The evolving relationship between casework skills,engagement, and positive case outcomes in child protection: A structural equation model

This paper reports a study that aims to increase the understanding of the relationship between workers and their child protection clients through the development of a client engagement model. A conceptual exploratory structural equation model (SEM) of caseworker skills, engagement and client outcomes is presented. Results indicate that including parents in the planning, not ignoring problems parent identify as important, not asking them to do something they would not find helpful, and locating appropriate services, leads to higher client engagement. Although not directly related, having workers return clients phone calls acted as mediator between other worker casework skills and client engagement. Client engagement was also influenced by satisfaction with the case outcome. Worker engagement was also influenced by whether they included parents in the planning, which in turn was influenced by worker experience. Workers who were kind and considerate were more likely to be engaged. Worker engagement predicted satisfaction with the case outcome and whether workers' believed families would contact the agency in the future. Lastly, client engagement predicted worker engagement although it is our belief that this is an iterative reciprocal process.     

Critical factors of intensive family work connected with positive outcomes for child welfare clients

Mechanisms producing positive change in troubled families were analysed. The study aimed to answer the questions: What kind of case and client outcomes does intensive family work (IFW) produce for child welfare clients? From the perspective of family workers, what kind of critical factors for positive child, parent and family outcomes can be identified? The study used child welfare case files of 35 families with 93 children from one social office and interviews with 20 family workers and IFW managers in 5 municipalities in Finland. The shades of worries scale was used in evaluating the change in each family's situation. The case outcome measures for children included changes in the child's status in open care, short-term placement or foster care. During IFW, positive changes took place in 23 families out of 35 (66%). Twenty-seven children from 16 families did not continue as child welfare clients. Eleven children were placed into foster care during IFW and two years after it. The critical processes for outcomes included time, trust building and engagement, practical help, facilitating communication and guaranteeing the best interest of the child. IFW was considered effective for positive outcomes for the majority of families with complex needs.     

Staying with it: A case study

Abstract

This is a case study which illustrates some of the conflicts and dilemmas facing local authority social workers in child protection. The worker had to learn to understand and deal with his feelings about a client, who was at different times unable to communicate verbally, sexually procative and seductive, hostile and aggressive. For the client there was a gradual shift from acting out her fears and fantasies about men, to being able to verbalise and trust the worker.

The worker moves towards an understanding of the client's problems and also of his own difficulties in dealing with the case. He believes that his personal involvement was of value to the client.     

Working with Families Who Experience Parental Mental Health and/or Drug and Alcohol Problems in the Context of Child Protection Concerns: Recommendations for Service Improvement

Child abuse and neglect often occur within the context of multiple risk factors, in particular parental mental health (MH) and/or drug and alcohol (D&A) problems. Interventions aimed at improving parental MH and D&A issues can have a positive impact on children now, as well as in the future. However, implementing sustainable service models that facilitate positive change for families with multiple risk factors is challenging. The purpose of the present study was to gain feedback from key stakeholders on a service model targeted at families where there are parental D&A, MH and child protection concerns to identify possible strengths and limitations of the model. This identified possible strategies for service improvement from the perspective of discharged clients and clinical staff. Gaining feedback from key stakeholders on service models is increasingly recognised as central to service evaluation and development. Ten interviews were conducted with clinical staff and twenty interviews with discharged clients of a pilot service that works with families where the child or children are at risk of significant harm in the context of parental MH and/or D&A issues. The interviews with clinicians highlighted difficulties working with this complex client group and its impact on staff burnout. Clinicians suggested how the model could be changed to better support clinical staff from burnout. Interviews with discharged clients highlighted the importance of the relationship with the worker in establishing client engagement and facilitating change. The way in which these recommendations informed the design of the service model is discussed.     

Survival and change: Social work with angry men

Abstract

This paper discusses the risk elements in encounters with six angry male clients of a social services neighbourhood team. Their preoccupation with basic survival needs produced an identification of the worker with an elusive “stolen object”; this leads to a discussion of how we also felt we had become identified with an image of persecuting parent, rooted in their childhood experience. The key notion of our “struggle” with them is linked to that of “boundary-setting” and the therapeutic value of the characteristic escalation of client/worker conflict is examined. The worker's survival is seen as a confirmation of the client's personal integrity. The process of disengagement is then analysed with particular attention to the material transactions between client and worker that served to mark the end of the engagement. We acknowledge the minimalist nature of our strategy with these men, and attempt to examine outcomes.     

