Academic journal article Child Welfare

A Multimodal Intervention for Grandparents Raising Grandchildren: Results of an Exploratory Study

Academic journal article Child Welfare

A Multimodal Intervention for Grandparents Raising Grandchildren: Results of an Exploratory Study

Article excerpt

This article describes the results of an exploratory study of a multimodal, home-based intervention designed to reduce psychological stress, improve physical and mental health, and strengthen the social support and resources of grandparents raising grandchildren. The six-month intervention included home visits by registered nurses, social workers, and legal assistants; the services of an attorney; and monthly support group meetings. The intervention resulted in improved mental health scores, decreased psychological distress scores, and increased social support scores. Participants also experienced improvement in the level of public benefits received and in their legal relationships with their grandchildren. Implications of these findings for practice are highlighted.

The number of children being raised by grandparents has increased significantly in the past decade [Harden et al. 1997; Fuller-Thompson et al. 1997]. Several societal factors have contributed to this dramatic increase. The so-called "crackcocaine drug epidemic" has played a major role as drug-addicted mothers often abandon or seriously neglect their children [Dowdell 1995; Kelley 1993; Minkler & Roe 1993]. Many of these children are cared for by grandparents through informal arrangements among family members as opposed to being formally placed by child protective services (CPS).

Another factor contributing to the increase is the rise in the number of children in the out-of-home care system. Between 1983 and 1993, the population in out-of-home care increased 135% paralleling the dramatic increase in the incidence of child abuse and neglect [Goerge et al. 1996]. With the trend among CPS agencies to favor kinship placements-the formal placement of children with relatives-the number of children in kinship care has increased significantly [Goerge et al. 1996]. In addition to substance abuse and child maltreatment, other reasons for grandparents raising grandchildren, although less common, include HIV/AIDS, homicide, incarceration, or psychiatric illness of the birthparents [Dowdell 1995; Dressel & Barnhill 1994; Kelley 1993].

Grandparents raising grandchildren are often negatively impacted by their caregiving responsibilities in several areas, including psychological stress, physical health, economic resources, and social support [Burton 1992; Dowdell 1995; Joslin & Brouard 1995; Kelley 1993; Kelley & Damato 1995; Minkler & Roe 1993; Caliandro & Hughes 1998]. Although several authors have discussed the services available to, or needed by, this population [Burton 1992; Kelley & Damato 1995; Minkler & Roe 1993], to date no studies are available in the literature concerning the testing of interventions to improve outcomes for grandparents raising grandchildren. This exploratory study tests a multimodal home-based intervention with grandparents raising grandchildren. The goal of the intervention is to decrease the grandparents' psychological stress and improve their physical and mental health, social support, family resources, and legal resources.

The Status of Grandparents Raising Grandchildren

Psychological Stress

Assuming full-time parenting responsibilities for grandchildren is associated with increased psychological distress in grandparent caregivers [Burton 1992; Dowdell 1995; Kelley 1993; Kelley & Damato 1995; Minkler & Roe 1993]. In one study [Kelley 1993], grandparent caregivers scored significantly higher than a normative group on psychological distress as measured by the Symptom Checklist-90-Revised (SCL-90-R) Inventory [Derogatis 1983]. Moreover, 44% of grandparents scored higher than the 90th percentile or what is considered to be in the clinical range (e.g., psychological stress levels high enough to warrant mental health intervention). Social isolation and stress from the demands of parenting, as measured by the Parenting Stress Index (PSI) [Abidin 1990], were also found to be predictors of increased psychological distress. …

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