Integrated Substance Abuse and Child Welfare Services for Women: A Progress Review

A review of empirical literature reveals improvements in service utilization and outcomes for women when substance abuse and child welfare services are integrated. The increased use of substances by women involved in the child welfare system has resulted in a call for integrated, coordinated, evidence-based practices. Since the late 1990s, specific system- and service-level strategies have been developed to coordinate and integrate the provision of substance abuse and child welfare services such that women are remaining in treatment longer and are more likely to reduce substance use and be reunited with their children. The strategies reviewed provide useful guidelines for developing components of effective, evidence-based programs for substance-involved women in the child welfare system.     

Treatment Approaches for Child Welfare Mothers with Addiction Problems

Abstract

This paper argues that child welfare mothers with addiction problems may require specialized treatment approaches based on their gender. The prevalence of women's problems with addiction and the unique ways addictions manifest themselves in women are discussed. The literature is then used to guide a discussion on the limitations of traditional treatment approaches that have been designed for men and may be of ill service to child welfare mothers. Alternative treatments are reviewed, and suggestions for improving treatment services to child welfare mothers with addiction problems are provided.     

Developmental Outcomes of Vulnerable Youth in the Child Welfare System

Abstract

Adolescent development of youth in foster care holds great interest for society. This article examines a random sample of 200 adolescents currently placed in foster care on developmental outcomes. Using face-to-face interviews, the present study found that a majority of foster youth have biological families experiencing multiple problems and experience many developmental difficulties. A large percentage of the sample youth experience mental illness, school failure, substance abuse, and other antisocial behaviors. This paper considers implications from the study findings for policy and interventions designed to foster better developmental outcomes among youth in the child welfare system.     

Illuminating the Black Box From Within: Stakeholder Perspectives on Family Drug Court Best Practices

This article describes a mixed-methods, concept mapping study in an urban family drug court (FDC) designed to identify keys to FDC success from stakeholders’ perspectives. Participating FDC team members and clients developed a set of items they deemed integral to an FDC, thematically clustered the items, and then rated their relative importance. Using these data, cluster analysis and multidimensional scaling generated 6 themes perceived as contributing to positive outcomes. Resultant concept maps revealed that, compared to team members, clients view relational aspects of the FDC as more important. The findings point to implications for future research and social work practice.     

The Relationship of Welfare Receipt to Child Outcomes

Welfare receipt often is correlated negatively with children's cognitive and behavioral outcomes. Yet, virtually all children in households that receive public assistance are poor, prompting the question of whether poor outcomes are an effect of welfare, a spurious relationship between welfare and child outcomes, or a result of welfare selection. Using the NLSY-CS, these possibilities are examined by controlling for poverty and for selection into welfare. Controlling for child and maternal characteristics accounts for the majority of bivariate associations between welfare and outcomes among Black children. Controlling for poverty does little to change the relationship between welfare and outcomes for Black or White children. Controlling for selection into welfare further reduces the relationship between welfare receipt and outcomes among White children and has little discernible effect among Black children.     

Children's Challenges to Efforts to Save Them: Competing Knowledges in the Child Welfare System

The child welfare system is founded on a belief that children are sometimes endangered by their parents or caregivers and must be saved by agents of the state. Children are perceived as objects to be saved, but they are rarely seen as active strategists in their interactions with child welfare system social workers. Using ethnographic data collected during observations of social workers and juvenile court proceedings, this article shows how children have their own complex understandings of state intervention and strive—to varying degrees of success—to contest official views of their lives and provide competing forms of knowledge. Specifically, children attempt to rework state actors' perceptions of their families and familial problems, use state actors as an audience for their versions of their lives, and attempt to mobilize state power for personal or material gain.     

Characteristics of Sexually Abused Children and Their Nonoffending Mothers Followed by Child Welfare Services: The Role of a Maternal History of Child Sexual Abuse

Considering the importance of mother’s support in the adaptation of a sexually abused child, it is relevant to determine if the mothers and children involved in an intergenerational cycle of child sexual victimization differ from dyads in which only the child has been abused. The purpose of this study was to compare mother–child dyads with sexually abused children according to whether the mother had herself been victim of child sexual abuse. The sample included 87 dyads with sexually abused children aged 3–18 years old and their mothers (44 reporting maternal and child abuse), followed by social welfare services of the province of Quebec (Canada). The two groups of mothers were compared on their past family abuse experiences and past family relations, their mental health history, their current psychological distress, their parenting behaviors, and their current levels of family functioning. Children were compared on their adaptation. Multivariate analyses indicated that mothers reporting child sexual abuse were more likely to report more other maltreatments in their childhood and greater prevalence of lifetime history of alcohol abuse disorders, dysthymia, and panic disorder compared with mothers who had not experienced CSA. Compared to children whose mothers had not experienced CSA, those whose mothers had experienced CSA showed higher rates of problems behaviors and were more likely to report having been sexually abused by a trusted person. These results highlight the specific clinical needs for the assessment and treatment for sexually abused children whose mothers experienced child sexual abuse.     

