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Growing Support
7. Community networking models and volunteer befriending schemes
Principles of enhancing informal support
Traditionally most interventions have relied on specialist or professional input to children, parents or families. Increasingly strategies are being used to strengthen the help and advice available to families informally, whether from their kin, neighbour and friendship networks or through linking families with a volunteer. Such help may be less expert than professional services, but it is often more acceptable, more flexible and more available.
Gilligan (2000) and others have argued that children's social and community networks are of vital importance when considering the development of effective interventions. This is no doubt true, but for the very young children being considered in this review it is somewhat difficult to do this. Therefore it is largely the networks of parents that need to be considered, though these do then impact on young children's own social networks (Hill 1989). Support networks can provide parents with the buffers from stress, information and confidence that allow them to parent more effectively. It is therefore important for professionals involved with vulnerable families to be aware of the importance of these networks and provide interventions that will complement them. Gilligan identifies nine ways that professionals can assist young people in keeping contact with existing social networks. Although not all are relevant for the group under discussion, most (seven) can be adapted to facilitate the development of community based social networks for vulnerable parents with very young children. Briefly they include:
- mapping the network by establishing who it incorporates;
- validating the network by pointing out to all involved the significance of the network;
- gathering relevant information from members of the network;
- negotiating and mediating between the focal member and other members of the network, especially if communications breakdown;
- negotiation and mediation between the focal member and other professionals;
- co-ordination of meetings and information sharing between focal member and other network members; and
- helping to reinforce the identity of the network through arranging celebrations and outings for special occasions.
A social network model of intervention
A good example of how effective support can be provided to vulnerable families through community support networks is the Neighbourhood Parenting Support Project carried out in two disadvantaged inner city areas of Winnipeg, Canada (Fuchs 1995). This project used an experimental design to test the effectiveness of ways to mesh formal services with informal support and helping networks to support parents and reduce the risk of child maltreatment. Parenting support was provided to a total of 100 parents in neighbourhood A, while neighbourhood B was used as a comparison.
The social network of each person was identified and mapped by the 'networker' and links were developed in a way that would provide the focal person with more support and resources. In addition the networker also worked with parents to help them identify stress factors, existing social supports and develop plans to improve their networks. Findings from the project were based on assessments carried out before and after the intervention. These showed that parents in Neighbourhood A had increased and diversified their social support networks. In addition a smaller group of residents in neighbourhood A who had more intense support had even lower levels of depression and family violence than the rest of neighbourhood A, and increased levels of social support. Neighbourhood A families showed higher levels of support than neighbourhood B over a two-year period, and the ratio of support to stress had increased slightly in neighbourhood A over the two years, but in neighbourhood B it had decreased by 13 per cent. Therefore the main findings showed that: i) social network intervention can assist in developing better parenting support networks for vulnerable families; ii) a trained 'networker' can help to mesh formal and informal networks; iii) social network intervention can reduce the risk of child maltreatment (Fuchs 1995:121).
Befriending
A more common approach to expanding the informal resources available to families, especially in the UK, has been the development of volunteer befriending schemes. One such example is Home Start. This is a voluntary organisation in which trained volunteers offer regular support, friendship and practical help to young families under stress in their own homes, helping to prevent family crisis and breakdown. Home Start provides a range of practical help, advice and support. A wide range of referrals are accepted, but most common are depressed or isolated young mothers. The aim of Home Start is to build on the existing resources of families and the communities they live in (for more information see Frost et al 1996). Research has shown that volunteers help families with quite similar needs and risks to those in touch with social services. Parents were significantly more satisfied with the help from their volunteers than were social workers' clients with their more formal 'help' (Gibbons 1995). Part of the explanation appears to be the greater time that volunteers can spend with the family, though their independence from statutory agencies doubtless contributes too.
Home Start in Scotland undertook a retrospective evaluation of its services using questionnaires to collect the data from families, referrers and Home-Start co-ordinators. These were based on a number of selected outcome measures that were largely taken from the Family Outcomes Study being carried out in Northern Ireland. No experimental design was used due to ethical and practical constraints. The evaluation showed that all respondents felt the programme had benefited them, although views about specific benefits varied between families, referrers and co-ordinators. There was emphatic consensus among all groups that families experienced increased confidence and self-esteem (Kirkcaldy and Crispin 1999:33). Overall, the evaluation reported that vulnerable families could be helped by such schemes as Home Start when experiencing difficult times. The number of schemes operated by Home Start Scotland is expanding, particularly through local authority use of Sure Start funds.
The New Parent Infant Network (NEWPIN) provides another example of a community support programme based on befriending, but also giving access to a wider range of services. The initial programme was based in London, although it has now expanded to other areas. It is specifically targeted at vulnerable mothers where there is a danger of family breakdown. More specifically it is aimed at mothers with depression, social isolation and poverty (Oakley et al 1995). The majority of referrals come from health and social work, although a few are self-referrals. Most of the work is done through therapy, training and social involvement with a peer group who provide added support. Initially mothers are matched with a befriender who is an established NEWPIN user. In addition there is also the opportunity to attend a drop-in centre with crèche, and participate in training such as a personal development programme.
Two evaluations of NEWPIN have been carried out. The first in 1991 (Cox et al 1991) suggested that mothers had benefited, but extended involvement of 7-12 months was required in order to see improvement in mothers' mental health. Among the chief gains was a greater capacity to anticipate children's needs, increased warmth and sensitivity, and more effective control (Gibbons 1995; Smith 1999). The second evaluation was carried out in 1994 and looked at 214 referrals in 1992. The response rate (63 per cent) was thought to be adequate considering the type of population under investigation, although those who did respond were reported to be less disadvantaged and therefore more likely to engage with services (Oakley et al. 1995). The problems identified by the evaluation included social isolation, depression, relationship problems, problems with children's health and behaviour and housing problems. Despite this wide range of problems less than half those surveyed used the services available through NEWPIN, and the majority of users went less than five times. This indicated that a large proportion did not become regular users. However, 47 per cent of those surveyed reported that it was very or quite helpful, but those referrals who did not use it indicated that it did not meet their needs or they had access problems. There were a small group who used the personal development training and felt it was helpful, but most users indicated that the opportunity to meet other women was of most importance.
It was concluded from the evaluation that NEWPIN did provide a valuable service for a very vulnerable group of women. However, those who engaged with the service only represented a minority of the total number of mothers who were referred. Evidently this difficulty in take-up is a matter that requires further exploration.
The Community Mothers Project also helps young mothers by linking them with an experienced supporter. However, the emphasis in this scheme was more educational. Lay volunteer community mothers have been recruited to provide a child development programme to disadvantaged parents with children up to one year. An RCT was used to assess the impact of this non-professional intervention in parenting (Johnson et al 1993). The study showed that at the end of a year children in the intervention group were more likely to have had all their vaccinations, were more likely to be read to daily and were less likely to be given cows milk before 26 weeks. Mothers in the intervention group were also seen to have benefited more than the control group, with reports of more positive moods (Johnson et al 1993) and better diet (Macdonald and Roberts 1998).
It is therefore not disputed that personal and community networks can provide assistance to parents in ways that more formal support cannot. However, some appear inappropriate in view of low take-up or high drop-out rates.
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