Building Integrated Connections for Children, their Families and Communities [1 ed.] 9781443832809, 9781443832779

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Building Integrated Connections for Children, their Families and Communities

Building Integrated Connections for Children, their Families and Communities

Edited by

Karl Brettig and Margaret Sims

Building Integrated Connections for Children, their Families and Communities, Edited by Karl Brettig and Margaret Sims This book first published 2011 Cambridge Scholars Publishing 12 Back Chapman Street, Newcastle upon Tyne, NE6 2XX, UK British Library Cataloguing in Publication Data A catalogue record for this book is available from the British Library Copyright © 2011 by Karl Brettig and Margaret Sims and contributors All rights for this book reserved. No part of this book may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission of the copyright owner. ISBN (10): 1-4438-3277-4, ISBN (13): 978-1-4438-3277-9

CONTENTS

List of Illustrations ..................................................................................... ix Foreword ..................................................................................................... x Margy Whalley Acknowledgements .................................................................................... xi Introduction ................................................................................................. 1 Karl Brettig

Part One: Foundations Chapter One............................................................................................... 8 What is Neuroscience Telling Us about Supporting Families? Margaret Sims Chapter Two ............................................................................................ 23 Family by Family Co-designed and Co-produced Family Support Model Sarah Schulman, Carolyn Curtis and Chris Vanstone Chapter Three.......................................................................................... 42 The Role of Community Development in Supporting Families and Children Sarah Spiker and Paul Madden Chapter Four ........................................................................................... 52 Child and Family Centres: How Effective? Elspeth McInnes and Alexandra Diamond Chapter Five............................................................................................. 73 Developing Integrated Child and Family Communities Paul Prichard, Suzanne Purdon and Jennifer Chaplyn

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Table of Contents

Chapter Six............................................................................................... 86 A Vision for Integrated Early Childhood Service Delivery Margaret Sims

Part Two: Promising Implementation Strategies Chapter Seven Supporting Vulnerable Children and their Families Building Bridges between and Capacities within Services...................... 102 Michael White Safe from the Start: For Children who have Witnessed Domestic Violence................................................................................................... 107 Nell Kuilenburg and Angela Spinney Occupational Therapy in Children’s Centres........................................... 113 Kobie Boshoff Hackham West Community Centre Family Work Project....................... 116 Cathie Vincent Chapter Eight Developing Social, Emotional and Spiritual Wellbeing in Children Moving towards a Father Inclusive Practice............................................ 124 Paul Prichard The Fatherhood Engagement Project....................................................... 129 Janet Pedler, Ted Evans and Aaron Phillips Parental Separation and Kids................................................................... 133 Meggan Anderson and Trecia Spowart Modern Grandmothering ......................................................................... 136 Susan M. Moore and Doreen A. Rosenthal Young Mums and Dads Parenting Together............................................ 140 Karl Brettig



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Chapter Nine Community Development Initiatives Families Live in Communities................................................................. 146 Frank Tesoriero Working Together with Children and Families in a Rural Setting .......... 150 Heather Bean and Judy Delahunty What a Faith Community can bring to Healthy Child Development....... 154 Bryce Clark First Steps: Supporting and Strengthening the Local Community for the Early Years................................................................................... 158 Alan Steven and Jane Swansson Chapter Ten Emerging Integrated Child and Family Centre Models Children’s Centres for Early Childhood Development and Parenting..... 164 Andrea McGuffog An Integrated Service in Action .............................................................. 168 Lynne Rutherford and Kaye Colmer Seaton Central ......................................................................................... 173 Fiona Dale Seamless Transitioning through Integrated Service Delivery at FamilyZone.......................................................................................... 177 Karen Stott and Jane Swansson The FamilyZone Para Hills Parent Centre............................................... 182 Lisa Manning and Kerry Tomaras Chapter Eleven System Sustainability The Challenges of Building Multi Agency and Trans-disciplinary Teams ...................................................................................................... 186 Karl Brettig



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Table of Contents

Information Sharing: A Vital Tool in Early Intervention ........................ 190 Donna Mayhew Health and Safety in Child and Family Services: Taking Care of those who Take Care of Others ...................................... 193 Kelvin Lee The Challenges of the East Kimberley Experience in Collaboration and Sustainability .................................................................................... 197 Juan Larranaga and Anthea Whan Driving System Change to Support Vulnerable Children and their Families .................................................................................... 201 Diana Hetzel, Sharyn Watts and Elizabeth Owers Chapter Twelve...................................................................................... 206 Navigating Future Directions Karl Brettig List of Contributors ................................................................................ 222 Index of Chapter Sub-headings ............................................................... 229



LIST OF ILLUSTRATIONS

1:1 The epigenetic picture ......................................................................... 11 2:1 The Family by Family model .............................................................. 27 2:2 A link-up in progress at the local swimming pool............................... 31 2:3 The approach used to develop Family by Family................................ 38 3:1 Structure of the Di Cwinyi self-help group ......................................... 48 4:1 FamilyZone end of year celebration .................................................... 66 10.1 Seamless transitioning .................................................................... 180

FOREWORD

I feel hugely privileged to have visited Adelaide each year since the late nineties and have seen firsthand the amazing services which are being developed – services which really support children and their families in the 21st century. Conceptualising and developing integrated services that are truly responsive to the needs of children and families has become a global project. Politicians, policy makers and practitioners across the developed world are driving this agenda forward. We all work in seriously divided societies where the most vulnerable communities are still not able to access the resources that more affluent families take for granted. It is essential that we prioritise the needs of our youngest citizens – they only get one shot at being two and three and four and they have no time to waste. This book makes a major contribution to the debate about how we can make services available to the families that most need them. It also addresses the critical issue of co-producing services with children, families and communities so that they feel powerfully engaged in the process. Families don’t want to be passive recipients of welfare handouts. They want to be treated as citizens with voice and choice – equal and active partners in developing public services. History makes it clear that unless early years services are conceptualised as having transformational possibilities they are unlikely to achieve emancipatory outcomes. Karl Brettig and Margaret Sims have gathered together authors with strong vision, passionate commitment and extensive experience of community work. The projects and programs that they describe show that it is possible to restore hope back into communities, and bring about change for every child. Margy Whalley July 2011

ACKNOWLEDGEMENTS

Thanks to Ruth, Daniel & Joel for all that you have taught me along the journey and still do, about what it means to be a family. To co-editor Margaret Sims, thank you for your strong commitment to better outcomes for children through research, insightful presentations and inspiring leadership. Thanks also to the team at Salisbury Communities for Children for translating a vision for child and family friendly communities into an emerging reality. To Alan Steven, Director of Community Services at the Salvation Army Ingle Farm, Katrina Shephard and Project Assistants Cathie Bishop, Jacquie Dell, Jane Swansson and Lisa Wynne, thank you for your outstanding contributions towards building better communities for children. Thanks also to partnering agency Lutheran Community Care especially Karen Stott, Kathleen Wilson, Cathy Lawson, Sharon Davis and Helen Lockwood for your high level of commitment to supporting families and working in partnership. We’d also like to acknowledge the significant contributions of community partners Centacare, the City of Salisbury, Relationships Australia, the Schools Ministry Group, staff from the Department of Families, Housing, Community Services and Indigenous Affairs and the SA Department of Education and Children’s Services. Thanks for your outstanding contributions to the teams and partnering service providers at FamilyZone Ingle Farm, First Steps Playtime and FamilyZone Para Hills Parent Centre. Thanks also to Joanne Menadue, Mario Trinidad, Margaret Hunt, Kirsty Drew, Carol Perry, Kaye Conway and all who have been a part of the Salisbury C4C Committee and contributed to the productive discussions we have had around the table. Thanks also to UniSA evaluation team Elspeth McInnes and Alexandra Diamond and to Margy Whalley, Director of Research at Pen Green Research, Development and Training Base and Leadership Centre for her foreword and pioneering work with involving parents in their children’s learning. Also acknowledged is the collaborative work of colleagues from C4C sites, Janet Pedler, Michael White, the Children Communities Connections conference team and all who have contributed to this publication. —Karl Brettig

INTRODUCTION KARL BRETTIG

Recently in South Australia an eminent UK liver specialist delivered a public lecture on the subject of ‘Alcohol – The UK’s Increasingly Problematic Relationship with its Favorite Drug’. He began by saying that a while ago he decided to work with a new paradigm. Instead of continuously rescuing drowning people from the river it might be a good idea to have a look upstream and find out how they were getting in there in the first place. He went on to inform the audience that he was not at all qualified to speak about his subject for the evening as he was neither a sociologist nor a social researcher nor a pop psychologist! What he had to say however did make a lot of sense to those who gathered at University of Adelaide Medical School to hear him speak. It is good to specialize and it is also good to develop a holistic integrated approach to working with vulnerable families. In much of the western world we are seeing something of a meltdown in terms of the capacity of statutory services to deal with the number of child maltreatment cases that are being reported. Over the last 5 years in Australia the number of children on care and protection orders has increased by 47% from 24,075 (from 4.8 to 7.0 per 1,000 children) (AIHW, 2010Ϳ͘The time involved in processing escalating notifications is enormous and often comes at the expense of providing actual support for the families involved. The Australian Centre for Child Protection in recent times has advocated addressing this issue through promoting a public health model of child protection (Scott, 2006) which recognizes that child protection is everybody’s business and not simply a matter for the statutory child protection authorities. We need to identify and support children at risk and their families before the trauma of abuse begins. The 2009-2020 Australian Child Protection Framework incorporated a strategic plan which endorsed a number of initiatives. One of these was to expand the Communities for Children program by realigning existing sites to enhance integration, target the most disadvantaged communities and

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Introduction

establish new sites to test models of integrated service delivery. One initial outcome of this initiative has been the establishment of the adult specialist, family sensitive Communities for Children Plus model of service delivery with workforce development training being provided by the Australian Centre for Child Protection. Other initiatives include the implementation of 35 integrated and colocated Aboriginal Child and Family Centres and support for existing state children and family centre developments. Key strategies included investigating options for improving information sharing between NGO’s and government agencies through a common approach to assessment, referral and support. In South Australia we had the privilege of having Dr Fraser Mustard as a Thinker in Residence during 2007-2008 with a brief of looking at the development of integrated early childhood services. He described the mosaic pattern of funding arrangements for early childhood services as chaotic and outlined some of the challenges we face (Mustard, 2008, p38). Rationalizing the range of programs and services, layers of tradition, and the mosaic of funding patterns of the governments for the support of a variety of activities in early child development will be difficult and requires legislation and specific funding for the children’s centres. Different South Australian government departments, federal government, community organizations and non-government organizations support diverse non-integrated programs in early child development. Establishing integrated programs for early child development from this mixture will be difficult and slow.

South Australia is by no means unique in this regard. The United States government began investing in early childhood through the Head Start initiative in 1965 aiming to improve school readiness by enhancing social, emotional and intellectual growth. A recent report (Haskings & Barnett, 2010, p95) concluded that: The United States has a complex array of early education and childcare systems. It would be nice to believe that these programs are woven into a cohesive fabric, where strengths of one system are combined with strengths of another and where resources can be combined to reach the individual needs of the families being served. Unfortunately we are far from this level of coordination of effort and resources, with the result being a confusing array of services and programs for families to navigate



Building Integrated Connections for Children, their Families and Communities 3 and the constant potential for unnecessary duplication of effort and gaps in availability.

Fraser Mustard went on to identify some of the key issues facing those engaged in the process of developing effective integrated service delivery in his 2008 report, p38: In my discussions with Professor Philip Gammage, an early childhood education research fellow to DECS, he outlined some of the issues that have to be addressed to establish integrated early child development programs. • There needs to be integration of policies at the level of the ministers and the chief executives. • There needs to be excellent communication between the different ministries and within the ministries. • There needs to be an approach to ensure quality of staff and parity of status for people working in early child development. • There has to be a willingness to avoid disputes over any putative levels of professional superiority, or notions that no part of education, care, health, or family support is intrinsically more important than another.

In attempting to develop a sustainable funding model for effective integrated child and family centres, policy makers and practitioners are encountering significant challenges in terms of how to negotiate this mosaic (Anning et al., 2006, Brettig, 2009). Federal Communities for Children sites developing Child and Family Centres and State Department of Education and Children’s Services Children’s Centres continue to grapple with the issues involved. Allocation of state and commonwealth responsibilities in terms of co-ordination and resourcing remains a significant challenge. Other challenges include boundary disputes between agencies, changes in staff roles and responsibilities and information sharing protocols. Parents and caregivers are the first and often most significant contributors to better early childhood development outcomes based on the evidence of the significance of the first 3-4 years of life. The 2007 Federal Government partitioning of early childhood and family support into separate departments added difficulty to the challenge of developing a way forward for funding child and family centres that have a strong focus on both of these areas. The Toronto First Duty (2006) and UK Sure Start (NESS, 2008, 2010, Melhuish et al., 2010) experience has begun the process of establishing their validity as a significant initiative in prevention, early intervention, social inclusion and child protection.



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Introduction

In 2009 the Australian federal Department of Families Housing Community Services and Indigenous Affairs refunded the Communities for Children initiative for three years and in 2011 extended for a further two years until 2014. However, this extension operates in a culture of siloed services in education, health and community/family support services despite significant rhetoric about integrated services. Each discipline has its own peculiar inherent biases and territorial tendencies. Health is becoming more psycho-social in its approach and FaHCSIA and the Department of Education Employment and Workplace Relations more holistic, however much cultural change is still needed. There still seems to be a perception in the community that significant investment in early childhood means the provision of more childcare centres while the development of child and family integrated early childhood service centres is yet to be given priority in the manner of international evidence-based developments such as the UK Sure Start initiative with its roll out of 3,000 children’s centres in recent times. In implementing a National Early Childhood Development Workforce Framework the complex issues encountered in multi-agency and transdisciplinary service delivery need to be addressed. While an integrated approach is highly beneficial, in many cases it fails to deliver because of a lack of understanding, motivation and skills with regard to what is required to work together in delivering integrated, holistic services. At Salisbury in South Australia through the Communities for Children initiative we have had the opportunity in recent years to develop several communities that support children and their families during the critical early years. One of these is an integrated early childhood services hub we call FamilyZone at Ingle Farm Primary School which regularly supports 3400 families and provides a range of predominantly adult focused services with professional and volunteer support for young families. Another is a ‘continuous’ playgroup which also facilitates music, movement and literacy groups activities for 2-300 families based at the Salvation Army. A third community gathers at Para Hills Primary and is largely run by volunteers and facilitates similar activities for some one hundred children and their families. Training for volunteers is provided through a 6 x 2 days/wk early childhood leadership training course which includes sessions on child development, parenting issues, group dynamics, conflict resolution cultural awareness, communication and statutory requirements including child safe environments and first aid.



Building Integrated Connections for Children, their Families and Communities 5

Other Communities for Children sites in South Australia have developed similar initiatives though they are all different as diversity is intrinsic to the adoption of a community capacity building approach. This publication brings together a range of policy makers, researchers and practitioners including contributors from a number of federal Communities for Children initiatives, state Children’s Centres and the Australian Centre for Child Protection. It has a focus on developing effective integrated, place-based support for children, their families and communities. In part one we look at some of the key foundations that underpin effective integrated support. We begin with some of the latest research findings in the field of neuroscience which have had a major impact on policy and service delivery in recent years. This is followed by recent ethnographic research that has led to the development of an innovative family support model by the Australian Centre for Social Innovation. It is a family mentoring model that has been co-designed and co-produced in genuine partnership with families. A look at the principles of community development in supporting families and children is followed by some new research into the effectiveness of child and family hubs. Centres such as these really function as communities, as the title of the following chapter on developing integrated child and family communities suggests. We then look at a vision for integrated early childhood service delivery and the kind of training that is needed to optimise outcomes for families. In part two we look at a broad range of promising implementation strategies that are being developed in the field. We conclude by looking at some key areas identified by researchers and practitioners for future policy and practice development. It is our hope that this publication will make a worthwhile contribution to improved provision of effective integrated and holistic support for children and their families.

References AIHW (2010). Child protection Australia 2008-09. Cat. no. CWS 35. Canberra: AIHW. Anning, A., Cottrell, D., Green, J., Robinson, M., (2006). Developing multidisciplinary teams for integrated children’s services. London Open University Press.



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Introduction

Brettig, K. (2009). Salisbury Communities for Children. Report retrieved from http://www.salisburyc4c.org.au/resourcedownloads/SalisburyC4C_200 5-2009_Report.pdf Haskins, R.., & Barnett, W.S. (2010). Investing in Young Children – New Directions in Federal Preschool and Early Childhood Policy. National Institute for Early Education Research. Mustard, Fraser (2008). Early Childhood Development the Best start for all South Australians, Retrieved from http://www.thinkers.sa.gov.au/images/Mustard_Companion_Document .pdf Melhuish, E., Belsky, J., & Barnes, J. (2010). Evaluation and value of Sure Start. Archives of Disease in Childhood, 95, 159 - 161. NESS (2008). The Impact of Sure Start Local Programs on Three Year olds and Their Families. National Evaluation Summary Report, National Evaluation of Sure Start Research Team. Retrieved from http://www.dcsf.gov.uk/everychildmatters/research/evaluations/nationa levaluation/NESS/nesspublications/ Scott, D. (2006). Towards a public health model of child protection in Australia Communities, Families and Children Australia, Vol 1, No 1, July 2006. The National Evaluation of Sure Start (NESS) Team. (2010). The impact of Sure Start Local Programmes on five year olds and their families. London, UK: Department for Education. Toronto First Duty (2006). Evidence-based Understanding of Integrated Foundations for Early Childhood. Toronto First Duty Phase 1 Summary Report. Retrieved from http://www.toronto.ca/firstduty/TFD_Summary_Report_June06.pdf





PART ONE: FOUNDATIONS   

CHAPTER ONE WHAT IS NEUROSCIENCE TELLING US ABOUT SUPPORTING FAMILIES? MARGARET SIMS

There is clear evidence that what happens to children in the early years of life can shape their lives forever (Irwin, Siddiqi, & Hertzman, 2007, p. 67; United Nations Educational Scientific and Cultural Organisation, 2010). Children growing up in disadvantaged families and communities have poorer outcomes across all health, development and wellbeing indicators. We can see this with indigenous Australians (Steering Committee for the Review of Government Service Provision, 2009). Indigenous teenagers are 4 times more likely to become pregnant than non-indigenous teenagers. The rate of notifications for child abuse has increased 4-6 times faster for Indigenous families than for non-Indigenous families over the past 10 years. Indigenous adults are 13 times more likely to be in prison than non-Indigenous adults, and Indigenous juveniles 28 times more likely than non-Indigenous juveniles. Differences in outcomes are identifiable when children start school. Children living in the most remote parts of Australia and children living in the most disadvantaged communities are much more likely to be developmentally vulnerable on all dimensions of the Australian Early Developmental Index at school entry (Centre for Community Child Health & Telethon Institute for Child Health Research, 2009). Developmental vulnerability on one or more domains is evident in 23.4% of all Australian children, 31.8% of children from the most disadvantaged communities and 47.3% of Indigenous children. Heckman (2006) argues that gaps in outcomes between children from advantaged and disadvantaged backgrounds become evident in the early years of life and that these gaps in outcomes continue to widen until about

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age 8. After that age the gap remains relatively constant: not narrowing but not widening further.

The importance of early intervention For decades, early intervention programs have been targeting the early years of children’s lives in an attempt to narrow these gaps. Ongoing evaluations of these interventions show they have a significant long-term impact (Penn, 2009; Sims, 2002), indicating that improving learning opportunities in the early years can make a life-time of difference. For example, the Perry High/Scope program offered what is now considered to be a late form of intervention given that it provided quality preschool education in the year before starting school to children who were significantly disadvantaged (Schweinhart, Barnes, & Weikart, 1993; Schweinhart et al., 2005; Schweinhart & Weikart, 1993; Schweinhart, Weikart, & Larner, 1986). The children showed initial gains in IQ that faded after several years at school. However, despite being no different in IQ from children from similarly disadvantaged backgrounds who had not received the intervention, the Perry High/Scope graduates grew up to demonstrate significantly better educational outcomes (more completed secondary school and gained a tertiary qualification, less needed special education services), and better health and wellbeing outcomes (more likely to have a job, more likely to own a home, physically and mentally healthier, less likely to have a teenage pregnancy or to be involved in juvenile delinquency, less likely to offend and be involved in the justice system). Other intervention programs demonstrate that beginning earlier in children’s lives (from birth or even during the pregnancy) is likely to result in better outcomes (Karoly, Kilburn, & Cannon, 2005; Olds, Eckenrode, & Henderson, 1997; Reynolds, Temple, Robertson, & Mann, 2001).

Environmental impact on brain development So how does what is going on in the world around children impact on their outcomes so significantly? Several classic reviews are now available of some of the earlier work in this area (Gunnar & Quevedo, 2007; McCain, Mustard, & Shanker, 2007; Shonkoff & Phillips, 2000). Basically, we now know that stimulation prompts the neurons in the brain to connect and create pathways which transmit the incoming information. Growing up in an enriched environment with a variety of stimulation, enables the young child’s brain to become wired with great complexity. The formation of brain connections proceeds through the first years of life



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Chapter One

and the child’s brain becomes so complex that a process of pruning then occurs (roughly from about the ages of 3 to 12). If those connections are not sufficiently stimulated (used again and again) they will disappear. We see this in a child who has not heard particular language sounds in the early years of life (for example a child growing up in a monolingual home). The child will lose the ability to hear and produce the sounds that have not been heard. Later in life when attempting to learn a second language, the child (adult) will find certain sounds problematic as the ear and tongue cannot hear or produce them. The research suggests that we need to provide our young children with a variety of stimulation, and regular stimulation, to ensure that their brains wire up appropriately. However, we need to consider in what ways that stimulation is offered. We know that when children are chronically stressed outcomes are not good (Evans & Schamberg, 2009; Gunnar & Quevedo, 2008; Luby, Belden, & Spitznagel, 2006; National Scientific Council on the Developing Child, 2010; Paradies, 2006; Van Itallie, 2002; Yashmin, Karten, & Cameron, 2005). Living with family violence and/or child abuse and neglect, for example, results in increased risk of poor outcomes for children (Caspi et al., 2003; Taylor et al., 2008; Tomison, 2002). We are now beginning to understand the biology underpinning this impact (Anda et al., 2006; Carter, 2005; Gunnar & Fisher, 2006; Perry, 2000; Twardosz & Lutyzker, 2010). What becomes clear from this work is that chronic stress impacts on the physiology and neurology of developing children, increasing the risk of poor outcomes. However, attachment appears to provide protection from the risks associated with chronic stress. In a very early study Gunnar and colleagues (Gunnar, Larson, Hertsgaard, Harris, & Brodersen, 1992) showed that infants who were cuddled when transitioning into childcare showed lower stress reactions (lower cortisol elevations) than infants who were not, even when those who were not cuddled did not show visible signs of distress or appear to need comforting. Since this work there have been many studies demonstrating the importance of loving relationships between children and their carers in moderating stress (cortisol) reactivity (Balbernie, 2001; Gunnar, 2005; Nachmias, Gunnar, Mangelsdorf, Parritz, & Buss, 1996; Sims, Guilfoyle, & Parry, 2006). In my own work, (Sims, 2007; Sims, Guilfoyle, & Parry, 2005) I argue that establishing secure and loving relationships with children is an essential component of quality child care and it is in the context of these relationships that children’s stress levels reduce and they are open to learning.



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Nature vs nurture For many years researchers have argued about the relative importance of nature versus nurture in shaping the adult (Rutter, 2006). We now know that both are important. Nature (the genetic code) creates the plans and lays the foundations which shape our outcomes. However, the experiences we have (nurture) shape the way that genetic message expresses itself. This interaction of genetics and environment is called epigenetics. Epigenetic research is helping us understand how relationships impact on long term outcomes (Sweatt, 2009). In his early work with rats, Meaney showed that the “…behavior of the mother towards her offspring can ‘program’ stable changes in gene expression that then serve as the basis for individual differences in behavioural and neuroendocrine responses to stress in adulthood” (Meaney, 2010a,p.56). The basic argument is outlined in Figure 1: Figure 1:1: The epigenetic picture

Plasticity of the brain These epigenetic changes are passed on from generation to generation (Bales & Carter, 2009; DiLalla, Elam, & Smolen, 2009; Kaufman et al., 2004; Meaney, 2010b; Swain, Leckman, Mayes, Feldman, & Schultz,



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Chapter One

2005). Meaney (2001) showed that rat pups fostered at birth to a poor rat foster mother grew up to demonstrate excessive stress reactivity, poor health and wellbeing, and themselves, were less nurturing to their pups, who subsequently produced further generations of rats with poor outcomes. In contrast, rat pups fostered at birth with a good rat foster mother demonstrated better outcomes and these better outcomes were inherited by subsequent generations. The impact of the fostering was diluted when it occurred later in the life of the rat pup. We see similar trends in human society. For example, we now know that Indigenous children who have a parent or grandparent who was a stolen child are more likely to have poorer physical and mental health outcomes than Indigenous children who do not have a stolen child in their ancestry (Silburn et al., 2006; Silburn et al., 1996; Zubrick et al., 1995; Zubrick et al., 1997; Zubrick et al., 2005). In addition, there is evidence from a large study in Queensland that the socioeconomic status of grandfathers impacts on grandchildren’s cognitive outcomes (Najman et al., 2004). There is some evidence that epigenetic effects are reversible, so that inheriting a particular DNA sequence that is not mylinated does not sentence an individual to a life-time of high stress reactivity and poor outcomes. Meaney (2010a, p. 64) argues: “parental signals over the perinatal period serve as an important catalyst for epigenetic remodeling of the genome.” To help unpack this, researchers have focused on attempting to identify the underpinning biology of secure and loving relationships. Ultimately the aim of this research is to use that knowledge to help shape appropriate supports for those children and families where there are significant risks for poor outcomes (exactly the work being undertaken in Australia by initiatives such as Communities for Children). Our chromosomes have small caps on the end, rather like the caps on the end of shoelaces (Greider & Blackburn, 2009). These are called telomeres. Telomeres normally shorten as we age. Unduly shortened telomeres are associated with a range of poor outcomes including cancer and premature mortality. Undue shortening of telomeres seems to be associated with chronic stress. Epel and colleagues (Epel et al., 2004) found that women who were caring for a child with significant disabilities had shorter telomeres in comparison to women caring for a child who was not disabled; the shortening was equivalent to 6 years of ageing for every year of chronic stress. More interestingly, such shortening appears to be reversible when social support is provided (Barthel, 2010). Ornish and colleagues (Ornish et al., 2008) indicate that lifestyle changes such as



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better nutrition, exercise, and stress management coupled with social support can have a significant impact on telomere length. This improvement seems to arise through an increase in the cellular enzyme telomerase. Researchers have identified that oxytocin (OT), a neuropeptide hormone, is associated with the establishment and maintenance of caring relationships (bonding): “… early social experiences, such as those between the infant and its caregiver, may also have long lasting effects on the neural systems responsible for later sociality. For example, parental caregiving style, crucial to the formation of secure or insecure attachments, could directly exert long-term effects on social bonding via changes in peptides such as OT...” (Bales & Carter, 2009, p. 255). Stanley & Siever (2010) found higher levels of oxytocin in couples with strong, loving relationships, and lower levels in children and adults who had a history of abuse. An increase in oxytocin levels can lead to an increase in trust in humans (Bartz & Hollander, 2006). It appears that early experiences of abuse or neglect reduce the ability to bind oxytocin which impacts on future ability to share loving relationships and grow social/interpersonal trust. In summary what we are seeing is that licking and grooming in rats changes the mylination of the stress receptor genes leading to a reduced stress response. Similar changes in the mylination of the estrogen receptor genes leads to a change in oxytocin functioning which is linked to increased maternal caregiving behavior in female offspring. Parallel changes in dopamine genes results in greater sensitivity and responsiveness to infant cues, enhancing caregiving behaviours. In humans we see similar reactions (Meaney, 2010a). Securely attached mothers showed a higher oxytocin elevation when interacting with their infants. Securely attached mothers show increased dopamine-based activation in the reward part of the brain in response to infant cues (either a smiling infant or a crying infant). Insecurely attached mothers only show this dopamine-based brain activation in response to a smiling infant cue but not to a crying infant cue, suggesting that insecurely attached mothers find negative signals from their infants more distressing and do not experience feelings of satisfaction when attending to infants expressing negative affect.



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Chapter One

The attachment relationship Developing the attachment relationship begins from the moment of birth and the development of biochemical/neurological self regulation is dependent on the outcome of this relationship (A. Schore, 2009a, 2009b; J. Schore & Schore, 2008). Infants make eye contact from birth and this eye contact increases their physiological arousal levels (via the sympathetic nervous system). This leads to discomfort and infants need to disengage to allow the parasympathetic nervous system to decrease arousal levels. After a brief period of dis-engagement infants will then seek to re-engage. It is essential that adults are ‘in-tune’ with the infants’ dance of engagement/ dis-engagement. An ‘in-tune’ dyad, co-regulating arousal levels, supports the development of regulation skills, and ultimately self-regulation, which is reflected in the organisation of the right frontal cortex, in levels of neuropeptides such as oxytocin and levels of neurosteroids such as cortisol, all essential for brain development and social bonding. Many researchers now see emotional regulation as a key component underpinning good outcomes for children (Andrews Espy, Sheffield, Wiebe, Clark, & Moehr, 2011; Graziano, Reavis, Keane, & Calkins, 2007). Crittenden (2008) argues that the form of attachment developed between an infant and adult is reflective of the environment/context in which they are functioning. In her dynamic-maturational model (DMM) she suggests insecure attachments reflect the adaptation of each member of the dyad to the context in which they are placed, and actually function to reduce the risk of harm. Infant behaviours represent strategies for eliciting caregiving behaviours from their parents. For example, when parents respond contingently to their infants’ cries, infants learn to associate their behaviour with the parental response – that is, crying results in comforting. Infants are biologically aroused when they are crying and the comfort they receive lowers their arousal levels. Ultimately infants learn to anticipate comfort will arrive and may stop crying when the parent enters the room. However, when parents fail to respond to infants’ signals, or alternatively respond punitively or non-congruently (for example laughing at a crying child) infants learn to hide their distress and to inhibit displays of negative affect. Thus the likelihood of punitive parental behaviour is reduced. When parents respond unpredictably (that is they may comfort some of the time but ignore the crying at other times), infants learn to increase the level and duration of their cries in the hope that this will result in comforting. However, they may display mixed feelings; appearing to be seeking comfort but rejecting it when it is offered. Parents are often



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confused by these mixed signals and this tends to increase their noncontingent responses. Meaney (2010b) concurs. He argues the increased stress reactivity resulting from living in an adverse environment is actually adaptive. Haapasaloa and Tremblay (1994) showed that shy, more timid youth (a trait associated with increased stress reactivity) growing up in poverty in high-crime areas were less likely to be involved in criminal activities than their more outgoing peers. However, whilst increased stress reactivity may be found to function as a protective factor in this particular stressful environment, it does not provide blanket protection. These youth are more likely to experience mood disorders in later life (Pérez-Edgar & Fox 2005). Meaney (2010b, p. 67) concludes: “Moreover, under such adverse circumstances a parental rearing style that favoured the development of a greater level of stress reactivity to threat could be viewed as adaptive. If indeed there is no single ideal phenotype, then it should follow that there is no single ideal form of parenting [italics in the original]”.

Implications for integrated early childhood services What does all this mean for those working in integrated early childhood services? I argue the implications are (Sims & Hutchins, 2011): • Children need to live in environments where they are cared for and cared about (and there is no rule that requires that caring to be delivered solely by one person, ie the mother); • We can support families to build a network of loving, caring people around children who together will ensure that children do not experience chronic stress, and that unavoidable stress is buffered through high quality relationships; • We remember that there are many different ways to build loving caring relationships. • Even apparently negative behaviours are likely to be adaptive and we should not focus on changing these until we understand the purpose they serve and can ensure that purpose is attained in a different way. The new field of developmental social neuroscience (DeHaan & Gunnar, 2009, p. ix) brings together a range of disciplines to look at the “…neural mechanisms underlying the development of social processes, ranging from the perception of social signals to the expression of complex forms of social behavior. A basic assumption of this approach is that a full



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understanding of social development requires a multilevel analysis, wherein both biological and social levels of analysis and their relations are considered”. However, such work is only useful if it can be translated into practice. We are only beginning to take that next step.

References Anda, R., Felitti, V., Brenner, J., Walker, J., Whitfield, C., Perry, B., et al. (2006). The enduring effects of abuse and related adverse experiences in childhood. A convergence of evidence from neurobiology and epidemiology. European Archives of Psychiatry and Clinical Neuroscience, 256(3), 174 - 186. Andrews Espy, K., Sheffield, T., Wiebe, S., Clark, C., & Moehr, M. (2011). Executive control and dimensions of problem behaviors in preschool children. Journal of Child Psychology and Psychiatry, 52(1), 33 - 46. Balbernie, R. (2001). Circuits and circumstances: the neurobiological consequences of early relationship experiences and how they shape later behaviour. Journal of Child Psychotherapy, 27(3), 237 - 255. Bales, K., & Carter, S. (2009). Neuroendocrine mechanisms of social bonds and child-parent attachment, from the child's perspective. In M. De Haan & M. Gunnar (Eds.), Handbook of developmental social neuroscience. (pp. 246 - 264). New York: The Guilford Press. Barthel, K. (2010). Making connections 2010: current concepts in attachment neurobiology. Paper presented at the 2nd International Association for the Study of Attachment Biennial Conference. Retrieved from http://www.iasa-dmm.org/index.php/iasa-conference/ Bartz, A., & Hollander, E. (2006). The neuroscience of affiliation: forging links between basic and clinical research on neuropeptides and social behaviour. Hormones and behaviour., 50, 518 - 528. Carter, S. (2005). The chemistry of child neglect: Do oxytocin and vasopressin mediate the effects of early experience? Proceedings of the National Academy of Sciences, 102(51), 18247 - 18248. Caspi, A., Sugden, K., Moffitt, T., Taylor, A., Craig, I., Harrington, H., et al. (2003). Influence of life stress on depression: moderation by a polymorphism in the 5-HTT gene. Science, 301(5631), 386 - 390. Centre for Community Child Health, & Telethon Institute for Child Health Research. (2009). A Snapshot of Early Childhood Development in Australia. Australian Early Development Index (AEDI) National Report 2009. Canberra: Australian Government.



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Crittenden, P. (2008). Raising parents. Attachment, parenting and child safety. Cullompton, Devon: Willan Publishing. DeHaan, M., & Gunnar, M. (Eds.). (2009). Handbook of developmental social neuroscience. New York: The Guilford Press. DiLalla, L., Elam, K., & Smolen, A. (2009). Genetic and Gene– Environment Interaction Effects on Preschoolers’ Social Behavior. Developmental Psychobiology, 51, 451–464. Epel, E., Blackburn, E., Lin, J., Dhabhar, F., Adler, N., Morrow, J., et al. (2004). Accelerated telomere shortening in response to life stress. Proceedings of the National Academy of Sciences, 101(49), 17312 17315. Evans, G., & Schamberg, M. (2009). Childhood poverty, chronic stress, and adult working memory. [available http://www.pnas.org/content/early/2009/03/27/0811910106.short?rss= 1&ssource=mfc downloaded 2 July 2009]. Proceedings of the National Academy of Sciences, doi: 10.1073/pnas.0811910106 5 downloaded. Graziano, P., Reavis, R., Keane, S., & Calkins, S. (2007). The role of emotion regulation in children's early academic success. Journal of School Psychology, 45(1), 3 - 19. Greider, C., & Blackburn, E. (2009). Telomeres, Telomeraqse and Cancer. Scientific American, October 5, 6 pages downloaded. Gunnar, M. (2005). Attachment and stress in early childhood development: does attachment add to the potency of social regulators of infant stress? In C. Carter, L. Ahnert, K. Grossman, S. Hrdy & M. Lamb (Eds.), Attachment and bonding. A new synthesis. (pp. 245 255). Cambridge, MA: MIT Press. Gunnar, M., & Fisher, P. (2006). Bringing basic research on early experience and stress neurobiology to bear on preventive interventions for neglected and maltreated children. Developmental Psychopathology, 18, 651 - 677. Gunnar, M., Larson, M., Hertsgaard, L., Harris, M., & Brodersen, L. (1992). The stressfulness of separation among nine-month old infants: effects of social context variables and infant temperament. Child Development, 63, 290-303. Gunnar, M., & Quevedo, K. (2007). The neurobiology of stress and development. Annual Review of Psychology, 58(1), 145 - 174. Gunnar, M., & Quevedo, K. (2008). Early care experiences and HPA axis regulation in children: a mechanism for later trauma vulnerability. In E. de Kloet, M. Oitzl & E. Vermetten (Eds.), Stress hormones and post traumatic stress disorder. (Vol. 167, pp. 137 - 149). Amsterdam: Elsevier.



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Haapasaloa, J., & Tremblay, R. (1994). Physically Aggressive Boys From Ages 6 to 12: Family Background, Parenting Behavior, and Prediction of Delinquency. Journal of Consulting and Clinical Psychology, 62(5), 1044 - 1052. Heckman, J. (2006). Investing in disadvantaged young children is an economically efficient policy. Paper presented at the Committee for Economic Development, Pew Charitable Trusts. January 10, 2006. New York. Paper available at www.ced.org. downloaded 13 April 2006. Irwin, L., Siddiqi, A., & Hertzman, C. (2007). Early child development: a powerful equaliser. (Final Report for the World Health Organisation's Commission on the Social Determinants of Health.). Vancouver, BC: Human Early learning Partnership (HELP). Karoly, L., Kilburn, R., & Cannon, J. (2005). Early childhood interventions. Proven results, future promises. Santa Monica, CA: RAND Corporation. Kaufman, J., Yang, B., Douglas-Palumberi, H., Houshyar, S., D, L., Krystal, J., et al. (2004). Social supports and serotonin transporter gene moderate depression in maltreated children. Proceedings of the National Academy of Sciences, 101(49), 17316 - 17321. Luby, J., Belden, A., & Spitznagel, E. (2006). Risk factors for preschool depression: the mediating role of early stressful life events. Journal of Child Psychology and Psychiatry, 47(12), 1292 - 1298. McCain, M., Mustard, F., & Shanker, S. (2007). Early Years Study 2: Putting science into action. Toronto: Council for Early Childhood Development. Meaney, M. (2001). Maternal care, gene expression, and the transmission of individual differences in stress reactivity across generations. Annual Review of Neuroscience, 24, 1161 - 1192. —. (2010a). Epigenetics and the Biological Definition of Gene x Environment Interactions. Child Development, 81(1), 41 - 79. —. (2010b). Maternal care and Gene -Environment Interactions Defining Development. Paper presented at the The 2nd Biennial International Association for the Study of Attachment Conference. Retrieved from http://www.iasa-dmm.org/index.php/iasa-conference/ Nachmias, M., Gunnar, M., Mangelsdorf, S., Parritz, R., & Buss, K. (1996). Behavioural inhibition and stress reactivity: moderating role of attachment security. Child Development, 67, 508 - 522. Najman, J., Aird, R., Bor, W., O'Callaghan, M., Williams, G., & Shuttlewood, G. (2004). The generational transmission of socioeconomic



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inequalities in child cognitive development and emotional health. Social Science and Medicine, 58(6), 1147 - 1158. National Scientific Council on the Developing Child. (2010). Persistent Fear and Anxiety Can Affect Young Children’s Learning and Development. . Harvard University, Boston, Mass: National Scientific Council on the Developing Child, Centre on the Developing Child. Olds, D., Eckenrode, J., & Henderson, C. (1997). Long-term effects of home visitation on maternal life course, child abuse and neglect, and children's arrests: fifteen year follow-up of a randomised trial. Journal of the American Medical Association, 278(8), 637 - 643. Ornish, D., Lin, J., Daubenmier, J., Weidner, G., Epel, E., emp, C., et al. (2008). Increased telomerase activity and comprehensive lifestyle changes: a pilot study. Lancet Oncology, 9, 1048 - 1057. Paradies, Y. (2006). A Review of Psychosocial Stress and Chronic Disease for 4th World Indigenous Peoples and African Americans. Ethnicity and Disease, 16(1), 295 - 308. Penn, H. (2009). Early Childhood Education and Care. Key lessons from research for policy makers. Brussels: European Commission for Education and Culture. Pérez-Edgar, K., & Fox , N. (2005). Temperament and anxiety disorders. Child and Adolescent Psychiatric Clinics of North America, 14, 681 706. Perry, B. (2000). The neuroarchaeology of childhood maltreatment. The neurodevelopmental costs of adverse childhood events. In B. Geffner (Ed.), The Cost of child maltreatment. Who pays? We all do. http://www.childtrauma.org/Neuroarchaeology.htm. Downloaded 5/9/02). Binghamton, NY: Haworth Press. Reynolds, A., Temple, J., Robertson, D., & Mann, E. (2001). Long-term effects of an early childhood intervention on educational achievement and juvenile arrest: a fifteen year follow-up of low-income children in public schools. Journal of the American Medical Association, 285, 2339 - 2346. Rutter, M. (2006). Genes and behaviour: nature-nurture interplay explained. Oxford: Blackwell. Schore, A. (2009a). Relational trauma and the developing right brain. An interface of psychoanalytic self psychology and neuroscience. Annals of the New York Academy of Sciences, 1159, 189 - 203. —. (2009b). Relational Trauma and the Developing Right Brain: The Neurobiology of Broken Attachment Bonds. In T. Baradon (Ed.), Relational trauma in infancy. (pp. 19 - 47). London: Routledge.



