Research and Evaluation in Child, Youth and Family Services

Volume 6 Cover Page + List of Editors

2024-06-17

Journal Front Pages

Volume 6 Table of Contents

2024-06-17

Journal Front Pages

Volume 6 Journal Aims & Preface

2024-06-17

Journal Front Pages

Volume 6 Editor's Note

Barbara Lee — 2024-06-17

Journal Front Pages

Examining Support Needs for Children, Youth & Caregivers in Kinship/Out-of-Care Arrangements

Grace Pegg — 2024-06-17

The purpose of this research project is to examine the necessary support[s] for kinship/out of care families. In a joint opportunity, the Ministry of Child and Family Development (MCFD) and Fairness for Children Raised by Relatives (F4CRR) partnered with the common goal of understanding what supports are necessary for kinship families. This research project delves into the challenges and support needs of kinship caregivers in British Columbia (BC), with a focus on understanding the specific resources and support systems required by kinship caregivers to effectively care for both the children/youth in their care, particularly those with complex trauma histories, as well as their own mental, physical health and overall well-being throughout their caregiving journey. Through qualitative research methods, specifically thematic analysis, the study revealed two main themes relating to the complex demands of caregiving and caregivers feeling alone. Kinship caregivers face significant challenges, including financial strain, lack of access to resources, and feelings of ostracization. Despite these challenges, kinship caregivers express a sense of reward and blessing in their caregiving role. Disparities between kinship and foster caregivers in terms of support and recognition is evident, highlighting the need for more support and access to resources for kinship caregivers. The study emphasizes the importance of culturally relevant support and training programs to address the diverse needs of kinship caregivers and the children/youth in their care. While the research provides valuable insights, limitations such as small sample size, using non-probability sampling methods, and the exclusion of youth in kinship care emphasized the need for further research. Overall, this research contributes to advancing the understanding of kinship care challenges and support needs, paving the way for more inclusive and effective support systems for kinship families living in BC.

At Home Program Medical Benefits

Tala Endacott — 2024-06-17

The At Home Program (AHP) Medical Benefits by the Ministry of Children and Family Development (MCFD) provides medical equipment to children and youth with support needs in British Columbia. However, there has been no formal evaluation of its effectiveness or the definitions of "basic" and "medically necessary" since its inception over 30 years ago. The number of children benefiting from AHP Medical Benefits has tripled in the past three decades. However, criticisms highlight inadequacies and outdated definitions, leading to inequities in accessing benefits. Studies show that children with medical complexity or neurodevelopmental disorders require more support, and caregivers often face burnout navigating the system. Three focus groups were conducted with healthcare providers and AHP Medical Benefits staff, revealing discrepancies in interpreting "basic" and "medically necessary" equipment. The adjudication process was critiqued for its length and lack of clarity, impacting access to benefits. In discussions, participants highlighted semantic hurdles, bureaucratic inefficiencies, and the need for clearer communication. Recommendations from focus group participants include clearer definitions, increased funding, and hiring healthcare professionals as AHP Medical Benefits staff. Frustration exists due to a lack of education and alignment between healthcare providers and AHP Medical Benefits staff. This research aimed to bridge this gap and improve policy alignment to better serve children and youth with complex needs. In conclusion, addressing the identified challenges and implementing the recommendations can lead to a more effective and equitable At Home Program Medical Benefits, ensuring better support for children, youth, and their families across British Columbia.

Beyond Compliance: Exploring Quality In-Person Private Visits with Children and Youth in Care

