Recovery coaches and the stability of reunification for substance abusing families in child welfare

Substance abuse is a long-standing challenge for child welfare systems. Parental substance abuse disrupts family stability, family cohesion, and jeopardizes the well-being of children. In the current study we test an intervention to improve child welfare outcomes for substance abusing families, specifically the probability of families achieving a stable (at least 12 months) reunification. The intervention was an integrated case management model where recovery coaches were appointed to substance abusing parents associated with an open foster care placement. A diverse group of families (n = 1623) were randomly assigned to either a control group (services as usual) or an experimental group (services as usual plus a recovery coach). Multinomial logistic regression indicated that substance abusing parents associated with a recovery coach were significantly more likely to achieve a stable reunification as compared with similar families in the control group.     

Predicting Permanency Intentions Among Kinship Caregivers

This study examines kinship caregivers’ (n = 830) experiences and their perceptions of the children (n = 1,339) in their care in order to predict permanency intent. Permanency intent is a caregiver’s expressed intent to adopt the child in his or her care or to provide permanent, legal guardianship. The results of this study reveal that most caregivers’ permanency choice is guardianship and not adoption. However, binary logistic regression results uncovered six factors (i.e., thorough explanation of case plans, decreases in caregiver emotional stress, decreases in child depression, child lack of communication with birth parent, caregiver providing care for a sibling group, decreases in run-away behavior) that predict that a caregiver will adopt the child in his or her care. Policy, practice, and research implications are noted.     

Disparate Juvenile Court Outcomes for Disabled Delinquent Youth: A Social Work Call to Action

Current service delivery for at-risk youth is through four separate systems: special education; mental health and substance abuse; juvenile justice; and child welfare. Many youth (and their families) are involved with more than one of these systems, making early disability identification and subsequent systems coordination paramount in leading to more successful juvenile court outcomes. This coordination is an important and prioritized public policy concern because a majority of youth (disproportionately minority) within juvenile justice populations has been identified with mental health disorders, special education disabilities, or maltreatment histories. This study of a unique sample of probation-supervised delinquent youths (n = 397) identifies these disabilities and their corresponding court supervision, detention, and incarceration outcomes for a 48-month period in Cuyahoga County, Ohio (greater Cleveland). Within this youth sample over 32% had a special education disability, over 39% had a mental health disorder, over 32% had a substance abuse disorder, and over 56% were victims of maltreatment. Even higher disability rates were found for those youth who were subsequently detained or incarcerated. Many of these youth had multiple disabilities (and subsequently poorer juvenile court outcomes) and were concurrently involved in more than one disability service system. Policy and client services implications are reviewed and discussed.

The relationship between parent immigration status and concrete support service use among Latinos in child welfare: Findings using the National Survey of Child and Adolescent Well-being (NSCAWII)

The underutilization of concrete services by immigrants is widely documented across several service sectors, yet evidence is lacking on the use of such services among immigrants reported to child welfare for the purposes of reducing maltreatment. It has been suggested that Latino immigrants involved with the child welfare system may face steep challenges to receiving needed services due to issues surrounding legal status, language and cultural barriers. The purpose of this study was to determine whether referral to and receipt of concrete services by Latino families reported to child welfare agencies, was associated with legal immigration status. The sample included children of Latino parents who participated in the second National Survey of Child and Adolescent Well-being (NSCAWII), who remained in the home following a child welfare investigation (n = 561). Over a third (37%) of Latino families were referred for at least one concrete service, yet only 17% received any. Weighted logistic regression models showed that families in which the primary caregiver was undocumented had significantly lower odds (OR = .24) of receiving services once referred. Families who had trouble paying for basic necessities (OR = 7.52), those with active domestic violence in the home (OR = 4.98), and those receiving ongoing child welfare services (OR = 4.52) had increased odds of referral for services by the caseworker. The odds of receiving services increased when the primary caregiver was unemployed (OR = 5.24), when there was domestic violence in the home (OR = 4.59), and with the receipt of child welfare agency services (OR = 8.83). There appears to be an unmet need for concrete services among Latinos investigated by child welfare, as demonstrated in the gap between overall service referral and receipt. A parent's legal status may be one reason for that unmet need, implying that children of undocumented parents are less likely to have basic needs met to mitigate economic stress and reduce maltreatment risk upon contact with child welfare. Policy recommendations and implications for child welfare practice are discussed.     