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Schore, J., & Schore, A. (2008). Modern attachment theory: the central role of affect regulation in development and treatment. Clinical Social Work Journal, 36, 9 - 20. Schweinhart, L., Barnes, H., & Weikart, D. (1993). Significant benefits: the High/Scope Perry preschool Study through age twenty-seven. Ypsilanti, Mich: High Scope Press. Schweinhart, L., Montie, J., Xiang, Z., Barnett, W., Belfield, C., & Nores, M. (2005). Lifetime effects: The High/Scope Perry Preschool Study through age 40. Ypsilanti, Michigan: High/Scope Educational Research Foundation. Schweinhart, L., & Weikart, D. (1993). Success by empowerment: the High/Scope Perry Preschool Study through Age 27. Young Children, 49(1), 54 - 58. Schweinhart, L., Weikart, D., & Larner, M. (1986). Consequences of three preschool curriculum models through age 15. Early Childhood Research Quarterly, 1, 15 - 45. Shonkoff, J., & Phillips, D. (Eds.). (2000). From Neurons to neighbourhoods: The Science of Early Childhood Development. Washington D.C.: National Academy Press. Silburn, S., Zubrick, S., De Maio, J., Shepherd, C., Griffin, J., Mitrou, F., et al. (2006). The Western Australian Aboriginal Child Health Survey: strengthening the capacity of Aboriginal children, families and communities. Perth, WA: Curtin University of Technology and Telethon Institute for Child Health Research. Silburn, S., Zubrick, S., Garton, A., Gurrin, L., Burton, P., Dalby, R., et al. (1996). Western Australian Child Health Survey: family and community health. Perth, WA: Australian Bureau of Statistics, Catalogue No 4304.5 and the TVW Telethon Institute for Child Health Research. Sims, M. (2002). Designing family support programmes. Building children, family and community resilience. Altona, Vic: Common Ground Press. —. (2007). The determinants of quality care: Review and research report. . In E. Hill, B. Pocock & A. Elliot (Eds.), Kids Count: Better early education and care in Australia. (pp. 220 - 241). Sydney: University of Sydney Press. Sims, M., Guilfoyle, A., & Parry, T. (2005). What cortisol levels tell us about quality in childcare centres. Australian Journal of Early Childhood, 30(2), 29 - 39.



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Sims, M., Guilfoyle, A., & Parry, T. (2006). Children's cortisol levels and quality of child care provision. Child Care, Health and Development, 32(4), 452 - 466. Sims, M., & Hutchins, T. (2011). Program planning for infants and toddlers. In search of relationships. Castle Hill, NSW: Pademelon Press. Stanley, B., & Siever, L. (2010). The interpersonal dimension of borderline personality disorder: towards a neuropeptide model. American Journal of Psychiatry, 167, 24 - 39. Steering Committee for the Review of Government Service Provision. (2009). Overcoming Indigenous disadvantage. Key Indocators 2009. Melbourne, Vic: Commonwealth of Australia. Swain, J., Leckman, J., Mayes, L., Feldman, R., & Schultz, R. (2005). Early human parent-infant bond development. Society of Biological Psychiatry: Science Direct (online service), 57, 1125. Sweatt, J. (2009). Experience-dependent epigenetic modifications in the central nervous system. Biological Psychiarty, 65(3), 191 - 197. Taylor, P., Moore, P., Pezzullo, L., Tucci, J., Goddard, C., & De Bortoli, L. (2008). The Cost of Child Abuse in Australia. Melbourne: Australian Childhood Foundation and Child Abuse Prevention Research Australia. Tomison, A. (2002, 16 October 2002). Evidence-based practice in child protection: What do we know and how do we better inform practice. Paper presented at the What works? Evidence Based Practice in child and Family Services, Bondi Beach, NSW. Twardosz, S., & Lutyzker, J. (2010). Child maltreatment and the developing brain: a review of neuroscience perspectives. Aggression and Violent Behaviour, 15(1), 59 - 68. United Nations Educational Scientific and Cultural Organisation. (2010). Concept Paper. The World Conference on Early Childhood Care and Education (ECCE) Building the Wealth of Nations. Geneva: United Nations. Van Itallie, T. (2002). Stress: a risk factor for serious illness. Metabolism, 6(2), 40 - 45. Yashmin, J., Karten, A., & Cameron, H. (2005). Stress in early life inhibits neurogensis in adulthood. Trends in Neurosciences, 28(4), 171 - 172. Zubrick, S., Silburn, S., Garton, A., Burton, P., Dalby, R., Carlton, J., et al. (1995). Western Australian Child Health Survey: developing health and well-being in the nineties. Perth, WA: Australian Bureau of Statistics and the Institute for Child Health Research.



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Zubrick, S., Silburn, S., Gurrin, L., Teoh, H., Shepherd, C., Carlton, J., et al. (1997). Western Australian Child Health Survey: education, health and competence. Perth, WA: Australian Bureau of Statistics and the TVW Institute for Child Health Research. Zubrick, S., Silburn, S., Lawrence, D., Mitrou, F., Dalby, R., Blair, E., et al. (2005). The Western Australian Aboriginal Child Health Survey: The social and emotional wellbeing of Aboriginal children and young people. Perth: Curtin University of Technology & Telethon Institute of Child Health Research.



CHAPTER TWO FAMILY BY FAMILY CO-DESIGNED AND CO-PRODUCED FAMILY SUPPORT MODEL SARAH SCHULMAN, CAROLYN CURTIS AND CHRIS VANSTONE

Families are stressed. When we ran stalls in 2010 in front of supermarkets, shopping centres and on street corners to ask South Australian families about stress, hundreds stopped to talk. Every family spoke about the multiple stressors they lived with - time, money, relationships, kids’ behaviour, housework, health, and school made the top of the list. Statistics tell us that 91% of Australians are stressed by at least one area of their life (Lifeline Australia, 2008). We quickly learnt that while all families could name everyday stressors, what differentiated families were the types of stressors experienced and the resources available to cope and act. Resources are not just financial. They include the assets internal to a family - such as motivation, optimism, communication, problem-solving and the assets external to a family - such as informal support, information, and services (Berry, 1997). Resources build on each other. Good friends and neighbours can help us to feel more motivated and optimistic. Good communication skills can help us to access the right kind of information and services. Where do families acquire the resources to move through stress and towards what they want? There are fewer places to acquire these resources than in the past. Social capital refers to the resources that come from our relationships with trusted others - be it family, friends, neighbours, communities, or services (Crosone, 2004). New research indicates that social capital in Australia is on the decline (Leigh, 2010).

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Without social capital to draw on, stress can easily build. Froma Walsh, who writes about resilient families, notes that, "A pile-up of internal and external stressors can overwhelm the family, heightening vulnerability and the risk of subsequent problems…These stresses can derail the functioning of a family system, with ripple effects to all members and their relationships (2003, p.3-4)." The ripple effects include mental illness, family breakdown, domestic violence, child neglect and abuse. These crises trigger a statutory state response, even as state crisis services struggle to cope with rising demand. Last year in South Australia, 20,298 children came to the attention of child protection services. Nearly 5000 cases were actioned, while many received minimal state response (AIWH, 2001). Even if crisis services could cope with such high demand, a crisis response is rarely the best response for families. The statutory child protection system has been designed to manage immediate risk to children (Lamont and Bromfield, 2010). Their tools are coercive: investigations, assessments, and court orders. Yet, the research tells us that services work best for families when they engage rather than compel families to take part; when they maximise families' choice; when they focus on families' strengths rather than deficits; and when they recognise different cultures and value sets (Arney and Scott, 2010). Indeed, ‘helpful services’ challenge traditional notions of professional-client relationships. As researchers Miranda Roe and Anne Morris write, “In contrast to widelyheld practice ideas about the importance of professional distance to ensure objectivity and discourage dependence, women place a high value on having a close relationship, akin to a feeling of friendship, with their workers (2004, p.6). The costs of ineffective interventions are high. Every year in Australia about $1,944m is spent addressing the long-term impact of child abuse and neglect: including $976.9m on adult criminality; $288.57m on juvenile delinquency; and $335m on mental health services (Valentine and Katz, 2007). We need a radically different way of keeping families from interfacing with crisis services, and preventing re-entry of families who have had contact with crisis services. Family by Family is a new model of family support designed with families to address the problem of too much demand on crisis services, and too few families with the supports to manage chronic stress and



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isolation. Given the opportunity, families do not just want to survive. Families want to thrive. Thriving families look beyond today; they have a sense of direction, aspirations for the future, and ideas of how to get there. These families are open to experiencing what is new and different in order to create change. We learned the meaning of thriving from families. Over a 12-month period, we spent time with 100 South Australian families to experience the ups and downs of family life and to co-develop & prototype the concept & interactions behind Family by Family. Family by Family offers a new kind of support: support delivered by, with, and between, whole families. It finds, trains, and resources families who have overcome tough times and connects them with families who want things to change. Professionals serve as coaches, brokering families to each other, rather than directly delivering services. For 12 weeks, we tested and improved the model with 20 families. Families who took part experienced shifts in family goals, attitudes, behaviours and social networks. Family by Family demonstrates a new way to engage families in both the design and delivery of human services. It is an example of a codesigned and co-produced solution: a solution that recognises people as assets, builds on their existing capabilities, establishes mutual responsibilities between professionals and people, and supports people to help themselves (Boyle, Slay & Stephens, 2010). Throughout this chapter we will explore the Family by Family model and methodology, providing stories and examples from the families who took part in the prototype.

The model Family by Family started with the brief: how can we enable more families to thrive, and fewer families to come into contact with crisis services?

Thriving as the outcome Ethnographic research with 35 families led us to identify and define family thriving as the primary outcome measure. Every family we met experienced chaos and stress, yet some families were still moving towards the lives they wanted. In our words, they were thriving. Thriving families tried new things, set goals for the future, brokered family members to new



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opportunities outside the house, and gave and received positive feedback (Lockett, et al., 2010).

Behavioural modelling as the lever Co-design work with 30 families helped us test how to enable families to adopt thriving behaviours and build the necessary support networks. Families described learning by doing, yet we observed few opportunities for whole families to see and try new ways of doing family. Family by Family brings whole families together to see and learn from each other. Families who have been through challenging times (sharing families) are trained and supported to link-up with families who want things to change (seeking families). Sharing and seeking families link-up for 10-30 weeks. Link-ups serve as a vehicle for family-led change: sharing families model thriving behaviors and connect seeking families to new community resources.

Implementing evidence-based practice What works for families in Family by Family aligns with the literature on effective family interventions. Effective family interventions emphasise family strengths, resilience, and protective processes rather than deficits (Kumpfer and Alvarado, 2003). Thriving behaviours and social connectedness are important protective factors for averting and overcoming traumatic life events (Lang, et al., 2003). Evidence-based strategies for helping families overcome trauma include: planning and doing positive activities, developing skills for managing distressing situations, developing helpful thinking, building problem-solving skills, and developing supportive connections (Bromfield et al., 2010, p.19). Family by Family puts these evidence-based strategies into practice. The focus is not only on enabling families to rebound from tough times - what is commonly referred to as resilience - but enabling families to plan and take steps towards the future.

Complementing community development & professional services Family by Family implements evidence-based practice using whole families rather than professionals as the delivery agents. Sharing families are trained and supported to use their own stories, strategies, and connections to help seeking families identify & move towards their goals. Seeking families choose what they want to change. Family by Family



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occupies a new kind of intervention space: one that blends the behaviour change focus of professional services with the informality and universality of community development. Families, rather than parents or children, are the focal point of the intervention. Fig. 2-1 The Family by Family Model

The experience Family by Family has been co-designed at a conceptual and an interaction level. Where the conceptual level outlines the outcomes (e.g. thriving) and the activities (e.g. link-ups), the interaction level looks at how families engage with each component of the activities: the materials, the offer, the roles, the training, the tools, etc. Family by Family consists of five types of activities: (1) identifying & engaging families; (2) developing sharing families; (3) linking sharing and seeking families; (4) supporting seeking and sharing families; and (5) measuring change. We describe how these activities played out during the 12-week prototype, below. Films and further documentation from the prototype can be found online: www.tacsi.org.au/designpapers.



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Finding & engaging families Family by Family finds & meets families in places that are already part of the family routine. We run pop-up stalls in supermarkets, malls, fast food restaurants, parks, and even on the street to meet two kinds of families: those who want something to change and those who want to share their stories and strategies to enable other families to change. Pop-up stalls feature fun, developmental activities for families taught by other families, like origami, Filipino games, kite making, gingerbread decorating, and paper aeroplane folding. The message to families comes from families: “We’re a group of families who are about more good stuff for families. We link up families with stuff in common to change the things they want to change - like kids’ behaviour or going out more as a family. We’re not government. We’re not religious. We’re not political.” The materials feature families. We show families what it looks like to engage in Family by Family and how Family by Family feels different to traditional services using photos, film, and family stories. Family by Family also works with schools, children’s centres and targeted services to let families know about the Family by Family offer. The goal is to attract and engage families - not to offer them another referral. We provide materials, a website, and coaching to service providers so that families want to opt-in.

Training sharing families Families are Family by Family’s biggest resource. We hire and train families who have come through tough times, now live a life with more ups than downs, and want to share their stories and strategies with others. Once we meet potential sharing families at pop-up stalls and through services, we share a take-away dinner and use purpose designed games with the whole family to explore the sharing family role. If families feel that being a sharing family fits with their life, we pair them with a buddy sharing family and invite them along to a weekly sharing family dinner. The prototype taught us what makes an effective sharing family. Effective sharing families have the time and space to work with other families, and demonstrate or learn these strengths:



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• Building influential relationships with other families, even those they may not like. • Modelling thriving behaviours and sharing personal strategies and stories. • Focusing on change. • Brokering families with useful people and places in the local community. Families who are a good fit for the sharing family role are invited to a 2.5 day training camp. Here, the whole family learns new skills for working with other families. The focus is not just on sharing stories and strategies, but on enabling change. We draw on storytelling, life coaching, personal training, and behaviour change methods. An additional curriculum has been designed for children with age appropriate streams that align with the core principles and beliefs of Family by Family. All family members are invited and encouraged to participate over the 2.5 days, with additional support provided for infants and toddlers. Being a change enabler is a new, and sometimes uncomfortable role for families. It is more than a friend or volunteer helper. We provide a grant to sharing families, whilst they are in a link-up, to recognise the intensity of the role. Sharing families can choose how to invest their grant: towards link-up activities, their own families, or in growing Family by Family. This flexible system allows families to volunteer by investing their full grant back into Family by Family whilst also enabling families in need of financial assistance to draw payment without stigma.

Linking-up families Family by Family brings together trained sharing families with families who want something to change. Families who want something to change are called seeking families. A seeking-sharing family pair is called a link-up. Link-ups start by matching families. Seeking and sharing families create a profile of their family. Profiles use photographs, quotes and stories from families rather than a more professional and standardised assessment. Families talk about their interests, hobbies, and aspirations for the future. Seeking families choose which sharing families they would like to meet.



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A Family by Family coach facilitates the first meeting between seeking and sharing families to establish the focus of the link-up, and brainstorm what families might do together to further their goals. Goals include: going out more as a family, meeting good people, dealing with kids’ problem behaviours or learning more about Australian culture. Over an initial 10-week period, families do intentional activities together. Examples include barbecues, community outings and playing games at home. Through these activities, sharing families can model their interactions & behaviours, share their own stories & strategies, and enable seeking families to see & experience different ways of doing. By the end of the link-up, we aim to have helped families move towards their goals and to have brokered them to the people and places that continue their forward momentum. Helping families ‘do without’ their sharing family is a critical part of long-term change. The length of a link-up is flexible, and based on what will enable the most change for families. Seeking families with big stories and a history of significant trauma could benefit from a second or even third 10-week linkup. We know from the literature that the most intensive home visiting programs involve around 100 hours of intervention - which is the amount that a 30-week link-up enables (Valentine and Katz, 2007, p.15).

Supporting link-ups Family by Family emphasises family-led change. Behavioural change is rarely a linear process, and requires external ideas, motivational support, repetition and troubleshooting. The Family by Family coach is a new professional role designed to motivate families, generate ideas, provide emotional support, and step-in if families come across problems that are beyond their scope to solve. The coach is available at any time to intervene or provide additional support to families. Coaches meet with sharing families 1:1 every week to debrief, re-focus the link-up on measurable change, and brainstorm ideas and activities. Coaches also connect with seeking families half-way through the linkup to see how things are progressing and to facilitate a joint coaching session to inspire families to keep moving forward. At the end of the link-up, the coach runs a joint wrap-up session to help recognise and celebrate change, to record change, and set future goals.



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During the prototype, professionals found the coaching role to be new and, at times, uncomfortable. Professionals move from being direct service providers to behind-the-scenes facilitators. We’ve found that the best coaches are from a diverse range of disciplines - from social work to life coaching to personal training - and are able to motivate families by drawing ideas & methods from their professional and personal lives. Family by Family intentionally blurs the professional-personal divide. We recognise the value of professional knowledge and practice alongside the expertise of families. We bring together all of our sharing families and coaches every week for a ‘yarn over dinner’ to exchange link-up experiences and learn from each other. Yarns are whole family spaces, where kids and adults find new ways to support seeking families to change. Figure 2-2 A link-up in progress at the local swimming pool

Measuring change Family by Family works to create and measure four kinds of change with and for seeking and sharing families: • • • •



A change in family goals A change in family attitudes A change in family behaviours An increase in the number and quality of social connections

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Families sign-up with Family by Family to work on a particular goal, but through their interactions, often shift their goals and change what they think might be possible for them. In the prototype, we found that most families went from feeling alone and disempowered to feeling supported and in control. Through their link-ups, they visited new places, spent time with new people, and established new family routines. Family by Family also measures changes in sharing families, including an increase in: • Job readiness • Family income We use a series of tools to help families identify what they want to change, and to track those changes over time. Families measure change at three points in time: the first meeting, the mid-point coaching session, and the wrap-up coaching session. We co-designed a tool called ‘the bubble diagram’ to help coaches help families map what they want to change; what they have to ‘do, say and think’ to get to that change; and what that change will enable. Families also use a series of sticker sheets to capture shifts in attitudes and behaviours, along with a link-up album to record meaningful quotes, anecdotes, and photos. Both kids and adults take part in reflecting on change. Our aim is to prompt seeking families to continue changing, and to re-engage them as sharing families. Family by Family uses evaluation as a motivational tool, rather than an accountability tool. We’re interested in learning what does and doesn’t work for families as we go along so that we can rapidly iterate better ways to enable change. This is in line with the goals of developmental evaluation (Gamble, 2008).

Who do we recruit? Family by Family has been designed with and for all families. There are no eligibility criteria or risk thresholds, yet not all families engage with Family by Family for the same reasons. Rather than group families according to professionally assessed risks or needs, we group families by their motivations and goals. Such user-facing segmentations allow for more systematic adaptation of experiences and interactions. Five types of



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families have been attracted to Family by Family: families who are stuck, families in and out of crisis, families moving on, families wanting more, and families wanting to share.

Stuck families Families that are stuck live in constant stress. Things are consistently tough: the kids’ behaviour is consistently bad; money is consistently tight; relationships are consistently strained. They have no space to think about the future. One event could be the tipping point for contact with Child Protection or another crisis service. Yet on a day-to-day basis things aren’t ‘bad enough’ to be eligible for support. These families are often turned away from services for not meeting eligibility criteria, or find themselves below the radar of services. Families that are stuck see Family by Family as an opportunity to break out of the daily grind and do something different. The opportunity to connect, exchange and learn from a family that has been in their shoes is both motivating and comforting. Choosing the family they connect with allows them to feel in control and empowered to move forwards.

Families in and out of crisis Families who are in and out of crisis live through lots of ups and downs. Day to day living is volatile: from violent relationships to addictions to child removal and reunification. These families are involved with crisis services, and often have multiple caseworkers. While they have lots of service contact, these families have few good people to turn to their informal networks have brought more bad than good. Although they want to ‘get rid of services’ they have few alternatives. Their focus is on day-to-day survival. A different future seems unattainable. Families that are in and out of crisis are attracted to Family by Family because it gives them the opportunity to connect with a non-professional: someone like them who is interested in their story and will help them change the things they want to change without judgment.

Families moving on after crisis Families moving on after crisis have big stories. They are starting over after a major trauma or life event - be it leaving a violent partner, having children removed, or recovering from addiction. These families have had service contact in the past, but now that the acute crisis has passed, have



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found their case closed. Yet they often remain isolated without the resources to move forwards. Family by Family offers them an opportunity to think about and work towards life beyond crisis and resilience. Connecting with another family lets them see what’s possible and start moving in that direction.

Families wanting more Families who want more are actively looking for new opportunities. They may have just moved to the area or to Australia, and are seeking good stuff for their families. Whilst they have very little service contact, they can identify what they want to be different. This may be to improve family relationships, share ideas about parenting, see new places or make new friends. Family by Family offers families wanting more the opportunity to exchange ideas and aspirations with other families and to adapt to a new cultural context. By helping these families to connect in to their community, they become a resource for other families.

Families wanting to share Families who have overcome tough times often do not realise they have something valuable to share with other families. These families are so busy doing family they have not had the opportunity to reflect on how or why they are now thriving. As one sharing family put it: “To be invited to be a sharing family was quite humbling...Initially I thought I raise kids, I look after my house and I couldn’t work out what in that was useful.” What motivates sharing families to engage is the idea that their personal experiences and struggles can be useful. In the past, they may have been the clients of mental health, domestic violence, and new migrant services. Now, they can offer strategies and supports to others.

Case studies During the 12-week prototype, sharing families linked up with families who were stuck, in and out of crisis, moving on, and wanting more. We learned families stuck with self and with services could benefit from longer link-ups. Below are two case studies of link-ups with families in the stuck with self and in and out of crisis segments. Names and some details have been changed.



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Lawson and Velmer families The Lawson Family first heard about Family by Family through door knocking in the local area. The Lawson family has a long history of intervention from a range of crisis services. Three of the Lawson children have a diagnosis of ADHD and their father, Sam, often resorts to calling the police as a means of managing their behaviour. Lucy, Sam’s wife of three years, moved to Australia from the Philippines. She attends English classes several times a week, however still feels an overwhelming sense of isolation. There is not enough money for Lucy to return home to visit her family and friends. Despite repeatedly asking for help, the Lawson family have been told their problems are 'not bad enough' to receive a service. Family life remains stuck. The Lawson family linked up with the Velmer family who also migrated from the Philippines three years ago. The Lawson family joined Family by Family to “get their kids behaviour in check”, however over time that goal shifted. Now they are working on spending more time together as a family, exploring new places, meeting new people. The two families have visited museums, libraries, the beach, had shared dinners, games nights and bible study. The Velmer family also linked them into the local church, which they now attend together every Sunday. Both Sam and Lucy have reported significant changes for themselves and their family: “The changes in my boys have been influenced by the Velmer family...they’re more well behaved, more respectful towards us and more helpful around the house.” The Lawson's now have the confidence to go out as a family and have a new appreciation for each other and are motivated to keep moving forwards.

Breen and Smith Families The Breen family connected to Family by Family through their social worker. Sally Breen is a mother of five. Four of her children were removed by the state child protection agency, and are now in the care of their maternal grandmother. Her 6-year old son, Matt, is still in her care and has special needs that require regular trips to the hospital. Since her children were removed, Sally has made some significant changes to hers and her family’s life. The one remaining concern was the extreme social isolation and lack of social support. The services involved with Sally and her family were ready to close her file, however due to a lack of social support, were concerned that she might re-enter the system. Sally opted-in



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to Family by Family after she saw pictures of what it was all about, but was nervous about meeting a “stranger” who might not understand Matt’s condition. The Breen family linked up with the Smith family and Sally's mind was quickly put at ease. Together they went ‘op shopping’, walking, to the local park, to the markets and the library. The Smith family also introduced Sally and Matt to a Thursday knitting club and Friday night dinners at the local community house. The Breen family are now strongly engaged in both of these community events and look forward to them each week. Sally now reports that people from the community say hello to her, and she knows there are more people to turn to for help.

Deacon family We first connected with the Deacon family when door knocking in the local area. The Deacon family consists of mum, dad, four children and a grandchild on the way. Mum had her first child at 14 years of age and at age 34 is about to become a grandmother. Teenage pregnancy and parenthood is just one story for this family. Workplace injury, unemployment, poor mental health and victims of violence are other challenges this family have faced. After sharing dinner with the Deacon family it was clear that we were in a household that was filled with positive feedback, energy, support and a desire to help others. When we first asked the family to be a sharing family, they thought we were joking. They couldn’t figure out what they had to give. The Deacon family now report that Family by Family has enabled their own family to grow and change while helping another family to do the same.

Methodology Family by Family is the product of a 12-month process to co-design, prototype and scale a different response to family stress and crisis. Codesign means working with users to create interactions & experiences that are of value. Prototyping means repeatedly testing and improving those interactions & experiences, along with the policies & systems needed for spread and scale. Co-design and prototyping are design methods. We blend design methods with social science, community development and business methods to understand how people behave in context; to activate and connect people; and to create ways to leverage new resource at scale. More important than the methods we use are the questions we ask. We



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group questions and methods into seven phases of work: Ready to Start, Look, Create, Prototype Practice, Prototype Policy, Build, and Run. This methodology has been developed by The Australian Centre for Social Innovation’s Radical Redesign Team.

The ready phase The project, initiated by The Australian Centre for Social Innovation, began with assembling a team to tackle the brief. South Australia’s child protection agency seconded a senior manager to the project team to provide insight into the existing system and learn a new way of working. She joined a project team which included a service designer and a sociologist, who had developed and used the design plus social science methodology in the UK as part of the organisation InWithFor. Alongside the project team sat a sounding board of city, state government officials, academics, and an NGO director. The Sounding Board provided critical feedback and support.

The look phase The real project work began by going out and about to meet and learn from families. We wanted to know: What does it look like for families to thrive? Which families are thriving despite the odds - in other words, which families are the positive deviants? We met families in front of shopping centres, supermarkets, bus stops, and door-knocking; shared dinner with 25 families; and spent 2-3 days doing ethnographic work with 10 families. We collated our experiences and insights into case studies and a report Going for the Good Life (Lockett, et. al, 2010).

The create phase Using the insights from the Look Phase, we asked: What are all the opportunities for enabling families to thrive? We brainstormed hundreds of ideas, developed scenarios and paper-based materials, and took everything back out to families to test. Most of the ideas didn't resonate with families, but one idea started to excite families: bringing families together with similar experiences to ‘do more good stuff’.



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The prototype practice phase Once we had a concept that resonated, we looked at how to make the concept real and effective. We asked: What interactions and experiences seem to prompt change for which families? We fleshed out the idea for Family by Family, and ran the model at a small scale with 20 families for 12 weeks to learn what worked and what didn't. We learnt that families saw immediate value in the concept, but that focusing in on behaviour change was hard. We iterated the training, coaching role, and materials to emphasise behaviour change. Fig. 2-3 The approach used to develop Family by Family

The prototype policy phase Having identified practice that prompted change with and for families, we asked: What systems and policies need to be in place to support that practice? We created and tested metrics and materials for service providers



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and are continuing to explore how Family by Family can shape systemwide practice.

The build phase The goal is to grow Family by Family. We asked the question: What is the business model and case for growing Family by Family? We ran projections, calculated the social return on investment, and wrote an investment case for cities, governments, and other funders. Family by Family goes to scale by using a hub and spoke model wherein a central hub supports multiple local sites: the more local sites up and running, the more efficient the cost model.

The run phase Transitioning Family by Family from a small-scale prototype to a large-scale solution requires building the right team for scale with the capacity to continually innovate and generate new resource. Over the coming months and years, we will continue to work with families to iterate the Family by Family model. We'll explore for which families Family by Family prompts the most change, and where Family by Family is not creating change, co-design new kinds of iterations and experiences. We'll also explore how Family by Family can shape professional practice and existing family services.

The limitations and opportunities Family by Family is one response to family stress and crisis; it cannot be the only response. Indeed, Family by Family complements, rather than replaces, existing professional services and community development activities. Many families’ stories are so complex that multiple interventions are required. Understanding when and where Family by Family fits in the sequence of interventions will be important to its long-term success. So will understanding the intensity and duration of link-ups most likely to prompt sustainable change with and for families. Despite the unknowns, Family by Family offers policymakers and practitioners a new way of engaging people, identifying their resources and capabilities, and using them as the solution to tough social problems.



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References AIHW (2011). Child protection Australia 2009-10. Child welfare series no. 51. Cat. no. CWS 39. Canberra: AIHW. Arney, F., & Scott, D. (2010). Working with vulnerable families: A partnership approach. Cambridge University Press. Berry, M. (1997). The family at risk: Issues and trends in family preservation services. Columbia: University of South Carolina Press. Boyle, D., Slay, J., & Stephens, L. (2010). Public Services Inside Out. London: NESTA. Bromfield, L., Lamont, A., Parker, R.., & Horsfall, B. (2010). Issues for the safety and wellbeing of children in families with multiple and complex problems: The co-occurrence of domestic violence, parental substance misuse, and mental health problems.” NCPC Issues, 33. Crosnoe, R. (2004). Social Capital and the Interplay of Families and Schools. Journal of Marriage and Family, 66, 267–280. Gamble, J. (2008). A Developmental Evaluation Primer. Retrieved from http://impact.animatingdemocracy.org/node/326 Kumpfer, K., & Alvarado, R. (2003). Family strengthening approaches for the prevention of youth problem behaviours. American Journal of Psychology, 58(6-7), 457-465. Lamont, A., & Bromfield, L. (2010). History of child protection. NCPC Resource Sheet, October, Australian Institute of Family Studies. Lang, A., Goulet, C., & Amselt, R. (2003). Lang and Goulet Hardiness Scale: Development and testing on bereaved parents following the death of their fetus/infant. Death Studies, 27(10), 851-880. Leigh, A. (2010). Disconnected: The Decline of Community and the Fraying of Social Fabric in Modern Australia. University of NSW Press. Lifeline Australia (2008). Stressed out Australia - Survey sparks call for urgent change. Retrieved from http://www.lifeline.org.au/AboutLifeline/Media-Centre/Media-Releases/Lifeline-Australia-MediaReleases/default.aspx?retain=true&PagingModule=470&Pg=3 Lockett, S., Schulman, S., & Vanstone, C. (2010). Going for the good life. Retrieved from www.tacsi.org.au/our-projects/design/designpapers/ Middlebrooks, J.S., & Audage, N.C. (2008). The Effects of Childhood Stress on Health Across the Lifespan. Atlanta (GA): Centers for Disease Control and Prevention, National Center for Injury Prevention and Control. Valentine, K., & Katz, I. (2007). Cost effectiveness of early intervention programs for Queensland. Social Policy Research Centre, UNSW.



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Walsh, Froma. (2006). Strengthening family resilience. New York: The Guilford Press. Roe, M., & Morris, A. (2004). The capabilities of women: towards an alternative model of responsibility in supporting families and children. Refereed paper presented to the Australian Political Studies Association Conference, University of Adelaide, 29 September - 1 October.



CHAPTER THREE THE ROLE OF COMMUNITY DEVELOPMENT IN SUPPORTING FAMILIES AND CHILDREN SARAH SPIKER AND PAUL MADDEN

You know that something is terribly wrong when a young mum with multiple issues can identify twenty professional support workers involved in her life but can’t identify a single friend. This recent scenario in Adelaide’s north, though perhaps at the extreme end, is reflective of the situation for many. Isolation and disconnection from community is a feature of modern life in Australia and it’s not just young mums who experience it - it is also frequently experienced by those who are old, disabled, sick or abused. Loneliness has become an urban epidemic with helplessness its debilitating companion. It is the kind of helplessness that erodes confidence, fosters self-doubt and drives people further inward and away from others. Since the early 1990’s in South Australia we have seen a reduced investment by government in developing communities and efforts have been concentrated instead on service delivery to those in need. This unfortunate direction was highlighted by the recent decision to cut 23% from the Family and Community Development Fund which is the key funding vehicle for family support programs, neighbourhood houses and the like. In the process of reducing investment in community development we are losing something very significant. While acute services are important, the flight of resources and energy toward the acute end has been very much at the expense of investment in community building activities that strengthen the capacity of families and children to care for themselves and one another. Although it can be a good thing to have a capable social worker it is even more important to have a supportive friend – someone who will stand with you when the winds of adversity blow and whose commitment to you is not constrained by the

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terms of their employment contract. Professional support workers, no matter how committed or capable they are, cannot be there for you in the way that a friend or supportive neighbour can.

The two worlds of community welfare service delivery Delivering community welfare services in Australia and working in community development projects both here and abroad illustrate very different ways of working, despite their surface similarity. In the first world the service delivery emphasis is largely on the individual and their needs while in the developing world the meagre resources available means that a more congregate approach is essential. The first world approach is mostly delivered by trained professionals and is frequently a high cost/high intensity/low volume intervention. No matter how effective these responses may be, they are not an option in the resource-poor developing world. In the developing world necessity dictates that responses need be to a wider audience and focussed on developing skills and capacity that strengthen individuals, families and communities. This is achieved by tapping into the skill base and resources already present in the community, no matter how meagre they might be. In the first world the focus is on “bought in” and “brought in” services, while in the developing world the focus is on identifying, organising and mobilising the human and physical resources which are already present in the community even if they are latent and hidden. While none of us would want to swap the conditions of the poorest urban communities in developing nations with those in poor urban communities in Australia, it is not uncommon to find that there is a sense of community in the developing world that is sadly absent in our poor neighbourhoods. It is also not uncommon to find that helplessness and impoverishment of spirit is also greater in poor local neighbourhoods in Australia. International research clearly identifies that happiness is not strongly linked to economic development and that subjective wellbeing is greater in the developing world than in countries such as Australia, America and the United Kingdom. (Economist, 2011) Instances like those of the young mum mentioned at the beginning of this chapter lead us to question the merit of the service delivery paradigm on which we, in Australia, have constructed our responses to vulnerable



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families and children. Service responses can be disempowering, focussing as they often do on meeting the presenting need without offering opportunities that strengthen capacity and connect individuals and families to their communities. Services frequently fail to challenge old and young alike to be all that they are capable of being and through misguided generosity we, at times, enable a lethargic existence and fail to promote self-reliance. The certainty of income security payments, even though they are not sufficient for those who receive them to live as they would like, does not provide impetus for change in the way that the absence of a safety net does for those in the developing world. In saying this we do not advocate for an Australia without a safety net, however, we need to honestly acknowledge that the services and benefits available to those in need in Australia leave some, if not many, comfortable in their lean but manageable circumstances and unwilling to strive for anything better. This also dampens any sense of urgency for collective action within communities. While it is possible to point to some inspiring instances where socially and economically disadvantaged Australian communities do work together, it is more generally the case that they do not, and the very things that we consider to be holding them up are actually holding them down. In the developing world the simple struggle for survival provides an imperative to become self-sufficient. In those communities, where good community development practice is at work, people pool their resources, they work together, they know that learning is critical to their advancement and they unite in seeking to provide a better future for their children. In communities like these you find activity and lots of it. Savings and self-help groups, literacy programs, vocational training, microenterprise development, micro loan schemes and community advocacy are frequently part of the landscape. Funding for community development in Australia is no longer a high priority as agencies within government and outside retreat to what they consider to be core business. This retreat hints at a limited understanding of the economic and social value of a community development approach that strengthens the capacities of individuals, families and communities. The more effective we can be in creating room for relationships within communities to develop and flourish in ways that are meaningful, relevant, productive and mutually supportive then the more holistic and natural will be the support that families and children experience.



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Principles of community development The principles of community development are worth considering as they are as relevant to the Australian context as they are in the developing world. Community development as a practice has become increasingly formalised over the past 30 years and there are widely accepted principles of community development, which are intended to influence both theory and practice (Kenny, 1999; Tesoriero, 2010; Higgins, 2010). Sue Kenny highlights the characteristics of community development as; ‘powerless people and social justice, citizenship and human rights, collective action, diversity, empowerment and self-determination, change and involvement in conflict, liberation, open societies and participatory democracy and accessibility of human services programs’ (1999, pp. 2122).

While not all of these aspects are equally present in every situation where community development is actively undertaken, there are aspects that can be identified in most community development situations. The norms, standards and values of the community will inevitably influence the practice and processes used in community development. As Kenny explains, “values underpin the everyday activities, assumptions, commitments and principles of community development” (1999, p20) and the principles of community development can and should be applied in ways that are culturally sensitive and that work within different values systems (Kenny, 1999; Radcliffe, 2006). As values are subjective, the way community development principles are applied will differ depending on the community. This level of diversity, and a need to adapt to differing community needs and contexts, makes its adoption at odds with many existing funding models. The nature of the existing structures in a community will also affect how the principles are applied. Shaw explains community development can be seen as a process of changing existing power structures to benefit people who are powerless or disempowered, or on the other hand it can be a process to encourage social inclusion, that is to shift the community and its services into the existing power structures (2008). This creates real challenge to service providers. In the service delivery model there is a clear power imbalance between the “professional” service provider and the “client” and also between the funding body, the contracted agency and the recipient community. There is rarely a participatory democracy at work



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here and frequently the “client” and their community are barely recognised as key stakeholders. Community development requires flexibility in both cultural implementation and methodology. Despite the appearance of flexibility in some community development, constraints do exist. As processes become more formalised and as bigger agencies get involved with large and highly complex projects, the power of communities tends to be eroded as organisational imperatives overtake community development principles. Inevitably, the pressure of timelines, a need for pre-determined outputs and funding limits influence decision making. Many agencies will also have a particular issue or target group on which they focus and this is useful as a way of prioritizing project activity, advocacy and funding (Eade & Williams, 1995). However as communities are made up of a complex mix of people, community development agents need to consider interrelated people outside a single target group and also those not directly affected by the social issue in focus. Just as it is important to support and enable children in the context of their family it is also important to support and enable families in the context of their community. Community development by its nature is both a relational and inclusive process that draws together the vast interests and stakeholders in a community recognising that a community is bound together by much more than the singular interests of the individuals within it. The broadly accepted outcomes for community development, as defined by Todaro (cited in Kenny, 1999, p. 10) are: • ‘To increase the availability and widen the distribution of basic life sustaining goods, such as food and shelter; • To raise the levels of living, including greater attention to cultural values as well as higher income and more jobs; • To expand the range of economic and social choices in society.’ It is in the context of the pursuit of community development outcomes like these that we are able to engage families and children in ways that don’t simply respond to present need, but in ways that prepare them for the future. Fostering the development of skills, engaging them in activities that enhance both their economic and personal capacities and connecting them



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with others with whom they can engage in meaningful ways is integral to a community development approach that supports families and children.

Intercultural perspectives The following case studies, one from a community in Uganda and another from India highlights a way of working from which we in Australia can learn.

Case study 1 – Lukodi, Northern Uganda In a rural village in Northern Uganda, sitting under the shade of a mango tree, a group of local people are meeting to discuss community issues, needs and initiatives. If you look and listen closely, it is this forum which illustrates everything you will read in a Community Development textbook and in a developing world context, is everything an NGO would hope for in their work. This village was devastated by both the long slow suffering of war in Northern Uganda, and the brutal trauma of a massacre which occurred in 2004. These are people who have experienced what it is like to struggle to feed their family, to experience trauma and family separation. Now they are rebuilding their lives and their community. This is the meeting of Di Cwinyi - a self-help group formed voluntarily to discuss the actions in their village that they want to drive in order to improve the community. The Di Cwinyi group is a single self help group in a village of approximately 1,000 people. It has a democratically elected governance structure, they hold regular meetings, they plan, debate, prioritise, fund and implement community development activities in their village. The group has been active in this village for over 20 years. After a hiatus during wartime, they have re-grouped with the shared goal of rebuilding their community. Originally forming as a women’s group, they now extend membership to men as well. Self-help group structure The group has over 300 members (306 at last report). Each group member is part of a local geographically-determined sub group called a Rot Kweri. The Rot Kweri structure allows smaller group discussions and even more local issues to be discussed and brought back to the combined Executive meetings. Each Rot Kweri is also a loan association or savings group providing micro-loans to community members through a peerregulated system of finance. Through these loan groups the community members are organised and supported to contribute regular savings from



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which micro-loans are administered to individuals or groups for productive purposes.

Figure 3:1: Structure of the Di Cwinyi self-help group. NGO involvement

In this partnership a local Ugandan Foundation was the initial catalyst for the group to expand, and they have been the provider of critical funds to speed up community activities and progress. Backing for this also comes from the Australian Aid & Development Fund, Bright Futures. This two-tiered funding model is similar to many development partnerships around the world, but this case allows change to be determined by the community. The devolution of power from the funding NGO to the community group does not necessitate the disempowerment of the NGO. Power does not need to be thought of as a zero-sum game. There is a commitment to priority areas, and principles, however specific targets or activities are not determined by the funder, nor are they known very far in advance. A rural self-help group in Northern Uganda is unlikely to develop program logics, or discuss objectively verifiable indicators, however what they will do is make decisions that are appropriate, sustainable and agreed upon by the wider group.



