicization of research: Researchers and policymakers are not viewed as being objective, but rather present information and/or make decisions based on ideology.

Dror’s (1984) concept of “fuzzy gambling” challenges some of these above factors, with policymaking being a process of unknowable, and constantly changing “rules of the game” (p.15). There is an assumption that research is a yes/no or true/false process. But, Dror (1984) suggests that it is more of a “multi-valued” logic. By viewing research and policymaking through this lens, research and policymaking become more open to dialogue between one another, because they understand that it’s not an all-or-nothing process.

Building upon the policy gambling perspective, Dror (1984) suggests that policy scientists broaden their methodologies, including methodologies “capable of handling irreducible uncertainty, including qualitative uncertainty with inability to specify qualitatively main alternative possible futures” (p.16). Social workers work with qualitative data all the time, in listening to clients’ situations and when conveying these situations through advocacy efforts in attempts to persuade colleagues and government bodies. Edwards (2005) mentions a valuable qualitative methodology, which bridges research and policy: the case study. Edwards notes: “To determine more systematically what works when, there and how, ideally calls for case studies designed to illustrate the diverse ways in which research can connect to policy” (p. 71). Qualitative research methods are an important addition to the policymakers’ toolbox, for they can persuade and convince in a way that quantitative data alone cannot. For example, the United Nation’s Office of the Special Representative of the Secretary General for Children in Armed Conflict has been consistently monitoring the six grave violations (killing and maiming of children; recruitment and use of child soldiers; rape and other forms of sexual violence against children; abduction of children; attacks against schools and hospitals; denial of humanitarian access to children) against children during armed conflict. In the gathering of evidence, the UN has solely relied upon qualitative data, which has made quite an impact on the depth of the problem. Nevertheless, the scope of the problem has yet to be understood, and therefore, efforts are being made to supplement the qualitative data with quantitative methods, both of which provide breadth and depth.

Perhaps the divide between research and policy is not so dichotomous. Aren’t researchers always asking themselves, How can our work be relevant and useful? Or is this an idealistic or naïve perspective of research? As a humanist science, social work researchers should be constantly thinking about their work’s impact on practice and policy. For example, I worked as the program manager for the Care and Protection of Children in Crisis-Affected Countries (CPC) Initiative (www.cpclearningnetwork.org), which sought to create a global network of researchers, practitioners, and policymakers to collaborate on research projects to develop new methodologies for child protection in crisis-affected settings. This culminated in the Child Protection Action Summit, which gathered these figures for a four-day meeting to discuss ways that international child protection research could be relevant to policy, and vice versa. Edwards (2005) notes that even though the literature may suggest that if researchers and policymakers work closely together then there should be good policy outcomes, this might not be true in all circumstances, because there are multiple factors at play. For what didn’t work with CPC was what Edwards noted was most important for the success of bridging the divide. She notes: “The degree to which research influences policy often depends on individuals building relationships of mutual trust and respect, rather than on an ongoing and sustained discourse between governments and researchers” (p.73). CPC conducted the Child Protection Summit, holding conversations with the goal of creating common research priorities. However, over one year later, these conversations are no longer taking place. Meetings are currently happening with researchers and practitioners determining the research agenda, with policymakers at the receiving line of research several years after the major decisions have been made. Why can’t we include policymakers in the “ongoing and sustained discourse”, starting from the research proposal and moving forward? We know that it shouldn’t be such a dichotomy, but rather a partnership. Nevertheless, we still don’t know how to effectively bridge the divide for effective partnerships between research and policy.

Sources:

Dror, Y. (1984). Perspectives on public policy: On becoming more of a policy scientist. Policy Studies Review, 4(1), 13-21.

Edwards, M. (2005). Social science research and public policy: Narrowing the divide. Australian Journal of Public Administration, 64(1), 68-74.

