Students will reflect on the topics of the week, their role in the case consultation group and any emotions or questions that are arising for them as a future clinician at this point in the course (fears, concerns, hopes, barriers, learning curves to becoming a clinician). This will be a cumulative, reflective, critical analysis journal with the focus on your experience in this course exploring concepts, interventions, and readings that evoked a response from you. What rubbed you the wrong way? What surprised you? What aligned with your values? What was Challenging? How might you overcome these Challenges? What do you think triggered these reactions?
Readings
Understanding Parenting as Situated in the Larger
Sociocultural Context in Clinical Social Work
May-Britt Solem
Published online: 8 September 2012
� Springer Science+Business Media, LLC 2012
Abstract As a corrective to an unbalanced focus on children’s problem and
diagnoses, this study addresses the importance of recognizing the place of parenting
within the context of clinical social work. Sixteen parents of children with or
without behavioural problems were selected according to parents’ appraisal of the
child-rearing situation, children’s problems and ages, parents’ marital status. The
main finding was the seriousness of the situation for parents who have other
problems in addition to a child’s behavioural problems. Knowledge of variations in
family structures and normal family processes are important to prevent clinical
cases from always being seen as
deviant.
Keywords Critical realism � Normal family processes � Parenting stress �
Risk factors � Salutogenic approach
Introduction
This article explores and analyses parenting as situated and challenge an unbalanced
focus on problem behaviour and diagnosis in child and family practice. The
empirical basis is a mixed method research study from Norway,
1
which included
192 parents of boys aged 6–12 years (64 boys defined with behaviour problems and
128 other boys whose parents formed the comparison group). This study, which
aimed to examine parental coping practices and predictors to parental stress,
indicated that there were no differences between the groups with regard to parents’
coping strategies. The present article was inspired by these unexpected results, and
M.-B. Solem (&)
Faculty of Social Sciences, Oslo and Akershus University College of Applied Sciences,
Post Box 4, St. Olavs plass, 0130 Oslo, Norway
e-mail: may-britt.solem@hioa.no
1
The results published in Infant and Child Development: DOI:10.1002/icd.681.
123
Child Adolesc Soc Work J (2013) 30:61–78
DOI 10.1007/s10560-012-0278-9
http://dx.doi.org/10.1002/icd.681
uses a follow-up qualitative approach to explore situating parenting in context
within clinical social work.
This study emphasizes the need for clinical social workers to not only consider
the child’s problems but to also consider and be directed by the larger sociocultural
context wherein parents do their parenting. A contextual understanding of parenting
requires a focus on the parental environment and day-to-day life and recognition of
the different ways parents’ social and material conditions influence their parenting.
Solem et al. (2010) and Hilton et al. (2001) have emphasized the determining role of
families’ cultural backgrounds, social relations, and living conditions in parent–
child interactions. Traditional developmental psychology is often criticized for
seeing children as abstract individuals with a historical psychological needs, which
their parents may fulfil to different degrees (Allison et al. 1998; Woodhead 1999).
The child is seen either as passing through universal phases or stages or as a product
of interactions with their nearest caring person; in these views the historical and
social contexts in which the child develops are of less concern (Ohnstad 2010). I
argue that family therapy practices, that only takes into consideration those parent–
child interactions that occur in the therapeutic setting, has important limitations, and
that a wider, more inclusive investigation in planning treatment and therapy is a
more fruitful way to help families.
Like Dreier (2008), I argue that focusing on the relationship between the family’s
everyday life and the ongoing therapy may enhance the clinician’s ability to support
the child. Therefore, it is vital to understand parents’ child-care and child-rearing
practices in context and to contextualize family therapy. Detailed descriptions of
families’ socioeconomic situations would facilitate more comprehensive under-
standing of the links between families’ living conditions and organization of
everyday life and the child’s
development.
Social work as a discipline acknowledges the complexity of the interaction
between individual and environment. Understanding parenting in the larger
sociocultural context in clinical social work means to broaden the focus from ‘‘a
difficult child’’ to ‘‘a difficult child-rearing situation’’. This results in a situation-
specific and situated concept of parenting.
Clinical Social Work Practice
When family therapists work with parents in demanding child-rearing situations the
focus often becomes so narrow that only those parent–child interactions seen in the
therapeutic setting are considered. The larger social system in which the child and
parents are embedded is often ignored. Therefore, I aim to challenge traditional
explanations with a multi-faceted understanding of the problems facing children and
their families and to discuss the importance of this perspective for clinical practice.
Because social work has a person-in-environment perspective, it is a field that
deals with complex multi-faceted issues requiring insights from more than one
discipline. The necessary interdisciplinary point of view crosses traditional
boundaries between academic disciplines or schools of thoughts, and is ‘‘constituted
on the basis of the integration of a number of disciplines into a cluster which
provides a new framework or understanding’’ (Hartvig 2007b, p. 259; Næss 2010,
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p. 70). The challenge for social work practice is to integrate a balanced person-in-
environment perspective, to transcend both sociocultural views that place little
emphasis on the individual and psychological views that pay little attention to the
environment. Social workers in practice need to analyse the difficult life situations
unique to each client and to contribute to changes with positive consequences for
the particular family asking for help.
