To preserve or not to preserve:That is the question. Decision-making about family preservation among families in multi-problem situations

High rates of failed reunification indicate that family preservation (FP) does not necessarily lead to permanency for children. It could be argued that, in such failed cases, the decision-making process leading to the preservation of the family was inadequate. In order to gain insight into the role that decision-making plays in family preservation practice, we studied decision-making within an FP-intervention program provided by the Expertise Center. The Expertise Center explicitly combines treatment and decision-making in an assessment-based intervention that is provided to families seeking either to be reunited with their young child (0–2) or to avoid an out-of-home placement of the child. In addition, at least one of the parents has psychiatric problems. We hereby attempted to a) map decision-making trajectories in practice and b) provide feedback about Expertise Center decision-making based on evidence regarding the – sometimes evolving – quality of parental behavior as observed in the participants. We have used a descriptive design (n = 100) as well as a one-group repeated measures design (n = 28) to examine parental behavior using the Atypical Maternal Behavior Instrument for Assessment and Classification (AMBIANCE). We hypothesized that a negative recommendation regarding family preservation would manifest itself in the display of more frequent and more severe atypical parental behavior. Our results indicate that the Expertise Center succeeded in contributing broadly to timely decision-making in the context of permanency planning, and that implementation of the Decision-making Continuum potentially improved the quality of clinical decision-making. Furthermore, our hypothesis was confirmed by four out of five measurements of parental behavior that have been proven to be significant for children's attachment security. Since these are promising results, the Expertise Center program could serve as an inspiration for the practice field

Assessing parenting in the context of reunification of infants/toddlers and their families:: How to face the challenges?

Since a substantial portion of infants and toddlers reenter care after reunification, the question of whether family reunification is feasible needs to be answered very cautiously. How parenting is assessed is of major importance in answering this question, but the quality of these assessments is often poor. With an eye to improving current practice, we conducted an integrative review, in which we analyzed the challenges related to the assessment of parenting vis-à-vis reunification and linked relevant knowledge from research with significant know-how from practice. The challenges appear to be embedded in the struggle to define (especially good enough) parenting and the complex context of child protection. As an answer to the challenges, the integrative review resulted in a framework of four key components required for sufficient parenting-assessment practice: (a) the use and development of expertise; and (b) providing families aiming for reunification with an intervention that is intensive, (c) flexible, and (d) organized as teamwork. Providing families with such an intervention gives them the opportunity to make substantial changes in their parenting and helps professionals assess the capacity of parents to grow to an acceptable level of caretaking for their child. Further implications for research and practice are discussed

Establishing a positive working alliance during formal parenting assessments:Parent perspectives on what works

The working alliance between families and professionals within the context of child protection faces substantial challenges from a variety of factors, but it plays an important role in accomplishing positive outcomes. To gain insight into what works when establishing positive working alliances between parents undergoing formal parenting assessments and professionals, we interviewed 22 parents about their experiences with the intervention program of the Expertise Centre for Treatment and Assessment and Psychiatry (Expertise Center) in the Netherlands. The majority of parents considered the approaches used by the Expertise Center to build positive working relationships with families effective. A central theme identified within the study concerns the importance of a connection between parents and professionals. Characteristics of professionals that parents identified as promoting a sense of connection include humanity, respectfulness, availability and responsiveness, and good communication skills. A sense of connection can help parents develop a relationship of trust in which they eventually feel safe enough to share their stories, insecurities, questions, emotions, and thoughts, all of which play an important role in achieving change within the family. Parents valued individual conversations with professionals with whom they felt connected over specific intervention content (e.g., group activities). They identified several strategies applied by the Expertise Center professionals as having helped them to make changes in their parenting. We organized all key themes into a conceptual model for establishing a positive working alliance to promote change