Students will reflect on the topics of the week, their role in the case consultation group and any emotions or questions that

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: [email protected]

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

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

123

• 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

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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

Situated parenting in context 69

123

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

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