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Chapter Aims In this chapter, you will learn: 3.
about traditional approaches to understanding and acting on behalf of
disadvantaged children and families and the problems associated with such
approaches 4.
2. the values and
principles of community psychology that enable us to reframe our notions of
disadvantaged families and how to respond to their needs 5.
about multi-focused, community-driven interventions and social
policies for disadvantaged children and families. |
3.
INTRODUCTION
In this chapter
you will learn how community psychology helps us to understand the context of
disadvantaged children and families and how we can act on behalf of and with
these families to change their conditions of marginalization and oppression. In
my discussion I consider how families and their problems have been understood
and how (western) society has responded to family needs. I also examine some of
the difficulties associated with understanding families in such ways and some
of issues that arise from a traditionally reactive and microlevel response. The
values that are central to understanding families and their needs from a
perspective of liberation and wellness are outlined and guiding principles and
concepts from community psychology that help us understand or reframe our
notions of families and their needs are discussed. Finally, multi-focused,
community-driven interventions and social policies for disadvantaged children
and families are described.
In the beginning
chapter of this volume Geoff and Isaac use the metaphor of a journey as a means
of explaining the context of community psychology. The analogy is also
appropriate for this chapter which focuses on disadvantaged children and
families. Families are not static entities. As they journey through life they
experience many developmental and situational transitions. These transitions
result in a dynamic context for family life that presents both opportunities
and challenges. Disadvantage may also be conceived of as a journey, if it is
understood as a process of needs not being met which leads to distress, crisis
and oppression.
It is important,
at the outset, to be clear about the meanings that are associated with the
designations “children and families” and “disadvantage.” Although there are
many family constellations, this chapter is focused on families in which there
is at least one infant, preschool or elementary school-aged child and at least
one primary caregiving adult who share a biological, adoptive or foster
relationship. Why focus on families with children? Unlike most other groups in
society, children are wholly dependent on others to meet their needs; they are
in essence “only beneficiaries of values” (Prilleltensky, Laurendeau,
Chamberland & Peirson, 2001, p. 147). Within society, children are
relegated to a subordinated position; they possess neither political nor economic
power. The actualization of their rights, which are stipulated in the United
Nations Convention on the Rights of the Child (1991), is contingent on the
ability and willingness of others to provide them with education, health care,
protection and adequate resources. Although children’s primary context is the
family, their well-being is influenced by, and therefore must be understood in
relation to, forces operating at broader levels of analysis.
Elsewhere Isaac,
Geoff and I have defined wellness as “a favourable state of affairs brought
about by the combined presence of cogent values, satisfactory psychological and
material resources, effective policies, and successful programs” and family
wellness as “a state of affairs in which everybody’s needs in the family are
met” (Prilleltensky, Peirson, & Nelson, 2001, p. 8). Disadvantage can be
considered in contrast to wellness, as a state of affairs in which values,
resources, policies, and/or programs are not satisfactory to meet the needs of
children and families. Disadvantage may be acute, transitory and related to
singular constraints or it may be chronic, generational and related to multiple
factors. Regardless, the consequence is that the ability of families to
function effectively in the ecological system (i.e., the personal, relational
and collective contexts) is compromised and there is a need for formal or
informal interventions to support them and respond to their unmet needs.
Although disadvantage may derive from many sources, in this chapter the impact
of low-income or poverty and the associated risks of such circumstances are
considered to be the primary cause of disadvantage for children and families.
Child poverty has
become a significant concern in Canadian society. Although there has been a
reduction in the number of children in Canada, the percentage of children
living in poverty has increased to the point where children constitute the
single largest group of poor people in our country (Ross, Scott & Kelly,
1996b). In the late 1980s the House of Commons passed a resolution to eliminate
child poverty by the turn of the century. At that time 14.5% of the child
population was living in poverty (Campaign 2000, 1997). However, during the
1990s the situation got worse, not better, with the child poverty rate rising
to 21% (Campaign 2000, 1997; Canadian Council on Social Development, 1998).
Obviously efforts toward the goal were unsuccessful.
The notion of
“child poverty” is somewhat misleading. As stated above, children do not hold
economic power and they are not expected to be financially responsible for
their needs or the needs of their families. A more accurate way of framing the
problem would be in terms of “family poverty.” Poverty rates in Canada are not
based on an official poverty line, rather they are often based on the
Statistics Canada low-income cut-off levels which vary greatly across the
country and are calculated according to family and community size. In the
mid-1990s the National Council of Welfare estimated that there were 2.6 million
poor households in Canada (Canadian Council on Social Development, 1997).
