Definition, essential elements, practice strategies, intergenerational disadvantage, alcohol, drugs, mental illness, family and domestic violence.
Social work with families impacted by intergenerational disadvantage, alcohol and other drug use, mental illness, and family and domestic violence
What is structural social work?
Structural social work links individual “problems” to broader societal injustices. It views social inequalities, rather than individual deficiencies as the root of people’s problems. The twofold goal of structural social work is to address people’s problems by examining the social order that surrounds them while simultaneously working to transform society through social reforms and fundamental social change. Social workers operating from a structural perspective foster an open, supportive and egalitarian relationship with people by recognising and honouring the person’s expertise in their personal situation (George & Marlow, 2005).
Developing respectful and honest relationships with families is key to this structural and strengths-based practice approach. Understanding the challenges parents have faced, the strategies they use to overcome these challenges, and their hopes for their children is critical. At the same time, an honest relationship allows for a genuine understanding of the effects of adult adversity on children. This understanding is key to the safety and wellbeing of children who are living with complex and intersecting issues such as disadvantage, parental substance use, mental illness, trauma and violence (Wendt, Rowley, Seymour, Bastian, & Moss, 2023).
Structural Social Work Practice and Intergenerational Disadvantage
Intergenerational disadvantage is commonly defined as socioeconomic disadvantage which reflects not only people’s lack of economic resources, but also their social exclusion and limitations on their aspirations and political voice. Disadvantage can persist within communities across generations when there is a lack of socioeconomic opportunities for vulnerable people and their families.
Factors that may contribute to intergenerational disadvantage include:
Education
Socioeconomic background
Family size and culture
Ethnicity
Cultural background
Language spoken at home
Poverty, trauma, abuse and neglect, and mental health difficulties play out within and across generations, yet are often responded to as short-term, individual and isolated challenges.
Practice strategies for families experiencing intergenerational disadvantage
Acknowledge that structural issues, not the person, are at the root of problems. This gives a different sense of the situation. It shifts the social worker from being the expert with solutions to a person who shares and reflects with the person, ideally concentrating on the person’s strengths.
It is important to develop the human connection. Be upfront. Be honest, respectful, not over-promising, just telling the person what the practitioner’s role is, what she or he can and can’t do
Acknowledge that the actual attendance of parents at a session and willingness to have a conversation is an act of resilience.
Notice the things the person has done, the attempts to do things differently while acknowledging that times can be challenging.
Stress that the person is not alone in their experiences and there are elements of the situation that are bigger than them. Identify these structural conditions that enable and maintain the position the person is in.
Where relevant, tap into the children’s experiences—ask what children are experiencing, and ask the parent what she or he thinks the children are experiencing (Wendt, Rowley, Seymour, Bastian, & Moss, 2023).
Structural Social Work Practice With Parents Who Use Alcohol and Other Drugs
A structural approach to addressing issues with alcohol and other drug use holds two clear aims. Firstly, there are many co-existing reasons why people use substances, and they need to be supported to recover through nuanced and non- stigmatising practice. Secondly, the safety and wellbeing of children living with people experiencing substance use issues can be negatively impacted in the short and long term.
It is common for children of parents who use substances to experience emotional and mental health issues including depression, anxiety disorders, obsessive compulsive disorder and attachment-related issues. Children may also experience difficulties with trust and forming relationships and may struggle with the impacts of stigma. They may develop difficult behaviours, underachieve academically, use alcohol and other drugs themselves, and become prematurely sexually active.
Children who are unable to live with their parents due to parental substance use issues may be cared for by other family members, including grandparents, or within private fostering arrangements. Emotional support from extended family members, teachers and other adults can be pivotal in supporting children to thrive in this context.
Practice strategies for working with parents who use alcohol or other drugs
Seek to involve and partner with parents and their children (if appropriate).
The balance between acknowledging the multiple traumas that many parents have or may continue to experience, while not minimising the effects of unsafe parenting on children, remains one of the most challenging aspects.
Over time it is important to establish trust so the hard conversations can be had with the parents. Be open to their story, be honest, be yourself, show empathy. Take the time to build a connection. From this foundation, difficult conversations around the impact of AOD use, especially on children safety, can be had. Helping parents achieve their goals for their children is a way of approaching this, rather than having to impose something on the parents and children. You have the conversation out of respect for the parents. Understand the parents are struggling.
It is important to treat the individual/s with substance use issues in the context of their family. Failure to do so both ignores the impacts on the family and their own need for support and overlooks the potential role of the family in enabling meaningful change.
Conduct sensitive, non-judgemental and hopeful conversations about parents’ strengths and hopes for their children’s future.
