New 3 Flashcards
(273 cards)
1
Q
If I’m a social worker entering a house for the first time and see that the child isn’t adequately cared for what steps should I take to determine if it is caused by neglect or poverty?
A
<div><br></br></div>
<div> If there are immediate safety concerns
## Footnote
take necessary actions to address them
such as removing the child from the home or arranging for emergency services.</div>
<div><br></br></div>
<div>2. **Gather Information:** Engage in open-ended conversations with the caregiver(s) to gather information about the family's circumstances
including their financial situation
access to resources
and any challenges they may be facing. Ask about the child's daily routines
including meals
hygiene
healthcare
and supervision.</div>
<div><br></br></div>
<div>3. **Observe the Home Environment:** Conduct a thorough observation of the home environment
noting factors such as cleanliness
living conditions
availability of food and basic necessities
and overall safety hazards. Take photographs or detailed notes as needed.</div>
<div><br></br></div>
<div>4. **Assess the Child's Needs:** Evaluate the child's physical and emotional well-being
including signs of malnutrition
neglect of hygiene
unmet medical needs
and emotional distress. Consider factors such as the child's developmental stage and any special needs they may have.</div>
<div><br></br></div>
<div>5. **Explore Caregiver Capacity:** Assess the caregiver(s)' ability and willingness to meet the child's needs
considering factors such as mental health
substance abuse
cognitive impairments
or other challenges that may impact their caregiving abilities.</div>
<div><br></br></div>
<div>6. **Consider Cultural and Community Context:** Take into account the family's cultural background
beliefs
and community support systems when assessing the situation. What may appear as neglectful in one cultural context may be considered acceptable in another.</div>
<div><br></br></div>
<div>7. **Consult with Colleagues and Experts:** Consult with colleagues
supervisors
and relevant experts
such as medical professionals or child development specialists
to gather additional insights and perspectives on the situation.</div>
<div><br></br></div>
<div>9. **Develop a Plan of Action:** Based on your assessment findings
develop a comprehensive plan of action to address the child's needs and mitigate any risks identified. This plan may involve connecting the family with supportive services
providing referrals to community resources
or initiating child protection interventions if necessary.</div>
<div><br></br></div>
<div>10. **Monitor Progress:** Continuously monitor the family's progress and reassess the situation over time to ensure that interventions are effective and the child's needs are being met.</div>
2
Q
A
3
Q
<div>“This is one of the reasons why a lot of people go straight for adoption
</div>
A
that they don’t bother with foster care. It’s because of the investment—you see your investment go down the drain in months.”</div>
4
Q
</div></div>”
A
5
Q
Cruz-Katz first weeks as a caseworker? “<div><div>
A
6
Q
<div>“I was thrown into it. There was no training
</div>
A
just a woman who drove around with me the first two weeks. Every day I’d just learn from the day before
” Cruz-Katz explained
long after he’d quit and moved on to graduate school. Current caseworkers I spoke with were reluctant to give their names or speak on the record (ACS has a tightly managed media relations department and requires that all interviews be funneled and approved through its office)
but their stories were similar to Cruz-Katz’s. “I spent a lot of time driving and I spent a lot of time worrying about my safety. I was alone with the families that had histories of violence and drug abuse and I’d have to take their kids away. I’d be threatened
followed to my car. An uncle would stand next to me and say
‘I know what you did. I know your car.’”</div>
7
Q
</div></div>”
A
8
Q
How old are those who are often deciding whether or not to remove? “<div><div>
A
9
Q
<div>She said she found it deeply troubling that the people on the decision-making front lines
</div>
A
the people who choose to physically remove kids from their parents and their homes
are often just barely out of childhood themselves. These recent college graduates are often the only people who will accept the low pay and difficult demands of a caseworker job. They can make snap decisions
based on the black-and-white sense of justice that comes with the righteousness of youth rather than with the nuance and compassion that can come with age and experience. The commissioner herself was once one of these caseworkers.</div>
10
Q
</div></div>”
A
11
Q
biological families regardless of removal and termination? “<div><div>
A
12
Q
<div> the biological families stayed connected whether she terminated rights or not. They found each other on Facebook; they reunited after high school graduations; and so on.</div>
A
13
Q
</div></div>”
A
14
Q
Attachment theory (simple) “<div><div>
A
15
Q
<div>Attachment theory
</div>
A
in simple terms
goes like this: Ideally
in infancy
a child connects deeply with an adult who can intuit and then meet his needs and soothe his emotions. This is called a “secure attachment.” As he grows
this child internalizes this adult who has taught him to manage his urges to scream or kick or rage
and he can begin to contain difficult internal states
rather than act them out. If attachment is ruptured
or never there to begin with
a child doesn’t trust that there’s anyone constant to soothe him
and there’s no internalized
subconscious mom or dad to maintain impulse control. That’s why
my partner says
nearly every kid in foster care is diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) or even Oppositional Defiance Disorder (ODD)—they don’t have impulse control
because they never had proper attachment. Unfortunately
the system tends to tackle the symptoms rather than the cause
by medicating the children for their hyperactivity or aggression
without addressing the underlying loss
which can take years to repair.</div>
16
Q
</div></div>”
A
17
Q
<div><div>
<p>Child welfare, in general, has been soaking up attachment theory since it was first developed by John Bowlby and Mary Ainsworth in the fifties and sixties;</p>
</div></div>
” “<div><div>
<div>it’s why states shifted from keeping babies in orphanages to moving them into individual homes. It’s the primary theory in the scientific papers on foster care’s child-parent dynamics, and it’s the reason experts leverage when they argue for fewer removals and fewer placements once in care. A child’s bond with her parent, especially in her first few years, is almost unspeakably critical.</div>
</div></div>
A
18
Q
<div>Impact of multiple foster agencies and kids returned to bio parents?</div>
” “<div><div>
<div>One of the things Allyson worried about, she said, was that if Tom got custody of Allen, he’d have another relapse. Not because Tom would hurt his son—she knew he was gentle and loving—but because if Tom relapsed again, Allen would be removed and the chances of Allen landing with the Greens’ agency and thus back with the Greens would be slim at best. “Tom could have Allen for a while and then get Allen put back into the foster care system,” Allyson fretted out loud. “He’d be put with a different agency and then just get lost.”</div>
</div></div>
A
19
Q
<div><div>
<div>She reflected that, as Gabriel’s mother, “I have a</div>
</div></div>
” “<div><div>
<div>motivation and I have somebody who loves me. I have somebody who depends on me.” The investigator’s visit threatened to upend that. This stranger had the power to whisk Gabriel away in an instant, separating the toddler from his home and family.</div>
</div></div>
A
20
Q
Impact of social worker working for CPS “<div><div>
A
21
Q
<div>“This”—she drew circles in the air with her pointer finger—“is not gonna make it any better. Imma let you know right now. It’s not.” She began to cry.</div>
A
22
Q
</div></div>”
A
23
Q
How do people feela bout CPS “<div><div>
A
24
Q
<div>“Nobody likes CPS
</div>
A
” she told me two days after that first meeting. “When somebody says that word
nobody says
‘Oh
yay
CPS.’ No. Your stomach is dropping.”1 She compared the investigation to walking on a tightrope—a high-wire act with ruinous consequences for the tiniest misstep.</div>
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CPS impact on mothers not drawn into system "
27
With CPS saturating poor neighborhoods
experiences of precarious motherhood extend even to mothers who haven’t (yet) been drawn in. Through seemingly routine
## Footnote
low-level encounters
through often well-meaning people trying to help
governments perpetuate marginality and reinforce existing inequalities.
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child maltreatment and social construct "
30
Like crime
child maltreatment is socially constructed
## Footnote
which means that there is no discrete thing constituting “child maltreatment.” Instead
societies decide what behaviors to classify as maltreatment
making moral judgments about what (and whom) they deem appropriate or inappropriate
right or wrong.
31
32
Categorizing brutal beatings and sexual abuse as child maltreatment seems relatively clear-cut. But beyond these extreme cases, it’s less straightforward. The state declines to
intervene in many things parents do every day that could conceivably endanger children. For instance, parents who allow their children to ride bicycles without helmets are arguably placing children at risk of harm, yet suggesting that CPS pursue such parents would
33
And although we can agree that parents shouldn’t intentionally starve their children, who gets to decide whether parents’ actions are
ntentional, and on what basis? Moreover, the same behavior may be perceived differently depending on context: Can you make the case that letting elementary-age children play outside unsupervised threatens their safety? How about if they live on a busy street or in a neighborhood with high levels of violence? Or if they have special needs?
34
As we see, drawing the child maltreatment line is far from a neutral,
value-free determination. All kinds of behaviors can be cast—or not—as abuse or neglect, and what’s considered standard or appropriate parenting has varied considerably over time and across societies. With the flexibility of the child maltreatment category, CPS intervention is a political tool that can expand (or contract) to bring more (or fewer, or different) families under its purview.
35
The vast majority of CPS reports allege neglect rather than abuse, alleging parents’ failure to
provide adequate supervision, medical care, shelter, food, or clothing—“failures” often rooted in poverty and structural racism.
36
n the last few years, there have been about seventy thousand cases of parental termination annually
but only fifty thousand adoptions.
37
Lowry says child welfare’s spotty report card has to do with a simple lack of incentive. People at all levels of the system, she claims, will do as little work as they can do because
there’s no reason to do better. Because there’s no real cultural value placed on the lives of foster children or their families, the people hired to work for their benefit don’t strive to provide much value.
38
I told Arelis about Dr. Rittner, the director of the social work school who was so reluctant to terminate parental rights. At the conference, Rittner said she terminated only two times in all her years of work (later she remembered a few more), but I recounted Rittner’s public speech, and Arelis
exploded. “For you to oversee a thousand cases and terminate only two, you’re doing something wrong!” She slammed her hands on the table and gazed up at the ceiling in exasperation.
39
acial prejudice in drug testing is only one reason that there are proportionally more kids of color than white kids in foster care. Nationally, African American children represent
47 percent of the children in foster care placement, but they constitute only 19 percent of the total child population. White kids have an inverse situation: they constitute 61 percent of the children in this country but only 38 percent of the foster care kids.
40
Although the brief addressed the potential of racism in foster care, the authors mainly attributed the disproportionality in maltreatment to the disproportionality in poverty among blacks and whites. It’s time, they said,
to stop trying to reduce the numbers of African Americans in care because we presume there’s a bias and instead focus on the reasons the numbers are so much higher and direct help toward the families that need it. If poverty and its attendant burdens—depression, anxiety, drug use, heightened community violence, paucity of support systems, and so on—can sow the seeds for child abuse, then child welfare needs to go back to prevention. But this is a tall order for one sprawling and splintered administration, which has always been reactionary: it treats symptoms, not disease. The solution, as it has always been, is bigger than foster care, bigger than abuse; the real solution will be rooted in society as a whole.
41
Can mothers on drugs be adequate parents? "
42
We already learned this with all the research on cocaine—that addiction is a mental health disorder. There’s plenty of evidence that it’s treatable. There’s also plenty of evidence that mothers who use can be adequate parents. Of course
some are not adequate parents
## Footnote
but then there are also mothers who don’t use who are not adequate parents either.”
43
44
Accuracy of newborn drug tests? "
45
One final troubling statistic is that the newborn drug tests are wrong on average more than 25 percent of the time. A study by the U.S. Substance Abuse and Mental Health Services Administration and the American Association for Clinical Chemistry found that initial urine screenings can produce false positives. Even tests on a baby’s first stool (long considered the gold standard in drug testing) can be wrong up to 70 percent of the time.
46
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“But if I’d had support groups and parenting groups or people to come into my home and help me and not be afraid they were going to take my kids if I said something—” Robbyne choked up and looked down at her hands. “If there was more support,
I could have done it with the children at home. But the way things were back then, there was no option but removal.”
48
Two prongs of adopting through foster care "
49
The trouble with two prongs is this: they twist up together. Although thousands of children are available for adoption
and hundreds of agencies do concurrent foster and adoption planning
## Footnote
the biological parents themselves—their abilities
desires
promises
and fallibilities—change all the time. Yes
there are the moms who walk away from the delivery room and never look back
but there are also the Robbyne Wileys
who had their babies removed against their will
and who fight every day to get them home. And then there are the moms like Oliver’s mom
Caitlin
who change their minds. Agencies can’t predict the birth parents’ actions
and they don’t want to promise something they can’t deliver.
50
51
Trauma forecloses
grief,” Francine Cournos said to the audience, mostly composed of social work students. She told us that she was devastated by her mother’s death but not traumatized. The trauma came from her placement in foster care. “Trauma shuts you down, so you can’t grieve. Nobody thinks of children in foster care as bereaved, but they are.”