Infant and child observation as preparation for social work practice

This paper argues that infant and child observation is not only valuable as part of social work training for work with children and families but that it has a wider value in equipping workers with assessment skills relevant in all areas of social work, including care management. It describes the introduction of infant and child observation as a required component of the BA/Diploma in Social Work at The University of Reading and the effect on students' learning and their practice skills. It shows how child observation festers the development of reflective practice, enabling workers to look beyond the presenting problem and to understand the situation as a whole. The resulting intervention is then more likely to be appropriate in meeting a client's needs.     

Public child welfare workers' perception of efficacy relative to multicultural awareness,knowledge and skills

Maintaining a well trained pool of workers in public child welfare agencies continues to be an ongoing problem. Research suggests that it is critical that we continue to explore the factors associated with worker efficacy. Existing research has found that outcomes for families and children are affected by numerous individual and organizational characteristics including worker's perceived efficacy (Advancement of Social Work Research, 2005; Bernotavicz, 2007; Collier, 2007; Ellett, 2007; Government Accountability Office, 2003; Milner, 2003). This study describes public child welfare workers, and their perceptions of efficacy relative to multicultural awareness, knowledge and skills. Study outcomes have implications for worker training, supervision, and curriculum on child welfare.     

Looking at engagement and outcome from the perspectives of child protection workers and parents

This paper reports a study that sought to understand what facilitates engagement between parents and child protection workers and to ascertain the relationship between such engagement and intervention outcome. Quantitative and qualitative data were gathered through personal interviews with 131 worker-parent dyads (workers and corresponding parents receiving service) from 11 child protection agencies in Ontario, Canada. Measures included scales for engagement, parental well-being (depression and stress), and worker well-being (burnout, job satisfaction, stress). Outcome measures included perception of child safety, changed parenting practices and satisfaction. A relationship was found between workers' perception of parent engagement and parents' perception of their own engagement, as well as between the perceptions that workers and parents had around their own respective engagement. Workers who were satisfied with service outcomes were significantly more engaged than those who were unsatisfied. Parents thinking that their children were safer as a result of intervention were significantly more engaged than parents who thought that their children were less safe. The strongest reason given by parents for positive change was being able to trust their worker (p < .001) and believing that their worker was knowledgeable about parenting (p < .01). Qualitative data suggested that parents valued experienced workers because they thought such workers could better understand their problems and how to deal with them. Correspondingly, workers felt that experience enabled them to better understand clients' problems and provide more effective support. No relationship was found between parent engagement and parental depression or stress, but the mean depression score for parents placed them at risk of clinical depression. There was a negative correlation between worker stress and engagement. The study demonstrates that engagement between clients and workers is related to positive outcomes (as reported by workers and parents) and supports the contention that promoting engagement is integral to a successful child protection intervention.     

Approaching drinking problems in single male clients receiving social assistance

How are drinking problems in single male clients receiving social assistance approached? This subject has been investigated in two studies. In Study I, 103 social workers responded to a questionnaire on how they would act towards a hypothetical client. The results suggest that there is no consensus among social workers as to how to act towards their clients' drinking problems and that personal values more than anything else are what seem to influence the choice of action taken. Study II is based on focus group interviews with social workers. The social workers' approach to the clients' problems is described as a mobile point within a two-dimensional system. One dimension concerns the client's right to equal treatment versus the right to have their application judged individually with special circumstances considered. The other dimension is related to the client's integrity versus the need for support and control. The results are contextualised mainly from three aspects: the demands on ‘knowledge’ in social work, the specific framework of social work, and changes in the public discourse regarding socially acceptable drinking habits.     

Social work and artefacts: social workers' use of objects in client relations

Social workers' use of physical objects—i.e. artefacts such as paper, computers and plastic models—in client relations is rarely investigated. Most often, research focus is on interpersonal relations, user groups, professional skills and treatment methods in social work. In a study of decision-making tools and their impact on caseworkers' decision making, examples were found of caseworkers using artefacts in client relations. This paper presents these findings and discusses the purposes for which the caseworkers use artefacts. The empirical data consist of 30 qualitative interviews with caseworkers from a study of three different decision-making tools used in eldercare, employment services and child protection in Danish municipalities. The analysis shows that the caseworkers are concerned with the issue of how to justify the questions they ask clients and their assessment of clients. Job counsellors use artefacts to justify sensitive questions, for instance, questions concerning substance abuse. Family counsellors use artefacts as proof that they are guided by a model rather than making up the questions themselves. The caseworkers who grant homecare service use artefacts when rejecting an application.     

