This thesis is an examination of foster home finding methods in a large child-placing agency. The study was undertaken as an investigation into the causes of dissatisfaction and difficulties experienced by agencies in their efforts to achieve a good standard of care for their children through the medium of foster homes. It is also a consideration of the manner in which the case work approach in home finding can be brought to bear on the amelioration of these problems. The agency in which the study was done, the Children' Aid Society of Vancouver, B.C., is typical of several in this country wherein the agency is committed to planning for several hundreds of children who come into its care through the administration of the various statutes related to the protection of children. It cannot be compared to small specialized agencies giving service to a selected clientele. The study includes: 1. An account of the development of the use of foster homes in child placement, and the use of case work method in this. 2. Review of social work philosophy and how it may be applied by the administration and personnel of an agency in home finding. 3. An examination of the agency's actual case records of foster home studies. The information sought was a comprehensive knowledge of the job of home finding through professional literature and observation of practice. The findings would support the contention that professional case work disciplines could be applied with greater effort, and that there is need for more emphasis on the part which foster home finding plays in a total child care program. / Arts, Faculty of / Social Work, School of / Graduate

This study is concerned with the problem of multiple placement s of foster children, i. e., children who are placed in more than one foster home while they are in the care of a protective agency. Children become "wards" of such societies if there is no possibility of their leading normal, happy, and emotionally secure lives within their own homes. The agencies provide foster home care as a substitute home to give them the care they were not able to obtain in their own homes. But frequent replacement prevents many foster children from gaining security and healthy development due to lack of attachment to a family. The study shows that thirty-nine out of the fifty children in the sample were placed in more than one foster home during their period of care by a children's aid society. The average number of foster homes for the total group was 3.52 homes per child, which means that a child remained in each foster home for a period of 2.08 years, on the average. The study was based on the records of foster children from both of Vancouver's children's aid societies, the sample being selected on a one-in-four basis from all children falling within certain definitions: (l) children who had been in the care of one of the agencies at least two years; (2) children of the white race; (3) children now in the "latency" stage of development; i. e. between the ages of seven and twelve years. The material utilized includes the files kept by the agencies, regarding each individual child, his family and the foster homes. The sample was grouped into four divisions according to the number of placements the children have had. Group A with a single foster home placement only, representing the ideal in child placement; Group B with two foster home placements; Group C a clear multiple placement problem, with three or four foster home placements; and Group D the usually serious situation where a child has lived in five or more foster homes. The cases were then studied in terms of the foster homes in which the children were placed; the intelligence levels of the children; and their adjustment to the foster home program. The adjustment of the child is believed to be the crucial factor in deciding whether foster home placement has succeeded or failed. The third part of the study examines what can be done to improve the methods of placing children in foster homes in order to lessen the problem of multiple placements. There is evidence that the problem of multiple placement of foster children could be reduced by more careful preliminary observation of the child and his needs, closer assessment of foster home potentialities, better matching of the child and the foster home, professional casework service while the child is in the home, and treatment for disturbed children in homes which are especially equipped for this service. The study suggests that many children without family ties could be placed for adoption, thus attaching them to one family instead of facing the possibility of repeated replacements. / Arts, Faculty of / Social Work, School of / Graduate

This study is concerned with a twofold problem: the present operations of Embury House, a receiving home for children in Saskatchewan, and its desirable role in relation to the total child welfare program of services in Saskatchewan. At present Embury House lacks any suitable program to serve the needs of those children requiring institutional care. Consequently, it is not an institution with a definite purpose, but a place where dependent and neglected children in Saskatchewan are kept when there are no other services available to meet their needs. The evaluation of present operations in Embury House is based on the records of fifty children placed there during 1949-1950. These fifty children, the average monthly population of the institution, reveal a typical cross-section of the problems and needs of children kept in Embury House. Analysis showed the children fell into three groups, each needing a different type of service: (a) casework services in their own home, (b) placement in foster homes, and (c) placement in an institution. It also showed that only eighteen per cent of the total population of Embury House could profit by the services of an institution for general care, which type seemed most nearly to describe Embury House. In addition, the analysis showed that eighteen per cent of the total population required the specialized services of a study and treatment institution, fifty per cent required foster home care, and fourteen per cent required case work services in their own home. The program of services offered by Embury House during 1949-1950, was evaluated in terms of the standards for children's institutions recently constructed for the State of Washington. The program was also assessed by applying four criteria to the institutional program: (a) the social service program, (b) the physical care of the children, (c) the education and social training, and (d) the quality of the staff. This showed that the physical needs of the children and their education and social training are well served at Embury House, but there are serious lacks in the social service program and in the staff. Recent trends in professional thinking regarding the services which can or should be offered by an institution are reviewed. A definite classification is also made of children who should not receive institutional care, and of children who can be served in an institutional setting. Against this background, there is evidence that Embury House could serve more effective purposes in the child welfare program than it does at present. There are no facilities for the treatment of emotionally disturbed children in Saskatchewan, but these children tend to be placed in Embury House. It is suggested that Embury House could fulfil a necessary role as a study and treatment centre for seriously disturbed children. There are undoubtedly more children in Saskatchewan who could benefit from such a service; and it would be better to work out a foster placement and case work program for those children not suited for institutional care. Revision of the social service program, and certain changes and additions in the staff, as recommended, would modernize Embury House as a valuable study and treatment institution. / Arts, Faculty of / Social Work, School of / Graduate