52
One woman in sweats and gold jewelry said the social workers were
never available when she called, and if she ever did get through, they talked to her “like you’re lower than they are.” Others nodded in agreement.
53
She said her attitude comes from her anger, of which she has a lot. “Every time I trust someone or love them,
they leave. So I can’t trust,” she whispered. “That’s why I’m angry.”
54
We’ve all pushed and poked and tested at some time to say,
“Will you love me anyway?”
55
Foster kids usually believe they caused their biological family to
tumble from orbit, so of course they could dislodge a foster family too. Foster kids have found the weak spot in a universal law about parents and children; they’ll keep pushing for that weak spot again and again until someone stands up and says, “I will love you anyway. Stay.”
56
You’ve got kids who need families, kids who need criminal rehabilitation, and kids who need psychological treatment, all living together in
upstate farmland, rubbing off on one another.
57
Because I could no longer visit Holy Cross, I took a trip to Graham Windham. I tried to imagine being a thirteen-year-old kid like Jonathan, arriving for the first time—
with no family or adult allies on the outside (his social worker, after all, had been the one who drove him to Holy Cross).
58
Kecia explained that the first of her theories was the most basic and obvious: group homes led to jail because
of the connections that you made in care. The kids you met could lure you into trouble, and the adults were strangers you couldn’t trust. One thing led to another. “It’s much easier to deviate in a group home,” Kecia said, blandly. “You’re not held to anybody’s standard. I mean, there’s not enough love in a group home to keep a kid loyal to any particular person.” Even with adolescent rebellion, depression, experimentation, and all the rest, a teenager in a family can be bound enough to another’s affirmative view of herself to pull through the tough years. Sometimes friends provide the positive mirror. But in a group home, that all goes awry. A teenager makes herself anew, in anyone’s image.
59
“There’s a lot of movement, they pull you out of school all the time, and you never feel stable. It’s easy to jump into anything because group homes promote that kind of lifestyle,” Kecia said. “You’re always free to do mischief. You don’t owe anyone
anymore—that’s really the connection to the criminal justice system.”
60
Percent of inmates who were in foster care Approximately 13-19% of the prison population in the United States consists of individuals who were formerly in foster care. This statistic highlights a significant correlation between experiences in the foster care system and later incarceration [oai_citation:1
Women's Mass Incarceration: The Whole Pie 2024 | Prison Policy Initiative](https://www.prisonpolicy.org/reports/pie2024women.html) [oai_citation:2
## Footnote
Did You Know That 13 Percent Of The Prison Population Grew Up In Foster Care? - The Ring of Fire Network](https://trofire.com/2016/04/29/know-13-percent-prison-population-grew-foster-care/). Furthermore
nearly 25% of youth in foster care will have an encounter with the criminal justice system within two years of leaving foster care
underscoring the challenges faced by these individuals as they transition out of the system [oai_citation:3
The foster care-to-prison pipeline: A road to incarceration ](https://www.crimlawpractitioner.org/post/the-foster-care-to-prison-pipeline-a-road-to-incarceration). This data emphasizes the need for systemic improvements and support for children in foster care to help mitigate the foster care-to-prison pipeline.
61
If she lands in a “good” jail—like Bedford Hills or Taconic in New York—
she may get to live with a newborn in the nursery programs and learn critical mothering skills. Prisons like these partner with programs such as the Children of Incarcerated Parents, which provide transportation for older kids to and from the facilities. But if the parent lands in a worse jail, or gets assigned a caseworker who won’t return calls, she’s stuck watching the clock tick by on ASFA’s deadline.
62
You have to start where the client is. I mean just sit back and
be a good listener—give them an opportunity to express themselves,”
63
A few years after this meeting, I spoke with a therapist who had been volunteering with the Fostering Connection for three and a half years; she had been seeing the same teenager the entire time, and he’d shown tremendous progress. TFC’s model worked, this therapist told me, though she had learned
to be flexible: she found her client was more comfortable meeting her in a diner than at her office, so they talked, every week, over turkey burgers and omelets. This long-term, individualized therapy also worked, she said, because her client really wanted to be there. With the luxury of free weekly appointments over several years, they had time to build trust; at the beginning, they played cards and talked about snacks.
64
Can a child whose whole life has been commandeered by a string of faceless lawyers and judges and social workers, a child who has been driven to strangers’ homes in strangers’ vans for unseen motives,
have any faith in self-advocacy? At seventeen years old?
65
"
" their only power lies in saying no.
She told her if she had to relocate, she would run away. This is the kind of self-advocacy she knew: like many foster kids who have little experience getting, or even imagining, what they really want,
66
"
" kids emotional attachments.
Dr. Francine Cournos has written and spoken extensively about child welfare since she was a foster child herself in the late fifties, and she says that still, workers focus too much on rules and protocol rather than on
67
I told her about Dominique, and she sighed; she’d heard it all before. Foster parents, like Dominique’s “Grandmother” or even Bruce and Allyson Green, are often viewed as “interchangeable parts,” she said. She volleyed with a story of her own, about a foster mom whose child was sent back to his biological parents. When the parents were deemed unfit a number of months later, the foster mom wanted him back.
Unfortunately, the agency said no: she had since fostered another child, and there wasn’t enough bed space. “It’s such a remarkable thing that people think about furniture and square feet instead of attachment—when there are children all over New York City who live in crowded places,” Francine said. “If the system was following the child’s attachments, the child’s continuity . . .” She trailed off. “The day somebody asks a foster child, ‘Where were you living before your biological mother’s? How long were you there? How did that work out?’—that will be a very good day.”
68
So now, he says, with Florida’s increased spending flexibility, investigators can allot more time to the
nuances of each individual family. “If it’s a substance abuse case, talk to a substance abuse expert; if it’s a poverty case, there are a lot of poverty people you can bring to the table,” Abramowitz said. “Before you make the decision to remove, there are a lot of experts you can involve, a lot of services you can look at.”
69
The trouble with buzzwords like community, and the privatization it connotes, is that every community is different. The state may be a bureaucracy, but it’s big and public and, in theory, it treats everyone the same.
Private agencies (even if they’re nonprofits, governed by outside boards as they are in Florida) can raise their own money and thereby range widely in terms of quality or breadth. And dropping the fee-for-service model can also mean dropping accountability or tracking measures for each individual child. Critics of privatization in child welfare—and there are many—argue that although there may be a kind of perverse incentive to retain kids in foster care to retain the day rates they incur, when you change to a flat rate there is the disincentive to provide higher-quality, expensive services. In other words, when you’re handed a flat sum (rather than a budget that changes every month based on changing client numbers), you’ll tend to run the least expensive programs. You’ll also target the broadest common denominator, and kids with specialized needs will fall off the map.
70
“They always come back.” Foster children are sometimes called “orphans
of the living,” and it’s a particularly apt designation: they’ve been abandoned in some fundamental way, and yet the biological bond is very much alive. Even if their parents’ rights were terminated long ago. Even if they want, desperately, to be adopted by somebody else.
71
I suspected there was more to it. Adoption may be the explicit goal for foster kids with parents who have lost their rights, but it can also be a trigger. This is it,
adoption says. You can never go home again. A pending adoption pushed Dominique right to the edge and out of the house. And Fatimah’s adoption may have made Chanel jealous and sent Tonya scurrying back to her mom and childhood neighborhood, just to make sure she still mattered somewhere else.
72
Mike Arsham, the executive director of the Child Welfare Organizing Project in New York, told me that as foster kids gain their independence and thus run out of options, they often return to their birth parents. “ACS and the court seem
oblivious to these persistent relationships because the case record says something different. Yet it is not uncommon at CWOP to see women raising the children of children to whom they lost their rights years prior,” Arsham said. “The system lives in denial of this reality.”
73
The agencies and the foster parents (myself included) don’t know how to manage what every single foster child seems to need—
that need to go back. Because, whether physically or psychologically, they will go back to their parents and what hurt them, if only “just to look,” as Dominique says. We need to get better at this part of the foster care trajectory because that journey back is land-mined for self-destruction.
74
Most foster kids I know do not use the term independent living. They call it getting
“discharged”—as though foster care were military service. And every year, the thousand or so youths “discharged” to the streets of New York City, even according to ACS, “must rely primarily on themselves.” They have nobody else to turn to.
75
The problem is, the kids usually don’t have enough money saved to sustain the apartments once the gig is over; many haven’t graduated from high school,
their job prospects are grim, and they have no families to fall back upon.
76
One researcher conducted interviews with child services experts in Massachusetts and found that they commonly described not being able to serve transition-age youth because
that wasn’t the mission of their agency. Foster care was designed to serve children, they said, and its purpose was to protect them—not prepare them for adulthood.
77
“A crowd gathered and was shouting, ‘Kill her! Kill her!’” Mary remembered. “I called the police to break it up because I didn’t know if they were really going to hurt each other.” Both girls went to their rooms, and Mary called their agency, as parents are required to report any serious trouble. “The agency just said, ‘Who should we pick up?’
Amy and Anni thought the same thing. They were upstairs, packing up their things, ready to go.” But Mary wasn’t running a standard group home; she was creating a family. Both girls were shocked when she told them to unpack their bags and stay. And then she signed up everyone, herself included, for weekly family therapy. A fight that big never broke out again.
78
Said Mary, “We say an eighteen-year-old should be doing such-and-such, but you can’t have milestone expectations like that.
They can’t all go at the same pace, and they’re stuck in different places. They might be twenty, but emotionally fourteen.”
kids are often emotionally stranded in a life stage when they were first traumatized.
79
Pat, along with several credible studies, estimates that about 50 percent of the current homeless population were
once in foster care. This is why Pat describes YGB, above all else, as homeless prevention.
80
Her story spoke to the notion that a state can’t raise a child, because
the state deposits that child squarely into isolation at adulthood. And while that brand-new adult may well make it on her own for a stretch, at some point she’ll need backup.
81
Glenn and Mindy exchanged glances; this was happening awfully fast. In the parent training, they tell you to expect a certain process: first you’ll meet a child in a neutral setting, then maybe the child will come to visit you at your home. This could lead to an overnight, and then to a weekend visit, and then maybe a longer weekend, and if all goes well, you decide to permanently welcome her into your family. On paper, this gives parents time to adjust (and squeeze in a final cruise) and helps the child smoothly transition from one placement to another.
In reality, there often isn’t such wiggle room. Kids need to leave unsafe or, as with Oneida, expensive placements when the state says it’s time.
82
When Tonya stood before a criminal court judge in Pennsylvania, she wasn’t the Tonya with a thick child welfare file, longtime foster daughter of Bruce and Allyson Green, former star student, and first-time offender.
She was a more anonymous adult black female, caught on a ShopRite videotape stealing powdery white toiletries with which a drug dealer could cut cocaine.
83
That’s the way the agencies are. When they need you to do something, they need it done tomorrow. When you need something for the kid,
you get nothing,” Glenn said, shaking his head. What Glenn and Mindy needed, for the therapeutically classified teenager, was therapy.
84
Glenn told her to wait; he was at an important part of the game. Or she could simply get her clothes and go. Oneida was horrified, and furious. “I said, ‘You want to watch me get my bra and panties? Have some type of respect—I’m a female,
I sleep here!’ I called him a pervert.” Oneida knew from past experience that she had to be extra-vigilant to protect herself. She told me she’d been raped twice, in her teens, by two different men, and she was molested repeatedly as a young child.
85
I say this because ACS rarely investigates the upper class.
They know those people have lawyers.”
86
To CPS, investigations are opportunities
to provide guidance, information, and social service referrals so that family challenges do not escalate. With these aspirations, CPS weaves itself into the U.S. social safety net. Indeed, the investigator saw himself as assisting, rather than punishing, Jazmine. In line with his training, he hoped to identify and build on her family’s strengths. He wanted to do what he could to help her manage her stress and improve conditions for little Gabriel. Even before Jazmine met him, though, she knew she didn’t want him in her life. As she understood, CPS social workers are not just friendly visitors, serving at the pleasure of parents. Families rarely initiate CPS contact voluntarily, and CPS’s involvement ends when the agency says it does. The agency can forcibly remove children at any time and petition the court to keep them and place them wherever it likes. Thus, no matter how helpful individual CPS staff may want to be, their assistance occurs under the perpetual threat of family separation.
