Telling the Strengthening Families story:case studies 2011

Since 1996, more than 37,000 children and young people have been involved in Strengthening Families cases. The following case studies show how government and community organisations worked together to strengthen 12 families facing a diverse range of issues, each requiring a blend of support tailored to their individual circumstances. The common thread through all the case studies is the value gained by the agencies working collaboratively rather than individually with the families.Please note that some details in the case studies have been changed to protect the privacy of families.

 

Right from the start

Most new babies and parents in New Zealand are supported by a midwife and then visited by the Plunket nurse. Some families get ongoing support through Family Start home visits, particularly if their own support networks are limited or they are facing other challenges. Like Strengthening Families, Family Start builds on the strengths that exist within families to improve a family’s circumstances so their children get the best possible start in life.

Qualified whānau kaitiaki/Family Support workers provide guidance and advice to families to improve overall wellbeing in the areas of housing, budgeting, parenting skills, accessing support in the local community, relationship conflict and any other matters important to families. They also are trained to provide the Āhuru Mōwai/Born to Learn curriculum, a comprehensive parent support and development home visitation programme, comprising information on child development, neuroscience and parenting strategies. This curriculum is FACS’ core parenting component, delivered through the Parents as First Teachers and Family Start programmes.

From early on, Hine was a big baby. This had been noted by Plunket, and the baby referred to the local hospital paediatrician for screening tests. When the tests came back negative Hine’s size was put down to overfeeding. As the mother was a sole parent with four children, little social and family support and limited finances, she was visited regularly by a Family Start kaitiaki. Hine’s rapid growth continued and the kaitiaki become concerned. She helped the baby’s mum carefully map feeding for a while; this ruled out the overfeeding theory. Eventually a growth hormone irregularity was diagnosed and Hine came under the care of the hospital, for this and an eyesight condition.

Family Start continued to support mother and child, but with the growth condition affecting Hine’s development it was clear the Āhuru Mōwai/Born to Learn curriculum and developmental milestones needed to be adapted for this child. The family car was tiny and Hine needed special equipment. This meant that with Hine in the car the rest of the children couldn’t fit. Necessary trips to the supermarket were a logistical nightmare, as was attending an early childhood education centre. The family couldn’t go out together, which limited their social contact.

Hine’s health needs were complex, and the family was soon dealing with several hospital departments. Not only was this confusing but they could not actually get to appointments. Help was available but there were huge practical barriers to accessing this. The kaitiaki introduced the family to the Strengthening Families process, and a first meeting was scheduled.

Experienced in both Family Start and Strengthening Families, the kaitiaki took on the role of lead agency. This involved working with the mother to decide who needed to be involved in the process, getting the process under way and seeing it through – until the family could take full charge themselves. Many of the agencies invited to join the process were already working with the family, but the volume of agencies and departments and the cross-over between some services had the family confused. Clarity was required around the role of the professionals – what each could and would do, how they could work more effectively with the family and how gaps could be filled. For many families, dealing with professionals can feel disempowering. This mother felt on the ‘back foot’ because she had missed appointments through lack of transport, lack of child care for her other children or because of appointment clashes. Strengthening Families meetings acknowledge the expertise of families, and explicitly identify their strengths. Sometimes it is as simple as ensuring that everyone has access to all the information – or speaks the same language in the case of a multi-disciplinary team. Sitting at the Strengthening Families table, on an equal footing with professionals, developed this mother’s skills to manage her relationships with the professionals who will continue to be part of Hine’s life.

Once the existing services were mapped it was easier to see what other support the family needed. The transport issue took six months and the collaborative effort of several agencies to resolve. Funding was applied for through Enable New Zealand (which manages Ministry of Health funding intended to improve the quality of life for disabled people). The process was rigorous, and required expert information and advocacy to secure the funding and ensure the vehicle modifications met Hine’s requirements. Grants were also sought from local organisations; for example, to fund special glasses to help overcome Hine’s impaired vision and support the child’s development.

Having the family’s Work and Income case manager at the meetings meant she gained a full understanding of the family’s needs and made sure they received all their entitlements, relieving financial pressure and opening up avenues of support. This included an offer of funding for home help with bathing and personal care. The family chose not to accept the home care because they felt there were so many organisations involved in their lives already, and this was one aspect of care they wanted to manage themselves. Instead, funding was found for a gym membership and swimming to strengthen the mother’s back so she could manage this aspect of her child’s care.

Other funding was accessed to modify equipment to help the mother lift her child. Housing New Zealand found a more accessible house which needed far less modification to suit the family. Connections were made to link mother and child with support groups and other families. Thanks to the involvement of Barnardos’ Kid Start, special lifting equipment and extra training for caregivers enabled the daughter to participate in early childhood education. Budgeting advice was gained, and arrangements were made for the older children to attend camps, recognising that because of budget and transport constraint they had missed out on these kinds of experiences.

After seven meetings, this family took the initiative to end the Strengthening Families process; they felt well equipped, well informed and well placed to take charge of their lives.

 

Agencies involved

  • Family Start (referrer) (home-based support for families from pre-birth to school age)
  • Housing New Zealand
  • Work and Income
  • District Health Board (Child Development Unit, dietician and social worker)
  • Barnardos (child and family services including early childhood care and education, information and advocacy).

Main issues

As well as dealing with the challenges of sole parenting and financial pressures, this family faced practical challenges such as transport, housing and the sometimes daunting task of dealing with a range of professionals in advocating for a disabled child.

  • health and development issues for youngest child
  • confusion around health and development services
  • little family support and social connections
  • debt
  • unsuitable housing
  • no transport.

 

Main outcomes

Better co-ordination between the services involved removed pressure from this mother so she could establish positive ongoing relationships with those involved in her child’s care. It also opened doors; for example, equipping and training carers at the early childhood education centre. Obtaining and successfully modifying a vehicle would not have been possible without the expertise and advocacy of several organisations. And, because Housing New Zealand had a full picture of the family’s needs they were able to re-house the family into accommodation which required less specialist modification than their original property.

  • collaboration between 10 key services
  • better housing
  • child carers trained in requirements of child
  • mother’s back strengthened to cope with physical demands of care
  • mother and child connected to support group
  • modified vehicle obtained and disabled parking funded
  • financial entitlements clarified and accessed
  • budget services.

