Trends in state budgets and child outcomes during and post child welfare class action litigation

Litigation is the most prevalent mechanism for comprehensive child welfare system reform. Litigation has resulted in increased funding to child welfare systems. This study assesses the impact of litigation on budgets during and after litigation and the budgets correlation with child outcomes. This mixed methods study analyzes 7 years post-litigation data in 4 state case studies. Individual interviews were conducted with key stakeholders (N = 17) in the lawsuits to determine what impact the lawsuit had on budgets and outcomes. Findings indicate that litigation likely impacts outcomes at least partially through increased financial investments (decreased reunification impacting decreased reentry after reunification and rate served); however, the impact of these outcomes is mitigated because financial investment in child welfare is not sustained.     

Determinants of maltreatment substantiation in a sample of infants involved with the child welfare system

Children under one year of age are highly vulnerable to child maltreatment, which can lead to serious immediate and long-term physical and mental health consequences. Child welfare workers encounter unique challenges when assessing allegations of maltreatment involving infants. This study identifies correlates of maltreatment substantiation in a sample of 793 infants less than one year of age investigated by child welfare. It is based on data from the 2003 Canadian Incidence Study of Reported Child Abuse and Neglect (CIS-2003), a national study of reports of child maltreatment. The analysis consisted of two stages. First, bivariate analyses were conducted using unadjusted odds ratios and chi-square tests on variables known to be associated with substantiation. In the second stage, a logistic regression was performed to examine these associations in a multivariate model.Multivariate findings suggest that certain vulnerabilities present in the primary caregiver, such as substance abuse and few social supports, as well as the child's positive toxicology at birth are associated with substantiated infant maltreatment. Exposure to domestic violence, which is reported mostly by the police, and physical harm stemming from maltreatment are strongly associated with substantiation, whereas reports of physical abuse and neglect have an inverse relationship. The authors discuss these results and implications for policy and programs.     

Closer to home: parent mentors in child welfare

This article addresses the emerging use of parent mentors--parents who have successfully negotiated the child welfare system and provide support and advocacy to others. The theoretical justification, roles, and expected outcomes and benefits of parent mentors are explored. The organizational factors thought to be required for such programs are also described, drawing on the available literature and the practice experience of a recently implemented Parent Partners program in a county child welfare agency.     

Context matters: The state of racial disparities in mental health services among youth reported to child welfare in 1999 and 2009

Upwards of 50% of youth reported to the child welfare system (CWS) do not receive mental health services, despite need. While children of color are less likely to receive services than Caucasians, the mechanisms through which disparities are sustained remain largely unknown. Data come from two nationally representative cohorts of youth who were referred to the CWS in 1999 and 2009. Results showed that while need for mental health services decreased, significant differences in the number of children who received services was not detected between cohorts. African American youth were less likely to receive services compared to their Caucasian counterparts, even after controlling for age, gender, type of maltreatment, and placement instability. However, after taking into account urbanicity, poverty, and the organizational-social context, the disparity between African American and Caucasian youth dissipated. Service disparities between Latino and Caucasian youth were not detected. The odds of service receipt were lower among youth nested within stressful organizational climates and urban (versus rural) counties, and the organizational-social context did not moderate the relationship between race and service receipt. Findings underscore the need to develop and implement strategies to increase access to services in urban counties and to promote an organizational climate conducive to reducing racial disparities.     

The emotional encounter with child welfare services: the importance of incorporating the emotional perspective in parents' encounters with child welfare workers

The child welfare service (CWS) in Norway represents a growing field. In 2011 about 52,000 children received help. Families mainly received supportive services in their homes while around 8000 children were taken into the custody of the CWS. Although most actions taken by the CWS are deemed to be supportive and have the consent of the parents, many parents find being assessed by the CWS to be distressing, and there is a widespread feeling that there is a stigma attached to receiving help from the CWS. This article discusses the importance of parents' emotions, and how these emotions can influence their cooperation with the CWS by using the concepts of recognition and trust. The data are based on analyses of 385 interviews with parents in which they describe their emotional encounters with the CWS. The results show that certain emotions can create a barrier between the family's need for assistance and the CWS's actions and initiatives. The article concludes by discussing how the emotional encounter challenges child welfare practice.     

Evaluating situations in child welfare: From tools to workgroups

The assessment in child welfare raises a number of questions. Number of work in this area focuses on the issue of tools. This paper presents an approach based on collective development process, the working team. Four situations have been studied extensively in the context of action research. The analysis focused on the collective working time (meetings) and helps to highlight the influence of organizational framework, the importance of sense of security and ways of proceeding that may limit the quality of evaluations. Improving the quality of assessments cannot rely solely on tools: it also depends on the quality of teamwork.     

