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Evaluation of Intensive Family Support Projects in Scotland

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4. Supportive Interventions

Chapter summary

An analysis of a sample of individual family Support Plans submitted by each of the projects found that the plans reflected the overall aims of the Breaking the Cycle programme; usually focusing on improving family dynamics and parenting, enhancing household management skills, reducing antisocial behaviour and increasing children's engagement with nurseries and schools. Half of the Support Plans included measures aimed at reducing alcohol or substance misuse. The initial assessments on which the Support Plans were based typically identified key family strengths as their positive engagement with the projects, their desire to change their circumstances and the loving relations between family members.

The actual delivery of Support Plans and provision of supportive interventions evolved considerably as the Projects developed. Project workers faced new challenges in responding to the size of families, the intensity of the support required and the need to holistically address a wide range of family problems. The size of caseloads and the model of dedicated worker teams for each family appeared effective. However, the typically formidable challenges facing families, the frequently protracted nature of assessments, and the sometimes sporadic pattern of subsequent engagement all tended to increase the duration of support programmes by comparison with what had originally been expected by Managers of some of the more recently-established Projects. While Projects attempted to avoid families becoming dependent on caseworker contact, this had in some cases proved difficult to achieve and consequently some families whose cases had been formally closed continued to access guidance and advice from Project staff.

Supportive interventions delivered mirrored Support Plan priorities, focusing particularly on addressing underlying causal factors such as low self-esteem, depression or substance abuse. Most interventions were delivered directly by Project workers, although these frequently included helping adult family members to access other services, both mainstream and specialist. Key themes in support provision also typically included help with parenting, emotional support, benefits advice, domestic management and children's school attendance. Promoting healthy social networks was another common component of Project support - both in terms of reducing isolation and detaching family members from harmful circles.

Through their 'core block' services the Aberdeen and Dundee Projects were able to offer particularly intensive support and supervision. This was seen as highly beneficial for certain families. However, core block placements could also bring to light problems previously unknown to Project staff (or social workers). Such 'emerging problems' sometimes included child protection issues, and this could lead to children of 'core block families' needing to be looked after and accommodated by the relevant local authority.

4.1. Introduction

4.1 This chapter analyses the interventions undertaken with families by the five Projects. It identifies the forms of support provided and the nature of the work undertaken with families, the key issues prioritised for intervention, the range of agencies involved and the intensity and duration of engagement with the families. The chapter is presented in two main sections. First we analyse a sample of family Support Plans produced by each of the Projects which detail the programme of assistance envisaged as being provided to families following the acceptance of referrals. This analysis relates to Support plans drawn up by the five Projects in the first half of 2007. The second half of the chapter describes how Support Plans were translated into the actual delivery of interventions with the families and the key issues arising. This is based on interviews with Project workers, family members and representatives from partner agencies carried out in summer 2008.

4.2 Support planned

Structure of Support Plans

4.2 This section presents the findings of an analysis of the Support Plans prepared by the Projects in relation to the caseload of families accepted for Project support in the first half of 2007. The analysis is based on the written material contained within the Plans. It should be read in conjunction with the summary analysis of support provided to former service users as included in the following section (4.3).

Table 4.1 - Number of Support Plans analysed

Project

No. of individual plans analysed

No. of families covered by plans

Aberdeen

3

3

Dundee

5

5

Falkirk

3

3

Perth

5

5

South Lanarkshire

9

5

Total

25

21

Notes:

1. The Support Plans for Aberdeen, Dundee, Falkirk and Perth were collective plans covering all family members (although in Perth two of the plans related to individuals in single households). In South Lanarkshire, there were Support Plans for individuals, across five family groups.

2. Aberdeen Families Project submitted 3 Support Plans and 2 Support Plan reviews (these reviews are not included in this analysis).

3. Where the type of placement was identified on the Support Plans, the majority were outreach placements, with one core block placement in Aberdeen and one core block placement in Dundee

4.3 Four of the projects (Aberdeen, Dundee, Perth and South Lanarkshire) used exactly the same template for the Support Plans, whilst Falkirk's was slightly different. All of the Support Plans had a front page that identified:

  • Family strengths (This section of the Support Plan had not been completed in South Lanarkshire, as the Plans related to individuals)
  • Key issues to be addressed
  • The aim of the placement

4.4 All of the Support Plan documents took the form of an agreement with the clients which was to be signed by all parties, reflecting the ethos of service user consent, proactive engagement and joint ownership of their work programmes.

4.5 The main content of the Support Plans set out in more detail the planned interventions. For Aberdeen, Dundee, Perth and South Lanarkshire, this comprised a grid with the following headings:

Agreed tasks

Methods to
be used

What will be
done, by whom

When and
where will it
take place

Desirable
Changes

Timescale

4.6 In Falkirk, The grid headings, under a title of 'major targets for the next three months' were:

What are our targets
and who are they
for?