Combination of Education and Trauma Healing Activities Decreases Trauma Symptoms in War-Affected Children in Sierra Leone

Though research indicates that higher levels of traumatic events among war-affected children leads to greater incidence of negative mental health outcomes, there is little evidence about the effectiveness of psychosocial interventions to mitigate these consequences. Gupta and Zimmer (2008) focus on determining the effectiveness of a psychosocial intervention study among children affected by the conflict in Sierra Leone. The sample was randomly drawn from school registration lists provided by the Ministry of Education, which contains all school-age children residing in the Grafton and Trade Center camps for internally displaced persons. The sample focused on an equal number of boys and girls ages 8-17, for a total sample size of 315 children. The Rapid-Ed intervention consisted of an education module enhanced with eight sessions of structured trauma healing activities and unstructured recreation activities. Children were interviewed for the pre- and post-test by trained camp teachers using a semi-structured questionnaire, which was translated and back-translated into the local language (Creole). The pre-test was administered approximately 9-12 months after the start of armed conflict, and the post-test was administered 4-6 weeks after participants completed the intervention. Results show that 96% of children reported a significant reductions in concentration problems, sleep disturbances, bad dreams, and intrusive images after participating in the Rapid-Ed intervention. The study also found that there was a slight increase in avoidance symptoms after the intervention.

The study addresses selection bias by randomly selecting children from the target communities. Also, the low attrition rate (3%) was a strength, and most likely due to the accessibility and reliability of finding the students in formal schooling programs. However, the results of this study would be strengthened with the addition of a control group. Use of a control group would indicate whether it was the intervention that caused the decreased psychological distress or whether other factors were responsible. Firstly, maturation poses a threat to the internal validity, because the study is unable to discern whether the intervention was the cause of improved psychosocial outcomes or whether it was due to the subjects’ internal healing processes. Secondly, statistical regression may pose a threat to the internal validity, because the change due to the intervention cannot be distinguished from the effect of scores reverting toward the mean. A control group would have addressed these concerns and greatly improved the study’s internal reliability. However, the sensitive context creates ethical challenges in regards to whether one group can receive the intervention and the other one doesn’t.

Reference:
Gupta, L. and Zimmer, C. (2008). Psychosocial intervention for war-affected children in Sierra Leone. The British Journal of Psychiatry, 192, 212-216.

Quality of Parental Involvement More Relevant Than Use of Child Corporal Punishment in Development of Negative Adolescent Outcomes

Child development researchers have long suggested that corporal punishment is a predictor of negative behavioral outcomes in children. However, because they suffer from serious methodological limitations, studies on the effects of corporal punishment have yet to definitively determine if corporal punishment is causally related to negative adolescent outcomes. In this study, the authors attempt to determine the extent that quality of parental involvement and corporal punishment independently predict adolescent maladjustment, specifically adolescent aggressiveness, delinquency, and psychological well-being. The authors used a prospective study design, interviewing 332 families annually over a three-year period. Interviews consisted of parent self-reports, adolescent reports, and observed ratings of family interaction tasks. Corporal punishment was determined by time (i.e., consistent use of physical discipline over the three-year study period), age-appropriateness (i.e., continuing during adolescence, indicating harsh discipline), and type (i.e., use of object, being shoved or pushed.) Quality of parental involvement was determined by display of warmth and affection, monitoring and supervision, consistency of discipline, and use of inductive reasoning to explain rules and expectations. The authors found that once other dimensions of parenting are controlled for, there exists a significant relationship between quality of parental involvement and adolescent outcomes. Contrary to past research on this topic, the study found no significant relationship between corporal punishment and the adolescent outcomes.

This study’s main strength lies in its design aimed at isolating other parenting behaviors to determine that quality of parental involvement, rather than corporal punishment, was a predictor of maladaptive behavior among adolescents. The study’s use of self-reports from parents and adolescents, combined with observation of family interactions, created a more comprehensive depiction of family interaction. However, the sample selection presents some limitations to the study. Firstly, the sample represents a rural population, highlighting the need for the study to be replicated in an urban setting. Furthermore, though 451 families were recruited for the study, only 404 families completed all four waves, 19 families were not eligible after divorcing during the study period, and there was incomplete data for 53 of the families. Secondly, the authors emphasize that corporal punishment should not be confused with physical abuse, for in this study, the corporal punishment wasn’t extreme enough to be considered physical abuse; therefore, additional studies should be conducted to examine the effects of physical abuse on adolescent outcomes, independent of other parental behaviors. Thirdly, there might be other adolescent dimensions not addressed in this study that would be important indicators of maladjustment; the authors suggest looking at autonomy, self-reliance, and creativity in future research.

