CHILD GUIDANCE AND FAMILY WELFARE CENTRE

The Child and Family Guidance Center has been making a difference in the lives of
children, teens and families since 1962.  It offers an array of mental health treatments
and related services that are considered among the best in the nation.  The Center
strives to provide innovative, clinically sound, strength-based programmes that are
sensitive to each family’s unique needs.

Behavioral health services for youth and families

The Child Guidance Clinic For Central Connecticut, Inc. is an established community

leader providing a continuum of comprehensive behavioral health services to children,
adolescents and their families.   Specialized services include behavioral health
evaluation and treatment, substance abuse treatment, outreach services and prevention
programs.  Child Guidance also provides consultation and educational services to a
variety of community agencies and organizations.

1Clinical Program

The Child Guidance Clinic For Central Connecticut, Inc. provides specialized
treatment with a multi-disciplinary team of experienced clinicians.  As an Enhanced
Care Clinic, the Clinical Program offers comprehensive behavioral health services,
including:

 Initial triage, assessment and evaluation

 Individual, family and group therapy
 Psychological evaluation
 Psychiatric evaluation and medication management
 Sexual abuse evaluation and treatment
 Anger management and psycho-educational groups
 ADHD assessment and treatment
 Parent groups
 Training and consultation to schools and community organizations
 Substance Abuse Program

Adolescent Substance Abuse services are offered to youth to assist in making the
behavioral, psychological, and lifestyle changes to become drug and alcohol free and
avoid  relapse. 
 Program components include:
 Evaluation
 Group Treatment
 Individual and Family Therapy
 Family Education and Support
 Early Childhood Consultation Partnership
 ECCP, Early Childhood Consultative Partnership,  offers families
 Early Childhood Educators (preschool, and daycares, etc.) mental health
consultation to support the healthy social and emotional development of children
ages birth to five.
 The continuum of program services includes brief phone consultation, center-based
consultation and child-specific consultation.    
 Care Coordination
Our Care Coordination and Enhanced Care Coordination programs partner
with families with children with unmet behavioral health needs. Using a team
approach of both traditional and non-traditional members, staff are able to
assist families in meeting these needs

2 Family Enrichment Services

The Family Enrichment Services Program provides home based education,

advocacy and case management services to families who reside in Meriden and
Wallingford.  Through a diverse staff of Family Enrichment Specialists, the strength
based approach provides support and encouragement while assisting families in
mobilizing their personal resources. There is no fee to the families who participate in the
program and services are available in English and Spanish.

Services include:

Home based parent education and support Home-based

parenting education, advocacy & case management services include budgeting,
home management, communication skills & more

Advocacy

Coordination of Services

Reunification Services

Case Management

EXAMPLE:Welcome to Henrietta Weill Memorial Child Guidance Clinic...

The Henrietta Weill Memorial Child Guidance Clinic is a private non-profit,

outpatient mental health center for children and families. Since 1946, the Clinic
 has provided individual, family, and group counseling services for children,
adolescents and families who reside in Kern County, California.
 What Types of Families Does the Clinic Serve?
The Clinic serves families with a wide range of issues. Typically, children and
adolescents are referred to the Clinic because of difficulties that interfere with
their functioning at home, in school or in the community. Problems may be
related to control, attention, mood, anger management, etc. The Clinic also
serves children and adolescents who have experienced various forms of abuse,
neglect or other hardships that affect their daily lives.
 How Does The Clinic Help?
Several options exist for treating emotional and behavioral issues.  Children and
families seen at the Clinic receive an initial assessment at which time
an individualized treatment plan is developed by the parent(s) and therapist.
Treatment may include parent education groups and/or individual, family or group
counseling. A psychiatrist is available to provide medication support services, as
needed. All of these services are provided in a bilingual, culturally appropriate
environment.
 Mission Statement
The Henrietta Weill Memorial Child Guidance Clinic provides mental health and
substance abuse services and the resources necessary to promote wellness and
recovery for Kern County children, adults and families.

 The Child and Family Guidance Center was founded in 1925 to address the
emotional and psychological wellbeing of children and their families. To this end the
Center offers a wide range of outpatient mental health and substance abuse
counseling services for children under the age of 18 as well as a variety of in-home
supportive services to their families.The Center operates three outpatient clinics
located in Bridgeport, Stratford, and Fairfield.

The Child Guidance Clinic of Greater Waterbury is a regional center that helps
over 5,000 children, adolescents and families each year through an array of treatment
and prevention programs.  Services include outpatient counseling and treatment of
victims of physical and sexual abuse; investigative interviews of victims of child abuse;
emergency mobile psychiatric response to home, school and community crises; early
identification and intervention at pre-schools; school-based treatment services;
assistance to victims of crime; intensive in-home treatment; child abuse prevention and
family supports; and a therapeutic group home (Paladin House). Performance and
outcome oriented projects that empower families and help keep children together with
their families characterize our programs.  

  Mission Statement

The mission of the Child Guidance Clinic of Greater Waterbury, Inc. is to provide quality
behavioral health services for children, adolescents, parents and families from the
greater Waterbury area without regard to their ability to pay.
                                                  

Vision Statement

In 2003, the Child Guidance Clinic of Greater Waterbury underwent a

comprehensive strategic planning process that included internal and external
assessments and identification of major trends that were likely to impact the future. 
After lengthy research, study and discussion, the Board of Directors adopted a strategic
vision statement.

Our mission is to promote the delivery of strength-based, context-sensitive,

developmentally-informed mental health training which builds on and supports
the emotionally-sustaining relationships of children, adolescents, adults and their
families.
ABOUT THE CLINIC

GENERAL DESCRIPTION

The Community Child Guidance Clinic is a private, non-profit mental health agency
offering diagnostic, treatment and consultation services to children up to the age of 18
and their families.  The Clinic serves families whose children or adolescents are
experiencing emotional, social, behavioral or academic problems.

It is Founded in 1959, the Clinic's professional staff includes child psychiatrists, clinical
psychologists, psychiatric social workers, and marriage and family therapists.  The
Clinic also serves as a training center for interns in these professions. 

CLINIC SERVICES

The Clinic provides a range of diagnostic and treatment services.  Psychiatric

evaluation, medication evaluation and psychological testing are available as needed. 
Treatment services include individual and family therapy, group therapy, and play
therapy.  Consultation is provided for schools and other agencies involved with the child
and family. SPECIALIZED SERVICES

The Clinic provides a number of specialized programs to address specific problems.

The Clinic's Sexual Abuse Treatment Team (SATT) provides assessment and
treatment for families in which sexual abuse is a presenting problem.  SATT services
are coordinated with those of other community agencies involved with the family. 

The Birth to Five Early Intervention Program (BTF) provides mental health services
to families with children aged 0-5 years who exhibit emotional, behavioral, and/or
developmental problems.  A comprehensive range of diagnostic and treatment services
is available.

The Firehawk Children's Program is a prevention program to assist children engaged

in fire-setting or fire-play.  Children are assessed in collaboration with the Town of
Manchester Firehawk Intervention Team.  Recommendations are made for mental
health services, fire safety education and other community interventions.

The Victims of Crime Assistance Program  (VOCA) provides support, therapy,

advocacy and referral to children and families who have been victimized by violent
crimes such as physical and sexual abuse, homicide, robbery, assault and domestic
violence.  Both in-home and office-based services are provided by a clinical social
worker

The Building Blocks Autism Assessment Program (BBAAP) is one of several

specialized services provided at the Community Child Guidance Clinic.  It was
developed out of our awareness that early identification and treatment in addressing
problems at a young age is of critical importance.  The goal of the program is to identify
children with autism-spectrum concerns, and then assist parents and providers in
attaining appropriate and timely treatment.

HOME-BASED SERVICES

The Clinic provides home-based services through seven programs:  WATCH (Wrap
Around the Child) provides an in-home social worker and/or mentor to prevent
residential placement.  The goal of INTENSIVE FAMILY PRESERVATION PROGRAM
is to maintain children and adolescents in their homes and communities.  The
REUNIFICATION PROGRAM provides a three-state program which planfully returns
children home from out-of-home care.  Included in the home based services department
is the INTENSIVE SAFETY PLANNING PROGRAM. It is a new initiative in the state
that provides intensive in-home support to parents just after the children have been
removed. If the parents are quickly able to work on the causes for removal, the children
may be returned home before the state takes commitment of the children and that is in
everyone's best interest. The service runs for 24 days.

The North Star Intensive Outpatient and Partial Hospital Program provides
structured clinical services within a therapeutic milieu to children ages 6-12 and their
families who are experiencing behavioral and emotional crisis.  These services include
intensive individual therapy, family therapy, multifamily therapy, group therapy,
behavioral management, structured therapeutic and psycho-educational groups,
medication management, and collaboration with schools or other community providers,
all focused around a therapeutic milieu. 