The general trend toward community care of the mentally ill is a relatively recent development in the treatment and rehabilitation of this segment of society. The purpose of this study was to examine a group of boarding home residents who are psychiatrically handicapped in order to discover whether they were satisfied with their situation in the community and whether they had achieved an appropriate level of social functioning. Another question addressed was whether the cost of maintaining the patients in the community is less than that of institutional care. The scope of the study was restricted to individuals residing in mental health boarding homes in the Kamloops, British Columbia area. The majority of these had been patients at the Tranquille School, facility for the retarded. However, included in the 69 subjects interviewed were those with other psychiatric handicaps. One questionnaire was administered to residents, boarding home operators, employers, and workshop staff. A subjective response was elicited from the boarders regarding their satisfaction with their situation; in addition to the subjective-response, "satisfaction" was measured quantitatively with regard to social activities, that is, contacts with friends and family as well as attendance at community activities. Other items on the questionnaire related to social functioning of the subjects and included adjustment in the home and at work, and interpersonal relationships. Ability to remain in the community was considered to be an important indicator of social functioning, as well as moving on to independent living. Fifty-eight of the sixty-nine (84.06%) responded that they were satisfied with their situation in the community. These represented a substantial number of the moderately retarded. Contact with relatives and friends were found to be infrequent, and most subjects were dissatisfied with this. A high percentage of the respondents (88.4%) attended community activities at least once a week, and 30.43% at least twice a week or more often. These factors may have contributed to the boarders' satisfaction with community living. Social functioning was felt to be closely connected to some form of community employment. A total of 68.12% of subjects were away from home in some work related activity, a fairly high indicator of social functioning. Amount of supervision needed in such activities as eating, sleeping, toilet, dress, and spending money was considered in the study as being a measure of social functioning. With regard to the rate of returning to institution, the .5% per month compared favorably to the Province wide average of less than 1% per month. 6.8% of the boarding residents were found to have moved on to independent living in 1973, as compared with the provincial average of 11%. The possibly high percentage of retarded subjects in boarding homes in the Kamloops area as compared with other districts in the Province may have influenced both of these findings. A tentative conclusion was reached that the cost of maintaining patients in the community is considerably less than institutional care, but a more comprehensive study would seem to be indicated. / Arts, Faculty of / Social Work, School of / Graduate

Objective – Some of the most vulnerable children and youths in our country are those in out of home care, and these children demonstrate higher rates of psychopathology and fare more poorly in school and in social relationships than their peers. Typically, when studying at risk populations, negative outcomes are examined, thereby ignoring those who do well despite their vulnerability. These children, who demonstrate positive patterns of functioning and development despite their exposure to adversity, are considered resilient. The objective of this study was to identify factors associated with a resilient outcome among children and youths in out of home care. Method – The study sample was comprised of 417 children 10 to 15 years old in Ontario who had been removed from their homes of origin and placed in out of home care. Predictor variables were selected based on previous research findings in the area of resilient outcome. In the cross-sectional study, a series of sequential logistic regression analyses were conducted to identify factors associated with a resilient outcome among children in out of home care. These children were then followed one year later. In the longitudinal study, another series of sequential logistic regression analyses were used to identify variables that were related to future resilient outcomes among the same children in out of home care. Results – The findings showed that many of the independent variables predicted resilient outcome on the different dimensions. Furthermore, overall resilient outcome was best predicted by the foster parental report of high sociability. Conclusion – The findings in the present study confirmed that there exists a subset of resilient children among children in out of home care. The findings allowed for the identification of some factors related to resilient outcome among this population. The practical implications of these findings are discussed.