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Recently the group was seeking funds to buy a replacement mill after their original mill was no longer working after being destroyed in war. A mill can be used to grind rice, maize (corn) and other products into flours or other forms making them more useful and of greater value if sold at market. An interested funder was identified in Australia and sufficient money was provided to purchase a replacement mill. The group met to plan the purchase and to decide what they would buy, and in the process they decided to not only buy a new mill which would be used for a range of other grains they were currently unable to grind, but they would all contribute savings to enable their old mill to be repaired. The group members contributed their own savings to repair the old mill and established a management system for the mill whereby a small fee was paid by all users to repay the loans to the community group and to cover the ongoing costs associated with running the mill. Flexibility and adaptability are evident in this project. The group drives the activity and while the progress is monitored by a Community Development worker who acts as a connector between the Di Cwinyi group and the Ugandan Foundation, the group are the decision makers on what is to be done, who is to do it, when it will happen and where it will be located. In other settings these critical questions are so often determined or at least heavily influenced by the funding body, however in this village it is the mobilised community group who own the progress and development in their community and this capacity will exist long after the foundation or funding ceases.

Case study 2 – Bangalore, India In an inner-city slum in Bangalore, India, 1,000 households house an estimated population of 7,000 on two acres of land. A local Indian NGO supported by Australian donors has been working in the area for a number of years and have been using their sparse resources to deliver vocational training for women who have never had a job, and are trapped in a vicious cycle of extreme poverty. The Community Workers identified that health care is a serious un-met need in the area and they voiced this concern. If asked, almost all people living in this area, regardless of age or sex, would reveal they had never seen a Doctor, let alone received significant medical treatment. The community development budget would never stretch to set up a clinic, open an infirmary or even fund a mobile clinic so the NGO needed to mobilize existing resources in the area. They began approaching local hospitals to partner with them in the running of



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health camps; single day clinics in slums and remote villages for people who did not have access to health care. Local village leaders were consulted and involved in determining when and where clinics would be held. The NGO managed logistics and advertising largely through their network of self-help groups, vocational training centres, adult literacy classes and schools – and set up the colorful charminar or tent for shade and seating for those queuing to have their consult with the doctor. The hospital provided for the doctors, by granting them a day’s pay to treat however many people they could in that day and the NGO provided them with transport, tea, a meal at lunch time and a supply of over-the-counter medications which could be given to patients free of charge. The partnerships would vary in each village, depending on hospital locality and availability. However the formula remained the same. While there were real costs incurred by each of the partners involved, it was the brokering of the partnership and coordination of existing services, which brought real value to the situation. The involvement of the community through local leaders and self-help groups made the clinics a huge success and they continue to be held in the same communities on a regular basis. People in the communities also get advice from the doctors about other free services available to them, services about which they had no previous knowledge. This combination of health promotion, improved access and partnership between private and public hospitals, the NGO and the community leaders is a cost-effective example of what can be achieved when we work together.

Summary There is much we can learn from good examples of community development in the developing world. We can learn the importance of empowerment in assisting people to take responsibility for their own issues and find solutions from within. We can learn about the power of a connected community, one in which people know each other and form friendships which sustain and encourage. We can also learn about the importance of focusing on activities that strengthen people by increasing their skills and capacities and helping them find the strengths that already lie within. While there will always be a need for acute services that respond to urgent need and there will be families that fall through the cracks,



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community development provides a robust foundation for addressing the most basic needs of individuals, families and children and has its focus on improving their circumstances both socially and economically. These are powerful and practical ways to support families and children not just for the short term but for the rest of their lives as it is built on their growing strength and capacity and not ours.

References Eade, D & Williams, S 1995, The Oxfam handbook of development and relief, Oxfam, UK. Economist, T. (Producer). (2011). Happiness. The Economist Online Debates. [online debate 19 May 2011] Retrieved from http://www.economist.com/debate/days/view/702 Higgins, D. (2010). Community development approaches to safety and wellbeing of Indigenous children. Closing the Gap Clearninghouse Resource Sheet (pp. 14). Canberra, ACT: Australian Institute of Health and Welfare and Australian Institute of Family Studies. Kenny, S. (1999). Developing Communities for the future: Community Development in Australia, 2nd ed. Nelson ITP, Melbourne, Australia. Radcliffe, S. (2006). Culture in Development Thinking: Geographies, Actors & Paradigms. In Radcliffe, S (ed.) (2006), Culture and Development in a Globalizing World: Geographies, Actors and Paradigms, Taylor & Francis Ltd, Oxon. Shaw, M. (2008). Community development and the politics of community. Community Development Journal, 43(1), 24 – 36. Tesoriero, F. (2010). Community development : community-based alternatives in an age of globalisation. (4 ed.). Frenchs Forrest, NSW: Pearson Education.



CHAPTER FOUR CHILD AND FAMILY CENTRES: HOW EFFECTIVE? ELSPETH MCINNES AND ALEXANDRA DIAMOND

Integrated provision of family and children’s services, bringing together health, education, care and family support, has been an increasingly preferred model of service provision in countries which provide government funded services to families and young children. Processes of integrated service provision are complex, with many considerations and variations in combinations of services and models of governance in delivering services to families. The federally funded Communities for Children program has supported the establishment of FamilyZone Hub at Ingle Farm in Adelaide’s northern suburbs since 2006. This research reports on aspects of an evaluation of experiences of families using its services.

Introduction The FamilyZone Hub, located in the grounds of Ingle Farm state Primary School in Adelaide’s northern suburbs, has been providing health, education, care and support services to families with young children since its establishment in 2006 under the Communities for Children program funded by the Federal Department of Families, Housing, Community Services and Indigenous Affairs. The Communities for Children program targets integrated services development and support for families in communities identified as having significant levels of disadvantage. In 2009 the focus moved to attention on specific vulnerable groups. Groups identified as being potentially vulnerable include families from culturally and linguistically diverse backgrounds

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(CALD) and Aboriginal and Torres Strait Islander (ATSI) families, socially isolated families, families with infants under two, homeless families or those in temporary accommodation, families experiencing social and economic barriers to participation, families in transition and new arrivals, parents aged under 25, grandparent carers, families where children or parents have a disability or developmental delay or mental health issue, and families experiencing family violence or abuse, or drug or alcohol abuse (FAHCSIA, 2009). The Salvation Army Ingle Farm is the Facilitating Partner of Salisbury Communities for Children, working alongside Lutheran Community Care, Centacare, the City of Salisbury, Child and Family Health Services, the Department of Families and Communities (DFC), Central Northern Primary Health Care Service and the Department of Education and Children´s Services (DECS) to deliver services through the FamilyZone Ingle Farm Hub. FamilyZone Hub is auspiced by a stakeholder representative Salisbury Communities for Children Committee. Lutheran Community Care has been subcontracted to oversee co-ordination and management of the Hub. The suite of services and activities provided at FamilyZone Hub aim to achieve the following outcomes: • Improved ante-natal and post-natal health, child physical health and development, child cognitive development and competence, child social/ emotional development • Positive and supportive parent/child relationships • Improved parenting competence and style • Improved family resources and capacity including gaining employment • Increased knowledge and skills related to family functioning, family safety and child development • Maintaining improved family relationships. Before detailing some findings from the evaluation of experiences of families using the services, we will briefly discuss some rationales behind family services integration, key elements of service integration, policy contexts of family services integration, and evaluations of integrated services.



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Reasons for child and family services integration Integration of child and family services provision has been an evolving process in Australia and elsewhere. Models being developed by the Sure Start Children´s Centres in the UK, Early Head Start in the USA and Toronto First Duty initiatives in Canada have demonstrated various ways families with young children can be supported to gain access to needed services, improve their knowledge about parenting and child development, and establish and maintain social connections. Some reasons for the push for service integration include: • Recognition that social and health problems are interrelated, leading to efforts to link social, educational and health service “silos” to provide more cohesive support (Sanson & Stanley, 2010). • Recognition that family contexts are critical elements of learning and development in early childhood (Bronfenbrenner & Morris, 2006) leading towards provision of seamless services to support effective parenting, family functioning and wellbeing, rather than education aimed only at children (Department of Education and Children’s Services, 2005). Increasing evidence that adverse early childhood environments are involved in the etiology of costly social and health problems such as asthma, obesity, diabetes, child abuse, binge-drinking, drug abuse and mental illness, has resulted in pressure to increase the efficiency of prevention measures along with minimising government expenditure (Mustard 2008). With this has come a move to the notion of “investing in children” (Heckman, 2000, p39), whereby children’s wellbeing and development are seen as requiring “all families to enter into an active relationship with the state” (Nichols & Jurvansuu, 2008, p.117). Along with this is recognition of increased numbers of mothers of young children in the workforce and of access issues for many families leading to the provision of ‘one stop shop’ services (child care, education, social and health services in one location) from conception through early years of school (Department of Education and Children’s Services, 2005). Although “degrees of collaboration range from co-existence (services operating independently) to full integration (services amalgamating to form one entity)”, it is accepted that higher levels of collaboration lead to improved service coordination and better outcomes for consumers (The Royal Children’s Hospital, 2009, p.2). Whilst there is no single model of



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best practice, effective integrated service settings require some key elements (Press, Sumsion & Wong, 2010; The Royal Children’s Hospital, 2009). Successful service integration requires management of the “multilayered policy landscape” (Nichols & Jurvansuu, 2008, p.118) to meet the needs of children and families in their community. Nichols and Jurvansuu (2008) refer to the different policies produced by different nongovernment organisations, State and Commonwealth government departments at different times, and their different and frequently contradictory assumptions. For example what a policy means when it refers to a “centre’s community” can involve problematic assumptions. Does the “community” include only those who use the centre? In which case how do other families get voice or access? Or does “community” refer to some idea of wider community? In which case who is included/ not included in that wider community? Integration involves management of multiple programs within complex sets of regulations using funding from multiple sources, and attending to multiple lines of accountability to effectively meet the needs of children and families in their community. This requires creative, well informed, organised leadership with a strong, persuasively communicated vision, sturdy relationships and continuity. Typically in early childhood settings, leadership involves “collaborative leadership” rather than a single leader (Rodd, 2006, p.16). The various service providers within effective integrated settings develop shared professional understandings through open communication and become informed about each others’ roles and constraints (Press, Sumsion & Wong, 2010). Only through development of shared visions, trust, goodwill and professional respect can they engage in shared planning, budgets and program delivery. For programs to be more accessible and responsive to the needs of all parents and children in the wider community than prior to their integration, staff must provide quality programs, and put the needs of children and families in the wider community at the centre of decisions about program provision and the model of integration used (The Royal Children’s Hospital, 2009). Co-ordinated action between service professionals is needed so that problems such as impending homelessness, mental or physical illness, and delays in children’s development are identified and comprehensively addressed earlier than they would have been before integration (The Royal Children’s Hospital, 2009). Coordinated action depends on good communication, shared understandings



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of the integrated service environment and positive relationships between different professionals providing services to families (McInnes & Nichols, in press).

Evaluating integrated child and family services Rationales for, and benefits of, area-based integrated service provision are ultimately tested by examining whether there are differences in outcomes for children and families who have access to such services compared with those who do not. The following section provides a brief overview of national evaluations of programs delivering integrated child and family services in the UK, the USA, Canada and Australia. Sure Start Local Programmes commenced in the UK in 1999 targeted some of the most deprived areas in England, with programs for families with children aged 0-3 years, managed by a partnership of health education, social services and voluntary sectors. An early evaluation of UK Sure Start programs identified that whilst overall outcomes for families were positive, children of most disadvantaged families, defined as those with fewest resources, displayed adverse outcomes (Belsky, Melhuish, Barnes, Leyland & Romaniuk, 2006). The evaluation team speculated that reasons for this may be that more advantaged families took more opportunities from services provided, leaving relatively less access for more deprived families. Another possibility was that “relatively more socially deprived parents may also find the extra attention of service providers in SSLP areas stressful and invasive” (Belsky et al 2006, p1476).The evaluation also found that sites led by health services were more effective than other sites. A later report found that children from Sure Start communities were more socially positive in their behaviour and more independent, whilst parents were less negative, more in touch with services, and provided a better home learning environment for their children than those without Sure Start (Melhuish, Belsky, Leyland & Barnes ,2008). The authors speculate the differences in outcomes from the earlier studies may reflect the evolution and increasing sophistication of the programs offered (Melhuish, Belsky & Barnes, 2010). In the USA the federal Early Head Start program aimed at low-income pregnant women with infants and toddlers commenced in 1995 with performance standards requiring programs to provide high quality child development services delivered through home visits, child care, parenting education, case management, health care and referrals and family support.



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An evaluation found benefits for 3 year-old children who had been involved in the program (Love, Kisker, Ross, Raikes, Constantine, Boller, Brooks-Gunn, Chazan-Cohen, Tarullo, Brady-Smith, Fuligni, Schochet, Paulsell, & Vogel, 2005). Compared with children who had not participated, Early Head Start 3 year olds showed better cognitive and language development, less aggressive behaviour, more sustained engagement in play and higher emotional engagement with their parents. Parents who had involvement in Early Head Start were more emotionally supportive of their children and provided more language and learning stimulation, reading to their children more and hitting them less than other parents. Love et al (2005) found that highest impacts were for programs that offered a mix of centre-based and home-visiting services and that had fully implemented their performance standards shortly after commencement. Between 2001 and 2005 the Canadian Toronto First Duty program developed integrated services across child care, kindergarten and family support in five community school-based hubs. A second phase from 2006 to 2008 focused on putting knowledge into practice, changing policies and further developing the model (Corter, Pelletier, Janmohamed, Bertrand, Arimura, Patel, Mir, Wilton & Brown, 2009). Evaluation of Toronto First Duty sites found that children benefited socially and were more prepared for school with higher levels of parental involvement compared to children who had not participated. Researchers found that parents felt more confident in helping their children learn, and made connections with other parents. They also found that quality of non-parental care services for children was the central and most consistent factor determining effects of those services on children (Corter et al., 2009). The evaluation team offered some key points for providing quality integrated services for children and families (Corter et al., 2009). These are summarised below: • Sustainable change requires an overhaul of legislative requirements, professional education, funding mechanisms and governance structures from the ministry through to program management. • Success of full day learning depends on front-line staff. New approaches to training can help prepare practitioners to work across professional boundaries, but attention to developing equitable compensation and working environments is also required. Although child care is central to the range of options necessary to support young children and their families, it remains the program component that is most difficult to incorporate and expand in an integrated



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model. Effective integration requires the vertical integration of children’s programming from birth through primary school as well as the horizontal integration of education, child care and parenting supports. Leadership is critical. A leadership development strategy is essential starting with the Ministries and working through to systems administration, the program and the classroom. The Australian Communities for Children program, which commenced in 2004, aims to support development of children in 45 disadvantaged community sites around Australia by improving coordination of child and family services for 0-5 year olds, addressing unmet needs, supporting community engagement with services and improving community contexts for young children (Muir, Katz, Edwards, Gray, Wise & Hayes, 2010). The Program has undergone a national evaluation. Researchers identified that the Communities for Children program increased the number, type and capacity of services in communities in which is it based. Increases in service provision were accompanied by increases in recruitment and engagement of families who were not attending early childhood services, particularly those from more marginalised groups such as families from culturally and linguistically diverse and low income backgrounds, and Indigenous families. Muir et al. (2010) also found that collaboration between services increased significantly in Communities for Children sites, particularly with respect to referrals, interagency staff training and information exchange. Overall benefits to children and families indicated that fewer children were living in households where no adult was employed, and parents used less harsh parenting practices and felt more effective in their roles as parents (Muir et al., 2010 p. 39). Researchers also found that parents in Communities for Children sites were more likely to report their children as having lower levels of physical functioning. Researchers also found decreased reported mental health of mothers with year 10 education or less; decreased reported general health of mothers in lower income households and decreased child physical functioning in households with mothers with low education, low income or single parent households. Researchers speculated that these health findings may be due to undiagnosed health problems subsequently being recognised through education and exposure to services. They noted that the overall impact of Communities for Children were positive but small, and speculated whether a more coordinated system of service provision for families had an overall positive community impact.



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“The fact that the effect sizes for CfC were comparable to many alternative early childhood interventions, and that these effects were evident irrespective of whether parents and children in CfC communities had actually received services, seems to point towards an additional effect over and above the provision of new, stand alone services, possibly as the result of a better coordinated local system of early childhood services and/or other enhancements to the community context in which children develop.” (Muir et al., 2010, p.42)

This brief overview of evaluations of child and family integrated services programs across the UK, USA, Canada and Australia indicates that there are some overall benefits to individual children and families, and benefits to the wider communities in which programs are based. Across all programs parents generally reported feeling more informed and effective as parents, and children were generally seen as having improved social and emotional functioning. Across all four programs, integrated services provision generally improved collaboration, referrals and information sharing between agencies and services. There was also some evidence across the different programs that children and families facing highest levels of disadvantage did not benefit as much as families with more supports (Belsky et al., 2006; Muir et al., 2010).

FamilyZone Hub evaluation Unlike national program evaluations which conducted large–scale comparisons between populations which were included in programs and similar populations which were not included, the evaluation of FamilyZone Hub primarily focused on the experiences of families at the site. The evaluation has sought to identify from referring agencies and parents how parents and their children benefitted from the service. The evaluation process included a range of data sources, including parents, the Home Visiting Service at FamilyZone Hub and agencies which have a referral relationship with FamilyZone Hub. Parents using FamilyZone Hub services have been key informants in the evaluation process. As Winkworth, McArthur, Layton, Thomson and Wilson (2010, p431) found in their study of isolated parents, mothers were less likely to engage with services when they felt “judged and under surveillance.” Parents’ positive feelings about coming to FamilyZone Hub



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and continuing to engage in activities at the service could therefore be seen as key indicators of effectiveness of the service. The need to know how parents felt about coming to FamilyZone Hub indicated that qualitative data would be required to provide the necessary depth of detail (Liamputtong & Ezzy, 2005). Structured interviews, focus groups and surveys sought to capture both quantitative and qualitative elements of service usage.

Methods Interviews with 42 caregivers attending FamilyZone Hub were conducted by a Communities for Children staff member who did not provide services at the site, but who was familiar to site staff. Families attending FamilyZone Hub were informed by notices at the site that the service was being evaluated and they could contribute their views by offering to be interviewed or completing a short survey. This approach to data collection was chosen after discussion with staff who voiced concerns that families should not feel obliged to give personal information to FamilyZone staff or strangers. Two focus groups were used to collect data from five African and nine Afghan mothers, attendees of the ‘African group’ and ‘Afghan group’ at Family Zone. For the African group a translator was engaged to translate to and from Dinka and Arabic, two languages spoken by all but one of the women. The woman who spoke neither Dinka nor Arabic was able to participate using basic English. A translator was also engaged for the Afghan group to translate to and from Afghan, the language spoken by all the participants. Questions aimed to assess whether participants felt more informed about Australian society, whether they felt a part of their community and more able to engage with the wider community, as these were the objectives of service provision. Results for the African and Afghan groups have been summarised as they were voiced via translators and so cannot be seen as the participants’ own words. Agencies which have a referral relationship with FamilyZone Hub completed a short survey. The survey was posted to 18 agencies identified by FamilyZone Hub staff and 11surveys were returned, giving a response rate of 61%.



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The Home Visiting Service operating from FamilyZone Hub provided a Case Study example of the process of engagement with families over time. The following data section begins with the Case Study before going on to detail parent data from interviews and focus groups, concluding with agency survey data.

Evaluation data The Home Visiting service at FamilyZone Hub is the key outreach activity provided by the site. Families are identified by referrals from other agencies or services, friends and self-referral. The following Case Study illustrates how a range of different services can ‘wrap around’ a family with multiple issues and improve day to day family life and the context of a child’s growth and development. Teresa1, Carl and baby Oliver were referred to Home Visiting when Oliver was 6 months old and was reportedly an ‘unsettled’ baby. Initial assessment was that Teresa was suffering from depression – later diagnosed as post natal depression. The house was disorganised, dark and gloomy and Teresa was immobilised on the lounge with a screaming baby on a mat on the floor. Teresa said her husband Carl was on Work Cover. He couldn’t handle the baby crying and had withdrawn from the family emotionally and physically by closing himself in his study. Home Visiting referral to a local GP resulted in referrals to a paediatrician for baby Oliver, a psychologist for Teresa along with a mental health plan which gave her access to child care and a post natal depression support group (Being with Baby at FamilyZone Hub). Home Visiting allocated a family support worker to visit on a regular basis. The paediatrician diagnosed reflux and medicated baby Oliver who began to settle a little easier. Anti-depressants combined with Being with Baby supported Teresa, as did the family support worker who for a short time visited on a daily basis, later reducing to weekly visits. The skills learned from Being with Baby contributed to Teresa changing her pattern of thinking. She persevered with child care at times finding the conflict between wanting to be a ‘good’ mum (and therefore not use child care) and her need for time out, almost too much. The skills learned from

 1

Names have been changed.



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this group also influenced her marital relationship (along with support from Carl’s psychologist). To support the positive changes occurring in this family, Teresa was offered the opportunity to attend Stepping Stones play group which follows on in the Being With Baby time slot. This is a very small supported play group which encourages families at an individual level. This group also makes connections with the broader community, such as the library and a speech pathologist. Teresa was also encouraged to join several of the groups operating at FamilyZone Hub. She chose to join the New Age Mums group which meets on a Friday afternoon, following Friday morning playgroup. Within this group she found the support to enjoy her parenting but also voice concerns and ask questions of the other women. This group enjoys crèche on occasions but it is more common for the women to interact with their children within the group setting, which was again a growth experience for Teresa. On Mondays, Teresa began to attend Busy Fingers, a craft group which meets for craft together with the support of a crèche. Teresa found it supportive to have her baby close by but be able to enjoy the company of the other women. Although the fingers in this group are busy, more value comes from the conversation which occurs between the women. Twelve months later Teresa has secured child care with which she is happy – she has returned to work three days a week. Apart from referrals to treating specialists, the Home Visiting service linked the family to the FamilyZone Hub groups Being with Baby and Stepping Stones to assist parenting relationships, the New Age Mums and Friday playgroups to support the development of children’s play and adult peer networks and the Busy Fingers craft group to provide peer support as well as practice in allowing other people to care for her child. Without intervention the family’s experiences were likely to reflect the difficulties arising from two parents with depression and no employment and a baby with gastric reflux and difficulty settling. Research by Cohn and Tronick (1983) has found that when mothers are emotionally unavailable, their infants exhibit more depressed behaviours (crying, wariness and looking away) and toddlers exhibit more negative behaviour including withdrawal, aggression and failing to engage



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in play. Ongoing depressed mother-infant interactions are statistically associated with attachment insecurity (Carter, Garrity-Rokous, ChazanCohen, Little & Briggs-Gowan, 2001), poorer cognition at age 18 months (Murray, Fiori-Cowley, Hooper, & Cooper, 1996), and aggressive, antisocial behaviour in primary school-aged children (Hay, Pawlby, Angold, Harold & Sharp, 2003). Interviews with parents provided both quantitative and qualitative data about their experiences.

Interview sample Of the 42 interview respondents; three were family day care providers and 39 were mothers. No fathers were present at the times of data collection interviews. Most respondents (60%) were aged between 26 and 35, with the remainder aged 36 or more. There were no respondents aged 25 or under. Most respondents (88%) lived in couple households. Fifteen couples had one child, 14 had two children, four families had 3 children and two couple families had four or more children. Of the sample’s five single parent families, three had one child, one had 2 children and another had three children. Thirty-one of the 42 respondents (73.8%) were born in Australia. Two were from the UK, two from Korea and two from the Philippines. There was one family from each of the following countries: New Zealand, Germany, India, China, Japan. None of the respondents identified as Aboriginal or Torres Strait Islander. Thirty-six families spoke English at home as their first language. Other languages used matched cultural identities of parents, including Tamil, Cantonese, Korean, German and Japanese. Thirty-seven respondents (88%) relied on wages for their household income. Four respondents (9.5%) relied on Centrelink income support payments. Three of these received Parenting Payment Single. Twenty-six respondents (61.9%) reported good family health but the remainder indicated that someone in the family had a health problem needing regular medication or treatment. Five mothers stated they had a health problem. Four families reported that one child had a health problem. In two cases one parent and one child had a health problem. In another two cases both parents had a health problem. In a further two cases both parents and one child had a health problem. One family reported that both parents and two children each had health problems.



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The most commonly reported conditions were depression or anxiety (n= 8), featuring in half of all reported health problems. One in four cases with health problems reported asthma or another respiratory condition (n=4). Gastric reflux affected one in six families (n=3). Two families were dealing with diabetes, two families had allergies, two families had muscleskeletal problems and two families reported arthritis or gout conditions. Health problems affecting only single cases included mobility disability, carpal tunnel syndrome, failure to thrive, heart condition, autism spectrum disorder and hypertension. Conditions affecting children included asthma, allergies, gastric reflux, failure to thrive and autism. The interview sample did not include fathers, Aboriginal or Torres Strait Islander families or families with mothers aged less than 25. Families reliant on income support payments and single parent families were also under-represented.

Reasons for attending FamilyZone Hub Referral from another service and word-of-mouth between mothers were common pathways for families coming to FamilyZone Hub. Service referral was the most common reason given, with 14 parents saying they had been referred, usually after experiencing post-natal depression. Twelve respondents had wanted a playgroup. Ten mothers came seeking more social interaction for themselves and their children. Nine women said they had been referred to FamilyZone Hub by friends. Five mothers wanted their children to have access to other children and wider activities. Two mothers said the location suited their needs and one mother attended specifically for the craft group at the centre. Some comments from parents about reasons they began coming to FamilyZone Hub are detailed below: “My girlfriend actually recommended it and because I wasn’t doing anything and didn’t have a playgroup to go to at that point she actually recommended it.” Lola, 1 child aged 3. “I was stuck at home by myself for a bit and then I was home with the baby and not knowing any friends and stuff, but this place is really good. I just needed other mums to talk to and somewhere different for my kids to play where they weren’t stuck at home all the time.” Niki 2 children.



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“I was alone here. My country is India. Here I was alone so I needed some friends so I came here. My friends told me about this.” Sarina 1 child 9 months. “I was being monitored for depression. The program at the hospital was full so I was referred to Being with Baby at FamilyZone Hub, which was also closer.” Toni 1 child 15 months.

Mothers wanted their children to have opportunities to play with other children and to be able to get out of the house. Those who had moved away from family and friendship networks identified a need to develop their social contacts, whilst those with health problems such as post natal depression, were often referred by health services.

What mothers valued Being able to talk to other adults, being made to feel welcome, experiencing understanding and supportive non-judgement and having access to the wisdom of other mothers and of staff were named by mothers as valued aspects of attending FamilyZone Hub. “Every time they (staff) see me they’re like ‘Oh great to see you here’ so I feel like they actually want me to come...they’re always happy to see you.” Rosie, 2 children 2 and 5 months. “Once you get in here you just mostly talk with the other mums. It’s just really nice having adult conversations rather than talking with children all day.” Sasha 2 children, 2 and 1.

Mothers also valued being able to share responsibility for caring for their children in a safe environment, and being able to have time out for themselves and other children by using the crèche. “If you’re having a rough time they will take the baby for you for a little bit and they’ll always be there to provide encouragement and stuff and they know you and they know the baby.” Rita

Receiving support from others, learning about parenting, developing wider social networks and increased self-confidence were most commonly nominated changes reported by mothers as a result of coming to FamilyZone Hub. Parents also valued the opportunities for their children to have the company of other children.



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Playing with other children, improved social, language and motor skills development and having access to a wider range of toys and activities were most frequently nominated benefits for children. Two mothers commented that coming to FamilyZone Hub helped them be better parents and this in turn helped their children. ‘Definitely having a more attentive mother... I actually hated my youngest son for a while there, because with the PND I resented him taking me away from my older child. So coming to Being with Baby, having other people to talk to, has given me back to my family. Now I have people who are a support system to help, with me being there for them.” Ella 2 children. “Definitely the happy atmosphere and the fact that she’s happy. I will certainly keep coming back because she enjoys it and if she’s enjoying it, I’m enjoying it.”Lola, 1 child aged 3.

Fig 4-1: FamilyZone 2009 End of Year Celebration



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Focus group data The women from both African and Afghan groups identified perceived benefits to their children, to themselves, and to their parenting role. Both groups appreciated that FamilyZone Hub provided their children with opportunities for play, bilingual development and relationships with others, while giving parents opportunities for social interaction and English language practice. The African mothers noticed that when they did not attend FamilyZone Hub their children become bored and that their behaviour was more challenging. They were pleased their children had opportunities to learn English because crèche workers at FamilyZone Hub spoke to them in English rather than in Dinka or Arabic. The mothers said their children had formed strong, affectionate relationships with the African playgroup coordinator. They enthused about her smiling, friendly demeanour, her genuine care and passion for her work, and her positive conversations with them about their children. They expressed a wish to strengthen their relationship with this staff member by having her visit them at home. Afghan mothers also enjoyed their children’s opportunities to play with each other and with the toys at FamilyZone Hub crèche, to get out of the house and to go on excursions to the zoo and to picnics. Both the Afghan and African women said that family life benefitted from getting out of the house with the children and socialising. The African mothers said they appreciated the chance to get away from home and they felt good again after attending. They said that without FamilyZone Hub they would be bored, lonely, friendless and anxious. Despite language differences, some group members had formed very close friendships through FamilyZone Hub, speaking to each other on the phone and visiting each other’s homes during the week. They saw FamilyZone Hub as a safe place to go with their children where they gained new information about education, welfare and other options. Likewise the Afghan women said that their group had helped to alleviate depression as they talked and shared their problems. The opportunity to get out of the house also helped them to feel more connected to each other and their culture. Their friendships had extended to phone calls and visits to each-others’ homes. Without FamilyZone Hub the Afghan women said they would be sad and sometimes angry, and that the group had helped them to learn about other cultures and to appreciate



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that people from other cultures also suffered from mental stresses. The Afghan women particularly appreciated the excursions organised by FamilyZone Hub as they helped them to understand the locality and its amenities. Attendance at the group had also taught them about dental and mental health services for children and accommodation and primary medical services for women.

Referring agency survey data Nine of the 11 agencies surveyed reported referring families to FamilyZone Hub on at least a monthly basis. Ten agencies received referrals to them from FamilyZone Hub. Two-thirds of the agencies reported that attending FamilyZone Hub had ‘a great deal of impact’ on families they had referred. Agencies were asked to identify benefits for families from attending FamilyZone Hub from a list of possible benefits and the top three impacts they observed. Table 7: Agencies observations of benefits to families Possible Benefits to Families

No. observing benefit N =11

No. who rated benefit in their top 3

Information about parenting Information about child health and development Increased parenting confidence

8 8

2 1

10

8

9 9 11

5 2 2

10 10 10

1 6 3

Access to services Wider social networks Time out with other adults and their children Time with their children Improved parent well-being Improved child well-being

While most agencies agreed that families benefited in all the ways listed in the survey, the top three observed significant benefits were ‘Increased parenting confidence,’ ‘Improved parent well-being’ and ‘access to other services.’



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Agencies provided comments on the FamilyZone Hub services. “FamilyZone Hub is an ideal location for our organisation to operate English Language classes for newly arrived migrants and refugees in the area. The benefits to our students of this location are considerable. Intended ‘side-effects’ of coming to the class include becoming aware of and participating in the services. Also staff at FamilyZone Hub have become familiar with many of the newcomers in their area and encounter these potential ‘clients’ at a very strategic early stage of their settlement experience in Australia.”

Other comments praised aspects of FamilyZone Hub services. “I have been very impressed with services provided by FamilyZone Hub. Clients and children benefit from contact and connections they are able to establish and the support available to them. Importantly it reduces social isolation for many clients.” “Excellent service. It is also very helpful being sent letters acknowledging they have become involved or if there has been lack of contact, so thanks.” “Our clients who have been referred to FamilyZone Hub have all reported highly on the service provided. The group supporting PND mums has proved to be a huge success with our clients.” “The service is very approachable and efficient. It is great to have extra support for families especially access to services at FamilyZone Hub.” “Keep up the great work with big thanks.”

Discussion Mothers attending FamilyZone Hub reported a range of perceived benefits from attendance. Evaluation data pointed to service strengths in providing a welcoming environment for both parents and children, social interaction for children and adults, parenting education and improvements in parent-child relationships. Activities targeting specific cultural groups have assisted immigrant families to learn more about their community and supported formation of friendship groups within cultural communities as well as social and developmental gains for their children. A particular strength of FamilyZone Hub has been the establishment of effective referral pathways for mothers with post-natal depression beyond the diagnosing and treating health service. Opportunity for mothers to



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have home visits, one to one support and to participate in groups to support improved parenting, has transformed family life for a number of women who had been overwhelmed with negative feelings. A key element of the effectiveness of mental health referral pathways has been screening for post-natal depression, enabling more mothers to be identified and provided with a suitable service. Referring agencies assessed FamilyZone Hub as delivering important benefits to families, giving the agencies a valued avenue to connect vulnerable families to services on an ongoing basis. There were however important gaps in the data with respect to experiences of fathers, young parents, grandparent carers and Aboriginal and Torres Strait Islander families as these groups were not present in the data sample. It may be that these groups attend at different times and their numbers at the service may fluctuate, however the under-representation of families living on income support and sole parent families points to the continuing need to provide effective outreach approaches for more isolated families.

References Belsky, J., Melhuish, E., Barnes, J., Leyland, A. & Romaniuk, H. (2006). Effects of Sure Start local programmes on children and families: early findings from a quasi-experimental, cross-sectional study. British Medical Journal, 332 p1476. Bronfenbrenner, U. & Morris, P. (2006). The bioecological model of human development. In R.M. Lerner (Ed.), Handbook of child psychology: Vol. 1. Theoretical models of human development (6th ed., pp.793-828). Hoboken, NJ: Wiley. Carter A., Garrity-Rokous, F., Chazan-Cohen, R., Little, C. & BriggsGowan, M. (2001). ‘Maternal depression and comorbidity: Predicting early parenting, attachment security, and toddler social-emotional problems and competencies’, Journal of the American Academy of Child and Adolescent Psychiatry, 40, 18-26. Cohn, J. & Tronick, E. (1983). Three-month-old infant’s reaction to simulated maternal depression. Child Development, 54, 185-193. Corter, C., Pelletier, J., Janmohamed, Z., Bertrand, J., Arimura, T., Patel, S., Mir, S., Wilton, A., & Brown, D. (2009). Toronto First Duty Phase 2: 2006-2008: Final Research Report. Toronto: Atkinson Centre for Society and Child Development, Institute of Child Study/ Department



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of Human Development and Applied Psychology Ontario Institute for Studies in Education/University of Toronto. Department of Education and Children’s Services (2005). The Virtual Village: Raising a Child in the New Millenium; Report of the Inquiry into Early Childhood Services, Hindmarsh: Government of South Australia. http://www.ecsinquiry.sa.gov.au/files/links/Virtual_Village_report.pdf Department of Families, Housing, Community Services and Indigenous Affairs (2009). Community and family partnerships guidelines. Canberra: Australian Government. http://www.fahcsia.gov.au/sa/families/progserv/Pages/cfp_guidelines.a spx Department of Families, Housing, Community Services and Indigenous Affairs (2011). Communities for Children. Canberra: Australian Government. http://www.fahcsia.gov.au/sa/families/progserv/communitieschildren/P ages/default.aspx Hay, D., Pawlby, S., Angold, A., Harold, G., Sharp, D. (2003). Pathways to violence in the children of mothers who were depressed postpartum. Developmental Psychology, 39(6), 1083-1094. Heckman, J. (2000). Policies to Foster Human Capital, Joint Center for Poverty, Research Working Papers 154. Northwestern University / University of Chicago. Katz, I., La Placa, V., & Hunter, S. (2007). Barriers to inclusion and successful engagement of parents in mainstream services, Joseph Rowntree Foundation: Water End, York. http://www.jrf.org.uk/bookshop/ebooks/barriers-inclusion-parents.pdf Liamputtong, P., & Ezzy, D. (2005). Qualitative research methods (2nd Ed.). South Melbourne, Vic.: Oxford University Press. Love, J., Kisker, E., Ross, C., Raikes, H., Constantine, J., Boller, K., Brooks-Gunn, J., Chazan-Cohen, R., Tarullo, L., Brady-Smith, C., Fuligni, A., Schochet, P., Paulsell, D. & Vogel, C. (2005). The Effectiveness of Early Head Start for 3 Year Old Children and their Parents: Lessons for Policy and Programs. Developmental Psychology, 41(5), 885-901. Melhuish, E., Belsky, J., & Barnes, J. (2010). Evaluation and value of Sure Start. Archives of Disease in Childhood, 95, 159 - 161. Melhuish, E., Belsky, J., Leyland, A., & Barnes, J. (2008). Effects of fully-established Sure Start Local Programmes on 3 year old children and their families living in England: A quasi-experimental study. The Lancet 372 (9650), 1641-1647.



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McInnes, E. & Nichols, S. (In press) Partnerships in Integrated Early Childhood Centres: Getting from Policies to Practices. Muir, K., Katz, I., Edwards, B., Gray, M., Wise, S., Hayes, A. (2010). The National Evaluation of the Communities for Children Initiative Family Matters, 84, 35-42. Murray, L., Fiori-Cowley, A., Hooper, R. & Cooper, P. (1996). The impact of postnatal depression and associated adversity on early mother-infant interactions and later infant outcome. Child Development, 67(5), 2512-2526. Mustard, F. (2008). Investing in the early years: closing the gap between what we know and what we do, Adelaide Thinkers in Residence, Department of Premier and Cabinet, South Australia, http://www.thinkers.sa.gov.au/lib/pdf/Mustard_Final_Report.pdf Nichols, S. & Jurvansuu, S. (2008). Partnership in integrated early childhood services: An analysis of policy framings in education and human services. Contemporary Issues in Early Childhood, 9(2), 118130. Press, F., Sumsion, J., & Wong, S. (2010). Integrated early years provision in Australia, NSW: PSC National Alliance, Charles Sturt University. Rodd, J. (2006). Leadership in early childhood, 3rd edn. St Leonards NSW: Allen & Unwin. The Royal Children’s Hospital Melbourne (2009). Integrating services for young children and their families, Policy brief no. 17, The Royal Children’s Hospital Melbourne, http://www.rch.org.au/emplibrary/ccch/PB_17_FINAL_web.pdf Sanson, A. & Stanley, F. (2010). Improving the wellbeing of Australian children and youth: the importance of bridging the know-do gap. In G. Bammer, A. Michaux & A. Sanson (Eds.), Bridging the ‘know-do’ gap: Knowledge brokering to improve child wellbeing, ANU E-Press; http://epress.anu.edu.au/knowledge_citation.html Winkworth G., McArthur, M., Layton, M., Thomson, L. & Wilson, F. (2010). Opportunities Lost--Why Some Parents of Young Children Are Not Well-Connected to the Service Systems Designed to Assist Them, Australian Social Work, 63(4), 431 – 444.



CHAPTER FIVE DEVELOPING INTEGRATED CHILD AND FAMILY COMMUNITIES PAUL PRICHARD, SUZANNE PURDON AND JENNIFER CHAPLYN

The recent move towards integrated models of early childhood service delivery across Australia presents unique opportunities for babies, young children and their families, and poses an exciting challenge for entire communities. It presents an opportunity to do something extraordinary where, in years to come, future Australian generations will look back on this time and view it as a turning point in the way services are delivered for children and families. Yet, across Australia and in other countries, there are numerous examples of local early childhood services that freely use the words “collaboration” and “integration” while, in reality, they provide little more than a cluster of co-located services sharing resources. They are proof that little will change for children and their families unless real change occurs in the design and delivery of relevant early childhood services. The term “Integrated Service Delivery” refers to the process of building connections between services in order to work together as one to deliver services that are more comprehensive and cohesive, as well as services that are more accessible and more responsive to the needs of families and their children. In order to create truly integrated services, connections between individuals must be present through every stage of the process. Success in building these connections is underpinned by the modelling of respectful and helpful relationships which must be reflected at all levels of service delivery. However, it must be acknowledged that successful integration is a continual process. It takes time as it requires new ways of working and impacts on all aspects of service delivery including governance structures.

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This change will undoubtedly present great challenges for services, communities and governments, and ultimately requires significant change from individual workers. A mounting body of evidence points to the changing nature of children and families requiring new and distinctly different service responses. Families in many communities still only have access to early childhood and family support services that were designed to cater for family structures that were more common in past generations. Given that many services may still function in isolation from one another, there is an ever increasing number of families that miss out, or don’t fit into these traditional service structures. Now, more than ever before, more flexible and inclusive service options are required for families. For the benefit of our children, it is undeniable that the most helpful change would be reflected by services working in far more connected ways. One of the most powerful ways to support sustainable change is to model what it is we want to achieve. If what we want is a truly integrated local service model, then both behaviour and processes at all levels need to reflect the values, beliefs and culture required to create a partnership with communities. The Family Partnership Model (Davis, Day & Bidmead, 2002) suggests there are fundamental characteristics of people who are effective in supporting families and communities to recognise their own potential. They include, but are not limited to, qualities such as respect, empathy, genuineness, humility, quiet enthusiasm and personal integrity. Modelling these qualities, when designing and implementing an integrated service model, will help create a collaborative culture for the services involved and the families who access them.

Modelling partnership The process of integrating services requires a great deal from us as individuals, services, communities and governments. Any governing body or structure that has responsibility for the implementation of a collaborative project must firstly consider the critical importance of modelling collaborative processes and behaviours itself. An integrated service model in any community will demand give and take on the part of all stakeholders.



