Listen to this

FAMILY PROGRAM

The Children's Cottage: A respite service for children and parents in crisis

Jim Allison, Patty Kilgallon and Sandra Reilly

In December 1986, the Calgary Chapter of Parents Anonymous began operation of the Children's Cottage, a 24-hour crisis nursery for children up to six years of age. Housed in a converted three-bedroom bungalow in a southwest Calgary community, the Cottage has a total capacity for six children who may stay up to 72 hours. In its first year and one-half of operation the Cottage has served more than 700 children from over 400 families. Normally parents have friends, relatives, or neighbours to turn to in times of emergency. Some parents do not have these supports and have no where to turn for emergency help. Being able to access safe, high-quality care for children for a short time may be the deciding factor in enabling a parent to resolve a stressful family crisis.

The idea for a crisis nursery in Calgary was first initiated in 1981 by the members of the Child Abuse Team at the Alberta Children's Hospital. In their judgement, the unavailability of relief for families unable to cope with crises and emergencies was a pivotal factor in child abuse. They reasoned that a period of relief or respite for parents in crisis might well prevent maltreatment of children. The idea soon grew into a plan to establish a crisis nursery in Calgary which would have as its primary objective, the prevention of child neglect and abuse.

The Child Abuse Team approached the Calgary Chapter of Parents Anonymous to undertake this project. The agency’s reputation for helping parents in crisis through its existing programs of Parent Support Groups, a 24- hour Stress Line, and One-to-One Friends made Parents Anonymous an appropriate choice. Key to this decision was the confidential, non-threatening and non-judgemental reputation for which these programs were known. These characteristics were seen as essential for the successful operation of a crisis nursery. The staff and Board of Directors of Parents Anonymous decided to pursue the idea and, in 1983, the development of a proposal to establish a crisis nursery was set forth. The program as designed by Parents Anonymous was meant to prevent abuse before it became a way of life for parents and their children. It was felt that this could be accomplished by offering short-term relief to highly stressed parents in crisis situations and by linking parents to the larger system of social services when appropriate.

In 1984, discussions ensued between Parents Anonymous and Alberta Social Services and Community Health. The members of Parents Anonymous were encouraged by the highly positive response to a Notice of Intent. The govemment agency stated that this program appeared to be much in keeping with the major thrust of the new Child Welfare Act in promoting early intervention as an alternative to increased involvement with the protection system.

As a next step, a formal proposal was developed and submitted that same year. In November 1985, the Board of Directors of Parents Anonymous received notification of the intention of Alberta Social Services and Community Health to fund the project. The Children's Cottage officially opened its doors to Calgary families on December 18, 1986.

Before proceeding with a description of the Cottage program we wish to note that on-site visits were made by members of the Parents Anonymous Board to four existing crisis nurseries: the crisis nursery operated by the Saskatchewan provincial govemment in Saskatoon (Mortin, 1983), the Vanessa Behan Crisis Nursery in Spokane, Washington, and the “Island of Safety” crisis nursery in New York (Fontana and Sawicki, 1987), and the Family Support Centre in Salt Lake City, Utah. While each of these programs has some unique characteristics, they are basically quite similar, and they are all able to report that their respective services are highly valued.

Information gained from these centres was used in the design stage for the Children's Cottage. Also, a manual entitled, Crisis Nurseries: Practical Considerations, published by the National Centre for the Prevention and Treament of Child Abuse and Neglect. Washington, D.C. (Beezley and McQuiston, 1977) was particularlv helpful in the early stages of the project’s development.

Program description
The Children's Cottage defmes a crisis as any emergency in the family that makes parents less able to care for their children. Parents request admission for their children for a variety of reasons: marital conflict, housing problems, sudden illness or hospitalization, trouble coping with their new born or with the behaviour of their child, financial crisis, feelings of isolation or depression, fear of hurting or neglecting their child, or simply need for a short break from the responsibilities of child care

Usually these emergency situations are of short duration and parents are able to resume care of their children. Occasionally, however, the problems presented are more serious, and parents may need help to consider longer term placement resources for their children.

The Cottage is designed to serve as a temporary home for children six years of age and under for periods up to seventy-two hours. There is no fee for the service, and it is available to parents twenty-four hours a day throughout the year.

Admission to the Cottage is on a “first-call” basis. Only six children can be accommodated at any one time, and not surprisingly, there are occasions when admission is refused because the Cottage is full. When that occurs parents are encouraged to call back at a later time, or they may be assisted to consider other altematives.

There is no formal program of activities at the Cottage. Nevertheless, expectations placed on staff members with respect to child care and contact with parents are considerable. Despite its nursery-like appearance, the Cottage is a service which provides crisis intervention to families. The members of these families are often upset and in need of special care and attention. Thus, the Parents Anonymous agency decided to hire staff with professional qualifications. The Director of the Cottage holds a Baccalaureate Degree in nursing, and all child care staff have diplomas or certificates in child related areas. Similarly, all volunteers at the Cottage who have contact with children and parents must attend training sessions.

Arriving at the Cottage one encounters a warm, friendly, home-like atmosphere. There is no evidence of formality and routine. Instead, one sees high quality professional care being given to children in a very pleasant environment. Parents can sense immediately that this will be a safe, loving place for their children.