87
CPS has no answer to societal neglect, as when children go hungry because wages and food assistance benefits are insufficient to cover family meals. But CPS can tell parents what to do differently and send them to therapeutic programs focused on things like parenting and substance use. Fixing what’s wrong with
parents falls squarely within CPS’s domain; meanwhile, the agency can do little to fix what’s wrong with the conditions under which parents are raising children.
88
What they’ve experienced as children, heard from family and friends, and seen on the news or social media breeds cynicism about the system, teaching mothers that the agency harms families as much as it might help them. So, like Christina, they do their best to ward off CPS, carefully managing interactions with
children, social network ties, and service providers even if not (yet) drawn into the system. These rational responses may protect their families from unwanted state intrusion—no home visitor reported Christina to CPS. But nor did baby Anthony benefit from the assistance a home visiting service might have provided.
[how widespread is this behavior]
89
LLow-income mothers like Jazmine told me how profoundly motherhood had changed them. The mothering role meant
everything, providing a sense of identity and pride. Their children were the center of their worlds; they aspired to provide a better life for their kids.
90
I asked mothers what proportion of families they knew, or families in the area, they thought had had CPS involvement.
. Of the sixty Rhode Island mothers offering an estimate, thirty said at least half, with many guessing well over that.12 “Everybody, 90 percent of people, they have CPS in their life or they got CPS in the house,” remarked Selena, a Dominican mother. Not all mothers perceived such high levels of CPS involvement, but even new mothers, with no prior CPS experience, were acutely aware of the agency. “Everybody knows about it—it’s common,” said Odalys, a Latina mother whose firstborn was just three months old.
91
, “I know people who does things right and, like I said, it’s that one little thing you could do in front of
the wrong person who’s judgmental.”
92
When you call CPS, they’re not coming to say,
“Oh, sorry. You got no money? Okay, we’ll get you that money for you to do this.” No. When you contact CPS, first, they are in your house now. They coming to see what you’re doing to the kid. They’re coming to see what is the problem.… CPS looking for the fault from you. What is it that you’re doing to this child, that they cannot stay in the house? What is it you’re doing to this child that they’re going through this? (emphasis added)
93
Even for mothers never reported to CPS, the possibility of reports creates trade-offs that foster a sense of constraint and make it risky to disclose difficulties to people who might help. Most mothers I interviewed about this issue (sixty-seven of eighty-three Rhode Island mothers), across racial and ethnic groups, with and without CPS experience, described
proactive strategies they pursued to protect themselves from CPS reports.20 This strategizing parallels marginalized groups’ efforts to avoid other enforcement authorities, such as police and immigration enforcement.21 Ultimately, mothers’ risk-averse approach—a rational response to CPS vulnerability—perpetuates marginality by reinforcing a sense of constraint and distancing families from assistance.
94
People generally act in ways that make sense. If you don't understand why someone does something (ex. a parent)
there's a good reason your missing a part of their story.
95
Beyond interactions with children or with social networks, encounters with professionals are especially perilous for mothers trying to keep
PS at a distance. Although anyone can call CPS—from strangers to close friends and relatives—most reports come from educational, health care, and other professionals legally required to report suspected child maltreatment. To navigate these interactions, mothers described declining voluntary services, concealing adverse experiences, or, alternatively, making themselves visible to systems.
96
Two years later, after CPS removed that child, Susan acknowledged that she was selling pills and selling her methadone while caring for her son. “I was still probably in active addiction,” she added. “I tried to make it seem
like I wasn’t, I guess … so nobody would take my son. I felt like … if I asked for help, I would be judged by it, and they would take him, so I kept it to myself.” For Susan and others, fears of CPS intervention impeded help-seeking. Mothers told me about declining voluntary services and staying away from psychiatric hospitals. Such decisions distance families from assistance, but mothers had to weigh the perceived benefits of support against the possibility of CPS reports.
97
Mothers’ strategizing may protect against state scrutiny, but their disengagement also hinders
he development of trusting relationships with service providers and cuts families off from critical sources of support. For instance, with waiting lists for housing assistance years long, going through the homeless shelter system could be the only way to secure subsidized housing promptly in Providence. Yet, in explaining why they chose not to enter homeless shelters during times of need, several mothers spontaneously pointed to shelters’ practices of calling CPS. Brittni and Pete, the couple who stayed in their car, first mentioned CPS to me in passing, when they recounted their experience trying to obtain cash assistance and food stamps. As they shared, the local welfare office asked for proof of residency, but they had come to Rhode Island from out of state and didn’t want to reveal their living situation. “I didn’t tell [welfare] we were living in the car, because if they find out, they have to tell CPS, and CPS will come and take the kids away,” Brittni explained.
[at what point does hiding abuse become abusive? But is it there fault if the only alternative might lead to a CPS call? But even in a shelter how bad would it be for the child? I guess it depends on how long the parents are expected to be there and what caused them to end up there in the first place]
98
Ideally, Brittni and Pete suggested, welfare would respond by offering housing assistance. But realistically, the couple felt certain that disclosing their situation would lead to CPS involvement, so they received no cash assistance or food stamps for six months. As we see,
CPS fears generate strategic responses from parents trying to care for their children, but such responses can also impede this care.
99
Like several other mothers I met, Bethany contemplated going to another state to give
birth, a possibility inhibiting consistency in health care services and making mothers in recovery feel like fugitives on the run.
100
For instance, Jennifer could not accommodate the recommended service given her
work schedule; she was frustrated to receive no transportation assistance. “Where are you helping me?” she asked rhetorically. “Because I am a working mother. I am a single working mother.” Viewed another way, Jennifer’s supposed noncompliance reflected social service systems’ failure to meet her family’s needs.
101
Like Marla, reporting professionals, almost to a person, said that they would have reported their most recent report absent
the legal mandate, often expressing no hesitation as they said they “absolutely” or “definitely” would have reported. “I don’t think of it, ‘Oh, my God. I’m a mandated reporter. I have to do it.’ I don’t think like that. I think: This mom needs help. This baby needs to stay safe,” a maternity ward nurse said. As a school social worker put it, “I need to be able to sleep at night.” [are there studies on this?]
102
Nearly all reporting professionals I interviewed cited goals of
support in notifying CPS. Recognizing challenges families were facing, they felt that CPS would know better how to help.
103
azmine had not taken up the mental health and other referrals Cate had made, so Cate hoped that CPS’s involvement might
nudge Jazmine to get the support Cate believed she needed. “I hope this is a push in the right direction. Sometimes, a lot of times, our clients need a little fire underneath their feet to actually start doing things,” Cate said. “A lot of people are afraid of CPS, so a lot of times they’re like, ‘I don’t wanna piss off CPS, because it won’t be pretty.’ ” Likewise, a middle school principal acknowledged that she could recommend social services to parents. But she added, “I can’t tell a parent they have to do that.… I think [with CPS] parents kind of realize, ‘Oh, I need to do this.’ It’s kind of that thumb that CPS has over parents.” Reporting professionals saw CPS’s authority over families as an effective tool in disciplining families. So reporting professionals’ purportedly benevolent aims also reflect their conviction that they know what families need and that an enforcement agency can pressure families to behave in ways deemed appropriate.
104
All my work is office-based. I don’t get to see what’s happening. I only know what they’re reporting, and often, that’s not
the whole story. I used to do a lot of in-home work, so I know that being in the home, you see a lot of different things, and you can really assess the situation more fully. That’s where I think CPS has some leverage, is being able to go to the home and see, okay, here’s the difficult relationship between the parents.
105
CPS’s broad reach also stems from social and policy structures that encourage widespread reporting. Systems are organized around eliminating
“false negatives” (unreported maltreatment) rather than “false positives” (reported non-maltreatment). Reporting professionals, attuned to the potential dangers of not reporting, framed calling CPS as the safe and harmless option. [how true is this?]
106
Mandated reporters are immune from prosecution for reports they make in
good faith—they face no professional or legal consequences for erroneous reports—but can be prosecuted for failing to report.19 Connecticut’s mandated reporter training makes this clear, also highlighting statutes that outlaw interference with reports and retaliation against employees who report.
107
Mandated reporters are rarely arrested for
failing to report, but when this happens, typically following an egregious case, it can draw substantial public attention.
108
Notably, families’ vastly divergent exposure to CPS begins well before cases arrive in court; the bulk of inequality emerges at the
point of reporting. In federal fiscal year 2014, Black children experienced CPS reports at a rate nearly twice that of White children. That year, Black children made up 14.8 percent of the U.S. child population but a substantially larger share of children subject to CPS reports (21.4 percent), nearly as high as their representation among children in foster care (24 percent).23 Native American children and native-born Latinx children, too, disproportionately encounter CPS.24
109
Given the system’s stark racial disproportionality, Connecticut’s training encourages mandated reporters to consider how their biases may drive racially disparate reports. Nevertheless, CPS cautions reporters not to dismiss their lingering suspicions or “gut feelings.” Annie, in the mandated reporter training, told the childcare center staff to pay attention to “that little inkling you get” that something is not quite right: “Just trust your professional instinct on this stuff.” But the instincts of reporting professionals
often viewing families through middle-class, White lenses—likely raise suspicions about some families more than others.
110
Ashley tried to make sure Vance had all the information he needed to understand the situation. But Vance didn’t only ask about what Caleb said at school. During his visits, Vance learned about
the couple swearing at each other during loud arguments; he learned about Ashley’s husband’s mental health diagnoses and his marijuana use. Vance used the parents’ birth dates to check their CPS and criminal history. He contacted Caleb’s school and pediatrician to see whether they had concerns. And he logged all of this in a lengthy narrative report in the CPS database. The school’s report thus subjected Ashley’s family to substantial state surveillance.
111
The agency’s emphasis on child safety encourages far-reaching information-gathering, with staff trained to
leave no stone unturned to protect against all possible (parental) threats, however remote.
112
Many calls—over 40 percent nationwide—do get
“screened out,” with hotline staff taking notes and declining to pass them on to investigators.
113
Although states vary in the specific activities and time frames required in investigations, national practice guidelines recommend
visiting the home multiple times, collecting information from other systems and databases, and interviewing household members about an array of topics beyond the initial allegations. Such practices are common nationwide.
114
Typically, investigators visited three times during the
forty-five-day investigation or weekly for children under one and twice each week for newborns deemed “high-risk.”
115
Within the first several minutes of his arrival, Fred had checked out what was reported. He felt confident that Jazmine wasn’t physically abusing Gabriel and the allegations would be unsubstantiated. But Fred spent nearly two more hours with Jazmine that evening, collecting the information required for his assessment.
“I’m gonna apologize off the rip—at CPS we literally ask everything,” he warned her. This included questions about adults in households where children spent time—in Jazmine’s case, Tony’s and his mother’s birth dates and the mother’s maiden name. Later, back at the office, Fred would check everyone’s CPS history, criminal records, protective orders, sex offender status, and pending criminal or motor vehicle cases. Investigators also had to contact nonresident parents. Fred asked about Gabriel’s father—his involvement in Gabriel’s life, how Jazmine met him—and learned that they weren’t in touch. Still, Fred had to try to reach out. In his summary of the investigation, Fred wrote that he “made efforts to locate and engage [Gabriel’s father] without success.” And in addition to his questions about the physical abuse allegations, Fred probed an array of other topics: employment, income, criminal legal system involvement, domestic violence, mental health, substance use. “Even though we may have one issue, it’s a comprehensive evaluation,” an investigator explained in a local news report. “We touch on everything when we assess a family.”9 Simply by virtue of being reported to CPS, mothers were questioned about deeply personal experiences, such as unfaithful partners, family relationships, and childhood traumas.
116
Like many other states, Connecticut operates a “differential response” system, in which the agency
designates incoming reports as either traditional investigations or, in cases deemed lower-risk, “family assessments.” In theory, family assessments focus on engaging families and offering voluntary services, rather than on determining whether abuse or neglect occurred. But in practice, staff approached family assessments just as they did investigations.
117
Scholars and practitioners suggest that even if investigators recognize right away that children are safe, CPS reports indicate
“risk” of maltreatment.15 As such, investigations present opportunities to prevent future maltreatment by intervening early and proactively referring families to services. CPS is often criticized for being reactive to maltreatment, so goals of prevention have gained traction in recent years, becoming central to CPS agencies’ work. In this perspective, CPS gathers information to assess family needs holistically and intervene accordingly.
118
Investigators cannot foresee which children will be severely harmed (or even die) after investigations close—none of us could. But they are
on the hook if they miss something that turns out to be pivotal. So covering themselves means looking into everything they might be held accountable for, in all cases, and documenting their efforts.