Parents who refer children to child and adolescent psychiatric services experience
more stress than other parents and are more likely than parents in the non-clinical
group to be single mothers, have a lower education, be unemployed, and have little
social support (Solem et al. 2010). Other studies show that single mothers have
relative disadvantages in every socioeconomic area and in some aspects of stress
and psychological well-being (Hilton et al. 2001; Hill and Hilton 1999). On the
other hand, studies also show that single fathers generally enjoy higher incomes,
higher job status, lower poverty rates, more stable employment (Leininger and Ziol-
Guest 2008), and more social support than single mothers (Hilton and Kopera-Frye
2007). A difficult socioeconomic situation, little social support from family and
friends, and conflicts between parents are environmental risk factors that contribute
to the development of problems for children (Richman et al. 1982; Holahan and
Moos 1987). Including the parents’ overall parenting within the context of clinical
social work, means taking into account possible risk factors that prevent parents
from performing normal family processes, but also taking into account possible
protective factors by exploring parenting strength and coping with
stress.
Theoretical Background of the Study
Social work as a discipline acknowledges the complexity of the interactions
between parents, children, and the environment, resulting in a situation-specific and
‘‘situated’’ concept of parenting.
I argue that parents’ life experiences and specific life contexts determine their
parenting practices. Therefore, it is important to explore how parents live and parent
in varied social contexts and to understand their interactions as developmental
processes located in time and space. Parenting practices take place in families’
everyday lives, which are structured by regular habits, rules, principles, and events.
‘‘Situated parenting’’ refers to parenting in this day-to-day organization and its
changes over time as the child develops. The concept of ‘‘guided participation’’
entails the varied ways children learn as they participate in and are guided by the
values and practices of their local culture (Rogoff 2003) The analytical concepts in
this article—situated parenting and guided participation—must be understood to
mean the actions and interactions that take place in specific contexts.
This comprehensive understanding of a child’s life is rooted in three analytical
perspectives most relevant for social work:
• Ecological and interactional (sociocultural) perspectives focus on human
developmental processes (Bronfenbrenner 1979, 2005; Rogoff 2003) and
emphasize families’ everyday lives.
Situated parenting in context 63
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• Salutogenic perspectives focus on health promotion through the knowledge of
people’s resources and view individuals holistically. The concept of salutogen-
esis (salute—of health, genesis—origins) was created by Antonovsky (1979,
1987) as a reaction to the one-sided focus on pathogenesis (identifying what
causes illness) in health research. Salutogenesis focuses on practices that lead to
successful coping and health, and represents a broader and more complementary
perspective than does the pathogenic orientation. Salutogenesis improves our
knowledge of parents’ and children’s coping practices by promoting the
investigation of variations in family construction and the expansion of our
concept of normality.
• Finally, social work practice and research also needs a third perspective, critical
realism, to take into account our ‘‘being in the world.’’ Parents’ social and
material conditions may be resources or hindrances in the parenting situation. I
argue that the sociocultural and salutogenic analytical perspectives are
compatible with the position of critical realism held in the theory of science.
Critical realism takes into account the influence of external environments on the
functioning of families, while viewing the social world as socially constructed
(Bhaskar 1998, Houston 2001).
Situated Parenting
The concept of situated parenting is directly related to Bronfenbrenner’s ecological
theory of child development. This theory is not a stage theory but a systems theory,
which describes children’s developmental processes by explaining how a child’s
interaction with the environment affects how the child grows and develops
(Bronfenbrenner 1979). In this view a child’s maltreatment is seen as a social
problem that is as much a manifestation of social and community conditions as it is
of any individual parent’s pathology. Bronfenbrenner delineated four types of
nested systems: the microsystem, the mesosystem (two microsystems in interac-
tion), the exosystem (external environments that indirectly influence development),
and the macrosystem (larger sociocultural context). Each system contains roles,
norms, and rules that can powerfully shape development.
Situating parenting means taking into account all of these nested systems in the
analysis. The microsystem includes who the child is (age, gender, diagnosis), who
the parent is (age, gender, education), and who the family is (one or two parents,
number of siblings). The meso- and exosystems include the child’s school or
kindergarten, the parent’s employment status, the families’ socioeconomic situation
and housing qualities, the families’ social network, and the parent’s relation to
assistance agencies (e.g. child and adolescent psychiatric services). The macrosys-
tem includes the larger culture, laws, and rules influencing family life. By viewing
parenting as situated within these systems, parents’ interactions with their child may
be seen as guided participation, and their reasons for organizing caring in different
ways become clearer. I argue that this view of situated parenting is relevant for
clinical practice, and outline below three particular concepts that inform this
argument.
