Child and Family Social Work 2003, 8, pp 341–350 © 2003 Blackwell Publishing Ltd 341
Blackwell Science, LtdOxford, UKCFSChild and Family Social Work1365-2206Blackwell Publishing Ltd, 2003November 200384341350Research ReviewResearch Review: Engaging parents and carers with support services – lessons from research on help-seeking K
Broadhurst
Research Review
Research Review Editor: Brid Featherstone
Engaging parents and carers with family
support services: What can be learned from
research on help-seeking?
Karen Broadhurst
Department of Social Work, University of Central
Lancashire, Preston, UK. Correspondence: Fernbank,
Fernleigh Road, Grange-over-Sands, Cumbria LA11 7HT,
UK. E-mail: karensroom@btinternet.com
INTRODUCTION
The importance of gaining insights about help-
seeking appears across a number of fields of health
and welfare (Hartnoll 1992; Tucker 1995; Baistow &
Wilford 2000; Kanaisty & Norris 2000; Ullman &
Filipas 2001). A common concern is that those who
may need help (or be perceived to need help) do not
ask for help from available services. In relation to the
welfare of children, whilst there have been a number
of very positive changes to the landscape of personal
family support services, concerns remain about the
uptake of services (Pugh & DeAth 1994; Wattam
1997; Oakley et al . 1998; Frost et al . 2000), the gen-
dered pattern of service use (Daniel & Taylor 1999;
Pithouse & Holland 1999; Armstrong & Hill 2001),
problems of reaching some of the most vulnerable
families (Wattam 1997; Colclough et al . 1999; Mac-
donald & Williamson 2002) and accessing services in
an increasingly diverse landscape of provision (Oakley
et al . 1998; Petrie & Wilson 1999; Hallett et al . 2000;
Tunstill & Aldgate 2000). It is in this context that
questions about help-seeking become highly relevant
to the development of family support services.
The current landscape of personal family support
services can be described as ‘post- Messages from
Research [Department of Health 1995]’ (Frost et al .
2000), and is characterized by a mixed economy of
traditional and innovative family support initiatives.
New developments in personal family support have
spawned a flurry of evaluative studies which provide
information about the effectiveness of new develop-
ments. Many of these recent evaluative studies present
some positive responses from target communities
(Pithouse & Holland 1999; Department of Health
2000; Armstrong & Hill 2001; Gray 2002; see Smith
1999 for a summary ‘what works’). The central argu-
ment of this paper is, however, that whilst the trend
towards evaluative studies does provide some infor-
mation about sources and types of referral, the cur-
rent literature on family support offers limited insights
into processes of help-seeking. Evaluative studies
which focus on referred populations are problematic,
in that it is not possible to assume any direct corre-
spondence between referrer and help-seeker. Indeed
findings such as those of Thorpe (1997), who found
differential rates of complaints and allegations made
against single parent and Aboriginal families in an
Australian study, and Cawson et al . (2000), who show
that the majority of child maltreatment remains
under-reported, highlight the inherent problems in
drawing conclusions about help-seeking based on
referred populations. In the current literature on
family support in the UK, important questions about
processes prior to and leading up to referral, owner-
ship of the referral and the interface between informal
and formal support remain unanswered.
This paper reviews literature on the subject of help-
seeking and ‘stigmatizing problems’, providing an
overview of research across fields of health and social
welfare. Literature is drawn from mental health, sub-
stance abuse, domestic violence and family support/
child protection, from both national and international
studies. Literature is also included which offers
generic models of help-seeking processes. The ratio-
nale for this review strategy is that, whilst the family
support literature in the UK offers a limited number
of studies related to help-seeking (Gibbons 1990;
Farmer & Owen 1995; Pithouse & Holland 1999;
Tunstill & Aldgate 2000), in the main research offers
findings based on inferences about help-seeking, rather
than any detailed study of help-seeking processes.
Daro (1993), Daro & Cohn Donnelly (2002) and
Tunstill & Aldgate (2000) all offer typologies of help-
seeking behaviour; however, these typologies are con-
fined to studies of formal service use. Studies such as
that of Hallett et al . (2000), which focus specifically
on help-seeking and explore divergent pathways to a
range of sources of help, are infrequent. In contrast,