Extended Day Treatment  is a cooperative program between our clinic and the Village
for Families and Children.  The after school program provides comprehensive, intensive
clinical treatment services for children ages 6-12 who exhibit emotional and behavioral
problems. Five days a week the children attend a structured, intensive, therapeutic
milieu with integrated clinical treatment services.   

CLINIC SCHOOL

The Clinic School was established in 1974 and is a State-approved private special
education facility serving children ages 3-15 in two separate programs. 
Developmentally disordered students learn functional and cognitive skills within a highly
structured classroom program.  Behaviorally disordered or emotionally disturbed
children learn academic as well as social skills.

Classroom instruction is accompanied by extensive interdisciplinary efforts including

home consultation, parent counseling, individual therapy, speech therapy and
occupational therapy.  The combination of special education with clinical services
provides a comprehensive program for children and their families.  Referral is through
the child's local Board of Education.
CLINIC REFERRALS

Families may contact the Clinic on their own or they may be referred by a variety of
sources such as pediatricians, family physicians, schools, day care providers, the
Department of Children and Families, courts, police departments, private mental health
professionals, and other agencies and programs.

After a referral is made, the parent calls the Clinic for an appointment.  A brief session
with one of the Clinic social Workers is scheduled soon after the initial call.  This
appointment provides an opportunity for the parent to describe the problem and to
determine whether services are needed or appropriate.   Parents are asked to sign
releases for collateral information and to complete a Child Information Packet that
provides the Clinic staff with background information on the child.

If Clinic services are indicated, an appointment is scheduled for the entire family to meet
with a therapist.  Priority is given to serious problems or crisis situations.  Upon
completion of an assessment, a treatment plan is made for each child and family which
includes recommendations for therapy.

ASSIGNMENT OF THERAPISTS

Therapy assignments are based on the nature of the presenting problem or any special
needs of the child.  One or two therapists may work with a family, and others may be
consulted for particular problems.  Clients have the right to request information about
the educational and professional background of their treating therapists.

APPOINTMENTS

Treatment is usually scheduled on a weekly or bi-weekly basis for a one- hour

appointment.  Younger children may be seen for a shorter period of time.  Appointments
for a parent and child are scheduled at the same time whenever possible.  Parents or
guardians are expected to accompany children to the Clinic for their appointments. 
They should register with the receptionist and wait in the waiting room until the therapist
comes to pick them up.  If the child is to be seen individually, the parent or guardian is
expected to remain in the waiting room during the child's appointment.  Treatment will
usually involve a combination of individual and family sessions.  At the end of the
appointment, unless a fee is being paid, it is not necessary to check with the
receptionist prior to departure.

ACCESS TO THERAPISTS

Therapists are available for telephone contacts between appointments.  Clients can
reach therapists by calling the Clinic at (860) 643-2101.  Should the assigned therapist
be unavailable, another member of the therapy team or a supervisor will be available for
the family.
EMERGENCIES

In case of patient emergencies, a 24-hour answering service is available.  Efforts

are made to refer the call to the family's therapist; if the therapist is not available, the
call will be taken by another member of the Clinic staff.  Clients can access the
-answering service by calling (860) 643-2101.

MEDICATION

The Clinic psychiatrist may recommend medication as part of a child's treatment. 

This will be done with the permission of the parent or guardian, and the potential
benefits and possible side effects will be explained.  While the Clinic may prescribe
medication, it does not administer medication.  Administration of medications is the
responsibility of the child's parent or guardian.

DURATION OF TREATMENT

The length of treatment will be determined by families and their therapists.  Brief
treatment is considered to be from one to four months, and long-term treatment from
four months to one year or longer.  Termination is appropriate when a mutual decision
has been made that problems have been resolved.

CONFIDENTIALITY

Most information shared with the Clinic will be considered confidential and will not be
shared with parties outside the Clinic without written permission of the parents. 
Confidentiality requirements are described in Section 17A-28 of the Connecticut
General Statues.  Exceptions to this policy are child abuse or neglect situations, which
are mandated by law to be reported to the Department of Children and Families. 
Suicidal or homicidal behavior, and other circumstances where the best interests of the
child will be served by disclosure, are also situations not considered confidential.

MANDATE TO REPORT TO DCF

Chapter 301, Section 17a-101 of the Connecticut General Statues requires us to

report the suspicion of physical or sexual child abuse to the Child Abuse Hotline of the
Department of Children and Families (DCF).  The Regional DCF office in which the
abuse was disclosed is charged with the responsibility of investigating the complaint to
determine whether or not abuse has occurred and whether steps should be taken to
protect the child in question.

FEES

The Clinic's fees for services are determined by a sliding scale based on the family's
income.  Fees may be modified according to a family's special circumstances, and
adjustments are made when a family's situation changes.  Services are never denied
because of an inability to pay.  The Clinic accepts State medical cards and private
insurance.  All families are encouraged to discuss with their therapists any problems
they may have with the established fee.

INSURANCE COVERAGE

Families who have private health insurance are asked to provide a signed
insurance claim form and their insurance card in order for the Clinic to apply for
benefits.  Their fee is based on the amount not paid by insurance and is adjusted to
family circumstances.  If a family  is insured by an HMO which has its own providers
and does not cover the Clinic, the family may still elect to seek Clinic services. 
However, in such cases, a flat fee rather than a sliding fee will be charged.  Families
with Title XIX coverage are asked to provide their Title XIX card, their medical card and
their social security card for billing purposes.

MISSED APPOINTMENTS

Families are asked to give 24 hours notice when canceling appointments. 

Appointments cancelled with less than 24 hours notice or appointments which are
missed without notice are billed at the rate of the family's usual fee.  Exceptions are
made in cases of emergency or sudden illness.

WEATHER DAYS

The Clinic usually does not close during bad weather.  However, when weather
makes driving hazardous, it is advisable for clients to call the Clinic to make sure that
the Clinic is open and that therapists are available.  Whenever possible, the Clinic will
contact clients ahead of time to cancel appointments due to weather problems.  In case
of a power outage or other unusual emergencies, our answering service will provide the
client with that information.

 Some types of problems treated are:

 academic underachievement
 adolescent adjustment reactions
 anxiety
 attention deficit disorder
 bed wetting
 behavioral problems
 depression
 developmental delays
 eating disorders
 encopresis
 family conflict
 fire setting
 hyperactivity
 OTHERS MAY INCLUDE:

learning difficulties, low self-esteem ,lying, poor peer relations, poor peer relations,
school phobia, serious emotional disturbance, sexual abuse, sleep disturbance,
stealing, stepfamily issues, stepfamily issues, substance abuse, suicidal behaviors.

CLINICAL PROGRAMMES

Clinic Programs

The goal of the Building Block Autism Assessment Program is to identify children with autism-
spectrum concerns and then assist parents and providers in attaining appropriate and timely
treatment.

The Birth to Five Program addresses developmental concerns and issues in children from
infancy through 5 years.

The Intensive In-Home Child & Adolescent Psychiatric Service Program is designed for
children with serious disorders who would otherwise need hospitalization to be stabilized in their
homes and communities.

The Sexual Abuse Treatment Program offers evaluation, diagnosis, treatment and consultation
to families in which one or more children are experiencing emotional or adjustment problems
related to sexual abuse victimization.  

Victims of Crime Assistance Program supports children and families who have been victimized
by violent crimes including physical and sexual abuse, domestic violence, homicides, robberies,
assaults and motor vehicle crimes.

The Wrap Around the Child Program provides home-based therapeutic services to families.  All
referrals for this program come through the Department of Families and Children.
OTHER PROGRAMMES

The Firehawk Children's Program is a nationwide preventive program to assist children who
set fires.

The North Star Program is an active, intensive and therapeutic after-school program for children
ages 6 to 12 and is designed to limit the length of stay a child may experience in  a more
restricted setting.

Parent Education Groups are designed to help minimize the negative impact of divorce on
children at a time when parents are naturally preoccupied with their own adjustment.

The Community Child Guidance Clinic provides School Based Services through the Head Start
Program which allows social workers to provide mental health services in schools throughout
Manchester.

Summer Programs at the Community Child Guidance School are designed for children
who are at ri Parent education

Evening Parenting Education Sessions

Parenting Information Sessions

InPre School, Day Care Centre or Family Day Care and provide parenting information
sessions are arranged for parents and staff.

Suggested Topics
Sleep and Settle, Toddler Behaviour, Dietary Needs, Toileting, Biting, Tantrums,
Helping children adjust to day care.
COMMON QUESTIONS

Ask for academic or behavioral and emotional deterioration over the long summer break

Most Common Questions > Nutrition

Q. I want to commence solids but have heard many stories about what I should
and should not do. What do I need to be aware of?