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Guided Participation
Using the concept of guided participation (Rogoff 1990), children’s development is
seen as a complex of ongoing processes energized through social interactions
embedded in material, social, and cultural contexts, and the meanings parents
attribute to their own parenting represent cultural standards for caring. This concept
provides a perspective that focuses on the varied ways children learn as they
participate in and are guided by the values and practices of their cultural
community, social class (Rogoff 2003), or macrosystem. The concept is meant
broadly and includes interactions beyond those that are intended as instructional. A
child’s development and direction occurs through participation with parents and
other significant people in shared sociocultural activities, and the child is seen as an
agent in this process. It is important to view these guided interactions in the context
of the socioeconomic conditions and practices that determine these interactions.
Socio-Economic Practices
In this article I argue that cultural processes are embedded in specific kinds of
socioeconomic practices (e.g. social class) that allow some parents access to
opportunities and limit access for others (Devine and Savage 2000). In this
perspective, social class may be viewed as something we ‘‘do’’ (Lawler 2004), and
as parenting reflects social class, ‘‘doing’’ parenting is also ‘‘doing’’ social class
(Stefansen and Farstad 2008; Devine 1998). Like Stefansen and Farstad (2008), I
have chosen a pragmatic approach to the position of class, defining as middle-class
those families with at least one college- or university-educated parent with a work
position that demands such higher education. Working-class families are those with
no education beyond secondary
school.
Socioeconomic conditions contribute in different ways to parental stress, which,
because it influences parents’ capabilities to cope, is the third important factor to
include in the analysis.
Parenting Stress
Parenting stress is a possible risk factor that may influence the emergence or
exacerbation of behaviour problems (Margalit and Kleitman 2006), since a highly
stressed parent may engage in negative behaviours, such as inconsistent or harsh
parenting (DeGarmo et al. 2004). Hecht and Hansen (2001) suggest that parents
who have higher levels of parental stress are more likely to view their child
negatively. Stress is related not only to parents’ overt behaviours, however; parental
stress and well-being have also been shown to affect the ways in which children
cope or adapt their own behaviour (Willinger et al. 2005). In a study by Solem et al.
(2010), the concept of ‘‘parenting stress’’ was broken down into situational
parenting stress (caused mainly by demands in exo- and macrosystems) and
relational parenting stress (caused mainly by demands in microsystems). Situational
stress can be modified with parent-training programmes, in which a key focus is on
enhancing coping strategies in various contexts, as well as helping them ask for
Situated parenting in context 65
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more social support. Some parents may require help to improve their families’
living conditions. Relational stress is understood as a result of problems in either
relatedness or attachment patterns developed between the child and the parent over
time, or in patterns developed through coercive parenting because of the current
situation with the child. It is important to view both aspects of stress in situated
parenting. It may also be important to focus on situational stress and relational stress
as two different dimensions that should be treated differently in clinical practice,
while recognizing that situational parenting stress may influence relational parenting
stress.
Method
Participants
The data in this article is taken from a Norwegian study (Solem, Christophersen and
Martinussen, Solem et al. 2011) that predicted parenting stress and coping practices
in a sample of 192 parents of boys 6–13 years old (64 with behaviour problems and
a comparison group of 128 without). The Nijmegen Child-rearing Situation
Questionnaire (NCSQ) (Wels and Robbroeckx 1996) used in this study includes,
among other aspects, a global appraisal scale of the child-rearing situation ranging
from (1) ‘‘Parenting my child is going exceptionally well. I experience no problems
at all. Support or advice is completely unnecessary’’ to (8) ‘‘I despair when I
consider how I am functioning as a parent to my child. I have tried everything, but
nothing seems to help. Matters seem to be worsening. I need immediate support or
advice from someone who can help me, because I have exhausted all of my own
ideas about what it is that I should be doing.’’
To make up a suitable sample size for the qualitative analyses, 16 parents who
represented the range of distribution from 1 to 8 on the global appraisal scale were
chosen. Six parents were recruited from the clinical group and ten from the
comparison group. They represented a variation in scores on the NCSQ, in marital
status, and in the child’s age and problems.
The study was approved by the Regional Committee for Medical Research Ethics
and the Data Inspectorate.
Characteristics of the Parents in the Study
Of the 16 parents, six were single at the time of the interview (three from each
group); three were divorced, two were widowed, and one had not been married.
Three of the single parents were university-educated and one well-employed, and
one of the widowed parents and the unmarried parent had only 10 years of
education and were both on sick leave. Among the ten married or cohabiting
parents, in five couples at least one partner had university education and in five at
least one had 12 years of education. Only one couple had a difficult financial
situation at the time of the interview, but their housing was good.
66 M. Solem
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The unmarried parent, Mona, and her son Anders are highlighted in the
presentation of the parents’ situations. They belong to the clinical group, as the son
was referred to the child and adolescent psychiatric unit for behaviour problems.
Except for Mona and the widowed parent on sick leave, all parents lived in good
housing and had friends and relatives to help and support them. All parents except
Mona had more than one child, which means that Anders and Mona were in a
special situation. They had few resources in the meso- and exosystems, almost no
support from friends or family, and very little financial security. This family was
therefore chosen to demonstrate the importance of viewing parenting with a broad
understanding, as situated within overlapping systems and subject to a unique set of
circumstances.
