PLANNED RESPITE CARE: HOPE FOR FAMILIES UNDER PRESSURE.
Abstract: Respite care -- having breaks from the constant demands of parenting -- has long been recognised as a crucial service for families of a child with a disability. Only more recently has it been considered equally beneficial for families at risk of abusing or neglecting their children. A growing body of research demonstrates the negative impact of social and economic stress on people's capacity to raise their children effectively. The experiences of welfare workers indicate that planned respite care can be an important means of reducing stress and lessening the likelihood of child maltreatment and the possibility of children's removal to long- term care. A case is outlined for a much more substantial investment in planned respite care as part of an integrated range of family support services.
Subject: Respite care (Research)
Author: O'Brien, Jon
Pub Date: 02/01/2001
Publication: Name: Australian Journal of Social Issues Publisher: Australian Council of Social Service Audience: Academic Format: Magazine/Journal Subject: Sociology and social work Copyright: COPYRIGHT 2001 Australian Council of Social Service ISSN: 0157-6321
Issue: Date: Feb, 2001 Source Volume: 36 Source Issue: 1
Geographic: Geographic Scope: Australia Geographic Code: 8AUST Australia
Accession Number: 74438774
Full Text: 1. History and purpose of respite care

Respite, according to the Macquarie Dictionary, is `to relieve temporarily, especially from anything distressing or trying; to give an interval of relief from.' In a family support context it means providing relief from the relentless demands of parenting, especially for those who experience the additional stress of poverty, isolation or coping alone.

It is generally acknowledged that child-rearing can be a difficult task. Most families encounter stresses in domestic life which, at times, are beyond their capacity to cope. In such cases many can call on an extended network of available family and friends able to take on some of the tasks of parenting for a time. Others lack such assistance, either because they do not have readily accessible family or friends or because they lack confidence in those people's capacity to offer adequate care to their children.

For such families, respite care can take many forms. For children `at risk' respite often consists of 24-hour care for one or two days a month in an alternative family setting within the community. Respite care services can also help families who need crisis care, as when, for example, the main caregiver is unexpectedly hospitalised.

1.1. Background to respite care

Respite has long been a critically important service for families of children with a disability, to provide breaks from full-time care in order to keep the child within the family unit.

In the 1950s and 1960s respite was offered mainly in such institutional settings as hospitals and large specialised care centres. Later, parent groups began lobbying for more flexible arrangements and respite that was similar to the child's own home. A number of community respite centres began in England in the early 1970s. Soon after in Sydney a group called Action for Handicapped Citizens initiated a community-based respite care service called Interchange.

As respite in the disabilities field developed, welfare practitioners began to recognise that social and economic stress could also impede family functioning. Research was beginning to explore the links between family stress, social supports and the risk of child maltreatment (Garbarino 1976). There was good reason to believe that respite from the demands of parenting in difficult circumstances might be as significant a service for families at risk of breakdown and abuse as it was for those of children with a disability (Szwarc 1993). Child welfare agencies responded to this thinking. For example, in 1976 Barnardos began its first NSW respite care program, named Temporary Family Care.

The aim of the Barnados program was to aid disadvantaged families in the rapid resolution of family crises. It soon became apparent that planned episodes of care could assist parents to cope better with their difficulties. Families experienced fewer breakdowns and were less likely to go from crisis to crisis when they had access to regular planned care. Since that time Temporary Family Care has been established in other areas and a number of other child and family welfare agencies have developed their own respite services, usually as part of a wider system of family support. However, currently in NSW there is no government funding to initiate new programs and existing programs are over-stretched.

1.2 What can respite care achieve?

Initially, the emphasis of respite services was on giving parents relief in order to avoid family breakdown and the admission of children into long-term care. These days attention is also directed to other ends. Welfare practitioners see the following as among the main purposes of planned respite care (from Aldgate et al. 1996):

* to provide relief from the normal stresses of being a parent;

* to provide children with relief from stressful daily living;

* to help manage children's behaviour;

* to help with the stress of living in continual poverty;

* to offer an alternative to admission to full time accommodation;

* to provide relief to sick parents;

* to provide early diversion from potential physical abuse;

* to build parents' self-esteem and confidence;

* to offer children a different and relaxing experience;

* to allow parents to address their own problems;

* to give children someone else to go to if they need adult help; and

* to give birth parents support and ideas about positive child management.