However, using statistical levels or cut-offs misrepresents the extent and
intensity of the problem. Many families live on incomes far below these levels
and there are also many families existing just above the levels which are not
included in the figures, yet encounter many of the same challenges and
difficulties as ‘officially’ poor families (Clarke, 1992; Ross, Scott &
Kelly, 1996a). Economically disadvantaged families experience unemployment or
underemployment, low levels of formal education, and negative social impacts
(Robichaud, Guay, Colin, Pothier & Saucier, 1994; Ross, Shillington &
Lochhead, 1994; Steinhauer, 1998). In addressing the Standing Committee on
Health, Simmons (1997) stated:
We know that growing up in poverty – and it
isn’t just the economic deprivation, it’s the psychosocial deprivations that
are highly clustered in a poor population – doubles the rate of just about
every poor outcome for children except conduct disorder, which is the
forerunner of delinquency, and it more than triples the rate of that. (p. 12)
As a risk factor, poverty begets stressors that magnify the challenges
of raising children and can hinder parents’ abilities to meet families’ needs
(A Choice of Futures, 1989).
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Insert Box 22.1 about here |
REFRAMING OUR NOTIONS OF FAMILIES AND
DISADVANTAGE
TOWARDS A WELLNESS AGENDA
In this section of
the chapter I examine traditional or neoliberal approaches to understanding and
responding to disadvantaged families. I also consider some of the challenges
that arise from such ways of knowing and acting. The values and principles of
community psychology are invoked to help reframe our notions and to better
understand and respond to the realities and needs of families experiencing
disadvantage. The conceptual framework presented in chapter two (see table 2)
is used as an organizing structure for the discussion.
From Individualism and Victim Blaming ...
The traditional
approach to understanding disadvantaged families is focused on a micro level of
analysis and looks either for difficulties within the family unit or within
particular family members. The dominant worldview in western cultures is that
of individualism. The assumptions of this narrative which include initiative,
independence, personal responsibility, and freedom of choice can be transferred
onto families. Families are expected to be self-sufficient entities and when
problems arise they are attributed to poor choices or deficits within the
family. Not recognizing the broader forces that influence disadvantage leads to
victim blaming and a doctrine of personal culpability (Goldenberg, 1978; Ryan,
1971) and encourages social acceptance of the negative consequences for
families (e.g., dislocation to segregated environments such as social housing
or the streets, working at menial jobs, living on social assistance).
Furthermore, there is evidence suggesting that individualism is associated with
negative outcomes, that in turn lead to more problems for disadvantaged
families (Lipset, 1996). For example, in conservative times of economic
restraint, individualism allows us to blame families on social assistance for
their problems and rationalizes cutbacks in social spending. Reductions in
benefits and/or withdrawal of employment programs further increases the
problems experienced by families and leaves little hope for overcoming
adversity.
The conventional
approach to helping disadvantaged families is equally problematic. The response
is often reactive, treating or administrating the family (e.g., counselling,
assistance programs) after problems have occurred. Since individualism views
the source of disadvantage within the context of the family, it is at this
level that intervention is directed. The influences of community and societal
level forces on family functioning are rarely considered. We try to change
families, not situations of poverty, unemployment, poor housing, limited or
inaccessible resources, and lack of social cohesion. We focus on the surface
manifestations of disadvantage, not the deep causes (Joffe, 1996). As such our
efforts are ameliorative rather than transformative as we try to teach families
how to live with adversity rather than working to change the unjust social
conditions that lead to problems in the first place. This approach puts
disadvantaged families in a subordinate position to the rest of society and
implies that they need to be repaired somehow or that their lives need to be
managed by others.
... to a Holistic, Strengths-based Ecological Perspective
Adopting a
holistic perspective redirects our attention from a deficit-orientation towards
a focus on the strengths of families living in adverse conditions. An
empowering or strengths based focus identifies assets and capacities in
families that offers hope and opportunities not only to families but also to
service providers. Consider the following scenario. The Smith family includes a
single mother and two children ages four and six. Child support payments are
nonexistent and their only source of income is through social assistance
benefits which are usually insufficient to cover expenses for basic needs. They
live in a social housing complex that is in poor repair and frequented by local
drug dealers and users. The family does not own a car, so many community
resources, including grocery stores, the library, parks, and doctor’s offices
which are located several miles away, are not easily accessible. What does this
description lead us to believe about the Smiths and the possibilities for
improving their situation? The picture looks rather bleak for this family and
it would not be unreasonable for a community service worker to feel powerless
to assist in a meaningful way given the complexity of challenges. However, if
the assessment was reframed to considered the strengths of the Smith family and
their environment (e.g., a supportive grandmother who will care for the
children while the mother attends an employment retraining program, interest
from residents in the housing complex in forming a neighbourhood watch program,
a community kitchen, and a co-operative day care centre) the situation and
potential opportunities might appear quite different.