Getting on top of things

Many New Zealand families face an ongoing challenge when their children have health problems. Most take charge and manage very successfully with the support of health professionals, but sometimes problems crop up that tip a family into crisis.

This was the case for one family who sought the help of Strengthening Families. Because two of their six children had a hereditary health condition, they already had a relationship with the public health nurse, who also happened to be a trained Strengthening Families facilitator and a member of the local Strengthening Families management group.

When the father became ill with a life-threatening condition, the family business came under threat and financial pressures mounted. Suddenly the mother found herself caring for her seriously ill husband and trying to hold the family business together. This was on top of her existing commitments, which included home-schooling her children and managing extra healthcare requirements for two of the children. To add to the pressure, the youngest child, a five-week-old baby, had been tested for the same hereditary condition suffered by two of his siblings. The family was waiting anxiously for the outcome of the tests.

This was a united and motivated family who already had some support in place and were keen to work with agencies to do the best possible for their children. But, at the time the referral was made, the family couldn’t see their way forward.

The father was reluctant to ask for help, but eventually agreed as he could see his wife needed support. An initial meeting was planned and held in the home so the father could participate. He provided valuable information for the agencies present. The agencies included the public health nurse (who became lead agent), the Buddy Program co-ordinator, the social worker from the local children’s health camp, the Kip McGrath educator, the Work and Income case worker and the Strengthening Families co-ordinator, who also acted as facilitator. Providing an independent facilitator at meetings is an essential step in the process as it ensures everyone is heard, that family members are equal partners in the process and that meetings are run efficiently and kept focused and forward looking. This was a small rural area with no independent facilitator available at the time.

Although a number of the agencies were already involved with the family, the Strengthening Families process provided an important breakthrough. The family needed support to identify the steps forward, which they were able to do by working alongside the agencies. Pulling the contribution of each agency into a single action plan showed the family there was a way to get back on top of things – something they had been feeling too overwhelmed to see. The action plan laid out the help each agency would provide, with clear deadlines and steps. The family could see “how the help was helping”, as the plan showed how each action fitted together and the progress being made. It also identified important steps for the family to take, and provided a sense of ownership of the process.

Accessing extra home help and respite care, with financial assistance from Work and Income, provided a much-needed breathing space for this family. During this period the father’s illness resulted in a month-long hospital stay. Fortunately, correct diagnosis and treatment saw him on the road to recovery, and the baby tested negative for the health condition suffered by his siblings.

Arrangements were made for the two children with health conditions to attend a health camp. One child went there almost immediately, and the mother and other siblings also attended the camp for part of her time there. One objective was to enable this child to mange her own physical care necessitated by her medical condition. Involving the other family members meant they also learnt about her care, and saw what she was able to do for herself. This ensured the new skills and responsibilities she developed were transferred back into the home. The camp was unable to take her brother immediately, because he was displaying disruptive behaviour, including fire lighting, so support was put in place to change the behaviour so he could attend later.

Four Strengthening Families meetings were held over six months. By that time the family felt sufficiently on top of things to end the process.

Agencies involved

  • public health nurse (referrer)
  • Buddy Programme (matches children with trained adult volunteers for activities that encourage positive interests, values and behaviours)
  • children’s health camp social worker
  • Kip McGrath educator (private tutoring to support children to achieve at school)
  • Work and Income case worker
  • respite carer, neighbour/support person.

Main issues

Co-ordinated support got this family through a critical period and equipped them with good skills and ongoing processes for future family life.

  • father is unwell – on unemployment benefit, financial stress
  • children have a genetic disorder, baby being tested for this
  • behaviour and control issues with children, stemming from their illness
  • mother home-schools all the children.

Main outcomes

Having extra help in place when it was needed was important for this family. Equally important was the empowering nature of the process and the systematic approach that showed the progress they were making and encouraged this family to keep moving forward.

  • respite care four children – home help in place when needed
  • heath camp visits arranged, including parenting course for mother
  • routines from health camp transferred back into home
  • behaviour issues largely resolved.

Strengthening Families strengthens schools

Schools are often confronted with tough issues, and the problems are much wider than just a child failing to reach their potential. A child can disrupt a classroom, making learning difficult for others. Sometimes this disruption extends to intimidation and even violence.

Schools have a range of educational and behavioural supports to call on, but some kids just don’t seem to fit the criteria. When a child exhibits difficult behaviours at school it can be symptomatic of wider social problems. It’s like an iceberg – there is a lot more under the surface.

For a small rural school there may be fewer avenues available to seek support, and staff may feel they are shouldering burdens beyond their understanding or power to help.

Strengthening Families can get families the help they need by applying a holistic approach, sharing the load for the school and the family and getting down to the underlying issues.

In one school, the children of a family newly arrived in the town bought chaos with them. The trouble started on the school bus in the morning and continued in the classroom. The principal, teachers, pupils and their families were all impacted. The community was small and all eyes were on the school. Ironically, this family had relocated here to get a clean start.

A relationship was quickly established with the parents, initially based around disciplinary measures. It was clear more support was required, but these children didn’t quite fit the criteria for the services the school usually called upon.

The principal decided to talk to the parents about Strengthening Families. She had been involved in a Strengthening Families case before but had never made a referral. “It seemed a natural progression of the relationship I was developing with the family. We held the meetings here at the school, which was convenient and a familiar ground for the family, and made it easy for school staff to be involved.

“For me, as a busy school principal, Strengthening Families was well worthwhile. The investment of my time was small compared with the benefits for the school, let alone the benefits for the family,” she says. “Using an independent facilitator means meetings run really well. If a family feels comfortable then you get openness, and once the issues are on the table things really get moving. Quick practical fixes, like getting a family car registered, or getting extra money for stationery make an immediate difference for people and open the way for support with more serious family issues, such as family violence. Getting the car fixed may sound like a funny priority, but it meant that these kids could attend school without coming on the bus where they were causing a problem for other children. It also provided transport to employment. Strengthening Families offers a way to deal with the big stuff and the little things.”

Strengthening Families meant support for the principal too, as other organisations picked up their share of the work. “I realised that there was a lot of help available out there I didn’t know about. Getting all the support agencies together got some doors opening, and everyone who had been at the meetings did what they said they were going to do. It was amazing what was achieved in just four meetings.”

On the immediate practical front there was help with housing, shoes and clothing for the children. Then ACC (Accident Compensation Corporation) and Work and Income helped support the father back into employment. Barnardos worked in the home to get good routines in place, and the resource teacher learning and behaviour (RTLB) provided resources for the mother to support her children with their learning and behaviour.

