Rehabilitation: Children and Families

Why Study Children and Families

• Studying children and families enhances understanding of how relationships affect development and rehabilitation.
• Families are key to supporting children's growth, especially when overcoming health challenges or trauma.
• Study family structures and their dynamics to improve care approaches.

Key Definitions

• Family is a social unit linked by biological, legal, or emotional bonds, offering emotional, financial, and social support.
• Childhood spans from birth to adolescence and is marked by significant physical, emotional, and cognitive development.
• Rehabilitation aims to restore one's abilities and community involvement after illness or injury.

The Family System

• Families operate as interconnected systems where each member's actions influence the entire unit.
• Roles are the behaviors expected within a family, often shaped by cultural influences.
• Boundaries are the rules that define relationships and responsibilities within the family.
• Communication Patterns influence how family members interact and express needs.

Children in Rehabilitation Settings

• Children's rehabilitation plans must prioritize their developmental needs.
• Professionals should communicate using age-appropriate methods.
• Rehab should have resources that align with the child's developmental stage.

Cultural Variations in Families

• Cultural norms determine family roles, structures, and decision-making.
• Nuclear Families are common in individualistic societies like the US.
  • Example: Moving out when you turn 18 is a common cultural norm.
  • Example: Living with family at 30 is often frowned upon.
• Extended Families are typical in collectivist cultures, emphasizing support across generations.
  • Rehabilitation professionals should consider these cultural factors when planning interventions.
  • Example: Moving out of home is considered shameful

Family-Centered Care

• Family-centered care focuses on teamwork between families and professionals.
• It respects family expertise regarding their child's needs.
• Information should be shared in an honest and transparent manner.
• Families needs to be empowered to make health decisions.
• This approach is important to improve trust and understanding.

Foundational Theories

• Attachment Theory (Bowlby): Secure attachments promote emotional stability and resilience.
• Ecological Systems Theory (Brofenbrenner): Development is shaped by various environmental systems.
• Family Systems Theory: Families function as interconnected entities where each member affects the others, offering a base for understanding complex dynamics.

Family Challenges in Rehabilitation

• Diverse Needs: Balancing each family member's individual requirements.
• Healthcare Systems: Understanding insurance complexities and medical services.
• Caregiver Burnout: Addressing the emotional and physical strain experienced by primary caregivers.

Adverse Childhood Experiences (ACEs)

• ACEs involve traumatic events like abuse or neglect before age 18.
• ACEs can lead to increased risk of chronic health issues.
• ACEs can affect brain development.
• ACEs can impact social and emotional well-being.
• Rehabilitation experts play a key role in reducing such effects through trauma-informed care.

Defining "At Risk"

• "At risk" denotes dynamics that could lead to negative outcomes for a child or adolescent.
• "At risk" indicates a situation that is not necessarily current, but can be predicted without intervention.

The At-Risk Continuum

• No Risk
• Minimal Risk
• Remote Risk
  • Risk caused by certain demographic characteristics and intersectionality/multiplicity
• High Risk
  • Risk caused by aggression and conduct problems, impulsivity, anxiety, depression...
• Imminent Risk
  • Mildly or moderately distressing activities (gateway behaviors)
• At-Risk Category Activity
  • Problems that define the at-risk category are already engaged in

Factors Influencing Vulnerable and Underserved Youth

• Lack of adequate parental leave
• Lack of affordable child care
• Lack of access to adequate and accessible housing
• Lack of increased employment opportunities. living wages
• Lack of full funding of women, infants, and children (WIC) and Head Start initiatives, universal preschool, and accessible health care.
• Youth of Color
  • US population is becoming more diverse.
  • Historical and contemporary marginalization. and unequal opportunities.
  • Many conditions that anticipate negative outcomes for youth, like living bad living conditions and underfunded schools are linked to youth of colour
• LGBTQ Youth
  • Most LGBTQ youth face stress linked to sexual orientation e.g. rejection from family, peers and society
  • denial of same-sex attraction impact relationships critical to identity formation.
  • particularly prone to alcohol issues, drug problems and depression compared to heterosexual population

Other Factors Influencing Vulnerable Youth

• Youth with Disabilities and Immigrant Youth
  • Transculturation refers to the act of a person battling 2 cultures simultaneously.
  • Executive Order on birthright citizenship (NBC News)
    • Experts warn those whose parents on work and student visa, may not be exempt
    • Two parents rule could be unheld
    • Violation of constitution and supreme court may not uphold it
    • Certain countries don't automatically give citizenship, meaning children might become stateless
    • Affects migration to the USA

Cyber Technology

• Cyber technology contains both blessings and curses
• Cyber technology effects child pornography, sexual solicitation, stalking, bullying, online harassment, body dysmorphia

The At-Risk Metaphor

• The soil: the person's social environment
• The roots: the person's family, school, peer group
• The trunk: the person's conduit for developing attitudes
• The branches: specific at-risk categories
• Foliage, fruit, and flowers: specific, individual young people
• The gardener: us, the person

The Ecological Model

• Human development is a product of ecological systems (Brofenbrenner).
• The 5 systems:
  • Individual: A person without social context (for example, genetics, temperament, psychology)
  • Microsystem: People in direct contact (e.g. family, classroom, little league team)
  • Mesosystem: Connections between microsystems (e.g., communication between a teacher and a parent)
  • Exosystem: Settings that don't directly involve a person, but exerts influence on them.
  • Macrosystem: (e.g., poverty, social norms, gender roles, and cultural values)
    • Social blueprint (e.g., cultural values, belief systems, societal norms, gender-role socialization, race relations)
  • Chronosystem: Sociohistorical circumstances and transitions that occur over an individuals life (e.g. development of connections over time/)

Environmental Factors That Contribute to Risk

• Current society exists within constant economic, political, social, and technological change.
• Influential factors: technology shifts, continued mobility, outsourcing and economy.