Children with problematic sexualized behaviors in the child welfare system

This study assessed the utility of the Child Sexual Behavior Inventory (CSBI) in a child welfare sample. In this study, 97 children from ages 10 to 12 from either foster boarding homes or a residential treatment center participated. Researchers interviewed foster parents or primary therapists about children's sexual behavior, traumatic events, clinical symptoms, and their attitudes toward the child. Findings revealed that problematic sexualized behaviors were more prevalent in the residential treatment center (RTC) sample than they were in a normative sample. The pattern of associations between sexual behavior problems, traumatic events, and clinical syndromes in both the RTC and the foster boarding home (FBH) samples was similar to what has been found in samples in which biological custodial parents were the respondents. Analyses comparing youth who met the criterion for having problematic sexualized behaviors and youth who did not meet the criterion revealed that the two groups differed on clinical symptoms, prior traumatic events, and negative reports by caregivers. Results confirm the utility of the CSBI measure for this population and highlight several important clinical and programmatic concerns for addressing problematic sexual behavior in children in the child welfare system.     

Getting with the (evidence-based) program: An evaluation of the Incredible Years Parenting Training Program in child welfare

This study evaluates four group sessions of the Incredible Years (IY) Parenting Training Program used for the first-time in two child welfare agencies in New York State. Few studies have examined process and evaluation outcomes of evidence-based parenting programs in child welfare. Qualitative staff interviews and surveys on parenting behaviors were used to examine program processes, improvements in parenting behaviors, and participant satisfaction. Program participation was associated with less parental distress, defensive responding, dysfunctional parent-child interactions, child difficulty, total stress, and greater empathy and social support. The effectiveness of this evidence-based, parent education program in the context of a child welfare population, as well as implementation challenges and recommendations, are discussed.     

Measuring organizational effectiveness to develop strategies to promote retention in public child welfare

Public child welfare agencies are under pressure to improve organizational, practice and client outcomes. Related to all of these outcomes is the retention of staff. Employee intent to remain employed may be used as a proxy for actual retention. In this study public child welfare staff in one Midwestern state were surveyed using the Survey of Organizational Excellence (Lauderdale, 1999) and the Intent to Remain Employed (Ellett, Ellett, & Rugutt, 2003) scales to assess the extent to which constructs such as perceptions of organizational culture, communication and other areas of organizational effectiveness were associated with intent to remain employed. A number of statistically significant relationships were identified which were presented to the public agency for use in the development of strategies for organizational improvement. Data were also analyzed regionally and based on urban/suburban/rural status to enable development of targeted approaches. This case study presents an example of how ongoing measurement of organizational effectiveness can be used as a strategy for organizational improvement over time in the child welfare system.     

Psychotropic medications in child welfare: From federal mandate to direct care

Background and objectiveChildren in the welfare system are prone to uncoordinated and unmonitored mental health care, including psychotropic medications. To address these issues, federal legislation mandated that state child welfare agencies improve the coordination and oversight of psychotropic medications. However, there is no clear guidance on how to improve these practices, particularly at the level of direct care. We aimed to identify specific areas for improvement through state-wide surveys of four groups.MethodsWe surveyed all known members of four groups working directly with children in foster care in one small northeastern state. Respondents included 209 foster and adoptive parents, 169 child welfare staff, 84 mental health therapists, and 33 clinical prescribers. Survey items addressed practices and perceptions related to sharing of information and cross-system communication and monitoring of medication effects and side effects.ResultsNearly two in five foster and adoptive parents reported not regularly receiving information about the purpose or side effects of psychotropic medications, and they disagreed among themselves on who was primarily responsible for monitoring safety and effectiveness. One-third of child welfare staff and two-thirds of mental health therapists reported that information about psychotropic medications is not regularly shared with the child's provider team. Half of clinical prescribers reported not regularly communicating with child welfare staff.ConclusionsWe identified specific areas for improvement related to communication, sharing of information, monitoring, and role clarification. Strategies to improving these activities are key to ensuring the safe and effective use of psychotropic medications in this population.     

