Psychosocial safety and security for children following maltreatment: Study 1. Factors associated with placement stability for children in out-of-home-care : Study 2. Multi-systemic and psychosocial safety (MAPS): inter-rater reliability & clinical utility of a clinician-rating tool for therapeutic child protection intervention services
thesisposted on 2022-03-28, 21:14 authored by Mia Markovic
This thesis presents a literature review, two clinically oriented empirical studies and an integrative discussion. The studies focus on factors involved in placement stability and psychosocial safety of children within the child protection system. In Study 1, thirty-nine foster and kinship carers were surveyed to explore factors associated with carer concerns about placement breakdown and caregiver satisfaction. Standardised questionnaires assessed demographic and support factors and the contributions of child behaviour and emotional functioning, carer parenting style, empathy and attachment style. The small sample size of this study limits interpretation and generalizability of results. However, the findings indicate that concerns about placement breakdown were uniquely associated with carer age and that caregiver satisfaction was associated with level of partner support and the number of previous placements the child had experienced. Caregiver comments were also analysed thematically, and these showed that a poor carer-agency working alliance impacted on carer’s views on their ability to maintain placements, their sense of support and overall satisfaction. The second study first reports on the development, and then the face validity, clinical utility and inter-rater reliability of a clinician-rating tool developed by the researcher. The Multi-Systemic Assessment of Psychosocial Safety (MAPS) was developed to assist clinicians to assess the ongoing psychosocial safety of children (aged 6-16 years). Consultation was undertaken with specialist child protection counselling teams. Additionally, nine specialist child protection counsellors, across three area health districts, participated in an inter-rater reliability study of the tool using clinical vignettes, and provided additional written feedback on the face validity and clinical utility of the tool. Moderate to very good inter-rater reliability for risk ratings on the tool was obtained for two vignettes. Poor inter-rater reliability was evidenced for a third, more complex vignette. Participants reported that the MAPS was relatively easy to use, clinically useful in identifying risks and protective factors in child and family contexts, and in identifying therapeutic intervention objectives.