The value of
holism also draws on the ecological principles (described in chapter four)
which allow us to contextualize the problems experienced by families over time
and across multiple levels of analysis. It reflects the importance of focusing
on the whole family in the context of relationships, settings and environments
in which the family is embedded. Within families, members rely on one another
for cognitive, emotional, psychosocial and economic needs. Often the analysis
stops here; looking at the individual or microsystem, but not beyond. The
ecological principles acknowledge that families are impacted by individual
members and the family setting, but also by other components of the microsystem
(e.g., extended family, peer networks), the organizations they are connected
to, the community environment, social norms and values, social and economic
policies, and environmental issues. The problems associated with, or leading to
family disadvantage do not always originate within the family or a particular
member of the family, rather they often arise due to conditions or changes
within broader structures that in turn influence the health and well-being of
families. Consistent with this understanding, the focus of interventions
targeting disadvantaged families should go beyond educational or skill-building
programs offered to parents and children, to efforts aimed at altering or
improving social and economic conditions within the meso and macro levels.
From Psychosocial Problems ...
Traditionally,
psychological research and action has focused on psychosocial problems within
individuals or the family unit (e.g., addictions, teen pregnancy, child
maltreatment, delinquency and crime). Dysfunctions are conceived as emanating
not from adverse economic conditions or individual attempts to cope with
inequalities in social and economic power, but rather from inferior genes, poor
parenting skills, lack of problem-solving skills, ineffective communication
patterns, and so on. In essence our understanding of disadvantage has been
reduced to the psychosocial level or to the surface manifestations of the
problem. This perspective has lead to a treatment orientation that seeks to
ameliorate difficulties at the personal or relational (within family) levels.
This approach does not challenge the status quo, rather it attempts to reduce
maladaptive behaviours or fix the individual and/or family to enable them to
function within established societal structures and norms.
... to Prevention and Promotion
The principles of
prevention and promotion invoke the value of health and are used to resist
psychosocial problems and to encourage well-being. In our everyday use of the
term, health has two meanings, one negative and one positive. The negative
definition of health, the one that is widely accepted in western cultures,
refers to the absence of disease or illness. The positive interpretation of
health, as defined by the World Health Organization in its 1946 constitution,
is “a state of complete physical, mental
and social well-being, not merely the absence of disease or infirmity” (p. 2).
It is the latter definition that is of interest to community psychology for it
recognizes that health is a multidimensional concept that can and should take a
positive form. A more recent publication of the World Health Organization, the
Ottawa Charter (1986), states that “health is a positive concept emphasizing
social and personal resources, as well as physical capacities” and calls for
“coordinated action by all concerned: by governments, by health and other
social and economic sectors, by non-governmental and voluntary organizations,
by local authorities, by industry and by the media” in meeting the
prerequisites for health which include “peace, shelter, education, food, income,
a stable eco-system, sustainable resources, social justice and equity.” These
ideas are also of interest to community psychology as they reflect a competency
orientation, the influence of the social context on health and well-being,
intersectoral cooperation at multiple ecological levels, as well as social
ethics and emancipatory values (refer back to table 1.1 which outlines the
assumptions and practices of community psychology).
Prevention and
promotion aimed at disadvantaged families can reflect personal, collective and
relational dimensions. At a person/family-centred level, interventions can
focus on: decreasing or dealing effectively with stress created by adverse
living conditions; reducing the detrimental effects of physical vulnerabilities
which may have contributed to or resulted from disadvantage; increasing
problem-solving, decision-making, social, and coping skills; expanding
perceived networks of social support; and, developing self-esteem and
self-efficacy (Albee, 1982). Such efforts respond to the values of
self-determination, caring and compassion, and health.
Interventions that
foster collective well-being emphasize the role of broader structures in
preventing psychosocial problems and promoting health. At an environmental
level, efforts can be directed toward: decreasing or removing stressors in
socialization settings (e.g., schools, workplaces, health care); reducing the
presence of risk factors in the environment that lead to increased physical
vulnerabilities (e.g., poor prenatal care, exposure to hazardous substances,
inadequate heating and ventilation); developing positive socialization
practices (e.g., effectively preparing parents, teachers, employers and others
to assume their roles); expanding the strength, availability and accessibility
of social support resources; and, increasing opportunities for positive
relatedness to others and connections with formal and informal settings (Elias,
1987). At the societal level, through the unified action of all sectors,
healthy public policies can be established to “[reduce] differences in current
health status and [ensure] equal opportunities and resources to enable all
people to achieve their fullest health potential [which] includes a secure
foundation in a supportive environment, access to information, life skills and
opportunities for making healthy choices” (World Health Organization, 1986).
These programs and policies foster the values of support for community
structures and social justice and accountability.
Promoting
relational well-being requires that interventions both in the personal and
collective domains, respect differences among disadvantaged families, allow
families to define their needs, promote acceptance, and facilitate meaningful
involvement of disadvantaged families in making decisions affecting their
lives. In so doing, the values of
respect for diversity and participation and collaboration are advanced.
Relational wellness may also be supported through interventions that encourage
involvement and collective responsibility such as mutual aid groups, community
development initiatives, and social and political action.
From Social Isolation ...
Physical
isolation, or geographic separation, can pose significant challenges for
disadvantaged families (e.g., limited interaction with extended family or
friends, lack of access to needed resources and services such as physicians,
schools, and transportation). On the other hand, simply living in close
proximity to others does not ensure that disadvantaged families are socially integrated.