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Given the nature of the change, and the shared commitment to enhance outcomes for children and their families, it will be very useful for all of those involved to openly discuss the nature of the relationship. This includes how achievements are celebrated, and how barriers and disagreement will be handled. The very notion of integration demands that all involved negotiate to manage this responsibility in new and creative ways, promoting and modelling a relationship that enables helpful outcomes for children and families. This process of negotiation could be challenging and perhaps even uncomfortable. Representatives of government and non government organisations, and their staff, will inevitably discover that truly integrated management processes need to reflect the ingredients of partnership. Ingredients for partnership include: working together, power sharing, a common aim, mutual respect, complimentary expertise, open communication and negotiation. This modelling of partnership, by service representatives and community members, will positively influence the culture within the new integrated service and be reflected in how they work with each other. In the process of establishing a productive and genuine partnership with all stakeholders, we must seek clarification of the following three questions: Why Change? What to Change? How to Change?

Why change? The question “Why change?” is one that needs to be clearly and collectively understood and answered by all parties involved. By international standards, families and communities in Australia are prosperous. However, a significant number of babies and young children are still experiencing relative disadvantage resulting in learning and speech delays and other impediments that are often characteristic of lack of contact with formal health and family-based services. We therefore have a duty to acknowledge that our system is failing these children and something needs to change. Early in the journey, it is important for all local stakeholders (community members, service providers etc) to agree that change is warranted because of these outcomes. The wellbeing of the child must be at the centre of every deliberation and decision. With the child firmly at the centre, service or individual agendas must be put to one side.



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This common purpose and focus provides us with an agreement against which we can check back. It also provides us with a basic bottom line when compromise is required. We then have the ability to insist that the child be kept firmly at the centre of all deliberations, decisions and actions, even when circumstances say otherwise. Agreement and understanding by all parties can be challenging to achieve. This can be supported more effectively when we build on a process of genuine community engagement and share a common language. In identifying and agreeing on why change is needed, four key elements will support that change. These are: • • • •

genuine community engagement, connecting the community, enabling and nurturing local leadership and, establishing a common language.

Genuine community engagement Any group that gathers to reflect on, and discuss options for, changing the way services are delivered must do so in a way that is accessible to, and inclusive of, all parties, especially those who traditionally have not had a voice. In consulting with a community, we must be mindful of the fact that it is easy to hear the opinions and ideas of the most confident, socially mobile and articulate community members. What is far more time consuming and complex is hearing and understanding the experiences and hopes of those families that traditionally do not engage so readily with services. Ultimately, this is the very group with which we most need to engage and from whom we most need to hear. Meaningful community engagement is often talked about as ‘important’ but is difficult to do well. At the forefront of every gathering that sets out to progress the concept of integrated service delivery, it is vital to consider and understand the importance of bringing together a group that is truly representative of the local community. Consideration needs to be given to subtle things we often do that can, at best, send the wrong or unhelpful message, and, at worst, exclude the very individuals and the community we set out to serve and support. We must discipline ourselves to consider the ‘effect’ of what we do in attempting to engage and include community members.



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Connecting the community Given the complexity of the task in bringing people together, it is important that an individual assumes the role of connecting people in the community—a community connector. This role will be pivotal in helping create change as the community moves through the integration process. The community connector can give greatest priority to ensuring the voice and opinions of those least often heard are listened to and acted upon. This role must be performed by a person with the attributes necessary to build and nurture a network of helpful relationships. The person will need to have a strong commitment to community development principles and have the full support of all participating services and community representatives, as well as a great deal of independence and autonomy.

Enabling and nurturing local leadership People do not always live in the same community in which they work. Often people work in services (such as teaching, nursing, child care, neighbourhood houses, police etc) in one community, and live in another community. Though they may be dedicated to the community where they work, the people who know the community best are those who choose to call it home. Therefore, it makes most sense to invest in identifying and enabling local people to emerge as leaders in this exciting process. The notion of enabling others to lead implies that ‘I’ or ‘we’ are prepared to move into less controlling and more support-oriented roles. This in itself requires certain leadership attributes of the ‘enablers’ and asks those involved to share a vision and belief that is child, family and community focused. As pointed out earlier, it is relatively easy to identify those community members who are considered local leaders. They are often quite prominent and they most often have well established outlets for their opinions to be clearly heard. These local leaders need to be valued and co-opted in the task of enabling other less prominent people who traditionally have not had a voice. This process can be complex and a high level of sensitivity is required. It is possible that an individual or group may find a voice and feel empowered to assume local leadership roles to the detriment of others. How all involved handle and view “power” can have a significant impact (positive or negative) on the overall process and outcomes.



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The most powerful examples of emerging leadership might be in the blossoming of previously disempowered people who, with appropriate support, education and mentoring, discover skills, abilities and confidence they previously did not know they had. Such an empowering discovery has the potential to be life-changing for them, their friends and family. The living example of such change models the possibility of change for others. Early in the life of the process, it must be considered a priority to ensure community members are supported to assume roles that are meaningfully representative of the local community. It is very important that these roles are genuinely valuable and not tokenistic.

A common language A common stumbling block in any major change process is a group’s failure to give sufficient time and energy to developing a shared understanding and common language. We sometimes fail to consider that we all arrive at our own, often quite different, interpretations of what we see and hear. We make sense of things, or construe things, in different ways. This process is heavily determined by our own individual life and work experiences. It is the case that we might belong to a committee or group where all the members use the same words but attribute different meaning to those words. If we take, for example, the words “service integration” - seeking definition of the term from group members may result in radically different interpretations ranging from “services colocated in one building” through to “services develop a new model of practice across disciplines and form one local governance entity”. This point highlights that throughout any change process we need to devote time to ensure we have a common understanding of the intent of the new model. We can do this by reflecting, discussing and checking to ensure everyone is clear where we are going, how we plan to get there, and what we are doing. When funding is announced for a community to develop an integrated service model, the temptation might be to quickly jump into discussion and planning around the building of a physical structure – a “centre”. This is, however, not the only way to address service integration, and, in the ideal scenario, this discussion would be preceded by serious consideration by all stakeholders (community members, service providers, funders, policy makers) at all levels, in developing a shared understanding and common language about integration and what it asks of the whole



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community. Importantly, the first step must be that the community supports the reason for this funding being directed towards their community. In some cases, the political imperative and time frames may not afford a community the privilege of putting such reflection and agreement before discussion about a physical building. In this case, reflection and discussion around ‘doing things differently’, and developing a shared understanding, deserves to be viewed as an equally important concurrent process.

What to change Now that we have highlighted the challenges faced in understanding why change is needed, we can build on those experiences and understandings to examine the question of “What needs to change?” It is now widely understood that communities and services must become more inclusive and supportive of all families and offer services that directly respond to the needs of local families. We also know that children and families benefit most from services working collaboratively. Some communities which are considering the implementation of an integrated service model (eg, isolated rural communities) might conclude that it is not just a change in service provision that is needed but rather that it would be helpful if services were accessible in the first place. Such communities are not likely to be completely void of early childhood services but the nature of current service provision (drive-in or fly-in locums or only home-based support) might exacerbate feelings of isolation or inaccessibility. An integrated service model for this type of community, with use of a physical, purpose built “centre”, may create the added impression of something NEW as opposed to a change in the way services are delivered. For other communities (those that currently have multiple available services), the effect of a service integration project may not be so much in the delivery of something new but rather evidence of increased benefit to children and families through services working more effectively together. What this will look like in reality will vary from community to community. Often services view family difficulty and dysfunction as an intergenerational problem that is complex and difficult to break. It may be worth considering that the way our services have traditionally been provided actually contributes to these difficulties. This clearly puts the



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onus back on to services to accept that it is not only families that need to change. In order for a community to identify and understand what change needs to happen, it also needs to first understand its current situation and available resources. Useful tools for this process include: 1. The facilitation of a local skills and resource audit. Gathering information around what physical resources (services, buildings, equipment, available dollars), people (workers and interested community members, and skills) are currently present in the community, is a useful exercise in understanding how much local resource already exists. 2. Analysis of available data sources and the story they tell about the community. In every Australian state and territory, a range of data is available for most communities that helps pull together a picture of how families are fairing. The Australian Early Years Development Index (AEDI) is a good example of such a data resource.

Establishing the vision In order to identify what they want to achieve, it is important for any group to consider “where are we going?” In other words “what is our vision?” Put simply, if we were to jump into the future, what would things look like for children in our community as a result of this integrated service delivery project? Our vision, that must be shared and agreed upon by all stakeholders, can be an aspirational statement (ie. we aspire to get there but it may not be immediately achievable). The vision states clearly, for all to see, our dream for the future around what could be possible. A vision can be created through a reflective exercise considering the following: • If we were to wave a magic wand and it is now 10 years on, things are really working for children and families as a result of this project. What has happened? Why? • Imagine, what is possible? • What do we hope to achieve? • What will be different? • What would success look like for this project?



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Important Reminders: • It is important to establish a vision for the strategic planning implementation process (outcomes; strategies; action plan). • Create a picture of where the service will end up and the anticipated outcome(s). • Make certain the picture is one of reality and captures your passion. • Make sure everyone knows ‘why’ the service is Changing (Centre for Community Child Health, 2009).

Identifying outcomes Any government or other funding source that is investing financial and human resource into supporting practice change, will have put significant time and energy into identifying exactly what it is they want to achieve. This statement or framework might be presented in different ways but will have clear overarching outcomes that need to be achieved. How we achieve these outcomes will start to make more sense when we plan locally. Creating a local plan is useful in developing a shared agreement of what communities may need to do to achieve the identified outcomes. In doing this planning, it may be helpful to call on the support of a facilitator from outside the group. Such facilitation is likely to be helpful in ensuring that a local plan is realistic and achievable.

What do children and families really need? Most communities have a number of early childhood organisations providing services in the best way they know how to support children’s care, education, health and wellbeing. The type of services, and the way these services are provided, varies from community to community. Very often, even when they are provided under the same roof, these services are delivered in relative isolation to each other and often governed and funded by separate entities. In the process of dreaming and visioning “what might be” for a community in a new integrated service model, a useful way of approaching this is to consider what babies, young children and their families ideally need to ensure the best possible outcomes for the child. It might be helpful to approach this task with the view of “regardless of what currently exists, or is not available in our community, what do children need and deserve?”, rather than “I need to make sure my service is named up in the mix”.



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This type of view should help us arrive at creative answers that don’t suggest typical or traditional service models and the way we view and understand them. So instead of the usual list of: Child Health Nurse, Child Care, Kinder, GP, Playgroup, etc, we are challenged to really think of the ideal types of support and how they might be provided. In doing this, we hopefully come to see that practitioners across service types have to work far more collaboratively in order to achieve the future picture we have in mind for our community. As with every component of the integrated model of service delivery, ensuring QUALITY service provision needs to be among the highest considerations. Far more important than how much we provide or even what we provide, is the quality of what we offer families. Quality is not something that is necessarily determined by the amount of funding available but rather the design, planning and personnel involved in the process. Quality is also reflected in service delivery, culture and the modelling of respectful and helpful relationships.

What should it look like? Integrated service models vary according to a number of factors, including local governance options. The resulting model created will depend on the extent to which local early childhood services are ready and able to change. The level and intensity of service integration reflected in a community may change over time. In the beginning, given the significant change required, it may be more practical or reasonable for a community to aim for a model reflective of “collaboration” with a view to moving forward to a truly integrated service model over time. However, if services are moving into a building together, the aim should be for the elements of true integration to be in place when service delivery begins. In other words, a cultural shift (towards integration) has to happen prior to moving in, otherwise the new building may be the only change that occurs. Here are some examples and distinguishing characteristics of different forms of integration (Centre for Community Child Health, 2009). • a ‘virtual’ services hub in which the parties involved coordinate and collaborate service delivery without co-locating or becoming a single organisation



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• a core services hub in purpose-built premises, with outreach services to isolated or vulnerable families provided by a ‘virtual’ service partnership • a number of services relinquishing their independent status and becoming part of a new service (which may or may not be located in a single purpose-built premises).

Governance The concept of integrated service responses relies on the expectation that communities are empowered to take control and responsibility for the design, implementation, and even governance of the new service model. There are a number of possible models of governance that might be considered ranging from simply a local advisory structure to the ultimate governance entity that assumes responsibility for the local service model and all its staff, activities etc. In any community, there may already be organisations or management structures that consider themselves likely candidates for this responsibility. However, ultimately it is the community that needs to be actively involved in determining what the governance structure will look like and how it will function. There are communities in Australia where serious negotiation and compromise across local services has occurred resulting in existing services amalgamating to form a local governance entity for the benefit of the community. In this case, there has been a very clearly understood and shared vision about what they wanted to the point that the community could navigate its way through serious and complex compromise and negotiation to arrive at the model that is most suitable for local families. The steps taken in establishing this shared vision can also be used to create a governance structure that reflects a genuine partnership between the community and organsiations tasked with the delivery of the new integrated service model. As noted earlier, the change required to implement an integrated early years service model is significant. The journey for any community poses challenges but the potential outcomes for children and families could be great. In order to embrace this task, a community will need passionate, dedicated, leadership to champion the cause. These champions need to be innovators and creators. Their enthusiasm and vision should be firmly fixed on the best outcomes for children and shared by all those involved. A



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“can do” attitude must prevail in order to challenge and overcome any barriers that present themselves along the way.

How to change A locally integrated service model requires changes in the way many organisations offer their services to families. Considering the fact that the new model asks services to share a common service framework, information, culture, governance structure, budget, we can only start to imagine the significance of the change this model may ask of the individual workers, many of whom are currently used to working in relative isolation from other services. This change will be embraced by some and others will find the change required too confronting. Moving towards working differently will be challenging and services (both government and non-government) need to be ready to provide considerable support to workers in order to facilitate this change and continue to balance current service demand. The practice change required will also necessitate that some organisations implement changes in policy and provide necessary professional development opportunities for front line workers. An essential part of this change needs to be the provision of ongoing professional learning opportunities to assist individuals and their services to understand the complexity of the change required, and recognise what needs to happen to enable the change. It is important to point out that many resources and tools are available for individuals and communities to assist in addressing some of the steps suggested throughout this document. Examples (of such resources) include: tools for conducting a community audit; planning, implementation and evaluation tools for local initiatives, and tools to assist in developing understanding of the process of change towards genuine integration. Other useful resources could include the use of an external and independent facilitator to assist groups in negotiating their way through more complex issues involving compromise and agreement. If these types of resources and supports are not familiar to readers, there are government project teams, in most jurisdictions, that exist to support the implementation of integrated service models. These offices may be a useful starting point in identifying where such resources may be found and how best to access and use them.



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The journey towards integrated service delivery is challenging and will take a significant level of commitment from government, services and communities. But the rewards of our collective efforts can create incredible opportunities for babies, young children, their families and entire communities. We have the opportunity to do something extraordinary where, in years to come, future generations will look back on this time and view it as a turning point in the way services are delivered for children and families. Key ingredients that are imperative to a successful journey include: • The CHILD is always at the centre of any discussion/work and the understanding that, in most cases, parents are that child’s main teacher, • The process is underpinned by the building of quality relationships and • partnerships, • Modelling the way we want things to be, • Genuinely engaging the community and all parties involved, and • The use of reflective practice to facilitate change.

References Centre for Community Child Health and Telethon Institute for Child Health Research (2009). Australian Early Development Index Platforms – A Service Redevelopment Framework. http://www.rch.org.au/aedi. Davis, H., Day, C., & Bidmead, C. (2002). Working in partnership with parents: the parent adviser model. London: The Psychological Corporation.



CHAPTER SIX A VISION FOR INTEGRATED EARLY CHILDHOOD SERVICE DELIVERY MARGARET SIMS

There is a growing recognition that social disadvantage is complex and that “… income inequality is a key generator of personal and social malaise…” (Rowlands, 2010, p. 80). We see across Australia significant levels of inequality and social disadvantage. For example, the Australian Early Development Index, collected nationally for the first time in 2009 (Centre for Community Child Health & Telethon Institute for Child Health Research, 2009), demonstrates that 23.4% of children are developmentally vulnerable on one or more domains and 11.8% on two or more domains. Children living in the most socio-economically disadvantaged Australian communities are much more likely to be developmentally vulnerable than children living in more advantaged communities (31.5% compared to 23.4% nationally on one or more domain; 17.5% compared to 11.8% nationally on two or more domains). Living in a remote area also increases risks for developmental vulnerability; 47.2% of children living in very remote Australia are developmentally vulnerable on one or more domain and 30.6% on two or more domains. Child poverty is particularly problematic because it is associated with lack of opportunities which result in life-long disadvantage. A recent UNICEF review (Adamson, 2010) identified that, compared to other OECD countries, child poverty in Australia is particularly concerning: the gap between the children who ‘have’ and those who ‘have-not’ in Australia is wider than in many other OECD countries. This impacts on educational resources (measured by having access to a desk, a quiet place to study, a computer for school work, educational software, an internet connection, a calculator, a dictionary, and school textbooks) and thus opportunities to succeed. Australian children have marginally more educational opportunities than children in Japan, Chile and Mexico but

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relatively less than children in Poland, Ireland, Portugal, Spain, Canada and Finland. Income distribution across Australia reflects disadvantage. The top 20% of income earners receive 50% of the total income earned, compared to the bottom 20% who receive 5% (Gallett, 2010). The Australian Council of Social Services (2010) estimate that currently there are over 2 million Australians who go without the bare necessities: this includes housing, employment, education, health care and community services. Single parent families are much more likely to be living below the poverty line: 16% were at 50% of median income poverty line compared to 7% of couples with children; 33% were at 60% of median poverty line compared to 12% of couples with children. Of those sole parent families receiving the Parenting Payment (Single), 43% lacked a decent and secure home, 57% could not pay a utility bill in the last 12 months, 56% lacked $500 in emergency funds, 54% could not afford necessary dental treatment, 24% could not afford up-to-date school books and clothes, and 40% could not afford a hobby or leisure activity for their children. The median income of Indigenous families is approximately 65% of non-Indigenous families. An increasing number of Australian families are ‘working poor’: that is there is some employment (though often part-time or casual). Couples with children make up 59% of the working poor category.

Impacts of disadvantage The impact of disadvantage is complex. Financial poverty is associated with lack of access to resources. Deprivation occurs when families/individuals can not afford the necessities of life (Saunders & Wong, 2009). These necessities are identified as having a decent and secure home; a substantial meal at least once a day; up to $500 in emergency savings; dental treatment; heating in at least one room of the house; and a separate bed for each child. In a survey taken in 2008 before the onset of the global financial crisis, nearly 66% of welfare recipients were deprived of at least 2 essential items, almost 50% were deprived of 5 essential items and 25% were deprived of 10 or more essential items. Sole parent families are much more likely to experience significant multiple deprivation. It is likely that the Global Financial Crisis has precipitated more families into deprivation. Social exclusion is a second impact of disadvantage: this occurs when people do not have the opportunity to participate in community, social



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and/or economic activities. Saunders and Wong (2009, p. ix) define social exclusion as consisting of: • “disengagement - lack of participation in social and community activities • service exclusion - lack of access to key services when needed • economic exclusion - restricted access to economic resources and low economic capacity.” Around 50% of people on welfare are likely to experience some form of social exclusion, with economic exclusion being the most common followed by disengagement. Nearly 40% experienced exclusion in at least 10 of the 26 indicators. We know that people who are socially isolated or disengaged from others have a greater risk (between 2 and 5 times) of dying from all causes in comparison to those who maintain strong ties to family, friends and community (Berkman & Glass, 2000). Many people living in disadvantaged circumstances also experience poverty of hope “…which is quite widespread within the Australian community” (Berkman & Glass, 2000, p. 55). A range of psychological problems go along with this including depression and anxiety. The impact of disadvantage lasts a lifetime. Smith and Smith (2010) followed a group of American children for 40 years, finding that children with psychological problems in early childhood (problems such as depression and anxiety) had lower educational outcomes. This lower level of educational achievement, coupled with an increased risk for less than full-time employment, was linked to a 20% reduction in adult family income and a reduction in adult family assets. This was equivalent to a lifetime cost of lost family income of approximately $US300,000. Smith and Smith estimate that 14% of American children and adolescents have mental health problems, putting the total lifetime economic damage of psychological problems in the early years at around $US2.1 trillion. A recent report (Australian Institute of Health and Welfare, 2010) indicated that 1 in 4 young Australians had experienced a mental health problem (anxiety disorders, substance use disorders and affective disorders) in the 12 months prior to the survey suggesting that the long-term burden of childhood mental problems to Australian society is even more significant.



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Including those who are excluded Existing service silos are not meeting need (Sims, 2002). The development of integrated services is an attempt to find alternative ways of addressing disadvantage and it is possible to identify relatively uncontested best practice principles for this new way of delivering services (Warren-Adamson & Lightburn, 2010). These include consultation with communities, building from community strengths, recognising that services need to be flexible and that one-size does not fit all, developing joined up integrated services, using evidence-based research to design interventions, planning for sustainability and taking a locational approach to disadvantage where possible. The assumption underpinning this is that if these principles are followed we will succeed in socially including those who are currently excluded. In the inclusive service delivery literature, inclusion and exclusion are often presented as two ends of a dichotomous continuum: the assumption being that we can identify those who are excluded, work to include them, and presumably society will then be ‘well.’ Webb (2006, 2010) argues that the process of inclusion cannot happen from top down (although we can create the policy conditions that facilitate that work) but can only arise as acts of resistance from those who are oppressed. That does not prevent us from working in ways that support those who are oppressed to resist, but rather focuses our efforts on the skills and attributes needed for resistance. We are still left with the assumption that if we can change structures sufficiently to avoid oppressing people, and if people who are currently oppressed can successfully resist that oppression, we will have an ideal society. However, acts of power and oppression are constantly changing (Webb, 2006, 2010). Groups who are oppressed at one point in time are not oppressed at another and vice versa. For example in Australia the ‘squatocracy’ were traditionally seen as privileged and part of the ‘ingroup’, but, because of sequential droughts, are now extremely cash poor and many are losing their land, resulting in their becoming the new group of excluded. Given groups who are excluded are constantly changing, it is possible for humans to have a society where NO-ONE is excluded: ie if we successfully include the groups who are currently oppressed, will that result in an unintended exclusion of other groups? Can we succeed in eliminating vulnerability when “...there is accumulating evidence that



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enduring inequality in our society appears to be creating it” (Rowlands, 2010, p. 81). Will creating integrated services (and getting better at delivering them) result in the intended inclusion of some and the unintended exclusion of others? Or will we simply need to keep changing our understanding of who is excluded, and adjusting our services accordingly?

Impact of integrated service delivery Certainly the current research on the impact of integrated service delivery is inconclusive (Rowlands, 2010). The latest evaluation of Sure Start (comparing children from Sure Start areas with children taking part in the Millenium Cohort study living in areas matched in levels of disadvantage with the Sure Start areas) showed generally positive impacts (The National Evaluation of Sure Start (NESS) Team, 2010) including: improved child physical health and body mass index, a more cognitively stimulating and less chaotic home environment, and less harsh discipline. However there were also higher rates of maternal depression and less contact between home and school in the Sure Start areas. Melhuish, Belsky, & Barnes (2010, p. 160) argue that the positive impact of Sure Start programmes is improving as the programme itself matures and demonstrates “... increasing quality of services, greater attention to the hard to reach, the move to children’s centres, as well as the greater exposure to the programme of children and families in the latest phase of the impact evaluation. The results are modest but suggest that the value of Sure Start programmes is improving.” A US evaluation found: “…although access, efficiency and co-ordination improved in integrated services, mental health outcomes did not. What was actually done for children and families determined outcomes rather than the structural integration of services” (Rowlands, 2010, pp. 83, my emphasis). My conclusion from this work is that it is important we reflect on what we are doing in our work, and not simply rely on our integrated service structure to make a difference. Garret and Lodge (2009) suggest that the key processes that shape successful integrated service delivery are: • Information sharing between professionals • A common assessment framework across different professions • Lead professionals • An online directory to ensure all staff have access to up-to-date information (unfortunately the new conservative government in the UK have since axed ContactPoint)



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• A programmatic approach called Team Around the Child

Effective integrated services Integrated services operate effectively when they create a community of practice (Wenger, 1998a, 1998b). Knowledge is created in such communities through people interacting and through the written documents generated. Workers construct their identities through this shared practice and the extent of joined-up working can be determined by the extent to which this work is undertaken together with shared accountability/responsibility and shared approaches (shared tools, language and actions). Communities of practice are not necessarily harmonious and conflict is a normal outcome of trying to work together in new ways (Engeström, 2000). This conflict needs to be recognised and explored through identifying points of difference, exploring alternatives, modelling solutions, and implementing activities. Creating an integrated working climate requires a clearly articulated vision for the future (shared by all partners) and actions taken at the front-line to implement the vision through agreed activities. This integrated approach is, itself, reflected in the new Australian Early Years Learning Framework which positions: “Holistic approaches to teaching and learning recognise the connectedness of mind, body and spirit ... [Educators] recognise the connections between children, families and communities and the importance of reciprocal relationships and partnerships for learning” (Department of Education Employment and Workplace Relations, 2009, p. 14). The on-the-ground strategies that shape integrated service delivery include (Sims, 2002): • Empowerment – supporting children, families and communities to make their own decisions and set their own goals. Workers scaffold and guide rather than provide solutions. Strengths-based approach – ALL individuals, families and communities have strengths and learning works best when it grows from existing knowledge and skills (Vygotsky’s Zone of Proximal Development). Learning works best when people feel proud of who they are and what they have achieved, and when they feel confident they CAN learn and they have something to offer.



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• Cultural competency – workers need to know a little about the range of cultural groups in their local community and be open to the potential for misunderstandings associated with these groups. Cultural competency is about listening to more than the words (in one publication we suggested listening with the heart - Sims, Guilfoyle, Kulisa, Targowska, & Teather, 2008) in order to create a shared understanding with each individual and family. Workers cannot expect to learn a multiplicity of other languages, but they should make an effort to learn to correctly pronounce names and a few key words. Working in this way takes time as relationship building is critical. Workers need to build trusting relationships with the children, families and communities in which they work. They cannot rely on a programmatic approach, nor assume that what worked in a previous instance will work with a different family, a different context or even with the same family at a different time.

Core skills and knowledge needed for integrated service provision Ultimately, quality in integrated services is not WHAT workers do, but HOW they go about working with people. I am concerned that if we do not ensure that workers in integrated services understand this and operate in this manner, integrated services will not work. Remember, structure alone cannot create change; it is what we do as workers that drives change. As an educator, I am interested in how we prepare people to work in this manner, and what we need to do to create the appropriate learning opportunities for workers in integrated services. Experiences in the UK with Sure Start appear to have identified a common core of skills and knowledge that workers need, irrespective of their particular disciplinary background. Garret and Lodge (2009, p. 11) define these as reflective of: “… common values for practitioners that promote equity, respect, diversity and challenge stereotypes, helping to improve the life chances of all children and young people and to provide more effective and integrated services. It also acknowledges the rights of children and young people, and the role parents, carers and families play in helping children and young people achieve …”. These knowledges and skills include:



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• Knowing how to communicate effectively and engage with people (other professionals, children, families and community members) • Understanding child and young person development • Knowing how to safeguard and promote the welfare of children • Understanding how to support transitions • Knowing how to work across multiple agencies • Understanding how to share information effectively I undertook research in WA to determine what practitioners and employers of graduates in a community work course in which I taught saw as the skills of an ideal community worker (Sims, 2010a, 2010b). Primarily they looked for “... passion that comes from the spirit rather than just a passion to providing a good quality service. I think anyone can do that. Making people see beyond the quality and into the stuff that makes a difference. And that is what good quality training brings into the sector, it doesn’t shut down that bit that engages people’s spirit” (Agency 7). Along with that passion comes a range personal attributes: • The ability to work independently and self-start (Agency 2, 4 and 7) • A willingness to learn (Agency 2 and 9) • The ability to problem solve (Agency 5) • Commonsense (Graduate 15) and a balance between enthusiasm and what is do-able (Agency 2) And a range of knowledge and understandings: • An understanding of confidentiality (Graduate 13 and 15): “...clients don’t want to be acknowledged in the street. It’s humbling for them to come to the service” (Agency 4) • Recognising the importance of interpersonal relationships, and the social skills necessary to build these, including empathy (Graduate 2, 15): “You need to have empathy, helping them almost walking alongside them” (Graduate 14). • A non-judgemental approach (Graduate 14, Agency 7): “...the ability to see things from other people’s perspective and bring them on board and work collegially, to get things across in a non-threatening way” (Agency 5). • A strengths-based approach (Agency 3): “You’ve got to work with what they have, not what you think they have, or you will set them up to fail” (Graduate 14).



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• Communication was seen as fundamental (Graduate 2, 3, 4, 5, 6, 9, 10, 14; Agency 1,2,4,5): “Strong interpersonal skills is a must, you need to know how to listen to people ... You don’t necessarily have to be an expert in whatever problem they are in but if you can listen they feel as if they are listened to and that you are a good community worker” (Graduate 9) and the ability to work together as part of a team (Agency 2, 6). Community workers need to use their interpersonal skills to build networks, partnerships and to identify resources and assets (strengths) (Graduate 2, 6, 10, 11, 13, Agency 1, 11) and to be aware of the ‘bigger picture’ (Graduate 6, 9, Agency 1): “...see the big picture as well as see how the other things hang together like how the money sits, economic justice. To be able to see the big picture, to see how the bit that they are concerned about fits in with that, and make it work for them” (Agency 7). A range of academic knowledge and learning was seen as essential: • Attachment and theories of child and adult development, the importance of the early years (Graduate 1, 5, 15, Agency 3, 5) • Mental health (Graduate 15, Agency 2) • Family dynamics/ working with children and families (Graduate 1, 7, 14, Agency 8) • Social disadvantage and social issues, prejudice and anti-bias (Graduate 8, 13) • Community development (Graduate 5, 10) • Empowerment and difference, social role valorisation/ normalisation (Graduate 8) • Crisis intervention and conflict management (Agency 2, 9) • Counselling knowledge (Agency 8) • Culture (Agency 3) • Advocacy (Agency 2) • Working with addictions (Agency 2) • Family violence (Agency 2) • Para-legal knowledge (Agency 2) • Undertaking research – finding information (Graduate 2, 6, 7, Agency 7, 8): “... knowledge of surveys and questionnaires ... evaluation is useful in providing reports to funding bodies and part of it is also linked to accreditations and meeting standards” (Agency 8).



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• Presenting that research in written form (Graduate 6, 8, 9, Agency 8): “...referencing and writing essays is a skill I have had to use for my projects” (Graduate 8). • Writing policy (Agency 8) • Computer literacy skills (Graduate 2)

Implications for training and development I argue (Sims, 2010b) that this range of knowledge and skills is not commonly found in current early childhood graduates and that we need to re-think how we train early childhood professionals to ensure they are prepared for working in integrated settings. In the process, we need to think about the other professional groups who are working in integrated settings, and how we can create a range of learning opportunities to meet these diverse needs. I acknowledge that no worker can have the skills to work across all aspects of integrated service delivery and nor would we want to create that expectation. I suggest that we need to develop core training and build specialisations around that core. The core component would prepare people in early childhood and family work (community work) and would contain some of the material discussed above. This could be offered in VET through a Certificate to Diploma pathway leading into a university-based Bachelor of Early Childhood and Family Pedagogy. Course material would be based around principles of community development with children and families and include ecological theory, empowerment, strengths-based practice, social justice/human rights, advantage/disadvantage/the operation of power and cultural competency. Graduates would be able to work as trained child care workers and family support workers. Students may graduate with this 3 year core course, or may choose to undertake a 4th year where they would specialise. Specialisations could include teaching (to work in preschools/kindergartens/child care centres as registered early childhood teachers for example), management (to run Parent-Child Centres and hubs as efficient, small, non-for-profit businesses), and family workers (to undertake support and education of more high risk families, and families with special support needs). There may be other relevant specialisations such as child protection, mental health, addiction, counseling, financial management and inclusion support.



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To address the needs of current integrated service workers, and the needs of those with an existing discipline qualification, I have been working on developing a suite of postgraduate courses at the University of New England. The suite will consist of a Graduate Certificate, Graduate Diploma, Masters, and ultimately either a PhD or an EdD. The courses will be offered part-time and online only, beginning in 2012. Students will need to begin with the Graduate Certificate (4 units) and can then advance to the Graduate Diploma (a further 4 units), then the Masters and ultimately the Doctoral degree. The Graduate Certificate and Diploma will each consist of 2 core units focusing on integrated service delivery (the early childhood and family context and strategies for working together) and 2 electives. The aim of the electives is to ensure that students are able to study in different areas than their previous qualifications (a teacher may do a unit on mental health, a child health nurse may do a unit on child development for example). Entry into the Graduate Certificate will require either a degree and access to an integrated service in which to apply the learning OR 5 years employment in an integrated service and current access. We aim to use interactive technology to create an online learning community (using a constructivist approach to learning) where we all learn together. .

My vision of integrated early childhood service delivery is one where we have a professionally accredited workforce who have either trained in child and family pedagogy/ adult education / integrated service delivery (with specialisations of their choice) or who have undertaken postgraduate training in child and family pedagogy/adult education / integrated service delivery. We need to: • Create a new profession, agree on how to name it, and determine what it will look like • Develop training (pre-service and in-service) • Accredit that training (set standards and benchmarks etc) I have jumped ahead and suggested some options for training in our new profession. I have left the discussion about what we will call it for another time (though I have suggested Early Childhood and Family Pedagogy). Maybe as we create a learning community in our new course we will have opportunities to explore this in greater depth, bringing many minds into the debate. Working together we will succeed: “ While one person can’t move a mountain … a well intentioned, well prepared group



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can build a mountain …” (Grey Felder, 2002, p1, cited in Anonymous, 2006, p. 1).

References Adamson, P. (2010). The Children left behind: A league table of inequality in child well-being in the world's rich countries. Florence, Italy: UNICEF Innocenti Research Centre. Anonymous. (2006). Creating communication for social change and building capacity for interprofessional collaboration. Community Report for Children in Price Albert Saskatchewan, February, 35 - 60. Australian Council of Social Services. (2010). Poverty and its causes. Poverty Report, October, 1-10. Australian Institute of Health and Welfare. (2010). Australia’s health 2010. . Canberra, ACT: Australian Institute of Health and Welfare. Berkman, L., & Glass, T. (2000). Social integration, social networks, social support & health. In L. Berkman & I. Kawachi (Eds.), Social Epidemiology. New York: Oxford University Press. Centre for Community Child Health, & Telethon Institute for Child Health Research. (2009). A Snapshot of Early Childhood Development in Australia. Australian Early Development Index (AEDI) National Report 2009. Canberra: Australian Government. Department of Education Employment and Workplace Relations. (2009). Belonging, being and becoming. The Early Years Learning Framework for Australia. Canberra, ACT: Commonwealth of Australia. Engeström, Y. (2000). Activity theory as a framework for analysing and redesigning work. Ergonomics, 43(7), 960 - 974. Gallett, W. (2010). Perceptions on Poverty: an insight into the nature and impact of poverty in Australia. : The Salvation Army Southern Territory Social Programme Department in conjunction with the Australian Eastern Territory. Garrett, L., & Lodge, S. (2009). Integrated practice on the front line. A Handbook. Totnes, UK: Research in Practice. Melhuish, E., Belsky, J., & Barnes, J. (2010). Evaluation and value of Sure Start. Archives of Disease in Childhood, 95, 159 - 161. Rowlands, J. (2010). Services are not enough: child well-being in a very unequal society. Journal of Children's Services, 5(3), 80 - 88. Saunders, P., & Wong, M. (2009). Still doing it tough: an update on deprivation and social exclusion among welfare service clients. Sydney, NSW: Social Policy Research Centre.



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Sims, M. (2002). Designing family support programmes. Building children, family and community resilience. Altona, Vic: Common Ground Press. —. (2010a). Re-envisaging early chldhood teaching. Every Child, 16(1), 6 - 7. —. (2010b). What does being an early childhood 'teacher' mean in tomorrow's world of children and family services? Australasian Journal of Early Childhood, 35(3), 111 - 114. Sims, M., Guilfoyle, A., Kulisa, J., Targowska, A., & Teather, S. (2008). Achieving outcomes for children and families from culturally and linguistically diverse families. (Available at http://www.aracy.org.au/AM/Template.cfm?Section=Publications). Perth: Australian Research Alliance for Children and Youth. Smith, J., & Smith, G. (2010). Long-term economic costs of psychological problems during childhood. Social Scienc and Medicine, 71, 110 - 115. The National Evaluation of Sure Start (NESS) Team. (2010). The impact of Sure Start Local Programmes on five year olds and their families. London, UK: Department for Education. Warren-Adamson, C., & Lightburn, A. (2010). Family centres: protection and promotion at the heart of the Children Act 1989. Journal of Children's Services, 5(3), 25 - 36. Webb, S. (2006). Social work in a risk society. Social and Political Perspectives. Houndsmills, UK: Macmillan Publishers LRD. —. (2010). Social Inclusion, Power and the Everyday. Paper presented at the Towards Social Inclusion Conference. Canberra, ACT: April 20 21. Wenger, E. (1998a). Communities of Practice. Cambridge, UK: Cambridge University Press. —. (1998b). Learning as a Social System. Systems Thinker. Retrieved from http://www.co-i-l.com/coil/knowledge-garden/cop/lss.shtml



PART TWO: PROMISING IMPLEMENTATION STRATEGIES

CHAPTER SEVEN SUPPORTING VULNERABLE CHILDREN AND THEIR FAMILIES

BUILDING BRIDGES BETWEEN AND CAPACITIES WITHIN SERVICES MICHAEL WHITE

The marked over-representation in statutory child protection services of families where there are parental problems of substance dependence, mental illness, homelessness and domestic violence means that it is essential that service providers in these fields develop the capacity necessary to support good parenting and respond to the needs of very vulnerable children. Similarly, service providers in traditionally child focused services need to be able to engage parents struggling with these issues and provide a holistic and family centred response to their needs (Arney & Scott, 2010). The findings of major child protection reviews and child death and serious injury inquiries continue to emphasise the significance of poor inter-agency and inter-sectoral collaboration as major contributing factors in cases of serious child maltreatment. The failure to provide appropriate responses leads to significant problems for the child, family, community and broader society (Scott, 2009). At the same time, the child protection and the child and family service systems in all states and territories are under significant pressure. Nationally the number of children who have been the subject of a notification has increased dramatically (28 per cent in the last five years or from 161,960 to 207,462) and whilst in the last two years there has been a small decrease, the total number of substantiations increased by approximately 121 per cent between 1999-00 and 2008-09. Whilst there are a number of reasons for this, such as changes in mandatory reporting, public campaigns and government views that have highlighted the problems of child maltreatment, such rises place significant pressure on existing systems (Bromfield and Horsfall, 2010).

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The National Framework for Protecting Australia’s Children It is clear from the interrelationships between the problems cited and notification figures, and despite significant increases in investment into child wellbeing, safety and protection, these systems are unlikely to be able to cope with the ongoing increase in service demand through their separate efforts (Winkworth & White, 2010). However, in the last few years a significant positive change in the policy environment has occurred. In 2009 the Council of Australian Governments (COAG) endorsed the National Framework for Protecting Australia's Children, a long-term agenda to improve the safety and wellbeing of Australia's children. The strategy is based on the proviso that "protecting children is everyone's business". The National Framework was developed through a strong partnership between the government and nongovernment sector and after extensive consultation (COAG, 2009). It recognises that all levels of government, the non-government sector and the broader community need to work together to ensure the safety and wellbeing of Australian children. The framework emphasises a commitment to better linking of supports and services to avoid duplication, and enabling coordinated planning, implementation and better sharing of information and innovation.

Beyond fragmentation and duplication It is now also recognised that it is necessary to develop systems and funding models that go beyond the fragmentation and duplication created by single input services based on categorical funding (Arney & Scott, 2010) and move to collaborative practice where all services work together to address the complex problems of child abuse and neglect (ARACY, 2009). However, collaborative models are, at best, emergent in Australia, some existing at state level with fewer crossing the state/federal divide and there has been little research into what facilitates their development and effectiveness (Winkworth & White, 2010). Meanwhile national studies with practitioners working in adult services responding to these issues have found that a large number of practitioners perceive themselves as having a role in supporting parenting and protecting children. However, there are several barriers that prevent them from providing this support. These include: lack of capacity to work with



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children or strengthen parenting; lack of coordination and collaboration between child and family services and adult services; and structural barriers that prevent or inhibit adult services attending to the needs of children and supporting parenting (eg. information sharing and mandatory reporting laws (AICAFMHA, 2004; Gibson & Morphett, 2010; Trifonoff et al., 2010).