A. It is best to commence solids at around 6 months of age, with plain foods such as
rice cereal, fruit and vegetables. Introduce one new food at a time. Begin with pureed
food and slowly introduce lumpier foods. Be aware of any strong family history of
allergies and avoid these foods, at least until twelve months of age. If there is a family
history of allergies to peanuts and peanut foods these should be excluded from a child's
diet until at least 3 years of age because of the risk of a severe reaction. Discuss the
risks with your Child and Family Health Nurse or family doctor before introducing them.
Do not give a child under twelve months honey, as it contains bacteria that may cause
infant botulism. You can also download our information brochure on starting solids on
the Karitane Website for more information.

Q. At what age do I give my baby solid food?

A. It is ideal to wait to around six months to start solids. Some babies may show signs of
being ready for solids before this time. Babies are not physically or developmentally
ready for solids before 4 months at the earliest. For more information on the signs of
readiness for solid foods, please go to our information brochure on starting solids on the
Karitane Website.

Q. I have tried to feed my baby solids but she has pushed them back out with her
tongue. How will I know when she is ready? I think she is hungry?

A. Some of the signs of being ready for solids to look for in your baby are:

 She is able to control her tongue to take food from a spoon and swallow it.

 She can hold her head up well

 She is interested in watching you eat (e.g. reaches out, opens her mouth when
you are eating and puts hands/toys in her mouth).

 She seems hungry after the breast or bottle feed

From around six months baby should be started on solids to make sure she gets
necessary vitamins and minerals, especially iron for growth, brain development and
learning.

Q. I am given mixed advice as to when I give solids. Is it before or after the milk?
How do I start?

 Choose a time when baby is happy and relaxed and you have time to enjoy
feeding and talking to her. Usually in the morning when babies are less tired is a
good time and you will have an opportunity to watch and seek help if an allergy
develops.

 When first starting solids, give baby a breast or formula feed first as this is still
the most important part of her diet at the moment. Offer the solids 1⁄2 hr to 1hr
after milk feed.

 Offer 1 teaspoon of smooth, slightly warm solids once a day at first. Rice cereal,
which is iron enriched, is recommended as a first food to offer. Let the baby taste
the food and suck it off the spoon. If she continues to spit out the food wait for a
few days and try again. She may not be ready for solids yet.

 A Baby's ability to take the food off the spoon usually improves during the first
week.

 Your baby may prefer some tastes more than others.

  If the baby appears to be unsettled by certain foods, stop giving it and try again in
a few weeks.

 If your baby develops a body rash, swelling or difficulty breathing, seek medical
advice urgently.

 As your baby becomes older (e.g. around 9 months), if she is not taking
appropriate amounts of solids you may decide to try giving the solids before the
milk feed.

Q. How often should I give solid food to my baby?

A. Start with a small amount once a day. Increase gradually to about half a cup before
increasing the number of feeds. Let baby's appetite guide how much is eaten. Progress
gradually so your baby is having 3 meals a day by about 7-8 months of 1⁄2 - 1 cup at
each meal. In addition to this some babies will also desire a small snack for morning or
afternoon tea if awake.

Q. My baby is now twelve months old. What can he eat?

A. Your baby at 12 months should be able to eat the family diet. He will have
progressed though puree to fork mashed to cut up food. Different foods would have
been introduced one at time and now he should be able to eat family meals. He should
now be introduced to full cream cows milk for his milk drinks (from a cup) and cheese
and yoghurts should be part of his usual diet. When preparing the family meals, set
aside your baby's meal first before adding seasonings or spices. Talk with your Child
and Family Health Nurse or call the Karitane Careline 1300 CARING (1300 227 464) if
you would like more information.

Q. My baby is fifteen months and has decided he is doesn't want to eat. He is still
having 3-4 bottles of milk but refuses anything else. I have tried so many different
foods.

A. At 15mths he doesn't need as much milk in his diet, and having this amount of milk
will actually stop him becoming hungry. Your son does need calcium in his diet and this
can be obtained in cheese, yoghurt, and other dairy foods. You may be giving your son
the milk because he refuses every thing else, however, if the bottles continue he will
continue to refuse other food. Children can become iron deficiency anaemic from too
much milk and not enough intake of other foods. Once you cut down his milk to some
on his cereal, a cup of milk with lunch and a cup after dinner, it is more likely that you
will see an improvement in his interest in other foods. The other issue is to encourage a
variety of foods and to put a limit on biscuits, chips or lollies and fruit juice. Children
mostly learn from their parents when it comes to eating, so modeling a healthy diet by
eating good food choices throughout the day will be a great example for your child. He
may also enjoy sitting at the table and eating at the same time as the rest of the family.
Water is the drink of choice for when he is thirsty.
Q. I have just started my 51⁄2 month old son on rice cereal. I give it to him in the
morning after one side of the breast. He started 4 days ago and today I noticed he
really chewed and seemed to "like" it. When do I introduce a second solid meal?
When can I give him some potato or pumpkin? I am a bit nervous about the whole
thing

A. Well done. Give him a few more days on rice cereal before you try the other foods,
increasing the amount of rice cereal every day one or two teaspoons at a time. Only try
one food at a time waiting 5-10 days before introducing another new food so that if he
has a reaction you know which food it is to. Be guided by him as to when to introduce
the next solid - it's a balancing act between continuing the breastfeeding and taking
solids. If he has too much solid food he may not take as much breast milk or formula
milk. For more tips and details on starting solids, you can download our information
brochure on the Karitane Website.

Postnatal Depression
Q. I'm pregnant and have been concerned about the way I've been feeling.
Sometimes I cry for no real reason, and I'm anxious most of the time.

A. While some women feel a sense of well being and happiness during pregnancy,
others (about 15-30%) may feel unsettled, depressed or anxious. Society considers
pregnancy a time of joy, but if depression or other problems occur, some women may
feel alone, unsupported and unable to reveal their true feelings. Talking to someone can
often help. If you are unable to talk to your partner or family member, talk to someone
you can trust, try your midwife, obstetrician or family doctor or ring the Karitane Careline
on 1300 227 464.

 Some things you can do. Find a support person who will be able to help after the
baby is born.

 Talk to your partner about taking time off after baby is born and give clear
suggestions on how they can help you.

 Be kind to yourself, self care is important - do something that you enjoy.

 Try not to move house or make big changes in late pregnancy.

 If your mood does not improve - seek medical advice and support sooner rather
than later.

Q. What is postnatal depression?

A. Postnatal depression(PND) is the name given to the mood disorder that occurs in
women in the months following childbirth. It can develop at anytime in the first year after
the birth and can begin suddenly or develop gradually. It affects 1 in 7 women and may
persist for many months. Many women suffer these symptoms in silence in the belief
that nothing can be done to help them, some feel ashamed if they are not coping with
motherhood (expecting that this should be a happy time.) Depression can occur at any
time in your life. It is sometimes related to a major event or life change that needs to be
dealt with.

Symptoms of postnatal depression:

 Feeling sad, irritable or unhappy most of the time

 Anxiety or panic attacks - feeling anxious or panicky most of the time

 Loss of interest in work, hobbies or things that used to be enjoyed

 Chronic tiredness or hyperactivity

 Difficulty concentrating, remembering or making decisions

 Feeling unable to cope with daily tasks

 Negative thoughts or morbid recurring thoughts

 Thoughts of self harm or suicide or thoughts of harm to the body

 Loss of confidence or self esteem

 Feelings of guilt or inadequacy

 Fear of being alone or withdrawing from social contacts

 Inability to sleep or excessive sleep

 Appetite change

Q. What can I do if I have postnatal depression?

 Ask a family member or your partner to support you and be around in the first few
months after the birth.

 Try not to make major life changes (move or renovate) late in pregnancy or in the
first few months after birth.

 Restrict visitors when you are feeling unwell, overwhelmed or tired.

 Try to rest or sleep when your baby is sleeping.

  Try to get out in the fresh air when the weather permits, e.g. take your baby for a
walk in the pram.

 Get to know your local Child and Family Health Nurse who can refer you for
assessment and support, or you can visit your family doctor and discuss your
feelings.

 Treatment options Individual counseling.

 Psychological treatment - therapy aims to support and teach you strategies to

deal with symptoms while addressing the underlying issues that have made you
vulnerable to developing problems.

 Support groups.

 Couple counseling - can help couples work effectively together to assist in the
adjustment to the changes experienced before and after childbirth.

 Medication - This is sometimes required and should be accompanied by

counseling or other support. Discuss with your doctor regarding the use of
medication and which antidepressants are safe to take during pregnancy and
breastfeeding.

 Where available, admission to a mother- baby unit can be helpful.

Q. Do fathers get depressed?

A. Men can suffer from depression too. It is suggested that as many as 1 in 14 new
dads may be affected. A new baby brings many life changes and challenges. The
impact of a new member of the family and adjusting to everything now revolving around
the baby might bring feelings of jealousy and resentment. Some men find it difficult to
adjust to life as a new father and may experience frustration and helplessness and find
it difficult to talk about their feelings. Men can present with similar symptoms as women
with depression. It is important that these symptoms are recognised and addressed ad
early as possible. Treatment is available once the problem has been highlighted and is
similar to the treatment options for women. See above or download a copy of

Most Common Questions > Breast Feeding

Q. I have just been discharged from hospital after having my first baby. I seem to
be having a hard time feeling comfortable with breastfeeding, in particular the
positioning. While in hospital I received many different opinions & ideas and
seemed to have established a good system. However, at home I'm feeling a bit
lost without having a midwife to see me every time I feed.