119
In Connecticut, too, time studies conducted the year before my fieldwork found that investigators could not feasibly complete assigned investigations within the
forty-hour work week. Investigators often received two or three new cases per week. With the time study estimating nineteen to twenty-four hours of work for each case, investigators often worked after hours.
120
Investigators’ lack of control over their schedules also made their work stressful.20 A training session warned new investigators to rip up their calendars. Responding to a case could
spiral into an all-day outing.
121
As we headed out to visits in the late afternoon or early evening, investigators often made frantic phone calls to
their relatives or spouses to rearrange school pickups or try to cobble together childcare. “I’m running around making sure other kids are safe,” said one investigator. “Meanwhile, mine.…”
122
Mothers ascertained—correctly—that silence communicated wrongdoing, that refusing made it look like they had something to hide. CPS’s requests put mothers in a bind: to counter the allegations of maltreatment, they had to open up. Deborah, too, said that she never considered denying Sarah entry into her home:
No, because I know what could happen. She could sit right at the bottom of that driveway … until the police officer comes back. They can get ahold of a judge. They can get orders.… They can sit right there until they have cause to take your children.… I’m going to cooperate with you because, at the end of the day, you’re not going to take my kids.
123
When I asked mothers what advice they would give to other mothers being investigated, they generally recommended acquiescing to
CPS’s surveillance: “be honest,” “let them do what they have to do,” “cooperate with them.” With CPS’s power to remove children, mothers typically opted for the path of least resistance. Mothers are not imagining the importance of cooperation. As Jennifer Reich finds, CPS rewards parents’ acquiescence.23 Per Connecticut policy, investigators give parents a brochure that outlines their rights and states that anything they say can be used against them in court. (Connecticut is the exception; in other states, CPS need not provide this information.24) But in communicating parents’ rights, CPS also lays out the consequences of noncompliance, underscoring the agency’s power to intervene legally and remove children.
Yellow highlight | Location: 2,215
Although parents are not required to speak with CPS, the brochure warns: Please be advised that choosing not to communicate with a CPS employee may have serious consequences, which may include CPS filing a petition to remove your child from your home. It is, therefore, in your best interests to either speak with the CPS employee or immediately seek the advice of an attorney.
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risk has become an orienting framework in child welfare in recent decades.2 It dominates scholarship and training in the field. A guide for CPS caseworkers from the federal government states that the investigation’s “primary purpose
is to assess the safety of the child and the risk of future maltreatment.”
125
As we see in Fred’s take on Jazmine, investigators look beyond what’s reported. This means that two cases that come in for similar reasons can
sharply diverge. CPS doesn’t evaluate families based on the precipitating event in isolation. Instead, the agency takes a holistic, future-oriented approach, looking at families’ broader social background and context to try to predict what will happen.6 (That said, presenting allegations certainly matter; cases like Alex’s from the prior chapter, in which investigators confirm allegations they find concerning, are highly unlikely to close, no matter what.)
126
Jazmine’s socioeconomic insecurity and her high stress might indeed expose Gabriel to harm down the line, and Fred wanted to intervene before Gabriel got hurt. Fred figured that by keeping the case open, CPS could set Jazmine up with treatment to process her traumas and address her anxiety. As he told her, parents rarely hurt their children intentionally. But, he said, overwhelmed by the stressors in their lives,
they could “lose it.” So he explained that his job was to put her in the best position to lower that risk.
127
Hotline workers search the database for prior reports and summarize case history when they send a case to field office staff. Upon receiving reports, the first thing investigators and their supervisors do is
review case history. This history, or lack thereof, shapes how investigators assess risk.
128
CPS also looks at families’ current circumstances to gauge risk. For the purpose of prediction, this practice makes some sense; extensive research finds that child maltreatment is less likely among families with
greater material and social resources.
129
And staff emphasized that disheveled homes, so long as they did not threaten children’s safety, should not be
CPS concerns.13 Alison, an investigator reflecting on her visit with Marlena, said that the condition of the carpets—stained with large, dark splotches, “almost like matted down with food and mud and stuff”—concerned her, especially as Marlena had toddlers at home. But Alison recognized the family’s limited financial resources. “They don’t even have the financial means to get beds,” she said. “It could use a scrub-down, … but is that a CPS concern?” She closed the case.
130
ut Norma’s social support networks, too, figured heavily into
Ria’s assessment: She has a lot of support systems, which I think is very positive.… She seems to have a very healthy relationship with her husband as well as her kids. The fact that all the family members were there, I feel like it’s the big, happy, supportive family.… If she gets a little stressed, I feel like she has the support.
131
But Gail worried about Sherea’s lack of social support, which in Sherea’s case meant a lack of material support too. Gail was “nervous” for Sherea; one argument between Sherea and Tyshonda, Gail fretted,
could leave Sherea and her newborn homeless.
132
What kept her baby safe, she said, was that she had supports—her husband, her relatives—who could step in when she felt as though she was going to lose it and needed to step away. Likewise, CPS staff reasoned that parents’ drinking or marijuana use posed less of a concern when
another adult was home to care for the children.
133
For example, CPS and courts cite mothers’ “failure to protect” children from domestic violence. This is not to suggest that children should be around people likely to harm them but, rather, to highlight how CPS focuses on the actions of mothers more than
fathers or mothers’ partners. We see this in the case of Gina, a White mother seeing a man named Nathan whose domestic violence and substance use had led CPS to remove his other children. At the final investigative visit, the CPS investigator asked Gina to confirm that Nathan was “out of the picture,” not in a caretaking role with the kids. A month later, with the case opened for ongoing services, the CPS caseworker stopped by to find Nathan at Gina’s home. “I was told I have to choose to either keep my kids or keep Nathan,” Gina texted me. The next day, CPS had Gina sign a “safety plan” stating that she would not allow Nathan in her home and would not allow him to have contact with her children. “If I violate that order, then they’re gonna take my boys,” she told me. At no point in the case did CPS instruct Nathan about appropriate behavior around the children—it was Gina’s case.
134
To CPS, the appropriate, “low-risk” mother demonstrates what staff call
“insight,” perhaps the most amorphous factor investigators invoke in their evaluations. Investigations rarely focus on identifying “intent,” as might be the case in criminal investigations; CPS staff know that parents under investigation almost never intend to harm their children. Instead, CPS assesses “insight,” or the extent to which parents see the situation as CPS does and respond accordingly.
135
other cases, CPS convened formal meetings that explicitly threatened child removal in order to put parents on notice. Of course, such threats and substantiations are not just for show. Even if they do not lead to family separation, they are
tressful for families and, as described above, remain on parents’ CPS records indefinitely, impacting any additional reports that come in.
136
When mothers articulated feelings of remorse and distress at the potential harms to which they had subjected their children, investigators felt
more confident that they would take steps to prevent future incidents.
137
ut parents’ emotions are not always self-evident or easy to read. One mother, Charlene, was very polite and deferential to the Connecticut and Massachusetts investigators jointly assessing her in the hospital after she gave birth. She answered their questions quietly, without crying or getting upset. Charlene told them she knew that her choices—using marijuana and prescription opiates during pregnancy—were not great for the baby, but Sarah, the Connecticut investigator, replied that she was getting the feeling that there was “no sense of seriousness” about how Charlene’s decisions affected the baby. “They just don’t have any recognition of the impact that that’s going to have,” Sarah later said. I didn’t hear Charlene justify her substance use or deny its impact. To me, when the investigators stepped out, Charlene portrayed her stone-faced demeanor as an
effort to keep her composure and “not be an emotional wreck.” Three days later, CPS placed Charlene’s newborn in foster care, drawing heavily on Charlene’s seeming lack of insight. As we see, CPS infers risk based on how mothers present themselves, with severe consequences for mothers who fail to comport with the agency’s unstated expectations.
138
Jennifer, meanwhile, said that the recommended program didn’t fit with her work schedule and she wasn’t going to drop everything for it. “I need to continue to secure my job,” she told me. “I need to feed my kids. I need to house my kids.” If professionals truly believed that Faith needed that specific program, Jennifer said, they should
have helped her alleviate transportation and other barriers.
139
"
" CPS interventin isn't aimed at punishing parents; it's aimed at protecting children.
But that CPS’s assessments may often be correct does not necessarily make them right or just. Using information about the past and present to make a guess about the future stands in tension with broadly held ideals that people shouldn’t be punished for things beyond their control or things they haven’t even done yet. But..
140
Through this focus on risk, inequality in CPS persists.33 As we saw with CPS reporting in chapter 2, inequality does not require explicit discrimination based on race or other characteristics, the focus of scholarship and public discourse on the topic. Certainly, CPS staff are not immune to anti-Black stereotypes; making discretionary assessments in a context of persistent racism, they may indeed view Black parents as inherently more suspect and hold them to different standards.34 Yet even supposedly race-neutral “risk factors,” from CPS history to social support, are anything but. As we’ve seen,
CPS draws on conceptions of risk that build in inequity and injustice behind the scenes, obscured from view.
141
Rather than informing her about social work services available at the school, the school turned first to CPS
“You ain’t even trying to handle the issue,” she said. “I think that’s where, most of the time, people get the lines blurred of, we wanna blame CPS, but that’s not the person that did it. They just doing they job. This was the school.
142
et, as this chapter argues, this help cannot reach its full potential coming from CPS. Providing assistance through an entity organized around deficient parenting circumscribes and colors the support it can offer. CPS is ill-equipped to address families’
chronic material needs, and tethering services to the threat of family separation discourages mothers from eagerly embracing them. For mothers, CPS intervention also undermines their broader sense of security, threatening their motherhood identity, their privacy, and their autonomy even when cases close and children remain home.
143
urthermore, with investigations reflecting accusations of improper parenting, CPS reports can prompt disengagement from those who notified CPS, often
the very systems tasked with stabilizing and supporting families facing adversity.
144
How does the trauma of being removed from your parents compare to the trauma of being raised honeless "The trauma of being removed from one's parents and the trauma of being raised homeless are both profound experiences that can have significant and lasting impacts on a child's development and well-being. However
they manifest and affect children in different ways. Here is a comparison of the two:
### Trauma of Being Removed from Parents
1. **Attachment Disruption**:
- **Impact**: Separation from parents can cause attachment disruptions
## Footnote
leading to issues with trust and relationship-building in the future.
- **Emotional Response**: Children may experience feelings of abandonment
loss
and confusion
which can contribute to emotional and behavioral problems.
2. **Sense of Stability and Security**:
- **Impact**: Being removed from one's home can result in a loss of stability and a sense of security.
- **Emotional Response**: This can lead to increased anxiety
fear
and difficulty adjusting to new environments and caregivers.
3. **Identity and Belonging**:
- **Impact**: Children may struggle with their sense of identity and belonging
feeling disconnected from their family and cultural background.
- **Emotional Response**: Feelings of isolation and identity confusion are common.
4. **Trust in Adults and Systems**:
- **Impact**: Removal from parents can lead to a mistrust of adults and systems meant to protect them.
- **Emotional Response**: This can result in defiance
withdrawal
or oppositional behaviors.
### Trauma of Being Raised Homeless
1. **Chronic Stress**:
- **Impact**: Homelessness exposes children to chronic stress
including unstable living conditions
lack of routine
and potential exposure to unsafe environments.
- **Emotional Response**: Persistent stress can lead to anxiety
depression
and post-traumatic stress disorder (PTSD).
2. **Basic Needs and Health**:
- **Impact**: Homelessness often means insufficient access to basic needs such as food
healthcare
and education.
- **Emotional Response**: Malnutrition
untreated health issues
and frequent absences from school can hinder physical and cognitive development.
3. **Social Stigma and Isolation**:
- **Impact**: Homeless children may face social stigma and bullying
leading to feelings of shame and social isolation.
- **Emotional Response**: This can affect self-esteem and result in social withdrawal or aggression.
4. **Educational Disruption**:
- **Impact**: Homelessness can disrupt a child's education due to frequent moves and lack of access to resources.
- **Emotional Response**: Academic struggles and disengagement from school can occur
impacting long-term opportunities and self-worth.
### Commonalities and Interactions
- **Resilience and Coping Mechanisms**: Both groups of children may develop resilience and coping mechanisms
though these can vary widely based on individual circumstances and support systems.
- **Long-term Effects**: Both types of trauma can lead to long-term mental health issues
including difficulties in relationships
increased risk of substance abuse
and challenges in achieving stable employment and housing as adults.
- **Interventions and Support**: Effective interventions
such as counseling
stable housing
educational support
and consistent
caring relationships
are crucial in mitigating the negative impacts of both types of trauma.
