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Emergency Services Child Abuse Prevention Program

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

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Key factors of the service:
  1. Meet multiple needs of families
  2. Access to rapid, barrier-free services
  3. Outreach families involving children and youth aged from prenatal to age 18
  4. 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

  1. Personal strengths
  2. Social supports
  3. Physical environmental resources
  1. Personal limitations
  2. Social stresses
  3. 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:

Click to go to Top of PageAssessment ModelClick to go to Top of Page

------------Components of Individual Functioning------------

INDIVIDUAL

INTERPERSONAL

ENVIRONMENTAL

Personal Strengths

Limitations

Supports

Stresses

Resources

Pressures

Augment

Reduce

Augment

Reduce

Augment

Reduce

ASSESS

  1. Cognitive functioning/ability
  2. Behavioural functioning (coping skills)
  3. Affective functioning (emotions & mood)
  4. Health
  5. Holistic resources/needs

ASSESS

  1. Social skills
  2. Primary supports (family, etc.)
  3. Secondary supports (formal, organisations)

ASSESS

  1. Access to resources
  2. Availability of resources
  3. Noxious stimuli (negative or unpleasant environmental factors)
  4. Living conditions

RESOURCES

  1. Public, technical schools
  2. Mental health agencies
  3. Hospitals
  4. Vocational training
  5. Self-help groups
  6. Private/public healthcare
  7. Youth service bureaus
  8. Drug/alcohol programs

RESOURCES

  1. Self-help groups
  2. Mental health agencies
  3. Social clubs
  4. Respite child care
  5. Family support centres
  6. Churches
  7. Home-based services
  8. Family servicing agencies

RESOURCES

  1. Municipal/state agencies
  2. Transportation services
  3. Shelters
  4. Consumer advocacy groups
  5. Youth service bureaus
  6. School-based services
  7. Police departments
  8. Local/state legislators

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The project's goals revolved around:

  1. Identifying substance-abusing families
  2. Rapid stabilisation of the current situation
  3. Improve the likelihood of positive long-term functioning by linking families to ongoing supports and services.

Case finding & initial contact

  1. 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.
  2. An advisory board was set up.
  3. Positive approaches. For example:
    bullet Local hospital social workers identify women in hospital with newborns who may have drug-related issues.
    bullet 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.
    bullet Aim is to initiate a positive initial connection with support services.
  4. Buddy and self-help systems established:
    bullet "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.
    bullet 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:

  1. The child's immediate need for safety
  2. The concrete emergency needs of the family
  3. The extent and impact of substance abuse on the abuser and the family
  4. 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.

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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:

  1. Child-centred and family focused
  2. Directed at change of verbal and physical interaction patterns between members
  3. Help to seek substance use treatment services
  4. Sub-contracts developed to allow for rapid, barrier-free access to drug services
  5. Staff work with the community of services to develop other barrier-free services
  6. ESCAPP services provided in the home
  7. Respite care for children (infant to age 12) contracted
  8. 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:

  1. Child and family focused mental health services
  2. Substance use treatment
  3. Legal advocacy
  4. Housing, energy and financial assistance, employment counselling and training, adult education, recreational programs and self-help support groups.
  5. Child care facilities
  6. Positive youth development activities
  7. Health care providers.
Length of intervention
  1. The program provides an initial four weeks of intensive intervention. Subsequently, an Emergency Service Liaison unit can provide booster services.
  2. The program is being reviewed to possibly provide less frequent intervention over a longer period of time.
  3. It is anticipated that most families will require longer overall treatment. However, the previously stated goals of this program are:
    bullet Identification
    bullet Stabilisation
    bullet 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, No 1 January-February pp 83-94.

Bloom, M (1990) Introduction to the Drama of Social Work Peacock Publishers, Illinios.

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Introduction ] Assessment Interview ] Assessment Tool ] Case Plan ] Screening ] On-Line Screening ] AUDIT ] CAGE Alcohol Screen ] GROW ] Community Assessment ] Community Plan ] [ Psycho-Social Assessment ]

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