A. Gain some follow up advice from your local Child and Family Health Nurse who may
be able to direct you to your local breastfeeding support group or clinic or offer some 1
to 1 support. Experiment with different holds to find a position that suits you and your
baby. Remember with practice you and your baby will find the position which bests suits
you. The main thing to remember is to ensure your baby is well attached with plenty of
breast tissue in her mouth. For more information on attaching your baby to breastfeed,
you can download our breastfeeding information brochure on the Karitane Website

Q. Sometimes my baby wants to keep feeding and other times falls asleep after a
short feed. How do I know if he is getting enough milk?

A. Signs to watch for are at least six wet nappies in 24 hours and adequate weight
gains. Weight gains should be calculated as an average over 4 weeks and be around
150-200grams/week for birth to 3 months; 100-150 grams/week from 3 months to 6
months; 70-90 grams/week for babies aged 6 to 12 months. Feeds should be led by
your baby, allow baby to indicate when and how much she needs. Some feeds will be
long and others are of shorter duration - this is normal. Like you and I, your baby will be
more hungry at some times than others. You will usually be able to hear her sucking
and swallowing on the breast. She should also be content between most feeds. Babies
usually have at least one unsettled period in the day. They may also demand more milk
in hot weather or if she is having a growth spurt. If you have concerns about your
feeding talk to your Child and Family Health Nurse/Karitane Careline(1300 227464).
You can also obtain more information about breastfeeding from our information
brochure on the Karitane Website.

Q. My nipples are becoming sore from breastfeeding. What can I do?

A. Some pain is Normal for the first few weeks. A cause of sore nipples can be incorrect
positioning of the baby at the breast. If you have sore nipples and you cannot improve
the positioning yourself, obtain help and support from your Child and Family Health
Nurse or contact an Australian Breastfeeding Association counselor, or Lactation
Consultant as soon as possible, to ensure baby is attaching to the breast correctly. You
can find more information about managing breastfeeding difficulties in our information
brochure on the Karitane website.

Q. I have changed how I attach my baby to the breast but my nipples are sore
from her previous attachment. Should I buy any creams to heal them?

A. To help heal sore and cracked nipples after feeds express a few drops of breast milk,
gently spread on the nipples and allow to dry. Leave nipples uncovered or loosely
covered between feeds and avoid using soap on the nipples. The breast milk contains
natural antibodies to help guard against infection and helps lubricate the nipple. For
more information on attaching your baby when breastfeeding and managing sore
nipples you can download our breastfeeding information brochures on the Karitane
Website
Q. Sometimes I worry that I don't have enough milk. I had so much milk at first
and now my breasts do not feel as full. How do I keep a good milk supply?

A. The more milk your baby takes, the more milk you make. Baby's sucking stimulates
your breasts to produce more milk. Your breasts will settle down from the early days of
feeding and might not feel quite as full. This is normal in most women and not
necessarily an indication of low supply. You can be assured your supply is adequate if
your baby is passing at least 6 wet nappies, is gaining average weight for age and is
reasonably settled. Breastfeeding mothers need three meals a day, plus snacks and
adequate fluids. Drink when you are thirsty. Water is the best drink. Try to rest and relax
as much as possible. Babies cry for many reasons, not just when they are hungry.
Ensuring your baby has access to breastfeeding and sucking to meet his/her needs will
help maintain a good milk supply. For more information about signs that your baby is
having enough breast milk, go to our information brochure on the Karitane Website.

Q. I need to go out and want to be able to leave my baby and miss a feed. How
can I store expressed breast milk?

A. Put the expressed breast-milk in a sterilized plastic container with a tight fitting lid. It
will keep at room temperature (26C or lower) for 6-8 hours and in a fridge for up to 3 to
5 days. Milk should be stored in the back of the fridge where it is coldest. Expressed
milk will keep in the freezer box in the refrigerator for 2 weeks, 3 months in a separate
door fridge/freezer, or deep freeze for 6 months. Once thawed, use the expressed milk
immediately. Throw away any milk that is left over after your baby has fed. DO not
refreeze or reheat the milk as this is not safe.

Q. My daughter is 5 1/2 months old and has always been breastfed but I would
like to get her to take a bottle of formula so I can leave her for short periods of
time. So far I have been unsuccessful in getting her to take a bottle of formula or
breast milk and so has my husband. She will play with the teat and let the milk
run out of her mouth but will not suck and swallow. I have tried stimulating her
sucking reflex with my finger and then substituting for the teat but still no go. Do
you have any advice for me?

A. Many breastfed babies take a little while to adjust to feeding from a bottle. When
trying to introduce a bottle it is best to not put too much pressure on yourself or your
baby. So give yourself and your baby a few weeks to get used to a bottle. When trying
to encourage a baby to take a bottle the following may be helpful:

1. Offer the bottle at a usual feed time (instead of a breastfeed).

2. Hold her as if you were going to breastfeed her i.e. in your arms close to your chest.
3. Hold the bottle so it is resting on your chest and facing towards the babies mouth.
4. Gently move the teat across the baby's lips.
5. Let baby turn her head towards the teat. Many will turn away, cry but then turn back
and look at the teat again. Don't try to force or follow the baby with the bottle.
6. Offer reassuring sounds like 'shh shh, it's OK'.
7. If your baby is crying and wriggling to get free for a few minutes put her down and
give a 5 minute break.
8. Re-offer again - repeat over a 20 - 30 time span. If there is no success, offer the
breast and try again at the same feed time the following day.

It may be helpful for another family member to introduce the bottle initially.
If you are needing to offer bottles on regular basis and the baby is refusing to feed,
contact your Child and Family Health nurse or call Karitane Careline on 1300 227 464
for additional support and guidance.

fluoride needed for healthy teeth. Extra fluoride might need to be added in country
areas. The quality of local water supplies can be checked with local council or the water
board.

All equipment must be washed in hot soapy water, rinsed and sterilized by boiling for 5
minutes or by using a sterilizing solution/tablet for the first twelve months. Microwave or
electric steam sterilizers may also be used. Follow the manufacturer's instructions.
Clean equipment well by using a bottlebrush to reduce the risk of gastroenteritis. Take
extra care with teats by pushing the water through the hole to clear any left over milk.

Q. Can I carry warm milk out with me so I am prepared for a feed?

A. Once the milk has been warmed, it is important that it is used quickly, within 1 hour.
This is to reduce the risk of gastroenteritis. It is best to take cooled boiled water with you
and a measured amount of formula in a small sterilized container and mix them just
before the feed. If possible, ask for some hot water to heat the freshly made up formula
or feed at room temperature.

Most Common Questions > Bottle Feeding

Q. How do I know what formula is right for my baby? Where can I get information
about formula feeding?

A. The most common formulas are cows milk based and are recommended unless your
baby has a medical condition (such as allergies or lactose intolerance). All formulas in
Australia meet a very high standard. It is best to start with a newborn formula and stay
with this until advised by your health professional. Always follow the instructions
carefully on the tin when preparing formula. Never water down, use half scoops or add
an extra scoop. You can contact the Karitane Careline or your Child and Family Health
Nurse if you need more information about formula and bottle feeding.

Q. I constantly hear about breastfeeding promoting closeness. As I have chosen

to formula feed, how can I use feed times to promote closeness?
A. It is important to always hold your baby when bottle feeding. Encourage eye contact
by talking gently to your baby during the feed and holding her close to your body. If your
partner and other family members are giving your baby a bottle feed, encourage them to
also take the opportunity to talk, hold her closely during feeds and enjoy this special
time.

Q. How do I clean and sterilize the bottles. Do I need to boil the water?

A. Cooled, boiled water should be used to make formula until the baby is twelve months
old. Bottled and spring water is not recommended as it does not contain the added
fluoride needed for healthy teeth. Extra fluoride might need to be added in country
areas. The quality of local water supplies can be checked with local council or the water
board.

All equipment must be washed in hot soapy water, rinsed and sterilized by boiling for 5
minutes or by using a sterilizing solution/tablet for the first twelve months. Microwave or
electric steam sterilizers may also be used. Follow the manufacturer's instructions.
Clean equipment well by using a bottlebrush to reduce the risk of gastroenteritis. Take
extra care with teats by pushing the water through the hole to clear any left over milk.

Q. Can I carry warm milk out with me so I am prepared for a feed?

A. Once the milk has been warmed, it is important that it is used quickly, within 1 hour.
This is to reduce the risk of gastroenteritis. It is best to take cooled boiled water with you
and a measured amount of formula in a small sterilized container and mix them just
before the feed. If possible, ask for some hot water to heat the freshly made up formula
or feed at room temperature.

