FAMILY THERAPY, FAMILY PRACTICE AND CHILD AND FAMILY POVERTY

1. FAMILY THERAPY, FAMILY PRACTICE AND CHILD AND FAMILY POVERTY HISTORICAL PERSPECTIVES AND RECENT DEVELOPMENTS

2. HARVY FRANKEL, M.S.W., Ph.D., ASSOCIATE DEAN AND ASSOCIATE PROFESSOR, FACULTY OF SOCIAL WORK, UNIVERSITY OF MANITOBA SID FRANKEL, M.S.W., Ph.D., ASSOCIATE PROFESSOR, FACULTY OF SOCIAL WORK, UNIVERSITY OF MANITOBA

3. CONTENTS • RELATIONSHIP OF SOCIAL WORK TO FAMILY THERAPY • AMBIVALENT RELATIONSHIP OF FAMILY THERAPY WITH POVERTY • INTERSECTION WITH CAUSE VERSUS FUNCTION DEBATE IN SOCIAL WORK • DEFINITION, MEASUREMENT AND DEVELOPMENTAL SEQUALAE OF POVERTY

4. CONTENTS CONTINUED • FOUR PROMISING MODELS DESIGNED FOR FAMILIES LIVING IN POVERTY • COHERENCE OF MODELS WITH SOCIAL SCIENCE LITERATURE • IMPLICATIONS FOR FAMILY CENTRED PRACTICE

5. RELATIONSHIP OF SOCIAL WORK TO FAMILY THERAPY • THE ROLE OF SOCIAL WORK IN FAMILY SERVICES CAN BE TRACED TO AT LEAST 1869, WHEN THE CHARITY ORGANIZATION SOCIETY WAS INITIATED • THE TERM “FAMILY-CENTRED PRACTICE” EMERGED IN THE 1950’S • SOCIAL WORKERS WERE WELL REPRESENTED AMONG FAMILY THERAPY PIONEERS IN THE 1950’S • FAMILY THERAPY BECAME AN IMPORTANT COMPONENT OF FAMILY SOCIAL WORK AND SOCIAL WORK EDUCATION

6. AMBIVALENT RELATIONSHIP OF FAMILY THERAPY TO POVERTY • PROBLEM OF POVERTY HAS BEEN AT HEART AND CORE OF SOCIAL WORK • CONVERSELY, FAMILY THERAPY HAS AN AMBIVALENT HISTORICAL RELATIONSHIP WITH POVERTY • ONE MAJOR SCHOOL DEVELOPED FOR URBAN POOR FAMILIES • EFFECTS OF SOCIAL ENVIRONMENT ACKNOWLEDGED • BUT, MAIN FOCUS HAS BEEN ON INTRA-FAMILIAL FACTORS TO THE NEAR EXCLUSION OF POVERTY ENVIRONMENTS

7. CAUSE VERSUS FUNCTION • HISTORIC CONCERN WITH POVERTY COMBINED WITH DEBATE ABOUT PROFESSIONAL ROLES • CAN CAUSE (REFORM) BE COMBINED WITH FUNCTION (SERVICE)? • LEE – CAUSE IS NATURALLY TRANSFORMED INTO FUNCTION AND THEY SHOULD NOT CO-EXIST • SCHWARTZ –CAUSE AND FUNCTION MUST BE COMBINED AS “PRIVATE TROUBLE IS ONLY A SPECIFIC EXAMPLE OF A PUBLIC ISSUE” • SPECHT AND COURTNEY – SOCIAL WORKERS HAVE BECOME UNFAITHFUL ANGELS AS THEY HAVE BEEN DIVERTED FROM SOCIETAL PERFECTIBILITY TO PSYCHOTHERAPY

8. DEFINITION OF POVERTY • CONTESTED ON POLITICAL AND IDEOLOGICAL GROUNDS DESPITE SIGNIFICANT BODY OF THEORY AND RESEARCH • STANDARD OF LIVING AT THE BOTTOM OF SOCIO-ECONOMIC STATUS HIERARCHY • INCOME • EDUCATIONAL ATTAINMENT • OCCUPATIONAL TYPE • RESIDENTIAL LOCATION