How is this going to
be done and how will
we know it has
worked?

Who is going to do it
and when?
Indicators

4.7 The Falkirk plans also included a section entitled 'important dates' which identified the regularity of meetings and a section listing agreed outcomes.

Identified family strengths

4.8 The family strength most commonly identified in the Support Plans was the voluntary or positive engagement of family members with the projects (see Table 4.2). In some cases this also extended to a declared willingness to work with social workers and housing officers to resolve problems, although this engagement could become more sporadic than initially envisaged. The second most commonly identified strength was the strongly knit bonds and loyalties within family units. This included mutual love and support between adult partners and between adults and children. In addition, the Support Plans highlighted the importance of wider family and social networks, including the positive impact of having wider family and friends living in close proximity and the key supportive roles played by the parents of some adult family members engaged with the Project and grandparents of children working with the Project.

Table 4.2 - Identified family strengths

Family strength

No. of plans

Positive and/or voluntary engagement with project

12

Strong family bonds, love and support

6

Evidence of progress and attempts to address issues

6

Awareness of issues and the need to address them

4

Good support network of family and/or friends

4

Clean living environment

2

School attendance

1

Children engaged in positive activities

1

Total number of Support Plans analysed

25

Source: Support Plans analysis

4.9 The Support Plans also commented on family members' recognition of issues of concern, and in some cases, reported evidence of ongoing progress by family members in addressing such issues. Comments on family members' perceptions of their situation included the extent to which individuals recognised their responsibility for antisocial behaviour and the need to address causal factors including alcohol use, parenting skills, lifestyles and social networks. The Plans also covered family member commitment to address problematic behaviour, in several cases linked to a concern amongst parents for the future welfare of their children. Evidence of attempts by individuals to tackle their problems included limiting alcohol consumption, changing lifestyles, honouring the conditions of an Antisocial Behaviour Order, efforts to interact more positively with their children and reducing contact with previous social networks.

Key issues to be addressed

4.10 All of the Support Plans included key issues to be addressed during families' engagement with the projects. The types of key issues identified as needing to be addressed were very similar across all five Projects.

Table 4.3 - Key issues to be addressed with Project assistance

Key Issue to be addressed

No. of plans

Antisocial behaviour/respect in home and community

14

Parenting

14

Tenancy management and maintenance of tenancy

12

Establishing healthy relationships within the family

12

Education and maintenance of school attendance

7

Condition and suitability of family accommodation

6

Employability and future careers

5

Budgeting and financial skills

5

Reduce alcohol misuse/dependency

4

Raising confidence and self-esteem

3

Drug misuse/ dependency

2

Gate keeping and management of visitors to home

2

Involvement in criminal activities/awareness of consequences

2

Bereavement counselling

2

Anger management

1

Keeping all agencies involved and informed

1

Total number of Support Plans analysed

25

Source: Support Plans analysis

Note: There is a degree of overlap between some of these categories (e.g. healthy relationships/parenting and antisocial behaviour/tenancy management/gate keeping). One Support Plan for a young child in the South Lanarkshire project also identified 'personal development appropriate to age', 'effective utilisation of a nursery placement' and 'health appointments being kept up to date' as key issues to be addressed.

4.11 The key issues fell into a number of related areas. As may be anticipated, addressing antisocial behaviour and parenting/family relationships were the most frequently identified issues (see Table 4.3). Antisocial behaviour included misconduct both within the home (including noise complaints) and in the community. In some cases this was more specifically identified as conflict with neighbours and also related to 'door control' and problems with visitors to the family home. In two cases, alleged involvement in more serious criminal activities was identified, alongside the need to make individuals aware of the consequences of such activity. Two of the plans identified the need to address how living environments were maintained and another plan signalled the need to look for suitable alternative accommodation for the family.

4.12 Although close and loving family bonds were commonly identified as family strengths, many of the Support Plans made reference to the need to establish more healthy relationships. This was closely linked to addressing parenting skills such as ensuring positive parenting, increasing confidence and assertiveness in parenting and establishing routines and boundaries. Many Plans also identified the need for improved communication and appropriately defined roles within the families.

4.13 A further set of key issues to be addressed related to the emotional wellbeing of individuals, including raising self-esteem and confidence, anger management and coping with bereavement. Six of the Support Plans also highlighted addressing drug or alcohol dependency. Four of these related to alcohol, either general misuse or dependency or an over-reliance on alcohol at times of crisis. Two of the plans cited tackling drug dependency as a 'key issue', with methadone specifically referred to in one case. In total, however, almost half of the Support Plans (12) included addressing alcohol or substance misuse in their outcomes and indicators (see below).