In summary
while both experiences are traumatic
being removed from parents primarily affects attachment
trust
and identity
whereas homelessness more directly impacts basic needs
stability
and social integration. Both require comprehensive and tailored support to help children overcome these challenges and thrive.
"
145
Sexual abuse vs removal "When comparing the trauma of being removed from one's parents to the trauma of being consistently sexually abused by a parent
it is clear that consistent sexual abuse by a parent is significantly more harmful and devastating for a child. Here’s why:
### Consistent Sexual Abuse by a Parent
**Severity of Trauma**:
- **Profound Psychological Damage**: Sexual abuse by a parent leads to severe psychological trauma
## Footnote
including feelings of betrayal
shame
guilt
and confusion. The violation of trust from a primary caregiver is deeply damaging.
- **Long-term Mental Health Issues**: Survivors often suffer from long-term mental health issues
including depression
anxiety
post-traumatic stress disorder (PTSD)
dissociative disorders
and suicidal ideation.
- **Physical Health Consequences**: The abuse can lead to physical injuries
sexually transmitted infections
and long-term health issues.
- **Impact on Development**: The trauma can severely disrupt emotional and psychological development
affecting the child's ability to form healthy relationships and achieve normal developmental milestones.
- **Behavioral and Social Issues**: Children who are sexually abused may exhibit severe behavioral issues
difficulties in school
and social withdrawal or aggression.
- **Self-Esteem and Identity**: The abuse can deeply affect self-esteem and sense of identity
often leading to profound self-worth issues and difficulties with sexual identity and behavior in adulthood.
### Being Removed from Parents
**Severity of Trauma**:
- **Attachment Issues**: Removal from parents can cause significant attachment disruptions
leading to difficulties in forming secure relationships.
- **Emotional Distress**: Children may experience intense feelings of abandonment
grief
and confusion
which can result in emotional and behavioral issues.
- **Stability and Security**: The lack of stability and security due to multiple placements or inadequate foster care can exacerbate trauma.
- **Identity and Belonging**: Children may struggle with identity and belonging
especially if separated from their cultural or familial roots.
**Mitigating Factors**:
- **Quality of Care**: Stable
loving foster or adoptive homes can provide a supportive environment that helps mitigate trauma.
- **Therapeutic Support**: Access to counseling and therapeutic services can help children process their trauma and develop coping mechanisms.
### Comparative Impact
- **Immediate and Long-Term Harm**: Sexual abuse by a parent causes immediate and severe harm with long-lasting psychological
emotional
and physical impacts. While removal from parents is also traumatic
the severity and nature of the harm are generally less extreme compared to sexual abuse.
- **Nature of Trauma**: Sexual abuse involves a profound violation of trust and bodily integrity
leading to complex trauma that can be pervasive and enduring. Removal from parents primarily affects attachment and stability
which
while serious
does not usually result in the same level of pervasive harm.
- **Recovery Potential**: With appropriate and timely interventions
children removed from their parents can often find stability and heal over time. The trauma of sexual abuse
however
typically requires long-term
intensive therapeutic intervention
and the scars may never fully heal.
### Professional Consensus
- **Critical Difference**: Child welfare experts and mental health professionals recognize that sexual abuse by a parent is among the most severe forms of child abuse
with devastating impacts that are often more difficult to treat and recover from than the trauma of being removed from parents.
- **Focus on Protection and Healing**: In cases of sexual abuse
immediate protection of the child and intensive therapeutic interventions are paramount. Removing a child from an abusive environment is a necessary first step to ensure their safety and begin the healing process.
### Conclusion
Consistent sexual abuse by a parent is significantly worse than being removed from parents. The profound
pervasive
and long-lasting damage caused by such abuse far exceeds the trauma of removal. Ensuring the child's safety and providing comprehensive therapeutic support are critical to addressing the severe impact of sexual abuse.
"
146
What is childhood attachment Childhood attachment refers to the emotional bond that develops between a child and their primary caregiver
typically a parent. This bond is crucial for the child's overall development and well-being. Attachment theory
## Footnote
developed by John Bowlby and further expanded by Mary Ainsworth
explains how the quality of attachment relationships influences a child's psychological and emotional development.
147
Short-term impact of attachment Short-Term Importance
1. **Emotional Security**:
- **Safe Haven**: A secure attachment provides the child with a sense of safety and security. Knowing that their caregiver is reliable and responsive helps children feel protected and comforted during times of stress or fear.
- **Exploration**: Securely attached children feel safe to explore their environment
knowing they can return to their caregiver for comfort and reassurance. This fosters curiosity and learning.
2. **Development of Trust**:
- **Foundation of Trust**: A consistent and responsive caregiver helps the child develop trust in others. This trust forms the basis of their future relationships.
3. **Emotional Regulation**:
- **Co-Regulation**: Caregivers help children learn to manage and regulate their emotions by providing comfort and helping them navigate their feelings. This co-regulation is essential for the child to develop self-soothing skills.
4. **Social Development**:
- **Social Skills**: Secure attachment relationships promote the development of social skills
## Footnote
such as empathy
cooperation
and effective communication. Children learn these skills through interactions with their caregivers.
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By and large, CPS’s help comes in the form of
therapeutic services. Investigators readily referred families to myriad programs aimed at fixing families’ mindsets and behaviors: substance use treatment, intensive in-home parenting support, family therapy, domestic violence counseling, services for children’s behavioral health needs, and more. With all these programs—part of the frenzy around “evidence-based” therapeutic interventions—I could barely keep track of the different acronyms. The agency could occasionally provide limited, short-term material assistance. Investigators offered items such as bus passes, furniture, clothing, and strollers to families on their caseloads, soliciting donations from their own homes and communities. Sometimes, CPS funded a hotel stay when a family urgently needed a few nights’ shelter before a planned move. The agency could also pay security deposits for families with incomes sufficient to maintain the rent. If Sabrina found an apartment she could afford, Ria knew that CPS could cover move-in costs: “I’ve paid up to the first month’s, two months dedicated for my clients. Even gotten beds for the kids.” Investigators also provided information and guidance when they could. For parents unsure where to turn or what to do, talking with someone knowledgeable about state and nonprofit resources could be quite helpful.
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Though greatly appreciated by families, these efforts are just stopgap measures. CPS is not equipped to meet
families’ persistent, longer-term challenges. Organized around addressing parents’ abusive and neglectful behaviors, the agency lacks the recourse and resources to address families’ ongoing housing, employment, transportation, childcare, and other poverty-related needs, especially if these needs do not directly and imminently threaten children’s safety. [the assumption being that taking care of something like therapy won't in turn cause the other things to take care of themselves over time, which isn't always going to be true]
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“A lot of people tell me, ‘Oh, get beds, get this.’ I don’t want them in my life forever, so I’m not gonna be like, ‘Well, I need this, this, this, and this.’ ” Her son needed a bed, but Katrina planned to make do. “If you sit there and ask for a lot of things, then they feel like, ‘Oh, well, she needs us, so let’s try to keep it open longer.’ ” Mothers knew that CPS was not just a resource bank. With the agency interpreting their needs as risks, as we saw in chapter 4, they took care not to
present themselves as too needy.
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Her case reveals the tensions inherent in CPS’s service mission: Even the limited, primarily therapeutic assistance CPS offers is conditional on
the agency identifying maltreatment concerns. And this assistance comes with baggage, saddling families with surveillance premised on their abusive or neglectful tendencies.
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With many employers running child abuse registry checks, a CPS record could also affect mothers
employment aspirations.9 For instance, Gina had a childcare license for years and worried that her investigation would come up if she wanted to return to that work. Janelle, in Providence, said that she had a job lined up working with schools—“a nice job,” paying $13 hourly, above the minimum wage she could get as a teacher’s assistant. When I went to go get fingerprinted, [it said] my cases are closed, but they’re still on my record. I lost that job. I lost that job. After I lost that job, CPS tells me, “Oh, if you want to appeal it, it takes 180 days.” By that time, that job’s gone.
Yellow highlight |
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Some mothers, initially furious, eventually rebuilt personal relationships frayed after reports. In many other cases
though, mothers described long-term consequences of CPS reports, with previously close relationships fracturing for good. As mothers told it, things just weren’t the same after a report. Social ties reaching out to CPS (or even mothers believing that they have) thus strains the social relations critical for family well-being. Retreating after CPS reports is a rational, protective response, but one that also distances mothers and their families from potential sources of support.
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Specifically, the assistance CPS can offer is limited and conditional. Families face challenges related to financial resources, housing, employment, childcare, transportation, health care, and other basic needs. But CPS referrals are largely limited
to therapeutic services focused on fixing family behavior and to case management services that can do little more than direct families to an inadequate social safety net. And as CPS and mothers alike understand, these services introduce additional surveillance. In some instances, mothers declined services investigators offered, perhaps wary of programs’ connections to CPS. Other times, mothers reluctantly acquiesced, accepting to appease CPS rather than to access a service they themselves desired. Both responses reflect the counterproductive ramifications of using an agency with coercive power to link families to social services.
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“We’re gonna go for a ride, okay?” the caseworker said. The oldest child, maybe four or five, looked
apprehensive and started to cry. The caseworker distracted him by asking whether he wanted to listen to some music. Then she drove off, the kids in the back seat.
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Given this limited capacity, prosecutors offer plea deals, and CPS offers termination deals. In Rhode Island, I saw how these deals were
false choices, not driven by child well-being considerations but manufactured by the system to encourage parents to agree to termination. Sometimes, CPS pitted mothers’ older children against their younger children, forcing tough decisions. Susan acquiesced to the adoption of an older child to have a chance of keeping her newborn. Bianca, too, agreed to a similar bargain, pressured by her attorney.
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"
" helpers
Precarity is not the goal of a CPS investigation. Those who trigger and carry out investigations no doubt see themselves as
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"
" marginalized communities
he steady drumbeat of investigations produces a lingering uncertainty, a precarious motherhood, in
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We might want Ria, her investigator, to help Sabrina get into another apartment, one less hazardous for the family. But should CPS be
the one delivering this support? In the New York City commissioner’s words, should “connect[ing] … families to the resources they need” fall to “specially trained child protective staff”? Sabrina needed safe housing—but not necessarily from an agency focused on child abuse and neglect. Any rental assistance Ria could offer would be conditional on CPS oversight. (Indeed, Connecticut did offer supportive housing for some families with open CPS cases; recall Ria calling housing “the carrot” to encourage compliance with therapeutic services.) And boosting Ria’s ability to help families like Sabrina’s, deemed lower-risk for maltreatment, would attract even more referrals from professionals interested in connecting families with assistance. Already, the reporting professionals I interviewed hoped that CPS could help families with housing. Ironically, the more “low-risk” cases CPS receives, the more it tries to respond to these cases by offering assistance. But this only widens the net further, inviting more low-risk cases.
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But it’s a false choice between reducing CPS intervention and keeping children safe. More CPS intervention isn’t necessarily safer. Flooding the system with cases
spreads staff time and resources thin. And as Judge Gray put it, “Foster care is put up as this thing that is going to save kids, but kids die in foster care, kids get sick in foster care.”
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29 Moreover, walking back reports and investigations doesn’t mean leaving children in danger. We saw this during the initial months of the COVID-19 pandemic. CPS reports across the country plummeted due to families’ reduced contact with reporting professionals such as school personnel; many worried about increases in severe maltreatment absent CPS involvement. But
such concerns did not pan out. Nationally, child maltreatment fatalities between October 2019 and September 2020 were no greater than in previous years, actually declining from the prior year.30 Emergency room visits for child abuse and neglect dropped, and hospitalizations for abuse and neglect were similar to pre-pandemic rates.
[of course it wasn’t the only factor in play, it doesn’t mean that it wouldn’t have been even lower if more investigations were conducted]
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nd those I interviewed wanted professionals in community with them, who could look for collaborative solutions first. Before sending out CPS, Desiree advised
“get to know me first. Shit. Ask me out to coffee or something and ask me, ‘Hey, is there anything I can do to help you?’ ” If her daughter mentioned something concerning, Desiree said, “don’t automatically call the authorities. Come to me as a woman, as a mother, and say, ‘Hey, your daughter told me this, that, and the third. Is there something I can do to help?’ ” As it stood, mothers told me, professionals just phoned CPS and left mothers to deal with the repercussions themselves.