The initial contact with the Cottage usually begins with a telephone call from a parent. Staff determine whether the request for service is appropriate and if so, and if space is available, an appointment is made for the child's admission. Skillful handling of the first contact is vital. Parents need to feel understood and be assured that they are not being judged or blamed for the crisis which they are experiencing.

It is common for parents to express feelings of inadequacy for needing to leave a child at the Cottage. Moreover, they often express concem that their use of the Cottage will be reported to child welfare authorities. Staff reassure parents that their child's stay at the Cottage will remain confidential, and that child welfare authorities are notified only if there is suspicion of abuse or neglect. Parents are informed that the staff are expected to comply with provincial reporting laws but that if such action was needed, the preferred procedure would be for the parent to initiate the report with staff support. If parents do not cooperate with this procedure, staff are obliged to make the report without the parent’s assistance.

Transportation to the Cottage is sometimes a matter of concern for parents. They may be too overwhelmed by their current stress to organize themselves and their child for travel to the Cottage. In such instances staff have access to a special transportation fund for taxi service.

Upon arrival at the Cottage parents are greeted by staff members and are invited to a comfortable area in the Cottage for a preliminary interview. Their child may remain with the parents or may choose to take part immediately in play activities.

The beginning interviews vary according to the circumstances of the parents. However, in all cases, staff members explore and review the reasons for needing the services of the Cottage. They also discuss with parents how the time away from child care will be used, offering suggestions or actual referrals for other appropriate services if needed. Again, sensitivity and skill are required to enable parents to feel at ease with their decision to seek respite care. Also, staff members must be able to make assessments of the nature and degree of stress which parents are experiencing, and be able to make judgements about how best to assist parents in resolving their current crisis. Parents need to feel welcome, they need to believe that their circumstances are understood by staff members, and they need support and encouragement in their problem-solving efforts.

The final task related to admission involves a physical assessment of the child. With parents present or near at hand, the child is examined for marks, scars, bruises, or any other irregularities, and notations are made on appropriate charts. Also, parents are asked about any special needs which their child may have, and the child's preferences about meals and nap times are noted.

After the parent leaves, staff members help the child become engaged in Cottage activities. Usually this is accomplished without great difficulty. However, some children maintain signs of upset about separation during their entire stay and may therefore need a lot of attention and reassurance from staff. If appropriate, parents may call or visit during the respite period.

As noted earlier, there is no formal child care program. Instead, the Cottage functions as much like an ordinary home as possible. Undoubtedly it is busier than most homes, with more people around, but the setting and the atmosphere are unmistakably home-like. Children see ordinary bedrooms and bathrooms, a kitchen, dining room and living room and a large colorful, brightly-lit play area. Most of them adapt to their new surroundings quite quickly. They play happily and eat and sleep well during their entire stay.

When parents return to pick up their child, they are given a verbal summary of how the child fared in their absence. Any irregularities in behavior, eating or sleeping are noted. In addition, parents may be given advice or information about useful child care techniques or resources. Hopefully, parents are refreshed after their period of respite and are able to report that the precipitating crisis is now solved or at least manageable.

Statistical summary
The Children's Cottage has been available for the use of parents and children since December 22, 1986. Statistics are presented for the time period from December 22, 1986 to December 31, 1987. Data from January to March 1988 are presented as well thus providing an opportunity for some early comparisons with the beginning year of operation.

Figure 1 describes the number of infants and children under care on a monthly basis. It is interesting to note, with the exception of December 1986, when the Cottage was open for only ten days, that the number of males has always exceeded the number of females.

The total number of children admitted to the cottage as of December 1987 was 584. Other data explains that these children belong to 387 families. January through March 1988 have been the most active months in our short history. To date in 1988, we have admitted 202 children who belong to forty-one families.

Figure 2 describes the average daily census by month. March, June, July and August were the peak months in 1987. In comparison in 1988, January through March indicates a steady increase in admissions. One might speculate that the major reason for the increase is that the service is becoming better known in the community. Table 1 indicates that the largest proportion of children staying at the Cottage are under three years of age. This figure gives an indication of the need for a high staff-child ratio. At times when all children staying at the Cottage are under three years of age, two staff are not adequate to provide these children with the care and attention they require. As a result, the need for assistance from volunteers is essential to the quality of care provided to the children.

Figure 3 illustrates that the majority of families require help during the daytime and evening hours. The time period 0800-2000 hours account for 79 percent of all admissions.

A further statistic worthy of note is that 144 of the 387 families who used the service, used it on more than one occasion. Generally, staff subscribe to the principle that each admission must be assessed on its own merits but there may be concem that some parents become overly dependent on the Cottage. In these instances the parents are encouraged to lind or develop other substitute care resources.

The Cottage staff had to tum away a total of 263 children from 159 families in 1987. Since January 1988, 137 children from eight-five families have been denied admission.

The usual reason for refusal is that the Cottage is full. However other reasons apply occasionally, and these may include contagious illness or other medical complications, misunderstanding about the service, and children being older than six years of age.