Needs-led child and youth care: Main characteristics and evidence on outcomes

Needs-led child and youth care has three main characteristics: a continuous focus on clients' needs, client participation in the care process (including decision making), and practitioners' displays of needs-led attitudes and skills. The primary aim of this review was to establish whether there is evidence for using a needs-led approach when working with children and families in need. We performed a literature search to find reviews and outcome studies of child and youth care for school-aged children and their families which included the core characteristics of needs-led care, and related them to outcome measures. Only a few studies attributed positive outcomes of care to the attention given to clients' needs and goals. Most studies referred to participation in terms of clients' involvement or engagement. Higher levels of participation were associated with positive changes in child behaviors and parenting stress, client satisfaction, higher completion rates, safety for children, feelings of well-being and empowerment, and better service coordination. Significant professional attitudes and skills included listening to clients and working in active partnership with them. There is some proof for the relevance of core characteristics of needs-led child and youth care, although that evidence is limited by the lack of rigorous studies. This study indicates that needs-led child and youth care can make a difference. Future research should pay attention to the intertwinement of the characteristics of the needs-led approach in care.     

Captured by the Game: Might a Focus on the ‘Therapeutic Relationship’ Diminish the Attention We Give to the Client's Intimate Network?

A recent project sought to clarify how psychotherapists and mental health workers understand psychosocial health and pathology. In this enquiry, I paid particular attention to the client's interpersonal networks: did the professionals actively consider, and if so to what extent, ‘intimate social and family relationships’ in constructing their understanding of the presenting problem and in the process they used for goal setting. Twenty‐two semi‐structured interviews were undertaken, eleven with psychotherapists and eleven with mental health workers. Across both groups, interviewees tended not to see their clients as embedded, relational entities, but primarily, often quite exclusively, as autonomous beings. Second, interviewees accorded a high value to the importance of ‘the therapeutic relationship’. Is it possible that the emphasis practitioners place on ‘the therapeutic relationship’ has the effect of marginalising the attention that is given to the client's significant‐other network?     

The Storied Approach: A Postmodern Perspective for Career Counseling

The author discusses the storied approach as a constructivist perspective on career counseling. The storied approach explores the client's world through story development as the client and counselor collaboratively co‐construct, deconstruct, and construct life stories. Story development encompasses the client's past, present, and future life experiences that are related to life roles (i.e., family, student, worker, leisure, community). Assessment consists of both quantitative and qualitative data that are woven into the client's story as the symbols or meanings that call for further exploration.     

Faith and Religious Delusions in First-Episode Schizophrenia

ABSTRACT

Empirical research has not adequately examined whether social workers and clients discuss sociocultural issues when addressing mental health problems, nor the quality of the interaction when such discussion occurs. This exploratory mixed-method study examined the interactional process associated with discussion of sociocultural issues in the first three counseling sessions with four white social worker/client of color dyads. Findings showed that productive cross-cultural interactions were associated neither with specific sociocultural content nor client-worker composition, but rather with the social worker's perception and skill. Analysis differentiated one worker/client dialogue from the others, highlighting the importance of training practitioners to apply social work knowledge and skills in a synthesized manner.     

Cost effectiveness of an integrated service delivery model as measured by worker retention

This study sought to examine the impact of housing child welfare ongoing teams in the community, near client neighborhoods, and in a setting that also co-locates other service providers that serve the same clients. The focus was the impact of location and service integration on perceptions of worker stress and actual worker turnover. Thirty four workers from this type of setting and from a more traditional setting in two urban cities in a Southern state were interviewed. In addition turnover rates were calculated and compared. It was found that those located near clients and with staff from other agencies had better morale, lower stress levels, more positive attitudes toward clients and client contexts, knew more about the communities the clients lived in and had more chances to collaborate to solve client problems than those in a more traditional setting with co-location only with family support staff. The turnover rate was lower in the integrated service delivery setting than in either the traditional setting or the state overall. Thus, integration of service delivery benefits not only the child welfare workforce participants, but also the clients who have greater access to other service providers and to the bottom line of the agency through the retention of workers. Implications are described.     