9. DEFINITION OF POVERTY • GENERALLY CONSTRUCTED ONLY AS FLOW OF INCOME INTO A FAMILY • NOT VARIATIONS IN FINANCIAL DEMANDS • NOT VARIATIONS IN ASSETS

10. ESTABLISHING THE POVERTY LINE • ABSOLUTE VERSUS RELATIVE MEASURES • ABSOLUTE: • GOAL OF PHYSICAL SUBSISTENCE (EXPERT NORMS) • NO REFERENCE TO SOCIAL AND CULTURAL NEEDS • SUBSISTENCE DEFINED RELATIVE TO NATIONAL AND CULTURAL STANDARD

11. RELATIVE POVERTY • GOALS • SOCIAL ROLE PERFORMANCE • PARTICIPATION IN SOCIALLY SANCTIONED RELATIONSHIPS AND ACTIVITIES • ADHERENCE TO CULTURALLY SANCTIONED BEHAVIORAL NORMS

12. MEASUREMENT OF POVERTY • OBJECTIVE VERSUS SUBJECTIVE • OBJECTIVE • ABSOLUTE: COST OF MARKET BASKET OF ESSENTIAL GOODS AND SERVICES IN RELEVANT MARKET • RELATIVE • PERCENTAGE OF MEDIAN INCOME • HIGHER THAN AVERAGE EXPENDITURES ON BASIC NECESSITIES

13. SUBJECTIVE MEASURES OF POVERTY • BOTH ABSOLUTE AND RELATIVE • PUBLIC PERCEPTIONS – SOCIETAL RATHER THAN EXPERT DEFINITION • DEPRIVATION INDEX OF SOCIALLY PERCEIVED NECESSITIES

14. IMPACT OF POVERTY ON CHILDREN • ELEVATED RISK FOR WIDE RANGE OF DELETERIOUS DEVELOPMENTAL OUTCOMES • PHYSICAL • EMOTIONAL • COGNITIVE • SOCIAL • EDUCATIONAL

15. SOURCES OF DEVELOPMENTAL EFFECTS • SOCIETAL DISCRIMINATION AND STIGMATIZATION • MATERIAL RESOURCES • COMMUNITY AND NEIGHBOURHOOD • FORMAL INSTITUTIONS • INFORMAL GROUPS

16. NEIGHBOURHOODS AND COMMUNITIES • MIXTURE OF PROTECTIVE AND RISK FACTORS • PROTECTIVE – SOCIAL SUPPORT • RISK – AMOUNT OF ECONOMIC INEQUALITY

17. ROLE OF FAMILIES • FAMILY STRESS THEORY • FAMILY INVESTMENT THEORY • ROLE MODEL THEORY • “WHAT MONEY CAN’T BUY”: PARENTAL FACTORS INDEPENDENTLY CONTRIBUTE TO UNEMPLOYMENT AND POOR PARENTING

18. PATHWAYS OF EFFECTS OF POVERTY • MATERIAL • PSYCHOSOCIAL • BEHAVIOURAL

19. PATHWAYS

20. EXEMPLARY MATERIAL PATHS • POOR NUTRITION • HOME ENVIRONMENTS WITH LIMITED STIMULATION OPPORTUNITIES • DELETERIOUS PREGNANCY OUTCOMES • EXPOSURE TO DISEASE AGENTS IN PHYSICAL ENVIRONMENT

21. BEHAVIOURAL PATHWAYS:AN EXEMPLARY MEDIATING BEHAVIOUR • HIGH RATES OF SMOKING • RESPONSE TO POVERTY ENVIRONMENTAL FACTORS • RELATED TO MORBIDITY FOR SEVERAL DISEASES • ESPECIALLY AMONG ADOLESCENTS AND SINGLE MOTHERS LIVING IN POVERTY