Agencies involved

  • primary school (referrer)
  • Child, Youth and Family
  • Work and Income
  • Barnardos (child and family services including early childhood care and education, information and advocacy)
  • resource teacher learning and behaviour (RTLB) (itinerant specialist support for students with moderate learning or behaviour issues))
  • Group Special Education (extra support to what is available in the classroom)
  • Community Trust (charitable trust)
  • Children's Health Camp
  • Housing New Zealand
  • public health nurse
  • Police
  • ACC
  • Brain Injury Association (education and advocacy support).

Main issues

The problems at school were symptomatic of bigger issues the family faced. They were new to the area and not connected to services. They were homeless and lacking in the basic necessities of life.

  • child behaviour
  • parenting support required
  • homeless
  • unemployment
  • brain injury and other health problems
  • domestic violence
  • transport
  • no telephone.

Main actions

  • access to school phone
  • emergency housing arranged
  • ‘options and advice’ process completed with Housing New Zealand
  • supported to go to real estate agents to look for rentals
  • put on Housing New Zealand waiting list
  • Ministry of Education assisted with travel costs to get the children from emergency housing to school and back
  • necessary paperwork completed for assistance with other health issues (Work and Income paid medical bills)
  • ACC case manager organised and paid transport to appointments
  • Work and Income provided benefit
  • support by Work and Income(and budgeter) to develop a plan to pay outstanding debts
  • linked up with Work and Income work broker and Workbridge
  • RTLB provided extra resources for the mother to use with children at home
  • Barnardos worked in the home with the family to get routines in place
  • health camp took children for a look around, then a referral was put in
  • supported by Community Trust to see the doctor and to put through a referral to the Brain Injury Association
  • letter to Salvation Army to get clothes donated
  • respite care of children organised
  • discretionary fund used to buy the children shoes.

Outcomes

The Strengthening Families process enabled the family to access a wide range of support and make progress on some very challenging issues. Some practical ‘fixes’ relieved immediate pressures in the school allowing the education of these children and their classmates to proceed more smoothly.

  • family now in a rental
  • phone on
  • debts cleared
  • vehicle on the road
  • father working
  • family getting counselling
  • family now well connected with services in the community.

Putting a house in order

Depression can be so debilitating it can sometimes override the bond between mother and child. For a young Somali refugee the challenge of sole-parenting two small children in a strange country while struggling to come to terms with the circumstances that had bought her to New Zealand left her overwhelmed. She was severely depressed and ready to give up as a parent. In addition to the complexities faced by any parent co-ordinating multi-disciplinary care for a child with a disability, Amina faced language and cultural barriers. There was a further complicating factor – a different view of depression held by the Somali community in New Zealand; Amina’s inability to manage her household would be seen as lazy. She felt unable to ask for help.

Amina was referred to Strengthening Families by the Somali Council for Social Services. In a short time a wide range of agencies came together to help her get well, provide educational and social support for her four-year-old deaf son, and provide practical home support. Work began on all three fronts. The presence of two Somali women in the team (a social worker and a public health nurse) was  critical  in bringing agencies on board and getting the services geared to the family, with these women providing what was in effect a cultural translation service.

Counselling was arranged for the mother to identify the causes of her stress and depression. Co-ordination between counsellor and GP (general practitioner/doctor) led to a review of her medication, informed by a fuller understanding of her circumstances. More normal sleeping and eating patterns were restored, and Amina felt supported.

With the help of education professionals her deaf son’s behavioural issues were identified as stemming from his frustrated attempts to communicate. He now attends the Deaf Language School, and all the teachers at this kindergarten have a good understanding of his needs. With parenting support from the Open Home Foundation his mother is more confident managing his behaviour. Disability support has been accessed through the NASC (Needs Assessment Service Co-ordination), and Work and Income has provided financial support for a number of the extra services needed by this family. The agencies are now looking at ways to get a laptop into this household so the family can learn sign language.

The importance of practical support cannot be underestimated in this case. Bringing PORSE early childhood support into the home freed the mother to get back on top of household management. Finding out about the kindergarten walking bus meant her four-year-old could participate in early childhood education outside the home, giving him important social contact as well as developmental activity. Help was even given to organise and get her son to play dates in the holidays.

The Strengthening Families process follows the formula of an initial meeting, review meeting (or meetings depending on the complexity of the case) and a final meeting. Many of the activities for Amina’s son were set in train at the initial meeting. However, by the second meeting it was clear that even more specific support was required to make these things happen; for example, to make sure money was available for bus fares and that Amina understood the route to get her son to his play date.

As her house was ‘put in order’, Amina identified another important need for her younger child, who at 18 months was not developing language. With an assessment process under way, any issues with Amina’s youngest can now be dealt with early.

This case is ongoing.

 

Agencies involved

  • social workers from the Somali Council (referrer) (promotes the welfare, culture and positive integration of Somali people)
  • GP and counsellor from Primary Health Organisation
  • Group Special Education
  • deaf advisor
  • Deaf Education Centre
  • teachers from the local kindergarten
  • public health nurse
  • Parent Support
  • Open Home Foundation (christian-based social service provider)
  • District Health Board social worker
  • Work and Income.

Main issues

This mother’s severe depression impacted on her ability to care for her young children. As a refugee she lacked family and social support and faced cultural and communications barriers. Her depression was misinterpreted by her community as laziness, resulting in the further isolation of her and her children. Her elder child was also isolated through deafness.

  • mother’s severe depression, isolation and lack of support
  • educational and social needs of children, including hearing disability.

Outcomes

Strengthening Families co-ordinated support on professional and practical fronts to keep this family together and connect them with the community. This included removing barriers to attend appointments and play dates. Cultural translation played an important role, with workers from the family’s own culture building understanding with other agencies involved. The children in this family now have access to specialist services, and a potential language development issue with the younger child has been picked up early.

  • treatment programme for mother
  • home support and respite
  • educational response for four-year-old, and access to additional disability services
  • early intervention and assessment for youngest child.

Realising a child’s potential

When a child is “being a bit of a handful”, there is often a relative prepared to step up and take charge. But when a child has had a really rough start it can take more than just love and commitment to ensure good outcomes.   Even with help from the multiple agencies involved it’s a long and hard journey to ensure the child reaches its potential. “Two steps forward and one step back,” is how the local principal describes it. But, as she is at pains to point out, that still adds up to one step forward.