Families may choose or be forced to become insulated from their neighbours and
surrounding community for a variety of reasons such as a fear of crime or
violence, suspiciousness, and the
burdens of caring for children or working at multiple jobs.
As one of the
structures of oppression, containment serves to intensify the social isolation
experienced by disadvantaged families. Goldenberg (1978) describes containment
as “limit[ing] the range of free movement available to a particular group ... increasingly
restrict[ing] and narrow[ing] the scope of possibilities that can be
entertained ... [and effectively] quarantining ... people from the
possibilities of change” (pp. 4-5). Families with limited economic resources
are often forced to move into social housing or other lower-income
neighbourhoods. The quality of life and the prospects for a better future for
residents in these areas are hampered by poor conditions, absentee landlords,
violence, stigma, and distance from important community resources such as
quality schools, clinics, and grocery stores. Mobility issues also contribute
to the social isolation experienced by disadvantaged families. Not having a
car, or a reliable vehicle, or other convenient and affordable means of travel
can limit the possibilities available to families. Getting to work, attending
appointments, grocery shopping, visiting community resources such as libraries,
parks and other facilities, and taking family trips can be arduous journeys
which may often be avoided, passed up or impossible. Disadvantaged families are
excluded from participating in their communities due to their inability to pay
for many services and opportunities such as recreational activities, summer
camps, and training courses. Endowments that might once have been available to
support the inclusion of disadvantaged children and families in community
activities have diminished or been eliminated in response to government funding
cutbacks. Essentially the oppressive social and economic conditions experienced
by disadvantaged families trap or ‘contain’ them in abject environments with
limited opportunities for inclusion in the broader community.
... to Community
The values of
caring, compassion, and support for community structures involve empathy and
concern for the welfare of others and emphasize the importance of networks and
settings that facilitate the pursuit of personal and communal goals
(Prilleltensky, Laurendeau, Chamberland, & Peirson, 2001). Although there
are many caring and compassionate practitioners who have dedicated their
working lives to helping disadvantaged families, there is not, nor will there
ever be a sufficient number of professionals trained to deal with the needs of
the population (Albee, 1959). Nor is the traditional professional-client
relationship the only, or best, context for responding to many of the problems
associated with adversity. Disadvantaged families need more than therapy or
other professional services, they need access to informal supports and strong
community structures.
Informal
relationships can provide disadvantaged families with ongoing generalized
support as well as specific support related to particular stressors (Sarason,
Sarason, & Pierce, 1990). Although adverse conditions may lead to a sense
of containment, most disadvantaged families do not live in complete physical
isolation from others. Psychological sense of community and social integration
can be facilitated through mechanisms of connecting families to one another
such as block or neighbourhood associations, community cooperatives, and
religious congregations. The relationships formed within these networks can
provide families with a sense of belonging, emotional support, socialization,
encouragement, advice, tangible supports such as child care, money, clothing,
meals, and transportation, as well as opportunities to reciprocate with support
when others require assistance. Relational well-being may also be promoted
through self-help and mutual aid groups that deal with problems or issues
affecting disadvantaged families and which provide connections to others and
various specific supports in egalitarian, respectful and reciprocal contexts.
In addition to
social networks, developing the capacity to promote family wellness can occur
through building support for the community structures that disadvantaged
families interact with in their everyday lives. Ensuring a broad range of
accessible, responsive and publically funded institutions is a critical factor
in preventing problems associated with disadvantage and for promoting the
well-being of all citizens (Prilleltensky, Laurendeau, Chamberland, &
Peirson, 2001). Included in this array would be health care services, schools,
transportation systems, waste management and water treatment facilities, libraries,
cultural and recreational opportunities, police and other justice services,
insurance and assistance programs, and many other vital resources and agencies.
However, these structures that work for the common good are often taken for
granted, and tend to be noticed more in their absence, in times of shortages,
cutbacks, or strikes. These institutions are also threatened by neoconservative
and neoliberal forces intent on dismantling the welfare state and privatizing
many community services (O’Neill,1994). Withdrawal of such fundamental public
resources or initiating fee-for-service policies would further disadvantage
many families already living in adversity and may also result in negative
consequences for families that are currently coping adequately because of
supports they receive from these various institutions. Recognizing, valuing,
protecting, maintaining and expanding the welfare state are important steps
toward promoting collective responsibility for the well-being of society’s most
vulnerable families.
From powerlessness ...
Disadvantaged
children and families lack both sense of control and actual control over many
aspects of their lives. Despair over the past and present and hopelessness for
the future are created and maintained by their oppressive social context.
Limited economic resources means that disadvantaged families are often forced
to live in social housing or low-income neighbourhoods. They usually do not own
their homes thus they are subjected to the conditions imposed by governments
and landlords. They usually cannot afford to register in skills training
programs or to send children to college or university. Without post-secondary
education they are often relegated to menial, low-paying jobs with little
opportunity for advancement, or they must rely on social assistance benefits.