What evidence is there that these objectives are achievable and that planned respite can reduce stress and ameliorate the circumstances which lead to increased risk of child abuse and neglect?

2. Evidence for the effectiveness of planned respite care

There are several sources of evidence for the actual and potential efficacy of planned respite in lessening the impact of stress and reducing the risk of family breakdown. First is the experience of welfare professionals themselves, developed over long periods of working with the most vulnerable children and families. Second is a substantial body of research on the effect of both stress and social supports on family functioning and child maltreatment. This material provides a strong theoretical and empirical base for the relevance and potential efficacy of respite care services. And third is a small number of evaluative studies of respite services which provide some evidence of positive service outcomes.

2.1 The experience of welfare professionals.

Welfare professionals display an impressive unanimity regarding the importance of planned respite care (Szwarc 1993: Voigt & Tregeagle 1996). In interviews conducted with UnitingCare Burnside staff for this paper, workers declared that respite was a vital service that produced tangible benefits, providing a much-needed break, especially for isolated and single parent families. Welfare staff were convinced that, without respite, many of the families they worked with would have had children taken into long-term care. At the same time staff pointed to other children they believed would not now be in care if planned respite had been available to their families. Offering planned respite in contrast to purely crisis care was also seen as very important. Providing exclusively crisis care means that families have to be in extreme difficulty before they receive support. But planned care can help families develop their capacity to function by providing a predictable and regular break. A Victorian review of respite services commented on this preventative function of respite care: `the family becomes more capable of survival as a unit if stress and risks are reduced.' (Szwarc 1993: 1.)

2.2 The impact of stress and social supports on parenting

A significant amount of research has demonstrated that child abuse rates are positively correlated with the amount of stress that perpetrators experience (e.g. Rodriguez & Green 1997; Whipple & Webster-Stratton 1991; Weatherburn & Lind 1997). A substantial body of research has also revealed an inverse relationship between the incidence of child abuse and the extent and depth of parent social supports (see Garbarino & Sherman 1980; Coohey 1996; Chan 1994). Although the concepts of parental stress and support clearly overlap, for reasons of clarity I shall examine each separately.

2.2.1 Economic stress and its impact on child abuse

Weatherburn and Lind (1997), in an overview of research on the impact of stress on parenting, distinguish between economic and social stress. Economic stress they define as economic deprivation which results in financial hardship. Their analysis of overseas studies reveals a strong positive correlation between measures of economic stress and rates of child maltreatment.

In Australia, a cross-sectional analysis by Young et al. (1989) indicated a similar relationship between low socio-economic status and elevated levels of child maltreatment. Vinson et al. (1989) found rates of physical abuse were two and a half times higher in the bottom four percent of post code areas (identified in terms of socio-economic variables) than in the six percent of post codes immediately above. In an analysis of 334 referrals to the Child Protection Service at the Women's and Children's Hospital, Adelaide, Hood (1998) found that 82% of these referrals came from suburbs in the bottom two of four socio-economic groups.

These data suggest a plausible connection between economic stress and child maltreatment. Explaining that connection is, however, another matter. Welfare practitioners have long been aware that poverty can exacerbate stress and disrupt the parenting process. Tregeagle (1990) summarises some of these impacts. Poorer parents get less relief from constant child-rearing. They are less able to afford baby sitting, quality child care, entertainment, social or sports activities or to go on stress-relieving holidays. They tend to experience higher levels of conflict and family disruption (Taylor & MacDonald 1998). They are also more likely to live in substandard and crowded housing where it is difficult to get a break from other family members. Parents living in relative poverty are less able to afford books on child rearing, or other resources (such as courses) which give practical help on parenting skills and coping with the normal stresses of raising children. Under these circumstances it is understandable that some parents form unrealistic expectations of their children's behaviour, which compound their sense of stress and may add to the feeling that they are living in an intolerable situation.

Especially significant is the effect of poverty in reducing parental monitoring and positive supervision of children (Sampson & Laub 1994). Both nurturing and appropriate monitoring of children are associated with healthy child development and the growth of competence (Amato 1987). The disruptive effect of poverty on parental care was starkly expressed in one study of single parent families:

2.2.2 The role of psycho-social stressors in child maltreatment

Alongside the impact of economic stress several potent psycho-social stressors make effective parenting much more difficult, significantly increasing the risk of child maltreatment. These include single parent status, large family size and lack of social supports. Other correlates of increased risk of child maltreatment include substance-abuse (Tomison 1996; Steinberg et al. 1981) and maternal depression (Whipple & Webster-Stratton 1991).

