Couples and Families

Although rates of adolescent pregnancy have exhibited a downward trend since 1991, the United States continues to have a significantly higher rate than other industrialized nations. Adolescent pregnancy, especially in early and middle adolescence, has long-term developmental and economic impact on the teen and her child, in addition to high social costs. This entry describes the current trends in adolescent pregnancy in the United States, and examines factors reported in the research literature as associated with adolescent pregnancy, discusses federal policy directed toward adolescent pregnancy prevention, and identifies various intervention programs.

Adoption of children from foster care and international adoptions have accelerated since 1987. Federal policy changes have markedly increased the termination of parental rights and adoption of children in foster care. Adoption by relatives and single parents has also grown markedly. Open adoption is increasingly normative. Adoption outcomes are generally positive although there is substantial call for post-adoption support for children adopted from foster care. These services are emerging but their efficacy is still untested. More work is needed on post-adoption services because there are now more former foster children in post-adoption status than there are children in foster care.

The practice of intercountry adoption is considered from a historical framework, beginning with World War II to other conflicts and the global dynamics of child circulation for adoption. Significant sources of children are presented, including Russia, China, and Guatemala, as well as moratoriums related to poor practice and fraud. Framed from a social justice perspective, the Hague Convention on Intercountry Adoption is presented with an exploration of child sales and abduction into intercountry adoption. A global market for children creates significant practice challenges for social workers who engage in assessment, both in the country of child origin and in the destination country. Follow-up care includes case management to support families and children in the intercountry adoption process. In conclusion, the significant decline in the practice is reflected upon pragmatically; the need for true reform in the practice is necessary to preserve intercountry adoption for orphaned and vulnerable children.

Adoption by lesbian and gay parents is becomingly increasingly common. This entry presents an overview of the limited research that has focused on lesbian and gay adoptive parents. Specifically, this entry addresses the experience of adoptive parenthood for lesbian and gay parents, with emphasis on the decision-making process (that is, choosing adoption, choosing an agency, choosing an adoption type, and specifying child characteristics), the transition to adoptive parenthood, the psychological adjustment of the adoptive parents and their children, and the adoptive parent–child relationship. We end with recommendations for future research and implications for practitioners and policymakers.

Adult Protective Services (APS) are empowered by states and local communities to respond to reports and cases of vulnerable adult abuse, neglect, and self-neglect. While incorporating legal, medical, and mental health services, APS programs are part of the social services delivery system and incorporate principles and practices of the social work profession.

African Americans number about 35 million or 12% of the U.S. population. Their life expectancy is lower than that of White Americans, and despite the educational gains made since mid-1980s, the unemployment gap between African Americans and Whites has increased. Similarly, although the number of African Americans working in white-collar occupations has increased, the disparity in wage earnings between African American and White workers continues. Regardless of social class African Americans are made to be cognizant of their race at all times. Today they are still at risk for social issues such as substance abuse, teen pregnancy, incarceration, poverty, high rates of female headed households, infant mortality that is twice as high as Whites, residential segregation, racism, and discrimination. As daunting as these problems are, the strengths of the African American community have allowed it to thrive even amid arduous circumstances.

Social workers address older adult issues at all levels of service planning, policy-making, and delivery and across a wide range of community and institutional settings. While various models of practice intervention with older adults exist, more recently the focus is on the integration of micro and macro strategies with an emphasis on strength-based perspectives to geriatric social work practice. The older adult population will expand dramatically and become increasingly culturally, racially, and ethnically diverse in the future and social work services will need to be sensitive to the variety of issues faced by a more heterogeneous and sophisticated older adult population.

The true extent of child abuse and neglect is unknown but reports to state agencies indicate over 3 million reports concerning maltreatment of over 6 million children are made each year. Confirmed reports involved over 679,000 children in 2013. Yet, only 32% of the children known to be harmed by maltreatment in the community are investigated by child protective services. The perplexing dilemma in surveillance and service delivery is how to identify those who need help without spuriously including those who do not. This entry focuses on the definition of maltreatment and provides an overview of the history, etiology, and consequences of child abuse and neglect as well as the current trends and dilemmas in the field. To afford some perspective for the reader, some international data and information are provided.

Child care services, enabling parents to commit themselves to paid employment while providing a supervised environment for their children, have a long and complex history in the United States. Child care services can provide children with educational and other advantages, as well as custodial care. In fact, the United States has multiple kinds of services providing child care and early childhood education. Publicly funded services have concentrated on care for impoverished children and those facing other risks or disadvantages, but many of these children and their families remain unserved because of gaps in programs and lack of support for subsidies, while other families purchase the services they need.

