The parent support service (Australian capital territory)
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Child Abuse and Neglect, Vol. 3, pp. 357 - 362. 6~ Pergamon Press Ltd., 1979. Printed in Great Britain. THE PARENT SUPPORT SERVICE (AUSTRALIAN CAPITAL TERRITORY) Elizabeth Smart Barbara Hicks 74 MacKenzie Street Mental Health Branch HACKETT. A.C.T. 2602 Capital Territory Health Commission AUSTRALIA A.C.T. AUSTRALIA INTRODUCTION "Speak roughly to your little boy And beat him when he sneezes, He only does it to annoy Because he knows it teases". The words of the Duchess in Lewis Caroll's "Alice in Wonderland" suggest a fairly massive projection of adult feelings onto a child in care, The hypothesis that was fundamental to the establishment of the Capital Territory Parent Support Service was that this phenomenon of projection regularly occurs when parents are under stress. It seems probable that, in Australia, holier-than-thou attitudes to those known to have abused a child, mask a generalised anxiety about personal parenting skills in today's complex society. The P.S.!?. was therefore designed primarily as a preventive measure, to provide supportive counselling for parents experiencing stress, and publicity for the service has aimed at creating a climate in which ANY parent can admit feelings of aggression, frustration and inadequacy. As the universality and normality of parents "back' feelings ebout themselves and their children is recognised and accepted it should become easier for those with deep-rooted problems to seek help before a crisis occurs. THE COMMUNITY BEING SERVED The sits for the capital of the newly created country of Australia was chosen in 1909, but Canberra only developed slowly until well after World War II. At that time the government became increasingly centralised and there was such en influx of public servants, academics, and employees of service industries that the population increased from 39,000 to over 200,000 in 20 years. Land in the Capital Territory is vested in the Commonwealth Government, so each suburb is carefully planned, In theory ne~ghbourhood groups are established. In practise there are problems comparable to those met in other rapidly developing suburban areas, but accentuated because the city is far from the centres of population where many residents still have their roots. Low density housing, and poor public transport mean reliance on the motor-car, and it is easy to feel isolated, especially if tied to the house with young children. 357 358 E. Smart and I). Hicks The residents of Canberra are younger and more affluent than the national average, and generally expect a high standard of living. Since 1977, however, the rate of unemployment has increased more rapidly than anywhere else in Australia. There is also a higti divorce rate, which can partiy be accounted for by the age structure of the population. Together, all this suggests that many families are probably under considerable stress. None the less the reported incidence of child abuse and neglect has been comparatively low up to date. BACKGROUND TO THE SERVICE "A City Without Soul" is a tern used by many non-residents to describe Canberra, but in reply to these critics it could be argued that it has a "heart" manifested by a wealth of individuals and groups concerned about community welfare. In 1975 the 1st Australian National Conference on "The Battered Child" was held in Perth (W.A.), and for a time Child Abuse was "news". Jan Carter addressed a meeting of workers in the ltielfarc Industry; housewives discussed the issues at 1ocal'Priendshi.p meetings"; the two statutory Health and Welfare Agencies struggled to come to grips with problems of inter-agency policy; and 16 different groups were found to be looking at ways to prevent child maltreatment. Eventually a voluntary service organiser and a senior social worker with the Statutory Mental Health Service took the initiative in bringing together those who were interested in co-ordinating their thinking, and rationalislng their planning. Many meetings later a Committee of Management was set up to establish the PARENT SUPPORT SERVICE, as an autonomous telephone counselling service far parents. staffed by trained volunteers working under the supervision of professional consultants. The aims of the service were:- To help clients to clarify their problems To provide information about community resources and to enable clients to use these effectively To provide clients with a reiiahlc and supportive listener whom they could trust in times of crisis. The decision to act was essentially made by individuals, supported in principle by the Mental Health Service and by a few community organisations. Three groups agreed to have official represent&ion on the Committee, and of these "LIFE LINE" - (an organisation similar to the Samaritans) - was the most significant. Life Line's willingness to provide the initial contact with clients, and their exoertise in the training of volunteers, made the P.S.S. a viable proposition. Immediately there was opposition from those who saw that problems would erise if the service infringed on the statutory duties already being carried out by government agencies. Time was taken to gain the co-operation of these antagonists, and in order to a+tain credibility and recognitinn, a detailed policy document was drawn up. This dncunent sets out the philosophy of the service, together with procedural guidelines for dealing with all situations that could conceivably involve legal liability. THE SERVICE As the P.S.S. was established without any financial backing it has no office facilities of its own. Tnose wanting to use the service have to ring the "Lifeline" number for their initial contact and within 24 hours the case is allocated to a volunteer who phones the client back (or makes a home visit if there is no phone). From then on the frequency of contact and the way in which the relationship develops, depend on the needs of the client. Parent Support Service 359 A client who described her counsellar as "somewhere between my mother and a social worker" was probably typical of those who have banefitted most from the service. In other words, the counsellor is someone who cares* but who is without the emotional involvement of a member of the family: someone who