Does Household Income Affect children’s Outcomes? A Systematic Review of the Evidence

By: Cooper, K., Stewart, K.

Child Ind Res (2020)

Review written by: David Westlake

What question does this study focus on? 

It is well known that children resident in lower income households fare worse on a wide range of outcomes, and several interventions have tried to address this. However, we don’t know how far this can be explained just by lack of money, or whether associated disadvantages such as lower social and cultural capital, or stress caused by financial difficulties, are more explanatory. This distinction is important because, as the authors point out, policymakers might be able to change family income relatively easily by adjusting tax and benefits or by other means. If money is itself a key factor, then this should have a positive impact. 

How did they study it?

In this paper the researchers systematically reviewed studies that might be expected to provide causal insights. This meant they included experimental and quasi-experimental studies, such as Randomised Controlled Trials (RCTs), and some other types of quantitative research. Reviewing a large cache of research is a good approach to unpicking some of the complexity, and the study had a wide timeframe going back to 1988. The main child outcomes of interest were cognitive development and school achievement; social, behavioural and emotional development; and physical health. Fifty-four studies made it through the selection process to be included in the review.

What did they find?

The review concluded that income itself is a causal factor in child outcomes, and not just something that is correlated with other types of disadvantage. This effect was seen in the majority of studies included, and the evidence was strongest in relation to cognitive and educational development, but also positively predictive of social, behavioural and emotional indicators. There was a more mixed picture in relation to child health outcomes. Interestingly, the study also identified some potential mediating factors, including “Consistently significant positive effects [linking income and] maternal mental health, parenting and the home environment”. This leads the authors to conclude that there is support for both the idea that money helps families buy things that promote child welfare (e.g. healthy food, learning materials), and the theory that reduced financial stress for parents creates better emotional environments for children. Referred to in the literature as the ‘family stress model’, this second idea suggests that a parent who is less worried about money may be have the mental and emotional capacity to spend more quality time with their children.

What are the implications? 

Like many reviews in this area, this one is limited by the amount and nature of the studies it includes. There were relatively few studies that met the inclusion criteria, and nearly half were from the USA. This means our understanding of this area will benefit from more research into the role of financial resources and studies from different countries and settings. The national context is even more important for this area than others, because countries vary markedly in terms of levels of welfare and state support available – which of course impacts family finances directly. 

This study makes an important contribution to our understanding of low income and child welfare outcomes, and it fits within a wider body of research on the role of inequalities and services for children and families. It suggests interventions based around material and financial help for families may be well placed to make a difference. This is consistent with our own evaluation of Devolved Budgets in three local authorities which was published last year.


Review written by

Profile photo of David Westlake who wrote this article review

David Westlake

Breaking bad news: Child welfare workers’ informing parents of care order proceedings.

By: Marte Tonning Otterlei and Ingunn Studsrød 

Child and Family Social Work 

Review written by Dr David Wilkins

What question does this study focus on? 

This study explored how child welfare workers talk to parents about the decision to issue care proceedings, and how workers cope with these difficult conversations.  

How did they study it?

Interviews were completed with twelve experienced child welfare workers from Norway. Workers were asked to reflect on their meetings with parents in which they had told them about the decision to seek a care order for the child.  

What did they find?

Telling parents about the decision to seek a care order was perceived as a ‘brutal and devaluing act’. Workers knew it would cause parents considerable emotional pain. As a result, they avoided talking about the parent’s failures, downplayed the reasons why the care order was needed and kept meetings short. Workers struggled to be direct and thorough, without being inhumane. One strategy was to provide information, without inviting a dialogue. Many workers, but not all, felt responsible for taking care of parents and children during and after the meetings. However, workers often found that parents were too angry to accept their offers of help, or suggestions about who else might support them. The workers also noted that the child’s safety was their ultimate priority, not the parent’s well-being.  

Many workers talked about finding these meetings exhausting, and emotionally draining. Some talked about being scared of parents, particularly if they had a history of violence. Workers felt desperate, angry, frustrated, anxious and confused. Some workers described themselves as being like a traitor to the family.  

What are the implications? 

From the study itself, the implications are that workers need to prepare well for these meetings, in order to ensure they know what they need to say, and how. Some of the coping strategies employed, such as downplaying the need for the care order, may ‘work’ in the short-term to protect the parent (and worker) from emotional pain, but in the longer-term are unlikely to help the parent understand what is happening. Seeking support and advice from colleagues and supervisors before and after the meeting is one important way of coping with and preparing for this task.   

