Kinship Care: Systemic Approaches & Models

• Extended families have provided care for children across cultures for thousands of years
• Care by relatives/nonrelatives, known as "kinship care," is a favored alternative if parents cannot provide care

Formal vs Informal Arrangements

• "Formal" kinship care involves the child welfare system
• "Informal" arrangements don't invlove the child welfare system, but may include formal procedures
• Informal kinship care can also be called "private kinship care"
• Formal kinship care is also referred to as "kinship foster care," which occurs when the state assumes custody of the child
• "Voluntary kinship care," happens when the state does not assume custody
• "Kinship care" refers to both formal and informal arrangements unless otherwise specified

Kinship Care Statistics

• 423,773 children were in formal foster care in the United States in 2009
• Nearly 1 in 4 lived with relatives
• Over 2.3 million children reside with relatives other than their parents
• Approximately 69% of these children live with a grandparent
• Most grandparent caregivers are women
• Caregiving grandparents and kinship caregivers tend to be African American, single, living in poverty, and having more people live in their homes

Context of Kinship Care

• Military deployment factors into kinship care arrangements
• Long-distance employment factors into kinship care arrangements
• Parental physical/mental health issues or drug use factors into kinship care arrangements
• Parental death factors into kinship care arrangements
• Lack of material resources factors into kinship care arrangements
• Young parenthood factors into kinship care arrangements
• Neglect, abuse, or abandonment of children factors into kinship care arrangements
• Parental incarceration factors into kinship care arrangements
• Families show commitment to each other and the children, even with the challenges of kinship care
• Expressions of love, keeping children away from nonkin foster homes, and caring for children despite physical/financial issues are common among kinship caregivers

Benefits of Formal Kinship Care

• Supporting familial, cultural, and community ties is a benefit
• More regular contact with birth parents is a benefit documented in studies
• Greater stability in placement is a benefit documented in studies
• High rates of placement with siblings is a benefit documented in studies
• High rates of feeling consistently loved is a benefit documented in studies
• Reduced risk of running away is a benefit documented in studies
• Lower risk of developing depression/substance use disorders once placed is a benefit documented in studies

Benefits for Kinship Caregivers

• Rewards related to supporting children's well-being/growth is a benefit
• Experiencing joy/pride in relation to the children is a benefit
• Feeling blessed by the children's presence is a benefit
• Helping adult children is a benefit
• Keeping their families together is a benefit
• Fulfilling a sense of duty is a benefit

Benefits for Birth Parents

• More regular contact with their children in kinship care is a benefit as well as gratitude for the love, safety, and care their children receive.
• The caregiver's role in keeping the child out of nonkin foster care is a benefit
• Multigenerational bonds often strengthen families' resilience in the midst of difficult life experiences

Challenges of Kinship Care

• Complex relational processes occur
• Financial strains occur
• Physical and mental health problems occur
• Cumbersome service systems occur
• These challenges often exacerbate each other

Frameworks

• Integrative, multisystemic frameworks are offered to consider complex challenges and strengthen families' resilience
• Offers a roadmap for understanding and addressing challenges these families face
• Complements family therapies, e.g. structural, intergenerational, attachment-based
• Augments other family therapies to address specific kinship care information
• Complements family-oriented interventions that address parenting, health issues, stress and coping, and complicated service systems

Systemic Perspective

• A systemic perspective knows the well-being of the children, caregivers, birth parents, and other family members is interwoven/interdependent
• It moves thinking beyond individual or dyadic levels to a "dynamic, mutually influencing interplay" among all members of the family system
• Family is interconnected with the sociocultural contexts with which the members interact
• Moves between close family interactions and broader system interactions

Identifying Overlooked Support Sources

• By paying attention to the broader family system
• Families rely on specific members, normally women, to assume caregiving responsibilities.
• Caregiving arrangements in crisis situations readily fall back on established patterns with little awareness.
• Grandfathers may be overlooked
• Those once uninvolved in childrearing might now be more actively involved.

Establishing Caregiving Arrangements

• Support family well-being and stability Efforts need to consider how families establish caregiving arrangements and the ways in which members can create a collaborative, team approach.
• One person might be the primary caregiver, and other members can offer additional assistance

Genograms

• Genograms show how family is made up
• One person takes responsibility, but others can help out
• Help to see the family on a broad scale
• It is important to include others who are not blood-related
• They help get a better view of the family
• They can help you find possible new helpers
• Enables clinicians to explicitly address multigenerational caregiving and cumulative strains from multiple caregiving

Interaction With More General Systems

• Requires attention to the broader systems
• Important to integrate the family's multiple socio-cultural locations
• The system in which children of color are disproportionately represented
• These factors contribute to a therapeutic climate in which the role of racism can be openly discussed
• Can engage with multiple systems and child welfare

Strengthening Interactions

• Strengthen interactions with broader systems facilitates empowerment
• By enhancing community connections
• By improving the solution of common problems
• It allows for better access to resources and reduced family stress

Kinship Care Routes

• Affect how families cope
• Some relatives may provide care early in kids life
• Birth parent presence varies
• Their intermittent presence poses challenges for the family as the family continually adjusts to them and their absence
• Others have little to no involvement
• Strain is associated with long-term care
• Gried relates to "ambiguous parental loss"
• Hopes and frustrations regarding the parents' ability to care for the kids

Other Kinship Care Examples

• Some caregivers assume roles in response to sudden events
• May need to adjust roles and responsibilities quickly
• Little to no time for preparation
• Can be based on observations of circumstances over time
• Adjustments may be facilitated by increases in caregiver involvement
• Finally some arrangements emerge over complex pathways.