The initiative of many families receiving social assistance benefits is
repressed as income received from other sources is clawed back from support
payments or there is a threat that benefits may be cut off entirely. These
conditions and restrictions reflect the concept of containment and another
structure of oppression, compartmentalization. “Compartmentalization is the
process which encourages partial rewards at many levels but denies fulfilment
at any one level” (Goldenberg, 1978, p. 11). Disadvantaged families are
powerless because they cannot change their living situations without risking
their access to shelter and means of survival. They lack choice and opportunity
and are subordinated to others who control, monitor and administrate their
lives.
Disadvantaged
families also experience powerlessness in the contexts of service provision
(e.g., mental health, physical health, legal, child welfare) and research. The
traditional approach views professionals as expert-technicians, as specialists
who have expertise and are given authority to assess and treat families.
Families, on the other hand, are viewed as clients, as passive recipients of
services that are under professional control. Unable to pay for private consultation,
disadvantaged families are without choice in terms of service options or
specific practitioners. They are often queued in lengthy wait lists to access
services which are deemed appropriate by others and which are provided by
agency-appointed staff. Disadvantaged families are also often treated as
passive objects of research. Traditional research has circumscribed the role of
the family to that of a data source. In a number of qualitative studies I have
been involved in, parents and youth have commented that researchers repeatedly
come to them for information about the realities of disadvantaged living, but
they are never certain what happens to the knowledge they convey because their
adverse situations persist.
... to Power
How can
disadvantaged families that experience such an extreme lack of control acquire
power and assert authority over their own lives? The principle of power
emphasizes the values of participation, self-determination, and social justice.
It is through the intertwining of these three values that disadvantaged
families can gain both voice and choice.
The value of
participation refers to respectful collaborative processes wherein all
stakeholders have meaningful input into decisions that affect their lives
(Prilleltensky, Laurendeau, Chamberland, & Peirson, 2001). The practical
experience of families living under adverse conditions must not be dismissed.
Disadvantaged families should be involved in identifying their needs and
determining appropriate responses. However, their participation must not be
based on token strategies of inclusion, for this denotes a subordinated
position. Instead, the power to define problems and shape solutions must be
shared in value-based relationships of partnership (Nelson, Prilleltensky,
& MacGillivary, 2001). Responding to the value of accountability, the
principles of commitment and depowerment direct researchers, service providers
and policy makers to work with disadvantaged families, not for them. Through
its inter-disciplinary ties, community psychologists are learning how to
promote the active participation of marginalized populations in decision-making
processes. Feminist-oriented participatory action research and the application
of traditional Native teachings are two examples of approaches to involving the
often unheard voices of disadvantaged groups.
To acquire power,
disadvantaged families must have more than voice, they must also have choice.
The value of self-determination refers to the ability of families to pursue
chosen goals and direct their lives without facing formidable obstacles
(Prilleltensky, Laurendeau, Chamberland, & Peirson, 2001). Rather than
having their lives externally orchestrated or regulated, disadvantaged families
need to have control over decisions that affect their present and future
well-being. Personal empowerment is enhanced when families maintain a sense of
agency and experience autonomy in their everyday lives. Self-efficacy, which
develops through having such control, acts as a protective mechanism against
various risks associated with disadvantage and helps families cope with the
daily stressors of living in adversity (Prilleltensky, Nelson & Peirson,
2001b). However, self-determination is dependent upon the actualization of the
third value connected to power, social justice.
In order for
families to be able to make choices, options must exist and opportunities must
be accessible. Social justice reflects the fair and equitable distribution of
bargaining powers, responsibilities, and resources in society (Prilleltensky,
Laurendeau, Chamberland, & Peirson, 2001). This value blends the components
of voice and choice such that the needs of disadvantaged families are
identified by those who live the experience and there are programs and policies
in place that respond to these needs. In the current conservative climate which
discriminates against disadvantaged families and other marginalized groups,
social justice is brought about through social change movements that promote
the notion of collective well-being and a vision of a more just and caring
society. There are many national, provincial, and local organizations that have
been formed across Canada to address the issues of disadvantage, fight poverty,
and advocate for equity in the division and distribution of societal and
regional resources, including Campaign 2000, the Ontario Coalition Against
Poverty, the Poverty Action Network in East Vancouver, the Poverty in Action
Society in Edmonton, the Community Action on Poverty Coalition in Winnipeg, and
the Hamilton-Wentworth Coalition for Social Justice.
From Discrimination ...
What is a family?