4.14 Wider life skills to be addressed through the plans related to financial management and domestic budgeting and also to helping individuals (through training and confidence building) to access employment. Finally, a number of the Plans also identified the need to maintain or improve children's school attendance.

4.15 In addition to the specific 'key issues' to be addressed by the Projects, the Support Plans from Aberdeen, Dundee and South Lanarkshire also included overall aims for the families' placement with the projects. In Falkirk, a section entitled 'main objective' included a generic statement that: 'We [the Project] are going to support you to improve the difficulties affecting you and your family and to change behaviours that cause difficulties to others'.

4.16 The overall aims of individual placements mirrored the key rationales for the Projects in terms of reducing antisocial behaviour, securing sustainable accommodation, enhancing parenting skills and removing the threat of children needing to be looked after and accommodated.

Outcomes and indicators

4.17 All of the Support Plans included key outcome targets, linked to identified needs and issues to be addressed, and measurement indicators for identifying whether outcomes had been achieved. The formation of these targets and outcomes varied between the Projects. The outcomes and targets also varied between identifiable 'hard targets' such as reduction in the number of ASB complaints, more regular school attendance, bills being paid and accessing employment, to more general improvements in family relationships and less quantifiable progress such as enhanced self-confidence and accepting responsibility.

4.18 As shown in Table 4.4 the most common groups of outcomes and indicators related to an improved interaction between family members, followed by household management skills. Such specified 'desired outcomes' included aspirations for the families collectively and for individual family members. Outcomes under the heading of 'improved family relationships' included enhanced contact and interaction between family members, parents setting boundaries and routines that children adhered to and more efficient resolution of conflicts within families. This was also linked to outcomes aimed at improving individuals' anger management skills.

Table 4.4 - Outcomes and indicators

Outcome/ indicator

No. of plans

Improved positive interaction within families and enhanced parenting skills

21

Improved household management skills, including financial and tenancy management

18

Reducing number of complaints about antisocial behaviour

14

Reduced dependency on drugs and/or alcohol

12

Increased self-esteem and confidence amongst family members

11

Improved school attendance, behaviour at school and educational attainment

10

Developing more appropriate friendships and extending friendship networks

8

Taking enhanced responsibility and increasing autonomy for decision-making

8

Enhanced employment opportunities and access into employment

6

Developing respect for others

6

Improved anger management

3

Ceasing involvement in criminal activities

3

Improvements in health awareness and diet

3

Improvements in mental health

2

Resolving family crisis situations more effectively

2

Enhanced communication/ involvement of agencies

2

Improved danger awareness

1

Total number of Support Plans analysed

25

Source: Support Plans analysis

Note: Reduced substance misuse was identified as a planned outcome in 6 of the Support Plans and reduced alcohol misuse identified in 5 of the Support Plans. One Support Plan identified outcomes relating to both reduced substance and alcohol misuse.

4.19 Household management outcomes included enhanced financial management (weekly budgeting, bills being paid, debts being managed, rent arrears being reduced and benefits entitlements being taken up), correspondence being responded to, appointments being kept, increased awareness and utilisation of available support services, tenancies being maintained, and home environments being managed and adequately furnished. This was also linked to outcomes and indicators around encouraging parents to take more responsibility for decisions.

4.20 The Support Plans also included outcomes and indicators for reducing and/or ceasing involvement in criminal or antisocial activities. The indicators ranged from reduced complaints from agencies to enhanced awareness of responsibilities and the consequences of behaviour, improved respect for others and better control of visitors to family homes.

4.21 Many of the Support Plans included outcomes related to education and employment (see Table 4.4). These included improved school attendance, improved behaviour whilst in school and enhanced educational attainment. Cited indicators on employment ranged from increasing awareness of employment opportunities to the submission of applications and the gaining of a job.

4.22 Enhanced self-confidence and self-esteem for individual family members was a commonly sought outcome of the Support Plans. Family members broadening their friendship circles or engaging in more appropriate social networks was identified as a desirable outcome in several Support Plans. Many of the Support Plans also had outcomes relating to alcohol or drug misuse. The indicators to measure these outcomes ranged from greater recognition of the problematic nature of substance abuse to reducing or eliminating alcohol or illegal drug consumption and maintenance of methadone treatment programmes. In addition to these outcomes, the plans also contained some more specific measures, such as ensuring that a family received new furniture for their home, or a family member was able to access driving lessons and ensuring weekly visits to a family member in hospital.

4.23 Two of the DFP Support Plans included indicators for measuring improved communication and liaison between agencies, ensuring that agencies felt informed and involved and providing a clear multi-agency support package for the family.