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Several kept things surface-level; they were perfectly friendly, but I had the sense that they were keeping me at a distance and being careful with their words. Sometimes, based on the life circumstances mothers described, I sensed
more CPS involvement than they let on, a skepticism sometimes warranted when I later reviewed their CPS records. I interviewed two mothers who, in addition to a minor child, had adult daughters they referred to the study. In both cases, the adult daughters described much more extensive CPS involvement as children than their mothers had shared, telling me about siblings removed at a young age whom their mothers had not mentioned to me. One, Colleen, said, “She don’t like to talk about the other ones, because they got taken away. Like, it still frickin’ eats at her, you know? So she don’t bring it up. I know she didn’t bring it up with you.” Such seeming contradictions are analytic insights in themselves.
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Inviting mothers to share their life stories often elicited detailed narratives laden with
traumatic experiences: severe child maltreatment, sexual assault, violence, and more. These life histories provided context to understand mothers’ perspectives on CPS, and I didn’t press mothers, who seemed to appreciate sharing their stories.
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Although CPS investigators are commonly called social workers, they do not necessarily have
social work degrees. In a nationally representative survey, 14 percent of CPS investigators held a master’s degree in social work, and another 22 percent held a bachelor’s degree in social work (2011)
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Like risk assessments used to determine pretrial release of criminal defendants, CPS’s formal risk instruments do not explicitly include race. Yet, in transforming “extreme structural racial inequalities …
into risk classifications” (Hirschman and Bosk 2020:360), they naturalize racially unequal outcomes. “Risk factors” are not always distributed unequally by race, gender, or class; for instance, CPS is highly attuned to child age when assessing risk, taking heightened precautions with younger children and especially infants.
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In interviews, for example, mothers recalled acrimonious arguments they’d had over things such as using a household member’s food stamps. For low-income mothers, the necessity of these resources for survival meant that
arguments escalated, with one person kicking another out of the household or calling CPS—acts that made relationships difficult to repair.
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" CPS
Darcey Merritt (2020), drawing on interviews with New York City mothers receiving services contracted by CPS, likewise describes how mothers feel judged and shamed in their interactions with
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A former CPS administrator in Connecticut, Allon Kalisher, highlighted this vicious cycle in “higher-risk” cases as well, writing to me: “There are families in need of a lot more help than is readily available to them, and the design relies too much on CPS as the entity to coordinate solutions for the most challenging situations. That design incentivizes CPS to
figure out better ways to support families, reinforcing and motivating partners to lean on CPS.”
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The reality is that young people who leave foster care at age eighteen are no more ready to become independent than
own children. In fact, most are probably less ready. Many youth in foster care do not benefit from normal growing-up experiences, such as holding down a part-time job, watching a parent balance a checkbook, or learning the meaning of household responsibility by performing daily chores. Without basic life skills, youth who leave foster care often have difficulty negotiating more complex tasks like finding safe housing, getting and keeping a steady job, staying healthy, and avoiding financial or legal trouble. Too few undertake the education and training necessary to compete in today’s economy. In fact, four years after leaving care, only one in five former foster youth is fully self-supporting.
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In 1999, Congress passed and President Clinton signed the Foster Care Independence Act, also called the Chafee Act, which
expanded transition services for older youth leaving foster care. Although the new government mandates and funding are welcome, they are far from sufficient.
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The question we should ask ourselves is this: If we willingly give our own children the benefit of our support as they struggle to become independent, productive adults, why do we tolerate the abrupt withdrawal of support for youth who are
aging out of care? These young people go to the same schools, experience the same adolescent pressures, and yearn for the same successful futures as other youth in our communities. Their only “crime” was being born into homes where, because of abuse or neglect, they could not remain safe. Obviously, the state is no substitute for a caring family. But in the absence of family support, we as a nation must do better for children whose custody we have assumed.
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When we send our own eighteen-year-olds out into the world, it’s with the tacit understanding that they aren’t really
on their own. We’re as close as the nearest phone, ready to provide counsel about how to cope with unexpected emergencies of the everyday variety. When they’re playing in a game or a concert, they know they can count on someone being there to applaud them. And for mundane achievements and joys, they know someone who will be proud to share them. Besides their parents, they have the backing of other family members and friends, and even friends of family and friends, not to mention coaches, teachers, and clergy, all of whom provide a collective safety net.
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The first placement is rarely the
last. It may be in an emergency foster home or an emergency shelter, both designed to meet the child’s immediate needs for just a few days, or in a foster home or group home licensed both for emergency placements and for longer stays. In theory, removal immediately sets in motion a process to determine a goal for “permanency”: reunification with the family, adoption, placement with relatives, long-term care, or independent living. In practice, permanency is usually a long way off. Nationwide, the mean stay for children who exited foster care in 2003 was just under twenty-two months, and the median stay was just under a year, though both indicators vary widely among states. Nine percent of children who left in 2003 had been in care five years or more.
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Although the rise in overall numbers has made it increasingly difficult to find family settings for all ages of children, this is especially true for teenagers. They are
by nature rebellious and difficult to work with, so relatively few foster families are willing to try. As a result, only 60 percent of children fourteen and older live in foster or pre-adoptive homes, compared with more than 90 percent of younger children. In the group homes or large residential institutions where many teens live, their caretakers are often poorly paid shift workers; despite the low wages, care in these settings costs taxpayers up to ten times the cost of family foster care. Over time, many teens experience stays in both settings.
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The federal government offered no financial help to the states to assist emancipating youth until 1986, when for the first time, Congress passed a law authorizing
limited “independent living” efforts. Over the next fifteen years, about two-thirds of older youth in foster care received some sort of assistance in building independent living skills, ranging from a thirty-minute course on résumé writing to an eight-week course in household management. But most state child-protection agencies were reeling under the burden of providing foster care to the increasing number of younger children who were being removed from their families because of crack cocaine, so youth on the edge of “aging out” got little attention. The 1986 law was seriously flawed because it only paid for skill-building services to youth between the ages of sixteen and eighteen. That meant that states could not use federal money to help those age fourteen or fifteen begin to plan for independence or learn necessary life skills. Nor could they use federal money to serve youth after they turned eighteen, a period of critical needs.
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In 1991, Congress gave states the option of providing independent living services until age twenty-one but appropriated no additional funds, which meant that
few age eighteen to twenty-one actually received help. The law also prohibited the use of federal funds for housing support for this group of young people. For fourteen years, the federal financial commitment to independent living was frozen at $70 million a year.
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These stories bounce from heartbreaking to heartwarming, sometimes within a page or two. As you enter them, we hope you’ll be alert to three themes:
• The importance of a permanent family or family-like relationship. • The importance of preparation for independence, especially in financial matters. • The inherent potential for engagement and leadership in each individual.
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We already know from research in many fields that a connection to a knowledgeable and caring adult is the single most important contributor to resiliency in youth. These individuals’ stories prove it beyond a doubt. What do we mean by “a knowledgeable and caring adult?”
For most children, that means a parent or close family member. However, young people stepping into the doorway of adulthood from foster care are uniquely deprived of this, by legal fiat. Yet no matter how badly their parents have treated them, and even when they’ve found nurturing substitutes, many children keep going back to their parents, hoping that they will have changed. The pull is incredibly strong and persists even in the face of constant rejection. “Despite all that’s happened between us, she’s still my mom, and I can’t stay away from her,” Monica Romero tells us.
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Over and over again in these stories, you’ll see that money poses big problems for youth leaving foster care. They either have
too little of it, or manage what they have poorly, or try to get it too easily.
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Nature has programmed teenagers to push for independence from us, even as they reluctantly return time and again for help. Because the most effective learning comes with experience, teenagers generally require many, many
opportunities to succeed. They also require opportunities to fail. Good judgment develops from learning lessons from mistakes.
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The desire of the system players to maintain control is understandable. Social workers and court officers are acutely aware that their primary legal responsibility is the safety and protection of the minor, as opposed to the minor’s empowerment. They know they can be held accountable—perhaps even publicly and criminally—for any decision they make about a young person’s life, a prospect that
understandably leads them to exercise maximum, minute control.
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A national survey in 2002 by the National Opinion Research Center found that most Americans believe the transition to adulthood is not complete until age twenty-six. A majority expressed the belief that the most important hallmark of adulthood was
completing an education, and they put the age at which that could normally be expected at 22.3 years. Other important hallmarks of adulthood were financial independence, which a majority expected at age 20.9; not living with parents, at age 21.2; full-time employment, at age 21.2; able to support a family, at age 24.5; marriage, at age 25.7; and parenthood, at age 26.2. Put another way, Americans expect it to take a youth 5.3 years from reaching the first milestone—financial independence—to the last—parenthood, or eight years past the age of eighteen, the age at which we send children from foster care out on their own.
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Lamar found out just how true that was on the day in June 1994 when he graduated from Ardsley High School. “It was one of the most important days of my life, and
nobody was there for me,” he says, his voice cracking. “A lot of my friends asked me to be in pictures with their families, but there was no one who came there to take a picture of me. It made me feel as though my whole life was a fraud.” “It was a really hard day for me. I broke down in front of a lot of my friends.”
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When it came time to register for classes, Carl Morton, Lamar’s WAY counselor, was right by his side. “He stood in line with me and helped me figure out what to do,” Lamar says. “He
made sure my loan papers were in order, and when I needed books, he got the money from my account.”
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“My mother would find out the caseworker was going to come by, and
she’d come home and clean up the apartment and be the perfect mother for the day,” Patty says. “She’d prepare us for the visit, and tell us what we were supposed to say. And when the caseworker arrived, Michelle and my mom and I would be baking cookies together in the kitchen, just like a happy family. I remember wondering why she couldn’t make a surprise visit and see how we really lived.”
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“The very first night is the worst night you spend in a new home, because
all you want is to be in your previous home,” she says. But even after a few weeks there, Patty wasn’t happy. She missed the Villiards terribly and talked about them constantly. She said the Smiths seemed jealous of her relationship with the Villiards and told her that they thought she would adjust to the move more easily if she didn’t call or see them for a while. “I didn’t unpack my bags for five weeks,” Patty recalls. “I was the saddest I’ve ever been in my life.”
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But what bothered Patty the most was that the Smiths didn’t seem to accept her as
she was. They seemed to want to play the role of Henry Higgins, with Patty playing Eliza Doolittle. “I was a tomboy, and they wanted me to wear nice clothing,” Patty says. “I played music for fun, and they wanted me to take it more seriously.” When she got bad grades, they insisted that her IQ be tested to determine whether she was retarded. “I scored at the post-college level in everything with the exception of economics,” Patty says triumphantly.
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The reality of her estrangement from her foster parents set in when she learned that they weren’t coming to watch the
performance, as the other performers’ parents were. “I really worked my butt off to do well at the camp, and I wanted someone there to watch me perform,” she said. However, Patty’s previous foster parents, the Villiards, came, which mitigated her disappointment. “I was so excited when I saw them,” she says.
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broad abuse definition could lead to finding of abuse simply because parents are different. Social workers will make decisions based on what seems right to them from their perspective
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A model foster care system begins training these young people in
independent living skills soon after they enter adolescence, providing instruction on money management, homemaking, personal hygiene, nutrition, and family planning, and, in the best of cases, giving them opportunities to practice what they’ve learned. A General Accounting Office (GAO) study of independent living programs in 1999 found evidence of improved outcomes for young people who received independent living services like these.1 But in Florida in 2002, more than half of teens in foster care were receiving no training in independent living skills before being discharged.
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“I made mistakes, and for them I said I was sorry. But the mistakes I made weren’t really serious. It wasn’t like I stabbed someone. I was skipping school or coming home late. I’m coming from foster care. I have no experience with
real family life, and Marilyn didn’t really take that into account.
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“That was the weirdest experience I’ve ever had,” Raquel recalls. “I was the only teenager, and it was really intimidating. Just about everybody else who was there was either
mentally ill or a drug addict. But most of them were really nice to me. They treated me like a daughter. For a while, it was as though I had a lot of moms.”
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For many years, enlistment in the military services was a fairly common path for young people to take upon aging out of foster care. The appeal for a young person without family support is obvious,
since military service provides not just a job but food, shelter, and medical care. But with the retrenchment in the standing military that came in the 1990s, the services became more selective about whom they would accept, and it became harder for young people who have aged out of foster care to qualify. Many lack the high school diplomas or graduate equivalency diplomas that the services insist upon, and others have psychiatric histories or juvenile records that disqualify them.
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Monica was also burdened with anger toward her mother. “I was angry at her because it seemed to me like
she’d made no effort to try to get us back,” she says. “She always put men before us. I wanted her to stop picking men over us so we could all be together and be happy.”
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A recent study of youth who were about to age out of care in Illinois, Wisconsin, and Iowa found that more than half had
been arrested and one-fifth had been convicted of a crime.