More broadly, the study highlights just how difficult the role of child welfare or child protection worker can be – and how under-prepared many workers feel for some of the most important tasks involved. Because of the nature of these meetings, we are often reliant, as in this study, on retrospective self-reports of what happened. It is difficult to know how we might more directly observe and learn from these meetings, and about what makes them more or less effective. Hearing more about the parent’s perspective would be one way of creating a more holistic understanding.  


Review written by

Dr David Wilkins

A Paradigm Framework for Social Work Theory for Early 21st Century Practice

By Caroline McGregor 

British Journal of Social Work, 49(8), pp. 2112-2129. 

Review written by: Dr David Wilkins

What question does this study focus on? 

This discussion paper considers whether theoretical frameworks for social work in the 20th century are still useful for social work in the 21st century.  

How did they study it?

The author reviewed the work of several notable social work academics, including David Howe and Robert Mullaly. 

What did they find?

For the 21st century, social work theory needs to recognise and emphasise the importance of local context in global conditions, move away from the dominance of ‘Western’ ideas, identity the commonalities between social work as practiced globally in different circumstances, and recognise the importance of critical reflexivity. Specifically, the article outlines a paradigmatic framework for understanding different types of theories, suggesting they can be understood on a set of continuums from transformational to reformist and from individualist to collectivist (see figure). 

A figure which supports the article review. Constants
Care and control
Person-in-environment
Ethical and practice codes
Attachment and Loss
Human rights and social justice

What are the implications? 

Social work as a profession, and social workers, need theoretical frameworks to provide a scaffold around which questions can be asked, challenges identified and to facilitate dialogues between services users, practitioners, educators, and policymakers. A-theoretical social work is a contradiction in terms. 


Review written by

Photo of Dr David Wilkins

Dr David Wilkins

‘Maybe a maverick, maybe a parent, but definitely not an honorary nurse’: Social worker perspectives on the role and nature of social work in mental health care.

By Tucker, L. and Webber, M. 

British Journal of Social Work 51, 545–563.

Review written by Professor Jonathan Scourfield

What question does this study focus on? 

What is the distinctive role of social workers in a mental health system that is multi-disciplinary but medically led? Surprisingly, perhaps, the authors of this paper say there has been little research on social workers’ own perspectives on their role – more research has been done on what other professionals think of social workers and on the Approved Mental Health Professional role. They set out to help fill this gap.

How did they study it?

They interviewed seven White British female social workers from multiple settings within one English NHS trust. Four interviewees were employed by the NHS and three by local authorities. 

What did they find?

Views of the mental health social work role tended to refer to the ‘context and intentions of practice’, more than to ‘tasks and responsibilities’. Recovery and social inclusion were not seen by interviewees as core to their practice – rather these aims were the responsibility of others, such as support workers. Working with and risk and family complexity was seen as central to mental health work in general, rather than just social work. Community work was not seen as everyday social work, but occasionally engaged with. Even then, it was seen to involve working with (other) statutory and voluntary services, rather than anything wider. 

There was a clear difference between those employed by the local authority and those working in the NHS in their views of statutory responsibilities, with the NHS employees not seeing social care law as part of their job.

Interviewees saw themselves as helping to bridge the health-social care divide, having a more holistic view and sense of the bigger picture for service users, as opposed to a narrower medical focus, and helping in a flexible way, in response to wider needs that are not directly or immediately about mental health. 

What are the implications? 

This was a study with a small and demographically specific sample in a single NHS trust. However, it raises some interesting issues. It suggests that national policy in connection with the mental health social work role may have had very little impact. Interviewees had either not heard of or were barely aware of the Strategic Statement from the College of Social Work. More work is needed at a national level in each of the UK nations to define the distinctive role of mental health social workers within a multi-disciplinary mental health system.


Review written by

Photo of Professor Jonathan Scourfield

Professor Jonathan Scourfield

Perceived Impact on Client Outcomes: The Perspectives of Practicing Supervisors and Supervisees

By Katrina Rast, Daniel Herman, Tony Rousmaniere, Jason Whipple and Joshua Swift 

SAGE Open 

Review written by: Dr David Wilkins

What question does this study focus on? 