Most Common Questions > Sleep

Q. Can you tell me how much sleep does my baby need?

A. Sleep needs vary, between babies. Each baby has their own sleep pattern and often
babies do not have regular sleeping patterns until they are older. You may find our
sleep and settle brochure on the Karitane website helpful for gaining an understanding
of the sleep needs of babies of various ages.

Q. I have heard that babies cry because they are overtired. How would I know?

A. If your baby has only short sleeps they can become overtired. An overtired baby may
grizzle, cry even though they have just been fed, rub their eyes, have poor eye contact,
seem to stare into space, yawn, have clenched fists, startle easily and have tense or
jerky movements.

Q. How can I help my baby to settle?

A. Your baby may be tired after a feed, change, playtime and cuddle. It's best to put her
to bed when she shows tired signs. Overtired babies can be harder to settle. Wrap your
baby in a light cotton fabric (available from Karitane by telephoning (02) 9794 2300).
The fabric will need to be at least one meter squared. Your baby should be wrapped
with her hands up near her face, as she may like to suck on her hands or use her hands
to self-soothe. If you are unsure how to wrap your baby please refer to our Wrapping
Your Baby Information Brochure on the Karitane website. Place your baby on her back
at the lower end of the cot and tuck in firmly. If your baby is calm and relaxed leave the
room and allow her to go to sleep on her own. If she needs help to settle gently pat,
body rock, rock her cot, or stroke her face and head. Gradually, slow down and reduce
these techniques as she calms and relaxes. Some babies enjoy having background
music played while they sleep - this could be your favourite radio station with the
volume on low or any soothing and relaxing music that you have.

Q. I sometimes put him to bed and he just keeps crying. What do I do?

A. If you are unable to stop your baby crying, try comforting him in your arms briefly until
he is calm, and then place him back in the cot awake and try some settling techniques.
See our Information Brochure for age appropriate techniques. You may choose to
continue these techniques for approximately thirty minutes. If your baby does not settle
you may choose to take him for a walk in the pram or pouch, give him a massage or a
relaxation bath. Then try to re-settle. At the next sleep time follow the same routine.
Remember being consistent is what will teach your baby to sleep. If you are unsure how
to wrap your baby please refer to our Wrapping Your Baby brochure or if your baby
continues to cry contact the Careline on 1300 227464, or your Child and Family Health
Nurse or General Practitioner.

Night waking 7 months - 18 months.

Q. My son is 15 months old, and in the past 2 weeks has started to wake at night.
He has got a molar coming through and I was wondering if he is waking because
of this, or is he getting used to us coming in to comfort him. My husband tried to
do this, as my son knows that I can feed him, but he is loosing a lot of sleep and
he has to get up and go to work. We have tried controlled comforting and it
doesn't seem to work. He also has just had an injection and the spot where the
needle went in is really warm. Could this also be an issue?

A. It sounds like all the things you have suggested, the teething or injection, may have
contributed to his night waking. Sometimes a child may start waking for a reason such
as being sick or uncomfortable, and at these times it is important that you do attend to
them. Most of the time, once the discomfort has passed, the child will start sleeping well
again, but sometimes they become accustomed to the extra time you spend with them
and can continue to wake at night looking for that extra comfort. What can you do?

First: Make sure your child is well and comfortable.

Second: Continue with the settling as you have been doing, remembering that
sometimes it may take a few weeks to see results. One of the most important things to
remember when settling your child is to be consistent (always giving the same
message, doing the same thing, this includes every time they go to bed e.g. all sleeps
day and night) and be persistent. An Information Brochure about how to settle your
baby can be downloaded from our website titled 'Sleep & Settle'.

We would also recommend that you start settling at a time that will suit your life style,
usually on the weekend when possibly your husband does not need to get up for work
the next day. You could also take it in turns to settle your little boy. Make up your mind
beforehand not to offer him the breast - this will also reinforce to your son that he does
not need the breast to go to sleep.

While you are working on his night time routine, you may like to review his day time
sleeps. Some babies at one year are able to manage with only one day time sleep, after
an early lunch. They may sleep for approximately 2 1/2 - 3 hours, though some babies
need the 2 sleeps until they are 18mths old. Sometimes when an older child is having a
lot of sleep during the day it impacts on their night sleeping. If you require some more
information or support you can also ring the Karitane Careline on 1300 227 464.

Night waking 19 months - 3 years

Q. I have a 2 year old daughter. I love her to death but at the moment she is
driving me crazy. For the past few months, she has been coming into our bed at
night. She started off with a vomiting bug so I would not let her sleep alone. Then
we went on holidays for two weeks and she ended up with a cold, so the moment
she coughed, I was in bed with her.

A. This is a very common situation. Often, after some type of setback (such as an
illness) you bring your child into bed with you and they become used to it. I would
suggest to you to try a settling technique. You may find it useful to download our
Information Brochure on sleep which outline settling techniques for various ages,
including the gradual withdrawal technique for toddlers in a bed. The best time to start
implementing any strategy is during the day and at a time that suits you. You could start
off targeting her day sleeps then move onto her night time sleep. It might also be a good
idea to start on a weekend.
Remember often when you implement settling techniques, they work fairly quickly, (a
few days to a couple of weeks). The important thing is to be consistent with your
approach. You might need to persist for a little while before you see results. It is not
uncommon for children to become a bit worse, just before you see an improvement.
Remember that children find routines reassuring, so include a routine at bedtime.
 Most Common Questions > Reflux
Q. My baby is 2 months of age and is very unsettled. He only sleeps for
sometimes 15-30 mins at a time during the day. At night he does sleep longer. I
think because he is so tired from not sleeping in the day. He fusses with his
feeding, arching his back and sometimes vomits after the feed. He looks like he is
in pain or has wind. I have heard of reflex but I am not sure what it is and if that is
what is wrong with my baby. Can you help?

A. Irregular sleep patterns, fussing with feeds, re-swallowing of milk (vomit then re-
swallow) or sometimes vomiting up milk in small or large amounts, arching and distress
at different times are a common combination of symptoms which may indicate the
possibility of 'reflux'. Treatment is varied depending on the symptoms of each baby.
Help from you Child & Family Health Nurse with settling and feeding can be of great
benefit. For a diagnosis and treatment of reflux see you family doctor or paediatrician.
You can also obtain more information about reflux and some suggestions by
downloading our Information Brochure on the Karitane Website, or by calling the
Karitane Careline.

Q. My 13 month old boy has had continuous reflux, I think. He has had a barium
swallow x-ray and came out normal. He can bring up a whole bottle of milk but
not every bottle. Since he has been on solid food he also can bring his meal up.
What can I do?

A. It is very difficult to make a diagnosis without seeing your child. It sounds like you
have already consulted your doctor about this problem but if you are still concerned you
may need to return to your doctor, or Child & Family Health Nurse for further
assessment and advice. Usually when children have reflux it is more constant and not
as intermittent as you describe. Most children with reflux as babies grow out of it as they
become older. It may be beneficial ceasing the bottles and offer food followed by a cup
of milk. It is important not to overfeed and cease feeding when hunger has been
satisfied.

Immunisation
Q. When is my baby's immunisation due?

A. Immunisation is very important to keep your baby healthy. Recommendations change

as new and improved vaccines are introduced.
Question to Karitane Careline OR Child Guidance Clinic
Some of the issues you may like to discuss include:

 Feeding problems - breast, bottle or solids

 Sleep and settling routines

 Immunisation information

 Weaning

 Toilet training

 Management of gastro-oesophageal reflux

 Developmental milestones

 Toddler behaviour management

 Information regarding common childhood illness/problems

 Postnatal anxiety, stress and depression

 About Karitane services

Education and research

 Education services

 Parent education
 Professional education

 Rural education

 Volunteer education

 Clinical supervision

 Graduate Diploma in Nursing (Child and Family: Karitane)

 UWS Master of Nursing (Child and Family Health Karitane)

FAMILY SERVICE CENTRE 
EMPOWERING THE FAMILY IN DISTRESS

Registration No: F 425 BOM

About us: Dedicated public-spirited women with a view to strengthen families who are in difficult
circumstances founded F.S.C. in 1955.  F.S.C is managed by professional guidance of College of Social
Work, Nirmala Niketan, Mumbai.  The centre believes that since socio-economic pressures in urban areas
often result in family stress, disintegration and child destitution, special interventions need to be evolved
as a response to the needs of such families 'at risk'.  A shift from "Welfare" to "Development" and from the
'needs' to the 'rights' approach is a significant change that the organization is striving to achieve.  This
broadening of concern is reflected in intervention strategies that are non-institutional, community-based,
family oriented, preventive and developmental in nature and thus the main programmes of the centre are
Adoption, Fostercare, Sponsorship and Community Development. 

Vision: Empowering the family, the core unit of society, by creating an enabling and supportive
environment, providing counselling and developing positive human values.