Each of us, no doubt, has our own opinion as to what constitutes the “ideal”
family which is shaped by personal experience and attitudes, social norms, and
media influences. The image often conjured is one similar to the Cleaver family
portrayed in the 1950/60s television series, Leave it to Beaver. But is this
suburban, two-parent (working father, stay-at-home mother), two well-adjusted
(although adventurous) children family “normal”? This scenario may be true for
some families, but in contemporary society there are various family
constellations. Families today take many forms and function under diverse
circumstances. For instance, there are two-parent married families, single-parent
families, blended families, cohabitating families, reconstituted families,
grandparent and grandchildren families, teen-parent families, same-sex
families, shared-home families, immigrant families, mixed ethnicity or religion
families, dual-earner families, poor families, adoptive or foster families, and
so on (McCoy, 1996). Although “recent studies have expanded the data base to
many cohorts ... diverse families still tend to be evaluated in comparison to
one standard” (Walsh, 1996, p. 268). Ideologically we still romanticize the
Cleaver family model popularized in the conservative era of the 1950s. Although
contemporary discourse reflects diversity and an acknowledgment of the
different types of families, conservative values dominate and nontraditional
families continue to be rejected (Leonard, 1997) and are discriminated against
by policies and social norms (Eichler, 1997; Lindeman Nelson, 1997; Nicholson,
1997). In turn, nontraditional families internalize this discrimination and are
made to feel ashamed for their differences and responsible for their oppression
(Goldenberg, 1978).
... to Inclusion
The principle of
inclusion calls upon the value of respecting diversity. Families should not be
judged against a single standard, they should have the right to be different,
and they should not be made to suffer because of their differences. The unique
social identities of families need to be respected and accepted. Our notions
about families guide our assumptions and the allocation of societies’ resources.
To promote equity, it is important that our policies and programs reflect the
different types of families and respond to their varying needs.
INTERVENTIONS
FOR CHILDREN AND FAMILIES:
ECOLOGICAL AND EMPOWERMENT APPROACHES
Community
psychology involves both thinking and action. In the previous section I
discussed ways in which we understand families and disadvantage. In this next
section I focus on the action component, describing some of the programs and
policies that benefit disadvantaged children and families. A review of the
literature indicates that there are numerous preventive interventions
targetting disadvantaged children and families (Nelson, Laurendeau,
Chamberland, & Peirson, 2001). Given that these families are already
experiencing adversity, and may be at-risk for additional problems, the types
of interventions they encounter tend to be selective or indicated (Institute of
Medicine, 1994). Many programs adopt a single focus (e.g., cognitive
problem-solving, social decision-making, stress management, home visitation),
are targetted at the micro level (on children, parents or families), and are of
a relatively short duration. Numerous programs are also professionally driven
or led, and are implemented in a single context (e.g., home, school,
workplace). While there is substantial evidence that supports the effectiveness
of many of these programs in realizing their goals, they do not respond to the
range of values and principles promoted by community psychology. In order to
advance personal, relational, and collective well-being for disadvantaged
families and to support a tranformative social agenda we must look beyond
traditional approaches to multi-focused, community-driven and policy level
interventions.
Multi-Focused, Community-Driven Programs
Multi-focused
programs acknowledge the value holism, recognizing that targeting single
contributing factors is unlikely to respond to the complexity of cumulative and
interacting variables leading to and perpetuating disadvantage. Drawing on the
ecological principle, multi-focused programs also recognize that factors beyond
the microsystem, at the meso and macro levels, significantly influence the
incidence and conditions of disadvantage. Although psychosocial problems associated
with disadvantage may be addressed within multi-component interventions, this
focus may be balanced by long-term efforts to develop social support and
community capacity. Community development is a major component of many
multi-focused programs often resulting in the creation of neighbourhood
organizations. These organizations typically respond to the needs of families
of preschool and elementary school aged children, offering a variety of
resources including child care and family support (Zigler, Finn-Stevenson,
& Stern, 1997). Reciprocal informal support among neighbours is also
stimulated by such interventions (Garbarino & Kostelny, 1992; Korbin &
Coulton, 1996; US Advisory Board on Child Abuse and Neglect, 1993).
The fact that
these programs are community-driven advances several additional values
including self-determination, participation, respect for diversity, and
accountability. While researchers and other professionals may be involved in
the process, it is in partnership with disadvantaged community members who have
a major voice in identifying their needs and wants as well as choice in
determining what types of interventions are necessary and how they will be
implemented (Nelson, Prilleltensky, & MacGillivary, 2001; Rothman &
Tropman, 1987).
Although most
programs targeting disadvantaged families are more narrowly focused and
professionally directed, there is evidence that multi-component, community
driven interventions are becoming more salient. Descriptions of proactive
universal applications for disadvantaged families are beginning to emerge in
the literature. Better Beginnings, Better Futures (BBBF), 1,2,3 GO!, and the
Community Action Program for Children (CAPC) are three examples of
multi-focused, community-driven, universal prevention programs being
implemented with children and families living in socioeconomically
disadvantaged communities in Canada. While these programs are situated in
high-risk communities, they fit the description of universal programs because
the services and supports are available to all families in the area with
children in the targeted age range.