Nine-year-old Falipa is now cared for by his grandmother, with Child, Youth and Family actively involved in ensuring his safety and wellbeing. There were concerns with his behaviour and progress when he first arrived at his new school, after moving in with his grandmother. The support of a social worker, public health nurse and special education services were enlisted. But when Falipa threatened another pupil by holding scissors to his neck, everyone wondered where to turn next. This affected his grandmother greatly: she became physically unwell and unable to manage her stress. A complaint was made to the police and a four-step police plan was developed for Falipa. One of the steps was a referral to Strengthening Families. Using Strengthening Families meant that police involvement could be forward looking and supportive. Strengthening Families also opened the way to address other issues in the home. There were already a lot of agencies involved with the family, and the grandmother was overwhelmed with the responsibility of co-ordinating them all.

The grandmother was amazed at the first meeting when eight of the invited agency representatives attended.

Falipa was referred to a community-based mental health service for children and adolescents where he was diagnosed with ADHD (attention deficit hyperactivity disorder) and entered a social skills programme. His grandmother received professional support with managing Falipa’s behaviour. Police Youth Aid joined the team and takes him to activities at the local community house, involving him in positive activities and giving his grandmother a break. Community Approach, an organisation that works exclusively with young people referred from Youth Aid, provides Falipa with activities after school and in the holidays, giving him new experiences and opportunities to flex his developing social skills. Young people and workers are carefully matched, so this also provides Falipa with a positive male role model.

Falipa’s grandmother was committed to raising her mokopuna, but she was also caring for her aged and unwell father and a brother with bi-polar disorder. Their housing was cramped and Falipa shared a room. This family had arrived in New Zealand without the usual documentation. A community worker was enlisted to help the family obtain the required papers, which will clear the way for Housing New Zealand to find better housing. Financial entitlements for the whole family were looked at and additional care was arranged for the boy’s great-grandfather and uncle, lightening his grandmother’s load.

Special Education, RTLB, the public health nurse and Child, Youth and Family all continue to support Falipa. Thanks to the Strengthening Families process everyone has better knowledge and better links. There are clear strategies in place and everyone working with Falipa has the full picture, providing consistency and stability. His behaviour is more settled and there are fewer incidents in school. Falipa has gone from being the “most serious behaviour case” ever dealt with in the school to a boy with “leadership potential”.

This case is ongoing.

Agencies involved

  • Police (referrer)
  • primary school
  • Youth Aid (manage police services for under 17s, designed to keep them out of the formal court system by providing individualised support in the community)
  • community social services
  • Youth Mental Health services
  • Group Special Education
  • Supporting Families in Mental Illness (support for families of people experiencing major mental illness so families can assist in recovery)
  • public health nurse
  • Children’s Health Camp
  • Community Child, Health and Disability (district health board)
  • Housing New Zealand.

Issues

The referral to Strengthening Families was precipitated by a violent incident. As the case unfolded it became clear that more support was required, not just for Falipa and his grandmother but for other family members reliant on the grandmother as caregiver as well.

  • violent behaviour
  • need to access therapy and support for Falipa
  • support for grandmother over-burdened caring for family members and becoming unwell herself.

 

Outcomes

Comprehensive co-ordinated support from the community is now in place around this boy, providing a settled and consistent environment in which his potential is emerging. Support is also in place for his grandmother to ensure she is well placed to continue to care for him, with the support available in the community.

  • Falipa’s behaviour is more settled with fewer incidents
  • Falipa’s treatment and support activities are well co-ordinated and well understood
  • practical support is in place for the grandmother to care for herself and other family members
  • essential documents have been obtained to help this family access government services.

 

Wrap-around service

Strengthening Families is classified as an early intervention, designed to support families before they reach a crisis. Sometimes life can spiral out of control suddenly. When this occurs, the Strengthening Families process can wrap services around a family, quickly dealing with immediate issues of safety, as well as planning to keep a family safe and together in the future.

For a mother with young children, the unexpected diagnosis of a fast-moving terminal neurogenetic disorder was devastating news. The prognosis included progressive loss of muscle control and decline in mental abilities, with symptoms already presenting. Lapses in concentration and loss of agility meant that the mother could no longer provide the care required by her active pre-schoolers. Added to this was the fear that the disorder might have been passed to the children – and grief arising from the imminent loss of a partner and mother. An NGO social worker specialising in young children became involved, and seeing that more could be done made a referral to Strengthening Families.

This was a complex case and there were risks to the children. It was clear agencies would have to work very closely together to get the care right.

At the initial meeting the family and agencies agreed on an approach that would enable the mother to keep her independence as long as possible, so the personal care and support for her to run the household were geared to supporting her to do it rather than taking over. The carers set up a structured process and schedule for household tasks such as shopping, cooking and cleaning, as well as arranging regular social activities outside the home. An occupational therapist and dietician were enlisted to ensure she was as well as she could be. This all needed to be carefully balanced to conserve the mother’s diminishing energy reserves, so it was essential that all the support services fully understood her condition and worked closely with one another.

The agencies involved included: a community-based social worker; a community-based disability support service; a home-based early childhood education provider; an occupational therapist from the District Health Board; Child, Youth and Family; Work and Income, and the support organisation for people experiencing the mother’s medical disorder. This support organisation ran training for everyone involved in the mother’s care to make sure they fully understood the mother’s condition and the challenges posed.

Ensuring the children’s safety was a critical challenge. Symptoms of the disorder included difficulty concentrating and withdrawal. Agreement was reached early in the process that the mother would never be alone with the children. However, an accident occurred, and Child, Youth and Family received a report of concern. A family/whānau agreement (covering steps the family must take to keep children safe) was negotiated alongside the Strengthening Families process, and the social worker from Child, Youth and Family monitoring the agreement became more involved in the Strengthening Families meetings.

As well as accessing financial support for the mother’s care, Work and Income arranged funding for child care. The maximum amount that could be funded from Work and Income was not enough to cover all the hours required. Based on a full understanding of the family’s circumstances, the home-based child care offered a special rate for the additional hours, removing some financial strain from the family and enabling the father to work. Work and Income also advised the family on their full entitlements. This was important as the family was required to meet some of the costs of the care required, and financial pressures were causing additional strain.