accepts feelings of anger, resentment and inadequacy without condemnation, but who also gives positive encouragement and reassurance; someone who has skills, but with whom there are not the barriers that some clients feel separate them from professional workers, It is made clear to the client that the service is confidential, but that each volunteer is responsible to a consultant. Permission to consult with other agencies or workers, is always obtained from the client, except when emergency action has to be taken on behalf of a child, and against the client's wishes. So far no such crisis has occurred, but if it does, responsibility for action will rest with the consultant and not with the volunteer. The disadvantage of using "Life Line" for clients' first contact is that, after ventilating their feelings, some subsequently deny that they have a problem. Under these circumstances it is hard for the P.S.S. volunteer to establish a relationship, and all that can be done is to leave the way open for the client to call back if another crisis occurs. THE VOLUNTEER COUNSEL~~RS AND CONSULTANTS The present group of 14 counsellors are all mothers. They differ widely in age and in cultural background, but they all possess the ability to listen to other people, and to care about their clients. They also share a readiness to risk having to make radical changes in their own attitudes. Men are not excluded, but so far none have volunteered. The selection of volunteers is crucial to the service. Not only are they expected to undertake rigorous training, to use the consultants regularly, and to accept considerable responsibilities, but their families must be ready for the service to intrude, at times, into the privacy of their home life. Personal interviews, before and after training, have proved effective in selecting out, by mutual agreement, those not ready to undertake the work. The three consultants ars professional social workers practising in local counselling agencies. Each is responsible for a group of volunteers and is available to them for consultation about their own or their client's problems. THE TRAINING All volunteers undertake a basic training course of at least 3 months. At first it was thought necessary to provide them with a fairly comprehensive knowledge of the medico-legal aspects of child maltreatment, so that they would be fully conversant with pitfalls that they should avoid. As it turned out the first group of trainees were well armed for problems they seldom met. After six months work with clients, it became increasingly clear that the role of the volunteer is to stand alongside the client as a supportive friend, avoiding as far as possible action that would link them in the client's mind with the statutory, legal, or medical authorities. The focus of the second training course was therefore radically altered. The didactic presentation of factual information was cut to an essential minimum, and trainees were taught to develop intra-personal awareness and inter-personal skills through such means as role plays and group discussion. In this way they were better prepared for the central core of the work that they were actually to undertake. Inservice training takes the form of regular monthly meetings, supplemented by more intensive learning experiences as they are found necessary. An example of this is a recent 6 week-course on child development, and age-related problems that parents can expect to encounter. 360 FINANCE AND PUBLICITY E. Smart: and B. Hicks The decision to risk starting the service without independant funds justified at the end of 1977, when the Parent Support Service won the Canberra Service Award for the year. This award is given annually and is sponsored by Canberra Building Society and by Radio ZCA. was C5mmunity a major With the $1000 cash and $1000 worth of radio publicity a public relations campaign was set in motion. Letters were sent to all medical practitioners in Canberra describing the service, and offering to co-operate with them by giving support to parents who seem anxious about their children's physical or emotional development. Liaison was established with other community health and welfare workers, and requests for speakers about the service were welcomed. Cards were produced far widespread letter-box distribution and for display at primary information centres. Radio and television stations arranged interviews with members of the service, and local newspapers printed news items and articles about the needs of parents and ways in which the P.S.S. could help. An effective form of publicity was the frequent repetition of 10 second RABID "blurbs" such as "If you are feeling uptight, or anxious about your child, phone OZ.2222 and ask for the Parent Support Service". Until the service becomes a bye-word in the community the work of the Public Relations Sub Committee will have to continue. Only than will parents automatically think about phoning the service rather than abusing their child. THE FIRST 12 MONTHS OF OPERATION During the period under review 55 women and 2 men consulted the service, and their families included I.25 children of school age or below. The number is not large, but with growing public awareness of what is available, the numbers are steadily increasing. The degree of actual abuse a client has mated out to a child is hard to assess on a telephone contact, but 49% of clients stated tha t they had reacted more violently than they had intended towards at least one of their children, and expressed fear of what they might do if they did not have help. 77% oF clients presented a child of 5 years or under as their main problem. More often than nota mother who had coped reasonably well with one young child, was finding the strain of having two children more than she could handle. As clients came to trust their counsellors it became increasingly clear that all were under stress for a multiplicity of reasons. Of the 44 clients living with their husbands 60% admitted that problems in their marriage were critical in their feelings towards their children. Many accused their partners of failing to give them the support they felt they needed in bringing up the children. Low self esteem was common amongst clients, and seven were conscious of reenacting their own childhood experiences af poor