Reference:
Simons, R.L., Johnson, C., and Conger, R.D. (1994). Harsh corporal punishment versus quality of parental involvement as an explanation of adolescent maladjustment. Journal of Marriage and the Family, 56(August 1994), 591-607.

Historical Roots of Community Engagement and Mobilization

Programs for disadvantaged populations risk encouraging passivity and creating dependency, which are adverse to recovery and sustainability. Social settlements, one of the cornerstones of modern social work, were founded on the tenet of collective action built on a basis of trust and cooperation with community members and local institutions to improve community life. The first settlement house was developed in late 19th-century London as a response to growing numbers of people living in poverty, especially immigrants. Soon thereafter, Jane Adams developed a settlement house in the United States, Chicago’s Hull House, which quickly took on several vital roles within the community – a center for social activity and learning, with youth clubs, women’s clubs, athletic classes, and college extension classes, as well as community advocacy. Though Adams’ settlement house movement did not only target vulnerable populations but rather “all sides of neighborhood life”, it is regarded as the starting point of social services to address the needs of the vulnerable within the community. Adams (1892) essay “The Objective Value of a Social Settlement” focuses on the tenets behind the settlement model, most importantly providing people with opportunities so they can help themselves, rather than relying on charity. Likewise, Agnew’s (2004) chapter on Mary Richmond, tells of her discouraging begging and handouts and focusing on educational and employment opportunities for the needy. Both emphasize that drawing upon all the resources that social programs offer as well as the resources of the community allows for collective strength and cooperation.

In the field of international child protection, community engagement and mobilization around the needs of children has always been key to creating a protective environment for children. For example, Richmond engaged with the community to safeguard children’s interests around regulating child labor. When a community is engaged to identify the needs of children in their community, children are prioritized. Collective planning facilitates the empowerment of adults and creates a sense of autonomy in uncertain and disempowering circumstances. Even in emergencies, communities still maintain structures and capacities for coping, aligned with their ideals, values, and relationships. Although pre-crisis coping mechanisms may be undermined during times of crisis, the community does not lose its capacity for developing solutions and rebuilding community life. Wessells and Monteiro (2008) suggest using an empowerment model rather than a service model to connect with the community in a front-line response to create a protective environment for young children and aid in their own recovery. Psychologically, part of community recovery is a reinstatement of collective efficacy and action to help monitor and reduce risks and prevent abuse and exploitation. In this way, caregiving structures for children in the community are strengthened. When the capacity of communities to recovery from crisis is recognized, feelings of hope and autonomy are increased. As Adams (1893) says, “They require only that their aspirations be recognized and stimulated, and the means of attaining them put at their disposal” (p. 61).

References:
Adams, J. (1893). The objective value of social settlement. In C. Lasch (1982), The Social Thought of Jane Adams. New York, NY: Irvington Publishers, p.44-61.
Adams, J. (1915). Subjective necessity for social settlements. In Twenty Years at Hull House. New York, NY: The Macmillan Company, p. 113-127.
Agnew, E. (2004). Families and the circle of reform. In From Charity to Social Work: Mary E.
Richmond and the Creation of an American Profession. Ubana, IL: University of Illinois Press,
p. 95-131.
Wessells, M. and Monterio, C. (2008). Supporting young children in conflict and postconflict
situations: Child protection and psychosocial well-being in Angola. In M. Garcia, A. Pence, and
J. Evans (Eds.), Africa’s future, Africa’s challenge: Early childhood care and development in
sub-Saharan Africa (pp.317-329). Washington, DC: World Bank.