An intensive mental health home visiting model for two at-risk early childhood populations

This study examined proximal outcomes of a mental health home visiting model for two populations at risk for child maltreatment: families with young children referred by child protective services (CPS) and at-risk pregnant women (Prenatal) referred by community agencies. Family- and caregiver-level outcomes were measured using the Family Assessment Form (FAF). Families (n = 215) showed significant improvement in all eight family functioning factors over the course of their participation in mental health home visiting services. Initially, CPS-referred families (n = 84) scored higher on the FAF measure of Interactions between Caregivers, indicating greater conflict between caregivers in the family. Prenatal referred families (n = 131) were at greater risk initially on Housing. Prenatal-referred families demonstrated greater risk reduction on measures of Supports to Caregivers, Developmental Stimulation, Caregiver Personal Characteristics and Housing. In addition, all families demonstrated significant improvements in functioning on 11 of 12 items comprising the Caregiver Personal Characteristics factor. Overall, CPS-referred families scored at higher risk on items reflecting externalizing problems, while Prenatal-referred families showed greater improvement on items reflecting internalizing problems. This model was successful in reducing risk factors and promoting protective factors for CPS-referred and Prenatal at-risk families. Implications and future directions are discussed.     

Understanding the diverging paths of stayers and leavers: An examination of factors predicting worker retention

The retention of qualified, competent staff has been a longstanding challenge for child welfare agencies. Given the stressful nature of child welfare work, difficulties with recruitment and retention of staff may not be surprising. However, considering the costs of chronic turnover, efforts to increase retention are crucial. The current study utilizes a large sample (n = 1102) of Title IV-E graduates from one statewide consortium in order to explore the usefulness of a conceptual model for understanding retention and turnover of workers in public child welfare. Logistic regression models reflect that at least one variable from each of four categories (worker, job-extrinsic, job-intrinsic, responses to job) predicted retention. Implications for child welfare workforce research, agency practice, and Title IV-E MSW programs are discussed.     

Preparing Black and Latinx children for police encounters: Caregiver response profiles and child self-regulation

We hypothesized that the goodness-of-fit between profiles of observed, caregiver-provided ethnic–racial socialization (ERS), and child self-regulation (i.e., inhibitory control) would differentially associate with child behavioral outcomes. Conversations between 80 caregivers (45% Latinx; 55% Black) and their children (M _age  = 11.09; 46% female) were rated for ERS. Measures included an inhibitory control composite (ages 2.5–3.5) and the Child Behavior Checklist (CBCL; age 12). Three profiles were determined: Comprehensive (n  = 34), Reactive (n  = 8), and Pragmatic (n  = 38). Only youth with low inhibitory control in preschool appeared to benefit from Pragmatic ERS, whereas youth with normative or high inhibitory control in early childhood displayed lower internalizing and externalizing behaviors when they had Comprehensive or Reactive rather than Pragmatic caregivers.     

Finding their way home: Factors associated with reunification for American Indian and White adults

Although reunification studies are abundant, those inclusive of American Indians are limited. Literature findings have indicated that minority children and their families tend to experience poor outcomes in child welfare. This study fills the literature gap by exploring the factors that contribute to the probability of reunification for American Indian and White adults who were separated from their families of origin during childhood by foster care and/or adoption. The study was grounded in Patterson's Family Adjustment and Adaptation Response theory. Data from the Experiences of Adopted and Fostered Individuals Project was utilized to examine a sample (n = 295) of American Indian and White adults. Logistic regression analysis was used to explore the factors that contribute to the probability of reunification. Contrary to prior research, race was not a significant factor for reunification. Rather, the odds of reunification increased with age, having traveled through foster care, and having experienced poly-victimization in the foster and/or adoptive home and decreased for those living in poverty.     