The Strengthening Families process operated for two months to equip this family to deal with a very challenging set of circumstances.

 

Agencies involved

  • Parent Aid (referrer) (emotional and practical support for families in stressful times)
  • disability care and support
  • DHB occupational therapist
  • disease support organisation
  • early childhood education provider
  • Work and Income
  • Child, Youth and Family.

Main issues

This family was hit ‘out of the blue’ with a tragic set of circumstances, which presented immediate risks to the children and the likelihood the family would not be able to stay together for the time remaining to the mother.

  • safety of children
  • unemployment
  • child care
  • social isolation
  • grief
  • carer support for the mother’s personal care and household management
  • help with managing the disease
  • job security for the father
  • social contact outside the house for the mother
  • support for the family to keep them together and to deal with grief.

Outcomes

Strengthening Families enabled a rapid and comprehensive response to this family’s needs, which kept the family together, maintained the mother in her role and kept the children safe. This was achieved by providing support on a number of fronts and carefully balancing the needs of respective family members to ensure the safety and wellbeing of all family members. This required a high level of co-operation and tight co-ordination among the services involved.

  • child care
  • care for mother to manage disease and maintain social activity
  • household management support
  • carers educated about the mother’s condition
  • counselling for father
  • financial entitlements.

This family was provided with a comprehensive support package to enable them to continue to function as a family, and to keep the family together and the children

Giving families a voice

Ask any sole parent asking for support to manage life’s challenges and they will tell you that sometimes it’s hard to be heard. They will also tell of the frustration of repeating their story to each new organisation that enters their lives, and the confusion of dealing with multiple agencies, all with different processes, procedures and requirements.

Take a profoundly deaf sole parent, and imagine the work and effort it takes to raise a family. Committed father Jack faced extra challenges parenting his children following a relationship breakdown with the children’s mother. He was still very involved with the children, often caring for them from 6am to 8pm while their mother worked long hours. As a result of miscommunication, Jack’s share of the caring was not reflected in the amount of family support he was receiving. Also, his housing was geared towards a single man rather than a family.

Jack lived in a rural location with few services to hand. Using the telephone was out. Trying to communicate with government departments meant trips to town and relying on family members to interpret. Often he relied on his seven-year-old daughter to interpret, but the financial concepts involved in dealing with the Inland Revenue Department (IRD) and Work and Income were beyond his daughter’s comprehension. It was also unfair to involve the child in a dispute between her parents about her own care and financial support. Other family members tried to help out, but as feelings were running high it was hard for them to be neutral. Understandably, Jack became frustrated at these visits, and in his attempts to be heard got louder and louder, creating disruption, with the unintended consequence of creating more barriers to getting what he needed.

When the local Strengthening Families co-ordinator met the family it was clear what Jack needed – he needed to be heard. He needed a neutral voice that could be heard by the agencies so they could support him.

A key part of Strengthening Families is to bring all the agencies who can help a family together in one place at one time, so they can all listen to the family’s story at the same time and then identify what each agency can do to help. Once agencies understood the issues they were able to provide Jack and his children with what they needed. By having everyone in the same room at the same time, with an interpreter and an independent facilitator, an action plan was quickly developed and each agency had the information they needed to do their job.

Inland Revenue adjusted the child support payments, recognising the substantial share of the child care that Jack was undertaking. Work and Income got the information they needed to ensure the entitlements were correct, and Housing New Zealand found more suitable accommodation. After a few meetings the family were well placed to move into the new phase of their life, with the parents living separately.

The interpreter was funded by one of the government agencies. However, the Strengthening Families way is always to see if one of the 11 government departments signed up to Strengthening Families can provide a service like this from existing resources. While departments offered interpretation services, most had restrictions on how and when this could happen. Local management groups (LMGs), which oversee Strengthening Families in their areas, include local departmental managers as well as local government and community representatives. They look at how well their departments work together and ensure that learnings from individual cases are fed back into work processes. In this case the LMG took the matter up and changes were made to enable the interpreter to come to the Strengthening Families meeting. Removing this barrier will help others in the future.

 

Agencies involved

  • IRD
  • Work and Income
  • Housing New Zealand.

Main issues

The main barrier in this case was communication. Strengthening families provided an opportunity to bring the agencies together so that the services of a translator were not required on multiple occasions. This was efficient for the agencies involved, and for the father who was required to travel to meet with agencies face to face.

  • financial entitlement and correct child support
  • housing.

Outcomes

Once the needs were understood agencies were able to respond quickly and the case was resolved.

  • suitable housing obtained
  • correct financial entitlements obtained.

Crying out for help

Parenting a teen is universally recognised as having ups and down. Where does a parent who recognises more than the usual teen troubles in her daughter get help to ensure a successful outcome for her child?

For one mother, a survivor of domestic violence, struggling to raise two children who had grown up witnessing violence, the challenges of parenting had proved overwhelming. At one point this ended up with her assaulting one of her children. Now that her daughter’s behaviour had become increasingly difficult to manage, her mother knew something was badly wrong.

“[I felt] like I was alone on a desert island and the rescue boats were sailing away on the horizon. I was trying to wave them down and crying for help,” she says.

When the family’s Child, Youth and Family worker saw the pressures mounting in this family she suggested the mother contact Strengthening Families. An initial meeting was organised, bringing in the school guidance counsellor and the home-based support worker. This really was just the beginning of the journey for this family. Over time the agencies involved grew to include Child and Adolescent Mental Health Services (CAMHS), a child psychiatrist, a private counsellor, a dietician and an anger management tutor. A number of these agencies also organised support and activities from a number of allied agencies.

The daughter was diagnosed with anorexia, and a treatment plan was put in place including positive rewards for weight gains. Counselling was provided for all immediate family members, and effort went into building better relationships for all the family – with each other, socially and with agencies. This holistic approach would have been unlikely to have occurred without the Strengthening Families process.

A considerable effort was made in setting up effective communication between the local GP and CAMHS, and with other health specialists including a dietician and psychiatrist. Being able to see that a total care package was in place took a lot of pressure off the mother who had felt solely responsible. This gave her the space to focus on her role in parenting her child. This included learning more about anorexia in order to understand and care for her daughter, a course to manage her own anger and other steps to look after herself.

Child, Youth and Family stayed involved until many of the initial issues were resolved. They ended their involvement when it was clear this family was taking big steps forward through the Strengthening Families process.