Better Beginnings,
Better Futures is a 25-year longitudinal prevention research demonstration
project that began in 1991 and is currently being implemented in eight culturally
diverse communities across Ontario. The project focuses on families with
children prenatally to age eight and has three primary goals: (a) to prevent
serious social, emotional, behavioural, physical, and cognitive problems in
young children; (b) to promote the social, emotional, behavioural, physical and
cognitive development of young children; and, (c) to enhance the ability of
socioeconomically disadvantaged families and communities to respond effectively
to the needs of their children. The program model followed in each of the eight
sites incorporates two key features: (a) a comprehensive, holistic perspective
addressing multiple ecological levels (child, family, and community), and (b)
local responsibility and collaborative partnerships among professionals,
parents, and other community members. While community involvement helped shape
the supports and services to match the needs and resources of each community,
there was uniformity in several elements: (a) professional and informal home
visitation for expectant parents and families with young children; (b)
classroom enrichment offering social skills training, academic tutoring and
teacher support; (c) child care enrichment in the form of additional staff in
existing child care facilities, drop-in centres, and toy-lending libraries; (d)
family and parent focused programs providing a variety of activities such as
parent training, support groups, cooking classes, and prenatal programs; and,
(e) community programs designed to establish new resources, improve quality of
life in the community at large, and enhance respect for cultural diversity. An
extensive multidisciplinary evaluation of the processes and outcomes at each
site, and across all eight communities, is in progress (Peters, 1994).
In 1995 the 1,2,3
GO! program began in six high risk neighbourhoods in greater Montréal with the
primary goal of creating environments conducive to the development of families
with children from birth to three years of age. 1,2,3 GO! adopts a multi-level
ecological framework that emphasizes community empowerment and respect for
diversity. The program operates by mobilizing community members and building
alliances among community resources to determine and meet the needs of
disadvantaged children and families in the area. Parents, citizens, community
practitioners and decision makers work in partnership to develop a vision and
specific action plans. The services and supports provided in each neighbourhood
vary depending on the unique needs identified in that community. Priorities in
some neighbourhoods have included creating safe parks, facilitating access to
toys and recreational opportunities, and enhancing the development of language
and reading skills. The 1,2,3 GO! initiative is supported by various committees
that address programming, community leadership, and funding. Using a
participatory approach, a research team is also studying the development of the
project and its outcomes (Bouchard, 1997; Centraide of Greater Montréal, 2001).
Whereas 1,2,3 GO!
is a locality based project and BBBF is a provincial initiative, the Community
Action Program for Children is a national program with long-term funding
provided by Health Canada. CAPC is one component of the Brighter Futures
campaign that developed out of the 1990 World Summit for Children at the United
Nations. The overriding goal of CAPC is to promote the health and well-being of
at-risk families with children prenatally to age six. In the year 2000, there
were 410 operational CAPC projects across the provinces and territories that
were providing almost 2,000 programs and reaching over 100,000 participants.
Although it is a national initiative, CAPC projects are established at a
community level, and the priorities and programs differ somewhat from location
to location, reflecting the specific needs and desires of each community. Some
of the main program objectives include improving parenting skills, decreasing
isolation, increasing self-esteem, improving child development, and increasing
knowledge of available services. There are many different activities that are
offered across the CAPC sites, but the more common ones involve child focused
activities, formal and informal classes, parent-child groups, one-on-one and
group support, drop-in, home visitation, and field trips as well as other
events, and most of these programs operate year-round. The CAPC model
emphasizes the importance of community level partnerships, recognizing that the
people who live and work in a particular community are best able to identify
needs and provide supports. Program participants become involved and contribute
to the management and delivery of their community project in various ways
including formal and informal opportunities to express views and opinions,
volunteering in the delivery of programs, participating on committees that
provide advice to the project’s governing body, or sitting on the governing
body that makes decisions about the project and its programs (Health Canada,
1999, 2001).
Multi-component
proactive high-risk applications for disadvantaged families also appear in the
literature [e.g., the Syracuse University Family Development Research Program
(Lally, Mangione, & Honig, 1988), the Houston Parent-Child Development
Centre (Johnson & Breckenridge, 1982), the Yale Child Welfare Research
Program (Seitz, Rosenbaum, & Apfel, 1985), the Avancé program in San
Antonio (Rodriguez & Cortex, 1988)]. However, while these programs are
considered to be community-based, the critical feature of community
participation is less evident in these approaches (Boutilier, Cleverly, &
Labonté, 2000). Without the partnership of those who will benefit from
interventions and retaining professional control over decision-making, it is
not certain that the programs that are implemented reflect the needs and desires
of the community.
Multi-focused,
community-driven programs that provide a comprehensive array of universal
supports and services to families in low-income communities, while engaging
residents in the definition and decision-making processes, are emerging as
promising interventions for promoting well-being and preventing psychosocial
problems associated with disadvantage. Although on-going, evaluative research
on these programs has begun to show positive impacts for children, parents,
families, and communities (Health Canada, 1999, 2001; Peters et al., 2000) and
studies have identified the development of successful partnerships involving
parents and community members in the creation and implementation of programs
(Cameron, Peirson & Pancer, 1994; Health Canada, 2001; Pancer &
Cameron, 1994).