This study considers two questions – (i) what is the perceived impact of supervision on client outcomes and (ii) how important is it to supervisors and supervisees that supervision affects client outcomes? The study was undertaken in relation to psychotherapy training and clinical supervision.

How did they study it?

The study used a survey to investigate the views of supervisors (n=189) and supervisees (n=185). The survey asked questions about the impact of supervision on clients and the importance of supervision having an impact on clients. Most of the questions called for a Likert-style response, with a 5-point scale (from 1 = do not agree, to 5 = totally agree). 

What did they find?

Supervisors and supervisees alike were positive about the impact of supervision on client outcomes, with overall average scores of 3.65 and 3.54 respectively (out of 5). In relation to the importance of supervision having an impact on client outcomes, supervisees were more positive than supervisors, with overall average scores of 4.06 and 3.87 respectively (ditto). Supervisors and supervisees agreed that supervision made a difference in relation to the impact of counselling / psychotherapy for clients and that it could help reduce client deterioration (problems getting worse). 

Supervisors also said that supervision helped with the personal and professional growth of their supervisees, for example by helping identify areas for professional development. Supervisors also said they helped supervisees by supporting them to develop collaborative relationships with their clients. Supervisees said that supervision helped by making them feel validated and well supported, and by providing them with ideas, activities, techniques and strategies to try out with their clients. 

They found no significant differences in the views of respondents in relation to gender, age, type of degree qualification, type of therapy offered, length of experience, number of clients or the use of outcome measures. 

What are the implications? 

Supervisors and supervisees in counselling / psychotherapy settings agree that supervision can and should make a difference for clients and feel this is an important aim for supervision. However, this link between supervision and client outcomes has yet to be empirically established (in counselling / psychotherapy, or in social work). The best evidence we have currently does not support the contention that supervision makes a major difference for people in counselling, or those using social work services, despite the views reported here. In two of the best designed studies of counselling supervision, the amount of variance in client outcomes explained by supervision ranged between 16% and 0.01%. In summary, these results indicate that supervisors and supervisees believe that supervision impacts on client outcomes, but there is no evidence or consensus to explain how this happens, or to what extent. 


Review written by

Dr David Wilkins

Workshops

Our workshops bring together researchers, practitioners and service users to develop practice and knowledge. 

Supporting Parents in and Leaving Care: #MessagestoCorporateParents

From January 2021 Dr Louise Roberts, Dr Dawn Mannay and Rachael Vaughan have been working on an ESRC funded Impact project to challenge stigma, discrimination, and poor outcomes for young parents in and leaving care. As part of this project they have drawn on the research of Dr Louise Roberts, working with care experienced parents and partner organisation Voices From Care Cymru, NYAS Cymru and TGP Cymru to produce a best practice charter and wider resources. 

This page will host all the resources produced as part of this project to raise awareness and hope to create meaningful change for parents in and leaving care. We will also share best practice examples from across Wales and the UK

Supporting Parents in and Leaving Care: #MessagestoCorporateParents

Research

The Charter

The Charter will be published soon.

Podcast

Two adult hands with a children's hand on top

Webinar

Supporting Parents in and Leaving Care

Dr. Louise Roberts and Rachael Vaughan, Cardiff University.

9th November 2021, 11am-12 noon.

This event will detail recent efforts to co-develop a best practice charter, aimed at creating meaningful change for parents in and leaving local authority care. Co-produced with care experienced parents, practitioners and policy makers, the charter is aimed at Corporate Parents; professionals with responsibility for supporting young people in state care. In Wales, corporate parents are directed to seek the same outcomes for children in local authority care as any good parent would seek for their own child. This event will share the best practice charter and wider resources developed about this important topic including discussion on research conduction in this area by Dr Louise Roberts.  Parents in and leaving care will support the development of this event.

The webinar forms part of the annual Economic and Social Research Council’s Festival of Social Science.