Interviews
The parents were interviewed according to the Life Mode interview format
(Andenæs 1995; Gulbrandsen 1998), and performed by the author. This interview
form is organized along a time axis and follows the everyday routines and events as
they unfold from early morning to bedtime, based on the day previous to the
interview. The parents were encouraged to reflect on many of their own issues and
feelings and to relate them both to the organization and routines of their family life
and to their beliefs about childcare and child-rearing. Routines and the organization
of the family’s day, activities and interactions, responsibilities and preferences of
the individual family members, and the reasons and background for what went on
during the day were highlighted. The parents’ were asked follow-up questions and
asked to recount former experiences to enrich and add detail to their stories. Plans
and hopes for the future were also elicited in the interviews. This is an approach that
has proven particularly useful for understanding children’s social interactions and
the affective qualities in such interactions. Almost all of the interviews were
conducted in the families’ homes, lasted from 1 h to one and a half, and they were
audio-taped and transcribed into a written text suitable for the analytic work.
Analysis
The analytic strategies were based on thematic organization (‘‘meaning condensa-
tion’’) and ‘‘meaning interpretation’’ (Kvale and Brinkman 2008). Meaning
condensation entails abridgement of the meanings expressed by the interviewees
into shorter formulations. Long statements were compressed into briefer statements
in which the main sense of what is said is rephrased in a few words. These
statements were then sorted into sub-themes, and then all of the sub-themes were
inductively coded, forming the basis for the new themes: organization of family life,
child and parent participation in family life, stress, and social support. Through the
analytic process, ‘‘organization of family life’’ and especially ‘‘parent–child
interactions’’ emerged as important themes to pursue.
With the help of another researcher the analysis was refined by going through the
interviews several more times looking for stories, reflections, pauses, and other
clues that could contribute to the clarification of the concepts. Little by little some
Situated parenting in context 67
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tendencies became clearer and opened up the material for new analytical questions.
Second, all of the interviews were read through again deductively and the
perspectives developed during the initial analysis were followed up, with particular
attention to the parents’ descriptions of their context, parenting stress, and ways of
guiding their children as they develop. We marked all of the ways parents interacted
with and guided their children, as well as the contexts in which these situations took
place.
The Microsystem: The Child, the Parent, the Family
Although parents’ social and material conditions may be supportive in the parenting
situation, they may also pose barriers and increase parents’ stress. Parental stress has
important implications for parent–child interactions, and hence for the living
conditions for the child (DeGarmo et al. 2004; Heller and Virginia 2006; Kadesjø
et al. 2002), and it may predict poor child adjustment over time (Heller and Virginia
2006; Kadesjø et al. 2002). Maternal psychosocial health may also have a significant
effect on the mother-infant relationship, which in turn may have consequences for
the short- and long-term psychological health of the child (Barlow et al. 2004). In
the following, therefore, I focus on Mona and Anders’ living conditions and
everyday life to illustrate a holistic perspective on children’s health.
Mona, aged 32, lives alone with her son, Anders, who is 7 years old. The family
is working-class according to the criteria of education and employment. Anders has
epilepsy, but is now symptom-free because he takes medication for this problem. He
also has a diagnosis of ADHD and problems with concentration and interaction in
certain situations, and therefore takes Ritalin every day. Lately, he has developed
eating and sleeping problems, known effects of the Ritalin.
The Meso- and Exosystems: Social Network, the Child’s School, the Parents’
Employment Situation, Socioeconomic Situation, Housing Qualities,
and Relation to Assistance Agencies
Mona and Anders have almost no contact with Anders’ father, who is therefore in
the mesosystem, rather than the microsystem. Mona and Anders seldom have
visitors at home, and they seldom visit other people or friends. She has two
girlfriends, but she does not see them often. Anders has no real friends to play with
after school, but he does play football with other boys. Mona’s parents divorced
years ago, and Mona has no contact with her father, who lives in another town. They
do, however, sometimes visit Mona’s paternal grandmother and grandfather. Mona
has infrequent contact with her mother, less than once a year, and while she visits
her mothers’ parents occasionally, she never invites them to her own
home.
Mona works as a clerk in a public office. Previously, she worked in a
kindergarten. Anders is in year 1 in primary school and participates in after-school
care programmes. When Mona was interviewed, she had been on sick leave for
some time, but was looking forward to returning soon to 100 % work through a
social services programme designed to help sick people return to work that would
pay 50 % of her salary. Mona and Anders live in a small two-room flat in an eastern
68 M. Solem
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municipality outside of Oslo, and she has severe financial problems. She has asked
social services for help managing her finances.
Mona goes to individual therapy once a week, which is covered by the social
security system. She has received years of therapy to help her cope with her own
childhood experiences of growing up with an emotionally unstable mother. About a
year before the interview, Anders was referred to a child and adolescent psychiatric
unit, where he received medication for his behaviour problems. They were not
offered family therapy in addition to medical treatment for Anders’ ADHD,
however, once a month Anders visits a relief family, and at the time of the interview
he was going on his fourth visit.