Social support and interdependency in transition to adulthood from child welfare services

This qualitative study explores the need for social support in transition to adulthood for youths in the child welfare service, focusing on what support they need and from whom they can get such support. We have conducted individual and focus group interviews with in all 43 adolescents that are, or have been, in contact with the child welfare service in adolescence/young adulthood. The interviews are transcribed and analyzed by doing initial longitudinal analysis, and thematic analysis inspired by the main structure in Systematic Text Condensation (STC).Through the analyses we have highlighted four different categories of social support that the youths need; practical support, emotional support, affirmational guidance support and participation support. Our findings indicates that such support is necessary, but not always available for youths transitioning out from the Child Welfare System, as many of them lack an informal network of adults that can support them in their transition to adulthood. Several of them consequently need continued support from employees in the Child Welfare Service, which for many of these youths seems to represent a crucial source of social support. One of the challenges seems to be that the youths urge of independency together with the expectations of independency from the Child Welfare Services, makes youths end the contact with the Child Welfare Service too early. The simultaneously need for social support and urge for independency makes it relevant to discuss this in light of the concept of interdependency; which emphasizes the importance of connections and social relations as not only normal but also necessary. This underlines the need for more flexibility and a gradual independency; in contrast to the “sudden adulthood” that many youths transitioning out of child welfare seem to experience.     

Instability in patchworks of child care when moving from welfare to work

We use longitudinal, qualitative interview data collected from 38 initially welfare‐reliant women in Cleveland, Ohio to examine the factors driving instability in child‐care arrangements when women transitioned from welfare to work. Grounded theory analysis revealed that decisions about care were circumscribed by scarce social and economic resources, women went to extraordinary lengths to patch together arrangements that typically involved multiple providers, relative care was central to patchworks of care, and patchworks of child care were often highly unstable. These complex arrangements and their instability were influenced by mothers’ desires to find the most suitable arrangements for their children within resource and job constraints, dissatisfaction with providers, difficulties accessing subsidies, and changes in provider availability. Findings suggest that policymakers must consider instability in patchworks of multiple child‐care providers as they consider alternatives for meeting low‐wage working women's and children's needs for safe, affordable, accessible, and enriching nonmaternal child care.     

From self-managed hearts to collective action: Dealing with incompatible demands in the child welfare system

This article describes how child welfare workers manage their feelings about residential care decisions which they consider in appropriate: a) they consider themselves failures or b) they imagine themselves omniscient predictors of client behaviours. Both of these feelings-management strategies allow for withdrawal from clients. Peer support groups offer a way to provide both social support for workers and a base for actions to correct the conditions which produce incompatible demands.     

Prevention of child maltreatment in high-risk rural families: A randomized clinical trial with child welfare outcomes

Few studies have specifically examined prevention of child maltreatment among higher-risk populations in rural communities. The overarching goal of this study was to conduct a randomized clinical trial of SafeCare augmented for rural high-risk population (SC+) compared to standard home-based mental health services (SAU) to examine reductions in future child maltreatment reports, as well as risk factors and factors proximal to child maltreatment. Parents (N = 105) of young children (5 years or less) who had identifiable risk of depression, intimate partner violence, or substance abuse were randomized to SC+ or SAU. Participants randomized to SC+ were more likely to enroll (83% vs. 35% for SAU) and remain in services (35 h vs. 8 h for SAU). SC+ (for participants who successfully completed services) may have had limited impact on child welfare reports during service provision. Further, SC+ had fewer child welfare reports related to DV than SAU. Parent self-reports of parenting behaviors, risk factors, and protective factors did not demonstrate significant sustained program impact. Limitations include power constraints related to sample size. Promising next steps entail future trials with larger sample sizes examining service compliance and further augmentation of SafeCare to bolster service impact and address risk and protective factors.     

Harnessing the potential of administrative data to inform child welfare programming with dynamic visualization methodologies

The majority U.S. states maintain administrative databases to collect information on the entry, movement, and exits of youth in the foster care system, yet the power of these data to inform continuous improvement efforts remains largely untapped. This underutilization ignores the vast potential inherent in longitudinal child welfare data to better understand the trajectories of youth in care and the effectiveness of the services they receive. To help promote the use of administrative data to inform child welfare programming, this paper provides an overview and demonstration of a Feedback Improvement System with web-based visualization technology to illustrate child- and agency-level child welfare data from the state of Utah. The procedures and system design elements used to obtain, process, and display the feedback data are detailed. Recommendations for designing and implementing web-based feedback systems for child welfare agencies are provided.     

Relationship of risk assessment to placement characteristics in a statewide child welfare population

Risk assessments allow child and youth services to identify children who are at risk for maltreatment (e.g., abuse, neglect) and help determine the restrictiveness of placements or need for services among youth entering a child welfare system. Despite the use of instruments by many agencies within the U.S. to determine the appropriate placements for youth, research has shown that placement decisions are often influenced by factors such as gender, age, and severity of social–emotional and behavior problems. This study examined ratings of risk across multiple domains using a structured assessment tool used by caseworkers in the Rhode Island child welfare system. The relationship between ratings of risk and placement restrictiveness was also examined. Risk levels varied across placement settings. Multivariate analyses revealed that lower caseworker ratings of parent risk and higher ratings of youth risk were associated with more restrictive placements for youth. Implications for the child welfare system are discussed.