Services:

EDUCATION & SPONSORSHIP: Life skill development, Personality development

FOSTER CARE: "Preventing disintegration of families"
ADOPTION: "Every child's right to be brought up in a nurturing family environment"
DEVELOPMENT: Capacity building through Mahila Mandals, saving and credit societies, bal mandals
and vocational training.
HEALTH & HYGIENE: RCH, sanitation, T.B control, HIV / AIDS

Impact: Educational sponsorship provided to 360 children.

 
Projects:
The Family Service Centre has tried to strengthen, consolidate and replicate its "Non-Institutional,
community Based Approach" in five urban slums. The integrated holistic perspective, and a participatory
approach help in the all round progress and sustainable development of the people in the community and
the focus is on the most vulnerable groups women and children.

We believe that there is strength in partnership and networking and hence FSC is a very active member
of all the networks in the city CCVC, VCA, FACSE and QICCA. The FSC also works closely with the Child
Welfare Committee, established under juvenile Justice Act 2000, in order to prevent institutionalization of
children, by providing alternate family based service like Adoption, Foster Care and Sponsorship.

FSC has worked with corporates like Taj Group of Hotel and Camilin in their community support project,
taken up as part of their Social Responsibility.

COMMUNITY DEVELOPMENT:
F.S.C's community development programme has grown tremendously since inception in 1997. The
projects undertaken are:
· Food Security and Rationing: Rationing was a felt need in the community therefore it was first addressed
by providing access to Public Distribution System (PDS).
· Garbage disposal: Volunteers work in close contact with BMC for removal of garbage.
· Bal mandal: Children's group formed by children themselves, are now a part of FSC and address issues
like cleanliness, sanitation, etc.
· Balwadi: There are 31 pre-schools age children awailing of this service.
· Study Class: Students in study classes are given evening meal along with regular tuitions.
· Self Help Groups (SHG): Mahila Mandal women members initiate the process of economic
empowerment through SHG.
· Tailoring programme: Adolescent girls and women enroll for this programme where issues like gender
discrimination, marital separation, child care and family like education are addressed.

ADULT LITERACY: The programme was initiated by Mahila Mandal members. Women regularly attend
the class by paying Rs. 20 as fees.
· Hobby Classes: Session on painting earthen pots, making of diyas and lamps, fancy embroidery, etc.

HEALTH PROGRAMME:
· T. B . Project was started in collaboration with Rotary Club of Bombay Harbour and BMC. At present it is
been continued independently with the support of Taj Group of Hotels. 
· Reproductive and child health: In collaboration with Deepam has created awareness on sexual health,
reproductive health and hygine, pre and post natal care and transmission and prevention of STDs / HIV /
AIDS.

ADOPTION: The adoption programme of FSC is based on the basic principle of 'best interest of the child'.
FSC is a pioneer agency in Pre-adoptive foster care programme. Last year FSC had 10 foster mothers
who fostered children awaiting for adoption. FSCe regular group meetings and provide them training input
on effective child care, nutrition, etc.

Recipient of Ahiliyadevi Holkar Award for the year 1998-99, & Shortilisted for BCPT/CAP AWARD
2005.

Financials:
Yearly Budget: Rs. 20 lacs
Revenue Sources: General / specific donations
Organization:
full time: 13
part time: 8
volunteers: 11

Help Needed:
Volunteers: yes 
Donations-in-kind: yes
Services needed: yes
Donation possibilities: One can sponsor a child by giving Rs. 3600 per year.

"Rajesh (name changed) is a 12 year old boy studying in std. 4th in a municipal school. Rajesh's
family condition compels both his parents to work. Rajesh had not been attending school for a long
period of time. The reason of this dropping out of school was that he had met with an accident and
hurt his hand. His classmate used to tease him with regard to his broken hand. Troubled by this
attitude, Rajesh complained about this to his teacher, who also did not show him positive behaviour.
The social worker primarily concentrated on convincing the teacher to allow him to attend school on
regular basis. Thus through a lot of persuasion, Rajesh was taken back to school and he is presently
doing well. The social worker worked on the attitudinal change of the teacher, thus creating a
positive environment for Rajesh to go back to school."

"  FSC is a   member of Credibility Alliance"

Nestled in a tiny office in the Eucharistic Congress Building, Colaba, Mumbai, Family Service Centre, a
voluntary organisation has sought to reach out to families in difficult circumstances through its various non-
institutional and community- based programmes. It is committed to preserve, promote and strengthen the
family as a unit for the past 50 years.

Socio economic pressures in urban areas often result in family stress, disintegration and child destitution
hence the Centre believes that need specific intervention should be evolved in response to such families at
risk.  A shift from the “welfare” to development” and “needs” to the “rights” approach is a significant change
in the organisation’s programmes. This broadening of concern is reflected in the organisation’s intervention
strategies that are non-institutional, community-based, family-oriented in nature.  All the programmes
revolve around empowerment and development of the family as a unit with the main focus being the child in
the family
Adoption as a programme for rehabilitation of Orphaned and destitute children is one of the
pioneering efforts of FSC initiated in 1962.  The programme works on the basic principle of - Best interest of
the child while helping the couple to build a family and rehabilitation on the Birth Mother.

Over the years not only has the process of adoption undergone a major change but Family Service Centre
has also widened its area of interventions. We have seen changes in attitudes, acceptance of Adoption as a
viable option for child in need of such care; and also not only the childless couples but even ones with
biological kids are coming forward to adopt a child. JJ Act 2000 amended in 2006 is a legal document
emphasizing the need to promote this programme as among the various non – institutional forms of
rehabilitation of child, Adoption is one of the most recommended forms of permanent rehabilitation. It
provides a loving and nurturing environment to the child; a family of its own.

Rehabilitation Of Birth Mother :  Adoption begins with Birth Mothers who relinquish their babies. They
are counseled about procedures, consequences and rehabilitation of child entrusted in our care.Even, the
mothers are helped to move ahead in their lives by counseling them on life skills and positive attitude
towards life. 
In 1997, FSC’s approach underwent a radical change. This was on two accounts, firstly, the organisation
decided to follow a neighbourhood policy and secondly diverse kinds of intervention were initiated. The
fallout was that the area of intervention was restricted to the geographical limits of “A” and “B” municipal
wards to avoid duplicity and to make possible the adoption of a more intensive and multi-faceted
intervention strategy.

Hitherto, FSC’s outreach had been limited to making visits to the homes of sponsored children. However
now for the first time, keeping in view the holistic development of the child and the need for a nurturing
environment at all levels, it was determined that intervention would have to be at the level of schools,
family and the community which comprise the significant stakeholder groups that have an impact on the
development of the child.

FSC’s foray into the community was initiated with this rationale. Azad Nagar was the first slum community
that we worked with. However we did not enter the slum community with any pre-determined programme.
Instead we began by interacting with the youth group that was pro-active but lacked direction. Hence we
channelised their energies in a more constructive manner and enabled them to take up issues of community
development. Through the youth group we met with the women in the community and in the initial period
restricted our role to information dissemination. As we discussed various socially relevant issues at these
meetings, the women gradually began to express their concerns and problems related to alcoholism, wife
battering, garbage disposal and food security.

It was thus that the points of our intervention emerged. Following is an account of the different kinds of
intervention that the organisation has undertaken over the past decade not only in the Azad Nagar
community but also in other slums like Ambedkar Nagar and more recently in the Sundar Nagar and Sudam
Zopadi slum communities where we spread our work slowly and steadily making positive impact.
Intervention initiated in the community :
The various programmes and activities undertaken with achievements reflected have been broadly emlisted
as:

Welfare
Balwadi Day care Centre Study Classes Tailoring Unit
Health Intervention
Health camps TB project Reproductive and Child Health  
Developmemt Activities
Mahila Mandal Self Help Groups Bal Mandals  

BAL SANGOPAN YOJANA (BSY)

The Child Welfare League defines foster care as “A Child

Welfare Service that provides substitute family care for a
planned period for a child, when his/her own family cannot
care for him/her, for a temporary or extended period.”

Indian society is known for its strong family ties and its
togetherness at all times. However, today industrialization
and urbanization have led to the subsequent disintegration
of the joint family system. The security and sense of
belonging once provided by the extended family is absent
in the nuclear family. Disturbed homes, maternal
deprivation or physical neglect by
parent/s are common. These factors in the child’s growing years seriously hamper his/her normal
personality development. Thus to have a family which is as close as possible to the child’s ethnic, socio-
cultural and economic background is essential. This facilitates the process of adjustment and transition from
the natural home to the foster home and vice-versa.

In India, The Central Social Welfare Board initiated the foster-care programme in the year 1964 as a pilot-
project in the Third Five Year Plan for the welfare of the family and child.  Family Service Centre was also
one of the pioneers who initiated the Foster Care Scheme. In 1994, Government of Maharashtra took over
the scheme from the Centre and renamed it Bal Sangopan Yojana (BSY).