Twelve-Step Facilitated Versus Mapping-Enhanced Cognitive-Behavioral Therapy for Pathological Gambling: A Controlled Study

This study examined the efficacy of two group treatments for pathological gambling, a node-link mapping-enhanced cognitive-behavioral group therapy (CBGT-mapping) and twelve-step facilitated (TSF) group treatment. Forty-nine participants meeting criteria for pathological gambling were recruited from local newspaper advertisements. These participants were randomly assigned to one of three conditions: TSF (n = 11), CBGT-mapping (n = 18), and Wait-List control (n = 9); 11 refused treatment prior to randomization. Outcome measures included number of DSM-IV criteria met, perception of control/self-efficacy, desire to gamble, and frequency of gambling episodes. Analyses revealed a significant treatment group × time interaction (η2_partial = .39). Specifically, the group treatments resulted in significant improvements in the dependent measures, while the Wait-List group remained relatively stable. Overall, CBGT-mapping and TSF had no significant differences on any outcome measure at follow-up assessments. Analysis of post-treatment and 6-month follow-up reveal a significant improvement in gambling outcomes (i.e., fewer DSM-IV criteria met, greater self-efficacy, and fewer gambling episodes (η2_partial = .35), with treatment gains maintained at 6 months. These results are consistent with previous research for group treatment for pathological gambling and provide support for the utility of TSF and a mapping-based CBT therapy as viable intervention for pathological gambling.     

Exploring patterns of employee psychosocial outcomes among child welfare workers

Child welfare workers continue to suffer from increased levels of job stress and burnout, often resulting in an intention to leave. Although the literature on these psychosocial employee outcomes is extensive, much of it is limited in that it has failed to determine if variability exists across these constructs in a way that can be systematically categorized. This cross sectional exploratory study utilized a statewide purposive sample of respondents (N = 209) from a public child welfare organization in a Northeastern state. Two complementary cluster methods and discriminant function analysis were used to determine if subtypes of job stress, burnout, well-being, job satisfaction and intent to leave exist among public child welfare workers. Since the results yielded three different clusters of workers, an Analysis of Variance was used to identify significant group differences, while Scheffé post hoc tests were examined to determine which groups differed. Findings show that the all three clusters significantly vary from one another in terms of the adverse employee psychosocial outcomes. Our findings suggest that child welfare workers represent a heterogeneous group with dissimilar psychosocial needs. To meet those employee needs and maximize their work output, child welfare administrators should make a concerted effort to better understand the unique needs of this strained workforce.     

A qualitative study of 369 child welfare professionals' perspectives about factors contributing to employee retention and turnover

A statewide qualitative study of personal and organizational factors contributing to employees' decisions to either remain or leave employment in child welfare is described. Of particular interest was identifying factors related to employee retention. Professional staff (n = 369) in a state public child welfare agency, representing all levels of the agency and regions of the state, participated in 58 focus group interviews comprising some 1200 person hours of data collection. Core findings of the results are presented and discussed in view of information from other recent child welfare workforce studies. Recommendations and implications of the results for policy and practice are described.     

Ready or not: The influence of readiness on healthy marriage and relationship education training outcomes

This exploratory study utilizes a sample of human service providers and administrators to examine personal, agency, and collaborative readiness as predictors of training outcomes (utility reaction, gains in knowledge, and transfer of learning). The study is informed by the child welfare training evaluation model to address the effect of participants' (n = 58) readiness indicators and learning impact in relation to the transfer of learning that takes place following a one-day training. Participants' personal and agency readiness predicted their utility reaction, while personal readiness predicted gains in knowledge. The association between agency readiness and transfer of learning was partially mediated by utility reaction. Implications are drawn for both human service providers and researchers.     