Child Welfare Workers' Adoption of Decision Support Technology

Child welfare workers must process complex information in deciding to refer clients to appropriate mental health services. Decision support systems have been demonstrated in other fields to be an important tool, yet little research has been done in child welfare. This study focused on the adoption of a specific decision support system into child welfare practice. Quantitative analysis was used to demonstrate the diffusion of innovation process among a sample of state child welfare workers, while qualitative analysis was used to explain the facilitators and barriers to decision support systems adoption. Results indicate that for decision support systems to be widely adopted in child welfare practice, they should be integrated into the referral system and include workers' knowledge and experiences with referral resources. For successful adoption, decision support systems need to respect the natural logic and flow of worker interaction as well as organizational constraints.     

An Examination of the Persistence of the Residual Child Welfare System in the United States: Addressing Charges of Radical Theoretical Myopia with Implications for Social Work Practice

The United States follows what has been termed a “residual” approach to its public child welfare system. This article describes the residual model and contrasts it with the policies of other industrialized nations. It also explores the causes and persistence of the residual model in the United States through the lens of structural-functionalist theory. By doing so, this article attempts to respond to critics of structural social work who maintain that it is overly reliant on conflict theory and has nothing to offer in terms of distinct practice methods. Suggestions for a structurally informed social work practice are made.     

Working with Me,Working at Me: Fathers' Narratives of Child Welfare

This article examines the experiences of fathers involved in the child welfare system. Fathers who were interviewed as part of a multiyear Canadian project were atypical in that they were actively engaged with the child welfare system. Their stories show how, although not always physically present, child welfare's ghostly form is still very much a part of the daily lives of fathers and their families. These fathers had to be resourceful and resilient as they endeavored to look “promising” to the child welfare system. The critical analysis offers insights into a more father-inclusive approach to child welfare that has implications for policy and practice development.     

A Survey of Problematic Sexualized Behaviors of Children in the New York City Child Welfare System: Estimates of Problem,Impact on Services,and Need for Training

ABSTRACT

Forty-eight of 52 (92%) agencies contracted with the New York City Administration for Children's Services (ACS) responded to a survey about problematic sexualized behaviors (PSB) of children in different levels of care within the child welfare system. Results revealed that almost all agencies reported PSB within their foster boarding home and residential treatment centers. A majority of agencies perceived PSB to be a significant problem for which staff and families were not sufficiently trained. These findings highlight many avenues for advocacy, clinical intervention, and staff development.     

Introducing Technology in Child Welfare Referrals: A Case Study

Access to social services is important for the safety of children and ultimately for reunification of families involved in the child welfare system. The process of linking families to services, however, varies by caseworker and can be cumbersome and time consuming. The Department of Children and Family Services (DCFS) Needs Portal is an Internet-based intervention to improve the timing and quality of social service referrals in Los Angeles County We used a case study approach including in-depth interviews, direct observations, and user feedback obtained from the Needs Portal to (a) determine perceived benefits and barriers to adopting the Needs Portal, and (b) report how the flow of information between users and developers was used to adapt to user needs. Our analyses revealed four major barriers: (a) caseworker apprehension regarding new technology, (b) variation in communication styles by user type, (c) lack of technological infrastructure, and (d) competing workplace demands. Information sharing between developers and users has the potential to better meet the needs of users and ultimately maximize utilization of new technology. Although Internet-based interventions are designed to inexpensively and effectively coordinate services, emerging interventions may require in-person assistance and modifications in order to succeed.     

Alcohol,Child Maltreatment,and Parenting Stress in the Lives of Birth Mothers

ABSTRACT

This exploratory study examines the potential relationship between parenting stress, child maltreatment, and alcoholism in a pilot data set. Twenty-four participants (six African-American, six European-American, six Mexican-American, and six Native-American) completed four questionnaires (Parenting Stress Index, Conflict Tactics Scale Parent-Child, Michigan Alcoholism Screening Test, Chemical Dependency Assessment Profile [PSI, CTSPC, MAST, and CDAP]). Through principle component analyses and multiple regression analyses, it was suggested that self-perceived parenting strength or competence directly affect a parent's tactics to deal with parent-child conflicts. Results indicated that self-confidence as a competent parent was related to the frequency of using verbal degrading and physical punishment. Parents who reported that the child's temperament bothers them a lot were more likely to physically abuse the child. Though all the participants could be categorized as alcoholic by the MAST, parents' alcoholic abuse did not appear to elevate the severity of child maltreatment, as measured by the CTSPC.     