This family had a team that supported them while progress was made. The mother describes her learning about parenting as huge. She understands now how the past has affected the family’s behaviour. She has gained practical skills through her course, and is connected with people she can talk to and get a better understanding of what to do, including venting her feelings and other strategies for keeping safe.

The full complexities of anorexia are not widely understood, and without collaboration among those involved in the child’s care, change would have been much more difficult. Communication was greatly improved between agencies, and the family now knows who to go to for what. The daughter has gained enough weight to be out of risk.

The mother says, “I’m now a stable rock able to hold my family. I couldn’t have survived without Strengthening Families.”

Agencies involved

  • Child, Youth and Family (referrer)
  • home-based support
  • school guidance counsellor
  • CAMHS
  • child psychiatrist
  • counsellor
  • dietician
  • anger management course tutor.

Main issues

The presenting issues for this case (behaviour and parenting challenges) evolved, and resulted in the diagnosis of a life-threatening condition which would further stretch the mother’s parenting.

  • diagnosis and treatment plan
  • behaviour management plan set up at school using horse riding interest (RDA) as a reward system for weight gain
  • holistic support at home and at school, eg professionals involved in both
  • counselling support for each individual in family
  • building better relationships for all individuals – with each other, socially and with agencies
  • setting up effective communication with/among primary health, mental health and specialists (dietician and psychiatrist)
  • mother given a lot more information about anorexia and this helped with her understanding and care for daughter
  • anger management course attended by mother
  • safety plan developed.

Outcomes

Strengthening Families enabled a holistic approach to the challenges faced by this family, including counselling for all family members and substantial parenting support for the mother, thus avoiding further involvement by Child, Youth and Family. The Strengthening Families process also enabled understanding to be built among key agencies involved with the daughter, allowing them to provide a consistent and co-ordinated approach to managing her anorexia.

  • Child, Youth and Family stayed involved until many of the initial issues were resolved, and did not call a family group conference. They withdrew from the process once they witnessed huge steps being taken by the family and that support was in place
  • the mother was equipped to manage her daughter’s condition, and to build in self-care for herself
  • the daughter gained sufficient weight to no longer be at risk
  • effective communication in place between primary and specialist health professionals.

School days

It is not uncommon to hear horror stories from people’s high school years. Here is one story where the simple act of co-ordination, getting the right people in the room at the same time, changed one teen’s story.

The girl in question had come to the attention of the school for bad behaviour. At first this appeared to be nothing too serious – talking back to teachers and not co-operating. But there was an escalation. Teachers noticed poor choices in friendships and slipping performance from a student judged able. The school had a relationship with the girl’s father (her chosen primary carer), who was also struggling with her behaviour, which included late night escapades and alcohol. The girl had a relationship with the school counsellor who was aware she was unhappy. When the school realised she was self-harming they referred her to Community and Adolescent Mental Health Services (CAMHS).

A formal assessment by CAMHS ruled out any serious mental health concerns, and CAMHS made a referral to Strengthening Families. The Strengthening Families process provided an opportunity to look at the environmental factors and address the full picture.

The teen, and her father and mother all participated in the meetings, along with the deputy principal, guidance counsellor, CAMHS and a local youth support organisation from which the teen was already receiving support. This was the first time the school had met the girl’s mother. With the help of an independent facilitator, each was encouraged to share their concerns and talk about how they wanted the future to be.

The deputy principal’s main concern was her pupil’s attitude and poor behaviour, particularly the behaviour directed at teachers. She also wanted to see the girl applying herself to her studies and achieving academically. The guidance counsellor noted the girl’s unhappiness and difficulties with relationships. She raised the question of unsuitable friendships, but was also able to highlight times when the girl had made good choices. CAMHS advocated for a united front from both parents towards behaviour management such as setting and maintaining boundaries. They also raised the possibility that the girl had a learning disability.

When her time came to speak, the girl talked about her struggle with learning. She also asked for help with her relationship with one teacher who she felt “had it in for her”. She was able to talk about her friendships and acknowledged she had not always made good choices. She talked about her relationship with her mother and her desire to have one-on-one time. Although she spent regular time with her mother, her mother had a new family and time was always shared with the new children.

Her father revealed he had a learning disability which had held him back in life, and advocated strongly for further testing for his daughter. He expressed concerns about her behaviour and his ability to deal with it, but he also restated his commitment to his daughter and his desire to do right by her.

A formal learning assessment was organised, part-funded by the family and part-funded through the Strengthening Families discretionary fund. The results formed the basis of an individual study plan with extra tuition. The school allowed her to withdraw physically from the class where the relationship with the teacher had broken down, studying instead in the learning support room. An arrangement was made for an automatic ‘class pass’ if she felt she needed to withdraw from any class rather than behave badly. When this happened she could go to the counsellor’s office to offload.

The school also agreed to a weekly lunch pass. Her mother adjusted her working hours so they could meet weekly for lunch, just the two of them.

CAMHS had some individual sessions with the girl, which were stopped as she was making good choices and had re-connected socially and positively, eg re-joining a sports team. CAMHS continued to work with her father on strategies for parenting a teen.

The case closed after four months with many positive reports from those involved.

 

Agencies involved

  • school deputy principal and guidance counsellor (referrer)
  • CAMHS
  • local youth support group.

Main issues

This teenager was identified as being at risk as her academic achievement fell and her behaviour deteriorated. The school counsellor was concerned at her level of happiness and thought she might be self-harming. When a mental health assessment ruled out any serious concerns, agencies involved with the girl came together to identify the problems and solutions.

  • teen behaviour and self-harm
  • relationships
  • academic achievement.

Outcomes

In this case participants, including the teenager, were able to talk openly about their concerns and what they wanted to happen. This enabled a chain of positive steps to be identified and acted on. The diagnosis of a learning disability cast a new light on what was happening at school, and extra help was put in place for learning with an accompanying strategy for managing feelings and conflict. The Strengthening Families meeting was the first time the school had ever had the chance to talk with both parents together.

  • learning disability identified and learning assistance in place
  • parenting support for father to manage ‘teen’ rather than ‘child’ issue
  • plan for one-to-one with mother in place
  • support for teen to make good choices
  • support strategy for managing feelings at school and avoiding bad behaviour.


Getting a family back together

For one mother Strengthening Families played a vital role in getting her family back together.