Parental depression may lead to an inability to cope effectively with child discipline. Depressed parents are more likely to use physical punishment and adopt a harsh or critical and rejecting approach with their children. In a 1991 study of families attending a child behaviour modification clinic, Whipple and Webster-Stratton noted that abusive mothers were more likely to exhibit a clinical level of depression and anxiety. Abusive mothers spanked their children three times as often as non-abusive mothers and criticised their children substantially more often with an average of 23 criticisms in 30 minutes (as against 14 criticisms in the case of non-abusive mothers).

Abusive families are more likely than non-abusive ones to perceive their children as difficult to handle. Whipple and Webster-Stratton noted that abusive mothers reported their children as having more behavioural problems than did non-abusive mothers. This perception was not confirmed by independent home visits which found no significant difference between the behaviour of children of abusing and non-abusing mothers. This highlights the impact of perceptions of stress in creating difficulties in parenting. Howze and Kotch (1984) contend that the perception of stress may precipitate an incident of child maltreatment, given other predisposing risk factors.

Providing a break for families living with constant economic and social stress may help them regain energy for more positive parenting. Clearly, some families will require additional help to develop or practise positive parenting skills. But regular respite from the demands of child rearing may be sufficient to help many disadvantaged parents approach their task with greater confidence. As one mother put it:

2.2.3 The impact of social support on child maltreatment

Research examining the relationship between social support and child maltreatment has consistently shown that social support ameliorates the damaging impact of social and economic stress and is thereby likely to reduce the rates of child maltreatment. This section briefly examines the elements that constitute social support and their effect on stress factors influencing the risk of child maltreatment.

As Coohey (1996) has pointed out, social support is not a simple, one-dimensional construct but comprises a number of different elements. It can be conceived of structurally in terms of the composition of a person's social network: notably, the size and structure of the network, the frequency of contact and the type of support offered; most importantly, whether it be emotional or instrumental.

Several studies have shown that maltreating mothers have smaller social networks than non-maltreating mothers. Gaudin et al. (1996) found that mothers who abused and neglected their children listed fewer `persons important in your life' than non-abusive or neglectful mothers. Coohey (1996) notes several studies that show maltreating mothers as having fewer social contacts, particularly with relatives. Salzinger et al. (1983) compared the social networks of a sample of mothers attending a clinic because of confirmed child maltreatment with a matched sample of non-abusing mothers. The researchers found that the `clinic mothers' were more isolated, had smaller networks, particularly peer networks, and less contact with their network members. In a 1980 study of two areas matched by socio-economic criteria but with differing rates of child abuse and neglect, Garbarino and Sherman found that mothers in a neighbourhood with higher abuse rates had less contact with neighbours and made less use of organised support services. Corse et al. (1990) found that maltreating mothers had less non-kin peer support, more disturbed relationships with their extended family, and less contact with the local community.

Perceptions of available support are also significant. In a collection of studies reviewed by Coohey (1996) the central finding was that mothers who abuse or neglect their children do not feel supported. This is particularly true of relationships with partners. Maltreating mothers generally rate their partners (where they have one) as less supportive and their relationship less satisfactory than is the case with non-maltreating mothers (Lacharite et al. 1996; Whipple & Webster-Stratton 1991). Maltreating mothers also believe that they receive less emotional support (being listened to, getting help with decisions and companionship) than their non-maltreating counterparts. It is clear from both research (e.g. Cochrane & Brassard 1979) and welfare practice that emotionally close and nurturing relationships have a significant impact on a mother's well-being and how she cares for her children. Polansky et al. (1981) assert that mothers who lack close caring relationships experience an intense loneliness which results in apathy and reduced nurture and attention towards children.

Instrumental support includes help with child care, assistance with household tasks and material and financial aid. Polansky, Ammons and Gaudin (1985) found that neglectful mothers considered they had less instrumental support available to them than did others. In particular, abusive or neglectful mothers believed their child care to be less adequate or available than mothers who did not abuse or neglect their children (Garbarino & Sherman 1980; Whipple & Webster Stratton 1991).