BSY recognizes that the best rehabilitation for children is not possible in an institution rather in a family.
Presently, Maharashtra is the only state implementing BSY in the country.  A unit of 50 children is covered
under the scheme By FSC.  The Government has allocated a sum of Rs. 500/- per month per child. This
grant covers maintenance stipend to parents, a percentage of the salaries of the social worker and office
assistant and administrative expenses incurred.
 Rehabilitation of the child in a family set-up by
offering an alternative to direct institutionalisation
of the child
Provision of a support system to a family in crisis and aid them in the
process of rehabilitation

Promotion of values of social responsibility and service within the

community.

Children's Services

Family Care Centre

Asthma Education Centre

The Asthma Education Centre offers children and their families information to
become more proactive in monitoring and controlling asthma. Staffed by a Registered
Nurse and Respiratory Therapist, it works together with the doctor and the child to help
the child and his/her family become more proactive in monitoring and controlling his/her
asthma. The child will undergo a complete evaluation and assessment, take a breathing
test before and after taking their medication, receive individual counselling on asthma
management and receive helpful information to gain a better understanding of their
asthma. This service requires a referral from a family doctor or specialist. Children aged
12 and under must be accompanied by an adult.

Canadian Clinic for Adopted Children

This clinic offers medical and developmental consultation services to individuals and
their families involved in domestic and international adoption. The clinic provides pre-
and post-adoptive services, developmental evaluations and screening. A team of
physicians, nurses, infant development consultants and social workers provide support
to parents wishing to adopt children..

Children's Procedure Clinic

Blood tests and other minor procedures such as circumcision, bladder

catheterization and electro-cardiograms (ECGs) are done by Paediatric Nurses in a
child-friendly environment. Minor procedures are also performed by Paediatricians .
Family Physicians with privileges at Trillium Health Centre. The Clinic places a strong
emphasis on pain control and management whenever an invasive procedure takes
place.

Hour   Monday to Friday 7:00 a.m. to 4:00 p.m.

s

Children's Emergency Follow-up Consultation Clinic

Children are seen by a Paediatrician within 1-3 days when an urgent referral is made by
an Emergency Care Centre physician or by a Family Physician after children have been
seen and discharged from the hospital's Emergency Care Centre.

Women's and Children's Services

Family Care Centre - Children's Health

Kid'z Klinic

Phone: 905-848-7174

This walk-in/after hours clinic provides care for

children beyond the hours offered by most
Paediatricians and Family Physicians. Located
in a child-friendly environment, it is staffed by
Paediatricians, Family Physicians and
Paediatric Nurses.

Hours
Monday to Friday
6:00 p.m. to 9:00 p.m.
Saturdays and Sundays
2:00 p.m. to 5:00 p.m.
Holidays
6:00 p.m. to 10:00 p.m

Neonatal Follow-up Clinic

This clinic offers developmental assessments for infants who have been identified
as being potentially at risk for developmental delay. Assessment of motor, speech and
behavioural development at various ages is done by an Occupational Therapist,
Paediatrician and Registered Nurse. The objective of early diagnosis is referral to
appropriate services.

Hour   Monday to Friday: Hours vary

s

Paediatric Diabetes Clinic (Regional Program)

A multidisciplinary team, including a Paediatric Endocrinologist, Registered Nurse,
Dietitian and Social Worker, help children and their families to learn about diabetes and
how to better manage it.

Hour   Monday to Friday: Hours vary

s

Trillium Health Centre’s Diabetes School Toolkit: Supporting Students With Type
1 Diabetes
 Type 1 diabetes is one of the most common chronic health conditions of
childhood.  In Canada we have the third highest rate of type 1 diabetes in
the developed world.  The condition develops in 1 in every 250-400 children,
which translates into approximately one child per elementary school. 

Type 1 diabetes is a health condition that develops when the body’s immune
system destroys the insulin producing cells of the pancreas.  It cannot be
cured, only managed by taking insulin injections and checking blood sugars
frequently. 

When blood sugars fall outside of a healthy range they can hurt the body, so
it is important to try and keep levels as close to normal as possible.  In order
to do this children, with type 1 diabetes must learn to check their blood
sugar levels frequently and take insulin three or four times a day by
injection. Looking after blood sugars is not easy – it takes a lot of hard work.

It is important for school staff to understand how best to support the student
with diabetes in the classroom so they can keep the student safe and also
understand how blood sugar levels impact learning.

Over the past year a group of diabetes educators, school board

members, community nurses and public health nurses, led by Elaine Wilson,
RN, of the Trillium Paediatric Diabetes Education Centre, have been working
together to develop tools that will help school staff better understand how to
support a student with type diabetes in the classroom.

The group has developed a DVD called “Diabetes in Children and Teens: A
Survival Guide” which explains what type 1 diabetes is and places special
emphasis on the identification and management of low blood sugars

The program was developed after input from students and parents who were
concerned that kids were missing more school than necessary because
teachers and other school staff didn't know what to do when the children
had low blood sugar reactions – resulting in missed classroom time for the
student with diabetes, disruption for classmates, and inconvenience for
parents who have to leave their homes or jobs to attend to crises at school.

Health Care Centres - Bangalore

: Health Care Centres - Bangalore

Child Health Centre

IN AHMEDABAD AT ISANPUR

FAMILY CARE MDICAL AND CHILDEN AND HEART HOSPITAL

FAMILY CARRE CLINIC AT SATELLITE

FAMILY CARE CLINIC AT HYDERABAD

 FAMILY CARE
MULTISPCIALITY
HOSPITAL AT GUNTUR
 Family Care Centre at
Vasna

 Family care centes outside of Ahmedabad

 At New Delhi
 At Pune
 At Hyderabad
 At Kolkata
 At Mumbai
 At Banglore
ORGANIZATIONS IN INDIA
Butterflies
 U-4,
 Green Park Extension,New Delhi
 Delhi - 110016.
 Delhi
   
 Karmayogi : .
 Tel : 011- 26163935
 butterflies@vsnl.com
 Website on Karmayog - http://www.karmayog.org/ngo/butterflie/
 Own Website - www.butterflieschildrights.org
     
 Notes - 24 hour help line for children

Butterflies, Delhi

Money: Donors can specify which Butterflies’ initiative (education, health care, etc) they
want to donate to. During Diwali, they can also buy candles and ‘diyas’ made by
the children.

Time: Volunteers can help with their education, health or alternative media
programmes, which include a newspaper, radio programme and bank run for working
children. Food can be donated to a community kitchen run by some of the children.

Contact: ‘www.butterflieschildrights.org
’ or call 011-26163935
Butterflies is a registered voluntary organization working with street and working
children in Delhi since 1989. We believe in the right of every child to have a full-fledged
childhood where she/he has the right to protection, respect, opportunities and
participation in his/her growth and development. Rights of street and working children
are no exception. Butterflies is committed to a non-institutional approach, follows
principle of democracy and promotes children’s participation in decision making as part
of its programme planning, monitoring and evaluation. Given its belief in participation of
children in all our activities, it is more appropriately called a "Programme with Street
and Working Children”. Our main aim is to empower street and working children with
skills and knowledge to protect their rights and to develop them as respected and
productive citizens. We use the Constitution of India, Laws related to Children and UN
Convention on the Rights of the Child as a major tool for ensuring government and
public accountability for all.

IN DELHI

1 LALA PREMCHAND EDUCATIONAL & WELFARE TRUST, Delhi – Delhi

2 Sambandham – Sambandham

3 Sarvaanchal Sewa Sansthaa, Delhi, Delhi – Delhi

IN MUMBAI

1 I Hear Foundation

2 India Sponsorship Committee

3 Indian Association for the Promotion of Adoption and Child Welfare (IAPA)

4 Indian Association For Promotion Of Adoption And Child Welfare

5 Institute For Exceptional Children

6 International Leprosy Unit

7 Isha Prem

8 Janseva Shikshan Prasarak Mandal

9 Jawahar Bal Bhavan

10 Jidnyasa
11 Jnana Prabodhini, Solapur
12 K.E.M. Hospital Research Centre In Pune

13 Karuna Sadan

14 Kautuk Shikshan Sanstha at Ganeshpur,Bhandara

15 Keshav Gore Smarak Trust

16 Kherwadi Social Welfare Association

17 Lady North Cote Hindu Orphanage

18 Lok Biradari Prakalp at Gadchiroli District

19 Lok Seva Sangam

20 Lokvikas Samajik Sanstha at Nasik

21 Love Humanity India

Notes: Empowering children of today so they grow into self-sufficient adults

of tomorrow who might one day change the future of India and possibly the
world. This is accomplished by: serving those of any race, creed, caste or
religion. Giving love without condition or reservation. Encouraging those we
serve to take responsibility for their lives and futures. Creating safe,
nurturing and permanent homes for orphaned, neglected and/or abused
children. Building safe and loving communities where children learn, where
they are encouraged and allowed to dream. Training individuals to be kind
loving caregivers/parents. Providing relief of and education to those in need,
distressed or underprivileged. Teaching individuals how to care for
themselves. Sharing out strength, hearts and energy.