Social Policy Interventions
While
multi-focused, community-driven approaches can respond to the needs of
disadvantaged children and families for prevention, inclusion, support, sense
of community and personal empowerment, they cannot change the macrosocial and
political factors that significantly influence conditions of adversity
(Febbraro, 1994). To address socioeconomic inequalities and poverty, and to
promote the well-being of children and families, social interventions must be
mounted to advocate and develop social policies that will ensure a more just
and equitable distribution of resources among all members of society.
As part of the
Family Wellness Project (Prilleltensky, Nelson & Peirson, 2001a), Ray Peters
and his colleagues (2001) conducted a comprehensive review of social policies
(legislation, benefits and services provided by governments) to promote the
well-being of children and families. In their research they found that many
countries, particularly those in western and northern Europe, have implemented
universal child-conditional income and tax transfer policies that effectively
reduce economic inequalities. In Canada cash benefits are no longer universally
provided, instead they are means-tested and targeted at lower-income families.
While this means that these non-taxable benefits are more responsively directed
at disadvantaged families, they assist working-poor families more than they
support families receiving welfare since provinces have clawed back benefits
from welfare parents supposedly in order to fund programs for low income
families.
At the selective
level of intervention, some countries (e.g., Sweden and France) have instituted
advance maintenance child support policies that guarantee payments to custodial
parents and thus protect single-parent families which are often vulnerable to
poverty and psychosocial problems. If a noncustodial parent defaults on
support, the government makes the payment to the custodial parent and then
assumes responsibility for collecting from the noncustodial parent. In most
Canadian provinces child support payments must be privately enforced, and while
the paying parents (usually fathers) are provided with tax concessions for
their support contributions, the custodial parents (usually mothers) are taxed
on the payments they receive.
Universal policies
that provide other benefits such as parental and extended child care leave and
early childhood care and education, are also important for promoting family
health and well-being during the early stages of parenthood. Compared to
Anglo-American countries, European nations provide more weeks of paid leave and
a higher rate of pay and many of these countries also offer supplementary
benefits to women who are raising children, regardless of their participation
in the workforce. On December 31, 2000 Canada doubled the total length of leave
for new parents (birth and adoptive) to a maximum of 50 weeks of combined
maternity and parental leave with benefits of 55% of average weekly insurable
earnings to a maximum of $413 per week (Human Resources Development Canada,
2002). Although still far below other countries in terms of the percentage of
pay provided during the legislated leave, the duration of leave has been
significantly extended. With respect to child care, despite advocacy efforts
from various sources, Canada still does not have a national policy to support a
public system of early childhood care and education services for its children.
This is a significant issue since child care is often the single largest
child-related expense a family incurs and it more than doubles the annual costs
of raising younger children. Public models of child care responsibility that
provide well-subsidized, high-quality child care to a large percentage of
parents have, once again, been established in a number of European countries
such as France and Sweden.
The importance of
focusing on a transformative social justice agenda through equitable and
responsive social policies is supported by research on the social determinants
of health. Wilkinson (1994, 1996, 1997) and others (Ben Shlomo, White &
Marmot, 1996; Kaplan, Pamuk, Lynch, Cohen & Balfour, 1996; Kennedy, Kawachi
& Prothrow-Stith, 1996) have argued from an economic perspective that in
advanced industrial societies a country’s wealth status does produce health to
some extent, but there is a point beyond which the relationship between wealth
and health disappears becoming instead a function of the relative gap between
rich and poor. Furthermore, it should be noted that it is not just the health
status of those individuals who exist at the polar extremes of poverty and
wealth that is at stake, but rather we are all affected as inequalities of
morbidity and mortality have been found to apply across the socioeconomic
gradient (Adler, Boyce, Chesney, Cohen, Folkman, Kahn & Syme, 1994). From
this perspective the focus of policy should not be relegated to wealth
generation strategies in the pursuit of improving health and the reduction of health
related problems, but rather to concentrate on developing and instituting
fundamental mechanisms for ensuring the equitable distribution of wealth across
the population. Social interventions promoting a model of collective
responsibility will thus serve not only those children and families who are
most vulnerable, but the whole of society.
SUMMARY
In this chapter, through a traditional lense we see that when disadvantaged families are viewed in terms of deficits, blamed for their misfortunes, measured against single standards, discriminated against, and treated as passive recipients of services, they become socially isolated, excluded, and powerless. However, viewed through a community psychology lense we see that disadvantaged families have strengths, are impacted by forces at multiple ecological levels, reflect diversity, and have rights to power, inclusion, and self-determination. It is also evident that interventions that focus on multiple components, that involve participants as meaningful stakeholders, and that promote equity and social justice, can foster hope, social change and enhance opportunities for disadvantaged children and families to become valued members of society and have their health needs met. By focusing on values, principles and interventions that support personal, relational, and collective well-being we can work to transform unequal systems of power and privilege thereby improving the lives of disadvantaged children and families.