This study was designed to assess the community identification of discharged mental patients in community boarding homes-specifically, those patients discharged from the Riverview Mental Hospital and placed directly into Vancouver City boarding homes as part of a cooperative programme between the Social Service Department of the Riverview Hospital and the Medical Section of the City Social Service Department. Community identification was defined in terms of three factors: physical presence in a geographic area; quality and quantity of social participation; and, relative opportunity for decision-making and independent functioning. Quantitative measurement of the latter two factors was attained through administering the Chapin Leisure Participation and Enjoyment Scale and the Vine-land Social Maturity Scale respectively. A qualitative measurement was attained by administering two questionnaires designed by the researchers--one to the boarding home operators, the other to the patients in the boarding homes The design of the study was initially that of a retrospective nature, comparing current data to data of previous performance obtained from hospital files. As this latter source proved inadequate, a longitudinal design was proposed, and a pretest of the research instruments was implemented with a boarding home sample and a comparative hospital sample. The findings of the study thus pertain to the qualitative responses of the former patients in community boarding homes, and to qualitative comparisons of the responses of the community and hospital samples. The qualitative responses were generally of a positive nature indicating a satisfaction with community placement and an enjoyment of community life. The quantitative responses indicated a decrease of social participation, occupational activity and socialization skills following placement into the community boarding homes, but an increase in the skill of self-direction and competency of locomotion. A comparison of the interviewers' ratings and the patients' ratings of significant impediments to social functioning indicated that the latter perceived this in financial terms while the former perceived it in psychological terms. Conclusions of this study, necessarily limited because of its preliminary nature, relate primarily to the concept of community identification and to the difficulty of defining this concept in concrete terms. As the findings indicated that autonomy and independent decision-making were most closely related to subjective feelings of community identity, and that this increase in autonomy was related to increased feelings of dignity and self-worth, it was suggested that greater autonomy was the principal factor in the community identification of this population, and that this indicated a positive evaluation of the boarding home placement programme in that it led to the enhancement of the patients' feelings of dignity and self-worth. Recommendations for improvement of the programme include psychiatrically trained staff to supervise the patients, new regulations concerning finances, and provision of more activities and facilities designed to enhance the patients' feelings of self-worth. / Arts, Faculty of / Social Work, School of / Graduate

This study investigated the relationship between living in a foster home and reading achievement among high school students. It involved 71 subjects living in foster and non-foster homes. Nineteen schools in Vancouver, Richmond and Surrey, British Columbia, were Included in the study. The first part of the study was concerned with the relationship between Type of Home and reading achievement, I.Q. and reading scores were obtained using the California Short-Form Test of Mental Maturity and the Reading Battery of the California Achievements Tests. Age, Sex, Grade, I.Q. and Type of Home and the interactions between Type of Home and I.Q. and between Type of Home and Sex were used as predictors in multiple regression analysis of the data obtained. The dependent variable was the grade placement of the subjects on the reading test. The results suggest that there is little relationship between Type of Home and reading achievement. However, there was a significant mean difference in I.Q. between the foster and non-foster children. The predictor variables included in the study accounted for about 75% of the variance in the dependent variable. In the second part of the study, relationship between the reading achievement of the foster children and Age of Admission to Foster Care, Length of Foster Care and the Number of Times the Children Changed Homes was investigated. The interactions between Age at First Admission and Length of Foster Care and between Socioeconomic Status of the foster parents and the Length of Stay in the Present Home were also considered. Again, multiple regressions were used to analyze the data. The results indicated that the number of times the children changed homes was more strongly related to their reading achievement than either Age at First Admission or Length of Foster Care. However, only Grade and I.Q. were found to be significantly related to the reading achievement of the children; they accounted for about 70% of the variance in the dependent variable. There were no significant interactions. It was suggested that future studies of the academic achievement of foster children should include elementary as well as high school students, both in regular and "special" classes. It was also pointed out that further research should consider not only the self-concept, school attendance and the natural home background of the foster children but also teacher expectations and the number of schools attended. Studies regarding the relationship between living in a foster home and the development of intellectual abilities were also recommended. / Arts, Faculty of / Psychology, Department of / Graduate