An examination of attachment representations among child welfare professionals

Research has documented a relationship between adult attachment representations and client relationships and outcomes for professionals in relationship-based fields (e.g., , , , , ,  and ), but has not examined the child welfare professionals specifically. The current study examined attachment representations of 54 child welfare professionals. The Adult Attachment Interview (AAI) was administered to participants prior to attending a professional workshop. Results indicated significant differences between the AAI distribution of child welfare professionals and a non-clinical norm sample (AAI four-way distribution: Goodness of fit χ² = 23.63, p < .01; Bakermans-Kranenburg & van IJzendoorn, 2009). Dismissing classifications were overrepresented and free-autonomous classifications were underrepresented. Results may indicate challenges in the child welfare system that could alter the effectiveness and decision-making processes of child welfare professionals. Further research is needed to evaluate whether these differences are typical for samples of child welfare professionals and if so, the impact it could have on families who are being served. Effective interventions, focused on shifting attachment from insecure to secure, for child welfare professionals also should be explored through further research.     

Mindfulness‐Based Relationship Education For Couples Expecting Their First Child—Part 1: A Randomized Mixed‐Methods Program Evaluation

This article is Part 1 of a two‐part series, in which we report on our evaluation of a mindfulness‐based relationship enhancement program for couples who are expecting their first child. In this mixed‐methods randomized clinical trial, we assigned 33 couples to the 4‐week Mindful Transition to Parenthood Program treatment group (n = 16 couples) or to a waitlist control condition (n = 17 couples). Men in the treatment group significantly improved in relationship satisfaction, mindfulness, and negative affect; women had no significant treatment effects. Small to large effect sizes were present for treatment group men and women in multiple areas. Mixed‐methods analyses demonstrated that this intervention may be especially helpful for men because of differences in social support needs, effects of program enrollment, and relational processes in the prenatal period. Video Abstract     

Early psychosocial risk factors and postnatal parental reflective functioning

Psychosocial factors have been found to relate to parental reflective functioning (PRF), a parent's ability to mentalize about themselves and their child. Relations between maternal psychosocial risk factors and PRF were investigated in a community sample. A sample of mothers (n = 146) was assessed for risk factors when infants were 6 months, infant temperament was assessed using an observational measure, and PRF was assessed with the Parent Development Interview-Revised (PDI). PRF was measured again with the Parental Reflective Functioning Questionnaire (PRFQ) when children were 4 years (n = 105) and 5 years (n = 92), with an additional sample of mothers (n = 48) tested at these two timepoints. Results showed that in infancy, total maternal psychosocial risk related to lower PDI-PRF; regression analyses highlighted low socioeconomic status, unplanned pregnancy, and low maternal anxiety as independent predictors of lower PDI-PRF. PDI-PRF scores at 6 months did not relate to PRFQ scores, but PRFQ subscales showed stability over time from age 4–5. Results are discussed with regard to the impact of maternal psychosocial risk and infant temperament on PRF and the stability and concordance of PRF measures.     

Educational risk,recidivism, and service access among youth involved in both the child welfare and juvenile justice systems

Dually-involved youth represent a population of youth who receive some level of supervision from both the child welfare and juvenile justice systems concurrently. The current study examined education-related risk factors, recidivism, referrals for services, and service access among dually-involved youth in Los Angeles County. Specifically, whether increased educational risk was associated with referrals to, and access of, educational services and supports and whether higher receipt of educational services reduced recidivism approximately six months post-disposition. Data for this study consisted of a sample of dually-involved youth (N = 131) who were adjudicated delinquent and also had a child welfare case open. An Educational Risk Index (ERI) was developed and included school attendance, credit deficiency, problem school behavior, and current grades. Results indicate that educational risk was negatively associated with mental health services accessed, demonstrating that those with higher educational risk accessed less mental health services. Educational risk, however, was not associated with increased educational service referrals or access, suggesting a possible mismatch in educational need and service referrals. Lastly, there were no significant differences between those that recidivated and those that did not recidivate in service access and educational risk.     