The Economy

• Economics is an exosystem influencing children's lives.
• Economic trends include:
  • Poverty; welfare reform.
  • The economic stagnation of the working poor.
  • Single Mothers and homelessness.

Poverty

• Poverty is most linked with family stress, school failure, hunger, and health problems.
• One in three US children will live in poverty in their childhood.
• Rural child poverty is higher than urban areas at 26.2% vs. 21.6%
• Children of color are more likely to be poor.

Effects of Poverty

• Poverty increases children's risk of exposure to violence and racism.
• Poverty causes unstable care, economic deprivation, and community insecurity
• Leads to academic failure, learning disabilities, and child abuse.
• Poor at birth increases risk of future poverty.
• White children at 30%, black children at 70% born in to lower economic status, will spend half of their life in that level of poverty

Stagnation of the Working Poor

• Just working is insufficient to avoid poverty.
• Economic issues impact development via parental attitude and behavior.

Parental Impacts of Financial Insecurity

• Parents facing employment issues get irritated, leading to punitive discipline
• Parents facing employment issues feel anxious and depressed and have a higher suicide rate.
• Parents consume alcohol more
• Effect greater on unemployed parent than employed parent.

Impact on Families of Color

• Major affect during economic downturn
• Disproportionate loss of income and jobs
• Manufacturing jobs have moved location impacting them
• Blue collar jobs most at risk

Young Single-Mother Families

• Young and female-headed families have greater risk of poverty and co-occurring problems
• Babies born to teen mothers are at high risk of being born prematurely and low birth weight

Homeless Families

• Homelessness is rising
• Those under schooling and independents are fast growing population

US Conference of Mayors (2014)

• Lack of cheap housing is most common cause of homelessness
• Families with kids count for approx 40% of the homeless population
• 2 year wait for public housing

Ennui - a Problem for All

• Boredom is connected to a lack of purpose, leading to dissatisfaction.
• Children from higher income families may lack values due to affluenza

Social Comparison

• Gap between those of higher and lower economic prosperity is ever increasing
• Higher discomfort during social connection

What's Needed

• More Childcare
• Comprehensive preschool programs (subsidized)
• Before and after school education systems
• Empowerment
• Community and neighbourhood envolvement

Empowerment

• Process of making power within a powerless group
• Allows awareness of dynamic within life
• Allows skill development and capacity to gain reason and control
• Exercising that control and avoiding infringing on right's of others

Ways Helping Professionals break trust

• The common line of , "I know what you need and what is best for you"
• Comments that show a patronizing attitude
• Dismissive
• And not supportive of the patient

Critical Consciousness

• Awareness of power dynamics in relation to self-reflection, to understand the contribution to a life ecology

Analysis of power

• Analysis of power can focus on families or schooling systems
• analysis of power can focus on national policy, racism, sexism of homophobia
• How the group helps a community through fostering self reflection

Chapters 3

The Family Life Cycle

• Unconnected young adult
• Establishment stage
• 2 final stages
• New parent stage etc

Chapter 4: (continued)

The Family System

• Each family is a balance, made of systems to maintain balance

Families as a Home Static System

• Every member contributes to Home-Static balance
• Home static systems can be open or closed systems

Types of Closed Families

• Systems are dysfunctional, is isolated and un receptive to stimuli
• detached families, members functions mostly independent
• Emeshed families, overly involved and overly concerned always worried

Variations

• This is important of what culture and family members identify themselves with
• Need 4 types of child rearing:
  • permissiveness
  • hostility
  • Involvement
  • Inconsistency

Dimensions of Child Rearing

• Restrictive vs Permissive: level of rules and strict enforcement
• Hostility vs Warmth
• Involvement vs Calm Detachment: degree of emotional reaction
• Consistency vs Inconsistency

Stress Within Families

• Divorce is stressful on families and kids
• More than `%15 have a birth to unmarried women
• Homes with LGBTQ can also be sources of stress

Latchkey Families

• Holiday and after school care situations causes issue
• Supervisions leads to behavior issues

Families of LGBTQ Youth

• Rejections of the youth may be high
• Leads to lack of support and homelessness

Children and substance abuse

• Issues in negligence and abuse likely
• High change

Chapter 4: (continued)

Families and incarceration

• Separation caused difficult situations such as poverty or negligence

Psychological issues

• Leads to emotional cognitive and social development of a child

Violence can also be an issue

• Can lead to harm against children

Cycle

• Often violent action is repeated in family relationships later in life

the value of eductaion

• In 2000 teachers where only reaching slightly below national average

School issues

• School standards lowered due to lack of teacher
• Lack of equality depending where you live

Educational institutions

• If not safe havens, health is lowered

PISA Study

• International standard test comparisons

Truths

• inequality remains the norm

School Climate

• Leadership
• Academic
• teacher involvement for success
• norms provided enhance people

Student climate

• Peer improve skills
• friends are good

involvement

• Preventative
• Reintegrating

Teacher

• Consistent

chapter 5: Individual Characteristics of children and youth

High and low risk

Resiliency

• to successfully operate in the face if adversity
• not static

resiliency to three areas:

• Social, family and youth

Environment

• Includes a child's family, school, community, and kinship network
• compensate if needed
• increase
• encourage

effective factors

• Effective
• support
• communication
• relationships

character

• proactive in problem solving
• relationships
• meaningful life
• independent

5.0

skills

• 5 of them

This assessment covers the importance of studying children and families in rehabilitation, family systems, and the influence of cultural norms. It also addresses family-centered care principles, communication patterns, and the ecological perspective.