The Building Bridges Building Capacity project To address some of these issues FaHCSIA, under the National Framework’s first three year action plan, has funded the Australian Centre for Child Protection at the University of South Australia to deliver a national project entitled, Protecting and Nurturing Children: Building Bridges between Services, Building Capacity within Services. The Building Bridges Building Capacity Project works with service providers in 12 Communities for Children and Communities for Children Plus sites across Australia. The project implements learning and development strategies to: • increase the knowledge and skills of practitioners within adult services to provide “child and family inclusive practice”; and • enhance the capacity of adult services and children and family services to work together. The Building Bridges Building Capacity Project is designed to complement existing service planning, coordination and delivery in individual Communities for Children and Communities for Children Plus sites. Project activities include developing relationships with sites and providers, establishing communication strategies, scoping training, drafting resources and competencies, benchmarking current practice and identifying relevant evidence based practice to support service improvement. Additional delivery of learning and development strategies includes: workshops, conferences, on-line communication and resource sharing for sites, brokerage and consultancy and the opportunities to network with other services engaged in similar work through the project. In developing the project, Centre staff have developed a working definition of ‘child and family inclusive practice’ to inform the project. It is defined as a practice framework for working with families in adult services which is supportive of parents in their parenting role, attends to the needs of children and is



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provided in the context of service provision where the primary role of the practitioner is to treat or respond to a presenting adult problem. The project does not see adult services as replacing the need for child and family welfare services but rather that they work in collaboration, sharing skills and knowledge and facilitating the support of both adult and child clients through referral, effective information sharing and case management. This should mean that no matter where the initial concern is observed or raised, a helping and protecting process can begin immediately. The project is consistent with Australian and international research that supports the establishment of protective networks (also referred to as child and family safety systems) for vulnerable children and their families (Daniel, 2009 in Australian Centre for Child Protection, 2010). The sites are Cardinia (Vic), Lismore (NSW), Kempsey (NSW), Campbelltown (NSW), Townsville (QLD), Ipswich (QLD) Alice Springs (NT), Playford (SA), Onkaparinga (SA), Midland (WA), Mirrabooka (WA) and Launceston (Tas). The project recognises that each of the sites are unique and so the Centre will work with each of them to develop tailored responses to their local needs.

References Australian Infant Child Adolescent and Family Mental Health Association. (2004). Principles and Actions for Services and People Working with Children of Parents with a Mental Illness. Sydney: AICAFMHA. Australian Research Alliance for Children and Youth (2009). Advancing Collaboration Practice Fact Sheet 1, 2, & 3. Retrieved from http://www.aracy.org.au/index.cfm?pageName=advancing_collaborati on_practice Australian Centre for Child Protection (2010). Working Together: MultiAgency Collaboration and Child Protection on the APY Lands, University of South Australia, unpublished report. Arney, F., Lewig, K., Bromfield, L., & Holzer, P. (2010). Using evidenceinformed practice to support vulnerable families. In F. Arney & D. Scott (Eds.), Working with Vulnerable Families: Cambridge University Press. Bromfield, L. & Horsfall, B. (2010). Child abuse and neglect statistics, National Child Protection Clearinghouse Resource Sheet, Australian Institute of Family Studies, ISSN 1448-9112 (Online) ISBN 978-1921414-37-4.



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Council of Australian Governments (2009). Protecting Children is Everyone’s' Business: National Framework for Protecting Australia's Children. Canberra: Attorney General's Department. Gibson, C., & Morphett, K. (2010). Think Child, Think Family: Child and Family Sensitive Practice within Specialist Homelessness Services. Adelaide: Australian Centre for Child Protection . Higgins, J., Adams, R.M., Bromfield, L., Richardson, N., & Aldana, M. (2005). National Audit of Australian Child Protection Research 1995 2004, National Child Protection Clearinghouse, Australian Institute Of Family Studies, Melbourne. Scott, D. (2009). Think child, think family: How adult specialist services can support children at-risk of abuse and neglect, Family Matters, 81, 37-42. Trifonoff, A., Duraisingam, V., Roche, A. M., & Pidd, K. T. (2010). Taking First Steps. What Family Sensitive Practice Means for Alcohol and Other Drug Workers: A Survey Report. Adelaide: National Centre for Education and Training on Addiction, Adelaide, Flinders University. Winkworth, G., & White, M. (2010). May Do, Should Do, Can Do: Collaboration between Commonwealth and State Service Systems for Vulnerable Children, Communities, Children and Families Australia, 5(1).



SAFE FROM THE START: FOR CHILDREN WHO HAVE WITNESSED DOMESTIC VIOLENCE NELL KUILENBURG AND ANGELA SPINNEY

In 2006, The Salvation Army in partnership with University of Tasmania Department of Rural Health conducted a research study ‘States of Mind’. The researcher (Bell, 2006) considered the specific needs of children aged 0-5 who have witnessed domestic violence. Recommendations from this research included a training program to educate child protection workers and professionals working with children about the effects of witnessing violence on young children. In 2008 Dr Angela Spinney was employed by the Salvation Army Tasmania to conduct the 12 month Safe from the Start action research project. Over 200 staff were trained in Tasmania including child protection and domestic violence workers, counselors and teachers. In 2010 funding was received from the Tasmanian Early Years Foundation to develop a one-day Train the Trainer program which provided training to over 500 people throughout Australia. Over 400 Safe from the Start resource kits have been sold in all states in Australia. The train the trainer program has now been conducted nationally in all Australian states and the project presented at conferences both in Australia and twice in the UK. The formal evaluation of the project identified the need for an Indigenous kit and for working with other cultures. The Salvation Army has been successful in gaining funding to develop an Indigenous Kit for working with Aboriginal families in Tasmania. In addition, a collaborative partnership has been developed with Charles Darwin University, Swinburne University (Vic) and The Salvation Army Tasmania and Darwin. A funding proposal has been lodged to develop an Indigenous kit for use in the Northern Territory.

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Research findings The research showed exposure to violence and abuse in the early years can have severe effects on a child’s brain development (Gunnar & Quevedo, 2008; Twardosz & Lutzker, 2010). Children who repeatedly witness or experience yelling, fighting and hitting around them form unhealthy neural connections. Whilst the disturbing research is cause for great concern the focus of this project was inspired by the statement ‘A child who lives with violence is forever changed but not forever ‘damaged’ and there is a lot that we can do to improve their future prospects’ (Cunningham & Baker, 2007, p1). The research took place in Tasmania, between September 2007 and May 2008. The Safe from the Start project investigated and researched the effectiveness of intervention tools, such as toys and books to assist mothers and refuge workers to hold ‘therapeutic conversations’ with young children living in refuges who have experienced domestic or family violence. The Research Report provided the context to Safe from the Start, and discusses why such a project was necessary. This is followed by a description of the project and an explanation of the methodology chosen and some early conclusions. In order to clarify how domestic and family violence can lead to women and children becoming homeless it is helpful to define domestic and family violence: the easiest definition describes it as a pattern of coercive behaviour used to maintain control over a partner, through a combination of physical, emotional, sexual or financial abuse, enforced social isolation and intimidation͘

The Safe from the Start project The Australian Commonwealth Government commissioned the Salvation Army Tasmania to conduct the Safe from the Start project for the year 2007/2008. The rationale behind the project was that children do not need to be in a designated program to have a therapeutic experience, but that what can also help with healing is a relationship experience. The more good experiences a baby has in a relationship the more chance there is for more connections to be made, not just emotionally but also



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neurologically. I think it is possible to offer something even if it is only a single encounter with an infant. (Thompson Salo, 2006, p3)

It is known that under extreme stress children use playing, an activity normally done ‘just for the fun of it’, for very specific purposes. They have an overwhelming need to play out crisis or trauma, and to use their play “to master their fear-provoking pasts and anticipated futures” (Boyd Webb, 2007, introduction). The medium of play can be used as the means of communicating symbolically with children, because through the manipulation of toys children can show more adequately than through words how they feel. Using this, children’s refuge workers can play a vital “first aid” role in allowing young children to explore their experiences in a safe and supportive environment, providing they have effective tools and training in how to use them. The objective of the research was therefore to identify and form a register of intervention activities and therapeutic play which children’s workers and parents living in refuges can use for working with children aged up to six exposed to domestic and family violence. The project also had a second aim, to train refuge service workers to work with the resources researched and developed.

Methodology Materials and resources were collected from around the Englishspeaking world in order to see which were most effective for children who have experienced domestic or family violence within an Australian, and specifically Tasmanian setting. Forty-one toys and books were selected and trialed by the nine organisations recruited by the research reference group. The organisations included five of the six domestic or family violence refuges in Tasmania, transitional accommodation agencies and support providers. The trial involved a survey of parents of children and also of children’s support workers within homeless accommodation and related services. Taking part in the trial involved staff and parents trying out the use of a simple intervention tool, such as a book or plaything that might help children come to terms with the situation they have experienced. The ethical dimensions of conducting research involving young vulnerable children and the fact that in Australia qualitative interviews with homeless service clients are relatively unusual (Parker & Fopp, 2004) meant that an effective research methodology had to be devised in which participating organisations and individuals were comfortable to participate.



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Parents and staff members were given an information sheet about the study and signed a consent form. The information sheet reinforced that if they wished to withdraw from taking part in the trial they could do so at any time and that this would have no impact on their accommodation provision. Participating clients of services agreed to try out with their children (or allow their children’s worker to try out) intervention tools that might help children come to terms with the domestic or family violence to which they have been exposed. Mothers then completed a questionnaire with a staff member on their thoughts and opinions on the effectiveness of the product. Staff members who trialed the products also completed a questionnaire, and had a semi-structured interview with the research project officer. The questionnaires were administered by a co-coordinator within each participating organization. They went through the information sheet and consent form with participants and also completed the questionnaire with client participants. Training sessions were conducted with each coordinator before the trialing process began. The questions asked of parents and staff were developed in liaison with the reference group. For ethical reasons care was taken to ask the questions in the third party, for example “How good do you think that this book would be in assisting a parent and child to have a conversation about the experiences they have been through?” rather than questioning specifically about how they and their child had reacted to the product. Full-trialing of the intervention materials took place after the information gathered from a piloting process was available. Piloting was conducted in two organisations, one in the north of the state and one from the south. The pilot resulted in minor changes being made to the staff and parent questionnaires. In total 120 questionnaires were completed, fifty-two by mothers living in refuge accommodation and sixty-eight by refuge staff. In addition seventeen qualitative interviews were conducted with children’s workers within the refuges. The data collected has been used to inform the final make up of the Safe from the Start toolkit and the content of the training course. The kit has been put together from the books and toys that the trial has shown is felt by parents and workers to be the most effective for young children who have experienced domestic or family violence. Of the forty-one products trialed twenty-two have been included within the kit. To date ninety-one participants have booked to attend the one-day training courses



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to be held around Tasmania and twenty-five sets of the kits have been ordered, at a cost of $AUD 500 each. Such numbers are important because an integral part of the project is to raise awareness within Tasmania of the damage done to children by domestic and family violence.

Feedback to the project Informal feedback from stakeholders involved in the research process has been very positive. General comments received on the products and the trials during the interviews included “Fantastic, wonderful, really effective, created different openings for conversations”, “Mum’s very happy to participate”, and “Mum’s said that until using resources they had never thought about children having feelings in all this. Now they are aware they must acknowledge their children’s feelings”. The University of Tasmania is currently conducting formal evaluation of the Safe from the Start project. Feedback about the products chosen for the kits from the data collection process demonstrates some of the benefits of having appropriate books and toys available to children temporarily housed within homeless accommodation. Quotes from respondents included remarks such as; “After reading this book mother and child had a joint language – could say ‘just like Ruby’ and know what each other means. Mum didn’t want to give the book back’ and, “It provided a non-threatening opportunity to discuss feelings. It was an ice-breaker to lead into discussions about a number of different events and how my child was feeling”.

Conclusion It is too early to know the extent to which the Safe from the Start kits will be effective in ameliorating some of the damage done to children made homeless by domestic or family violence. What is known is that tackling the complex disadvantage faced by this specific group is important for not only them but for the wider society. At first sight projects such as Safe from the Start can appear small and insignificant. However, early intervention projects such as these have the potential to play an important part in maximising social inclusion and in preventing inter-generational exclusion.



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References Cunningham & Baker (2007). Little Eyes, Little Ears How Violence Against a Mother Shapes Children as they Grow The Centre for Children and Families in the Justice System Retrieved from http://www.lfcc.on.ca/little_eyes_little_ears.pdf Bell (2006). States of Mind - A best practice framework for Women’s Immediate Emergency Accommodation SAAP services in Tasmania working with children aged 0-5exposed to domestic violence. Retrieved from http://www.salvationarmy.org.au/salvwr/_assets/main/documents/tasm ania/state_of_mind.pdf Boyd Webb, N. (2007). Play Therapy with children in crisis. 3rd edition. New York, Guildford Publications Inc. Gunnar, M., & Quevedo, K. (2008). Early care experiences and HPA axis regulation in children: a mechanism for later trauma vulnerability. In E. de Kloet, M. Oitzl & E. Vermetten (Eds.), Stress hormones and post traumatic stress disorder. (Vol. 167, pp. 137 - 149). Amsterdam: Elsevier. Parker, S., & Fopp, R. (2004). "I'm the Slice of Pie that's Ostracised..." Foucault's Technologies, and Personal Agency, in the Voice of Women who are Homeless., Theory and Society, 21, 145-154. Spinney, A., (2008). Challenges of working with/supporting children in a refuge environment, Swinburne University. Retrieved from http://www.homelessnessinfo.net.au/index.php?option=com_content& view=article&id=754:the-safe-from-the-start-project-challenges-ofworking-withsupporting-children-in-a-refugeenvironment&catid=100:domestic-family-violence&Itemid=87 Thompson Salo, F. ed. (2006), The Baby as Subject. Children’s Hospital, Melbourne. Twardosz, S., & Lutzker, J. (2010). Child maltreatment and the developing brain: a review of neuroscience perspectives. Aggression and Violent Behaviour, 15(1), 59 - 68.



OCCUPATIONAL THERAPY IN CHILDREN’S CENTRES KOBIE BOSHOFF

The findings of the Australian Early Development Index (that 23.4% of children are developmentally vulnerable in one or more of the AEDI domains) illustrate the need for early intervention and further support the government’s initiatives to provide services to developmentally vulnerable children – including the importance of providing allied health services, to address children’s developmental vulnerability through the Children’s Centres. As part of this initiative, positions for Occupational Therapists were recently created in the DECS’s new strategic directions in South Australia and participants of centres were informed where these services are available. Currently four occupational therapy positions are funded through DECS and these are based at Primary Health sites: Gawler Primary Health, Parks Primary Health, Playford Primary Health and Southern Primary Health. This Department of Education and Children’s Services funded project entitled “OT in Children’s Centres” was conducted by Kobie Boshoff and Sue Clayton at the Parks, Ocean View and Cowandilla Children’s Centres in South Australia during August 2009 – July 2010. During this project, an Occupational Therapy service was established at these centres in collaboration with the centres involved. The project was implemented using a project management approach, with distinct phases and corresponding reporting. The project commenced with a needs analysis phase (Phase 1) resulting in a Needs Analysis Report (Boshoff & Clayton, 2009a), which was presented to the steering group, together with a proposed model of service delivery. The implementation phase (Phase 2) then commenced, based on the needs analysis results. The steering group guided the priorities and direction for the implementation phase. The project was based from The Parks Primary Health Service, with services provided on site at the Children’s Centres. Occupational Therapists worked from a preventative primary health perspective, taking

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into account the social determinants of health and working toward early intervention to address children’s developmental needs, promoted early identification and intervention to minimise developmental delays. The service provision model focused on education and empowering staff via individual and group processes to develop skills and practices in promoting children’s optimal development.

Outcomes of the project As part of the outcomes, a service delivery framework for occupational therapists employed in these positions was developed in order to ensure consistency in models of practice across various sites. The framework was titled “Best Practice Guidelines for Occupational Therapy Service Delivery in Children’s Centres” (Boshoff & Clayton, 2009b). Other outcomes included the development of an allied health developmental screening tool, the development of a group program and workforce recommendations (Boshoff & Clayton, 2010). Workforce outcomes included the strategic facilitation of student placements. Outcomes were significant with 20 students placed in 2010 and positive feedback from sites. Collaboration occurred to enable the start of multi-discipline placements with other disciplines providing services in the centres. Collaboration with occupational therapists at other sites (not children’s centres) occurred with the initiation of a model of sharing of placements across these sites, enabling part-time therapists to take full time students. In addition, students developed resources for sites. These resources have been distributed to the Children’s Centres and the occupational therapists working in them and are currently in use. Informal feedback has been extremely positive from occupational therapists and sites, indicating reports that these resources are appropriate for the settings. These exciting new positions provide unique challenges as well as opportunities, such as multi- disciplinary collaboration and working within preschool/ child care settings as well as within community development programs.



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References Boshoff, K. & Clayton, S. (2009a). Report commissioned by Department of Health and Department of Education, Needs Analysis Report: OT in Children’s Centres Project. University of South Australia. Boshoff, K. & Clayton, S. (2009b). Report commissioned by Department of Health and Department of Education, Best Practice Guidelines for Occupational Therapy Service Delivery in Children’s Centres. University of South Australia. Boshoff, K. & Clayton, S. (2010). Report commissioned by Department of Health and Department of Education, Final Project Report: OT in Children’s Centres Project. University of South Australia.

    



HACKHAM WEST COMMUNITY CENTRE FAMILY WORK PROJECT CATHIE VINCENT

The City of Onkaparinga is one of the largest local council areas in South Australia and is situated south of Adelaide. Spanning 518 square kilometres of coastal and rural communities, the City of Onkaparinga employs 600 staff, and has a budget of over $100,000,000. Hackham West is situated in the southern area of the Council and is an area with multiple social disadvantage, placed amongst the top 3% of the most disadvantaged communities in Australia. The area has among the highest proportion of single parent families, low income households, people neither employed nor in the education system, unemployed people and Indigenous Australians in the Adelaide metropolitan area. Hackham West Community Centre is one of eight community centres in the City of Onkaparinga. The City of Onkaparinga owns and maintains all of the Community Centre buildings and provides the Centres’ volunteer boards of management and the support of a Community Development Officer. Hackham West Community Centre “strives to be a safe and inclusive hub with a diverse range of activities and opportunities that facilitates growth and empowerment with the local community” (Mission Statement, Hackham West Community Centre Inc., 2009). By adopting a strengthsbased approach to community development, the centre empowers local residents and assists in building community capacity, resilience and selfreliance. In 2010, the centre employed 30 part-time staff, managed 110 volunteers and offered more than 55 regular programs and services.

The Family Work Project The Family Work Project (FWP) has been funded by FaHCSIA since 2007. In the 2010 – 2011 financial year, FaHCSIA provided the Centre $123, 000. The project employed a Program Coordinator in 2010 (26

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hours per week), a Women’s Senior Worker (6 hours per week), a Men’s Senior Worker (6 hours per week) and a Counsellor (15 hours per week). The overall aim of the program is to strengthen parents, families and the local community by enabling the development of new pathways and opportunities to achieve their potential, and to break intergenerational cycles of poverty and disadvantage. The rationale of the program acknowledges that problems of dysfunctional families are complex and often deeply embedded, sustained change depends on family members taking responsibility for, and control over, their own lives and that the building of relationships with participants must be based upon trust and mutual interest. The knowledge that family systems are made up of many stakeholders, with different interests and needs, allows the program to involve whole families, using a range of complementary strategies to engage with various family members in order to maximize the chances of effective change. The six strategy streams are: 1. Parent engagement and relationship building 2. Parent education 3. Counselling 4. Supporting women in parenting 5. Supporting men in parenting 6. Community participation in project management

Principles that underpin the FWP The principles that underpin the FWP are based upon participants’ strengths, the continual growth of participants, participants’ involvement in the planning and delivery of interventions and acknowledging the different needs and opportunities of men, women and children. Building relationships with parents and families, and peer relationships among parents and children is fundamental to the success of the FWP. The Family Work Project workers regard participants in the context of family and work as a team to ensure optimal access to appropriate supports and resources. The FWP team is made up of all 12 of the Centre’s Program Coordinators. The team meets regularly to discuss strategies around ensuring the engagement and most importantly in developing an



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action plan for highly vulnerable families. The Family Work Project is considered a ‘whole of centre’ program.

Strategy stream 1 – Parent engagement and relationship building This strategy underpins all the others as it is only through engaging effectively with families and building a relationship of trust that the Project can enable families to take effective advantage of the opportunities offered by the project and ensure that the programs are relevant to their developing needs. The strategy also reinforces the way in which the FWP team and the Hackham West Community Centre staff and volunteers relate in all interactions with families across all six strategies. In essence, starting where ‘parents/caregivers are at’ is central to this strategy. How? Parents’ needs and interests are defined by parents themselves and identified through involvement in existing group programs and courses run at Hackham West Community Centre • General interest courses • One-off information sessions • Parents engaged via schools (HWCC programs that are based within schools) • Family fun days, school holiday activities – usually with free food • Informal/opportunistic contacts – getting ‘out there’ • Links with other agencies in the local area • Developing the skills of centre volunteers • A high level of trust by participants in the program leads to strong engagement. Together, these provide a foundation underpinning the pathway to improved knowledge and skills, parenting, motivated personal development and enhanced family function.

Strategy stream 2 – Parent education In general HWCC Family Work Project activities are used as opportunities for peer education, positive staff role modeling and creating a positive, interactive environment. When specific parenting courses were offered, they were poorly attended. The team responded to this by placing



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a stronger emphasis on modeling appropriate skills and providing group support in whole of family activities. How? • Informal contacts, conversations and modeling • Where possible, peer supports are encouraged and supported • Family Café Nights – low cost dinner with many children’s activities and games that parents can play with their children (staff and volunteers will lead and support throughout the evening) • One-off workshops around specific subject areas such as blended families and grief • School holiday activities

Strategy stream 3 – Counselling Although many times counselling is opportunistic among the FWP team, the Centre has also developed a memorandum of understanding with Relationships Australia – SA to meet the more complex and demanding cases of some families.

Strategy stream 4 – Supporting women in parenting The FWP uses various strategies to acknowledge and ensure that women have access to services and supports for issues including depression, family violence, drug and alcohol issues and parenting support. How? • Women Having Fun Group • Art Group • Craft group • Women’s Wellness Breakfasts • Family Café Dinners • Supporting events such as International Women’s Day, AntiViolence Week, Breast Cancer Awareness • Family after school activity program



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Strategy stream 5 – Supporting men in parenting Providing a range of out of hours activities for fathers to be able to engage positively with their children with the support of a men’s worker has been instrumental in the success of this strategy stream. Many of these activities provide the opportunity for men to realise that they do have a positive role to play in their children’s lives. How? • • • • •

Dad’s and kid’s barbeques Men’s breakfasts Dad Factor (7 week program) Family dinners Family after school activity programs

Strategy stream 6 – Community participation in project management The formation of the Community Reference Group has been integral to the management of this project. At least 10 local community members meet once per month (over dinner) with the Program Coordinator to discuss current issues, opportunities and needs of families in the local areas. The majority of activities that are run through the FWP have been instigated by the Community Reference Group. These include, for example, Health and Fitness, Zumba, Eat Your Way to Good Health, Information Sessions, Edmund Rice Camps, Library, Noarlunga Health Village, Vet, School Holiday Activities, beach day, Animal antics and making Christmas presents. How? • Community Reference Group meets monthly – agenda items include ‘time for dreaming’ and ‘goals for the month’ • Friendship group meets spasmodically on the weekends at local parks • Community Reference Group members are identified by current members and the Program Coordinator and asked if they would like to be involved



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As the Project has evolved, it has clearly focused on making the Centre and its services and resources as appropriate and accessible as possible, with an emphasis on enjoyable activities that parents/caregivers and their children can enjoy together, rather than earnest self-improvement or remedial deficit based approaches to behavior change. The Centre would like to acknowledge Paul Laris and Associates for conducting the original Program Logic and Two Year Evaluation Report.



CHAPTER EIGHT DEVELOPING SOCIAL, EMOTIONAL AND SPIRITUAL WELLBEING IN CHILDREN

MOVING TOWARDS A FATHER INCLUSIVE PRACTICE PAUL PRICHARD

Given the rapidly changing definition of “family”, and the resulting change in fathers’ parenting roles, there arises a challenge to services in Australia as to how prepared they are to engage with an ever changing queue of primary carers presenting with babies and young children. The initial response and behaviour towards a mum or a dad at the reception desk, in the car park, the consulting room or over the phone can significantly influence a parent’s desire to “do it again” and continue to access other early childhood services. Whilst many family-based or early childhood services do a reasonably good job in supporting most families, collectively, we still have a long way to go to be accessible to and inclusive of men as fathers. The family services sector is very good at considering whole groups of families in our community as “hard to reach”. Aboriginal families, teenage parents, families experiencing complex needs and dads, are examples of groups who often have the finger of blame pointed at them by many services as possessing the deficit of being hard to reach or engage, resulting in poor health and well being outcomes for too many children. Nothing will change in this regard until our services start to accept some responsibility for these groups’ lack of engagement with the service system. In considering what might need to change to turn this around, we will find more suitable answers if we turn this problem on its head and ask the question “why is it that our services are so difficult to access for so many Australian families”. The problem stops being ‘the family’ and instantly becomes the service and the way it currently provides its programs and services. If a service aims to move towards being more inclusive of and open to all parents, there are a few things that need considering that can make a service a more attractive option to dads who ordinarily would not walk in the door.

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Why move towards a model of father inclusive practice? Reflecting on this for ten minutes at a staff meeting can be an enriching exercise. The list of responses will be diverse and exciting. Some workers will suggest that it would be too hard, or bring unnecessary risks to encourage more men to walk in the door. Creative, innovative, energetic and enthusiastic workers will help a service arrive at an understanding that there would be great potential benefits if more dads were to be engaged by the service. The obvious end point to deliberations around this question has to be “because the children deserve no less!” Improving the health and well being of the child must be the highest priority for any family based service. In encounters with services, parents deserve to experience an atmosphere reflective of – “we would move mountains to ensure you and your child are happy, healthy, safe and confident”. This level of sincere concern and interest in the child and their family would demand of a service that it does all that needs doing to ensure the environment and the staff are suitably equipped to be inclusive of all groups of families that have traditionally been considered hard to reach. Father inclusive practice is not focused on hosting one-off activities or events aimed “getting dads in”. While these types of activities might be useful in consulting men, building relationships with them and gaining their trust, they will not in themselves enable a more permanent cultural shift in service delivery that makes a service accessible to and inclusive of fathers.

What do dads want from our service? Now the service is able to clearly articulate the reasons for moving towards a more inclusive practice, for dads it will be necessary to giving some time exploring everything we need to know about fathers. To do this respectfully a service will need to devote some time and energy in consulting with the local community to identify exactly what it is dads want and need from services. In engaging and consulting fathers a service must ensure it does not fall into the trap of consulting the wrong group of people. A common misconception in Australia appears to be - Mums are so much more available to our service and comprise 90% of parents that walk in the door. Perhaps as a short cut we can just ask them what their partners want and need from our service. This lazy approach to seeking a solution



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runs the risk of being disrespectful of the child and the father, and is likely to help us arrive at solutions that are not what the dads themselves want and need but rather what women believe their partners want and need. It is not surprising to find that the two are likely to be quite different. The only way to get an accurate picture as to what we need to do to become more inclusive of dads is to genuinely listen to dads. Practical strategies will include face to face conversations in the home, in the workplace, phone conversations or a well facilitated BBQ consultation meeting with a group of dads. Questionnaires will allow us to hear from the most articulate, mobile and opinionated dads but these are probably the few that are already happily accessing the service anyway. While there has been little research done in Australia around the differing expectations of men in accessing family based services and what they hope to encounter, there are a few general things worth considering about men and what they hope for from our services. 1. Where possible, provide more task orientated activities to promote conversation and to give men a sense of contributing to community/ family 2. Men access services for practical information & advice. Men generally want to leave your service with clearly understandable practical actions he can put into place to remedy an issue 3. Men are less inclined to want to form long term relationships with individuals in services 4. Like any one walking in the door, men obviously do not want to be treated as a special case, be patronized, or encounter behaviour that leads them to believe they can’t be trusted with children Australian research conducted in 1999 concluded that “Many professionals hold unduly negative views of men as fathers” (Russell, Barclay, Edgecombe, Donovan, Habib & Callaghan, 1999, conclusion). If workers in a service encounter dads whilst maintaining negative views or perceptions about men or their role as fathers, how can these professionals possibly provide the presenting dad, and their child, with the most respectful, engaging and positive experience possible?



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Consider how the service goes about delivering services for dads There are some very practical things services can do to move towards a more father inclusive model of practice. The following checklist for organisations working with men (King, Sweeney & Fletcher, 2004) is a useful tool in reviewing what should be considered in making services more accessible to dads. • Environment – does the service environment consider the needs of dads? A key thing for creating the right environment for men is to remember that they are quick to tune into suspicion and feelings of threat and safety. As service providers we should think about what will help or hinder men in our environment? • Language – is the language we use both in our literature and the way we interact with parents inclusive of dads? The language we use in encounters with dads must be relevant, honest and direct. • Initial contact & marketing – do our literature and other promotional tools take into account relevance to fathers? Men respond better to relationship marketing than to physical brochures or advertisements in newspapers. Men will approach information about services with suspicion, questioning, and preconceived expectations. Men prefer to hear about a service from other people. In your initial contact and marketing give names of people in the service that they can talk to. Experience has shown that if men face too much frustration, or if it is too difficult to make connection with the right person, men will walk away from a service. When the contact they have is with a specific person with whom they feel trusted and comfortable, they will make and maintain contact. • Service provision – are our staff equipped to engage with dads in an effective way? Do workers in this service have the skills, knowledge, values and attitudes that contribute to healthy and helpful relationships with all parents who this service engages? Given the increasing participation of men in undertaking active parenting responsibilities, the onus is on all family, care and health services to ensure our programs are delivered in such a way that all parents, regardless of gender, family structure, economic status, religion, or individual capacity have equal opportunity to access programs that promote, encourage and strive for optimal health and well being outcomes for both the child and the whole family.



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References King, A., Sweeney S., & Fletcher, R., (2004). A Checklist for Organisations Working with Men using the non-deficti approach., UnitingCare Burnside. Retrieved from http://www.dadsindistress.asn.au/downloads/A%20checklist.pdf Russell, G., Barclay, L., Edgecombe, G., Donovan, J., Habib, G., & Callaghan, H. (1999). Fitting fathers into families: Men and the fatherhood role in contemporary Australia. Canberra, ACT: Department of Family and Community Services.



THE FATHERHOOD ENGAGEMENT PROJECT JANET PEDLER TED EVANS AND AARON PHILLIPS

The Fatherhood Engagement Research Project was an 18-month research project that commenced in July 2009 and concluded in December 2010. The Project was initiated and led by the Department of Education and Children’s Services (DECS), in partnership with the Department of Families and Communities (DFC), SA Health and a range of government and non-government agencies. The project drew on recent research conducted by Dr Richard Fletcher and associates from the Engaging Fathers Program of the Family Action Centre, University of Newcastle NSW, and commissioned by SA Health. The report entitled Men and Children's Centres: A systematic explanatory review—Improving men’s participation in primary health services in South Australia, was published in October 2008. The research by Dr Fletcher recommended a range of implementation strategies that could be used in South Australia to increase the participation of fathers in Children’s Centres for Early Childhood Development and Parenting, including: • selection of fathers as a target population for the Children’s Centres and goals for their recruitment and participation • professional training for staff in father-inclusive practices • policy guidelines and management tools promote the adoption of father-friendly procedures and father-inclusive professional practice. These strategies provided the basis for the Fatherhood Engagement Research Project. A Project Management Group comprising of representatives from the DECS, DFC, SA Health, Anglicare, Lady Gowrie Training Centre,

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Community and Neighbourhood Houses and Centres Association, Relationships Australia and Centacare identified four key aims for the Fatherhood Engagement Project: • Increase the number of fathers involved in Children’s Centres for Early Childhood Development and Parenting, and other child and family services • Increase staff skills and competencies in father-inclusive practices • Enhance community awareness and advocacy for the positive role of fathers in children’s wellbeing and development • Develop a set of guiding principles and strategies for engaging fathers in Children’s Centres for Early Childhood Development and Parenting The purpose of the Fatherhood Engagement Project was to support the development and implementation of father-inclusive practices that encourage the participation of fathers in child and family services. Fatherinclusive practices refer to: the development and implementation of fatherhood specific programs, attitudes and skills of professionals, marketing and promotion of fatherhood activities, the manner in which groups are facilitated, hours of delivery and the physical environment. A call for expressions of interest resulted in eleven multi-agency Project Teams comprising of staff working in Children’s Centres for Early Childhood Development and Parenting and key government and nongovernment agencies from metropolitan and regional areas of South Australia. Project Teams were supported through workshops facilitated by Dr Richard Fletcher (Family Action Centre, University of Newcastle), Paul Prichard (Murdoch Children’s Research Institute, Melbourne), Andrew King (Mensline Australia) and Ross Fairbank (Men’s Health SA). The publication of two newsletters was effective in sharing good practice and innovation. The Project Teams conducted a range of events that contributed to increasing the participation of fathers. These included father specific events, workshops, playgroups, evening preschool sessions, and family fun events. Project teams recognised that making changes to service flexibility, marketing and promotion of events and creating father



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inclusive environments were effective strategies in engaging fathers in services. Quantitative data was collected at two points of time during the project using the Children’s Centre Fatherhood Inclusive Practice Audit Tool that was developed for the Project Teams to determine changes in practice. The audit tool plots the degree of ‘father-inclusivity’ against indicators within four specific areas: • • • •

service culture and environment service relevance and accessibility staff skills, knowledge and attitudes strategic planning and accountability

Improvements were evident against each of the 48 indicators, clearly demonstrating the success of the Fatherhood Engagement Project in achieving the four project aims.

Principles The following nine Principles of Father-Inclusive Practice developed through the Father Inclusive Practice Forum (University of Newcastle, 2005) were explored and adapted. 1. Father awareness 2. Respect for Fathers 3. Equity and Access 4. Father Strengths 5. Practitioner Strengths 6. Advocacy and Empowerment 7. Partnership with Fathers 8. Recruitment and Training 9. Research and Evaluation (University of Newcastle Family Action Centre, 2005) Throughout the project two additional themes consistently emerged that were effective in engaging fathers. One was the centrality of childfather relationships to the engagement of fathers. With the child at the centre of engagement, partnerships were formed which strengthened fathers’ opportunity to learn about their children’s development and to use their skills and knowledge to support their development. A second theme



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that emerged was the importance of interagency partnerships. When agencies worked in genuine partnership to engage and support fathers, the resulting programs and events were more effective and sustainable. Principles 8 and 9 were combined and two additional principles— ‘Interagency Partnerships’ and ‘Centrality of Father-Child Relationships’ were added. The ten principles that were found to be effective in this project were: 1. 2. 3. 4. 5. 6. 7. 8. 9. 10.

Father Awareness Respect for Fathers Equity and Access Father Strengths Practitioners’ Strengths Advocacy and Empowerment Partnership with Fathers Recruitment, Training and Research Interagency Partnerships Centrality of Father–Child Relationships

Practical strategies relating to each principle were developed through the project and are detailed in the full Fatherhood Engagement Project Report which will be available on the Children’s Centre website. The involvement of fathers in Children’s Centres and other family related services has increased as a result of this project.

References Fletcher, R., Close, N., Babakhani, A., & Churchward, R. (2008). Men and Children's Centres: A systematic explanatory review. The University of Newcastle. Retrieved from http://www.newcastle.edu.au/Resources/Research%20Centres/Family %20Action%20Centre/reports/SA_PHS_2Oct2008.pdf University of Newcastle Family Action Centre. (2005). Principles of Father Inclusive Practice. Retrieved from www.newcastle.edu.au/research-centre/fac/research/fathers/involvingfathers/evidence-base.html



PARENTAL SEPARATION AND KIDS MEGGAN ANDERSON AND TRECIA SPOWART

iKiDs (I Know, I Do) is a SCaSP (Supporting Children After Separation) program of Relationships Australia (South Australia) funded by the Attorney General’s Department and administered by FaHCSIA. iKiDs supports children and young people aged 2 - 18, schools and parents in responding effectively to the impacts of parental separation. Over 50,000 children are affected by parental separation in Australia each year and every state and territory has their own SCaSP program. iKiDs consists of three components: one – on – one and family counselling; therapeutic groupwork; and education skills programs. The guidelines on how the education work was to be delivered were relatively flexible, which presented the team with creative opportunities for engaging children. We present the education work in primary schools with the use of puppets, performance, narrative and drama.

Puppets, performance, narrative and drama The use of puppets, performance, narrative and drama complements current neurobiological research particularly around neuroplasticity, which is the capacity for the brain to create new neural connections and grow new neurons in response to experience (Siegel, 2010). By staging a production that is not usually a part of the average school day and curriculum, we can engage three of the most important principles of neuroplasticity namely “Novelty,” “Close Paying of Attention” and “Relationships” (Siegel, 2010). The hope therefore is that children will experience positive change from the messages in the puppet performances. The rationale behind using storytelling was that it conveys strong messages but in an enjoyable way and children are more likely to respond and learn if the message is in their language. Researchers such as Barish (2004) Beauregard (2001) and Lane (2008) also argue that interventions that target the emotions are more effective than other interventions in increasing emotional awareness, regulation and resilience.

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Two age - appropriate puppet scripts as well as a debriefing session were developed for schools, namely Dillon’s Secret Adventure (Reception to Year 1) and Leila’s Birthday Party (Years 2 to 4). A master puppeteer and scriptwriter were consulted in the project development process. The scripts and character development were mainly based on the iKiDs’ counsellors’ clinical experiences with individual clients. The result is that the scripts contain rich descriptions of common themes and complexities for children from separated families. Although the stories are set in the context of family separation and conflict, each story has themes and messages relevant to all children. These themes include the nature of secrets; distinguishing good and bad secrets; the healing power of sharing; the power of friendships; all families are different; pets as friends/companions/comfort; making sense of and managing feelings; normalizing experiences of separation; not taking responsibility for adults’ behaviour; finding the good stuff in things we don’t like; what you can and can’t change; encouraging help seeking behaviours; coping strategies and cultural differences.

Liaison with schools The education component began in August 2010 and currently visits one school a month. The counsellor for the school’s region as well as the educator are present at every show to ensure its smooth running and to also assist any children who may find the issues addressed in the show distressing. The educator liaises with the school counsellor before and after the show to assess and address needs. In particular, we are interested in how many children are likely to be affected by parental separation, school awareness of the impacts of separation and conflict on children and current school responses to these. The themes of the show encompass many elements of the Health and Physical Education; Society and Environment and English curriculums. The shows also complement the Child Protection Curriculum and most schools incorporate the show into its curriculum time. Each performance is followed by a debriefing session using the POOCH (Problem; Options; Outcomes & Choice) peer skill problem solving model, adopted by many schools. This model was chosen as it is non – confrontational and refers to problems in the collective. The children therefore feel safe to talk as they are invited to discuss the externalized problems dramatized in scenarios from the show, not about their personal circumstances. In this way, the



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counsellor and educator who deliver the debriefing can also assess children’s understanding of the content and messages of the show.

Post performance support Teachers are given a resource CD with pre-show and post-show activities to deliver to students. The pre-show activities are aimed at creating excitement and anticipation for the event while the post-show activities aim at reinforcing the messages of the show. The schools are also offered post performance support through therapeutic group work, referral for individual therapy, professional development for teachers around supporting children after separation and courses for parents. The response to the show thus far has been positive. The show is performed by professional actors with the result that it is a high quality and powerful production. Children have interacted with the show and debriefing, many commenting that they can relate to the characters’ experiences and many share stories and coping strategies that they use in their own lives. Some teachers have noted that those engaging with the material do not usually engage in the classroom. Schools have also received or are receiving therapeutic groupwork as a result of the shows and there have also been requests for parenting courses. It is hoped that the education component will continue to grow and future plans include developing a formal process for collecting evaluation and feedback and to develop and deliver an education program that addresses parental separation for high schools. Ultimately all these ideas depend on future funding but it is hoped that FaHCSIA will recognize iKiDs’ innovative and creative attempts to engage with children.

References Barish, K. (2004). What is Therapeutic In Child Therapy? Psychoanalytic Psychology, 21 (3), 385 – 401. Beauregard, M., Levesque, J., & Bourgouin, P. (2001). Neural Correlates of Conscious Self – Regulation of Emotion. Journal of Neuroscience, 21, 1 – 6 Lane, R.D. (2008). Neural Substrates of Implicit and Explicit Emotional Processes: A Unifying Framework for Psychosomatic Medicine. Psychosomatic Medicine, 70, 214 – 231. Siegel, D. (2010). Mindsight: Transform Your Brain with the New Science of Kindness. Oneworld: Oxford.



MODERN GRANDMOTHERING SUSAN M MOORE AND DOREEN A. ROSENTHAL

Most people eventually become grandparents (Thiele & Whelan, 2006), and an individual can expect to be in the role for about one-third of his or her life, an average of about 25 years (Smith, 1991). Yet there has been relatively little research into the expectations, experiences, meaning and satisfaction that the role holds for traditional, non-custodial grandparents (Somary & Stricker, 1998). What does ‘modern grandmothering’ look like? Stereotypes of grandmothers as frail ladies in lace and lavender no longer seem to hold. Many of today’s grandmothers are still working, taking exercise classes, travelling and otherwise involved in healthy, active lives. How do today’s women, many the products of third wave feminism, negotiate their grandmothering role? In our study, we aimed to describe the major roles and activities that Australian grandmothers undertake in relation to their grandchildren. Our study combined quantitative and qualitative approaches to enable us to both enumerate and describe these activities and roles.

The study We created a web-based survey that could also be completed as a hard copy and advertised the survey to seniors’ organizations and through several workplaces. We also sought volunteers to be interviewed in greater detail about their grandmothering experiences. Our survey sample comprised 1205 grandmothers, 91 percent of whom participated online. Their age range was 34-92 years (average = 64 years). Most were partnered (72%), the rest widowed, divorced or separated. Most had 2 to 4 grandchildren (range1 to 22). On average, these women spent

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12 hours a week with grandchildren, although the range was extensive – some never saw their grandchildren while a small proportion were fulltime carers. The 24 women we interviewed covered a wide spectrum of grandmother ‘types’. There were ‘hands on’ and more distant grandmothers, older and younger grans, city and rural dwellers and those with few and many grandchildren.