Child abuse is more likely to occur when feedback or support are not available to the parents, either because social networks are undeveloped or `through the presence of norms of parent-child relations which tolerate or even approve of abuse' (Vinson et al. 1996: 526). This is particularly so in families where there is little contact between the immediate family and more distant or formal elements of the social network. Such families are less likely to be exposed to a range of parenting information, attitudes and practices. Salzinger et al (1983) argue that as the limited social contact of abusive parents is often primarily with immediate family members who have similar values, the resulting patterns of child care lacked the more varied and challenging input that could be provided by other forms of social contact. Abusive parenting may therefore go unchallenged while more positive approaches simply remain unknown. These studies illustrate the overall significance of social support. As Garbarino and Sherman (1980) note it is the unmanageability of stress resulting from the mismatch between the levels of stress and the availability and strength of social support which is the most crucial factor in child abuse.

While the significance of social support is well established, the processes by which different elements of social support reduce the risk of child abuse and family breakdown are less clear (Coohey 1996). This should not deter us from implementing programs of social support such as planned respite care. We know enough to be confident about the efficacy of support services. A desire to refine our understanding of the impact of various types of social support should not deflect us from the task of providing much needed and effective services now.

2.3 Respite care: evidence of outcomes and results of evaluations

A third source of evidence for the efficacy of respite care comes from a small number of evaluative studies in both the disability and family support fields. As some commentators have noted (e.g. Szwarc 1993; Austin 1997) there is relatively little research on respite care despite the high demand for services. Austin's review of evaluative studies notes a lack of rigour in most evaluation methodologies. While recognising substantial anecdotal evidence and

client reports of the value of respite, she contends that a lack of other evidence means that questions of the benefit of respite care are yet to be conclusively determined (Austin 1997: 25). She comments that the purposes of respite care must be made clearer and more explicit if outcomes are to be accurately assessed. However, notwithstanding these caveats, existing program evaluations give some valuable indication of planned respite's effectiveness in a number of outcome areas.

2.3.1 Respite for families of children with a disability

The aim of the Shared Family Care program in Victoria was to give out-of-home respite for children with an intellectual disability or developmental delay (Volard et al. 1989). Results from a program evaluation indicated a positive impact for the family and child. Parents reported having more time with their spouse and their other children, felt that the program helped them in managing their children at home, and that it improved their child's social life. Nine out of ten respondents agreed or strongly agreed that regular respite would reduce stress in the family, and that regular respite would help parents cope with a child at home rather than placing them in a residential facility.

Szwarc (1988) reports an evaluative study of respite care conducted by the Children's Bureau of Australia. One hundred and forty two families with a disabled child living at home responded to a questionnaire focused on their use of respite care, the region they lived in and the level of stress in the family. Of the sample 43.7% were scored as stressed families on scales including the manageability of the child and parents' sleep patterns. The study supported the view that respite is an extremely important tool in maintaining a disabled child with their family, providing relief from emotional strain. Comparably, 82% of respondents stated that respite supported parental emotional well being and social interaction with the family. The results also revealed that respite care services were most likely to be used by the more stressed families and those with limited natural support networks.

Williams and Roper (1986) give an overview of community-based respite care operations in Sydney. Their report identified the lack of sufficient host families to meet the needs of client families. The report concluded that 24 hours respite a month was the minimum time to give parents an adequate break. Most families considered that further services were required to assist them in caring properly for their children.

Szwarc (1993) reviewed 1,052 respite placements organised by Family Focus during 1991. Results indicated how the service was used and highlighted social workers' perceptions of the program. The majority of children in respite care came from single parent families. Foster parent retention was not high, nearly half of the surveyed carets no longer being available the following year. The main reasons for referral included parents needing a break (44%); parent illness (22%) and parents' inability to cope (21%). Difficulties with respite included the splitting up of siblings (25% of cases) and the fact that nearly half of all referrals were not placed. Despite these problems, all social workers emphasised the importance of respite care as a key family support provision. And all respondents considered it a significant means of preventing family breakdown and the transfer of children to long-term care. The report recommended more adequate funds for services, in particular for career payments. It also recommended that respite care should be seen as part of a comprehensive package of preventative family services rather than as an end in itself.

