The least detrimental alternative : a systematic guide to case planning and decision making for children in care / Paul D. Steinhauer.

Includes bibliographical references and index.

Print version record.

When children are in distress or at risk in their homes, social service agencies may institute a number of measures. The most drastic entails removing such children from their homes and placing them in foster care. But placement often fails. Many children, some with severe and long-standing psychological, social, and educational handicaps, simply leave one unstable environment for another. In many cases, things just get worse. Paul Steinhauer, a child psychiatrist at Toronto's Hospital for Sick Children, argues that foster placement has suffered from a lack of proven or generally acceptable models of intervention. It has further been impeded by decreases in the funding of social services and by ambivalence, on the part of both society and the mental health professions, towards the child welfare system. These factors have combined to produce a high failure rate, decreasing morale, and widespread disillusionment and burn-out in both foster parents and child welfare workers. In this book Steinhauer brings together the fragmented research that has been done in a number of different disciplines. From this body of work he develops a model of intervention based on an understanding of attachment theory, development theory, and the practice of mental health consultation. The model provides a basis for pragmatic decision making and step-by-step guidelines for implementation of many of its components. Steinhauer provides an important tool in the struggle to protect society's most vulnerable population.

Contents -- Foreword -- Preface -- Acknowledgments -- PART ONE: The Historical Context of Foster Care and Adoption -- 1 The History of Adoption and Foster Care -- PART TWO: Background Issues -- 2 Issues of Attachment and Separation: Mourning and Loss in Children -- 3 The Child Who Could Not Mourn -- 4 Identity Formation and the Influence of Life History and Special Status of the Foster and Adopted Child -- 5 Assessing for Parenting Capacity -- PART THREE: Client-Related Issues -- 6 Guidelines for Removal and Placement of Children

7 Guidelines for the Clinical Management of the Sequelae of Separation8 Sharing a Child between Natural and Foster Parents -- 9 Visits of Foster Children with Their Natural Families -- PART FOUR: System-Related Issues -- 10 The Foster Care Service System -- 11 The Family Court System and the Quality of Foster Care -- 12 'Permanency Planning' -- 13 Potential Contributions of Mental Health Consultants within the Child Welfare System -- 14 The Role of Psychotherapy and Residential Treatment within the Child Welfare System -- 15 Four Innovative Models of Foster Care

PART FIVE: Issues Related to Sexual Abuse within the Foster Care System16 Developmental, Clinical, and Legal Implications of Children's Testimony -- PART SIX: Adoption as an Alternative to Long-Term Foster Care -- 17 Factors Related to Success or Failure in Adoption [with Margaret Snowden] -- 18 Placing the Older Child on Adoption [with Margaret Snowden] -- PART SEVEN: Summary and Review -- 19 Summary and Review: The Preventive Use of Foster Care -- References -- Index -- A -- B -- C -- D -- F -- G -- H -- I -- K -- L -- M -- N -- P -- R

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