 

Sarah was referred to Strengthening Families by her Child, Youth and Family social worker. Her two children had been staying in a Child, Youth and Family home for quite some time, and the Strengthening Families process offered a good opportunity to co-ordinate the support required for their transition home full-time. At the time she was expecting another baby. Her son had autism and attention deficit hyperactivity disorder (ADHD) and was exhibiting some behaviour that agencies were worried about because of the new baby. The Counsel for Child, whose role it is to represent the interests of the child,  was concerned that conditions were right for the children at home and for the arrival of the new baby.

 

Several agencies were involved in the process, including the midwife, social workers from the health and welfare sectors, CCS disability and local disability support services, maternal mental health services, the school principal, the Child, Youth and Family home, Family Works a social services agency,  the mother’s lawyer and Counsel for Child, as well as a Child, Youth and Family social worker and a supervisor.

 

For Sarah, the road to having her children returned had been long and hard-fought. She felt she had worked hard and kept sight of her goal of having her children back, completing parenting courses, anger management courses, and courses to learn about her son’s autism and how to mange his behaviour. But history seemed to be getting in the way. Her relationship with Child, Youth and Family had become adversarial. This was compromising communication and getting in the way of going forward.

 

She wasn’t sure about Strengthening Families at first, as she had had bad experiences with formal meetings in the past. But when the local co-ordinator made the time to talk her through the Strengthening Families process, she saw this could work. “The co-ordinator took the apprehension out of the process and I could see that this might be a way for me to get them to understand and to get something done,” she says. “Strengthening Families cut through all the old stuff and got the focus on the facts. I understood the process. Everyone’s role was clearly explained and I felt well informed. If I didn’t understand something I could get it explained, and I was expected to have my say. People took the time to understand. There was no judging. I didn’t have to fight anymore.”

 

From the mother’s point of view, the Strengthening Families process was transparent. “At the meetings everyone said what they would do. It was written down and they did it. Everyone had the same information. The information was flowing in all directions and I was included. This took the tension out of the process. Being on the inside rather than the outside meant I could see that progress was being made and that reduced my frustration.”

 

Six months and eight Strengthening Families meetings on, and with a lovely new baby and her two older children living with her under a shared custody arrangement with Child, Youth and Family, Sarah ended the Strengthening Families process. She describes her current life as “flying solo with support”.

 

“My son has comes leaps and bounds with his new buddy/mentor and is very settled at home now. His sister started a new school last year and has gone up four reading levels in one term, and my baby is doing well. I know what my family and I need, and I know how to ask for help if I need it. For now, I am enjoying the simple pleasures of being a parent, like making lunches and helping with homework.”

 

Agencies involved

  • Child, Youth and Family (referrer)
  • Child, Youth and Family home
  • lawyers
  • mental health services
  • midwife
  • social workers from the health and welfare sectors
  • CCS Disability and local disability support services
  • school principal
  • Family Works (Presbyterian Support social services for families).

Main issues

This family had been apart for several years, and all parties shared an interest in the success of the children’s transition back to their mother. There were several considerations including child safety, child behavioural and educational needs and the mother’s wellbeing.

  • child safety
  • child behavioural and educational needs
  • maternal wellbeing and support.

Outcomes

Strengthening Families offered a forward-looking process, which kept all agencies on track, and well informed and reassured as agreed steps were worked through. This resulted in the children’s return home with support in place to smooth the transition. Two children are now living with their mother and new baby brother under a shared custody arrangement with Child, Youth and Family. The children are doing well at school.

Starting over

Melanie first used Strengthening Families when her partner was hospitalised, diagnosed as a delusional schizophrenic. At the time Melanie was pregnant with her third child (who later died), and managing a son with autism. Her Work and Income case worker saw she could do with some help and suggested Strengthening Families. Help was put in place for Melanie’s family, including child care so she could keep working, and ongoing medical care for her partner. This got her through a rough patch, but it was not apparent at that time just how difficult her life was to become.

After some very bad times dealing with emotional abuse and a death threat to one of her older children, Melanie made the decision to leave her partner of 16 years. She knew she would need a lot of help to do this, and turned to Strengthening Families to support her while she rebuilt a new life for herself and her children.

Having been through the Strengthening Families process before, Melanie knew it was ok to ask for help. “I already had some support in place for my child who has autism, but I was struggling with his health and education appointments. I felt like I was doing it all on my own. I was dealing with the loss of a baby, and doing this really scary thing. Strengthening Families showed me all the support that was out there so I could make informed choices about what we needed. Housing New Zealand found us a place to live, and the Police liaison officer has been very supportive. I now have the ongoing support of Barnardos in managing my son’s care, and know I can call on Birthright for more help. The school has also been involved so we’re all on the same page with his care. IRD sorted out my child support, and I am working with Child, Youth and Family on arranging supervised access for my former partner. Last and really importantly, through Strengthening Families I got counselling for myself,” she says.

“I have got a lot to deal with and Strengthening Families has helped me to stay on top of it. I’m working part-time, and when I have my children really settled and everything in place I plan to work full-time.

“I want to say to other women that the support is out there. Just go for it.”

 

Agencies involved

  • Work and Income (referrer)
  • Barnardos (child and family services including early childhood care and education, information and advocacy)
  • Birthright (builds confidence skills and resilience within the family unit and with individual family members)
  • Housing New Zealand
  • Child, Youth and Family
  • DHB child development team
  • school
  • IRD
  • Police – family liaison.

Main issues

Making the decision to leave a violent relationship takes a huge amount of courage. It also takes huge support if it is to be successful. This case involved a high level threat to safety. Managing this needed to be balanced with providing continuity and stability for the children – including support for a child with autism, staying in employment and maintaining the mother’s own wellbeing.

 

  • violence and abuse – threat to safety from ex-partner and associates
  • grief from recent bereavement
  • support for child with autism
  • financial security
  • counselling required to support mother and children
  • housing.

Outcomes

This mother was supported to make a life-changing transition for herself and her children. In this case Strengthening Families provided a safety net, reassuring the mother that the help she needed was there. 

  • re-housed and security enhancements made to property
  • correct financial entitlements
  • counselling and support for mother and children
  • mother is now working part-time and hopes to return to full-time work as her children are increasingly settled and secure.

 

Where to from here?