2.3.2 Respite for other children at risk

Barnardos Australia has been conducting its Temporary Family Care program in NSW and the ACT since 1978. The program comprises both crisis and planned periodic respite care. Its aims are to reduce the social stresses on families at risk and build up a stock of parenting skills so that pressures leading to abuse and entry into care are lessened (Smith 1986). A 1980's evaluation of the program showed positive results. Despite some recurrence of abuse, families' circumstances had improved and their coping skills strengthened. Barnardos' data indicated that 91.4% of children had returned home with 3.4% being adopted. Only 5.5% of children entered long-term alternative care. This is a particularly good outcome given that the bulk of Temporary Family Care clients were high-risk families referred from State Community Service Departments. A later analysis of Barnardos' data also showed a very small proportion (5%) of children who used Temporary Family Care requiring long-term out-of-home care placement (Voigt & Tregeagle 1996). Another indication of both the quality of service and the level of demand for respite is that these programs are consistently full.

A four-year study by Aldgate et al. (1996) of short-term respite care accommodation in the UK revealed a range of resulting benefits. Participating parents felt more in control of their lives and experienced increased self-esteem, as measured by standard tests, and were more confident about their parenting. They were less preoccupied with their own chronic health concerns and over half the parents had taken action to reduce their social isolation. Around a third stated that creating links with careers helped them feel more part of the community. There was also no significant evidence that offering respite led parents to abandon their children to long-term care. Out of 60 placements for respite care only two became long-term care arrangements. The authors state that respite care clearly illustrates the use of family support to prevent family breakdown and simultaneously provide a protective service to children (Aldgate et al. 1996: 150, 159). Significantly, parental involvement was seen to be an essential characteristic of the services. It was clear that parents regarded respite care as the best option for their families. Their only complaint, the authors note, was that there was not enough of it.

In a United States study, Subramanian (1985) examined the relationship between the provision of emergency respite care, parental stress and the risk of child abuse and neglect. The subjects of the study were parents using the Wisconsin Respite Centre. The Centre offered emergency respite as well as counselling and other support. Two scales, measuring, respectively, source of stress and levels of stress, were administered immediately after the first phone contact with a parent. The level of stress scale was administered again after the parents had used the service. Results showed a statistically significant reduction in parental stress for five out of six sub scales. These included reductions in parental tension/anxiety, depression/dejection and the overall stress level. The authors found that additional help such as telephone support was valued by respondents as much as the actual respite. Parents felt they had someone to turn to when life seemed overwhelming. Subramanian concluded that the provision of emergency respite care was helpful in reducing the stress and isolation associated with child maltreatment.

3. Principles to undergird service development

This brief review of some of the literature on respite care and the impact of stress has highlighted three key principles for the development of effective services:

First: respite care will be most effective when integrated with a range of family support services.

Respite care is seen as a key service but is not a panacea. There is an emerging consensus that programs designed to enhance family functioning and prevent child abuse and neglect are most effective when they offer multiple components which target multiple issues (Cook 1997; Developmental Crime Prevention Consortium 1999). Generally, planned respite care services will be most effective when integrated with other supportive services (Szwarc 1993) This allows for a smoother transition of children between services as their needs change and facilitates better communication between workers.

Second: services should be characterised by a sense of partnership.

A common theme was that respite care services should uphold parental responsibility and ensure that parents and children are involved in planning placements. During placements parents am encouraged and expected to make decisions regarding their children. Often parents who use respite care are full of doubts about their parenting. Worker and carer attitudes can make a big difference to parental confidence and aid them to use the service most effectiveLy.

Third: carers must be paid at a rate that reflects the significance of their contribution and the responsibility they carry.

These responsibilities include supporting both children and parents and their accountability to the respite agency. Evaluations of existing services have shown that poor rates of carer payment make attracting and maintaining an adequate pool of carers very difficult (Volard et al. 1989). In contrast, Barnardos has paid above-award rates and been able to place families needing respite with a carer within 24 hours (Voigt & Tregeagle 1996). In addition to adequate remuneration it is essential that carers receive adequate training, supervision and support.

Conclusion

If we are serious about preventing abuse and family breakdown, an investment in respite care is essential. Planned respite care services can be an important element of an integrated family support system. The evidence for the effectiveness of planned respite comes from at least three sources:

* The repeated experience of welfare professionals is that respite is a crucial means of preventing child abuse and neglect, by giving vulnerable families a break from the stress arising from adverse economic and social conditions.