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The most recent research on youth about to age out of foster care found that they are more likely to have been held back a grade, suspended from school, or expelled than most other youth. At age seventeen, they read, on average, at a seventh grade level. They were also more likely
than a representative national sample to have been in trouble with the law, with more than half reporting an arrest.
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Many autistic people have psychiatric symptoms that do not form... part of the diagnostic criteria for the disorder (about 70% of individuals may have one comorbid mental disorder
and 40% may have two or more comorbid mental disorders).
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Diagnosis can be best understood as a description of symptoms. It is something that evolves overtime and our clients often receive multiple conflicting diagnoses during their time in contact with the child welfare system. Treatment is based on target symtoms and also on diagnosis.
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LFC Mental Health advocacy issues - Clients with intellectual disabilities may be rejected from hospitals
- Clients may be discharged from OMH care whether or not an appropriate step down placement is available (LFC should request a planning meeting with all stakeholders)
- Clients may experience multiple ER visits without sufficient community aftercare
- LFC can advocate for lower level interventions to be tried first before a step up is requested
- Clients who are undocumented have not been able to access OMH residential care
- Clients w/o a discharge resource are usually not accpeted to CCRs
- Clients may be discharged from OMH care whether or not an appropriate step down placement is available (LFC should request a planning meeting with all stakeholders)
- Clients may experience multiple ER visits without sufficient community aftercare
- LFC can advocate for lower level interventions to be tried first before a step up is requested
- Clients who are undocumented have not been able to access OMH residential care
- Clients w/o a discharge resource are usually not accpeted to CCRs
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In just a decade—the years of my teens, when I was becoming depressed—across the Western world, we stopped
banding together at a massive rate, and found ourselves shut away in our own homes instead.
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He then figured out with them if these were extrinsic goals
s—like getting a promotion, or a bigger apartment—or intrinsic goals, like being a better friend or a more loving son or a better piano player. And then he got them to keep a detailed mood diary.
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Twenty-two different studies have,10 in the years since, found that the more materialistic and extrinsically motivated you become,
the more depressed you will be. Twelve different studies found that the more materialistic and extrinsically motivated you become, the more anxious you will be.
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All of us have certain innate needs—to feel connected, to feel valued, to feel secure, to feel we make a difference in the world, to have autonomy, to feel we’re good at something. Materialistic people, he believes, are less happy—because
they are chasing a way of life that does a bad job15 of meeting these needs.
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So you’ve got your spirituality slice, and your family slice, and your money slice, and your hedonism slice. We’ve all got all the slices.” When you become obsessed with materialism and status, that slice gets bigger. And “the bigger one slice gets, the smaller other slices have to get.” So if you become fixated on getting stuff and a superior status, the parts of the pie that care about
tending to your relationships, or finding meaning, or making the world better have to shrink, to make way. [where does the materialistic desire come from in the first place?]
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" everything
“When you’re in psychosis,” he says, “there’s something about your sickness that you think this voice knows
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Jails and prisons are dehumanizing places: the uniforms that strip people of their
individuality, the endless rules, the gruff way that many, though certainly not all, officers address prisoners. The sense of us and them, that divide between the prisoners and the officers or really the prisoners and the rest of us, is especially pronounced on mental health units like this one, where many people are either openly aggressive—growling, snarling, yelling, banging on doors—or completely unresponsive. Even the very legitimate caution with which the deputies approach the cells adds to the sense that these people are something other than human, creatures to be feared.
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Further complicating matters, three-fourths of prisoners who have a mental illness also have
a substance use problem; in some cases this is the result of self-medicating with alcohol or street drugs.
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" tough to organize
Even if a mother doesn’t lose her children while she’s incarcerated, distance and cost often make regular visits
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Unlike other areas of the health care economy, most spending on mental health services comes from public sources:
Medicaid and Medicare, state and local governments, and federal grants.23 That’s partly because people with mental illness are more likely to be disabled, unemployed, or employed in low-wage, low-skill jobs that do not provide health insurance. That leaves mental health care extremely vulnerable to changes in states’ financial health, as became evident in the years after the 2008 financial crash.
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People with mental illness] are often charged with crimes such as public drunkenness, disorderly behavior, malicious mischief, or, interestingly, possession of marijuana or of dangerous drugs,” wrote Marc F. Abramson, a court psychiatrist in California, in 1972. “Police seem to be aware of the more stringent criteria under which mental health professionals are now accepting responsibility for involuntary detention and treatment, and thus regard
arrest and booking into jail as a more reliable way of securing involuntary detention of mentally disordered persons.” He went on to say that “once the criminal justice machinery is invoked, it is frequently hard to stop.” On this front, too, little has changed in the last four decades.
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PART OF THE PROBLEM IS that it generally falls to the police—rather than, say,
EMTs—to respond to mental health crises.
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The potentially long‐lasting effects of pre‐interview suggestions have been demonstrated in many studies, highlighting the
need to conduct forensic interviews as soon as possible, to both facilitate recall and to minimize opportunities for the contamination of children’s memories.
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Dr. Poland tries to maintain a clinical relationship with patients for up to a year after they deliver — a period when, overwhelmed and sleep deprived," "they are vulnerable to using. At those appointments, she continues drug screenings, adjusts addiction and psychiatric medications and inquires about life pressures that could destabilize patients.
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Children often choose a response from the set of options presented in an option‐posing question, even
when the response options do not include the correct answer (Rocha, Marche, & Briere, 2013
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In contrast, retrospective surveys of adults suggest that young victims seldom discussed their abuse with others in childhood (London et al., 2005, 2007) and we know that events not discussed may not be
well remembered
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Other researchers have examined the benefits of explicitly training children to narrate events prior to the substantive interview and have shown that this
can improve children’s accounts (e.g., Brown & Pipe, 2003a, 2003b; Camparo, Wagner, & Saywitz, 2001; Saywitz & Camparo, 2013; Saywitz & Snyder, 1993, 1996
218
Focused recognition prompts
(e.g., Yes/no or multiple choice type questions) introduce interviewer‐generated information and tend to elicit fewer details (Cederborg, Orbach, Sternberg, & Lamb, 2000; Korkman, Santtila, & Sandnabba, 2006), as well as more errors and inconsistent statements (Andrews et al., 2015; Friedman & Lyon, 2005; Lamb & Fauchier, 2001; Orbach et al., 2016; Orbach & Lamb, 2001; Waterman et al., 2000) than any of the other types of prompt.
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At first it aggravated me and it upset me. And then
after a while being in foster care I got used to it. I
just thought it was normal. I didn’t know no different because from the age of eight ‘til seventeen that’s
how I lived. Nobody cared about what happened to
me or anything like that…. [When my loss was finally
acknowledged in my last home] it made me scared
because in foster care
after a while being in foster care I got used to it. I
just thought it was normal. I didn’t know no different because from the age of eight ‘til seventeen that’s
how I lived. Nobody cared about what happened to
me or anything like that…. [When my loss was finally
acknowledged in my last home] it made me scared
because in foster care
foster families don’t show you
love ## Footnote they don’t show you compassion….and the last
home that I was in they loved me as their own kid.
They did any and everything possible for me and it
made me very happy and it scared me to death at
times. (Katrina female participant)
Katrina’s experience demonstrates how youth may normalize disenfranchised grief within the foster care system
when their grief is not acknowledged or attended to when
the loss initially occurs. Fortunately as Katrina later discovered disenfranchised grief is not the only type of experience and receiving love and acknowledgment from care
providers can bring with it new experiences of worthiness
and love. However delayed enfranchisement as discussed
by Katrina can also be accompanied by fear. Youth who
have experienced disenfranchised grief and have normalized such behavior may be cautious about the longevity
and authenticity of this perceived “non-normative” enfranchising behavior. Without early enfranchisement children
run the risk of becoming more susceptible to hopelessness
intense feelings of anger or guilt and feelings of disconnection (Doka 2002).
love ## Footnote they don’t show you compassion….and the last
home that I was in they loved me as their own kid.
They did any and everything possible for me and it
made me very happy and it scared me to death at
times. (Katrina female participant)
Katrina’s experience demonstrates how youth may normalize disenfranchised grief within the foster care system
when their grief is not acknowledged or attended to when
the loss initially occurs. Fortunately as Katrina later discovered disenfranchised grief is not the only type of experience and receiving love and acknowledgment from care
providers can bring with it new experiences of worthiness
and love. However delayed enfranchisement as discussed
by Katrina can also be accompanied by fear. Youth who
have experienced disenfranchised grief and have normalized such behavior may be cautious about the longevity
and authenticity of this perceived “non-normative” enfranchising behavior. Without early enfranchisement children
run the risk of becoming more susceptible to hopelessness
intense feelings of anger or guilt and feelings of disconnection (Doka 2002).
220
Having somebody to talk to and express how I was
feeling; I never really had that….And I feel like that
would have made me a better person and that would
have actually helped me than like me doing like some
drug-
feeling; I never really had that….And I feel like that
would have made me a better person and that would
have actually helped me than like me doing like some
drug-
or smoking weed or doing all this stuff that I
done to cope with it so I wouldn’t know like what else
to do ‘cause I just didn’t have anybody to talk to….
So if I had one person in my life to build like that
one like that trusting relationship and I feel like that
would have helped me. (Wendy ## Footnote female participant)
I didn’t have nobody to go to so that’s why I took it
the way I took it. I took it the wrong way. If I had
somebody there I could vent to or release some frustration or talk to then I I wouldn’t have been through
some of the other things in my life I’ve been through.
(Terrance male participant)
done to cope with it so I wouldn’t know like what else
to do ‘cause I just didn’t have anybody to talk to….
So if I had one person in my life to build like that
one like that trusting relationship and I feel like that
would have helped me. (Wendy ## Footnote female participant)
I didn’t have nobody to go to so that’s why I took it
the way I took it. I took it the wrong way. If I had
somebody there I could vent to or release some frustration or talk to then I I wouldn’t have been through
some of the other things in my life I’ve been through.
(Terrance male participant)
221
Other youth
such as Luis and Travis
## Footnote
identified people in
their life who acknowledged and attended to their grief
and how they were impacted by experiencing enfranchised
grief. When asked how it made them feel when someone
acknowledged their loss they replied: It made me feel human. She brought me back to life
cause the way I would describe my actions and the
way I felt I felt like a zombie I wasn’t really living.
I felt like I was living in prison. And I haven’t done
anything wrong; I got harmed. (Luis male participant)
It felt pretty good. It really did. Because if I if I didn’t
have somebody that I cared for so much or loved so
much to be there for me at that time I don’t know
where I’d be at right now. (Travis male participant)
their life who acknowledged and attended to their grief
and how they were impacted by experiencing enfranchised
grief. When asked how it made them feel when someone
acknowledged their loss they replied: It made me feel human. She brought me back to life
cause the way I would describe my actions and the
way I felt I felt like a zombie I wasn’t really living.
I felt like I was living in prison. And I haven’t done
anything wrong; I got harmed. (Luis male participant)
It felt pretty good. It really did. Because if I if I didn’t
have somebody that I cared for so much or loved so
much to be there for me at that time I don’t know
where I’d be at right now. (Travis male participant)
222
It is critical that intentional efforts are made to avert negative outcomes for youth
in foster care
in foster care
which may otherwise be prevented by the
provision of appropriate support and services. Youth report
that this one factor ## Footnote the enfranchisement of their grief
could make the difference between positive and negative
long-term outcomes
provision of appropriate support and services. Youth report
that this one factor ## Footnote the enfranchisement of their grief
could make the difference between positive and negative
long-term outcomes
223
Ask kid with substance issue: what do you think
You need to stay sober
224
Children in foster care are separated from
their family members (e.g.
their family members (e.g.
parents
## Footnote
siblings)
and many experience a lack of clarity about if
and when they will see their loved ones again
(Lee & Whiting 2007; Mitchell & Kuczynski
2010; Samuels 2009). In fact the implications
of this loss are noteworthy when one considers that losing a loved one is one of the most
stressful life events for an individual to experience (Boss 1999; Lord Gramling & Auerbach
2012). I
and many experience a lack of clarity about if
and when they will see their loved ones again
(Lee & Whiting 2007; Mitchell & Kuczynski
2010; Samuels 2009). In fact the implications
of this loss are noteworthy when one considers that losing a loved one is one of the most
stressful life events for an individual to experience (Boss 1999; Lord Gramling & Auerbach
2012). I
225
at ambiguous loss is the most distressful of all losses because it is unclear
there is no
closure ## Footnote and without meaning there is no hope.
According to Boss (1999) “People hunger for
certainty. Even sure knowledge of death is more
welcome than a continuation of doubt” (p. 6).
closure ## Footnote and without meaning there is no hope.