The Macrosystem
In Western Europe middle-class child-rearing practices are the norm for what we
consider to be ‘‘good’’ parenting practices (Hennum 2006). Middle-class parents
stimulate their children to develop in a specific way or direction by assisting their
children’s development, and they have the resources to carry out this project.
Norwegian research on children living in poor families shows that the most
vulnerable children are those living in families with single mothers, parents who are
unemployed, or parents receiving social support. These parents experience
significant stress, which in turn influences their parenting and their organization
of daily routines, as well as affecting their child’s social, physical, and cognitive
development. The middle-class idea of ‘‘family’’ also reflects an ideology that
values certain gender relations, mother love, and family privacy, and influences how
families construct themselves. Lack of resources, bad housing, low income, family
conflict, and chronic illness all make an already difficult living situation even more
difficult to escape, leading to low social status and the potential for stigmatization.
Many poor parents withdraw themselves and their children from social settings
because they are ashamed of their situation.
Results
Everyday Life of Mona and Anders
Mona says that after he started on Ritalin, Anders lost his appetite and he falls
asleep late in the evenings. This means he is very tired in the mornings, and Mona
must help him get dressed.
‘‘The side effect of the medication is that he falls asleep late and does not eat
much. So we are working a lot with his eating problem. He is followed up and
is weighed once a week. He has always been a compact boy, but now he is
thin, so skinny. He has lost weight, six kilos, since September, I think’’.
Breakfast is therefore a big project. Mona lets him decide what to eat, but she
needs to encourage every bite, pushing him to eat, otherwise he would not eat at all.
Sometimes the interactions between the two escalate to the point that he has to leave
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to participate in the school programme (before 8:00 a.m.) before he has managed to
eat. While he is at school, Mona does all the necessary shopping alone.
When Anders comes home from his after-school programme at 4:00 or 5:00 p.m.
he has learnt to put his thermos in the dishwasher and to wash his hands. While she
is cooking, Mona tries to get him started on homework. At the after-school
programme he is allowed to choose his own meal, but he often does not eat it.
Therefore, Mona tries to make him eat at once when he comes home.
Mona believes it is important that parents follow their children’s activities. She is
a coach for Anders’ football team, and she makes an effort to attend Anders’
football practice once a week and to help him with his homework every day after
school.
‘‘It is important that parents are involved with their children and support them
and back them up, no matter how the children are. My parents did not, and that
was a loss. There was never anyone to watch my football games when I was
little. So I decided that if he started with football, then I would follow up. And
if I can contribute to something, I will. They asked for trainers, and so I said I
might be the one. I am a team leader and there are two other trainers too. So I
am very into this, to follow his sport and to help him with homework. Mother
never cared about me’’.
When she is in football training with Anders and the other boys, Mona is never
stressed. At home, she tends to let some situations go by when she thinks insisting
will cause more problems. For example, she does not want to make an issue out of
the meals, so she often makes an effort to offer Anders the food he likes best, but
she struggles with boundaries and with being consistent. She has doubts about what
to overlook and when, as this may have big consequences for Anders’ health.
‘‘Before, he ate three to four sausages, but now I have to struggle to get him to
eat one sausage. And pancakes were his favourite, but now I have to struggle
to make him eat a single one. Meals are very laborious since he started on
Ritalin’’.
Now, when she is on sick leave, Mona feels even more pressured and stressed
because she feels that she has to ‘‘be there for him all the time.’’ However, even
though she is solely responsible for Anders, she sometimes must leave him alone to
fulfil other obligations. She has no one with whom she can share the care for
Anders, except for his the monthly visit to the relief family. When they visit
grandparents, Mona says, she is afraid that Anders will not behave properly; she is
always stressed over Anders’ possible behaviour when they are at someone else’s
home.
She sometimes becomes angry and punishes him by forbidding him from playing
on the computer for the rest of the day. She sometimes ‘‘explodes’’ and uses words
she later regrets. She believes she can contribute to improving his behaviour, but she
also contributes to escalating situations when she is tired. Mona has not been violent
and she never hits him; her abuse is verbal, and she shouts at him and uses bad
language when she is stressed. On other days she plays with him and sometimes she
makes amends by over-praising his good behaviour.
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When they have quarrels, and she has used bad language, Mona always asks him
for forgiveness and talks to him about it. When she called him a brat, Anders told
her that he became very sad; she is proud of having taught him to express his
feelings. When he said that she hurt his feelings, it made an impression on her and
she went into his bed and apologized. She speaks of serious conflicts that escalate
beyond her control because she has no energy left to decide when and how to
intervene. She also struggles with trying to understand his changing behaviour.
However, when the medication is working, she thinks he is a nice boy.
