Child Abuse

The research demonstration project described below is called The Emergency Services Child Abuse Prevention Program (ESCAPP). It's based on an article by Blau & colleagues (1994). This program aims to support family functioning where parental substance use features. Case identification, home-based interventions and coordination of support services are the essential components.
Contents Key factors of the service Systemic model Assessment Model Project goals Case finding & initial contact Stabilisation services Health care Treatment focus and availability Promoting resilience Length of intervention References
Key factors of the service: Meet multiple needs of families Access to rapid, barrier-free services Outreach families involving children and youth aged from prenatal to age 18 Contractual and collaborative relationships between services to wrap supportive services around the family
Systemic model based on Bloom (1990): Six sides of a cube represent the relevant aspects of a client's situation while the interior of the cube represents the personal-social-physical 'space'. The six sides described are:
Strengths/Helps	Limitations/Hinders
Personal strengths Social supports Physical environmental resources	Personal limitations Social stresses Environmental pressures

The ESCAPP assessment and case planning model is based on these "pushes and pulls" of a family's individual, social and physical circumstances:

------------Components of Individual Functioning------------
INDIVIDUAL		INTERPERSONAL		ENVIRONMENTAL
Personal Strengths	Limitations	Supports	Stresses	Resources	Pressures
Augment	Reduce	Augment	Reduce	Augment	Reduce
ASSESS Cognitive functioning/ability Behavioural functioning (coping skills) Affective functioning (emotions & mood) Health Holistic resources/needs		ASSESS Social skills Primary supports (family, etc.) Secondary supports (formal, organisations)		ASSESS Access to resources Availability of resources Noxious stimuli (negative or unpleasant environmental factors) Living conditions
RESOURCES Public, technical schools Mental health agencies Hospitals Vocational training Self-help groups Private/public healthcare Youth service bureaus Drug/alcohol programs		RESOURCES Self-help groups Mental health agencies Social clubs Respite child care Family support centres Churches Home-based services Family servicing agencies		RESOURCES Municipal/state agencies Transportation services Shelters Consumer advocacy groups Youth service bureaus School-based services Police departments Local/state legislators
The project's goals revolved around: Identifying substance-abusing families Rapid stabilisation of the current situation Improve the likelihood of positive long-term functioning by linking families to ongoing supports and services. Case finding & initial contact Outreach to traditional referral sources to help identify substance abusing families and refer to the program. Agencies included health care providers, child care facilities, police, school, state protective services, emergency shelters and other social service providers. An advisory board was set up. Positive approaches. For example: Local hospital social workers identify women in hospital with newborns who may have drug-related issues. ESCAPP services liaison worker visits the woman in hospital and offers a basket of gifts, a photo of the mother and child, and information about available resources. Aim is to initiate a positive initial connection with support services. Buddy and self-help systems established: "Phone-A-Friend" program set up by the Child and Family Agency and local Women's Centre to provide mutual support between children and adolescents. Adolescent peer counselling/self-help established Stabilisation services After referral, two workers (one senior) meet in the home within 24 hours to begin to assess: The child's immediate need for safety The concrete emergency needs of the family The extent and impact of substance abuse on the abuser and the family The general physical, social, emotional and intellectual capacities of the family including communication patterns and skills, parenting abilities, the nature and quality of the relationships within the family, and the family's contacts with community systems and supports.
Health care: A registered nurse under the supervision of the agency's medical directors provides health assessment and ongoing medical support. Treatment focus and availability: Child-centred and family focused Directed at change of verbal and physical interaction patterns between members Help to seek substance use treatment services Sub-contracts developed to allow for rapid, barrier-free access to drug services Staff work with the community of services to develop other barrier-free services ESCAPP services provided in the home Respite care for children (infant to age 12) contracted 24 hour-a-day, 365 days-a-year access to ESCAPP staff via an electronic beeper network
Improving family / child long term functioning: promoting resilience Link with a range of services such as: Child and family focused mental health services Substance use treatment Legal advocacy Housing, energy and financial assistance, employment counselling and training, adult education, recreational programs and self-help support groups. Child care facilities Positive youth development activities Health care providers.
Length of intervention The program provides an initial four weeks of intensive intervention. Subsequently, an Emergency Service Liaison unit can provide booster services. The program is being reviewed to possibly provide less frequent intervention over a longer period of time. It is anticipated that most families will require longer overall treatment. However, the previously stated goals of this program are: Identification Stabilisation Linkage to support services
Blau GM, Whewell MC, Gullotta TP, Bloom M (1994) "The Prevention and Treatment of Child Abuse in Households of Substance Abusers: A Research Demonstration Progress Report" Child Welfare 73, N^o 1 January-February pp 83-94. Bloom, M (1990) Introduction to the Drama of Social Work Peacock Publishers, Illinios.