Methods to be used

4.24 Each Support Plan indicated the methods to be used to address needs and achieve specified outcomes. The most common method was one to one work or family group work directly involving Project workers. Another commonly practised approach was dedicated communal times for families. Individual family members were also supported by Project workers in activities in the local community or at school. Specific programmes were referred to in the Support Plans, including Positive Parenting, ESCAPE family group work, Webster-Stratton Early Years Training courses, Scoda Young Persons Risk Assessment and the use of genograms and ecomaps during the assessment period. Interactive video-based sessions and relaxation therapies were also used.

4.25 Project workers were to undertake home visits to the families, in some cases to provide assistance with morning routines and accompany family members to libraries or leisure centres or other social activities. The Support Plans also identified a liaison and advocacy role for Project workers acting as intermediaries or advocates for the families in relation to interactions with housing and social work offices and schools. Project workers were also tasked with assisting family members in writing CVs and job applications and in liaising with colleges.

4.26 In relation to social networks, some Support Plans committed Project workers to helping family members with socialisation skills such as developing friendships. The Support Plans indicated that project workers would assess individual family members for referral to counselling services, including alcohol and drugs support services.

Workers and agencies involved

4.27 As stated above, Project workers had the most frequent contact with family members. The Support Plans also identified a range of other organisations and individuals with which the families would engage in the course of their support programme. These included:

  • Local authority social work and housing teams
  • Nurseries and schools (both mainstream and specialist)
  • Colleges
  • Police (for checks on family progress by Project workers, not direct contact with families)
  • Alcohol and drugs-related counselling/ support services
  • Other forms of counselling services
  • Mediation services
  • Local sports clubs, sports centres and libraries
  • Careers Scotland.

Frequency and locations of interventions

4.28 The frequency and duration of interventions were envisaged as varying considerably depending on the methods and tasks being used. Some tasks were to be undertaken on a daily basis. Other interventions were planned to occur on a weekly or fortnightly basis, or for the duration of a particular course. Some methods involved only a one-off session. The location of activities varied depending on the Project. For outreach and floating support projects the majority of interventions took place in the family home or the Project offices. In Aberdeen many activities took place in the Core Block. Other interventions took place in schools or other local community facilities and a few interventions were to happen in the premises of other support agencies.

Timescales

4.29 Many of the interventions with the families were planned as being on-going and reviewed on a daily basis. Other activities were to be reviewed fortnightly or six-weekly. Activities linked to dedicated courses or programmes were to be reviewed at the end of the particular programme. Other indicators such as school attendance or levels of complaints about antisocial behaviour were to be subject to review over a longer time frame. The two Support Plan review documents provided by the Aberdeen project were based on an assessment of the progress made towards each objective and further actions identified as being required to meet these objectives.

4.3 Delivering Project support

4.30 Most of the remainder of this chapter is a discussion on how Support Plans were actually implemented and supportive interventions delivered via the five Projects. The findings presented here are based on interviews with Project workers, local stakeholder representatives (including referral agencies) and service user families, themselves. To set this in context, however, Table 4.5 shows the incidence of different forms of support provided to families whose cases were closed during the evaluation period.

4.31 As shown in Table 4.5, Project assistance usually involved helping adult family members to access other services, help with parenting and in dealing with ASB complaints, emotional support, benefits advice and help with self-confidence. In most families (60%) Project staff aimed to help children to improve their school attendance (see Table 4.6).

Table 4.5 - Cases closed, 1 December 2006-30 June 2008: Forms of help provided to adult family members

Form of help

No of families

% of families

Help in accessing services (other than housing)

51

78

Help with parenting skills

50

77

Help in dealing with ASB complaints

49

75

Emotional support

49

75

Help with claiming benefits

40

62

Help with self-confidence

36

55

Help on school attendance

31

48

Help with managing money

30

46

Help in accessing training or work

29

45

Help with social skills

28

43

Help in accessing housing services

28

43

Help in obtaining furniture

27

42

Help on decorating, gardening etc

23

35

Help in accessing support

21

32

Help in managing depression

20

31

Help in anger management

19

29

Other help

13

20

Cases covered by analysis

65

100

Source: Case closure monitoring returns

Table 4.6 - Cases closed, 1 December 2006-30 June 2008: Forms of help provided to children

Form of help

No of families

% of families

Emotional support

38

69

Help in managing schooling

33

60

Help with social skills

29

53

Help in accessing services

23

42

Help on self-confidence

18

33

Help with anger management

16

29

Other help

10

18

Help in accessing training or work

8

15

Help in managing depression

2

4

Cases covered by analysis

55

100

Source: Case closure monitoring returns

Staffing, support models and timescales

4.32 As noted in Section 2.4, staff team members in all of the Projects provided a diverse range of skills and experience. Nevertheless, it was evident that the holistic nature of the IFSP model and the need to respond to often rapidly changing family circumstances and moments of crisis presented Project workers with a series of new challenges. Project workers reported regularly encountering situations not previously faced, the need for a 'steep learning curve' and the requirement to undertake further, often bespoke and specialised, training. However these challenges and the relative flexibility and autonomy afforded to them in working with families was an aspect of their role that most workers appeared to value. As also discussed in Section 2.4 caseworkers have to achieve a difficult balance of building the trust of families whilst maintaining a critical detachment and combining support and praise with attempts to challenge families' behaviour. This is a highly demanding role, particularly for staff members without substantial directly relevant experience. Tackling drug addiction and preventing the over-dependency of families on Project support were identified as being particularly challenging for less experienced staff members.