22. PSYCHOSOCIAL PATHWAYS • BROAD EFFECTS OF POVERTY ON MULTIPLE ENVIRONMENTS EFFECTING CHILDREN • INTERACTION BETWEEN PARENTS AND OTHER ADULTS – CAN IMPROVE PARENTING THROUGH SOCIAL SUPPORT • INTERACTIONS BETWEEN PARENTS AND CHILDREN – CAN BE NEGATIVELY EFFECTED • BALANCE OF NEIGHBOURHOOD RISK AND PROTECTIVE FACTORS

23. AN EXEMPLARY PSYCHOSOCIAL PATHWAY INCOME POVERTY FINANCIAL STRAIN PERCEPTION OF DISORDERED AND NEGLECTFUL NEIGHBOURHOOD ENVIRONMENT INCREASED PARENTAL ANXIETY, DEPRESSION AND ANGER

24. AN EXEMPLARY PSYCHOSOCIAL PATHWAY • INCREASED NEGATIVE PARENTING BEHAVIOUR AND DECREASED POSITIVE PARENTING BEHAVIOUR • POOR ADOLESCENT ADJUSTMENT

25. A CHILD’S VIEW OF RESOURCES AND PROTECTIVE FACTORS • FUNCTIONAL FAMILY RELATIONSHIPS • FRIENDLINESS OF NEIGHBOURS

26. FOUR FACTORS FROM POVERTY LITERATURE THAT FAMILY THERAPY SHOULD INCORPORATE • MATERIAL CIRCUMSTANCES • FAMILY’S COPING AND STRESS MANAGEMENT CAPACITIES • ASSIST PARENTS TO MAINTAIN GOOD RELATIONS WITH NEIGHBOURS AND COMMUNITY MEMBERS • PARENTAL MENTAL HEALTH

27. PROMISING MODELS

28. Congruence of Promising Models With Selected Findings from the Social Science Literature on Poverty

29. CONGRUENCE WITH SOCIAL SCIENCE LITERATURE CONTINUED

30. CAUSE AS WELL AS FUNCTION? • FAMILY THERAPIST INVOLVEMENT IN SOCIAL CHANGE ACTIVITIES • JUST THERAPY • THERAPISTS AS “THERMOMETERS OF PAIN” SHOULD INFLUENCE PUBLIC OPINION FOR POLICY CHANGE • THERAPISTS ARE ALSO INVOLVED IN COMMUNITY DEVELOPMENT, POLICY ADVOCACY AND POLICY RESEARCH AS PART OF THEIR JOBS • COMMUNITY FAMILY THERAPY FOCUSES ON SOCIAL ACTION AT THE LOCAL LEVEL AND NOT STRUCTURAL CHANGE • SYSTEMS ORIENTED FAMILY-CENTRED APPROACH FOCUSES ONLY ON AGENCY AND SERVICE SYSTEMS CHANGE

31. CAUSE AS WELL AS FUNCTION • MULTILEVEL SYSTEMS MODEL • COMBINATION OF PROFESSIONAL AND CITIZEN OBLIGATION • PUBLIC EDUCATION • AGENCY POLICY AND PROCEDURAL CHANGE • INFLUENCE PROFESSIONAL ASSOCIATIONS • RESEARCH • SUPPORT DEVELOPMENT OF COMMUNITY-BASED FAMILY SUPPORT PROGRAMS

32. SELECTED ASPECTS OF FAMILY-CENTRED PRACTICE • ALLEN AND PETR (1998) • STRENGTHS-BASED PERSPECTIVE • EMPOWERMENT ORIENTATION • RESPECT FOR DIVERSITY

33. Systems Oriented Just Therapy Multi-Level Community Family Family-Centred Systems Therapy Approach Therapy

34. Systems Oriented Just Therapy Multi-Level Community Family Family-Centred Systems Therapy Approach Therapy