Every day is almost the same, even in the summer holidays, because she has no
money for vacations. In the afternoons, they are almost always alone, doing
homework, playing on the computer, or watching TV. In the evening she brushes his
teeth because she remembers that she had to do this herself and even make her own
food before the age of five. She explains that she sometimes lies down beside him in
the evening to help him fall asleep but it often fails. Anders usually goes to bed very
late in the evenings. One Saturday when Anders had finally gone into bed but
continued to argue, she cried out: ‘‘Shut your mouth, you brat!’’ She wanted to
escape—to leave. In such situations, she thinks it’s impossible for her to control
Anders. Mona is often exhausted and feels that Anders is constantly pushing her
around and invading her personal time. She feels that she has no time for herself in
the evenings. She tries to develop routines and organize daily life as smoothly as
possible, but sometimes she fails because she is too tired.
Mona’s Difficult Situation in Contrast to the Other Parents’ Situations
All parents arrange for their children in many ways. The other parents in this study
plan the mornings to minimize problems. They may have to push a little bit, but they
see their children master more and more in everyday life for every year that passes.
Other children Anders’ age have duties at home, and they manage their morning
routines without their parents telling them what to do. Everything runs smoothly.
Mona’s situation is like having a boy who manages less than he did before because
of his health problems, and she is afraid she is not doing the right things. It must be
difficult not seeing improvements in his behaviour and development that are
apparent in other children.
It is obvious that Mona’s intention is to make up routines in their microsystem
that best fit Anders, but she cannot always arrange the day in ways that facilitate
their interaction. Mona has financial troubles and cannot afford to travel on holiday
or to do anything different from the daily routine. This makes her tired.
Nevertheless, she holds a developmental perspective in that she sees differences
between Anders’ past and present behaviour, and she believes his behaviour is
improving. She expresses concern and worry about Anders, and at the same time she
sees him as a clever boy.
While other parents construct more complex organized routines, Mona’s
organizational practice is limited to taking care of simple day-to-day elements
within a safe and sheltered framework. Mona seems see safety and stability as the
most important aspects of caring, in contrast to the middle-class parents in this
study, who are concerned with future planning, developmental values, and the best
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opportunities for their children. Mona feels powerless and able to influence very
little in Anders’ life. She has few alternatives.
‘‘It is only that I want him to be socially accepted, and have a nice social life.
And that is difficult with his behaviour’’.
Mona’s representation of her goals regarding child caring may be understood as
having a somewhat narrow scope with reference to her own mother’s parenting
practices. In the interview, Mona often talks about her mother’s inadequate caring,
and that her standard for adequate care is motivated by behaving differently from
her own mother. Mona’s empathy toward Anders’ situation may not be optimal. She
sees his problems mostly as difficulties in eating and sleeping because his general
behaviour has changed. Although they continue to have difficult interactions, she
apparently does not see that difficult situations may also arise from her way of
parenting. Therefore, it is significant important that Mona and her son are offered
adequate help and support from the meso- and exosystems in their everyday life
situation. Mona is struggling to be a good mother and to organize daily life for
herself and her son and she wants to ensure that Anders receives the same ‘‘good
standards’’ of childhood and parenting that other children are offered.
All of the parents in this study told stories about ignoring aspects of their
children’s behaviour on occasion. Many potential conflicts between children and
parents are avoided when parents, for one reason or another, choose to overlook
some aspect of an interactional situation. These exceptions are usually grounded in
ideas about age, development, and gender; ‘‘this special child’’; illness (e.g.
ADHD); something connected with the parent (‘‘I can’t stand…’’), or something
connected with special situations or certain times of the day. It is important to
understand parents’ avoidance of confrontation in the context of where and why it
happens before assessing whether the strategy as appropriate or not in the particular
situation. Avoidance actions are not uncommon in normal family processes, and
Mona’s situated parenting and use of avoidance may also be understood as normal
processes.
All parents may recognize Mona’s difficulty in trying to decide whether or not to
intervene in an effort to help her child with his eating problems. Being in such a
close and constant parenting relation with a child with serious health problems and
not knowing what to do is stressing for any parent. It is a real dilemma trying to
decide when to intervene.
‘‘I try to overlook [his missing meals] because children eat when they are
hungry. But he is not hungry, and this is the problem. His appetite is gone. I
have to buy his favourite food, but I really cannot afford it, right?’’
Mona has trouble maintaining her own ideals of child-rearing because of all the
challenges she faces. She is tired, has a bad financial situation, lives in too small an
apartment, and has only a few friends who can help her. It is not so easy to overlook
or to resolve a quarrel in a two-room flat, so avoidance, deciding what to overlook,
may be a suitable strategy in her everyday life. She is aware that these
inconsistencies do not always contribute to Anders’ developmental support. She
72 M. Solem
123
is supportive and participates in her son’s life, but she is tired of being alone with
the responsibility.
Mona has less opportunity to avoid difficult situations than other parents. She has
no resources to buy freedom, help, or relief, and her financial situation worries her
almost constantly. The heavy burden of debt and lack of money for vacations or
outdoor activities with Anders make her sad, so she avoids shopping with Anders
and withdraws from visiting family and friends to avoid any associated stress and
conflict. She says that when they visit her grandparents, she is irritated and
exhausted all the time because Anders demands her constant attention. Likewise, if
an adult comes to their flat, Anders becomes demanding again. This is better when
they are home alone, but mother and son are practically, as well as psychologically,
left alone with each other. Mona appears to be struggling with situational stress
because of her bad financial situation and too little social support.