Child support is the legal mechanism requiring parents to share in the economic support of their children. Under the law, parents are obligated to support their children regardless of whether they reside with them. Support calculations for noncustodial parents are based on many different factors, which vary from state to state. Enforcement is the single biggest challenge in the area of child support. The federal government continues to pass laws enhancing states' enforcement capabilities. Recipients of child support differ by race and ethnic group. Child support obligations are distinct from alimony and are usually independent of parenting time.

This entry discusses the evolution of the field of couples counseling from an auxiliary service provided through a variety of professional disciplines to a well-established field defined by its own standards, approaches, and a building body of research. While a few interventions for couples have been well researched using well-established standards, many of the interventions used by practitioners still lack evidence-based research or standard criteria. Also the research does little to address diversity and the application of interventions considering race, ethnicity, and socioeconomic levels. These concerns require ongoing attention.

This entry presents the demographic trends of divorce and the social changes that have impacted the divorce rate. A cultural perspective of divorce is provided by analyzing divorce in the context of race and gender and across nations. Current explanatory theories of divorce are described. Research on the consequences of divorce on adults and children is presented followed by the practice implications for social workers. Future directions for policy and research are discussed.

Economic insecurity and family Well-Being is a growing concern for American society. With the dramatic changes that occurred following the “great recession” of 2008, and the lingering effects since, families have experienced stressors and multiple strains in their adjustment to the impact of the changing fiscal climate and their financial demands. To understand the experience of economic insecurity, an understanding of economic security is helpful in providing a context for how these two dynamics emanate and impact families and their Well-Being. This article provides a glimpse of how the fragility of the economy and the mental tax experienced by the family are inextricably interdependent and connected.

As medical technology advances producing the ability to prolong life almost indefinitely, individuals and families are asked to make increasingly complex choices about what treatments best correspond to their conceptions of how they wish to die. These decisions create a need for attention to medical aspects as well as psychosocial consequences. Social workers play pivotal roles in ensuring access to needed information and resources and in safeguarding individuals' rights to self-determination in end-of-life decisions. This entry discusses issues related to advance care planning, the process of end-of-life decision making, and social work roles with individuals, families, and health care providers.

Families in almost all societies are viewed as the basic unit for coordinating personal reproduction and the redistribution of goals within the larger societal context of production and exchange. They are vulnerable to the rapidly changing economics of the environments in which they live. Universals regarding families worldwide include a delay in marriage, an increase in divorce rates, a decrease in household size and fertility rates, and nontraditional living arrangements. The most studied aspect of families continues to be family diversity, with greater emphasis on an interdisciplinary framework. There is also a movement toward more effective ways of treating families. Placing families in an historical context, this entry discusses evidence-based family interventions, the latest research on families, family diversity, and implications for social work practice and education.

This entry traces the historical, conceptual, and theoretical development of social work practice with families, beginning with the Charity Organization Society and the Settlement House movement. From the 1920s through the 1950s, social work practice was heavily influenced by psychoanalytic theory. However, emerging theoretical frameworks, including systems and ecological theory from the 1960s and the 1970s, shifted the focus of intervention back to the family. The 1970s saw the development of a proliferation of models for family therapy. The emergence of postmodern, constructivist, narrative and feminist thought has had a more recent influence on social work practice with families. Although these theories and models of family therapy have profoundly influenced direct practice with families, there is a renewed interest in what is described as family-centered social work practice. The theoretical foundation of family-centered practice emphasizes a strengths perspective and an empowerment model of social work practice. This approach represents a broad range of interventions that build linkages between the family and key environmental support systems of diverse, multi-stressed, and at-risk families. During the 2000s, attention has shifted to evidence-based practice (EBP). The focus on EBP has been to provide a source of information for clinicians and families to consider when selecting an appropriate intervention for the presenting problem.

There is evidence that family caregiving in the United States has been increasing at an unprecedented rate as a result of various societal issues. This entry provides a summary of the scholarly literature regarding elder-caregiving trends, demographics, legislation, challenges, and racial and socioeconomic impacts, as well as the rewards of caregiving. Additionally, the entry provides empirical findings regarding evidence-based interventions associated with family caregiving of older adults.

Family estrangement—a concept similar to emotional cutoff in Bowen family systems theory—is the unsatisfactory physical or emotional distancing between at least two family members. It is attributed to a number of biological, psychological, social, and structural factors affecting the family, including attachment disorders, incompatible values and beliefs, unfulfilled expectations, critical life events and transitions, parental alienation, and ineffective communication patterns. Family estrangement is often experienced as a considerable loss; its ambiguous nature and social disenfranchisement can contribute to significant grief responses, perceived stigma, and social isolation in some cases. The social-work profession has a role to play in raising social and political awareness of the prevalence of, contributors to, and effects of estrangement on the intergenerational family, with clinicians working to assess and address the impact of estrangement on individuals and the family system.