Characteristics and factors impacting reunification outcomes among Vietnamese immigrant families in the child welfare system

Using a mixed methods approach, this study examined reunification processes and outcomes among Vietnamese immigrant families involved in the child welfare system. A quantitative design was used to describe characteristics and reunification outcomes of Vietnamese immigrant children and families who are involved in family reunification services. Qualitative methods were used to explore factors that may influence reunification outcomes among Vietnamese families.The quantitative portion of the study included an exploratory design using administrative data from one county in the Northern California. The quantitative sample (N = 32) included children entering the foster care system for 8 or more days between January 1, 2001 and December 31, 2007 from child welfare administrative data (CWS/CMS) which was merged with eligibility data (CalWIN) in order to obtain parent and child place of birth to determine country of origin. The qualitative study included an exploratory design using interview data from child welfare workers (N = 8) and Vietnamese immigrant parents who had successfully reunified (N = 7).Quantitative results indicated that the most common type of maltreatment leading to entry into care was caretaker absence or incapacity, an abuse category that is often used in cases of parental substance abuse. 53.8% of Vietnamese immigrant children in the quantitative sample reunified with their parents, which is close to the national rate of reunification. Qualitative findings pointed to the importance of the following factors within reunification: acculturation-related issues, parental substance abuse, child welfare worker cultural competency and issues related to service availability and effectiveness. Implications for social work practice and policy are discussed.     

Internalizing and externalizing behavioral problems of American Indian children in the child welfare system

Children involved in the child welfare system display elevated or clinically significant behavioral problems. However, there is a dearth of literature on the behavioral problems of American Indian children following child welfare involvement. Grounded in Patterson's Family Adjustment and Adaptation Response theory, this study fills that gap. Baseline, 18-month, and 36-month follow-up data from the National Survey of Child and Adolescent Well-being were utilized. The sample (n = 3498) consisted of American Indian, African American, and Caucasian children ages 2–16 at baseline (M = 8.13 years old, SD = 3.85) and 51.7% were female. Nearest neighbor propensity score matching analyses were used to estimate the effect of race on clinically significant internalizing and externalizing behavioral problems. Findings suggest that although externalizing behavioral problems do not differ based on race after controlling for other important factors, internalizing behavioral problems do differ. American Indian children are more likely to display clinically significant internalizing behavioral problems.     

Practitioner views on the core functions of coaching in the implementation of an evidence-based intervention in child welfare

Despite coaching being identified as an important implementation strategy, scant information is available on the core functions of coaching, and few empirical studies are specific to coaching in the child welfare setting. This study explored practitioners' perceptions of the core functions of coaching by using semi-structured focus groups with coaches (n = 13) and interviews with coachees (n = 11) who were delivering Parent Management Training, Oregon (PMTO) model to families of children in foster care. Four themes were identified as the core functions of coaching: (1) supporting practitioners via strengths-oriented feedback; (2) promoting skill-building via collaboration and active learning strategies; (3) problem-solving for appropriate use and adaptation of the EBI with real-world cases, and (4) providing an accountability mechanism for high fidelity implementation. Collectively, this study's findings build knowledge on the core functions of coaching, which may be a critical strategy for integrating evidence-based interventions (EBI) into usual practice in child welfare settings. The findings suggest that this implementation strategy is more than a simple extension of training. Coaching was viewed as vital for supporting practitioners full adoption of the intervention in their day-to-day practice, fitting an EBI to the complex needs of child welfare families, and ensuring high-quality implementation. Also identified were some unique aspects of PMTO coaching, such as a strict strengths-orientation and observation-based feedback via mandatory video recordings of client sessions. Further research is needed to explore different coaching techniques, protocols, and formats to examine whether certain features promote a more effective path to implementation and, ultimately, client outcomes.