4.33 The Projects provided access to further training for Project staff, enabling new skills to be developed, although resource constraints limited access to some training courses. Joint training courses were organised with local authority social workers and family centre staff and this was reported to helped enhance partnership working and raise awareness of the Projects amongst potential referring agencies. Training was also important in affording Project workers opportunities for personal professional development. This resulted in many Project workers accumulating the specific experience and expertise required to more effectively engage with families and deliver supportive interventions. However, the need for such specialist skills highlights the difficulties some Projects have encountered as a result of relatively high staff turnover which necessitates new staff members having to rapidly acquire expertise. There was also an issue that Project staff pay rates were not seen as properly reflecting the skills and experiences required, in comparison to positions elsewhere.

4.34 Falkirk and Aberdeen operated a model of each family case being the responsibility of a lead project worker, supported by a second project worker. This enabled a clear line of accountability and responsibility, continuity with interactions with families and appropriate divisions of tasks, for example one worker focusing on parenting skills and another worker liaising with schools. This model was also essential to ensuring that families had constant access to a known key worker. Workers' caseloads varied across the projects but the common view expressed by both Project workers and family members was that the case load was manageable and facilitated the required levels and intensity of interventions. There was also flexibility within the Projects to re-allocate cases if there were problems in the personal dynamics between an individual worker and a particular family. There were instances where this had been an issue needing managerial resolution, perhaps resulting from tensions over the 'confidentiality' of information disclosed by a family member where this was felt (by the Project staff member) to indicate a previously unrecognised risk of child abuse.

4.35 A key feature of the IFSP intervention model is the ability of individual project workers to engage on a consistent basis with a small number of families, thereby strengthening relationships and facilitating the holistic support provided, enabling a wide range of issues to be addressed. While case loads were regarded as manageable, a consistent finding across the Projects was the significant scale of the work involved with each family, arising from the number of children involved and the need to develop relations with each family member and to address the needs of individuals alongside work on the collective dynamics of the household (including the relationships between siblings in addition to parent/guardian-child relationships). As an illustration of the scale of work required up to six agencies may be routinely involved with one child. This was exacerbated by the wide age range of the children in some larger families. It was evident that the workload that this generated was considerably greater than originally envisaged in the Support Plans. The intensity of interventions and interactions required and the consequential staffing implications had proved challenging for the Aberdeen Families Project in the development of its core block model.

4.36 A major issue that emerged across the Projects was the protracted nature of initial engagement with families, often resulting in assessment periods being extended far beyond what was originally envisaged. At the time of their referral many families had a long and antagonistic history with statutory agencies. Adult family members were often distrustful and resentful of housing, social work and police officers and were initially reluctant to engage with Project workers.

4.37 Although, over time, the Projects were relatively successful in differentiating themselves from other statutory agencies and building trusting relations with family members, it could take several months for significant progress to be achieved here. Once families had begun to engage, there could be a second protracted period of interaction in order to get family members to acknowledge and recognise their problems and their need for help. In addition, there was also an initial need to work around some underlying problems (such as alcohol dependency) rather than being able to tackle these issues directly from the outset. While such an approach was clearly the only feasible way of facilitating families' longer-term engagement with the Projects, the duration of these stages of intervention sometimes resulted in the planned period of service provision being considerably extended. This also suggests that, while earlier intervention with some families may be desirable, it is also vital to ensure that referrals are made at a time when families are willing and able to consider making changes to their circumstances.

4.38 It is also apparent that the progress of family members' engagement with the projects was not linear or consistent. Rather, many families were subject to change and crisis such as relationships ending, a partner returning to the family home or children entering or leaving local authority accommodation. Many families had periods of disengagement from the Project or various periods of alternate sporadic and more intensive engagement. Understandably, therefore, many cases taken on in early 2007 had yet to be closed in summer 2008.

