Psychosocial child adjustment and family functioning in families reached with an assertive outreach intervention

Families who experience a chronic complex of socio-economic and psychosocial problems are hard to reach with mainstream care. Evidence exists that the core of this problem is a problematic interaction between this type of family and current systems of care and services. To improve access to problem families, an assertive outreach intervention was implemented into the field of preventive child health care, The Netherlands. The study aimed to provide a more detailed insight into characteristics of the target group. Although there is consensus about some general features of hard to reach problem families, little is known about their specific characteristics because empirical studies among this group are rarely conducted. Especially, the problems of the children is shed insufficient light on. The studied population consisted of families included in the assertive outreach intervention delivered during one year (N=116). To assess psychosocial adjustment of the children, the Strengths and Difficulties Questionnaire was filled in by the parents. Furthermore, a Dutch questionnaire on family functioning was completed by professional carers. Descriptive data were calculated. The findings show that by using the assertive outreach intervention, programme staff came into contact with families characterised by a considerably higher than average proportion of single parents and unemployed households receiving social benefits. The families faced a high level of risk and a wide range of severe and multiple difficulties, including a lack of basic child care, an inadequate social network and poor parenting. Children in these families were also facing a number of risks. The proportion of psychosocial problems was well above the (inter)national average. The findings reveal the problem areas of unreached families and a need to improve the access to care for these families.