What we found Providing emotional support to grandchildren was the most frequently checked activity on the survey, with 90% of grandmothers saying they did this sometimes or often. Caretaking and babysitting were also heavily nominated (87%), as was engaging in educational activities, for example reading to children or helping them with schoolwork. Grandmothers also spent time with grandchildren in sporting/leisure activities (71%), on outings (74%), and in passive leisure such as watching TV (74%). Fortyfour percent of grandmothers took their grandchildren on holidays sometimes or often. Interestingly, from the point of view of grandmothers’ health and well-being, ‘the more activities the better’. Level of involvement with grandchildren was positively related to life satisfaction, satisfaction with grandmothering, feelings of generativity or sense of worth and health status. Those who were least satisfied were those who had little or no contact with their grandchildren. More detailed exploration of grandmother roles came through thematic analysis of the interviews. Women told us that ‘times and grandmothers have changed’, with smaller families, later age of parenting and grandmothers more likely to be older. Nevertheless they saw the modern grandmother as fitter, healthier, often still working, and more independent due to the changing roles of women. The implication was that today’s grandmother offers a different kind of role model to her grandchildren than grandmothers from previous eras. A major role for grandmothers was as an educator, but rarely in any formal sense. Rather, women saw themselves as providing extension and extra-curricular activities to their grandchildren, such as reading/telling stories, engaging in imaginative play, or teaching crafts, cooking, or nature study. This teaching was largely informal, relaxed, ‘fun-based’, often



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demonstrating a sensitive recognition of the child’s developmental stage and readiness. As one woman put it: I love showing them things, I love teaching them something new. I love challenging them in little bits of ways and making up poems for them. One example is I made up a little song for the three-year-old so she could remember her telephone number.

The grandmothers we interviewed were also active companions. They were dancing, singing, playing sport, riding bikes and going on outings with their grandchildren. Of course these activities were age-dependent, changing as the children (and the grandmothers) got older, and also as the children developed their own interests. Now that he’s getting older we cook together, we go for walks, play games. I have been known to be out in the backyard at 7.30 wearing shoes, dressing gown and sunglasses kicking a soccer ball.

A traditional role for grandmothers is as custodian and communicator of family traditions. Grandmothers often take the role of one who helps maintain a sense of history and continuity in the family, as well as transmitting family values and mores. Many women we interviewed had taken on this task, for example: [I] read to him every night (and) also build in some of the history of family. You know that this is where daddy went to school, this is where nana went to school… And: I believe a grandmother has the opportunity and privilege of building a heritage that will carry down through the years in to future generations.

It is worthy of note that some grandmothers do not experience what was described to us as ‘the luxury of handing them back’. About 2% of grandparents in Australia are full-time carers of their grandchildren, the reasons mostly being dramatic and tragic – such as parental death, accident, drug abuse or domestic violence. In our survey, a similar percentage of the total sample had full-time responsibility for a grandchild or grandchildren, while a further 2% spent 40 or more hours/week with their grandchildren but did not describe themselves as primary carers. Interestingly, high care grandmothers did not differ from the other grandmothers in reporting a great deal of satisfaction with their grandmothering role. Indeed, they reported personal benefits associated with this demanding role, for example an enhanced status in the family



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and greater understanding of the younger generation. They put a positive spin on their situation, for example: I think as we go through middle age we close ourselves up a bit … and a child just opens your arms back up. You know, you sort of embrace things again with a new energy.

Overwhelmingly, from full-time carers to occasional babysitters, grandmothers saw their major task as loving and supporting, not only their grandchildren but the children’s parents. They said things like: I’m not responsible for feeding them, clothing them, educating them, disciplining them, nothing. I’ve only got one job in life, that’s to love ‘em. And: I see (being a grandmother) primarily as giving unconditional love to the grandchildren and supporting your own children and their partners in their role as parents.

One of our interviewed grandmothers summed it up nicely: The role of a grandmother? To nurture, to teach, to be totally immersed in the child, yeah, to be there… just to be like a glowing bubble around them. That real sort of enveloping of this child.

We learned from our study that modern grandmothers have not abandoned their nurturing role. Far from it. They are intensely involved with their grandchildren and balance their grandmothering with many other activities. As teachers and active companions, they expand their grandchildren’s lives. They work to keep alive family traditions and impart values. But they are clear that loving and supporting is what matters most. In short, grandmothers (and grandfathers) are a huge community resource. How can they be better acknowledged and their contributions recognised?

References Smith, P.K. (1991). The Psychology of Grandparenthood. New York: Routledge. Somary, K., & Stricker, G. (1998). Becoming a grandparent: A longitudinal study of expectations and early experiences as a function of sex and lineage. Gerontologist, 38(1), 53-61. Thiele, D. M. & Whelan, T.A. (2006). The nature and dimensions of the grandparent role. Marriage and Family Review, 40, 93-108.



YOUNG MUMS AND DADS PARENTING TOGETHER KARL BRETTIG

If we were to ask articulate young children what they most appreciate from parents, apart from the mandatory self indulgences, you can easily imagine it would be things like a safe home environment with an absence of harsh conflict and a degree of harmonious relationships between family members. For the majority of parents this is not an easy thing to achieve and requires some very considerable skills. Family relationships are a major challenge for most of us as numerous researchers have highlighted. Gottman and Shapiro put it this way: “For as many as 67% of new parents, the transition to parenthood is accompanied by sharp declines in relationship quality, significant increases in relationship conflict, increased depression and psychopathology, and decreased quality of the parent-infant interaction. There has been no known psycho-educational intervention that has successfully taught couples the skills that they will need to preserve intimacy in their relationship, keep fathers involved with the baby, and help parents understand and appreciate infant development.” (Gottman & Shapiro, 2005, p2)

In order to address the issue they developed Bringing Baby Home - a research based and research tested two-day psycho-educational workshop designed to teach couples these skills while experiencing the transition to parenthood. The "Bringing Baby Home" workshop focused on helping expectant and new parents make a smooth, positive transition to becoming a family. The workshop has three goals: 1. Strengthening the couple’s relationship. 2. Facilitating and encouraging father as well as mother involvement in this parenthood transition 3. Giving expectant and new parents basic information about infant psychological development accompanied with relevant parenting tips.

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The role of fathers One issue arising from this work that has gained the attention of researchers in recent times is the role of fathers. For example one study (Quinton, Pollock & Golding, 2002) found that services are not inclusive of the needs of young fathers when caring for mothers but that the inclusion of fathers is desired by young mothers. It also found that the quality of the relationship with the child’s mother was a more powerful predictor of young fathers’ remaining in contact or losing contact than was the background disadvantage. According to the UK Fatherhood Institute (2010) children of highly involved dads tend to have: • • • • • • • •

Better friendships (and with better adjusted children) Fewer behavioural problems Better educational outcomes Greater capacity for empathy Non-traditional attitudes to earning/childcare Higher self-esteem and life-satisfaction Lower criminality and substance abuse More satisfying adult sexual partnerships.

The ideal of having fathers integrally involved in parenting raises all of the very challenging issues around couple relationships.

Key issues Baxter, Qu & Weston (2009, p43) found that: “it is important for parents to maintain a non-hostile relationship for the sake of the children and the ability for parents to do this is an important ingredient of “quality parenting”. Therefore it is necessary to target parents’ wellbeing, parenting, and co-parental relationships (including conditions that have negative impact on these matters), when implementing strategies related to ‘children’s best interests’.”

In the UK the Department for Children Schools and Families developed a Green Paper titled Support for All which was presented to UK Parliament in January 2010. Its conclusions based on a research report (Walker, Barrett, Wilson, & Chang, 2010) included these salient points:



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• People want relationships to last for life but all relationships are demanding and require work; • Having a baby, a miscarriage, juggling the demands of work and childcare, ill health and money worries can put extreme pressure on relationships; • Over half of those who had separated believed they could have spotted problems earlier and dealt with them better; • Most people thought that learning about and preparing for relationships should start as early as possible – in primary schools – and continue throughout life. In terms of dealing with relationships issues a clinical study of ‘forgiveness therapy’ (Parker & Pattendon, 2009) that “found that clients with substance dependencies, when compared to controls, recorded significant improvements in self-esteem, depression, anger, anxiety and vulnerability to drug use. The improvements were attributed to the exploration and examination of past resentments and emotions as part of the process (Lin, Mack, Enright, Krahn, & Baskin, 2004, cited in Freedman, Enright, & Knutson, 2005). Most benefits were sustained over a four-month follow-up period, and initial low levels of forgiveness rose to and stayed above the published adult norms.” This kind of therapy does not mean that partners choose to no longer adhere to boundaries in relationships which exclude unacceptable behaviors such as inappropriate expressions of anger, infidelity and any form of violence. Broken relationships can be repaired where underlying issues are thoroughly dealt with and changed attitude and behavior is evident. Prevention and early intervention is clearly a preferable strategy. There is a lot of good information that is now available to support vulnerable families in the critical early years. However a major problem is that this information is not readily accessible to those who are most vulnerable. We know from the 1996 International Adult Literacy Survey that approx. 6.2 million adult Australians didn’t have adequate literacy skills to cope with the demands of everyday life and work. The 2006 results from the Adult Literacy and Life Skills Survey showed that between 46% and 70% of adults in Australia had poor or very poor skills across one or more of the five skill domains of prose literacy, document literacy, numeracy, problem-solving and health literacy.



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In order to bridge the knowledge gap between what researchers are discovering and young families who are most vulnerable, in 2008 the Salvation Army Ingle Farm in partnership with The Department of Families, Housing, Community Services & Indigenous Affairs, Relationships Australia and Centacare released a booklet and DVD titled “HOW IT IS: young mums, the truth revealed”. The project emerged from a growing desire to support and educate young mums, young mums to be and young adults considering pregnancy. There was an increasing awareness of the lack of easily accessible resources that were suitably targeted at these groups. The resource included a booklet containing answers to commonly asked questions on relationships, sexual health, pregnancy, birth and perinatal care that appeals to youth culture with its graphics and simplified text. It also included a DVD containing detailed stories of young mums who tell it “how it is” in relation to the issues they have encountered. The DVD/booklet is in circulation around many states in Australia and has been used in many settings including senior school curriculums, by school counsellors and chaplains, community centres, Child and Family Health Services, maternity wards and by professionals who work with young mums and dads. One school counselor reported that it was particularly sought out by students experiencing relationship issues or a pregnancy scare who then passed it on to their friends. In 2009, in partnership with Families and Community Services and Indigenous Affairs, as well as Parenting SA, Centacare, Lutheran Community Care and the Salvation Army Ingle Farm, it was agreed to produce a sequel inclusive of young mums and dads. This resource includes sections on being prepared for baby, what children need in the first years, how baby develops, setting boundaries for children, issues for single parents, parenting as a team, relating with partners, attitude check, anger management, anxiety & fear, tips for healthy relationships, resolving conflict through negotiation and where to find support.



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References Adult Literacy and Life Skills Survey, Summary Results, Australia (2006). Australian Bureau of Statistics Cat. no. 4228.0. Baxter, J., Qu, L., & Weston, R. (2009, 29 September - 2 October). Family structure, quality of the co-parental relationship, post-separation parenting and children’s emotional wellbeing. Paper presented at the XXVI IUSSP International Population Conference, Marrakech, Morocco. Fatherhood Institute (2010). Invisible Fathers: Working with young dads Fatherhood Institute. Lin, W.F., Mack, D., Enright, R.D., Krahn, D., & Baskin, T.W. (2004). Effects of forgiveness therapy on anger, mood, and vulnerability to substance use among inpatient substance-dependent clients. Journal of Consulting and Clinical Psychology, 72, 1114-1121. Parker, R., & Pattenden, R., (2009). Strengthening and repairing relationships: Addressing forgiveness and sacrifice in couples education and counselling. (AFRC Briefing No. 13). Melbourne, Vic.: Australian Institute of Family Studies. Quinton D L., Pollock S B., and Golding J., (2002) The Transition to Fatherhood in Young Men: influences on commitment. University of Bristol. Shapiro, A,F., & Gottman, J.M., (2005). Effects on Marriage of a PsychoCommunicative-Educational Intervention With Couples Undergoing the Transition to Parenthood, Evaluation at 1-Year Post Intervention. The Journal of Family Communication , 5(1), 1–24. Walker, J., Barrett, H., Wilson, G., & Chang, Y. (2010). Relationships Matter: Understanding the Needs of Adults (Particularly Parents) Regarding Relationship Support. Institute of Health and Society Newcastle University. Retrieved from https://www.education.gov.uk/publications/eOrderingDownload/DCSF -RR233.pdf



CHAPTER NINE COMMUNITY DEVELOPMENT INITIATIVES

FAMILIES LIVE IN COMMUNITIES FRANK TESORIERO

Families live in communities. Communities are rich in their resources, strengths and assets. This is most obvious when disasters strike. The natural disasters in Australia, Chile and Japan are testimony to the power of community spirit, to the resources and networks of support which can be harnessed to protect people. There is a long history of working with communities and many prominent scholars have written about the power of community. The human need for belonging is the source from which many people’s aspirations for health and wellbeing stem. This means that it is imperative to work to enable communities to embrace its members so that families can belong. We also know that communities are made up of diverse families and groups. There are different types of families, different cultural groups, different ethnic groups, different religious beliefs and different races. Working with communities to embrace this diversity means that communities are more able to contribute to a socially inclusive and just society. We know that people are capable of making decisions. But we also know that this capacity is enhanced or restricted by the conditions in which people live. People can shape their own destinies, but only to the extent that their environment is supportive of their aspirations. Therefore, working with people in communities, as active agents to enhance the quality and capacity of their communities, is a potentially powerful way of working. Participation and collective action are two main strategies which flow from our knowledge about the power of people to create change for the better. The history of great social change tells us clearly that change happens when people work together. The great social movements, such as the black rights movements, the trade union movements, the green movements and

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the response to HIV/AIDS have all involved people working collectively and powerfully. Very few changes have been instigated by politicians.

Power shapes policy and practice The combined knowledge and wisdom about communities so often has failed to translate into social policy and family practice. Why is it that so often what we know does not inform what we do? It is because power shapes policy and practice. The powerful and dominant paradigms which shape our contemporary world are neoliberal, free market and managerialist within a world that dances to the tunes of economic globalisation. Here, governments strive to compete in a globalised marketplace rather than endeavour to build strong and vibrant societies. Our human service systems are often shaped by competition, efficiency, KPIs, risk management, privatisation, funding restraints and political agenda which erode their effectiveness to meet the needs of families and of communities, in a holistic way. There is ample evidence that the net result of these powerful forces is greater inequities – an ever increasing gap between the rich and poor, healthy and unhealthy, those who can access resources and those who cannot. There are, additionally, many other contradictory forces in our contemporary society which are barriers to people developing a sense of belonging to community. Work pressures, mobility which takes people to distant places, lack of transport and related issues which isolate others, are just some of the barriers to belonging.

Communities for Children However, sitting alongside these barriers is a powerful community development movement which works across many sites and alongside many communities to enable them to develop to more effectively support their members. Initiatives such as Communities for Children are examples of community-based approaches to human services work. Communities for Children is a vitally significant program. It is significant because it values the central role of community in promoting and protecting the wellbeing of children and families. But this is not the only reason – Communities for Children reflects the commitment of a national government to provide substantial support to local communities to shape their own strategies to support their families. Communities for



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Children, the Australian Government and the local community partners who work to build and strengthen communities for children and families fly in the face of powerful global forces. Communities can be seen as sites where problems need to be solved or as sites that are rich with resources and strengths, which, if tapped and worked with can be harnessed to address many issues. If communities are seen as sites of problems, then professionals enter communities to solve the problems for communities. Relationships of dependency and powerlessness are perpetuated. A view of communities as the site of family support entails community and organisations working in partnership, respecting and acknowledging the different knowledge, wisdom, skills and experience that each brings to the partnership and that ‘two heads are better than one’. Such an approach is more likely to build self reliance, resilience and pride where families and children are strongly supported and their well being protected and promoted. Working with communities in partnership is to reach out to embrace the lives of families rather than ‘providing for’ them. Working in partnership with communities means a commitment to engaging with families, including those families who may be isolated, overwhelmed, fearful or experiencing hard times. It means listening deeply and respectfully to their views about what they need to support their development as a family. It means supporting families to participate in the planning, implementation and evaluation of activities, programs, projects or services that will enable them to meet their aspirations. A belief in the expertise of families with regard to their own their lives is central to working with communities. Relationships, building connections, strengthening social support networks and mutual help are more important than professionals coming into communities bringing in services and programs.

Processes important as outcomes It may seem curious, but when working with communities, processes are as important as outcomes; good processes are outcomes; and outcomes are good processes. Powerful and capable families cannot be the end result of expert professionals providing services for a clientele which is viewed as lacking and deficient. Whether it is services, programs or projects, it is crucial that those working with communities have a commitment to sharing their knowledge and skills, and to learning from the knowledge of



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those who live in communities. Only then can processes and outcomes be congruent. Only then can outcomes be enduring. Working with communities is complex, sophisticated, dynamic, multifaceted, unpredictable and sometimes ambiguous. It is based on principles of participation, collective action and power sharing. Therefore, we need to ask the question, on an ongoing basis: how are we travelling? How are we being effective? Inquiring into these questions, like the practice of working with communities itself, must be a collective and participatory process. In South Australia, there are five sites of Communities for Children. Like communities themselves, each Communities for Children program site is distinctive as it shares the journeys of the families within the five different communities. Asking questions about effectiveness has yielded great learning in each site. South Australia is unique in the Australian Communities for Children program because the five South Australian sites have now collaborated to share their learnings and to develop strategies to engage in policy advocacy so that the inspirational outcomes, reached through inspirational processes, can be scaled up and can reach out to more Australian families and children. Major learnings have been in the areas of service system collaboration, working from a ‘bottom-up’, whole of community approach, sustainable processes and outcomes, building child-friendly communities, engaging in child and family inclusive practice, valuing fatherhood and strengthening an integrated service delivery system. There are so many sites in our world where people working together are creating and developing communities which nurture, support, include and protect. Communities for Children in South Australia is a powerful contribution to partnerships that are achieving inspirational outcomes.



WORKING TOGETHER WITH CHILDREN AND FAMILIES IN A RURAL SETTING HEATHER BEAN AND JUDY DELAHUNTY

Dedicated to the memories of Phyllis Crettenden and Joylene Crouch who both made significant contributions to Communities for Children in Murray Bridge and are tragically not able to be with us on the continued journey. Murray Bridge is a South Australian rural regional town just over an hour’s drive from Adelaide. With a population of approximately 19,000, it is a culturally diverse community with a significant Aboriginal population. The town is also considered to be relatively disadvantaged. The journey to increase collaboration in Murray Bridge and outlying communities intensified over 4 years of involvement with Communities for Children. This initiative is helping to join up services provided to children with young families. We collected feedback from community workers about this process. Four keys were identified: collaborative learning, networking, community development and partnerships.

The collaborative learning project The Collaborative Learning Project has brought community workers together to learn and share understandings. This was an intentional strategy of ACcare as the facilitating partner of Communities for Children in the site based on community development and capacity building principles (Francis & Tesoriero, 2010). Bringing quality speakers and courses to the district has supported development of workers’ and community members’ skills, understanding and confidence. Part of this has been a facilitated workshop process around community development and sustainability led by Frank Tesoriero form Flinders University. In the words of one worker, “training gives us all a common focus and a

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common language…to come together for the day and focus on what it really means in our day to day work”.

Networking Networking, the next key, through both formal and informal processes has supported collaborative work and relationships of a wide variety of agencies and workers. Networking has reduced worker isolation in this rural setting, provided a context for work and a supportive and informative environment for new workers. Networking has helped to identify service gaps and provided a forum for collaborative planning. It has also supported a significant change in culture around sustainability to a creative can do culture. However, different organizational expectations have sometimes been a challenge to participation in the networks that have been established.

A community development approach A community development approach embedded in collaborative work has been another key. Rather than just basing services in the community, it is about capacity building and strengths based approaches. Community led initiatives, with management support for a community development approach, have used reference groups and effective facilitation of conversations to allow outcomes that were not originally envisioned. Consultation in two towns asked for development of community infrastructure. This was outside the scope of conventional community service provision and funding agreements. By working with communitybased reference groups to liaise with council and business community, a fence was built around the Mannum river-side playground and Murray Bridge gained a play café. It has been important to follow the community’s vision, and not dismiss possibilities. Being transparent with the community about constraints regarding their level of control, however, was also important in the collaborative process. Providing support for individual learning has had significant outcomes. Some participant parents have moved through volunteer roles to become valued workers in the community sector, supporting other families. In a country town context, the knowledge and experience of locally based workers has been a strength on which to build. The network of workers provides its own community of learners. As such it also requires a community development approach which maintains a critical awareness of



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“the unwitting practices of exclusion”. Challenges included short term funding cycles, change of workers and the tension around partnering organisations’ “core-business”.

Partnerships Partnerships are the mechanism of collaborative work and the final key. Partnerships often developed organically and were formalized when required. Working collaboratively across agencies on particular projects has impacted on interagency knowledge of each other and coordination of services for the community. At times sustainability of programs has been threatened by funding restraints but solid partnerships have allowed creative solutions, flexible service delivery and new possibilities. An additional benefit has been the easier access for the community to a variety of programs. A relationship with one worker can be a doorway or soft entry point to a wider variety of services with fewer referral barriers. Better referral uptake has been noted as workers aimed to wrap the services around children and their families. Partnership is now considered a “norm” for service provision in the district and influences program planning. One worker described this as “thinking beyond the interests of one’s own agency and being generous in contributing ideas and cooperative responses to the broader views”. At times multiple reporting and internal agency processes have challenged this collaboration however naming these challenges, especially the tension between competitive tendering and collaboration has helped workers and organisations to stay connected around collaborative intent.

Collaborative outcomes In three small outlying rural towns, different community needs have led to a variety of collaborative outcomes. With the support of kindergarten directors in Callington and Mannum, these venues have become key “hubs” or mini “children’s centres” for families, from which programs have been delivered. Community reference groups have been instrumental to this process of capacity building. In Callington services were very limited with families scattered over several regional centres. A group program at the kindergarten brought families with very young children together for the first time. Different activities were developed to meet both community wishes and funding criteria, such as ‘Yoga with your Children’. By the end of the first phase of



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Communities for Children, the group was ready to become incorporated and continue independently. In the words of the kindergarten Director “they (C4C) have really supported us to build a community culture- not just activities but a sense of belonging and values”. In Tailem Bend, community processes were slower, but by persevering, offering a variety of activities and being flexible around venues and the partnership model, the community continues to access alternatives to traditional supports and programs. The latest activity is “Daddy & me” which facilitates building sessions at the local community centre workshop, where fathers and their children make wooden billy carts. So is the main key to collaboration the venue and locality, or the connection and relationship between people? Although venues are important, in a rural context one integrated service venue cannot meet the needs of all. Relationships and collaborative practice can be mobile and see needs met in peoples’ own communities with the support of local services.

Reference Francis, H., & Tesoriero, F. (2010). Building supportive infrastructure to support families of young children- A community-based approach. Association of Children’s Welfare Agencies conference presentation.



WHAT A FAITH COMMUNITY CAN BRING TO HEALTHY CHILD DEVELOPMENT BRYCE CLARK

Spirituality means connectedness; connected, or relationally aware, of your world, and with a united sense of self. This is part of what it means to be human and in fact there is a growing body of evidence from the scientific community that human beings are “hardwired” for it (Beauregard & O’Leary, 2007, Ludwig, 2000). Developing spiritual well-being understood in this way must be at the very heart of community capacity building as we learn to see the individual as an integrated whole whose centre is spiritual and from which centre emotional and social capacities flow. When this approach is not encouraged and nurtured then the individual is unable to reach his or her full potential and society is the poorer. (Hay & Nye, 2006). Faith communities are groups of people committed to one another over time and who model and pass on at least part of what it means to be a good person and live a good life (Kover Kline, 2008). By definition they deal with both internal and external issues that can form, or at least contribute to, the development of protective factors for healthy child development. These communities are situated to nurture relational awareness in the human experience whether it be understood as a person’s propensity to relate to his or her inner self, to the environment, to others, or to the eternal. These domains are the bread and butter of most faith communities from a wide variety of cultural and doctrinal persuasions. But it can be taken one step further. Research indicates that a families’ commitment to a religious institution is of significant therapeutic value for participating families as well as being an effective protective factor in developing resilience in the individual child (Kovner Kline, 2008).

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Practical benefits of faith communities Two broad categories of protective factors suggested by some authorities as being universal are networking and the search for meaning and these are essential ingredients of faith communities. Some faith communities can act as a checking point for cultural practices that are risk factors. They are able to provide personal support to assist in the assimilation of new information as well as an alternative social network to diminish the effects of ostracization of the those who are marginalised. Faith communities are often sought after because they offer stability, consistency, acceptance, trusting relationships, responsibility, accountability, dependability, identity, community (inter-age relationships, same gender and cross gender friendships), social, cultural and moral direction (through peers, elders, and external authorities, eg, Bible, Koran, Adi Granth), affirmation (from peers and mentors), advocacy (government authorities, welfare groups and family), volunteers for culturally relevant activities such as parent controlled play groups, youth activities, young mums groups, men’s support groups, after school care and/or tutoring, and language support. They can also provide social interaction through non-judgmental friendship, mentors for the children, baby-sitters, friendship circles and assistance to new arrivals from remote communities. The priest, or pastor or spiritual mentor, within a faith community can assist individuals to deal with troubling personal issues of conscience such as guilt and shame and to know forgiveness, find reassurance in notions of purpose, reasons for being, and direction in life through counseling and referral. Many of these activities and services are relationship based and in the context of a faith community they provide experience and guidance towards positive relationship skills and the development of relational consciousness; perhaps the most fundamental feature of a child’s spirituality (Hay & Nye, 2006). They give individual families an opportunity to become involved in the social life of the wider community. Children can learn covertly as they see older experienced members live, relate and prioritise and overtly through age appropriate and supervised peer interaction and friendship groups. Well chosen faith communities provide environments that operate on the basis of recognized protective factors and minimal risk factors with the expressed purpose of strengthening the resilience of its members. They are able to encourage and support the family unit in an environment that recognises the significance of the individual’s spiritual centre and in this



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way they can strengthen the capacity for resilience in what might otherwise be adverse circumstances.

Faith communities and resilience for Aboriginal families When we look at the growth of resilience of Aboriginal families it must be said that well documented aspects of Australian history, mean that any faith community wishing to be involved in the healthy development of Aboriginal children must first of all face up to the many examples of destructive influence faith communities (in conjunction with Governments) have had in the past so that these are not perpetuated through ignorance. Faith communities have been actively engaged in Aboriginal communities since colonisation through linguistics, education, welfare, hospitals and land and cultural preservation. Although it has not always been a positive involvement they can effectively contribute, all-be-it with greater accountability, sensitivity and wisdom (Hart, 1997). They can demonstrate their greater accountability, sensitivity and wisdom by rejecting the racist attitudes of the past (Reynolds, 2005). Only then can we begin the long journey forward to a position of equality and trust whereby, amongst many other things, the racially based distinctives of donor and receptor mentality of the past are cast aside. Aboriginal families suffer under the same negative forces as the wider community by way of general moral malaise, continuous undermining of historical authority structures and the diminishing influence of the traditional sources of cultural and moral guidance. They often also have to deal with a long history of dysfunctional family life, substance abuse, unemployment and entrenched institutional racism and racist attitudes. Against this background and as well as the resources listed previously, a well chosen local faith community can provide struggling families with something as practical as a social outlet or as profound and personal as reassurance, hope and purpose.

References Beauregard, M., & O’Leary, D., (2007). The Spiritual Brain – A Neuroscientist’s Case for the Existence of the Soul, Harper One. Hart, M.(1997), A Story of Fire Continued .New Creation Publications. Hay, D., & Nye, R. (2006). The Spirit of the Child, Jessica Kingsley Publishers, London.



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Kover Kline, K. (2008). Authoratative Communities, the scientific case for Nurturing the Whole, Child., Springer. Ludwig DJ (2000). ed, Social Work and the Family Unit, Journal of Family Social Work, Volume 3, No 4, Haworth Press. Reynolds, H. (2005) Nowhere People, How International Race thinking shaped Australia’s Identity, Viking.



FIRST STEPS: SUPPORTING AND STRENGTHENING THE LOCAL COMMUNITY FOR THE EARLY YEARS ALAN STEVEN AND JANE SWANSSON

During an initial consultation in the Salisbury Communities for Children site families said they would benefit from affordable and local play activities (Nechvoglod, 2005). The Salvation Army Ingle Farm was clear about their objective to develop a place for families/caregivers and children under 5 to visit and make connections with other families/caregivers in the community, be supported, find out about other services or information relevant to them, and have somewhere safe and free for the children to play outside of home. They saw the potential of removing pews from the worship centre so that the area could be transformed each week into a play and seated area for children and parents/caregivers. To make it most accessible to families they wanted it to be free and available for families to ‘drop-in’any time over three mornings a week. This activity was named First Steps Playtime.

Support from the church community The people who regularly use the church supported this project by making the space available and accepting that that the furniture and fixtures would rapidly become more worn out. They purchased fencing to protect the musical equipment and chairs and for security and safety. They continue to support this activity through their encouragement of it as a valuable service to the local community. Volunteers from the church also offer practical support by setting up and packing away furniture (including 270 chairs) and toys each week. The layout of the seating area, cleanliness and quality of the area and toys, as well as a friendly welcome from the coordinator and volunteers, contribute significantly to creating an open and friendly atmosphere.

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The coordinator (funded by FaHCSIA through Communities for Children, for three days per week), supervisor and a team of 7 volunteers (6 from The Salvation Army Ingle Farm) engage with the parents, casually seeing how they are managing in life as a parent. They are able to listen well and hear the needs of the families and respond to particular needs or tailor their responses to the identified common need among families.

Adding to the strength of the local community ‘First Steps’ provides the opportunity for a range of families, with varying parenting skills, experience and knowledge to share a peer learning experience, access support, friendship and fun and develop parenting skills in a safe environment. This is seen in action as experienced Family Day Care providers, grandparent carers, fathers, young mothers, mothers (with children at various developmental stages), a large number of families of non-English speaking backgrounds, children and adults with a disability or developmental delay, all share the same space as they interact with their children and each other. The young mum’s mentor (working for The Salvation Army Ingle Farm) visits ‘First Steps’ with isolated young mums to increase their support network and provide the opportunity for more peer support. Some families have visited after contact through the Emergency Relief program which shares a common foyer area and it is accessible to families because there is no cost. While ninety-five percent of families are not connected to the church the opportunity is opened for them to receive further support from the church community. In one example, an African family who accessed Emergency Relief is now involved in the church community with the children playing basketball and joining the youth group. These activities have given them access to healthy play options and friendship while the parents receive support from other families. Informal support and increased social inclusion were noted by FaHCSIA as key strategies of family support programs where in a 2010 study the overwhelming source of support for families was family members (especially parents) and friendship networks. This was exemplified by Mary who is from China and brought her mother, who speaks no English, with her just today. She’s due to have her second child in a couple of weeks and her parents are visiting from China for a year to support baby’s arrival. Mary has been in Australia for 5 years and found it very hard for the first two years when both her and her husband worked full time and had no friends here. Initially they found support through a



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local Chinese church and connected with other Chinese people via the internet. They also found out about other services via the internet. Now Mary attends ‘First Steps’ with her 2.5 year old daughter for 2-3 hours each Monday, one hour on Tuesday and one hour on Wednesday. She finds that it is good to get out of the house and “that way the house doesn’t get messed up”. She says that it also gives her a chance to rest and not have to be running around after the housework. She still finds her first child exhausting and finds her behavior difficult but is encouraged by the other mums with more children and observing their skills to manage. After she has the baby her mother will continue to come with their first child to give Mary a break and continue her child’s regular routine.

Attendance and structure of the activity ‘First Steps’ began in February 2006 with 25 families visiting on the first day and some staying for 4-5 hours (Wynne, 2006). 450 different adults and over 650 different children came during July-December 2010 – with most of these attending more than once. Around one sixth of families from culturally and linguistically diverse backgrounds (79 adults and 106 children) attended in the past 6 months (July-Dec 2010). With around 40 families visiting on some days it is necessary to have volunteers available to welcome new families and develop relationships with those revisiting. Mainly Music, a music and music initiative is also run in another room while First Steps is operating (this has a cost of $3 per family each week which includes a snack for every child). It is a vibrant and happy music group for children under five years. Local families participate and its growth in popularity has meant that it is now available at three sessions each week. The children enjoy the fun and enthusiasm shared by the facilitator, volunteers and parents/caregivers through song, music and movement. As they have fun they are developing skills and have an opportunity to experience positive bonding time with their parent/caregiver. A third program, Lapsit, is also run concurrently. During First steps Playtime the children are called over with their parents for this reading program. They love hearing the stories and the facilitator is modeling the value of reading to parents. Some parents have commented that they read more to their children at home as a result of Lapsit First Steps is an example of an early childhood community development initiative that can be readily implemented by a faith community in



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partnership with parents, caregivers, agencies and government. The level of response to this initiative is an indication of its value to the local community.

References FaHCSIA (2010). Occasional Paper No. 30 - Families’ experiences of services. Retrieved from www.fahcsia.gov.au/about/publicationsarticles/research/occasional/Pag es/default.aspx March 2011. Nechvoglod, L. (2005). Report on the findings from the Salisbury Communities for Children Initiative facilitated by Ingle Farm Salvation Army regarding the ‘Community Strategic Plan’ – consultation with the community. UniSA and The Salvation Army. Wynne, L. (2006). Salisbury Communities for Children meeting minutes 21/2/06.



CHAPTER TEN EMERGING INTEGRATED CHILD AND FAMILY CENTRE MODELS

CHILDREN’S CENTRES FOR EARLY CHILDHOOD DEVELOPMENT AND PARENTING ANDREA MCGUFFOG

The South Australian Government is establishing 38 Children’s Centres for Early Childhood Development and Parenting across South Australia, including four Aboriginal Children and Family Centres developed in conjunction with the Commonwealth Government as part of the Indigenous Early Childhood Development National Partnership. The key partner agencies of the Children’s Centres are the South Australian Government Department of Education and Children’s Services (lead agency), Department of Health and Department for Families and Communities. Children’s Centres support children from birth to age eight and families to achieve the best possible learning, health and wellbeing outcomes in a universal setting with targeted responses when additional support is required. Children’s Centres help parents and children to get the support they need, when they need it, within their own community. All the work connected with Children’s Centres contributes to the priority population outcomes as follows: 1. Children have optimal health and development. 2. Parents provide strong foundations for their children’s healthy development and wellbeing. 3. Communities are child and family friendly. 4. Aboriginal children are safe, healthy, culturally strong and confident. While each Children’s Centre differs according to their community strengths and needs, a range of services and programs are common across all centres, including: • Care and education • Playgroups and crèche

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Occasional care or long day care Preschool Health programs and information Family support programs and services Community development activities.

Decisions regarding which services will be offered in each Children’s Centre, and how these services will be delivered, are made by the key partner agencies and a variety of local contributors such as other government agencies, non-government and community based organisations, parents, community members and staff. Specific governance bodies operate to support joint decisions and partnerships.

Governance The governance structure for Children’s Centres works within existing legislation, incorporates the requirements of each partner agency and encourages people to build partnerships and develop flexible integrated responses to children and families. The structure enables and supports partners to make shared decisions about directions, priorities, policies, resources and accountability mechanisms. Children’s Centres are supported by governance bodies at the ministerial, central agency, regional and local levels. The shared commitment of all these groups is to put the needs of children and families first, provide services that families want and need, provide the best start for children and engage the community in building supportive environments for children and families. Together these groups plan and support integrated early childhood and family services that meet local needs, Children’s Centre priorities and government expectations.

Staffing Staff in each Children’s Centre includes a Director of Education and Care, early childhood qualified teachers and early childhood workers, a mix of qualified and unqualified child care staff and a Children’s Centre Community Development Coordinator who facilitates parenting and community programs. In Children’s Centres with particular needs, the team includes staff with expertise to provide targeted support.



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Family Services Coordinators are employed to improve outcomes for children and families experiencing disadvantages, parenting difficulties and child development issues. Family Services Coordinators provide targeted responses including counselling, service coordination, group work intervention and referrals, as well as taking an early intervention and prevention approach to improve the take up of services by vulnerable children and families. Allied Health staff in the fields of occupational therapy and speech pathology, utilize primary prevention and early intervention approaches to strengthen parenting skills and improve children’s developmental outcomes. The Allied Health program focuses on: 1. Promotion of processes & environments that assist children’s optimal development 2. Professional Development for Children’s Centre staff 3. Parent education 4. Intervention for children Health Promotion Officers have a particular focus on Aboriginal children and promote strategies to increase staff, parents and children’s knowledge and skills in healthy eating (including breast feeding), active play and oral health. Child & Family Health Clinic staff may be based fulltime or part time at the Centre and include maternal health nurses who provide child health checks. All Children’s Centre staff are expected to not only demonstrate knowledge, understanding and effective practice in their area of expertise, but also their ability to work in partnership with children, parents and communities, to be flexible and adaptable in the way they work and to effectively work in a collaborative team. This approach is underpinned by a shared commitment that the Children’s Centre will make a difference to children’s outcomes and that children and families will experience seamless service delivery.



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Professional development Professional development is critical in supporting change and equipping staff to work successfully within new models of integrated service delivery. Shared professional development, opportunities to share knowledge and skills and working alongside colleagues from other disciplines enhances the skills of all the staff in the centre. Children’s Centre Leadership Teams (including service leaders, both government and nongovernment) are being established to provide guidance and support in developing trans-disciplinary and integrated approaches, including developing joined-up responses for individual children and families and providing opportunities for common training and professional development. In addition to local professional development, the statewide Children’s Centre Professional Development Program supports consistency across disciplines and centres. Common training supports staff to develop the essential knowledge, skills and competencies to work effectively within an integrated Children’s Centre. The Professional Development Program supports staff to achieve the Children’s Centre vision and the four population outcomes identified within the Outcomes Framework. The program is designed around five core elements: 1. 2. 3. 4. 5.

The Children’s Centre Model Leadership and Integration Child Development, Learning and Wellbeing Family and Community Partnerships Cultural Competencies.

The impact of Children’s Centres is being measured using a variety of methodologies. The powerful voice of the parents using the services demonstrates the difference integrated early childhood services can have. “Here I get time with my child and in a good environment.…I feel relaxed and calm, so does my child”. “I benefited greatly being involved in the Children’s Centre when my child was a baby because all of my family live interstate. It felt good to be able to get advice and connect with people that have children the same age as mine.’”



AN INTEGRATED SERVICE IN ACTION LYNNE RUTHERFORD AND KAYE COLMER

Gowrie SA is a dynamic, community-based organisation leading the development of innovative and responsive services for children and families and building leadership capacity in the wider South Australian early childhood community. Gowrie SA offers a range of services including: • An integrated education and care program (preschool and childcare) at Thebarton and child care at Underdale; • An early intervention parenting program for families (Through the Looking Glass program); • Professional development and mentoring services for early childhood professionals through the Gowrie Training Centre; • A Resource Centre for the South Australian early childhood sector Opening in 1940, Gowrie SA (also known as Lady Gowrie Child Centre) is a demonstration early childhood centre with multidisciplinary roots. Historically the Gowrie has integrated education, care and health for young children and their families and our approach recognises that professional learning supports the engagement of all staff in a multidisciplinary system. The centre embraces this multidisciplinary approach and focuses on integration of service provision that is beyond colocation.

What is integration? Our understanding of co-location is where different disciplines are available on the same site, but don’t work together under a common philosophy and policies. Integration is where there are shared policies principles and philosophy, and different disciplines work together to improve outcomes for children and families in a co-ordinated way.

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Integration is multilayered and multidimensional. According to Press, Sumsion & Wong (2010) the achievement of full service integration requires action at the levels of: • • •

Government policy; Governance; Leadership;

Organisation culture & ethos; and Front line professional practice and team work It took many years of work to ensure that our programs were truly integrated. This work involved the development of a shared philosophy, the integration of policies and procedures as well as preparing staff and families for something ‘different’ but ‘better’. Leadership was recognised as being central to successful integration. This was understood as whole of service leadership and leadership that is distributed throughout the team. We set up a management structure to distribute leadership throughout the organisation and established a leadership development program for managers and team leaders. The challenge in bringing in innovation and change necessitated finding ways to engage all staff to be able to contribute to their full extent. This meant we had to address issues of organisational climate in order to nurture commitment and find ways to build challenges into staff’s daily work.