Interventions to address family issues

4.39 Project interventions aimed at addressing a wide range of issues impacting on families. In all of the Projects, this was based on an empowerment model that sought to give voice to all family members and to develop the skills and capacities of each individual concerned. Across the Projects, anti-social behaviour was conceptualised as a manifestation of family problems and the interventions focused upon reducing anti-social behaviour by tackling these family problems. However, while the IFSP model is sometimes portrayed as a wholly supportive model diametrically opposed to the traditional 'enforcement-based approach', this may be too simplistic. At least one Project, for example, found it very useful to obtain ASBOs in an effort to keep troublesome older teenagers away from the family home (from which they had previously 'moved out').

4.40 Typically, work with families comprised one to one sessions with individual family members, collective sessions with all family members and in some cases group work with several families. The majority of the interventions were delivered directly by Project workers, although families were also referred to other agencies and programmes (see below). Under the outreach model most of work with families took place in the family home. The core block model is discussed below.

4.41 Interventions with the families were planned to address key issues and aims identified in the Support Plans. However, a key characteristic of the support provided to families was the constant availability of Project staff to be contacted in order to provide support and advice. Much Project staff activity involved responding to the daily circumstances and practical and emotional needs of service users. Another important feature of the Projects' work was the tailoring and adaptation of staff training and educational resources to meet the needs of individual family members. This could involve the use of visual materials such as the 'outcome star' visual aid used in Perth and Kinross - something akin to the homework completion wallcharts issued by schools to children 10. More broadly, Project workers sought to balance challenging families' 'pathological' behaviour with positive feedback and praise for achievements.

Addressing underlying causal factors

4.42 As noted in Section 4.2, Support Plans identified causal factors underlying families' problems. Interventions aimed at addressing such problems included efforts to break the generational transmission of weak parenting processes. Many parents had experienced very difficult and in some cases abusive childhoods themselves. The Projects therefore sought to address the psychological consequences of this - e.g. through counselling. At the same time, they promoted alternative models of family interaction. Low self-esteem (of both parents and children) and mental health problems were other 'underlying issues' Project workers sought to tackle. Alcohol and drug misuse and dependency, prominent in many cases, were prioritised for intervention mainly through referral to specialist agencies. Early work with the families had also focused upon the need for parents to acknowledge problems, accept the need for change and to take on some ownership and responsibility for this change. This was challenging as initially some adults were reluctant to accept this and tended to blame agencies or neighbours for their circumstances (and it should be noted that some neighbour disputes did include inappropriate behaviour and victimisation on both sides).

- Parenting, boundaries and routines

4.43 The most common and frequent interventions with families focused on parenting skills and family dynamics. Such work was particularly challenging where parents were subject to learning difficulties. Generally, parenting work concentrated on developing confident, positive and assertive interactions of parents with their children and included referrals to bespoke parenting programmes as well as Project workers observing and guiding parents in their own homes. Such interventions also sought to generate respectful interaction between parents and children, in which children's voices were allowed to be heard and inappropriate responses to family conflict addressed, including anger management counselling and the development of consistent parental action.

4.44 A second strand of parenting interventions focused on boundary setting and the establishment of firm and consistently applied rules, for children, including their supervision in the local neighbourhood, supported by positive reward and sanction schemes, linking behaviour to consequences. A further strand of caseworker activity involved attempting to establish daily routines, particularly around mornings, evening meals and bedtimes.

4.45 The final element of parenting interventions aimed to increase the frequency and quality of collective family time, such as eating a meal together or participating in games and leisure activities within the home and neighbourhood. This also included family days out to local attractions, providing passes to local leisure centres and enrolling children in sports and arts activities or libraries. In addition some children were supported to gain access to organised leisure activities during school holidays. In a few cases there were attachment issues between a parent and their children. In general, however, parenting interventions across the Projects aimed to translate the love, protectiveness and mutual commitment evident through the assessment process into positive and constructive forms of family interaction.

- Household management and tenancy sustainment

4.46 A key criterion for referral to the projects was households being at risk of losing their social housing tenancy. Therefore supportive interventions sought to develop household management skills and to ensure that tenancies became sustainable. Such work included improving the cleanliness of properties, tidying up and maintaining gardens and improving diets and health. Project workers also attempted to address rent arrears and personal debt and improve financial management skills and to support families in communicating with statutory agencies, paying bills, claiming benefit entitlements, keeping appointments and responding to correspondence.

4.47 Project workers acted as advocates for families, including children, in their interactions with local service providers, attempting to ensure that families were receiving appropriate support. Interventions with many families aimed to improve 'door control' skills in relation to the family property to exclude inappropriate visitors or the congregation of many persons in the house. Interventions also aimed to re-establish constructive relations with neighbours through consideration of others with respect to the behaviour of children, recognition of boundaries and the playing of loud music or late night social activity. Project workers sought to provide new conflict resolution and compromise techniques for adult family members in their interaction with neighbours - e.g. how to effectively manage being at the receiving end of anti-social behaviour through the completion of an 'incidents' diary.