Parenteral nutrition is a therapy that supplies patients with all their nutritional requirements intravenously, thus eliminating the need for oral alimentation. The therapy was first introduced in the United States to hospitalized patients in the late 1960's. The benefit of long-term parenteral nutrition was soon recognized, and a program for ambulatory or home parenteral nutrition (HPN) was developed. In British Columbia, the first HPN patient was begun on such therapy in 1972. Since then, more than 50 British Columbians have received HPN. In March 1986, there were 24 patients on the program. The average annual cost per patient was $29,278 and the total 1986 operating budget was $702,660, not including costs for equipment or hospital training. Up to now, there has been no analytical assessment of the HPN program in B.C. This thesis describes the current home parenteral nutrition situation in B.C. and makes recommendations for its improvement. It looks at overall clinical outcomes (both physiological and psychosocial), at the results with different subgroups of the population, and at the cost of the HPN program in B.C., and also considers the potential of this therapy for children. In Chapter 2, the literature is reviewed and organized to cover a general description of HPN therapy, a summary of the results obtained from a number of academic centers, a review of HPN therapy in childhood and the psychosocial issues of concern to HPN patients. Chapter 3 provides a detailed description of the current HPN situation in B.C. The study methodology is described in Chapter 4 and the results in Chapter 5. The study is a descriptive analysis. Due to the lack of any obvious control group, a comparative evaluation per se was not possible. However, a Seattle study by Robb, reported in 1983, does allow for some comparison. The main sources of data were: 1. A Patient Questionnaire: The questionnaire was modelled on that used by the Seattle group. 23 B.C. patients, either on HPN at the time of questioning, or previously on the therapy, were surveyed. 19 (83%) responded. 2. A Health Professional Questionnaire: This questionnaire was compiled especially for and sent to all known health care workers in B.C. in the HPN field. 19 professionals, including physicians, nurses, pharmacists, dieticians, and administrators, were surveyed. 17 responded for a response rate of 89%. The patient survey provided basic demographic information, a description of HPN therapy received, as well as data on clinical outcomes, both physiological and psychosocial. Results showed that patient age, length of time on HPN, numbers of hours per week devoted to HPN, occupation and place of residence were the most important variables for predicting patient outcomes. Thus, patients that were older, had been on HPN less than one year, or spent more than 80 hours per week preparing and administering HPN solutions, had more physiological complaints and showed interference with more daily activities and personal relationships. Patients who were employed, rated the HPN experience more positively. Overall, patients found the HPN experience to be a positive one, although this was not true for a small group of patients. Data also indicated that B.C. patients achieved physiological results similar to the Seattle group, and to other centers reported in the literature, but appeared to have more interference with daily activities and personal relationships than did patients from the Seattle study. The health professional survey indicated that professionals considered the current situation in B.C. to be good with respect to patient training and the complication rate achieved. However, patient follow-up and the psychosocial support provided to patients were rated only fair to poor. These health care professionals cited problems with the program's organization, the need to standardize service to all patients, and the need to provide patients with pre-mixed solutions. In conclusion, some recommendations are made for improvement in the B.C. HPN program. / Medicine, Faculty of / Population and Public Health (SPPH), School of / Graduate

The effect of frequency of nursing home contact on family perceptions of quality care is the focus of this research. A family member characteristic, such as geographic distance from the nursing home, affects his or her frequency of contact with the nursing home. Frequency of contact, in turn, affects family perceptions of the care his or her loved one receives in the nursing home. The theoretical framework for this study is based on Allport's intergroup contact theory, which posits that when four contact conditions - institutional support, equal status, common goals, and intergroup cooperation - are present in an intergroup situation, a reduction in anxiety between groups is likely to occur. Regression analysis tested the stated hypotheses using survey data collected from 275 family members of residents in 10 Dallas-Ft. Worth area nursing homes. This study is among the first to quantify family geographic distance, finding that family geographic distance is a significant negative predictor of nursing home contact. Additionally, results build on Allport's theory by extending its' usefulness to nursing home organizations in two distinct ways. First, findings support Allport's premise that contact alone between groups - i.e., family members and nursing home staff - is insufficient for increasing or decreasing family perceptions of nursing home care. Second, three of the four contact conditions included in Allport's theory were statistically supported by the data. In sum, findings of this research provide nursing homes with an empirically tested model for improving family perceptions of quality nursing home care.

Bibliography: leaves 79-94. / The field of related foster care has to a large extent been neglected. Related foster care is regarded with considerable scepticism and ambivalence by many social workers because of a number of pitfalls which are often associated with such placements. The aim of this study is to explore the relative merits of related and unrelated foster placements, and thus to enhance knowledge in this area and so improve service delivery to foster children, their parents, by foster parents and child and family welfare agencies. A literature survey was undertaken during which it was evident that the field of related foster care has received little attention in both literature and research. The literature studies have highlighted some of the pros and cons of related and unrelated foster placements. A questionnaire was constructed and administered to a sample of related and unrelated foster parents. A descriptive analysis was made of the results with the focus being on the behaviour and academic functioning of the children. The overall findings in this study showed that children fostered by relatives seemed to be doing at least the same as, and in some aspects better than, those children fostered by recruited unrelated foster parents. Over a 11 there appeared to be some significant advantages for those children who were being fostered by relatives.