Supporting A Family's Kinship

• Facilitate understanding
• Help find what supports are needed
• Benefit: Families with long-standing challenges from events may benefit from family discussion.
• Benefit: Shifting organization, clarifying expectations/roles, and maximizing coping

Kinship decision making

• Decisions are "often" determined by assessments of the "ability" of the parents, safety, alternative care capacity
• Welfare agencies drive decisions as they try to keep child safe
• Families can feel more in power (empowerment) when included
• Use family group decision making
• Stemmed from conferences in New Zealand
• Designed to fix power imbalances

Central Aims

• Support identification of needs and create strategies families can use
• Honor family's cultural and community connections
• Build on families strength
• Enhance child and family outcomes

Transition

• Transitions are marked by uncertainty
• Stress happens as changes occur
• Major transitions include household, custody, and school
• Transitions involve shifting care-giving and visits
• Caregivers adjust as they help the children
• Caregiver and/or family can be jolted

Adaptive Steps to Take

• Identify transitions needing evolving adapatation over time
• Taking steps to make changes are less abrupt and disruptive
• Facilitating adaptive interpretations of changes
• Develop ways of coping

Navigating Change in Existing Relationships

• As family organization, roles, and responsibilities shfit, caregivers birth parents children and the extended family must navigate evolving relationships
• Family members have conflicting feelings
• Pre existing collaborative relationships can help with changes
• Strained relationships makes it more difficult
• Vulnerability to challenges is likely to happen when there are substance abuse issues involved
• Substance abuse can cause relational complexities
• Conflicting loyalties

Relational Examples

• Child may feel disloyal to parents by loving grandma
• He or she feels confused and frustrated
• Grandma feels pressure to honor the child's relationship with parents
• Mom might feel bad about not setting good standards
• This can put members in awkward positions and create stress
• In the situation that something is talked about and solved there is a much better chance of succeeding in fixing whatever issue is occurring

Important Family Bonds

• Research shows the importance of keeping a close bond
• In a study with 459 grandmas, researchers documents close bonds between children and caregiver being associate with well-being
• Similar research shows strong parent and caregiver relationships associates with increases in parent child contact

Actionable Interventions Involve

• Strengths of a family connections
• Improve resolution process
• Focus on better communication
• Family support for stress
• Chances for family to share fun
• Clear explanations of expectations

Challenges From Changed and Expections

• Members who assume caregiving roles may struggle to balance elements from their prior relationships while attempting to maintain children's well-being
• Challenges entail combining children into the current household, encouraging positive associations
• Challenges entail understanding how existing feelings about expectations from the family are affected

Actions

• Children may be testing to see if they can go back or to test boundaries
• Some want to confirm predictability
• Chafe against limits
• Structure, expectations, and limits influence the kid postively

How a family feels limits and behaviors

• Acknowledging behaviors
• Understanding how a family feels these processes are working
• Family stress can be reduced with direct communication and expectations
• Further alleviated with routine structure, expectations, and limits

Developmental Considerations

• Multiple developmental considerations influence kinship care experiences
• The age of the parents effect the situation
• The amount of children's needs
• As kids get older more concerns arise
• Kinship care encompasses wide range of developmental phases
• The degree to which caregiving is experienced is "off-time

Adapting to caregiving happens how:

• Individuals welcome family
• Couples who can can meet developmental expectations
• A couple that has to plans on caring for children might put plans on hold

Maximizing Fit

• By inquiring about expectations
• It will provide families the opportunity to relect upon and maximiz e the fit between kinship care arrangements, expectations and aspirations The process will be easier with questions about how plans and activites have been changed

Permanency And Legal Concerns

• Often times when children have to have their parents live somewhere else there are concern
• Legally binding arrangements help resolve this, see adoption/custody
• Arrangement can be lasting even without legal binding
• "The Adoption and Safe Families Act aims to quicken the time" ASFA allows for kinship to become a permanent plan

Permanent Caring Arrangements are a critical value

• Families should look at the permanence of the care as well
• Contribute to a sense of long term well-being

Poverty

• The most difficult family that engages in Kinship poverty is on of them
• Risk elevated with children with other relative is at 45% versus a standard set of 17% in the family setting
• Can increase the risk of mental and psychical challenges

Despite Risks Kinship May Not Receive Services:

• Services are complicated
• Factors include: Benefit eligibility and state
• Lack of resources
• Lack of help of welfare programs
• Support services include head start and welfare services

Clinicians Should Care:

• Know services available link with families that need it support
• Can come up with solutions for the active person to implement
• Make effort in their actions assess access of resources empowerment

Advocate For Reform

• Act to implement needed reforms
• Make suggestions
• Be apart of public policies

Physical And Mental And Health Concern

• Health concerns involved parents physical, mental, challenges
• Challenges involve things like substance abuse
• Often problems become apparent without neglect
• Psychiatric issues can occur also
• Youth that preparing for exit of kinship have PTSD estimated 12% lifetime
• These include disorders and defiance.

Health And Mental Affect

• Grandparents get hit the worst with parental difficulties

• They experience feeling of being let down

• This adds a lot to the caregivers

• Stress increases the amount of the disruption

• Help with coping and health

  Help By:

• Connecting kids with better services

• Provide better education

• Providing effective resolution

• Help manage material strength