Preventive Interventions Help Secure Attachment in Maltreated Infants

Child maltreatment presents threats to child developmental processes, including long-term maladjustment and development of psychopathology. Cicchetti, Rogosch, and Toth’s (2006) study examines the effectiveness of two preventive interventions: psychosocial parenting education (PPI) and infant-parent psychotherapy (IPP). Based on the theory that secure attachment is derived from parental knowledge and skills, PPI involves a series of psychoeducation-focused home visits with mothers to improve parenting skills, increase mothers’ knowledge of child development, and enhance coping and social support skills. IPP is based on attachment theory and includes an exploration of the parent-child relationship through therapy. The hypothesis that PPI or IPP interventions will be most effective for ameliorating the effects of maltreatment of infants is explored in this study. The study sampled mothers and their infants in maltreating families (n=137). Subjects were randomly assigned to one of three cohorts: (1) psychosocial parenting education (PPI), (2) infant-parent psychotherapy (IPP), or (3) community standard (CS). A normative comparison (NC) group of non-maltreated infants and their mothers (n=52), with similar demographics to the intervention group, was also included. Using validity tested measures, the authors found that mothers and children in the PPI and IPP groups showed greater increases in secure attachment than mothers and children in the CS and control groups. This study supports evidence that preventive intervention programs can alter attachment organization and ameliorate the negative developmental consequences of maltreatment.

As compared to results from the CS group, the authors provide evidence that the PPI and IPP interventions result in greater increases of secure attachment in maltreating families. However, the non-maltreating control group varied greatly from the maltreating group, with maltreating mothers reporting higher rates of maltreatment in their own childhoods, more insecure relationships with their mothers, more maladaptive parenting attitudes, more parenting stress, and lower family support. Similarly, despite trying to maintain uniform adherence to the therapeutic intervention, the therapy was not completely standardized, because the intervention used different therapists. Lastly, the intervention groups were actively pursued to follow the therapy schedule, which is not commonly done in treatment modalities such as the CS group.
The authors attempt to eliminate any self-selection bias, by seeking out maltreating families rather than the families seeking to be enrolled in the study.

Reference:
Cicchetti, D., Rogosch, F.A., and Toth, S.L. (2006). Fostering secure attachment in infants in maltreating families through preventive interventions. Development and Psychopathology, 18, 623-649.

Child-Centered Spaces are Beneficial to Young Children Affected by War in Northern Uganda

A widely used approach to aid children and their families in emergencies is the implementation of child-centered spaces (CCSs), which are physical spaces providing structured activities and support for children and their caregivers in emergencies. Despite the prevalence of CCSs, there has been little systematic research to assess their impact. Kostelny and Wessell’s (2008) evaluation of safe spaces in an internally displaced persons (IDP) camp in northern Ugandan is the first of its kind. The study uses both qualitative and quantitative methods to determine if CCSs protect young children (3-6) from risks and threats in their environment, improve children’s psychosocial well-being, and increase children’s knowledge and life-skills levels. Qualitative data were collected from focus group discussions with 92 caregivers and community members. Qualitative data informed development of a tool based on locally-derived indicators of child well-being in the northern Uganda context. Using the locally derived indicators and a Western developed screening tool for emotional and behavioral difficulties, quantitative data were collected from interviews with caregivers. The study randomly selected 176 caregivers of children attending CCS program and 118 caregivers randomly selected from a nearby IDP camp where there were no CCS services available. Significant benefits for children in the CCSs occurred within the domains of protection, psychosocial well-being, and life skills. The authors conclude that if positive effects can occur in as challenging an environment as northern Uganda, then the implementation of CCSs might have similar positive effects in other difficult settings.

This study uses locally appropriate measures to bypass questions of validity inherent in Western measures’ application to non-Western settings. Furthermore, the study focuses on outcomes versus process indicators, which rarely describe the actual benefits of a program in regards to child development, protection, and well-being. Nevertheless, the authors recognize limitations to their study. First, intervention and control groups weren’t systematically matched. Secondly, because the data rely on self-reports, the study may have experienced self-preservation bias with the intervention group reporting more favorable outcomes. Lastly, the external validity of the findings should be considered with caution, since this evaluation only addresses one specific context. In order to gain support that child-centered spaces are beneficial for children in crisis settings, more research must be conducted in other contexts.

Reference:
Kostelny, K. and Wessells, M. (2008). The protection and psychosocial well-being of young children following armed conflict: outcome research on child-centered spaces in northern Uganda. The Journal of Developmental Processes, 3(2), 13-25.