* The substantial literature on the negative impact of stress on family functioning and the positive effects of social support provide a strong theoretical base for the provision of planned respite care.

* Evaluative studies reveal a range of positive outcomes. Respite services can work to ameliorate parental stress and enhance family well being. There is good reason to believe that this will reduce the rates of child maltreatment. Some evaluations indicate that planned respite care significantly reduces the transfer of children to long-term care. Consequently, there is more than sufficient evidence to warrant the expansion of well developed and carefully evaluated planned respite care services across the nation.

Acknowledgements

This paper was originally prepared for the Coalition to Support Vulnerable Families, a NSW-based lobby group which advocated increased funding for early intervention services including planned respite care prior to the NSW State election in 1999. Members of the Coalition included Anglicare, the Aboriginal Educational Consultative Committee, the Association of Children's Welfare Services, Barnardos, Burnside, Centacare, the Family Support Services Association, the NSW Council of Social Service, and Wesley/Dalmar. Particular thanks to Sue Tregeagle, Barnardos, for her suggestions.

References

Aldgate, J., Bradley, M. & Hawley, D. (1996) `Respite accommodation: A case study of partnership under the Children Act'. In M. Hill & J. Aldgate (eds) Child Welfare Services -- Developments in Law, Policy, Practice and Research, London, Jessica Kingley Publishers.

Austin, C. (1997) Respite Care: A Literature Evaluation, Melbourne, Deakin Human Services Australia,.

Amato, P. (1987) Children in Australian Families: The Growth of Competence, Sydney, Prentice Hall.

Chan, Y. (1994) `Parenting stress and social support of mothers who physically abuse their children in Hong Kong', Child Abuse and Neglect, 18 (3), 261-69.

Cochrane, M. & Brassard, J. (1979) `Child development and personal social networks', Child Development, 50, 609-15.

Coohey, C. (1996) `Child maltreatment: Testing the social isolation hypothesis', Child Abuse and Neglect, 20 (3), 241-54.

Cook, S. L. (1997) `Parent education and family support for the prevention of child maltreatment: What we know and what we don't know'. In N. Repucci, P. Britner & J. Woolard (eds) Preventing Child Abuse and Neglect through Parent Education, Sydney, Paul H Brookes.

Corse, S.J., Scmid, K. & Trickett, P.K. (1990) `Social network characteristics of mothers in abusing and non-abusing families and their relationships to parenting beliefs', Journal of Community Psychology, 18, 44-58.

Developmental Crime Prevention Consortium (1999) Pathways to Prevention: Developmental and Early Intervention Approaches to Crime in Australia, Canberra, Commonwealth Attorney General's Department.

Garbarino, J. (1976) `A preliminary study of some ecological correlates of child abuse: The impact of socioeconomic stress on mothers', Child Development, 47, 178-85.

Garbarino, J. & Sherman, D. (1980) `High-risk neighbourhoods and high-risk families: The human ecology of child maltreatment', Child Development, 1,188-98.

Gaudin, J.M., Polansky, N.A., Kilpatrick, A.C. & Shilton, P. (1996) `Family functioning in neglectful families', Child Abuse and Neglect, 20 (4), 363-76.

Hood, M. (1998) `The interplay between poverty, unemployment, family disruption and all types of child abuse', Children Australia, 23 (2), 28-32.

Howze, D.C. & Kotch, J.B. (1984), `Disentangling life events, stress and social support: Implications for the primary prevention of child abuse and neglect', Child Abuse and Neglect, 8, 401-409.

Lacharite, C., Ethier, L. & Couture, G. (1996) `The influence of partners on parental stress of neglectful mothers', Child Abuse Review, 5, 18-33.

NSW Department of Community Services, (1997) Trends in the Substitute Care Program, Sydney, Child and Family Services Directorate.

Polansky, N.A., Ammons, P.W. & Gaudin, J.M. (1985) `Loneliness and isolation in child neglect', Social Casework: The Journal of Contemporary Social Work, 6, 38-47.

Polansky, N.A., Chalmers, M.A., Buttenweiser, E. & Williams, D.P. (1981) Damaged Parents: Anatomy of Child Neglect, Chicago, University of Chicago Press.