Distributed leadership Siraj-Blatchford & Manni (2006, p. 20) suggest that ‘Distributed’, ‘participative’, ‘facilitative’ or ‘collaborative’ models of leadership call for a shift away from the traditional vision of leader as one key individual towards a more collective vision, one where the responsibility for leadership rests within various formal and informal leaders’. Margy Whalley (2006) also calls for shared leadership to be enacted through a ‘leaderful’ team. Our work with distributed leadership involves empowering staff to be involved in leadership and take ownership of their commitment to the organisation. It has also been important to make opportunities to discuss tensions and explore them – using them as learning opportunities for



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everyone. Tensions need to be understood as part of the complexity and embraced as supportive of growth and learning. Below are some examples of the partnerships we have: • A unique leadership structure at our Thebarton site. Team Leaders are paid at Assistant Director level and their duties are reflective of this. This allows the Children’s Program Manager to have an overview role as well as a stronger pedagogical focus. Staff qualifications and involvement are acknowledged through an Enterprise Agreement. • A participatory program involving early childhood and health. Through the Looking Glass is a parenting program which enables staff from health and the children’s programs to work cooperatively together with families. Structures are set up to encourage an equal partnership and opportunities to share knowledge. • A multi program partnership across the organisation. This group (called Nepurla) provides an opportunity for staff across our organisation to get together and critique as well as implement plans and practices relevant to the organisation philosophy. • Integration of program staff and training staff responsibilities. Children’s program staff were recruited as trainers and work with training staff to develop training packages and the training centre staff also have regular roles within the children’s programs. This structure allows us to consult about and initiate major initiatives within the organisation. This leadership model ensures staff are informed and perspectives and ideas are included. Some of the challenges have been: • Differing theoretical beliefs (eg Care vs /Education) • Professional discipline (eg. staff loyalty to their discipline rather than valuing each other’s qualifications and experience) • Status (eg. the valuing of kindergarten experiences for four year olds rather than looking at the program holistically for all children) • Qualifications (eg. Diploma vs Degree and Education vs Health) • Attitudes (eg. “This is the way it has always been”) • Differing focus - child or parent (eg. parenting programs tend to focus on the parent while education programs focus on the child) • Funding Cost of LDC vs subsidised cost of preschool sessions • Access to records (eg. confidentiality vs sharing information)



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Working in a truly integrated way addresses some of the above issues and also ensure staff are working toward a common goal and philosophy. We have found staff are better able to have enriched understandings and new approaches to problem solving through professional dialogue involving multiple perspectives. Staff have also supported each other to develop a culture of reflective practice and professional inquiry, challenging practices in a respectful way. When programs are integrated, we are able to ensure that systems and expectations are in place to support collaboration between different disciplines and ensure that professional learning and joint training opportunities are available and open to everyone.

What can others learn from our journey? Out of all of this work, we try to build opportunities for professional dialogue and collaboration as well as to ensure staff are able to be accountable for their actions. This ensures that all staff understand their personal and professional responsibilities within the organisation. A key finding from our work has been that collaboration cannot be increased without ensuring the appropriate structures and resources to support it are in place. Leadership and working toward integration has positive benefits for children, families and staff: • • • • • •

A more involved staff team Learning from each other Exploring new ideas and willingness to accept change Shared purpose, goals and focus Upskilling of staff Improved professional identity of educators

Working within the one organisation across different physical locations, with staff from a range of professional and theoretical backgrounds is challenging. For staff, the evidence suggests this integrative endeavour has promoted high levels of commitment, motivation, personal growth, professional development and career satisfaction.



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References Press, F., Sumsion, J., & Wong, S. (2010). Integrated early years provision in Australia. A research project for the Professional Support Coordinators Alliance (PSCA). Siraj-Blatchford, I., & Manni, L. (2006). Effective leadership in the Early Years Sector (ELEYS) Study. Institute of Education, University of London. Whalley, M. (2006). Leadership in Integrated centres and services for Children and families. A community development approach: engaging with the struggle. Childrenz Issues, 10(2).



SEATON CENTRAL FIONA DALE

North West Adelaide’s Communities for Children (C4C) has been facilitated by UnitingCare Wesley Port Adelaide since July 2004 and is funded by the Australian Government, FaHCSIA, Family Support Program. North West Adelaide’s Communities for Children program is well situated in a community of significant disadvantage and limited support. Following extensive consultations, and a national and international evidence review, in early 2005 programs were rolled out covering the broad domains of early intervention, health and wellbeing, child friendly communities, child development and increased pathways for families. C4C is described in the Family Support Program Community and Family Partnerships Guidelines (July 2009 p.6) as Communities for Children funds non-government organizations to develop and facilitate a whole of community approach building on community strengths and the existing infrastructure of organizations, networks and resources, making use of strong evidence of what works in early intervention. It is implemented through a national framework which allows for tailored approaches at the local level and provides communities with the opportunity to develop flexible and innovative approaches that best reflect their circumstances. Within a site, Communities for Children targets the whole community. Where a need is identified, specific strategies focus on particular target groups (for example, Indigenous Australians or people from Culturally and Linguistically Diverse Backgrounds). Each Communities for Children site is required to establish and maintain a Communities for Children Committee (CCC). The CCC is a voluntary group of key stakeholders within a site who work in collaboration with the Facilitating Partner to develop, guide and implement the Activity. Communities for Children funding recipients are required to comply with additional Operational Guidelines.

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Policy Frameworks Communities for Children programs across Australia work within the context of the Social Inclusion Agenda, Closing the Gap, and Protecting Australia’s Children Child Protection Policy Frameworks. Strategic plans address the needs of children, families and communities at a local level. Working within a child centred, family focused, community minded framework. The importance of the early years of a child’s life for their later outcomes is well known. It is also known that investing in all areas of children’s development in the early years is more cost effective than waiting to remedy problems when they surface later in life. A key initiative of North West Adelaide’s C4C approach is the innovative model of best practice, “Seaton Central,” an integrated, multidisciplinary child and family support service on the site of Seaton Park Primary School. The multidisciplinary team at Seaton Central provides professional support in a ‘home like’ environment, which is conducive to children’s learning and parents’ sense of trust through supported groups and supported play, at the same time as adults feel a sense of belonging and the ability to have fun while building relationships. The bright ambience creates an atmosphere that invites families to join in through varying entry points, which effectively accommodates any family’s level of vulnerability or social inclusion. The holistic approach strategically plans for and implements both universal and targeted programs, providing many levels of engagement. From targeted groups, families then have the opportunity to be involved in other universal activities on a daily basis, depending on their needs or strengths over time. The Seaton Central Team has a notable amount of professional skills and qualifications including: Social Work, Early Childhood Development, Community Development, Adult Education, Occupational Therapy, Physical Therapy, Child Protection, Primary Health, Children’s Health, Mental Health, Special Education, Counselling, Psychology, Perinatal Health, Disability and Attachment.



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Key elements of integration Integration is achieved through true partnerships with a range of funded Community Partners, agency partners and ongoing collaborations. The success of the service has grown at a rapid rate, which is historically unusual for a community development program, the dynamic team prides itself on ensuring all families’ needs are met, extended and respected. This is achieved through Seaton Central’s: • No wrong door practice – one registration form to all programs • One file per family – all team members involved with the family have input and access to the file for the purpose of a holistic, integrated service and comprehensive record keeping. • This includes, where required, a Mental Health Care Plan etc. Targeted programs may keep a separate more detailed file if required. • Multidisciplinary shared debriefs – all Team members within a program are involved in a shared debrief, including students, volunteers etc. • The debrief sessions are held immediately after programs. • They follow a reflective practice model asking 3 key questions – “What worked well?” “What could be improved?” AND “Who are we concerned about at this time?” • This provides a forum for questioning, critically analysing, developing and redesigning practices. • Target families are discussed and plans are made to address the strengths and needs of the family. • The debrief informs reports to funding bodies, programming for groups, and guiding where additional focus and support is required. • Collaboration, collaboration, collaboration – A consistent focus and effort on developing relationships as they are pivotal to every aspect of our work from children through to CEOS. The approaches to families’ needs are holistic within a successful prevention model in a child and family centre. The November 2006 Australian Early Development Index funded and coordinated by UCWPA’s C4C program revealed the importance of the strategic placement of Seaton Central within the North West Adelaide suburb of Seaton as it recorded the most significant number of children developmentally vulnerable on more than one domain.



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Communities for Children’s Seaton Central site is able to work from a community development framework to respond to emerging needs and has the capacity to improve service delivery and collaboration to enhance protective factors alongside children, families and communities. Providing support services within an integrated centre is one strategy of engagement. Home visiting has been incorporated into several roles within C4C and also as a Community Partner program to provide intensive home visiting for those unable to engage with the Centre atmosphere or have several identified risk factors impacting on their parenting roles. Fatherhood support is also provided across the region through one to one support, outreach to playgroups, perinatal sessions and library sessions. Seaton Central has moved beyond the rhetoric and clearly reaches valuable outcomes for young children and their families in the areas of health, education, care, wellbeing, relationships and reduction of social isolation. Currently over 1000 families are registered with Seaton Central and over 400 attend each week. The Communities for Children’s Seaton Central team pride themselves on providing real integration for real outcomes. As one parent recently stated’ “Your children learn from you, so make yourself someone worth learning from”.

Reference Department of Families, Housing, Community Services and Indigenous Affairs (2009). Community and family partnerships guidelines. Canberra: Australian Government. http://www.fahcsia.gov.au/sa/families/progserv/Pages/cfp_guidelines.a spx

    



SEAMLESS TRANSITIONING THROUGH INTEGRATED SERVICE DELIVERY AT FAMILYZONE KAREN STOTT AND JANE SWANSSON

The following case study illustrates how effective partnerships and creative solutions can impact a family and how forming partnerships also opens opportunities to provide accessible and seamless transitions for families to other services. H was referred to the FamilyZone by Helen Mayo House – an inpatient facility for women with mental health issues and their babies. H is an Iraqi woman who had recently had her third child and had been admitted with severe depression. She had limited English and was very socially isolated. H’s 18 month old daughter had been very negatively affected by the birth of her sister and her mother’s subsequent illness and absence and had developed severe behavioural issues. Her 8 year old son attended the local primary school but was reluctant to leave his mother due to the trauma in the family. H’s husband worked long hours to provide for his family, and was angry at his wife’s inability to cope and the couple had no other family in Australia. H was home from hospital but had been unable to engage with the other Iraqi women in this community due to her persistent fear that ‘someone’ would tell them about her hospital admission. This would bring shame on her family. She was being visited at home by a worker from Helen Mayo House and the worker was concerned that H would need to go back into hospital. A joint visit was arranged between the worker from Helen Mayo, a worker from the FamilyZone and an Arabic speaking support worker from the school. H was initially very reluctant to engage. Her fear that someone would tell the Iraqi community about her illness was only mitigated when she realised that the school support worker was Lebanese not Iraqi. A long talk about confidentiality laws in Australia ensued.

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Chapter Ten We agreed that: • H would walk her son to school every day. This would ensure that he stopped staying home to be with his Mum. It also met the school’s need to stop his truanting. • After dropping the boy at school, H would come to the FamilyZone with the two younger daughters. On Mondays; Tuesdays and Wednesdays she would attend English classes while the girls were cared for in the crèche. • The crèche worker (with a degree in early childhood education) would work with H on addressing her elder daughter’s behaviour. Together they would draw up a plan to cope with her attention seeking behaviours. This plan would be implemented at home and at crèche so the child received consistent parenting. • The worker from Helen Mayo House would continue to visit H at home on a weekly basis for one month. This meeting resulted in remarkable change for H and her family. After five months: H was walking her son to school every day. On three days she came to English classes and on the other two she met with another Iraqi woman from the school. H found that her English was not as bad as she had thought. In addition to ESL classes, she also started attending Conversational English. She made friends with an older Iraqi woman that she met at class and the two have become good friends. The crèche worker and H drew up a behavior management plan for the elder daughter. Whilst H still finds her daughter’s behavior challenging, she now has a plan and clear goals for dealing with it. Further, her new friend has teenage daughters who are willing to babysit the younger girls, which has given H some much needed time out. H comes and talks to staff when she is feeling overwhelmed or anxious. She has formed a good relationship with the Lebanese School Support Officer and will ask her to come and interpret for her if she needs to. H is far more trusting of professionals as she realises that we have not broadcast her situation to other people and that lots of other women “come and have a chat” with staff. Helen Mayo House staff no longer have any contact with H. Her medication has been significantly reduced and this is managed by her GP.

As a result of the relationships formed and the outcomes for H’s family, mental health services approached FamilyZone to provide services in partnership with them. This provided the initial impetus for support groups Being with Baby, Preparing for Baby and Managing Motherhood



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being offered. These activities are now a vital component of the support provided to families in the local area.

Accommodating particular circumstances and needs A recent paper noted that “Families reported feeling supported according to their particular circumstances and needs, rather than having to fit in with the structures and requirements of a specific program.” (FaHCSIA, 2010, section 7.1). The importance of families being linked with a service that would meet their needs was a repeated theme and it also recognised that “waiting times were a significant barrier to accessing services” (section 6.2). Long waiting times to access services mean that families and children are not being supported at the most crucial time. FamilyZone staff work intensively with other agencies to form good working relationships so that obstacles such as waiting times are overcome and effective, relevant options are able to be presented to families to meet their immediate needs. The FamilyZone team at Ingle Farm in South Australia aim to meet the needs of families and offer timely and relevant interventions for their physical, emotional and social wellbeing. Through the targeted services of Being with Baby (support and education for women with Post Natal Depression), Preparing for Baby (for women diagnosed antenatally with anxiety or depression), Beyond Being with Baby (an ongoing support group for families who have attended Preparing for Baby or Being with Baby and Managing Motherhood (mother/infant psychotherapy for women and infants referred for attachment disorders) specialised mental health services are offered to women and their families from 8-12 weeks after conception until the child is five years old. Agencies work in partnership allowing them to offer specialist social work and psychological support to families, direct referral to GP and psychiatric support, individual therapeutic support for attachment issues or parenting concerns and managed statutory intervention. Other targeted services such as parenting support and education, home visiting (for isolated families and those seeking support), supported playgroups, Afghan Women’s group and English classes also meet the specific needs of families referred. Universal services are also offered at FamilyZone that provide an easy entry point for some families who would benefit from more specific support and skills but have not accessed targeted services. Needs are identified by staff have an ongoing



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relationship with families and are able to actively listen to them. Some then access more targeted services at FamilyZone or other services in the community. Families also move from targeted services to universal services and benefit from peer learning, support, interaction and play and learning for the children.

First point of contact

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hŶŝǀĞƌƐĂůƉůĂLJŐƌŽƵƉ;ϱͿ WĂƌĞŶƚƐƵƉƉŽƌƚŐƌŽƵƉƐ;ϰͿ ĞŝŶŐǁŝƚŚĂďLJ;ϮͿ WĂƌĞŶƚŝŶŐĐŽƵƌƐĞƐ;ϮͿ ^ƵƉƉŽƌƚĞĚƉůĂLJŐƌŽƵƉ;ϭͿ

Fig 10.1 Seamless transitions from targeted to universal services

Figure 10.1 shows how mothers moved from the two targeted activities “Being with Baby” and “Home Visiting” to other targeted or universal activities at FamilyZone. This information was collected via interviews with families during April and October 2010. All of the seven families interviewed who started their contact with FamilyZone via Being with Baby, continued on after this course with a universal playgroup and a variety of other activities. Five of the six families who were interviewed and started their contact with FamilyZone via home visiting moved to a universal playgroup. Four also joined parent support groups and other activities. This demonstrates how the practice of targeted and universal services working in an integrated manner provides options and seamless support for families in need of support.



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Reference Department of Families, Housing, Community Services and Indigenous Affairs (2010). Occasional Paper No. 30 - Families’ experiences of services. Retrieved from www.fahcsia.gov.au/about/publicationsarticles/research/occasional/Pag es/default.aspx , March 2011.



THE FAMILYZONE PARA HILLS PARENT CENTRE LISA MANNING AND KERRY TOMARAS

In response to local interest from parents and school staff at Para Hills Junior Primary School, Salisbury C4C initiated the development of a parent and child centre at the school. A disused canteen building was offered for use, but it needed a lot of work. The Salvation Army Ingle Farm Director of Community Services organised a team to remove joinery and other fixtures to make room in this facility. A team of cleaners then spent a day cleaning the floors and walls. Another team which included several school parents painted the ceiling and some wall panels. Repairs were made to the toilets supplying and fitting new cistern, seat etc. A fence was supplied and erected on the verandah and some equipment supplied inside. The C4C Project Officer commented on the enthusiasm generated among the parents. “I caught up with the group, and they were going over to the library to read, and then they were coming back to make cupcakes. As an outsider, it was exciting to see the passion from parents who want this for other parents and children, and they now have the freedom to do it. We can have ideas about how we think it will develop, but it will develop from the parents. They have been brainstorming, and are looking to open next term. Communities for Children will help them in any way that we can. It is really exciting.”

FamilyZone Para Hills opened on the 24 July 2007. School staff were beginning to get a vision of what parents could achieve. The Assistant Principal, a school champion of the concept, commented “It’s good to see how the parents already there make new people feel welcome. It was also good to see six dads’ there today. We have lots of expertise in this group of parents. It’s great to see”

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Four years on Four years on the centre is a hive of activity. A volunteer Coordinator has been appointed working alongside a staff person who has taken on the role of Community Liaison Officer. The coordinator has a degree in Early Childhood Teaching and has planned a colourful program incorporating exciting themes term by term like Water and the Environment, Transport, Seasons and Celebrations around the World. Programming is inclusive of all nationalities and religions. On Tuesday mornings a playgroup that caters for children to do craft and cooking activities. This group is run by 2 coordinators with help from the community to set up and clean after the session. Current attendance is on average 18 children. In 2011 regular visits to the school library for the children were introduced. The librarian reads the children stories in harmony with the Family Zone’s current theme, introducing the children to reading and showcasing her colourful books. They are setting up a borrowing system where parents can have access to books to take home to share with their children. Wednesday morning sees the facilitation of a group called Tumbling Tots. This is a program where children participate in occupational therapy activities for gross motor skill development and tuning up tummy muscles to benefit social and physical development. Tumbling Tots started as an interest group for parents who were looking for more physical activities for their children to do. Currently there is an average of 8 children attending regularly. During 2010 physiotherapy students from The University of South Australia came along to these sessions and worked with the children and parents at improving fine and gross motor skills. This group is run by parents, with the volunteer coordinator overseeing the session. On Thursday there is a music group called Move and Groove which involves children and parents singing familiar rhymes and songs and playing a variety of musical instruments. Current attendance is 10 children per week. This group is supported by a facilitator and parents are stepping up to take turns in running the sessions. A small fee is charged for each session with proceeds going to purchase and upgrade equipment and resources used. Each term a new theme is introduced so that all 3 sessions work in harmony.



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Family Zone children visit the on-site preschool once a term to familiarise themselves with routines, the structure and the setup in order to make their transition to school more harmonious and less stressful. During these visits children have a chance to engage in activities like listening to a story, playing on the interactive whiteboard, and visiting the pre-school playground. They are greeted by friendly trained staff, and get to experience the warm friendly atmosphere of our pre-school. The Community Liaison Officer is on hand to show parents around and parents and children are welcome to ask questions about the centre. The Salvation Army facilitated Early Childhood Leadership training primarily for volunteers involved in community early childhood initiatives in the Salisbury site in 2008, 2009 and 2010. By 2010 five volunteer parents from Para Hills were attending the 6 X 2 days per week training, adding much to the capacity of this community to better support families in the early years. One of the parents from Para Hills Family Zone who completed this course in 2010, is currently at TAFE studying child care, and continues to have positive input into the Family Zone. The FamilyZone Para Hills Parent Centre is an example of a low cost development that can be initiated with minimal support in the context of a Junior Primary School/Pre-school and subsequently developed as additional funding is made available.



CHAPTER ELEVEN SYSTEM SUSTAINABILITY

THE CHALLENGES OF BUILDING MULTI AGENCY AND TRANS-DISCIPLINARY TEAMS KARL BRETTIG

Many question whether agencies with differing philosophies, values and policies can continue to work together in an integrated way. What happens when you add to the mix conflicts between different disciplines and work practices? The 2007 Sure Start evaluation concluded that “Multiagency team work, including effective ways of sharing information, and clarity about the cost effectiveness of deploying specialist and generalist workers strategically, proved difficult to manage and operate.” (Anning, 2007, p1)

When we opted to co-locate multidisciplinary staff from four Non Government Organisations and a staff person from the City of Salisbury in a State Government run school we, at first, didn’t quite appreciate what we were attempting to do. Our committee comprised of early childhood stakeholders, parents and representation from NGO’s who were engaged in providing family support. They had spent a year meeting fortnightly to work through the issues and develop the vision of what we wanted to achieve together, as described in our vision statement and community strategic plan. However when we began to employ staff to implement the vision we soon realised that most of them had not been involved in this process and it was not long before significant conflicting ideas about what they were supposed to be doing began to develop. Our July 2007 half yearly report included the following observation: The project manager has participated in some 20 meetings with key line managers & staff to work through issues relating to the development of effective working relationships between staff of the 4 NGO's involved and performance management issues. (SC4C Report, July 2007, p2)

Building a common vision Essentially we were attempting to deal with conflict between staff operating from differing disciplinary perspectives and agency cultures.

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Staff had different line managers from different agencies and each had different expectations regarding, at this point, the unenviable role of the Hub site co-coordinator/manager. Of course the usual personality clashes were also involved and, for some, the challenge of potentially losing their professional identity acquired over years of working in a single agency context was proving to be daunting. The eventual resolution of these conflicts was to be found in building a common vision among staff of what we were attempting to do and an understanding of the differing disciplinary perspectives. For example social work, early childhood and adult education perspectives on working with children and families can be markedly different. Had it not been for all the preceding work embarked on by the stakeholder committee in developing the vision and, more importantly, building relationships, the vision of a child friendly community may well have collapsed at this hurdle. However relationships between managers of the organisations involved were strong enough to enable us to work through the issues and put strategies in place to develop a functional multiagency and disciplinary staff team at the hub. We initiated a series of meetings between line managers and staff, put in place regular staff and managers meetings, provided a series of workshops to crystallise a common vision of what we were aiming to do as well as an understanding of multi-disciplinary teamwork and initiated additional team building exercises. We came to understand that multi disciplinary staff can still remain ‘siloed’ in terms of service delivery even though they are co-located. A trans-disciplinary approach which freed staff to work across disciplines was needed. For example supported playgroup staff became involved in home visiting and home visiting staff become involved in supported playgroups. This was the most effective way to develop seamless transitions between services because relationships matter in integrated service delivery. A family friendly kitchen was also established at around this time which provided a space for much worthwhile debriefing to happen. More structured reflective practice ensued. An embryonic transdisciplinary approach emerged which included formal case conferencing, semi formal staff meeting information sharing and informal debriefing in common staff areas.



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Working collaboratively Margy Whalley had some timely wisdom to offer as we struggled with these challenges. “Staff in Children’s Centres are often from different professional heritages and will have had very different kinds of training. When they come together to work within the Children’s Centre they need to be able to hold on to the passions and beliefs that made them go into their particular discipline. However they also need to work collaboratively and listen to the views of other kinds of professionals working in other domains. Increasingly staff within Children’s centres may be integrated professionals who have had more than one kind of training (Whalley, 2007, p11)

Some staff found the challenges of multi agency and disciplinary work too difficult to adapt to while others thrived in the stimulating environment it created. Much has been learned in terms of more effective staff recruitment for these teams. In addition to suitable qualifications, experience and skillset, potential new staff need to have a willingness to embrace the challenges of trans-disciplinary and agency work and be committed to working in a team environment. A strong sense of vocation in terms of the desire to work holistically in an integrated manner with vulnerable families has also been found to be helpful (Scott, 2009). Work with vulnerable families can be emotionally demanding. Some support workers thrive in an environment where they are sharing the load with others and regularly debriefing together while for others burnout and OH&S issues ensue. The issue of appropriate information sharing is a major challenge which needs to be addressed constantly in these settings as integrated service workers work together to pioneer system change. The need for appropriate training for staff clearly exists and it is gratifying to see new training initiatives emerging. They are a key to ensure the long term sustainability of effective integrated approaches to service delivery. Simply putting staff from different agencies and disciplines together in one place will clearly not deliver seamless integrated services. Despite all the challenges experienced multi agency and trans disciplinary teams work. By February 2008 some 21 new services to support families in the early years had been introduced into the Salisbury C4C site and the number of support services for families continues to increase. The need to constantly address conflicts between agencies and disciplines remains, however encouraging outcomes for families continue



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to provide the incentives to continue working in this way. As one agency leader recently noted, “This would be the most committed and effective team we currently have”. Multi agency and trans-disciplinary models of service delivery require the development of excellent communication and information sharing processes if they are to be sustainable and effective. The emergence of professional training in integrated service delivery that equips staff with the kind of knowledge & skills needed for trans-disciplinary work through a mix of academic and ‘on the job’ training should significantly enhance effective integrated service provision.

References Anning, A. (2007). Understanding Variations in Effectiveness amongst Sure Start Local Programs: Lessons for Sure Start Children’s Centres. Sure Start Evidence & Research. Salisbury Communities for Children Report, July 2007. Scott, D. (2009). Values and Vocation: the essence of working with fragile families. Presented at the Australian Association of Maternal, Child and Family Health Nurses Conference in Adelaide on 4 April 2009. Whalley, M. (2007). Leadership in integrated Centres and Services for Children and Families – A Community Development Approach Engaging with the struggle. Pen Green Research Training and Development.



INFORMATION SHARING: A VITAL TOOL IN EARLY INTERVENTION DONNA MAYHEW

Access Economics’ November 2008 report, The Cost of Child Abuse In Australia, estimated the annual cost of child abuse and neglect in 2007 at $4 billion. The report conservatively places the value of related costs at a further $6.7 billion (Taylor, Moore, Pezzullo, Tucci, Goddard, & De Bortoli, 2008). The social and psychological costs of child abuse and neglect to individuals and communities are huge and those who pay most are the children and young people who have been abused or neglected. According to a major review conducted by the National Child Protection Clearinghouse (Richardson, 2005), child abuse is associated with low self-esteem, increased fear, mental illness, drug and alcohol abuse, self-harm, homelessness, suicide and many other physical and mental ailments. Even for resilient individuals, these events can have a significant negative impact on success in employment, educational attainment, relationships, parenting and capacity to participate in and contribute to society. Over the past decade the focus of child protection policy has moved away from punitive measures to an emphasis on early intervention, improved interagency collaboration and education strategies. The key to success is to intervene early, when children are beginning to experience difficulty, share the warning signs, collaborate and take action before the problems become entrenched. (Keeping Them Safe, 2004, p16)

Child protection reviews and reports, like the 2009 National Framework for Protecting Australia’s Children and the 2003 Layton Review Report, advocate early intervention, interagency collaboration and improved information sharing among agencies.

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Information Sharing Guidelines In October 2008 the South Australian State Cabinet endorsed the Information Sharing Guidelines for Promoting the Safety and Wellbeing of Children, Young People and their Families (Groves, 2008), a state wide framework setting out how information can be shared to enable early and more effective coordination of services and to prevent further harm. The first stage of implementing the Information Sharing Guidelines (ISG) began in mid 2009. Participating agencies report that: • The ISG supports and expands on existing good practice within organisations. • There is benefit in having one overarching framework that provides a consistent approach and explains simply and directly how and when to share information and for what purpose. • Acting to protect vulnerable children and young people frequently involves sharing information about the adults whose behaviour poses a risk to the safety and wellbeing of the children and young people they relate with. • Supporting vulnerable adults supports vulnerable children. We work from an early intervention and systemic framework anyway, so we always consider the safety and wellbeing of the whole family in what we do. The ISG reinforce that. This process makes staff feel more confident they are doing the right thing. —Group Manager, UnitingCare Wesley Adelaide

Every family that is successfully supported will save the costs to government of investigations, prosecutions, responding to homelessness and provision of state care, mental health facilities, drug and alcohol services and other services. We have some very strong interagency groups set up across the region and we are continuing to set these up in areas of need. The ISG, and particularly the flow chart, have been used as an induction tool for these groups. Information sharing for us has been significantly supported by the existence and promotion of the ISG. … if anything it’s legitimised the practice we have always had and has strengthened interagency collaboration by removing some of the aspects of uncertainty that seemed to exist across agencies in the past. —A Regional Manager Support Services, Department of Education and Children’s Services



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A Child and Family Health Service worker speaking about a positive intervention involving a young mother and her six day-old child escaping family violence summed up the value of the information sharing guidelines this way: … the ISG gave all of the workers involved in this case the extra tools and permission they needed to ‘join the dots’ and provide the multi-agency support this family really needed.

References Commonwealth of Australia (2009). Protecting Children is Everyone’s Business. National Framework for Protecting Australia’s Children 2009 – 2020. Government of South Australia (2004). Keeping Them Safe: the South Australian Government's child protection reform program. Groves, G. (2008). Information Sharing Guidelines for Promoting the Safety and Wellbeing of Children, Young People and their Families. Government of South Australia. Layton, R. (2003). Our Best Investment A state plan to advance the interests of children. Government of South Australia. Richardson, N. (2005). Social costs: The Effects of Child Maltreatment. National Child Protection Clearinghouse, AIFS, Resource Sheet no 9 Taylor, P., Moore, P., Pezzullo, L., Tucci, J., Goddard, C. & De Bortoli, L. (2008). The Cost of Child Abuse in Australia, Australian Childhood Foundation and Child Abuse Prevention Research Australia: Melbourne.



HEALTH AND SAFETY IN CHILD AND FAMILY SERVICES: TAKING CARE OF THOSE WHO TAKE CARE OF OTHERS KELVIN LEE

The Centre for Excellence in Child & Family Welfare is the Victorian Peak Body for Child, Youth & Family services currently representing over 95 member organisations. The Centre was funded by WorkSafe Victoria to undertake a 2.5 year project targeting the improvement of work environments and reduced rates of injury for organisations providing Out of Home Care and Family Services. Funded until June 2011, the project seeks to address the high incidence of injuries, the rising cost of claims that impact on staff recruitment and retention as well as improve WorkSafe’s engagement with the sector.

Key issues for the sector Child, Youth & Family Services are facing the challenge of workers struggling to respond to the increased number of clients and the complexity of their needs. There are greater numbers of children coming into care and the age of entry is getting lower. Research indicates that these increasing challenges impose multiple psychological and physical risks to health and safety, contributing to the high injury rates that impact on staff recruitment, service delivery, morale and retention. Some estimate that it cost three times more to replace a worker than what it takes to keep one on the job! (Victorian Council of Social Services, 2007). The bulk of the claims in the Child, Youth & Family sector arise from muscular stress due to improper lifting, poor ergonomics and occupational violence. While these are on the decline, stress claims have risen to almost three times the national average (Claims Data 04/05 – 07/08). With the average stress claim costing three times more in compensation and time

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off, it is, and will continue to be, a huge drain on the sector if left unchecked, reducing the resources available to cash-strapped CSOs to provide services to children and families. WorkCover insurance premium rates for the sector are 70% above the average rate across all Victorian industries (WorkSafe Victoria 2009/2010).

Key project findings to date Stakeholder input drives the work of the project, with a sector Advisory Group providing valuable strategic direction to the project, and regular sector consultations with care providers, unions, government and peak bodies adding depth to the project. In 2010 the project undertook a survey of workers, management as well as board members and volunteers across the child, youth and family services sector which provided valuable insight into the management and culture of health and safety in this sector (OHS Champion Project Jan 2011 - 2). While there is a general view that organisations adhere to the legal requirements and strive to provide the necessary formal OHS structures, the majority of the 479 respondents stated the following impediments to a safe work environment for staff and volunteer workers in particular: • A high risk of physical and psychological injury on the job • Attitudinal barriers to personal safety (stemming from a culture of altruism within the community sector) where: o Up to 1 in 5 staff placed the care of clients ahead of their own safety o 1 in 3 reported feeling that their employer puts the care of clients above worker health and safety. Left unchecked, this situation will inevitably contribute to the high turnover in the workforce and decrease the viability of the sector to continue undertaking these important tasks. The good news is that the survey results indicate that organisations can improve this situation by incorporating OHS issues formally into all operational and review processes with training, networking opportunities around OHS issues and additional investment.



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Upcoming priorities The Work Health Safety Act to be introduced in January 2012 has created additional impetus for this project to focus on health and safety, review business practices and make improvements. It has been an effective trigger to further increase awareness and education in the community sector. The large turnout at a recent statewide seminar organised by the project, demonstrated clearly that there is uncertainty and an appetite for knowledge and understanding in relation to the new legislation in the community services sector. Additional funding for this project would enable further sector up-skilling and training around this important new legislation as the details of the legislative changes become clearer. Harmonization of OHS legislation will provide further leverage from which to continue the momentum already achieved in the project.

Upskilling the workforce Recognising that worker safety is good for business, the project continues to emphasize that worker health and safety directly impacts the continuity and quality of care. The Centre’s information and resource exchange networks continue to engage the sector by promoting peer review and highlighting the best of sector practice in OHS. The sector’s focus on advancing professionalism should be as much about recognising boundaries as it is about delivering quality outcomes; workers should not be accepting risks and injuries that are unacceptable in other sectors. Additional training, support and resources are necessary to plug identified skill and knowledge gaps and develop a continuous quality improvement culture around OHS in the community sector. The success of the project’s engagement with the sector has witnessed an increased awareness and engagement in OHS by workers and OHS practitioners. A timely investment that capitalizes on the attention to the new legislation as well as the networks, resources and momentum created to address the abovementioned objectives will go a long way in promoting a cultural and operational shift for improved worker health and safety outcomes.



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References Victorian Council of Social Services (2007). Recruitment and retention in the Community Sector: A snapshot of current concerns, future trends and workforce strategies. Claims Data 04/05 – 07/08 WorkSafe Victoria Community Support Services. WorkSafe Victoria (2009/2010). WorkCover Premium Rates Victoria.



THE CHALLENGES OF THE EAST KIMBERLEY EXPERIENCE IN COLLABORATION AND SUSTAINABILITY JUAN LARRANAGA AND ANTHEA WHAN

The Communities for Children (CfC) initiative has one been one example of the Australian Government’s push to focus on Early Years programs as central to meeting its “Closing the Gap” commitments for indigenous health. There are numerous compelling issues around operating early years programs with a community development mindset in remote Australian settings. Save the Children’s (SCA’s) has taken up the challenge of building capacity within the East Kimberley (EK) community in North Western Australia by examining the opportunities and then discussing the challenges facing practitioners. Since 2005 SCA has experienced and learnt wisely from the complexities of attempting to develop and implement early learning programs in communities well entrenched in a welfare mentality while trying to differentiate sustainable development from charity. As a Child Rights Development organisation, SCA is driven to protect and uphold the rights of children everywhere, and is committed to implementing rights based programs. Subsequently, and fundamentally, this provides the platform for all programs across Australia, including the Early Childhood Development (ECD) program in the EK. SCA’s Early Childhood Development programs seek to create innovative responses for the optimal well-being of children aged 0-5 (and beyond). This is achieved by engaging families in the early development and education of children, and through support to families and the community to protect children.

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SCA’s ECD Program works uniquely with the most marginalised communities and seeks the input and involvement of children, their families and communities in the development and delivery of the program.

Focus of the initiative All programs focus on achieving outcomes in: • Improved parental capacity to support early childhood development. • Increased connectedness between families and communities. • Specific support to vulnerable families. CfC activities must also be grounded in evidence about what works best to support early childhood learning and development. As well as addressing the key action areas stipulated by the program, the CfC programs of the EK encompass these and a whole of community approach aiming to: • • • •

Improve parenting competence and style. Improve child cognitive development and competence. Improve child social/emotional development and competence. Increase child/family participation in mainstream services.

CfC uses a collaborative, strengths based approach to community development to building family and community capacity to improve outcomes for young children and their families. Similarly, like SCA’s ECD programs, CfC aims to develop and implement a strategic and sustainable whole of community approach to early childhood learning and development in consultation with local stakeholders and duty bearers. According to the primary principle of capacity building, the purpose is the long term goal of teaching people they have the capacity to solve problems by working together in a democratic, participatory process. Save the Children’s capacity building efforts focus on a combination of four major strategies: • Leadership development - essentially, with no identified leaders, SCA had to work with key EK community representatives to identify and equip a local community member with the skills, commitment and engagement knowledge, to be more be more effective with assisting to mobilise the community into action.



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• Organisational development - focused on the strengthening of existing community organisations by supporting governance systems, enabling them to do their work better or in some instances to take on new roles, this was the case in the Wyndham community. • Community organising targeted the existing associational aspects of EK community functioning and “piggy backing” on the key reasons that cause collective mobilisation of individual stakeholders for particular collective ends in the EK.

Inter- organisational collaboration Inter-organisational collaboration builds on the organisational infrastructure of the EK communities through the Early Years Network to strengthen or develop relationships and collaborative partnerships at an organisational level to ensure improved integration of services. Using this approach, Save the Children emphasises a strength based community capacity building approach and working in partnerships with key community organisations. With this focus in mind, the following steps were taken to begin the implementation of the CfC initiative by Save the Children, East Kimberley: • Initial community consultation. • Service mapping. • The formation of a Community Consultative Committee (CCC) for the purpose of decision making, prioritising and goal setting. • Development of a Community Strategic Plan. • Engagement of Community Partners for the delivery of programs that uphold the goals and the vision of the Communities for Children initiative. • Formation of the Yambaba Partnership with the Lingiari Foundation to provide cultural brokerage and guidance to Save the Children in our initial introduction and response to our organisation and objectives. The Partnership acted as gatekeeper and facilitated the speed of establishing the initiative and the development of credibility in the region. Save the Children learnt these lessons the hard way. Initially, the stringent criteria that formed part of the funding specifications enshrined the importance of community participation and consultation. But it did not necessarily take into account that formal institutional forums such as the proposed CCC may not have been the most appropriate mechanism for



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engaging representatives of the broader community. Subsequently, hiring and equipping the right community leader with knowledge of and respected in the EK community set SCA on the path to building quality and sustainable early learning development programs. A testimony to this experience and lessons learnt in community development can be observed by examining the case study of the Wyndham Early Learning Activities (WELA) centre. The Wyndham experience has witnessed the WELA program emerge out of an organization purely responsible for managing parks and gardens employment projects. The early days saw WELA staff work hard to build relationships with the local state school to secure a stable home, and health and community service providers to improve service access. In 2010 WELA incorporated with its own board, and were subsequently awarded $1.6 million to build their own facility as part of the Australian Government’s regional development package. To cap a big year, the Western Australian Government recognised the program during its annual Children’s Week awards as the Regional “Outstanding Children and Family Service”. As a result of the continued investment in supporting community partners within the EK communities, 2011 and beyond will see not only a new centre for Wyndham, and a refurbished facility for the Warmun Early Learning Centre, but also a Children and Family Centre for Kununurra being built. The journey that commenced in 2005 and the important lessons learned along the way are starting to leave solid footprints in best practice principles to follow for effective community development in remote and isolated communities.



DRIVING SYSTEM CHANGE TO SUPPORT VULNERABLE CHILDREN AND THEIR FAMILIES DIANA HETZEL, SHARYN WATTS AND ELIZABETH OWERS

The Child Death and Serious Injury Review Committee (CDSIRC) in South Australia reviews all deaths of children under 18 years to identify systemic change and prevent avoidable deaths in the future. CDSIRC makes and monitors the implementation of its recommendations by government. The Council for the Care of Children (CCC) promotes and advocates for the rights and interests of all children in South Australia, with a particular focus on Aboriginal children, those with a disability and those in the care or custody of the Minister. ‘Highly disadvantaged families’ have ‘a range of difficulties that block life opportunities and prevent them from participating fully in society.’ These families receive little support in their parenting roles from personal support networks or community-based support services. (Vinson, 2007, p1)

They often experience: • • • • • •

restricted life opportunities; lack of social support and parenting skills; poverty, social exclusion; family violence, abuse, neglect; physical and mental health issues; drug and alcohol problems. (Social Policy Research Centre, 2010)

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Impacts of disadvantage CDSIRC identifies the ABS SEIFA Index of Relative Socio-economic Disadvantage (IRSD) as a key marker for vulnerability in the deaths of children in SA. The death rates for children in South Australia are: • 2.7 deaths per 100 000 children in the State’s least disadvantaged areas; compared with • 4.3 per 100 000 children in the State’s most disadvantaged areas. Children who are vulnerable because of socioeconomic disadvantage, are at greater risk of dying. Aboriginal children have a much higher rate of death compared to non-Aboriginal children. The rate of death from SIDS and undetermined causes is five times higher for children living in the State’s most disadvantaged areas. Socioeconomic disadvantage is known to be associated with sudden and unexpected infant death (Spencer & Logan, 2004).

Effective intervention To be effective, programs must address: • the psychological and emotional needs of the parents; • the parental behaviours that influence maternal, fetal and infant development; and • the situational stressors (including lack of housing, safety, adequate income and social supports) that can harm pregnancy, birth and the early development of a child. Policy and services should aim for ‘better parenting’ rather than ‘good enough parenting’ through better engaging young, multiply disadvantaged families. For ‘better parenting’, we need: • sustainable, targeted programs within a framework of universal service provision across a range of life domains; • initiatives to reduce unplanned teenage pregnancy; • responsive antenatal and post-natal care, and early childhood services; • information about relationships provided at school;



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• early intervention and family support to prevent family violence, child abuse and neglect; • better support for children in out-of-home care; • awareness campaigns to stop corporal punishment; and • the promotion of child- and youth-friendly communities.