A qualitative study on the pros and cons of ethnically matching culturally and linguistically diverse (CALD) client families and child protection caseworkers

A review of the literature indicated that empirical research into the advantages and disadvantages of ethnically matching child protection caseworkers and culturally and linguistically diverse (CALD) client families is not extensive. The main aim of this study was to address this gap. Qualitative interviews were conducted with 29 CALD client families and 17 child protection caseworkers (as part of a larger study). It was found that if CALD families fear a breach of confidentiality (because of cultural reasons to protect the family's privacy and name), and this fear exceeds the two main benefits of ethnic matching – namely, that it helps overcome language barriers and provides (cultural) sensitivity – then they are likely to prefer a non-matched caseworker. This may be a challenge in child protection practice if the pool of culturally competent caseworkers is small. Another challenge identified was when CALD families preferred an ethnic match but was seen by case managers as a risk to the accurate assessment of a child's wellbeing because the caseworker was over-identifying with the client family. Thus, the provision of a culturally sensitive service can be at odds with the need to protect children from harm. This issue is seen as best addressed on a case by case basis. This study is significant because it has shown that ‘over-identification’ is an important work practice issue in this matter. It has also used empirical evidence to inform best practice principles regarding ethnic matching.     

Family Unity Meetings: Decision Making and Placement Outcomes

ABSTRACT

The sample consisted of all families (747) who were invited to receive a Family Unity Meeting from a Public Child Welfare Agency in a large urban county. Data was derived from the review of agency case files. The design was a retrospective case review with an embedded prospective study. This study describes factors that distinguish between CPS clients who accept an invitation to participate in a Family Unity Meeting (FUM) and those clients who decline to participate. The meeting process is described, and logistic regression is used to identify variables that predicted successful outcomes FUM meetings.

Families with reunification as a goal were the most likely cases to agree to participate followed by Voluntary and Permanency Planning cases. Cases with severe neglect were the least likely group to participate in a meeting process. Approximately nine people attended an average meeting. Maternal relatives were more likely to attend than paternal relatives.

Empirical evidence was found to support the notion that FUM expands the notion of family. Only 38% of children were placed with a parent after a meeting, but 82% of children were placed with a family member. Children were not placed with either the parent or family if the social worker had placement as a goal before the meeting. Cases with permanency plans were also less likely to be placed with the family. Social workers were more likely to agree with a placement with relatives if they had a concern about parental drug abuse. Having a maternal aunt in attendance at the meeting was predictive of having a child placed with the family.

Social workers and families stated concerns prior to the meeting diverged. Families were more concerned with economic and financial issues than were the social workers. Social workers were more concerned with child protective service issues (type of abuse, placement issues, etc.) and the behavior of the parent (substance abuse, mental health, etc.) than was the family. Paying attention to family issues such as finances may be a necessary precursor to families focusing on more complex matters like substance abuse or parenting practices.

Placement outcomes were consistent with worker's goals stated before the meeting. If a social worker said they wanted to place a child with the family before the meeting, that placement was most likely the outcome of the meeting. Social workers may be guiding the decisions of the family. If this interpretation is correct then it raises questions about who makes decisions at the meeting. An alternative conclusion is that the social workers are good diagnosticians who know prior to the meeting if placement is necessary, and know what decisions the family will make.     

Health Care Professionals' Experience,Knowledge, and Attitudes Concerning Homosexuality

The purpose of this study was to examine the experience with attitudes towards, and knowledge about homosexuality of three groups of health care professionals. Subjects were 97 registeres nurses, social workers, and psychologists who responded to a six-page mailed questionnaire. Professional discipline of the subject, gender of the client, and gender of the client's lover in a fictitious scenario did not significantly affect ratings or suggested diagnoses of the client. Most subjects felt that they needed moer training in working with homosexual clients, which was consistent with their high but not perfect scores on a knowledge test. Subject's mean scores of the Attitudes Toward Lesbians (ATL) and Gay Men (ATGM) scales of Herek (1998) reflected significantly less prejudice than his college samples. More knowledgeable respondents were less prejudiced and had more positive attitudes about working with gay and lesbian clients; those with more positive attitudes toward clients also showed less prejudice on the ATL and ATGM scales. The authors argue that training health care professionals to be more knowledgeable about gay and lesbian issues would lead to more positive attitudes and better services for gay and lesbian clients.