Rodriguez, C. & Green, G. (1997) `Parenting stress and anger expression as predictors of child abuse potential', Child Abuse and Neglect, 21 (4), 367-77.

Salzinger, S., Kaplan, S. & Artesnyeff, C. (1983) `Mother's personal social networks and child maltreatment', Journal of Abnormal Psychology, 92 (1), 68-76.

Sampson, R.J. & Laub, J.H. (1994) `Urban poverty and the family context of delinquency: A new look at structure and process in a classic study', Child Development, 65,523-40.

Smith, T. (1986) `Crisis foster care and child abuse.' Paper presented at the Sixth International Congress on Child Abuse and Neglect, Sydney, 1986.

Steinberg, L., Catalano, R. & Dooley, D. (1981) `Economic antecedents of child abuse and neglect', Child Development, 52, 975-86.

Subramanian, K. (1985) `Reducing child abuse through respite centre intervention', Child Welfare, 64 (5), 501-509.

Szwarc, B. (1988) A Study into the Respite Care Needs of Families of Disabled Children in Victoria, Melbourne, The Children's Bureau of Australia.

Szwarc, B. (1993) Respite Care in Focus: Review of Respite Foster Care Services, Melbourne, National Children's Bureau of Australia.

Taylor, J. & MacDonald, F (1998) Life at Six: Life Chances and Beginning School, Fitzroy, Brotherhood of St Lawrence.

Tomison, A. (1996) Child Maltreatment and Substance Abuse, National Child Protection Clearing House Discussion Paper, Melbourne, Australian Institute of Family Studies.

Tregeagle, S. (1990) Poverty and the Abuse and Neglect of Children, Monograph 12, Sydney, Barnardos.

Vinson, T., Baldry, E. & Hargreaves, J. (1996) `Neighbourhoods, networks and child abuse', British Journal of Social Work, 26, 523-43.

Vinson, T., Berreen, R. & McArthur, M. (1989) `Class, surveillance and child abuse', Impact, April/May, 19-21.

Voigt, L. & Tregeagle, S. (1996) `Buy Australian: A local family preservation success', Children Australia, 21 (1), 27-30.

Volard, J., Baxter, C. & da Costa, C. (1989) An Evaluation of Shared Family Care and Out-of-Home Care Programmes in Victoria, Melbourne, Community Services Victoria.

Weatherburn, D. & Lind, B. (1997) Social and Economic Stress, Child Neglect and Juvenile Delinquency, Sydney, NSW Bureau of Crime Statistics and Research.

Whipple, E. & Webster-Stratton, C. (1991) `The role of parental stress in physically abusive families', Child Abuse and Neglect, 15 (3), 279-90.

Williams, M., & Roper, S. (1986) `Community-based respite care for disabled children', Caring, 11 (4), 14-17.

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Jon O'Brien has worked in community welfare for the last 18 years, and is currently a project officer with UnitingCare Burnside, the family, youth, and child welfare agency of the Uniting Church in NSW.
In the mid 1990s Sydney newspapers carried the story of the death of a six
   year old boy in a large coastal town. The boy lived with his mother, her
   partner and other brothers and sisters. Neither his mother nor her partner
   had a job and had recently moved from another town. Welfare agencies had
   been notified several times about bruises on, and general neglect of, the
   family's children. One day the boy's mother visited the local Community
   Service Centre. She told the staff that she needed a break from her kids as
   they were very demanding and she wanted to go out with her partner. She was
   afraid she might harm her kids if she didn't have a break. Her request was
   turned down. The Centre's resources were stretched and they couldn't offer
   respite care. Two weeks later the mother and her partner bludgeoned the boy
   to death.


The more efforts mothers saw themselves as having to make to balance family
   needs and family income, the more distressed and less nurturing they became
   ... Taken together, the findings from these studies provide strong evidence
   that ... economic stress really does disrupt the parenting process in ways
   which encourage child neglect and abuse. (Weatherburn and Lind 1997: 6.)


Its [sic] hard on them, since he [the husband] left. I get very low
   sometimes and a bit ratty, and there's nowhere much for them to play. Its
   [sic] a godsend, it gives me a break and they have a lot of fun. I'm glad
   to see them again. (Quoted in Aldgate et al. 1996: 151.)
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