4.48 A number of families or individual family members were also assisted in securing new or existing tenancies, having Short Scottish Secure Tenancies converted to full Scottish Secure Tenancies, negotiating a transfer or moving from temporary homeless accommodation to a suitable permanent tenancy. In some cases older teenagers were supported from the family home into their own tenancy, which could have a significant influence on family dynamics and levels of anti-social behaviour.

- Education and employment

4.49 As shown in Table 4.6, a focus of most support programmes was improving children's school attendance. This involved ensuring children were punctual and appropriately fed and dressed for school or nursery and improving children's attainment and behaviour at nursery or school. This involved working closely with schools or nurseries to reinforce messages, addressing children's low self-esteem or reluctance to attend and assisting parents in supporting the completion of homework. Some older children and adults also received support to gain access to college or employment opportunities.

- Family and social networks

4.50 The assessment of families referred to Projects often identified either the social isolation of parents or, conversely, inappropriate social networks. Supportive interventions therefore sought to enhance the positive influence of some family members external to the household (for example grandparents) and to discourage contact with relatives and friends seen as constituting negative influences. Isolated family members were encouraged to make friendships in the local neighbourhood or through schools or parents groups and to make greater use of local neighbourhood facilities.

Interventions with families in the core block model

4.51 The Aberdeen and Dundee Family Projects included core block accommodation for families in addition to providing dispersed tenancies and outreach services. The core block model presented specific issues in the delivery of supportive interventions. Both Projects were fully aware of the risks of institutionalisation and dependency and the need to work towards creating a 'normal' home environment that would facilitate an eventual return to an independent tenancy. However, the extent to which a 'normal' home environment could be established in the core blocks was constrained by legal requirements, including health and safety obligations. The rules governing visitors, pets and over-night stays outside the core block required to be balanced with facilitating some autonomy and independence amongst family members. In both Aberdeen and Dundee, Project workers encouraged families to take ownership and leadership of a problem arising before workers intervened to try to resolve the situation.

4.52 As would be expected, the supervision of families in the core blocks was intensive, with regular observation on a daily basis and the incidence of family requests for support was considerably greater than under the outreach model (reflecting the fact that their support needs would be typically greater). The core blocks also generated complex issues about the input of other agencies in working with families. The forms of intervention and work programmes with families were generally similar to those deployed via the outreach model (see above). However, the 'pastoral care' and emotional support element was particularly intensive in the core block environment, as was the capacity to praise positive behaviour or challenge problematic conduct. The level of supervision also facilitated a stronger focus on resolving 'door control' issues which have often been a central feature of antisocial behaviour problems triggering initial referrals.

4.53 Aberdeen and Dundee caseworkers saw core block placements as potentially valuable in enhancing the scope for Project workers to influence family lifestyles and behaviour. Part of this was about opening up families to greater scrutiny. However, one impact of this was to bring to light problems previously unknown to Project staff (or social workers). Such 'emerging problems' could include child protection issues, and this quite frequently led to children of 'core block families' needing to be looked after and accommodated. Such a scenario could be seen as calling into question both the purpose of core blocks, and what should count as a 'success' in terms of core block placement outcomes. Clearly, it was beneficial that children at risk had been accommodated. Nevertheless, for a project that was set up to prevent family breakup such an outcome could not be regarded, by most definitions, as an outright success. Some caseworkers were concerned that their Project's core block could come to be seen by prospective families as vehicle for children being looked after and accommodated by the local authority.

4.54 Scenarios where core block placements led to children being accommodated also raised practical problems for the Projects and their local authority partners. Parents were sometimes left with no children in their care and consequently were no longer eligible to remain resident. However, the lack of availability of suitable move-on accommodation could result in a situation where families remained in residence for considerable periods, thereby taking up places which would, ideally, be made available for other families who were eligible and could potentially benefit from such placements.

Involvement of external services

4.55 In the course of Project support programmes a range of other agencies and organisations were involved with the families. As shown in Table 4.7, social workers were directly involved in more than three out of four cases. It is, of course, acknowledged that some of the agencies listed in Table 4.7 (e.g. the Police) will have been involved with the family more in relation to enforcement action than to provide support. The 'other' agencies recorded as being involved with families during their support programmes (see Table 4.7) included: housing and education departments, health visitors, drugs and alcohol services, schools and Careers Scotland.