‘‘I often lay awake at night because of this financial situation of mine. I am
exhausted.’’
She also struggles with her conflicted feelings towards her son. She sometimes
acts out her emotions, and then feels she has to apologize after losing control. These
feelings may be viewed as relational stress.
‘‘By the time we go out the door, I am already stressed because I know it is
going to be terrible. He may be a little terror. I try to avoid such situations. I
actually avoid a lot because I want to have less stress in my everyday life.
Grandfather tells me to take a breath and go out to have a smoke when we are
visiting them. So I do and then I calm down’’.
There seemed to be a widespread idea among the parents that giving a child the
opportunity to calm down and ‘‘think it over’’ is an adequate strategy in certain
conflict situations. This of course also gives the parents an opportunity to calm
down, even if this is not a stated aim of the action. Parents do, however, tell stories
about how they retire from (potential) conflict in particular situations in order to
calm down, to cope with their own feelings of irritation or anger, to take the
opportunity to reconsider the situation, and to break an escalating cycle. Many
parents would actively avoid interaction in specific situations in order to steer clear
of, or escape, certain conflicts with their child. All parents in this study sometimes
withdrew from demanding situations with their children. They needed a time-out in
order to reflect on what might be the best intervention should the demanding
situation escalate. Mona and Anders, however, are isolated in a small flat and she is
not working. Neither of them have the opportunity to withdraw positively in order to
think about what to do.
‘‘Then I want to spank him, but I do not. I am rather angry and set boundaries
with following consequences if he goes beyond them. The consequence that
stings the most is taking away his computer. He also gets rewarded for good
conduct, and for him it is enough. When I see that he has behaved well, then I
exaggerate the praise. I overdo it, and he just drinks it in and feels good’’.
Situated parenting in context 73
123
Discussion
The Significance of Contextualizing Family Therapy
The opportunities to frame everyday interactions in suitable ways varied among the
families in this study. Unlike Mona, many parents in this study were in a co-
parenting situation in which they helped and relieved each other and were able to
find time to themselves. Divorced couples that shared custody were also able
individually to have time off when the children stayed at the other parent’s house.
Single parents have the stress of raising their children alone and the added
responsibilities that go along with a lack of support (Hecht and Hansen 2001). When
a single parent lacks social support and becomes stressed, it may result in
problematic parenting (Lengua 2006). Mona scored 5 on the NCSQ appraisal of her
child-rearing situation, indicating that she has a number of problems with being a
parent to Anders. She worries herself about this and wonders if she can get support
and help.
There is a need to add resources and relief from the exosystem to help single
mothers like Mona and their children. The greater the number of risk factors, the
greater the prevalence of clinical problems (Rutter 1979, 1995; Sameroff 2000).
Following Rutter (1979), the risk factors in Mona’s living condition (severe
financial problems, small flat, little social support) may potentiate each other such
that their combined effect is far worse than the sum of their separate effects. We
know there is a correlation between living conditions and health. In everyday life,
we take for granted that parenting is a situated process, influenced by the situations
in which parents act, the resources parents command, and the motivations and
beliefs parents wish to uphold. That should also be the case in clinical child and
family practice; we should recognize the situations, resources, motivations, and
beliefs of parents like Mona and help them to parent as well as they wish to.
Towards a Broader Understanding of Parenting Practices
Andenæs (2004) has stated that it is necessary to explore what kind of psychological
understanding is used in child welfare, because such understanding guides practice.
In psychiatric services, attention is generally directed most towards diagnoses and
implementing treatment from a biomedical viewpoint (Ekeland 2001).
A salutogenic perspective, on the other hand, strives to balance between
eliminating risk factors and enhancing protective factors; to emphasise normal
family processes as dynamic concepts, changing as the child develops; and to
broaden the concept of normality to include more variation and diversity (Solem
2011). By bringing knowledge from ‘‘normal’’ non-clinical parenting processes into
therapeutic practice, it may be possible to avoid always seeing clinical cases as
deviant.
The perspective of critical realism reminds us that environmental conditions
influence the framing of family life and parents’ coping practices. This study also
shows that the socioeconomic situation of the families and the regularity of co-
parenting arrangements have considerable impact on parents’ opportunities to avoid
74 M. Solem
123
demanding situations with their children. Parents with more socioeconomic
resources, social support, or active co-parenting practices have more freedom of
choice in their arrangements of family life than single parents with fewer
socioeconomic resources like Mona.
A broader understanding of parenting practices as situated in particular
socioeconomic circumstances will enable a more comprehensive understanding of
a child’s life by taking into account the family’s living conditions and lives in their
cultural and social contexts (Bronfenbrenner 1979, 2005). This understanding
highlights the meso-, exo-, and macrosystems affecting a difficult childcare and
child-rearing situation that may otherwise be viewed only on the microsystem level.