Affect Regulation of Homeless Youth Once in the Child Welfare System

This study examines experiences of homeless youth who were formerly part of the child welfare system. Using concepts from self psychology, 12 young adults between the ages of 18 and 26 participated in a semi-structured qualitative interview to gather information regarding their experiences prior to, during, and since having exited substitute care and completed a standardized measure of current functioning. Underlying subjects’ experiences is a pervasive sense of repeated disappointment from relationships and efforts to find idealizable others. A conceptual model for understanding these experiences is proposed.     

Evaluating the Effectiveness and Efficiency of Hong Kong Welfare Programmes in Reducing Child Poverty

This paper examines the effectiveness and efficiency of welfare programmes that are relevant to child poverty reduction in Hong Kong. We employ data from a cross‐sectional survey of a representative sample of families, conducted in 2015 through face‐to‐face interviews. Our results indicate that all four welfare programmes were inadequate in alleviating child poverty. This was either due to the deep poverty gap to be filled or high rates of exclusion error. Most programmes are also inefficient because of inclusion error. We conclude by suggesting some policy implications for the welfare programmes.     

Ethical Issues in Child Custody and Dependency Cases

Abstract

The emotional and psychological risks to children of high conflict divorce have led to the increased involvement of mental health professionals in child custody cases. Numerous service models (Greenberg & Gould, 2001; Johnston, 2000; Johnston & Roseby, 1997) have been developed to assist divorcing families in minimizing family conflict and supporting children'S needs. This underscores the need for judges and attorneys to understand the ethical and professional standards that underlie competent mental health practice in forensic cases. The practices of mental health professionals providing court-related services may have a substantial impact on the validity of their professional opinions, the effectiveness of services provided to children and families, and children'S development and adjustment. The authors suggest core ethical and clinical issues to be considered by all psychologists who work in the context of custody disputes. It is hoped that these professional practice suggestions will also be useful to attorneys and judicial officers in assessing the quality of mental health professionals' opinions.     

Reforming Poor Women: The Cultural Politics and Practices of Welfare Reform

This article employs participant observation and interviewing at a community-based job readiness program operating under welfare reform to explore how attempts at cultural retraining (that is, bringing presumably deviant behavior in line with dominant cultural norms) are delivered, received, and interpreted by welfare-reliant women. This study finds that poor women—the targets of these reforms—largely resist cultural retraining, but, ironically, assert its usefulness for welfare-reliant women generally. These ethnographic data support and expand upon previous interview and focus group studies that have encountered the same attribution paradox among welfare-reliant women.     

Child Protection,Voluntary Organizations,and the Public Sector in Sweden

This paper presents an analysis of the role of Swedish voluntary organizations within the field of child protection as well as processes of institutionalization within such organizations. The empirical focus is on the two most important voluntary organizations within the field today, namely Rädda Barnen (Save the Children) and BRIS (Children's Right in Society). And their importance within the child protection discourse, as well as their role as producers of welfare, is discussed. In the latter respect two different processes of professionalization—professionalization of volunteers and avant-garde professionalism—are identified. It is demonstrated that the relationship between the state and voluntary organizations is a key issue when understanding the nature of the organizations and their role in the organizational landscape.     

Clinician Perspectives on Relationship,Therapeutic Strategy,and Gender Responsiveness in Child Welfare Substance Abuse Settings

There is a growing acknowledgment of client–provider relationship as a determining factor within evidence-based practice implementation. This collective case study of 20 service providers examined the approaches used by clinicians working with substance-abusing mothers involved in child welfare to shed light on their use of empirically informed, gender-specific interventions. Analyses revealed that clinicians struggle to articulate specific evidence-based frameworks, and their approach relies on an intuitively driven client–provider relationship. Clinicians report little institutional support for integration of empirically supported practices into settings where workforce stress plays a critical role, and thus rely on relationship skills to frame practice approach.     

The Economic Consequences of Child Sexual Abuse for Adult Lesbian Women

This study is designed to extend the investigation of the long‐term consequences of child sexual abuse (CSA) into the workplace and to consider the effects on the economic welfare of 1,925 lesbian women from the National Lesbian Health Care Survey. It seeks to develop a two‐stage, least‐squares model that considers simultaneously the effects of child sexual abuse on four spheres of a woman's life—her physical health, mental health, educational attainment, and economic welfare; and to investigate the differential impacts of diverse forms of child sexual abuse on the adult woman's functioning. The CSA survivors experienced adverse health and mental health consequences. The type of CSA experienced was also a significant predictor of a woman's educational attainment and annual earnings.