Table 4.7 - Cases closed, 1 December 2006-30 June 2008: Involvement of other agencies with families in the course of Project support programmes

No

%

Police

21

34

Mental health professionals

5

8

Criminal Justice workers

15

24

Youth workers

7

11

(Other) Social workers

47

76

Others

38

61

Total cases for which data available

62

100

Source: Case closure monitoring returns. Missing data on two cases

4.56 Referrals of families by Project staff and contributing to families support programmes included those to parenting courses such as ESCAPE and Mellow Parenting, counselling, alcohol support services and drug rehabilitation programmes. Families were helped to access a range of support services and centres provided by local authorities, Action for Children Scotland and Aberlour in addition to services provided by other organisations, including specialist health visitors, educational psychologists and Youth Justice workers. The Projects also made use of college facilities and courses, including educational access training, cut-price hairdressing and manicure services and also employment training. Additional commissioned services included a Shelter child support package, interior design course and alternative therapies for stress.

4.57 Many externally commissioned services were regarded by the Projects as having beneficially contributed to support programmes. However, the take up of such services and their cost-effectiveness varied considerably. Consideration was also given to the ability of families to continue to afford or to access these services following the termination of Project support.

4.58 Most of the former service users interviewed by the research team (see Section 1.4) spoke about being referred by Project staff to specialist support services. Few had previously been aware of the agencies concerned and most therefore acknowledged that accessing such help could not have been achieved without Project assistance.

Partnership and review processes

4.59 Interventions with families were premised on joint working between Project staff and colleagues in housing, social work, and the police force as well as in nurseries and schools. Co-ordination of such inputs was viewed as essential. In most cases, multi-agency collaboration on individual family cases appeared to the researchers to have been positive and robust. In some cases Project staff provided colleagues in other agencies with weekly updates on families' progress. Project workers and referral officers reported regular exchange of information and collective influence on decisions about appropriate interventions with each family. This was achieved through joint assessments, joint visits to families, Project case reviews, co-ordinated actions and project workers attending Children's Hearings.

4.60 There was a view amongst Project staff in at least two projects that more reciprocal communication and information exchange from partner statutory agencies would be beneficial. There were some concerns amongst social workers and antisocial behaviour officers in one project area about the inconsistency between project workers approaches and some evidence of a culture gap between project workers and agency officers around some issues (see Section 2.7).

4.61 Across all five Projects, the Support Plans and progress with each family were subject to regular (typically 6-8 week) multi-agency Project case review meetings. These meetings were central to the co-ordination of inputs to each family's support plan. Existing plans and future supportive interventions to be provided were, thereby, adapted as required. The reviews also provided feedback to families and confirmed the roles and accountability of partner organsations for agreed tasks. Some Projects have faced difficulties in securing the attendance of housing and social work officers at these review meetings. The progress of each individual family case is also regularly subject to internal project review by staff and Project Managers review cases as part of their staff monitoring and appraisal systems.

Intensity of support, dependency and sustainability

4.62 The common model envisaged for family engagement with Projects was a programme of intensive support in the early stages of the programme with contact gradually tapering down towards case closure. In some cases, however, patterns of support have been different, often involving an initial period of sporadic engagement with the intensity of subsequent contact varying dependent upon families' changing circumstances. The typical intensity of outreach support varied between the projects. For example, the Aberdeen Project operated on the basis of an initial once weekly meeting and then less frequent meetings, while the Falkirk model assumed Project worker visits to families between two to four days a week in the early stages of a case. In South Lanarkshire it was reported that some families absorbed 25-30 hours per week of caseworker contact time in the initial phase of support. In all of the projects visits were complemented by the opportunity for families to make telephone contact with the Project at any time. Some families have made extensive use of this facility and the casenote records for families illustrate the regularity of contact and the large range of practical and emotional issues that Project workers have been involved in addressing.

4.63 The Projects were clearly conscious of the need to limit their interaction with families in order to avoid dependency and have retained a central aim of building the capacity of families to cope independently. It was recognised that the 'holistic' 24-hour nature of Project support (particularly in the core block context) could also make it harder for families to maintain independent progress thereafter.

4.64 As described in Chapter 6, the typical exit strategy involved a gradual reduction in the intensity of support. The framework for post-case closure contacts varied across the five Projects. In Dundee, families continued to enjoy access to an 'open door' and 'open phone' service enabling them to make contact at any time. A similar approach was envisaged in South Lanarkshire. The Falkirk project had attempted to address this issue by developing systems to enable a gradually reducing support service to be available to families even after case closure - for example weekly, then fortnightly, then monthly contacts. (Comparable information about Aberdeen and P4 Perth is not available.

4.65 Another key feature of Project support designed to promote sustainability of improved lifestyles and behaviour was helping families acquire self-development tools and coping mechanisms. Case closure conferences were another important part of 'exit processes'. Such meetings (ideally attended by all the professionals involved) were used as a forum for onward referrals, to try to ensure that families were linked in with appropriate mainstream and specialist services once the ongoing co-ordination of such inputs had ceased to be the responsibility of Project staff.