Principles for engaging young, highly disadvantaged families Principles for engaging young, highly disadvantaged families include: • Go to where the families are; • Promote and deliver services in a non-stigmatising and nonthreatening way: • Be persistent with outreach; • Employ empowering strategies and engage families in service design; • Develop and sustain relationships through practical support; • Waive requirements for formal referrals; • Build the capacity of local services and groups to meet families’ needs. (McDonald, 2010) • Focus on prevention and early intervention, invest early; • Target action to reduce inequalities in the outcomes for the most vulnerable children; • Introduce earlier assessment of a family’s needs during pregnancy and identify strategies to engage fathers; and • Experiment with policies and programs for children and families, rigorously evaluate them for effectiveness to enhance child wellbeing reallocate money from ineffective programs to effective ones. Professor Phillip Slee (2006, pv), observes that; ‘…in order to achieve improved outcomes for families at risk, a paradigm shift is required so that unequal outcomes for families and children are seen as social injustices, rather than as products of individual dysfunction or deficit.’

Dr Fraser Mustard (2008), a Thinker in Residence in South Australia, emphasised importance of nurturing relationships between the organisation/worker and child/family through:



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• warm, friendly settings; • a culture of caring within the organisation; • professional supervision of staff and support, including opportunities for debriefing for complex situations; • a high ratio of workers to families, to promote relationship building over long periods; and • accessible services for those with disabilities. Other important elements include: • establishing a relationship prior to the birth of a child; • building on a family’s strengths; • enhancing protective factors for children and families and build resilience; • encouraging positive parenting; • using a community development approach and be informed by families, and • providing long term intervention and support to improve parenting, child development and wellbeing and enhance parents’ life skills.

Recommendations for system change The Council makes the following recommendations for system change: • Careful selection of leaders of integrated services; • Streamlined and flexible funding and reporting process; • Service provision to enable families to develop thriving behaviours; • Link thriving families to those who need more support; • Consider redistribution of resources; • Actively seek high-need families not currently engaged with services; • Consider what would have to change to encourage families to seek support early; • Offer a range of supports for families; • Services may need to adopt different understandings of their role; • Be mindful of the unequal power relationship between service providers and families; • Respect the knowledge and experiences of people leading their everyday lives;



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• Provide both universal and targeted services which can adapt to individual differences.

References McDonald, M. (2010). Are disadvantaged families “hard to reach”? Engaging disadvantaged families in child and family services. AIFS Communities and Families Clearinghouse Australia Mustard, F. (2008). Early Childhood Development - The best start for all South Australians. S.A. Government Department of Education and Children’s Services. Slee, P. (2006). Families at Risk: The Effects of Chronic and Multiple Disadvantage. Adelaide: Shannon Research Press, pv. Social Policy Research Centre (2010). Brighter Futures Early Intervention Evaluation Interim Report. UNSW. Socio-economic Indexes For Areas (SEIFA) Australian Bureau of Statistics. Spencer, N., & Logan, S. (2004). Sudden unexpected death in infancy and socioeconomic status: a systematic review. J Epidemiol Community Health;58:366–373. doi: 10.1136/jech.2003.011551 Vinson, T. (2007). Dropping off the edge: The distribution of disadvantage in Australia. Melbourne: Jesuit Social Services.



CHAPTER TWELVE NAVIGATING FUTURE DIRECTIONS KARL BRETTIG

Katherine Hooper-Briar and Hal A. Lawson made the following observation in relation to the impact of a failure in professional collaboration and service integration: “Whether in our everyday observations or in research, we see that outcomes such as teen pregnancy, school drop-outs, mental health problems and poverty are related not separate. Yet our categorical approaches have assumed that they are separate. And because this assumption and others like it have been accepted, many of our systems have been flawed, despite the good intentions of the people working in them”. (Hooper-Briar & Lawson, 1994, p8)

In the past decade there has been significant movement toward the provision of integrated early childhood service delivery. Integrated practice models contribute to enhancing the ability of professionals to communicate across their respective systems. They may otherwise unintentionally undermine each other’s roles due to poor communication. In 2004 the then UK Prime Minister, Tony Blair, described child and family centres as the new frontier for the welfare state and education system. By 2005 many UK Sure Start Local Programs were establishing Children’s Centres reflecting the recommendations of the 2002 Interdepartmental Childcare Review. This review promoted the concept of providing integrated care and education, family support health services and childcare and crèche support. Programs offered at Sure Start Children’s Centres are varied depending on the strengths and needs of local communities. Local authorities have been given the responsibility for the delivery of Children’s Centres, including planning the location and development of centres to meet the needs of local communities, in consultation with parents, the private, voluntary and independent sectors.

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Does it work? As referenced in an earlier chapter in March 2008 the National Evaluation of Sure Start Research Team released the findings of its study of over 9,000 three year olds and their families in Sure Start Local Program (SSLP) areas who were initially studied when the children were 9 months of age (NESS, 2008). These were compared to similarly disadvantaged areas not having a SSLP. The findings indicated that 3-year old children in SSLP areas had better social development with higher levels of positive social behavior and independence/self-regulation than children in similar areas not having a SSLP (NESS, 2008). Further, the report stated that parents; “…showed less negative parenting while providing their children with a better home learning environment. The beneficial parenting effects appeared responsible for the higher level of social behavior in children in SSLP area. Families living in SSLP areas used more child & family related services than did families not in SSLP areas” (NESS, 2008, p. v).

The UK Select Committee for Children, Schools and Families (2010, p7) report puts it this way. “The Sure Start programme as a whole is one of the most innovative and ambitious Government initiatives of the past two decades… it has been solidly based on evidence that the early years are when the greatest difference can be made to a child’s life chances, in many areas it has successfully cut through the silos that so often bedevil public service delivery. Children’s Centres are a substantial investment with a sound rationale and it is vital that this investment is allowed to bear fruit over the long term”.

Co-location of services and the development of multi-agency teams have both been key strategies in promoting integration as part of the Sure Start initiative. “At the practice level integration was achieved by colocation of services, (all Sure Start Local Programs were given resources to build a local centre) multi agency teams and shared system.” (Valentine et al 2007, p8). Similarly the joint local, state and privately funded early childhood initiative, Toronto First Duty in Canada, has looked at co-location as a central service intervention platform. The Toronto First Duty initiative located early childhood and family support services in 5 elementary schools at its inception in 1999. The 2006 Phase 1 Summary Report concluded that;



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Integrated services do work well but we need to remember they are not without some major challenges to the status quo. “It meant that therapists who were comfortable with fifty minute office sessions might now have to do some of their work in schools and homes. It meant agencies opening their doors to parents to let them participate in meetings that heretofore had been the exclusive domain of the professional world. It meant proposals to blend funds among agencies and sharing data across agencies.” (De Carolis, 2005, intro p.19) System change does not come easily.

Communities for Children program logic The program logic developed for the Communities for Children initiative in Australia in 2004 identified short term, medium term and long term outcomes. It stated that more targeted ‘hard to reach’ families would become more engaged in the longer term as trust developed through service providers adopting a community capacity building approach to service delivery. LONG TERM (3-5 years +): Community outcomes start to emerge. Expectations are that child and family outcomes will start improving within the whole community (eg. a more trusting and safer community willing to participate in community activities), and that service delivery changes will be mainstreamed. Those people hardest to reach will be more engaged. (SFCS Program Logic, 2004, p5)

The Communities for Children initiative, as part of the Australian Government Family Support Program, provides prevention and early intervention programs to families with children up to 12 years, who are at risk of disadvantage and who remain disconnected from childhood services. It works towards ensuring that children have the best possible start in life by focusing on well-targeted early intervention approaches that bring about positive outcomes for young children and their families. A key platform is the development of collaborative, integrated childhood and family support services. Partnerships with service providers and families



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are built around responding to community needs as determined by ongoing consultation. Sites are governed by a stakeholder interagency committee which is given the task of developing a Community Strategic Plan. The plan is developed by a Facilitating Partner which is usually a non government organisation embedded in the local community. Local demographics are considered and evidence based practices reviewed. Development of the plan also involves a wide consultation with community service organisations, institutions, community groups and consumers. A Community Strategic Plan and Activity Work Plans with reference to the Communities for Children program logic are then compiled. Facilitating partners then subcontract other agencies as Community Partners to deliver activities outlined in the strategic plan. Various combinations of integrated services can be developed depending on the capacity of local communities. In South Australia state government Children’s Centres were initially based on the development of co-located childcare, preschool and junior primary schools. Similarly the North West Adelaide, Port Augusta and Salisbury Communities for Children initiatives developed child and family centres primarily based on adult focused services as well as developmental activities for young children. The Onkaparinga site took a different approach as several parent and child community initiatives were already present in the site. It’s focus was predominantly on supporting existing services and raising awareness of early childhood issues and support available among services and in the general community. The Murray Bridge site, which included several country towns, focused on collaborative learning and the development of community hubs built around existing services. The Salisbury site also developed a ‘continuous playgroup’ concept at the Salvation Army centre with reading music and movement activities as well as another smaller, predominantly parent driven centre in a local primary school. Communities for Children initiatives in South Australia found the program logic of the initiative to be a key to providing an effective blend of universal & targeted services. Targeted vulnerable families are more readily engaged in a setting that is non stigmatized and has developed a ‘word of mouth’ reputation for being ‘helpful’ and family friendly particularly if the setting is linked with home visiting initiatives. (AIFS, 2008)



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Where should child and family initiatives be located? Where should child & family initiatives be located? Dr Tim Moore from Melbourne’s Royal Children’s Hospital Centre for Community Child Health identifies characteristics of the population or problem that is to be addressed (Moore, 2010). These include disadvantaged and underserviced areas with many families with complex needs, and many children in poor home environments from a great diversity of family backgrounds and composition and with poor social supports. Locating child and family initiatives in primary schools adds the advantage of implementing a ‘no wrong door’ policy with the 6-12 age group as well as the 0-5, as this age group can be most readily engaged through primary schools. Child and Family Centres have the capacity to create a support and learning environment for both parents and children that includes input from a mix of professionals, para–professionals, trained volunteers and peers. This mix can be highly effective and efficient in engaging, supporting and facilitating better outcomes for large numbers of vulnerable families when it is well balanced and resourced. This direction in program design offers a significant way forward to more effectively supporting Australian families in the critical early years. In the Australian context this does however raise the perennial issue of commonwealth and state responsibilities as government schools are governed by the states. State governments however also decidedly lack the level of resourcing required to deliver what constitutes significant investment in the early years. In South Australia the State Government is developing a significant network of Children’s Centres however budget constraints limit the level of resourcing needed to deliver optimally effective services. Some guiding principles for service delivery in these centres include integrated and holistic support, early intervention, universal and inclusive service provision, relationship-based and family-centred practice and cultural sensitivity (Moore, 2010).

Developing self sustaining child and family communities It will take many years for the vision of child and family integrated support initiatives to be sustainably present in every community but there is significant potential to advance this agenda through building



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collaboratively on what is being done in existing state and federally funded initiatives and working towards the development of additional ones in partnership with other service providers. Ultimately we need to be looking at developing self sustaining communities rather than a plethora of agency support services, however child and family support centres represent a significant step in this direction. They employ professionals to be involved in the business of building community capacity through knowledge transfer and mentoring of caregivers who may then embark on a journey of lifelong learning and mentoring of other caregivers. The 2005-08 National Evaluation of the impact of the Australian Communities for Children initiative found that there were higher levels of vocabulary & verbal ability of children of mothers with year 10 education or less in groups exposed to Communities for Children initiatives (Muir et al., 2009). It also identified less hostile or harsh parenting, higher involvement in community service activities of mothers with year 10 education or less and increased parental perception of social cohesion in communities. Significantly, the evaluation also substantiated increased interagency working and cooperation and increased coordination between services. Co-location of interagency multidisciplinary staffing in hubs that facilitate a ‘no wrong door’ approach and are perceived as family friendly is a highly effective model of service delivery for families and children (McInnes & Diamond, 2011). Implementing this model does have significant challenges in terms of managing collaborations with multiple agencies and institutions and developing multi disciplinary teamwork, however it delivers very significant outcomes for families, if sufficiently resourced. The development of a child and family centre strategy of service delivery has the capacity to significantly change outcomes for children of families living in disadvantaged areas. An early childhood co-located and integrated service delivery model provides parents with the kind of positive partnerships and empowering support they need to function well in the critical early years of their children’s lives.



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Key themes for integrated service delivery The Communities Children Connections conference, convened by the Salisbury Communities for Children site, was held in Adelaide in November 2008 and again in 2010 under the theme of developing effective integrated place-based support for children and their families. More than 320 delegates attended the 2010 conference representing community services, education, health, commonwealth, state and local government and the non-government sector. Delegates holding practice, policy and research positions across the various family support sectors and disciplines attended from all states and territories of Australia. The closing session of the conference comprised a facilitated discussion with an expert panel and conference delegates. Through this process and prior input from practitioners, researchers and policy makers, key themes were identified. Emerging issues that have implications for effective policy and practice at the systemic level were listed as follows. In view of increasing evidence of the cost effectiveness and improved outcomes resulting from supporting vulnerable families and the significant gains made through the use of a community driven, collaborative and whole of community approaches, Children Communities Connections 2010 conference participants: • Acknowledge the significant gains that have resulted from developing and implementing the National Framework for Protecting Australia’s Children, the Early Years Learning Framework and a number of other related policy documents. • Ask that the Commonwealth and State governments work in ways that will support rather than inadvertently undermine effective implementation of emerging early childhood integrated models of service delivery. • In view of the National Compact which recognises the strength of the Third Sector, ask that government representatives work collaboratively and in a consultative manner with NGOs as partners. • Ask that prevention be kept high on the service delivery agenda, particularly in the early years with the best interests of the child at the centre and a community development focus as an imperative. • Note that in order to deliver significant outcomes, child and family centres and related holistic models of service delivery require significant levels of investment and resourcing to support multi-



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disciplinary practice, and staff recruitment and retention, including pay conditions, and workforce development. • Urge state and commonwealth governments to consider structural realignment that will better reflect and model respectful behaviours and principles of service delivery in relation to the need for integration of child, school and family services and implementation of sustainable and timely contractual funding arrangements. • Acknowledge and seek to add value to the role local government can play in creating capable communities through provision of services and the creation of spaces and places that facilitate community connections. • Recognise that the adoption of child-friendly policies can promote the active participation of children as young citizens within their communities, including within statutory structures such as the family court. • Consider the impact of competitive tendering on partnerships between competing organisations and pursue the development of alternative models. • Support the implementation of policies that prioritise children’s best interests and safety in cases involving domestic violence. • Support the adoption of father inclusive practice guidelines. • Support the improvement of culturally competent practice and ensure the voices of families and children are heard loud and clear. As we navigate a way forward into building supportive connections for children, their families and communities we need to consider the implications of each of these issues for policy and practice. 1. Significant gains have resulted from developing and implementing the National Framework for Protecting Australia’s Children, the Early Years Learning Framework and a number of other related policy documents. A number of useful policy documents and implementation frameworks advocating holistic integrated service delivery have been developed by both commonwealth and state governments and international organisations. The National Framework for Protecting Australia’s Children outlines comprehensive strategies for system change and better outcomes for children. The Early Years Learning Framework has a strong focus on best practice in child development initiatives. Related policy documents include the National Compact - Working Together which articulates the



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relationship between the government and the Third Sector and is part of the social inclusion agenda. These documents provide a sound platform for the challenge of developing place based integrated support services for families and children to proceed in a positive direction. 2. Commonwealth and State governments need to work in ways that will support rather than inadvertently undermine effective implementation of emerging early childhood integrated models of service delivery. In the Australian context this represents a hugely significant challenge in view of a long history of ‘arm wrestling’ over responsibilities. The development of COAG in recent times has been a significant attempt to alleviate this issue however there is, and probably will always be a lot of room for improvement. The biggest implementation challenges will be in terms of how genuine ‘partnerships’ can be maintained and ‘takeovers’ avoided. Fraser Mustard (2007) asked the question regarding who is in the best position to be the facilitating service provider to develop parent and child centres. Should it be state education as in South Australia or health as in the UK or local government or non-government community services as in the Communities for Children model? In the departmentalised model each department majors in what it sees as its core business and attempts to develop a more holistic approach can be easily thwarted by entrenched cultures within departments. Locally embedded non government community services agencies who at least theoretically adopt a more holistic community capacity building approach, may well be in the best position to facilitate the development of child and family communities. The CfC national evaluation (Muir et al, 2009) lends support to that view. 3. In view of the National Compact which recognises the strength of the Third Sector, ask that government representatives work collaboratively and in a consultative manner with NGOs as partners. The aftermath of the 2011 floods that inundated huge tracts of land in eastern Australia and Cyclone Yasi that subsequently followed, sufficiently demonstrated that it takes all sectors of the community to work together to effectively provide emergency support and rebuild broken lives and infrastructure. In a crisis the huge amount of resources needed becomes clear. However the need to work collaboratively and in a consultative manner often disappears below the radar in the humdrum of normal life where personal, political and territorial agendas begin to



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reassert themselves. The Working Together National Compact (2010) states that the Government “believes a strong, vibrant, independent and innovative Third Sector is essential to underpin a productive and inclusive Australia”. It acknowledges shared principles “based on mutual respect and trust”, “authentic consultation” and “genuine collaboration” (National Compact 2010, p.3). Recent years have seen some movement in this direction initiated by the commonwealth government and non government Organisations. State governments have moved to a degree with some new initiatives with NGOs now in place but impediments to genuine collaboration still remain. The issue of separation of powers between church and state remains a valid yet contentious issue, in terms of how it is applied, but it need not preclude authentic consultation which results in genuine collaboration for the benefit of vulnerable families. 4. Ask that prevention be kept high on the service delivery agenda, particularly in the early years with the best interests of the child at the centre and a community development focus as imperatives. Neuroscience is rapidly establishing what educators have long suspected regarding the importance of the early years in terms of the physical, intellectual, emotional, social and spiritual development of children. Political expediency is such that the current prominence of the early childhood agenda may easily disappear off the radar as more immediate pressing issues consume decision makers. We need to remember that the need for crisis intervention, with the enormous costs often associated with it, will only increase if we lose the focus on prevention. In the midst of significant social and economic problems, the voices of young children are rarely heard as immature adults clamour for attention to their perceived needs. The same can be said for the voices of marginalised vulnerable families and their advocates whose concerns can easily be brushed aside by their more ‘powerful’ counterparts. A genuine community development focus that builds services around evidence-based initiatives for which consumers are really looking, will ensure that finite resources are used effectively. 5. Note that in order to deliver significant outcomes, child and family centres and related holistic models of service delivery require significant levels of investment and resourcing to support multidisciplinary practice, and staff recruitment and retention, including pay and conditions and workforce development.



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Staff with the capacity to work effectively in multidisciplinary teams are not easily recruited and retained. Conflict is inevitable as activities are “refined, reassigned and distributed within changing organisations and teams” (Anning et al., 2010, p.12). A large percentage of attempts to establish such teams inevitably fail under the kind of pressures generated by this approach. The process of developing communities of practice (Wenger, 1998) such as these has clear benefits for families but has strong implications for both personal and professional identity and potential for conflict. Staff need to have a strong sense of vocation in order to stay the course and work through the challenges involved. Incentives such as pay and conditions for staff working effectively in child and family centres and delivering strong outcomes clearly help. Workforce development strategies such as are being delivered for the Communities for Children Plus sites and the initial roll out of CfC sites are integral to their effectiveness. The Australian Centre for Child Protection provides this service for the CfC Plus sites as did the Australian Research Alliance for Children and Youth provide training for CfC in its embryonic years. A key issue for governments is the reality that parent and child centres need adequate staffing resources to function well as they engage with increasing numbers of ‘hard to reach’ families partly because they are no longer ‘hard to reach’ services. For example for OH&S reasons alone at least two staff need to be present at all times as the nature of these services are such that challenging situations requiring skilled staff may arise at any time they are open. This has implications in the Australian context in terms of the need for a strong partnership between state and commonwealth governments that can sufficiently resource centres to deliver ultimately highly cost-effective prevention and early intervention. Child and family centres cannot be expected to deal with all the issues families are facing but they do offer arguably the most promising way forward in terms of effective family support services for the majority of vulnerable families. 6. Urge state and commonwealth governments to consider structural realignment that will better reflect and model respectful behaviours and principles of service delivery in relation to the need for integration of child, school and family services and implementation of sustainable and timely contractual funding arrangements. The 2010 realignment of Minister Garret’s portfolio into School Education, Early Childhood and Youth partially reflected the need for



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better integration of child, school and family services. The UK did implement a more expansive realignment through the formation of the Department for Children Schools and Families however this was abandoned by the incoming coalition in 2010. In developed countries there is an increasing recognition of the need to be holistic in service provision and some of the territorial behaviours that have been nurtured by departmental delineations have been highly detrimental to such service provision in the past. In Australia we face the added complication of having three levels of government involved in supporting children and their families. Federally funded new initiatives have rarely transitioned well into state funded universal child and family services, however recent movement in this direction has been encouraging. Promising initiatives need to be able to retain productive staff and infrastructure in order to continue deliver the kind of support that is effective for families. Clearly respectful behaviours and principles of service delivery are crucial in delivering services for families and the same can be said for the role of governments in terms of the manner in which contractual funding arrangements are made. 7. Acknowledge and seek to add value to the role local government can play in creating capable communities through provision of services and the creation of spaces and places that facilitate community connections. The role of local government varies considerably in different Australian states. In Victoria it has a key role in child and family service delivery while in South Australia it has a broader focus on influencing a child’s health, wellbeing and development outside of formal service delivery. Much can be done in terms of local government providing spaces and places within our communities where the community can informally meet, play and connect. Community capacity can be built through increasing parental awareness of child development issues and building leadership skills for the facilitation of early childhood initiatives within communities. As well as partnering in the development of child and family centres, local government can add value to the planning and implementation of service provision through building community connections, localised knowledge of programs, services, places and spaces and the use of community assets in partnership with other organisations.



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8. Recognise that the adoption of child-friendly policies can promote the active participation of children as young citizens within their communities, including within statutory structures such as the family court. The widespread introduction of child inclusive mediation and focus on parenting/children’s issues in Family Dispute Resolution procedures within family court referral agencies reflects a growing recognition of the importance of affirming the roles of children as young citizens within their communities. The adoption of child-friendly policies reinforces the belief in children that they are welcome to express their views on issues in dispute and that their views are important to the process of resolution. In the longer term they learn to avoid a victim mentality, recognise that they have some control over their own destiny and are better positioned to take up an active role as young citizens. 9. Consider the impact of competitive tendering on partnerships between competing organisations and pursue the development of alternative models. We need to unpack the dissonance that is brought about for NGO’s in having to gain funding through a competitive tendering process one day and then turn around and develop meaningful partnerships with the same organisations the next, while perhaps competing in another sector at the same time. Alternative models need to find ways to build on the existing strengths and performance of proven service providers who in turn are able to include and mentor smaller service providers as partners where appropriate. The Communities for Children approach has been an innovative step in this direction using the Facilitating Partner Model. There also needs to be more thought given to funding of initiatives that rely on building trust and need a significant period of time to deliver positive outcomes. 10. Support the implementation of policies that prioritise children’s best interests and safety in cases involving domestic violence. It is important to keep the best interests of children at the centre of all we do in terms of developing policy and this is no more important than in cases involving domestic violence. Neuroscience and other research into the effects of domestic violence on vulnerable young children is making it increasingly clear that they need to be protected from the seriously



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harmful effects of witnessing domestic violence. Perpetrators need to understand this well as do all parents and statutory authorities in making decisions about what is in the children’s best interests. 11. Support the adoption of father inclusive practice guidelines. Given the reality that parents who perpetrate domestic violence, often alcohol and drug induced, forfeit their right to care for their children, we yet need to understand that fathers have a much needed role in parenting their children and support the adoption of father inclusive practice guidelines. This is not a contradictory statement. Many men feel they no longer have a role as parents. Some of this is brought about by their own actions which need to change and some is the result of stigmatisation. Fathers need to engage with adult learning about their roles as much as mothers usually do. By far the greater proportion of parent education and support offerings are not geared towards the kind of educational and support experiences that engage men well. Some excellent work, such as the Fatherhood Engagement Project facilitated by South Australian Children’s Centres and the kind of approaches being developed by the Pen Green Children’s Centre in the UK, is being done in this regard though much more is needed. 12. Support the improvement of culturally competent practice and ensure the voices of families and children are heard loud and clear. There is currently a lot of good information available about child development and parenting but it is of little value if it is not being communicated in a language and culture that is well understood by those who need to receive it. The same can be said with regard to the voices of families and children who often lack the capacity to articulate their aspirations and needs in a way that is readily understood by professionals and policy makers. Effective communication is critical to the implementation of good policy and practice especially when working with the most vulnerable.

Concluding comments The implementation of integrated services does bring with it some significant challenges to organizations that have differing philosophies, policies, practices and values but as evaluation of what initiatives such as Communities for Children are achieving in terms of outcomes for families



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is documented, it is becoming clearer that the effort is well worth negotiating the challenges. In the same way as putting the interests of children first leads to a radical reorientation of parental priorities it also leads to a similar reorientation in the way services go about supporting families. A schools regional district director recently commented that one student had seen six different professionals in one day at school. That is precisely what a lack of integration is all about. We can only imagine what having six different parents would be like for children who are highly adept at playing just two of them off against each other. If children are to grow up into mature adults they need mature adults and service providers working effectively together. More importantly than simply avoiding duplication we need to provide the kind of integrated village environment that enables children to thrive. This implies that we need to take a whole of family, government and community approach to service provision defined by its ability to build community capacity. It’s about building integrated connections for children, their families and their communities.

References Anning, A., Cottrell, D., Frost, N., Green, J, & Robinson, M. (2010). Developing Multi-professional Teamwork for Integrated Children’s Services, Berkshire, Open University Press. Australian Institute of Family Studies. (2008). FamilyZone Ingle Farm Promising Practice Profile. Retrieved from http://www.aifs.gov.au/cafca/ppp/profiles/cfc_familyzone.html De Carolis, G.A. (2005). A View from the Balcony - Leadership Challenges in Systems of Care. Brown Books. Hooper-Briar, K., & Lawson, H.A. (1994). Serving Children, Youth & Families through Inter-professional Collaboration and Service Integration: A Framework for Action. Danforth Foundation & The Institute for Educational Renewal, Miami University. McInnes, E., & Diamond, A. (2011). Evaluation of a child and family centre: FamilyZone Ingle Farm Hub, Retrieved from http://www.salisburyc4c.org.au/resourcedownloads/FamilyZone_Ingle _Farm_Hub_2011_Evaluation.pdf Moore, T. (2010). CCCH Platforms Service Redevelopment Framework. Centre for Community Child Health, Royal Children’s Hospital. Muir, K., Katz, I., Purcal, C., Patulny, R., Flaxman, S., Abelló, D., Cortis, N., Thomson, C., Oprea, I., Wise, S., Edwards, B., Gray, M., & Hayes,



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A. (2009). National evaluation (2004–2008) of the Stronger Families and Communities Strategy 2004–200.9 Occasional Paper 24. Mustard, F. (2007). AW Jones Oration. transcript p12. Retrieved from http://www.unisa.edu.au/hawkecentre/events/2007events/ATIR_Musta rd.asp National Compact (2010). Working Together, Commonwealth of Australia. Retrieved from http://www.nationalcompact.gov.au p.3 NESS (2008). The Impact of Sure Start Local Programs on Three Year olds and Their Families. National Evaluation Summary Report, National Evaluation of Sure Start Research Team, March 2008. Retrieved from http://www.dcsf.gov.uk/everychildmatters/research/evaluations/nationa levaluation/NESS/nesspublications/ Select Committee for Children (2010). Schools and Families report on children’s centres. UK Parliament Fifth Report of Session 2009–10. Stronger Families and Communities Strategy Program Logic. Retrieved from http://www.fahcsia.gov.au/sa/families/pubs/SFCSevaluation/Document s/sfcs_%20evaluation_program.pdf Sure Start Children’s Centres Website. Retrieved from http://www.dcsf.gov.uk/everychildmatters/earlyyears/surestart/whatsur estartdoes/ Toronto First Duty (2006). Evidence-based Understanding of Integrated Foundations for Early Childhood, Toronto First Duty Phase 1 Summary Report, June 8, 2006., p5. Retrieved from http://www.toronto.ca/firstduty/TFD_Summary_Report_June06.pdf Valentine, K., Katz, I. & Griffiths, M. (2007). Early Childhood Services Models of Integration and Collaboration. SPRC, University of New South Wales. Paper prepared for ARACY, August 2007. Wenger, E. (1998). Communities of Practice. Cambridge: Cambridge University Press.



CONTRIBUTORS

Editors Karl Brettig is Manager of Salisbury Communities for Children, a community development initiative of the Australian Government which focuses on building support for young children, their families and communities. This initiative has been in operation since 2004 in 45 sites throughout Australia and the 2009 national evaluation demonstrated that it offers a promising model of supporting families through facilitating holistic, integrated service delivery. The Salisbury site is facilitated by the Salvation Army Ingle Farm and has been successful in developing a range of innovative child and family support initiatives including the FamilyZone Ingle Farm Hub. Karl has previously worked in various roles in child and adult education and community services across different sectors. Together with a team of child and family support stakeholders he convened the Children Communities Connections conference. It brought together practitioners, policy makers and researchers in Adelaide South Australia in 2008 and in 2010 to further develop effective policy and practice for integrated and holistic service delivery for children and their families. Margaret Sims is Professor of Early Childhood at the University of New England. Before her university life she was a community worker working with children and families in a variety of roles. She ran an inclusion program, supporting young children to attend regular early childhood settings and coordinated a pilot family support program based in an extremely disadvantaged school community. Her research interests focus around family support and community-based services for young children and families. She has an extensive publication record in this area including the text “Designing Family Support Programs”. The second edition of her infant and toddler text “Program Planning for infants and toddlers” has recently been published and a new text on social inclusion and the Early Years Learning Framework was also published in 2011. She is working with colleagues around Australia on developing a suite of postgraduate courses for those working in integrated early childhood services.

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Part One Jennifer Chaplyn is a consultant at Same Page Organisational Development Consultancy in Western Australia. She facilitates workshops related to planning the implementation of stronger partnerships, collaborations and integrated service delivery. Carolyn Curtis is the Director of Family by Family. A social worker by training, Carolyn worked for South Australia's child protection system for 10 years, most recently as the manager of Safe Babies. Safe Babies is a highly successful intensive home visiting program for families in crisis. She joined The Australian Centre for Social Innovation's Radical Redesign Team on secondment to develop new ways for families to thrive and fewer to come into contact with crisis services. Alexandra Diamond works in the field of Early Childhood in the School of Education at the University of South Australia. Alexandra has a strong interest in various areas of parenting and child rearing, including parenting and professional carer practices, child safety, attachment and development. Paul Madden is concurrently Executive Officer, Child & Family Welfare Association SA and Executive Director, Habitat for Humanity SA. He has served in senior executive and board roles in the community sector and has been involved in community development projects in marginalised communities in Australia, Asia and Africa. Dr Elspeth McInnes is a Senior Lecturer and Research Degree Coordinator in early childhood at the University of South Australia who is currently researching the effectiveness of integrated early childhood services. Her other research interests include social policy and social inequality, families and separation, gender and violence, child abuse and child protection and women in small business. She is a past president of the National Council of Single Mothers and their Children and convenor of Solomums Australia for family equity. Paul Prichard has a special interest in promoting the role of fathers and currently works with the Centre for Community Child Health leading the Learning and Development Strategy for the roll out of Child and Families Centres in Tasmania. He was previously the National Training and Development Manager of Good Beginnings Australia who provide a variety of preventative and early intervention parenting programs. Paul’s



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work focused on implementing innovative programs in universal services for parents of babies and young children and with children who are victims of severe abuse and neglect. Suzanne Purdon has been the Network Leader of the South East schools in the Launching into Learning program facilitating and supporting schools to provide high quality early years programs for their local community families. She is currently based at the Centre for Community Child Health in Victoria. Sarah Schulman is co-lead of the Radical Redesign Team at The Australian Centre for Social Innovation (TACSI). A Rhodes Scholar, she holds a doctorate in Social Policy from Oxford University, and a Masters in Education from Stanford University. She works with TACSI as part of InWithFor, an organisation she co-founded to blend social science, design, business, and community development methods to improving social problem-solving. Sarah Spiker is Executive Officer of Bright Futures Child Aid & Development Fund. She has been involved in the not-for-profit sector for over 10 years for Australian and International NGOs including World Vision, The Youth Affairs Council of South Australia, Mission International and Mission Australia. Sarah has a Masters degree in International and Community Development and has worked on community projects in East Africa, India and the Philippines. Chris Vanstone is co-lead of the Radical Redesign Team at The Australian Centre for Social Innovation (TACSI). He graduated from London's Central Saint Martin's as a product designer, and now applies design to solving tough social problems. He works with TACSI as part of InWithFor, an organisation he co-founded to blend design, social science, business, and community development methods to improving social problem-solving.



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Part Two Meggan Anderson is a qualified teacher and social worker and is the Children’s Education Officer for iKiDs. Heather Bean is a physiotherapist and coordinator in the Children and Families team at Murray Mallee Community Health Service in Murray Bridge South Australia. Dr Kobie Boshoff is a Lecturer in Occupational Therapy at the University of South Australia. She has had a broad range of clinical experience in paediatrics and employment for people with disabilities. Kaye Colmer has been the Executive Director of Gowrie SA since 1995. She is committed to building leadership throughout the staff team and to ensure that structures support staff participation and engagement. Rev. Bryce Clark is pastor of the Aboriginal Lutheran Fellowship of based at Ferryden Park in Adelaide. He has had thirty years involvement in the Aboriginal community of SA. Fiona Dale has worked with UCWPA since North West Adelaide’s Communities for Children since its inception. She has a background in Early Childhood and Social Sciences working for 30 years beside families to support positive outcomes for children and families Judy Delahunty manages Centacare’s Family Relationships Services at Salisbury in SA. She formerly managed two communities for children programs in Murray Bridge. Ted Evans is a Senior Policy Officer with the Community Connect Branch of the SA Department for Families and Communities. Dr. Diana Hetzel is Chair of the Council for the Care of Children SA, a member of the Child Death and Serious Injury Review Committee and Deputy Director of the Public Health Information Development Unit, University of Adelaide. Nell Kuilenberg is the Development & Research Manager – The Salvation Army, Tasmania. South East Tasmania Communities for Children.



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Juan Larranaga is Western Australia’s Program Manager for Save the Children, has a Master’s in Public Health and 19 years experience in health, of which eight years has been working with remote Northern Aboriginal and Torres Strait Islander health issues. Kelvin Lee, after starting with projects in Community Development and International Aid, has since extended his portfolio to include work with the Vocational Education and Training as well as Community Service sectors. Lisa Manning is a parent and School Services Officer at Para Hills Junior Primary School. Donna Mayhew is the Principal Advisor (Information Sharing), Office of the Guardian for Children and Young People. Andrea McGuffog is Manager of the SA Department of Education and Children’s Services Early Childhood Strategy. Prof Susan M. Moore is a Professor of Psychology at Swinburne University of Technology in Melbourne. She is author of several books mostly concerning issues of life-span development. Elizabeth Owers is the Principal Consultant for the Council for the Care of Children SA. Janet Pedler is the Professional Development Coordinator for Children’s Centres for Early Childhood Development and Parenting in South Australia. Aaron Phillips was the Fatherhood Worker at Inner North Community Health Services before recently taking up a new position as Community Development Worker at Hewett Children’s Centre in Gawler SA. Doreen A. Rosenthal is a Professorial Fellow at the University of Melbourne. She was formerly Director of the Key Centre for Women’s Health and the Australian Centre for Sex, Health and Society. Lynne Rutherford has been the Children’s Program Manager at the Gowrie Training campus in South Australia since May 2006, and has worked in early childhood since January 1990.



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Angela Spinney, Formerly Research Fellow, Housing and Community Research Unit, University of Tasmania, Dr Spinney is now based at the Institute of Social Research, Swinburne University of Technology. Trecia Spowart is a Registered Psychologist working as a family counselor in Relationships Australia (SA)’s iKiDs program. Alan Steven is the Director of Community Services at the Salvation Army Ingle Farm in South Australia which is the Facilitating Partner of Salisbury Communities for Children. Karen Stott was until recently the manager/site coordinator of FamilyZone Ingle Farm Hub in South Australia. Jane Swansson is the project assistant at Salisbury Communities for Children. Nayano Taylor-Neumann is the Manager of Lutheran Community Care, Murraylands SA. Frank Tesoriero is Associate Professor & Course Coordinator of Master of Health & International Development at Flinders University. His work includes Indigenous & refugee communities & disadvantaged urban communities in Adelaide and Murray Bridge. Kerry Tomaras is the Community Liaison Officer for the FamilyZone Para Hills Parent Centre. Cathie Vincent is employed by the City of Onkaparinga as a Community Development Officer based at Hackham West Community Centre. She has been involved in Community Centres for the past 13 years and has a passion for volunteer management and community engagement. Sharyn Watts is Executive Officer of the Child Death and Serious Injury Review Committee in SA. Anthea Whan is the Project Coordinator for the Communities for Children project with Save the Children in Kununurra, Western Australia.



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Michael White was until recently the Workforce Development Leader at the Australian Centre for Child Protection. He has been the CEO of the Victorian Community Services and Health Industry Training Board and the Centre for Excellence in Child and Family Welfare in Victoria.



INDEX OF CHAPTER SUB-HEADINGS PART ONE - FOUNDATIONS Chapter 1 What is neuroscience telling us about supporting families? Early intervention, 9 Environmental impact on brain development, 9 Nature v nurture, 11 Plasticity of the brain, 11 The attachment relationship, 14 Implications for integrated early childhood services, 15

Chapter 2 Family by Family co-designed & co-produced family support model Behavioral modeling, 26 Implementing evidence-based practice, 26 Complementing community development & professional services, 26 Finding & engaging families, 28 Training sharing families, 28 Linking-up families, 29 Supporting link-ups, 30 Measuring change, 31 Stuck families, 33 Families in and out of crisis, 33 Families moving on after crisis, 34 Families wanting more, 34 Families wanting to share, 34 Phases of development, 36 Limitations and opportunities, 39 Chapter 3 Role of community development in supporting families and children. The two worlds of community welfare service delivery, 43 Principles of community development, 45 Intercultural perspectives, 47 Self-help group structure, 47 Bangalore healthcare initiative, 49 Chapter 4 Child and Family Centres: How effective? Reasons for child and family services integration, 54 Evaluating integrated child and family services, 56

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FamilyZone Hub Evaluation, 59 Evaluation Data, 61 Reasons for Attending FamilyZone, 64 What mothers value, 65 Focus Group Data, 67 Referring Agency Survey Data, 68 Discussion and conclusions, 69

Chapter 5 Developing integrated child & family communities Modelling Partnership, 74 Why Change?, 75 Genuine Community Engagement, 76 Connecting the Community, 77 Enabling and Nurturing Local Leadership, 77 A common language, 78 What to change, 79 Establishing vision, 80 Identifying Outcomes, 81 What do children and families really need?, 81 What should it look like?, 82 Governance, 83 How to change, 84 Chapter 6 A vision for integrated early childhood service delivery Impacts of disadvantage, 87 Including those who are excluded, 89 Impact of integrated service delivery, 90 Effective integrated services, 91 Core skills and knowledge needed, 92 Implications for training and development, 95

PART TWO - PROMISING STRATEGIES Chapter 7 Supporting vulnerable children and their families Building bridges between and capacities within services, 102 The National Framework for Protecting Australia’s Children, 103 Beyond fragmentation and duplication, 103 The Building Bridges Building Capacity project, 104 Children who have witnessed domestic violence, 107 The Safe from the Start project, 108 Occupational Therapy in Children’s Centres, 113 The Family Work Project, 116



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Chapter 8 Developing social emotional & spiritual wellbeing in children Moving towards a father inclusive practice, 124 What do dads want from our service?, 125 The fatherhood engagement project, 129 Parental separation and kids, 133 Puppets, performance, narrative and drama, 133 Liaison with schools, 134 Modern grandmothering, 136 Young mums and dads parenting together, 140

Chapter 9 Community development approaches Families live in communities, 146 Power shapes policy and practice, 147 Communities for Children, 147 Processes important as outcomes, 148 Working together in a rural setting, 150 The collaborative learning project, 150 A community development approach, 151 Partnerships, 152 Practical benefits of faith communities, 154 Faith communities and resilience for Aboriginal families, 156 Support from the church community, 158 Adding to the strength of the local community, 159

Chapter 10 Emerging integrated child and family centre models SA Children’s Centres for Early Childhood Development and Parenting, 163 Governance, 164 Staffing, 164 Professional development, 166 An integrated service in action, 167 Front line professional practice and team work, 168 Distributed leadership, 168 Seaton Central, 172 Policy frameworks, 173 Key elements of integration, 174 Seamless transitioning through integrated service delivery, 176 Accommodating particular circumstances and needs, 178 The Para Hills Parent Centre, 181



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Chapter 11 System sustainability Building multi agency and trans-disciplinary teams, 186 Building a common vision, 186 Working collaboratively, 188 Information Sharing Guidelines, 191 Health & Safety in Child & Family Services, 193 Upskilling the workforce, 195 Collaboration and sustainability, 197 Inter- organisational collaboration, 199 Driving system change, 201 Effective intervention, 202 Principles for engaging young, highly disadvantaged families, 203 Recommendations for system change, 204

Chapter 12 Navigating future directions Integrated place based support for children and families, 206 Does it work?, 207 Communities for Children program logic, 208 Where should child and family initiatives be located? 210 Developing self sustaining child and family communities, 210 Key themes for integrated service delivery, 212 Concluding comments, 219