Eva Barker — 2024-06-17

This research was developed in response to child welfare audits published by the Ministry of Children and Family Development (MCFD) which found that Children and Youth in Care (CYiC) were not always seen by workers in accordance with policy guidelines. The study was grounded in Maslow’s Hierarchy of Needs to consider the function of worker visits with CYiC and how this contributes to their needs being met. A literature review was conducted to examine existing research on both quantity and quality of home visits with CYiC. This informed the following research questions, (1) What are the indicators of quality in-person private visits with children and youth in care that yield good outcomes? (2) What are the factors contributing to in-person private visits with children and youth in care not being completed as per policy requirements? (3) What can aid workers in the completion and documentation of in-person private visits? This explanatory and inductive research used a mixed-method approach collecting qualitative and quantitative data via an online survey. The eligibility criteria for participation included MCFD workers who currently hold guardianship responsibilities, which refers to workers who are accountable for children and youth in government care. The researchers conducted univariate and bivariate analysis to analyze the quantitative data which produced three key areas for examination - policy compliance, quality of visits, and documentation. The researchers also used codebook thematic analysis to analyze the qualitative data that resulted in the emergence of four themes including building connection, assessing well-being: ensuring safety, logistics, and building trust amidst trauma. The research found that although workers indicated they were completing visits with CYiC as per policy, they encountered significant barriers that challenged their ability to do so. The research also found that workers believed seeing CYiC once every 90 days was insufficient to assess safety or build meaningful relationships. Based on this research process, there are five encouraged considerations including (1) implementing flexibility in visit locations, (2) ensuring workers hold one job title, (3) integrating quality of visits into policy, (4) allocating funding for visits, and (5) streamlining documentation. To contribute further to this area of study, research should explore a child and youth centered lens, and examine this topic with Indigenous Child and Family Services (ICFS) Agencies. This research contributes knowledge to MCFD that may inform future revisions of Chapter 5: Child and Youth in Care Policy.

Clinicians' Experience, Success and Barriers in Applying Culturally Safe Practices at Intake and Initial Assessment in Ministry of Children and Family Development Child and Youth Mental Health Services in British Columbia: A Mixed Methods Design

Catherine Byler — 2024-06-17

This research study was conducted by three Master of Social Work student researchers from the University of British Columbia, partnering with the Ministry of Children and Family Development. As part of the Ministry of Children and Family Development’s commitments to the Calls to Action from the Truth and Reconciliation Commission, this research seeks to understand clinicians’ experience, success and barriers when applying cultural safety in the intake and initial assessment phase in Child and Youth Mental Health services in British Columbia. This study aims to understand whether the tools and approaches currently used during the intake and assessment process align with or support culturally safe practice and identify any opportunities for improvement. The literature review explores the concepts of cultural safety, humility and competence to include in practice approaches to address inequities experienced by Indigenous peoples and people from other minority cultures. The literature review also explored the demographics of children, youth and families in British Columbia accessing mental health services and the barriers experienced by marginalized populations including Indigenous, migrant, refugee and other minority population groups. Intake and initial assessment tools used by Child and Youth Mental Health clinicians including the Brief Child and Family Phone Interview Form and the Initial Child and Youth Mental Health Assessment Form are explored in the literature review. Utilizing a mixed methods design, the study collected data from two focus groups and a survey made available for Child and Youth Mental Health clinicians in British Columbia, Canada. The mixed methods design is a strength of the study; it allows the opportunity to interpret quantitative data collected from the survey in relation to the themes that came about from focus group qualitative data findings. In addition to this, quantitative data collected from the survey allowed a broader range of Child and Youth Mental Health clinicians across the province to participate in the research study. The study found that clinician participants are seeking to engage with cultural safety in their practice and have developed strategies to apply a culturally safe approach with the children, youth and families accessing mental health services; however, participants also identified a need for additional and more frequent or alternative cultural safety training opportunities regarding intake and initial assessment. Indigenous and refugee populations were particularly identified as population groups that may experience more barriers to accessing Child and Youth Mental Health services. Other barriers identified by participants in the study for population groups accessing Child and Youth Mental Health services may include a history of oppression, the impact of stigma and racism, the co-location of Child and Youth Mental Health services with child protection services, and flexibility of the system. Future research could consider the perspectives of service users to explore understanding their experiences. Policy considerations could include considering the impact of barriers and enabling flexibility in the system. Additional support Truth and Reconciliation Calls to Action, service capacity for outreach could be pathways to address barriers. Clinicians can also consider ways in which they can continue practicing cultural safety as a practice approach in the service delivery of Child and Youth Mental Health services with children, youth and families to decolonize and destigmatize experiences.