When lightning strikes twice: Perceptions of oncology social workers about working with families with two members in treatment.

OBJECTIVE: Families with a parent and child concurrently receiving cancer treatment are not common, but their needs are typically more complex than families with only one member in treatment. They have a heightened sense of loss, vulnerability, and mortality. The study purpose was to: (1) describe quality of life, social support, resiliency, and loss for these families; and (2) describe how healthcare teams can support these families. METHODS: This was a qualitative study with 20 oncology social workers who had worked with families with a parent and child concurrently receiving treatment for cancer within the past five years. The interview included questions about the emotional, social, financial, and other needs of these families, as well as their social support, quality of life, loss, and resiliency. RESULTS: Three themes emerged from the data: 1. Increased demands on the family with a concurrent cancer treatment, including emotional, financial, and logistical challenges for the ill parent and child and for the healthy parent and siblings; 2. Greater resilience and coping skills were experienced by some families; and 3. Implications for the healthcare team, including emotional distress in treating these families, challenges in treatment adherence, and providing the necessary support to these families. CONCLUSION: Supporting these families is challenging for social workers and other members of the healthcare team. Understanding the emotional, financial and logistical needs of these families, and coordinating their care across the adult and pediatric teams, will better support the patients, as well as the healthcare providers who work with them.

Birthfamilies as permanency resources for children in long-term foster care.

Provisions of the Adoption and Safe Families Act of 1997 mandated shorter time frames for making permanency decisions and facilitating adoption. Yet for many children, foster care continued to be a significant portion of their life experiences. This project explored the potential permanency option of birthfamilies and extended kin for children who languished in foster care while being free for adoption. Eighteen children achieved permanent placement with their birthfamilies. In addition, staff found that although many families could not provide permanent placements, they could offer appropriate relationships with the children. This project team recommends viewing family relationships as an integral component where placement is one option on a continuum that includes letters, phone calls, and visits.

The effects of sexual abuse as a child on the risk of mothers physically abusing their children: a path analysis using systems theory.

OBJECTIVE: The potential path from sexual abuse as a child to the current risk of physical abuse by mothers was assessed. Ontogenic variables including the experience of the parent's sexual abuse as a child and current depression or substance abuse were expected to have a greater impact on the risk of child abuse than microsystem and exosystem variables such as family functioning, domestic violence, income, community safety, and social support. METHOD: A path analysis using secondary data was conducted to examine these systemic impacts. The sample consisted of 265 women, the majority of whom were African-American with a high school education or GED. The majority of these women were employed, lower socio-economic status, and over 50% of the sample had never been married. RESULTS: Sexual abuse as a child was found to impact maternal depression. Maternal depression and locus of control impacted risk of physical abuse. These two variables accounted for 22% of the variance in the dependent variable. CONCLUSION: These findings indicate that it may not be the experience of sexual abuse itself that has an impact on a mother's risk of physical abuse, but rather whether she is able to resolve that trauma. Her locus of control appears to be important in this resolution. The majority of these women were low-income, urban African-American women; it may be important to focus on locus of control for this population.