When a well educated, well resourced couple adopted two young children they didn’t expect to leap straight to the “and they all lived happily ever after” page in the book. They were aware that their children had a poor start to life, experiencing trauma and abuse. When the children’s behaviour began to deteriorate they looked for support, but had difficulty identifying a source of funding that could provide the sort of specialist care their children required. They also recognised that their own stress levels were escalating in pace with the increasing difficulty of the children’s behaviour. They were struggling, but others around them just assumed they were coping. So where did they go for support? And where would the extra money required for specialist help and respite care come from?

ACC, who were already involved with the family, suggested Strengthening Families. The starting place was to bring the likely agencies around the table and see what each could provide and what funding was available. An initial assessment of the family’s needs identified a need for psychotherapy and sexual abuse counselling for the children, knowledge and support for the parents, the ability to spend more one-on-one time with each child to build attachment, for everyone to have a holiday and for respite care to be made available.

Child, Youth and Family arranged and funded counselling for one child with a leading specialist in attachment therapy, and the Child and Adolescent Mental Health Services (CAMHS) organised therapy to assist the younger child with bonding, toileting, eating and sleeping. The children seemed to be doing well at school, and initially the school was kept informed of developments by receiving minutes of Strengthening Families meetings. As a fuller picture of the children’s needs emerged, the school got fully involved, enabling a consistent and collaborative effort between home and school. The school sought the assistance of the resource teacher learning and behaviour, who set up a social skills group to assist with joining in, playing fairly and sharing.

Family Works (the youth and family arm of Presbyterian Support Services) provided parenting support and education and maintained ongoing support. This acknowledged and responded to the high stress the mother was under. Family Works took on the role of lead agent, co-ordinating and monitoring all the agencies involved and managing communications between the agencies and the family.

A well co-ordinated approach from the agencies provided this family with some much-needed support and the specialist professional help the children needed to overcome their early difficulties. This family is now managing well with help in place to improve the outcomes for their children educationally and socially.

 

Agencies involved

  • ACC manager and case manager (referrer)
  • school principal
  • Child, Youth and Family
  • CAMHS
  • DHB (counsellor / social worker / psychiatrist / paediatrician
  • Family Works social worker
  • GP
  • lawyers for children.

Main issues

This family felt alone and exhausted dealing with behavioural issues of the two children they had adopted. They didn’t know how to access the highly specialised help required or how they would afford it as they had dropped to one parent working in order to care for the children.

  • suspected history of child abuse/trauma
  • behavioural issues
  • parents need support and respite to manage successfully.

Outcomes

Through Strengthening Families specialist help was accessed for these children, and respite care was put in place to help the parents to stay on top of things. The school was drawn into the process, enabling a more consistent approach among school, home and respite care. Armed with more knowledge and understanding the school was able to put more support in place to ensure the children had every chance to achieve educationally.

  • specialist therapy and counselling for children
  • after school and respite care in place
  • consistent behaviour management between home and school.

Getting a family back together

For one mother Strengthening Families played a vital role in getting her family back together.

Sarah was referred to Strengthening Families by her Child, Youth and Family social worker. Her two children had been staying in a Child, Youth and Family home for quite some time, and the Strengthening Families process offered a good opportunity to co-ordinate the support required for their transition home full-time. At the time she was expecting another baby. Her son had autism and attention deficit hyperactivity disorder (ADHD) and was exhibiting some behaviour that agencies were worried about because of the new baby. The Counsel for Child, whose role it is to represent the interests of the child,  was concerned that conditions were right for the children at home and for the arrival of the new baby.

 

Several agencies were involved in the process, including the midwife, social workers from the health and welfare sectors, CCS disability and local disability support services, maternal mental health services, the school principal, the Child, Youth and Family home, Family Works a social services agency,  the mother’s lawyer and Counsel for Child, as well as a Child, Youth and Family social worker and a supervisor.

 

For Sarah, the road to having her children returned had been long and hard-fought. She felt she had worked hard and kept sight of her goal of having her children back, completing parenting courses, anger management courses, and courses to learn about her son’s autism and how to mange his behaviour. But history seemed to be getting in the way. Her relationship with Child, Youth and Family had become adversarial. This was compromising communication and getting in the way of going forward.

 

She wasn’t sure about Strengthening Families at first, as she had had bad experiences with formal meetings in the past. But when the local co-ordinator made the time to talk her through the Strengthening Families process, she saw this could work. “The co-ordinator took the apprehension out of the process and I could see that this might be a way for me to get them to understand and to get something done,” she says. “Strengthening Families cut through all the old stuff and got the focus on the facts. I understood the process. Everyone’s role was clearly explained and I felt well informed. If I didn’t understand something I could get it explained, and I was expected to have my say. People took the time to understand. There was no judging. I didn’t have to fight anymore.”

 

From the mother’s point of view, the Strengthening Families process was transparent. “At the meetings everyone said what they would do. It was written down and they did it. Everyone had the same information. The information was flowing in all directions and I was included. This took the tension out of the process. Being on the inside rather than the outside meant I could see that progress was being made and that reduced my frustration.”

 

Six months and eight Strengthening Families meetings on, and with a lovely new baby and her two older children living with her under a shared custody arrangement with Child, Youth and Family, Sarah ended the Strengthening Families process. She describes her current life as “flying solo with support”.

 

“My son has comes leaps and bounds with his new buddy/mentor and is very settled at home now. His sister started a new school last year and has gone up four reading levels in one term, and my baby is doing well. I know what my family and I need, and I know how to ask for help if I need it. For now, I am enjoying the simple pleasures of being a parent, like making lunches and helping with homework.”

 

Agencies involved

  • Child, Youth and Family (referrer)
  • Child, Youth and Family home
  • lawyers
  • mental health services
  • midwife
  • social workers from the health and welfare sectors
  • CCS Disability and local disability support services
  • school principal
  • Family Works (Presbyterian Support social services for families).

Main issues

This family had been apart for several years, and all parties shared an interest in the success of the children’s transition back to their mother. There were several considerations including child safety, child behavioural and educational needs and the mother’s wellbeing.

  • child safety
  • child behavioural and educational needs
  • maternal wellbeing and support.

Outcomes

Strengthening Families offered a forward-looking process, which kept all agencies on track, and well informed and reassured as agreed steps were worked through. This resulted in the children’s return home with support in place to smooth the transition. Two children are now living with their mother and new baby brother under a shared custody arrangement with Child, Youth and Family. The children are doing well at school.