According to Boss (1999) “People hunger for
certainty. Even sure knowledge of death is more
welcome than a continuation of doubt” (p. 6).
226
“Ambiguous loss is inherently traumatic because the inability to resolve the situation causes pain
confusion ## Footnote shock distress and often immobilization. Without closure the trauma of this
unique kind of loss becomes chronic” (p. 4).
227
). More than half of all children placed into
the US foster care system are 4 years of age or
older at the time of placement (US Department
of Health and Human Services
the US foster care system are 4 years of age or
older at the time of placement (US Department
of Health and Human Services
Administration
for Children and Families ## Footnote Children’s Bureau
2014b). As such many of these children have
had time t to develop roles expectations and
relationships with their original family unit and
to establish their own personal understanding
and experience of “family.” The accumulation
of these family experiences and transactions
contributes to children’s beliefs including
beliefs about who is involved in a family which
dynamics occur within a family the expectations within a family and one’s role within the
family unit. This conceptual understanding of
family can provide a child with psychological
security meaning and safety.
for Children and Families ## Footnote Children’s Bureau
2014b). As such many of these children have
had time t to develop roles expectations and
relationships with their original family unit and
to establish their own personal understanding
and experience of “family.” The accumulation
of these family experiences and transactions
contributes to children’s beliefs including
beliefs about who is involved in a family which
dynamics occur within a family the expectations within a family and one’s role within the
family unit. This conceptual understanding of
family can provide a child with psychological
security meaning and safety.
228
While living in foster care
children develop
relationships with many adult caregivers in the
absence of the physical presence of their original caregivers. Children in foster care are fed ## Footnote
clothed housed and nurtured by adults who
serve in the role of parents but are not their original parents. As these parent–child relationships
form and develop children may begin to question their beliefs about whom they should refer
to as Mom or Dad. Questions may arise such
as What is the meaning of a parent? Is a parent someone who lives with you? Can someone have many parents? Will it be hurtful to
my (original) parents if I allow other adults to
assume the role of parent? Will my (original)
parents be upset with me if I choose these people to be my parents? This process of meaning
making can be stressful for children especially
for those who are unclear about the structural
dynamics of foster care (i.e. structural ambiguity; Mitchell & Kuczynski 2010) and the duration of their foster care placement (i.e. temporal
ambiguity; Mitchell & Kuczynski 2010). B
relationships with many adult caregivers in the
absence of the physical presence of their original caregivers. Children in foster care are fed ## Footnote
clothed housed and nurtured by adults who
serve in the role of parents but are not their original parents. As these parent–child relationships
form and develop children may begin to question their beliefs about whom they should refer
to as Mom or Dad. Questions may arise such
as What is the meaning of a parent? Is a parent someone who lives with you? Can someone have many parents? Will it be hurtful to
my (original) parents if I allow other adults to
assume the role of parent? Will my (original)
parents be upset with me if I choose these people to be my parents? This process of meaning
making can be stressful for children especially
for those who are unclear about the structural
dynamics of foster care (i.e. structural ambiguity; Mitchell & Kuczynski 2010) and the duration of their foster care placement (i.e. temporal
ambiguity; Mitchell & Kuczynski 2010). B
229
Therefore
engaging in
situational reconciliation (i.e. ## Footnote when foster caregivers replace the original parents and become a
child’s parents in the psychological family) may
not be an option—or even desirable—for some
children in foster care. As such these children
may engage in n meaning making to achieve
global reconciliation; that is they adjust their
beliefs about their environment to accommodate
their global beliefs. For example children who
believe their parents should live in the same
home as them may become psychologically
distressed when living in a home where their
parents do not reside. Rather than change their
beliefs about who their psychological parents
should be to accommodate the situation (i.e.
situational reconciliation) these children might
adjust an initial belief of “my parents need to
live in the same household” to “my parents do
not need to live in the same household” (i.e.
global reconciliation).
situational reconciliation (i.e. ## Footnote when foster caregivers replace the original parents and become a
child’s parents in the psychological family) may
not be an option—or even desirable—for some
children in foster care. As such these children
may engage in n meaning making to achieve
global reconciliation; that is they adjust their
beliefs about their environment to accommodate
their global beliefs. For example children who
believe their parents should live in the same
home as them may become psychologically
distressed when living in a home where their
parents do not reside. Rather than change their
beliefs about who their psychological parents
should be to accommodate the situation (i.e.
situational reconciliation) these children might
adjust an initial belief of “my parents need to
live in the same household” to “my parents do
not need to live in the same household” (i.e.
global reconciliation).
230
More than half of children in the foster care
system have siblings who are also in foster care
(Child Welfare Information Gateway
system have siblings who are also in foster care
(Child Welfare Information Gateway
2013).
## Footnote
most siblings
do not reside in the same placement while
in foster care (Leathers 2005). This fact is
particularly disconcerting when one considers
that research on sibling relationships in foster
care reveals that placing siblings together can
promote resilience and well-being (Richardson
& Yates 2014). For
do not reside in the same placement while
in foster care (Leathers 2005). This fact is
particularly disconcerting when one considers
that research on sibling relationships in foster
care reveals that placing siblings together can
promote resilience and well-being (Richardson
& Yates 2014). For
231
My own correspondence with numerous
youth in foster care supports this view; that
is
youth in foster care supports this view; that
is
when separated from their siblings
## Footnote
older
children often experience guilt for being unable
to provide for their younger siblings and fulfilling the “parental” role they believe they
should assume. Ultimately not only are these
children grieving the loss of their siblings; they
are grieving the loss of their identities and their
role within their psychological family (Mitchell
2016).
children often experience guilt for being unable
to provide for their younger siblings and fulfilling the “parental” role they believe they
should assume. Ultimately not only are these
children grieving the loss of their siblings; they
are grieving the loss of their identities and their
role within their psychological family (Mitchell
2016).
232
Numerous supports can be offered to children
in foster care who are grieving the ambiguous
loss of a loved one
in foster care who are grieving the ambiguous
loss of a loved one
including
## Footnote
but not limited
to acknowledging and enfranchising the loss
(Doka 2002) providing opportunities within
the family for children to openly honestly and
safely discuss their grief experiences (Boss
1999 2006; Hooghe & Neimeyer 2013) and
increasing human connection through relational
and supportive networks (Boss 2006; Mitchell
2016). A
to acknowledging and enfranchising the loss
(Doka 2002) providing opportunities within
the family for children to openly honestly and
safely discuss their grief experiences (Boss
1999 2006; Hooghe & Neimeyer 2013) and
increasing human connection through relational
and supportive networks (Boss 2006; Mitchell
2016). A
233
But the rate of abuse-related fatalities has steadily" "increased over the past five years.
234
After years of research and scores of narratives from social workers and families, the profession has come to terms with the fact that our history of distinguishing poverty, racially biased practices and generational trauma from actual neglect has been" "imprecise and fraught with poor judgment. This resulted in labeling many families as “neglectful” and treating them in a punitive manner, sometimes separating children from their parents. It also created a significant backlog of cases in child welfare agencies, when an alternative, more family-friendly approach would have been more productive. [but, this push seems to align with a slight increase in child fatalities (although is that a price worth paying, but more fatalities means more non-fatal abuse to) (but is it consistent with increasing population numbers, no that numbers been decreasing)(but sometimes cause of poverty is also cause of neglect/abuse, as oppose to poverty being the direct cause of neglect/abuse)]
235
Number of children born per year in America "
Last year's slowdown marks an official end to the uptick in new babies that began during the COVID-19 pandemic. At least 3
591
## Footnote
328 babies were born in the U.S. in 2023
down 2% from the 3
667
758 born in 2022.
This is on par with annual declines seen before the pandemic
the report said
which averaged around 2% fewer babies each year.
"
236
Our messaging to candidates for national and state offices should include the reality that child welfare system is frequently the final stop for families who are beset by" " insufficient income for basic needs, the enduring remnants of generational poverty and trauma, untreated parental substance use and mental health problems, and complex child behavior issues that are too significant for other systems. These factors cause toxic stress in a family, putting kids at risk. [this is true to and maybe increase in child fatalities is also failure systematically. Of course it is, and some is individual, and some is systemic but so ingrained in that family that little can be done by the time they show up on CPS's radar]
237
The child welfare system has traditionally addressed safety, permanency and well-being, with safety receiving the most focus and funding. Child protection remains our priority, but in a way that is more expansive. Safety has been viewed through the narrow lens of " "physical harm. Decades of research on brain development, trauma and attachment make it clear that safety must also include emotional and psychological well-being. Extreme interventions like separation of children from their families may be a temporary, sometimes necessary fix in a time of crisis, but it can sacrifice the child’s sense of emotional and psychological security, ultimately creating long-term negative outcomes.
238
The phrase “hurt people hurt people” reflects a psychological truth: individuals who have experienced pain or trauma often unintentionally project that pain onto others. This can happen for several reasons: "
1. Unresolved Trauma: People who haven’t processed their pain may express it outwardly through anger
frustration
## Footnote
or harmful behavior
often without realizing it.
239
2. Learned Behavior: If someone grew up in an environment where harm or mistreatment was normalized
they might replicate those patterns in their relationships.
240
3. Emotional Overload: When someone is overwhelmed by their own pain
they may lack the capacity to empathize with others
## Footnote
leading to actions that inadvertently hurt those around them.
241
4. Defense Mechanisms: To protect themselves from further hurt
people may lash out preemptively or use harmful behavior as a way to feel in control.
242
243
Understanding this dynamic doesn’t excuse harmful behavior
but it can help foster compassion and guide efforts toward healing and breaking the cycle.
"
244
Children raised in abusive or neglectful households often internalize their experiences in ways that shape their emotional
psychological
## Footnote
and social development. This can lead to a cycle where the pain they endured influences how they interact with others later in life. Here’s how this process works: "
1. Internalizing Abuse as Normal
245
• Learned Behavior: Children exposed to abuse or neglect may come to view these patterns as normal or acceptable ways to handle relationships or emotions.
246
• Distorted View of Love and Trust: Abuse or neglect can blur the lines between love and harm
making it difficult for them to form healthy relationships.
247
248
2. Trauma Responses
249
• Fight
Flight
## Footnote
Freeze
or Fawn: Chronic stress from abuse can lead to maladaptive responses
such as lashing out (fight) or shutting down emotionally (freeze).
250
• Emotional Dysregulation: Abuse disrupts the development of self-regulation
leading to difficulty managing anger
## Footnote
sadness
or fear
which can result in harmful behavior toward others.
251
252
3. Attachment Issues
253
• Insecure Attachment: Neglect or inconsistent care often leads to insecure attachment styles
such as avoidant or anxious attachment
## Footnote
which can make relationships tumultuous.
254
• Fear of Rejection: Kids from abusive households may hurt others to avoid being hurt themselves
pushing people away before they feel vulnerable.
255
256
4. Low Self-Worth
257
• Projection of Pain: Feeling unworthy or unloved
they may project their internal struggles onto others
## Footnote
perpetuating the cycle of harm.
258
• Seeking Control: Having grown up in chaotic environments
they might use aggression or manipulation as a way to regain a sense of power.
259
260
5. Cycle of Abuse
261
• Repetition Compulsion: Without intervention
children might unconsciously replicate abusive dynamics because they are familiar
## Footnote
even if harmful.
262
• Unhealed Trauma: Unprocessed pain can manifest as anger
distrust
## Footnote
or detachment
which can harm their relationships.
263
264
Breaking the Cycle
265
266
While the cycle is powerful
it’s not inevitable. Healing is possible through:
267
• Therapy: Trauma-focused therapies
such as cognitive-behavioral therapy (CBT) or EMDR
## Footnote
can help reframe harmful patterns.
268
• Supportive Relationships: Safe
loving relationships can provide a model for healthy interactions.
269
• Self-Awareness: Recognizing the impact of their upbringing is a crucial step toward change.
270
271
Understanding the root of their behavior helps foster empathy while emphasizing the importance of healing and accountability.
"
272
If you can capture the government or persuade officials to see things your way
this can be worth billions of dollars. Financial regulation has failed repeatedly and in many countries precisely because the regulators became too close, in their worldview, to the people over whom they were supposed to be watching.
273
Create misperceptions of quality and you can overcharge people. This is obvious to you in a grocery store, because you can figure out at home the same evening if items are overhyped. But did you know
that some important parts of professional money management operate on exactly the same basis? Principal-agent theory may sound like irrelevant jargon, but in fact the core idea—that the people you hire do not necessarily have your best interests at heart—is the dominant organizing principle of modern finance.