Commentary
When we pause after sixteen months of operation to reflect on how the Children's Cottage has evolved, there is a strong sense of satisfaction that the basic objectives related to the services provided by the Cottage have been met. Without question, the Cottage has provided hundreds of hours of respite for parents and their children. We are confident from what parents say that the respite is serving its intended purpose. They come back refreshed and, for the short term, are better able to care for their children. Likewise, the children seem to benefit from the comparative stability of the Cottage.

During this initial period of operation we have learned a great deal about the many stresses which families experience, and we are confident that our ability to be helpful to parents is improving, in part because we believe that our service of providing safe care for children and respite for parents must be viewed in the broader context of crisis intervention. The majority of parents who have used the Cottage need more than a simple break from child care. If we wish our help to be effective it must be attentive to both the factors which are producing current stress for parents, and to the possible interventive options which will hopefully be helpful beyond the respite time period. In order to accomplish this, a number of staff functions must be present.

First and foremost is the importance of providing emotional support to parents. While it is expected that staff be supportive to parents, there is a growing recognition of how skillful support can be crucial in facilitating crisis resolution. Staff frequently note that parents experience tremendous relief in being able to talk with someone who listens and understands. Occasionally this support by itself may be enough to enable parents to summon up the strengths they possess so that they are better able to manage their affairs.

Secondly, the referral function of the Cottage has gained prominence as staff have become more knowledgeable about the range of services in the Calgary community which may be of benefit to families. Parents simply do not possess knowledge about the entire service delivery system, nor are they always aware of certain services to which they are entitled. A timely referral, therefore, may enable a family to receive a service which could be instrumental in helping them resolve their current crisis. Similarly, some parents, because of the complexity of their circumstances, need help in coordinating access to several services. Here again staff are able to be helpful by making practical suggestions or by providing new information to parents.

Thirdly, educational support given to parents seems to be well received and helpful. Parents may observe and leam about new ways to relate to their children, and they are often open to suggestion about possible ways to improve their care-giving skills. There is often insufficient contact time with parents to allow for very ambitious objectives in this regard. However, a process can be initiated which hopefully will be reinforced if parents follow up with referral suggestions.

Advocacy on behalf of parents has also evolved as an important staff role. Feelings of powerlessness and alienation often beset parents when they are required to deal with social service agencies. They are easily intimidated and sometimes not willing to put up with criticism and possible embarrassment. An intervention on their behalf is not only warranted but may be instrumental in securing a much-needed service for parents. Indeed, our experience indicates that the Cottage is in a formidable position of being able to influence other service providers on behalf of parents.

The Cottage has an ongoing responsibility to inform the professional community of its evolving role. Our early experience shows that community agencies tend to assume that the Cottage is an extension of the emergency placement resources operated by govemment child welfare services. Thus, there is a continuing need to inform police, social workers, and health care professionals that our primary objective is to serve families before formal protection services are needed. We are not, for example, willing to accept placement of abandoned children. For the most part, however, our relationships with other agencies have been excellent, and have been characterized by mutual respect and reciprocal leaming.

A final matter concerning the perception of our role is influenced by our relationship to Parents Anonymous. We continue to believe in the importance of self-help as a powerful factor in promoting lasting improvement in parental functioning. Thus, while crisis resolution frequently requires the intervention of formal service providers, there is the acknowledgement that informal and long-term supports are needed by most families as well.

Conclusion
It has been gratifying to see the ideas and dreams of a few committed child care professionals come true in a relatively short period of time. It would be wrong to suggest that the Cottage evolved magically or without effort; indeed, many people worked long and hard for the vision to become a reality. But an undeniable asset in this venture right from the outset has been the appeal and “rightness” of the basic premise of the Cottage. All parents can understand the need for getting a break from parenting once in a while. Even more readily understood is the need for respite in a crisis situation.

In conclusion it seems fitting to share some of the comments made by the parents and children who have used the Cottage.

A pregnant mother of an eleven-month-old and a two-year-old remarked, “What a relief when I came home the other night. I felt the pressure go down right away. Thanks for your facility.”

George, age seven years, was telling his four-year-old brother at bedtime, “It’s okay, don’t worry these people are kind.”

"My marriage is falling apart and we are in financial ruin. My children (ten weeks, and two and one-half years old) cannot get the care and attention they need from me for the next days. I have to figure out where our next meal will come from. I am so grateful that the Cottage exists. I don’t know what I would have done without it!”

“Thank you all so very much for your loving care of my son. This note is hopelessly inadequate as an expression of my gratitude. I feel that you really saved our lives.”

References

Beezley, P. andMcQuiston, M. (1977). Crisis nurseries: Practical considerations. Washington, D.C.: National Center for the Prevention and Treatment of Child Abuse and Neglect.

Fontana, V. J. and Sawicki, S. (Summer 1987). Crisis nurseries – Effective prevention for Child Abuse. Missing/Abused.

Mortin, J. (April 1983). Nursery Tales. Western Living.

This feature: Allison, J., Kilgallon, P. and Reilly, S. (1988). The Children's Cottage: A respite service for children and parents in crisis. Journal of Child Care, 3, 5. pp. 1-11.