It is important that parents can tell their stories in ways that highlight the strategies they have used to keep their children safe, or to nurture wellbeing despite their substance use. While these stories are important in reducing stigma for parents, practitioners need to be clear about the non-negotiable safety needs of children. A strengths-based approach with parents should not involve a minimisation of those behaviours which are placing their child’s safety or wellbeing at risk.
Have a conversation with each family member to understand the impacts of AOD use. Assess the impact of parental substance use on children’s health, education and social lives.
Preface conversations with “I know this is going to be uncomfortable for you and for me, but let’s have this conversation.” Eventually, practitioners may have to state that “Because of the way you are acting, your child cannot be safe.” Practitioners have to be brave about making those calls, and not having their relationship with the parent get in the way of hard decisions around the welfare of the child (Wendt, Rowley, Seymour, Bastian, & Moss, 2023).
Structural Social Work Practice With Parents Affected by Mental Illness
It is estimated that up to 1 in 5 young people live in families with a parent who has a mental illness. Children living with parental mental illness are more likely to experience trauma, emotional and/or behavioural difficulties; be removed from the family home and taken into care; and develop their own mental health difficulties and/or substance use issues. A retrospective study conducted in 2014, however, highlighted that young people living with parent/s with mental illness also develop significant strengths including resourcefulness, confidence and maturity. It is not uncommon to only realise a parent has a mental illness when child protection concerns are raised.
With a focus on building the strengths of each family member, social workers seek to engage, empower and partner with families by connecting them with comprehensive, culturally relevant, community-based networks of supports and services.
Practice strategies for supporting parents affected by mental illness
Invariably, parents have found ways to manage their mental illness that provide opportunities to develop strong relationships with their children. Taking the time to inquire about parenting histories, stories of success and strategies that work helps to position the parent as capable and caring, rather than a problem that needs to be fixed.
The aim is to bring to the forefront the impact mental health may be having on someone’s life and the lives of those around them at that moment.
Social workers should adopt a position of curiosity to develop a picture of the ways in which the parent’s mental illness might be affecting their children. Curiosity promotes a collaborative approach and encourages and supports a parent’s autonomy and can lead to an open discussion about parenting, their children and family.
Adopt a family-focused approach to gain a full picture of how the family functions. Working solely with the parent as an individual fails to recognise their continuing parenting roles and responsibilities, as well as their own concerns about their children’s needs (Wendt, Rowley, Seymour, Bastian, & Moss, 2023).
Structural Social Work Practice With Families Affected By Violence
Witnessing and experiencing family and domestic violence has profound effects on adults, children and young people. However, FDV services are more likely to focus on the needs of parents than the immediate needs of children.
A child-focused approach to family and domestic violence planning
Planning for children and families affected by violence should be grounded in a holistic and systematic assessment of children’s safety and needs. A holistic assessment evaluates a child’s:
needs
unique stage of development
familial context and circumstances
culture and identity
risk and trauma response; and
relationship to the perpetrator
Establishing a relationship of trust is critical for working with children and families in ways that facilitate the development of meaningful plans.
The focus needs to shift, so the child is part of the situation and is being impacted like the women. Children have a right to be involved in the decisions that affect them. They should therefore be given opportunities to contribute to their own assessments in ways that are both appropriate to their developmental capacity and that respect their cultural, spiritual, gender and sexual identity. Children should be provided the time and space to communicate when they feel ready, in a way that suits them; and may require support to ensure that their voices are heard and taken seriously.
Children’s needs are best met by whole-of-system responses involving universal, specialist and tertiary services as required.
Services responding to FDV must always be conscious of the risk presented by perpetrators. It is important to monitor changing circumstances, along with any behaviours that might indicate a heightened risk of harm and lethality.
Social workers must guard against taking away or minimising a woman’s agency. Social workers need to shift the conversations from ‘he’s strong and you’re weak’ to recognising women’s agency in those situation. Social workers need to be compassionate and understanding and sensitive around what women are living with (Wendt, Rowley, Seymour, Bastian, & Moss, 2023).
References
(copies available on request)
George, P., & Marlowe, S. (2005). Structural social work in action. Journal of Progressive Human services, 16(1), 5-24. doi:10.1300/J059v16n01_02
Wendt, S., Rowley, G., Seymour, K., Bastian., & Moss, D. (2023). Child-focused practice competencies: Structural approaches to complex problems. Emerging Minds Practice Paper. https://emergingminds.com.au/resources/child-focused-practice-competencies-structural-approaches-to-complex-problems/?audience=practitioner