This means that interventions should be designed as comprehensive programmes
that enhance as many aspects of family life as possible by increasing social support
or promoting economic security to create more stable and financially secure homes
(Appleyard et al. 2005). Parents in situations like Mona’s need help to enhance their
living conditions and decrease their stress so that their parenting may improve and
their parenting intentions become easier to fulfil. Rearing a child with behavioural
problems demands better coping resources than rearing a child without problems;
parents with diminished resources and a child with behaviour problems need help
appropriate to their situations to allow them to parent effectively.
Although research suggests the neurobiological basis of the condition and the
effectiveness of the medication used in treating ADHD, the quality of the parenting
and social environment also plays a significant role in the aetiology, maintenance,
and treatment of ADHD-associated problems (Howe 2010). According to Howe, by
recognising the part that psychosocial elements play in understanding the condition,
family therapists or social workers may become valued members of multidisci-
plinary teams to support parents and help them to understand and manage their
ADHD-diagnosed child. Through enhancing parental coping practices, such help
may also prevent other psychosocial problems in the family. Developmental goals
for child-rearing and the availability of social support must be included in assessing
and understanding parent–child interactions and the organization of everyday life in
a particular family.
Working Class Family Values and Clinical Practice
Many of the parents in this study emphasized flexibility and adaptation in their
parental practices, while at the same time maintaining their ideas of family life and
developmental values. They make up routines and arrange the day in ways that
facilitate interaction, and they make preparations to strengthen their children’s
skills. Sensitive and thoughtful organization of everyday life mediates parenting
values and prevents conflict and emotional stress throughout the day. Parents value
routines and the forward-looking perspectives such as hopes, plans, goals, and
dreams that give parenting power and direction as a formative project of child
development.
A sociocultural perspective expects that most parents organize special child-
focused activities or expect children to learn from guided participation in ongoing,
shared endeavours. In the macrosystem of middle-class families, parents often
Situated parenting in context 75
123
structure children’s learning by organizing the children’s attention, motivation, and
involvement (Rogoff 2003). They frequently structure parent–child engagement in
child-focused activities, conversations, and play that prepare the children for school
participation. This means that middle-class parents stimulate their children to
develop in a specific way or direction by assisting their children’s development.
Mona tells that she is occupied with constructing a safe and sheltered framework
around Anders. She also helps Anders with school homework. Her interactions may
be understood as she does not structure Anders’ learning by organizing his attention,
motivation, and involvement enough to influence his development in the right
direction. On the other hand, her interactions may be understood as her mothering
project and goal are good enough. The question is: does Mona construct normal
family processes that give Anders adequate developmental support? If the middle-
class values in the caring practices are the gold standard in clinical assessments, the
answer is ‘‘probably.’’ Because of her heavy burden of stress, Mona avoids many
social situations and does her shopping and other errands alone. By avoiding social
situations that could be embarrassing, Mona limits Anders’ opportunities for
‘‘guided participation’’ to those in which she does the guiding, and he may become
deprived of the varied and necessary social experiences that promote social
competence. Mona’s avoidance actions may also undermine her opportunities to
receive assistance from others. Like some of the other parents, she reported that she
was ashamed of her son’s behaviour in front of other people, and therefore avoided
some social settings and family situations. Mona has become more socially isolated,
which in turn reduces her chances to withdraw from Anders to recover or to find
new ways to respond to him that are age appropriate. This also reduces Anders’
opportunities to learn social competence. Anders needs to be exposed to different
social arenas to develop adequately. Although it is positive that Mona is so active in
training Anders’ football team, they both need more social interactions with other
people and away from each other.
In child and family practice, normative assessments are necessary in the clinical
understanding of particular families’ situations. Considerable work is involved in
any parent’s effort to build a ‘‘normal family,’’ but for parents like Mona, whose
opportunities are limited by their situations, that work should be supported by
targeted help specific to their circumstances. In Mona’s case, this would mean
guided participation in the parenting situation with Anders in addition to practical
and social support.
Conclusions
This study demonstrates, as a corrective to an unbalanced focus on problem
behaviours and diagnoses, the importance of considering the family in context in
clinical social work. From a child protection perspective, it is important in clinical
practice to understand parenting as situated within specific social contexts, and it is
important to identify risk and protective factors that are unequally distributed in
society. These factors must be identified using an interdisciplinary approach that
includes insights from outside health services. Parenting stress should be assessed at
76 M. Solem
123
the onset of services to understand the unique needs of the particular family and to
help parents use age-appropriate discipline strategies with their children. An
analytic model that focuses on the contextual variables that influence families’ lives
is further needed in clinical practice.
Acknowledgments The study was supported by Grants from The Foundation for Health and
Rehabilitation, Mental Health of Norway, The Centre for Child and Adolescent Mental Health, Eastern
and Southern Norway (RBUP) and Josef and Haldis Andresen’s Legacy. I thank the families who
participated for their time and commitment to this research. Kari Moxnes, University of Trondheim,
provided thoughtful and provocative feedback and support. I am also grateful for constructive comments
from Liv-Mette Gulbrandsen and Anbjørg Ohnstad, Oslo University College.
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