Register for your space


Best practice examples

If you would like to share best practice examples with us about how you work with parents in and leaving care in your local authority, please get in touch at cascade@cardiff.ac.uk

An image showing an adult's hands holding a baby feet

Policy Press | The Children of Looked After Children – Outcomes, Experiences and Ensuring Meaningful Support to Young Parents In and Leaving Care : By Louise Roberts

Publications

Roberts, L., Maxwell, N. and Elliott, M. 2019. When young people in and leaving state care become parents: What happens and why?. Children and Youth Services Review 104, pp. 104387. (10.1016/j.childyouth.2019.104387)

Roberts, L. 2019. ‘A family of my own’: When Young People in and Leaving State Care become Parents in Wales. In: Mannay, D., Rees, A. and Roberts, L. eds. 2019. 
Children and young people ‘looked after’? Education, intervention and the everyday culture of care in Wales. Cardiff: University of Wales Press.

Roberts, L.et al. 2018. 
Sexual health outcomes for young people in state care: Cross-sectional analysis of a national survey and views of social care professionals in Wales. Children and Youth Services Review 89, pp. 281-288. (10.1016/j.childyouth.2018.04.044)

Roberts, L.et al. 2017. 
Care-leavers and their children placed for adoption. Children and Youth Services  Review 79, pp. 355-361. (10.1016/j.childyouth.2017.06.030)

Roberts, L. 2017. 
A small-scale qualitative scoping study into the experiences of looked after children and care leavers who are parents in Wales. Child & Family Social Work 22(3), pp. 1274-1282. (10.1111/cfs.12344)

Building knowledge for policy and practice based on service user and carer experiences: A case study of Scottish adult safeguarding research

By Fiona Sherwood-Johnson and Kathryn Mackay

Journal of Social Work 

Review written by Dr David Wilkins

What question does this study focus on?

This study considers how the knowledge base for adult safeguarding policy and practice can be developed through collaborative dialogues between policymakers, professionals, service users, carers, researchers, educators, and students. The article starts from the perspective that despite its obvious importance, the knowledge base for adult safeguarding is limited, and the views of service users and carers have been under-represented in research. 

How did they study it?

The study was based in Scotland where, much as in Wales, there has been a concerted effort in recent years to ensure that social services are more responsive to the wishes and views of citizens, with important policy changes made in order to promote choice and human rights perspective on practice. 

What did they find?

The authors draw on their experiences of undertaking a range of research projects in the field of adult safeguarding, and their efforts to promote the participation of service users and carers. Reflecting on these projects, they identify two themes based on evaluative approaches (in simple terms, questions about what works) and exploratory approaches (questions with a broader focus).

For evaluative approaches, the paper highlights the importance of causing no (further) harm. When researching adult safeguarding, many of the service users (and carers) involved will have experienced different forms of abuse or neglect. Understanding how services can respond to this effectively is important, but not at the cost of causing further harm, for example from trauma resulting from revisiting difficult experiences. There is also the question of informed consent. Some adults involved with safeguarding services will have dementia or learning difficulties. Learning from their experiences is vital, but gaining informed consent is not necessarily straightforward. Some gatekeeping processes, whereby professionals help to contact service users and carers on behalf of the researchers, may inadvertently end up excluding some people and certain groups. One key message is that service users and carers tend not to understand adult safeguarding processes as being wholly distinct from other professional activities. For exploratory approaches, the authors found that working with service users and carers at an early stage helped to inform their research questions and make them more relevant, as well as leading to the use of more creative methods. 

What are the implications?

The paper highlights the complexities and limitations of much of the research in fields such as adult safeguarding, which by its nature is often tentative and exploratory. Yet policymakers and sometimes practitioners are often looking for research that provides clear answers, perhaps even simple answers, to what are very complicated and complex problems. Research rarely provides ‘how to’ messages for practice, and there is a risk that indefinite and somewhat speculative findings are metamorphized into something more certain and concrete once they are disseminated into policy and practice. 


Review written by

Photo of Dr David Wilkins

Dr David Wilkins

Motivational Interviewing for working with children and families – a conversation

MI is now widely used in services for children, playing a key part in innovations such as Family Drug and Alcohol Courts, the Family Safeguarding model and Intensive Family Support Teams. In this session Steve Rollnick (co-creator of Motivational Interviewing) spoke with Donald Forrester, David Wilkins and Charlie Whittaker about their forthcoming book on this topic. Discussion covered the contribution that MI can make to child and family work and how to respond to key problems or challenges such as how to have difficult conversations and applying MI principles in the context of child protection – plus wherever else the conversation went! There were opportunities for those attending to ask questions, share experiences and be involved in the discussion.