22 M.B. Barvalia Foundation

Notes: The organization works for the welfare of the community through
various community care programmes especially for the welfare of the
mentally challenged children & disabled, providing a holistic therapy,
education and rehabilitation.
Aims & Objectives: Child welfare, Disability, Health.

23 Ma Niketan at Thane
Notes: Children’s village runs by the Helpers of Mary (Shraddha Vihar) for
destitute, abandoned and needy girls. No court committed girls. Do take
young destitutes, widows, but are reluctant to take unwed mothers. Girls
sent out to nearby schools for education. A family atmosphere is provided by
housing the children in-groups of mixed ages in several homes that do the
village grounds.

24 Magic Bus

Notes: To give the Mumbai slum children a break from slum or pavement life
and have fun learning about themselves and their environment through
recreational programmes

25 Maharashtra State Women’s Council

Notes: MSWC is a social welfare organization working for the upliftment of

underprivileged and destitute women in distress, and children in Mumbai It
runs residential institutions for the orphans and rescued children and girls .
It also carries out various foster care programmes, balwadis, adult literacy
classes, etc.
Aims & Objectives: Work for the upliftment of the children and see to the
child welfare, and also concentrate on women’s issues.

26 Maharashtra State Branch of Indian Council of Social Welfare

Notes: Runs two slums centres, balwadis and a youth club

27 Maharashtra State Probation and After Care Association

Notes: Organises placements and supervises children put on probation by the juvenile
courts

28 Mahila Samasya Nivaran Mandal

Notes: To work for the overall development and welfare of rural population. To provide
better agricultural facilities and to undertake watershed development programmes. To
provide better educational and training facilities. To establish health care and de-addiction
centers. To make the women aware of their rights with aim of making them independent
and self-reliant. To work for the welfare of the tribal community. To work for the welfare or
artisans and the village community. To work for the overall welfare of women and children.

29 Make A Wish Foundation Of India

Notes: The mission of “Make A Wish Foundation India” is to grant wishes of children having
life-threatening illness, irrespective of their socio-economic status, religion.
Aims & Objectives To work on issues related to child welfare.

3 Manav Foundation 
Notes: A day care centre and rehabilitation centre for mentally ill.

4 Marathi Mission Nagpada Neighbourhood House 

Notes: Variety of services to meet the needs of the people who live in and outside the area.
Mostly slum dwellers and pavement dwellers and socio-economically backward people. The
programmes are: medical centre, vocational guidence programmes, Craft sales centre,
women activities (stree udyog), day care centre. 
5 Meljol
Notes: Meljol is a non-profit organization working with children. It sensitizes them about
their rights and responsibilities within the context of the UN Convention on the rights of the
child. It consists of a team of dedicated and professionally trained social workers and child
development professionals whose mission is to nurture a generation that truly believes in
equal rights, opportunities and responsibilities for all. It disseminates information through
direct intervention with children in school and communities, teachers and publication of
material
Aims & Objectives: The aim of the foundation is to ensure that underprivileged Children get
proper education.

6 Mobile Creches – Mumbai

Notes: Mobile Creches provides integrated day care for children of working mothers, mostly
those employed on construction sites. Mobile Creches, Mumbai has been established since
1972, with the vision that every child should have the kind of childhood, which gives them
opportunity to develop their whole personality. This would effect from the basis for and
would determine the child’s adult life. Over the years in accordance with the child’s needs
several programmes for different age groups birth 12 years have been initiated.
Aims & Objectives: Work on issues related to Child welfare, Educartion, Food and Nutrition
etc.
7 National Association of Adoptive Families

Notes: Established on 1995, promotes adoption, gives guidance on adoption and also provides post adoption
counseling

8 National Institute For Sustainable Development

National Societies For Clean Cities – India

Notes: NSCC-I was established with an aim to supplement the efforts of the civic authorities
to keep the cities clean. The society has produced literature, recoded songs, arranged
seminars, talks and involved school and college students to create awareness among the
public about the importance of a clean and hygienic environment. With the help of the
municipal corporation it has undertaken planting of trees in the city. It is also engaged in a
number of activities for the welfare and well being of the under-privileged children and
women in the slums. These activities include Balwadis, nutrition programmes, medical
centers, creative art centers, children’s library, classes for the hearing handicapped children,
training centers for the women which include training classes on sewing, beautician,
mehendi and fabric. It also conducts programmes for street children

9 National Sponsorship Council

Notes: Offer education requirements to school children of average intelligence. Child should
have a history of regular school attendance and normal environment hindered by economic
conditions which warrant financial assistance. Children in institutions also considered.
Individual sponsors contribute towards educational, medical and other expenses. No
financial assistance

10 Nurture –The Craft Shop That Cares

Notes: NURTURE is a shop that sells handicrafts made by underprivileged women, children
and handicapped persons. The products in the shop come from various voluintary
organizations that are trying to make them self-reliant. The proceeds are sent back to the
organizations from where it came. It also keeps other gift items to cover its overhead costs

ADMINISRATION AND POLICY IN MNTAL HEALTH

VOLUM23,NO-3,JANUAY 1996

The real world of the Child Guidance clinic

John B.Mordock Ph.D.ABPP

Abstact:

Utilizing yearly clinic census data and alaarger smpl of childen seved over a three year
of period by hre child guidance clinics in Dutchess Counry ,New York, this study
describes the types of children seen in out paient clinics,the actual services which the
children received ,the outcome of three services.The majority of clients received a
combination of tratmnts ,with each receiving a unique sequence o modalities.

He institution of medicine (1990)has mphasized because outpatient clinin and inpatient

Hospital units were the front line of mntal health car for children,information on paint
characteristics,th treatments they received and thir adjustments before and after
treatment would be useful to th researchers studying child and adolescent menal
disorders.Analysis of such daa would reval th kind of individuals who seek for
reatmnt,the problem fo which tament is saught,the kinds of interventions typically
employed for various problems and th chages xprienced by patients who received th
eamn .the interrelationship among the paents,interventions and outcome could be
helpful to investigators that we study teatmentfforts in controlled clinical trials.

Unfortunately most tatment facilities throught the unitd staes collct little or no
systematic data on their child patients,the treatment provided o changes in childen
ovrer the course of treatment.
A s a result he information that could be hlpful to the understanding of what take place
“on the front line” of child guidance has not be disseminated widely.

   
      
 

  

[Conflicts between parenteral expectations and children's needs in child guidance

clinics].

Prax Kinderpsychol Kinderpsychiatr. 1995 Nov;44(9):359-65

Abstract

The central question of this article is whether the Law for Children and Youth Aid
(Kinder- und Jugendhilfegesetz KJHG) from 1991 is justly accused of being more a Law
for Parent Aid than a law in keeping with the times which also does justice to the
problems and needs of children. The article especially pursues the question whether the
legislator of the KJHG considers the precarious balance of a conflict between parental
rights and children's welfare as required by the constitution. Whether the child's welfare
is endangered in an individual case and which strategies to limit further dangers are
promising can often only be answered in an interdisciplinary manner; competencies
from child psychologists and child psychiatrists should be utilized more extensively to
determine problems and find decisions in youth care.
Sociodemographic Characteristics of Dropouts From a Child Guidance Clinic

Paula Armbruster M.A., M.S.W.1 and Mary E. Schwab-Stone M.D.1

1
Child Study Center of Yale Urnversity School of Medicine;

This study examined the characteristics of families who dropped out and families who
maintained contact with a children's psychiatric outpatient clinic through various phases
of intake and treatment.

Methods: One year after intake, the authors examined the status of all patients (N=555)
who had sought treatment at an urban, university-affiliated children's psychiatric
outpatient clinic over a two-year period and had completed the intake process. Factors
associated with dropout were identified at four points in the clinic process: during intake,
during evaluation, at completion of evaluation, and during treatment.

Results: Urban residence, minority status, single-parent status, and Medicaid status
were related to dropout at intake and during evaluation but not at subsequent clinic
phases. Nonminority, twoparent, suburban famiies of higher socioeconomic status were
more likely to drop out at the completion of the evaluation.

Conclusions: These results indicate that factors associated with attrition vary with the
clinic phase. Further investigations of the clinical course of minority children and families
involved with children's mental health services are necessary to understand the needs
of this population and to design interventions such as increasing minority staff and
providing training in multicultural competence.
WEBSITES:
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http://www.familycare.utoronto.ca/ - 21k

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http://www.fscmumbai.org/ - 13k

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http://findarticles.com/p/news-articles/times-of-india-the/m.

http://www.karmayog.com/lists/childrenip.htm - 52k

http://mohfw.nic.in/rtirak.pdf

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http://openmed.nic.in/1995/01/chakraborty_das.pdf - 75k
http://wcd.nic.in/schemes/workchild.pdf - 75k -