parenting. Loneliness, isolation, and ths feeling of being tied to the house and childreb were major factors in the problems of more than half the clients. In 1C cases counsellors worked closely with professionals in other agencies. These clients all had long histories of failure and inadequacy. In this situation the role cf the volunteer is that of a nurturing parent helping the client to use community resources more effectively, The Length of time spent with clients naturally varied considerably - from the 7 who rejected the service on the first contact, to the 20 who have been working with a counsellor for between 2 and 10 months. It was encouraging that 4 clients re-contacted their counsellor when a new crisis arose, after termination had been mutually agreed on some time before. "Thank you for caring" was perhaps, the highest tribute paid to a volunteer. Parent Support Service 361 The value of the service to the client did not appear to depend on the length of contact. Effective intervention at the time of crisis enabled some to mobilise their own strengths after 2 or 3 contacts, ard altogether the volunteers assessed that on termination 28 clients were coping satisfactorily either on their own or in conjunction with other community resources. 12 ceased contact with results unknown, and 10 were continuing with the service on 31.5.78. THE FUTURE The committee has applied for financial support from the Government, and so plans for expansion of the service depend to some extent on the outcome of this application. They include the provision of a "befriending" service to clients in their own homes, and the establishment of a centre Where parenting skills can be taught and where parents can come together to share their problems. The results of an independant evaluation of the service are not known as this paper goes to press, but they too will influence future decisions. DISCUSSION This paper describes the experiences of a group of people working with a small number of parents and children in a particular community. As the emphasis of the work being done was on prevention and not on research,no significant conclusions can be reached, but the observations of the team are comparable to those reported in the literature on Child Abuse and Neglect. Guthrie (1) makes the supposition that a child entering the Health System from the suburbs is diagnosed as "Failure to Thrive" whereas the diagnosis would be "Question of Neglect" if the same child came from an urban area. Kempe (2) believes that "the poor are far more likely to be reported, accused, and convicted". Thus it may be presumed that there are "at risk" families in affluent suburban Canberra, despite the low incidence of reported abuse and neglect. The admission of 49% of clients that they feared for their children's safety suggests that the service is in fact reaching some of these families. Smith (3) claims that it is unrealistic to expect battering parents to take the initiative, and to use a 24 hour telephone counselling service. This seems a valid criticism of some such services, but it ignores the on-going nature of the relationship of trust between the volunteer and client, which, if built up steadily, should make it easier for the parent to seek help in a crisis. As Lipner (4) points out "The consistent and supportive involvement of a good friend is often the key to a change in the parent-child relationship", and this is how most clients see their volunteer counsellor. The high incidence of marital disharmony disclosed by clients as being a factor in their "bad" feelings about their children, bears out not only the observations of Walker (5), who has found that couples project their hostile feelings about each other onto their children, but also that of Smith (6) whose research showed that "abusing mothers had problems with their partners . . . more frequently than did the controls". These problems involved a lack of support in child-rearing, which has also been a consistent complaint amongst the Canberra mothers. Avery (7), discusses the way in which clients must "have their own needs met, so that they are able to respond more appropriately to their children". This describes almost exactly the observation of the volunteers, and applies particularly to the clients for whom they acted as 'nurturing parent', While complementing the work of the professionals involved with a family. 362 E. Smart and B. Hicks Smith (8) records that loneliness and social isolation were reported by both control and abusing mothers, but that the former were better able to compensate. This is relevant to the Canberra setting where so many of the clients feel isolated and it suggests that those who use the service briefly (mainly as an information-giving resource) are acting constructively and are less likely to be "at risk". The insistence on adequate training and support services for the volunteers themselves is confirmed by Lipner (9) who says "all who offer to help families in crisis need supervision and a forum to air feelings connected with this work". Using one of Kempe's (10) criteria for assessing achievement in intervention, the Parent Support Service claims to be a success in that it has been instrumental in ensuring that a few "parents who were joyless, now seem to have some fun". 1. 2. 3. 4. 5. 6. 7. 0. 9. REFERENCES Guthrie A.D. "Child Abuse on Main Street" In Belling N. and Hill D. (1975) (Eds.) "Child Abuse Intervention and Treatment" p.24 Publishing Sciences Group Acton Mass Kempe C.H. "Paediatric Implications of the Battered Baby Syndrome" Archives of Disease in Childhood 1971.46.28 Smith S.M. (1975) "The Battered Child Syndrome" Butterworth's London ~210 Lipner J.D. "The Use of Community Resources in Work with Abusive Families" in Belling N. and Hill D. (Eds.) op. cit. p131 Walker A. "Social Assessment" in Carter J. (Ed.) 1974 "The Maltreated Child" Priory Press London p70 Smith S.M. Op Cit ~213 Avery N.C. "Viewing Child Abuse and Neglect as Symptoms of Family Dysfunctioning" in Belling N. and Hill D. (Eds.) Op. cit. P89 Smith S.M. Op. cit. p2OY Lipner J.D. Op. cit. p132 10. Kemp C.H. (1975) "The Battered Child" Proceedings of the 1st Australian National Conference an the Battered Child. Department of Comm. Welfare. W.A. 1975
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