Sexual risk behaviors among youth in the child welfare system

This study uses data from the National Survey of Child and Adolescent Well-Being (NSCAW) to provide estimates of sexual risk behaviors for 877 youth, age 11–14 at baseline, in the child welfare system. It examines the association between baseline psychosocial risk and protective factors on engagement in sexual risk behaviors after 36 months. It further compares rates of sexual risk behaviors between youth placed in out-of-home care and those who remained with their biological family. Key findings include a high rate of pregnancy, a high percentage of youth who initiated sexual activity at or before age 13 as well as a limited role of protective factors in moderating sexual risk behaviors. A history of placement into out-of-home care is not significantly associated with greater engagement in sexual risk behaviors. Implications for intervention development and child welfare policy for this population are discussed.     

Lost in transition: Illicit substance use and services receipt among at-risk youth in the child welfare system

This study examined the use of mental health and substance abuse services among adolescents in the child welfare system (CWS) who reported use of illicit substances. 1004 adolescents age 11–15 years at baseline were followed for 5–7 years, over five waves of data collection. Shortly after the investigation for maltreatment (baseline), 69.1% of youths using illicit substances received mental health and/or substance abuse outpatient specialty services. By the last follow-up, during the transition to adulthood, only 21.5% of young adults using illicit substances received outpatient specialty services. Youth who used illicit substances were more likely to receive outpatient and inpatient specialty services than non-users at the time of contact with the CWS (mostly baseline), but this difference faded over the follow-up period. By 5–7 years follow-up, there was no significant difference in specialty services receipt for illicit substances users versus non-users. Predictors of outpatient service use at most waves were having Medicaid, mental health needs, and having recently seen a school counselor or primary care physician. Among illicit substance users transitioning to adulthood, African American youths were less likely to receive outpatient specialty services than White youths. These findings reveal a need for more attention to illicit substances use among youth in the CWS, better cross agency integration, and special attention to the needs of transition-age youth to better connect them with services as they age out of the CWS.     

Moderating effects of race on internalizing and externalizing behaviors among children of criminal justice and child welfare involved mothers

This study examined whether the influences of multiple maternal criminal justice involvement (MCJI), community adversity, and violence exposure on children's internalizing and externalizing behaviors were moderated by race. The study included 409 children of criminal justice and child welfare involved mothers, ages 5–15 who participated in the National Survey on Child and Adolescent Well-Being (NSCAW). Results indicated that race, defined as Black vs. non-Black, moderated the associations between multiple MCJI and internalizing and externalizing behaviors. Decomposition of the regression effects indicated that non-Black children exposed to multiple MCJI, as compared to non-Black children who were not exposed to multiple MCJI, exhibited significant increases in both internalizing and externalizing behaviors, while Black children who experience multiple MCJI, on average, showed no increases. Similarly, race moderated the association between exposure to community adversity and externalizing behaviors. The decomposition of regression effects indicated that non-Black children who experienced higher levels of community adversity exhibited increases in externalizing behaviors, while Black children showed no increases. Criminal justice and child welfare practice and policy implications are discussed.     

Four contexts of institutional oppression: Examining the experiences of Blacks in education,criminal justice and child welfare

ABSTRACT

Institutions are key sites of oppression. Institutional oppression is defined as the mistreatment of people of a particular group that is enforced by society and its institutions. It is a system of invisible barriers that emerge from institutional laws, customs and practices, thus producing inequities for particular groups across race, gender and class. Woven together, the web of institutional oppression is vast, cumulative and multi-faceted, including both overt and covert discriminatory practices and behaviors. Based in a critical review of the literature, the authors of this article introduce and describe four characteristics of institutional oppression that specifically impact the lives of Black Americans. Furthermore, we provide a case vignette that illustrates these characteristics of oppression. The article concludes with recommendations on dismantling institutional oppression and highlights the roles that social workers can play in collaboration with educators and other professionals.     

Why youth leave care: Understandings of adulthood and transition successes and challenges among youth aging out of child welfare

Child welfare policies and practices are changing to allow more youth to remain in care beyond age 18. Yet, the majority of youth do not stay. Given recent evidence suggesting that remaining in care may be beneficial, there is a need to understand why youth leave. Using data gathered from in-depth interviews with young people aging out of care, this paper explores this question, relating it to youths' understandings of adulthood and the successes and challenges they face during their transitions. We find that youth leave care because of misunderstanding and misinformation about the requirements for remaining in care, as well as because of a desire for autonomy and independence. Specifically, many youth equated adulthood with independence, and thus felt that they needed to leave care to achieve adulthood. Unfortunately, these efforts to be independent often hinder youths' development of supportive relationships, which they reported to be one of the greatest challenges in their transitions. Based on these findings, we conclude by challenging the conflation of adulthood and independence, as well as of childhood and dependence, calling for connected autonomy as a goal for child welfare involved young people of all ages.     

Employment outcomes of former foster youth as young adults: The importance of human, personal, and social capital

In spite of a prevailing policy focus, little is known about the employment outcomes of former foster youth during early adulthood and the factors associated with those outcomes. We explore how former foster youth who aged out of care in Illinois, Wisconsin, and Iowa are faring in the labor market at age 24 and what explains variability in employment and wages for these youth. We utilize multilevel models to analyze youth's employment using four waves of the Midwest Study. Our findings point to a critical need to better understand and address barriers to education, causes of substantial racial disparities, and characteristics of family foster homes that facilitate youths' employment. We find that youth who remain in care past age 18 attain higher educational credentials which translate into better employment outcomes. This research also highlights the need for policies directed at current and former foster youth who become early parents.     

Prevalence of children with disabilities in the child welfare system and out of home placement: An examination of administrative records

This article explores the prevalence and characteristics of children with disabilities within the child welfare system using administrative data from the State of Minnesota. This study finds that more than a fifth (22%) of children with substantiated maltreatment are labeled in administrative records as having a disability, and more than one quarter of children (27.9%) over age five. The most common type of disability among children with substantiated maltreatment was emotional disturbance, while other common disabilities included intellectual and developmental disabilities and learning disabilities. Using logistic regression, this study finds that children with substantiated maltreatment with disabilities were about two times more likely to be in out of home placement than children with substantiated maltreatment without disabilities.     

Reducing racial disparities and disproportionalities in the child welfare system: Policy perspectives about how to serve the best interests of African American youth

This article examines current debates about how to reduce the overrepresentation of African American youth in the child welfare system and address related disparities. These debates reflect tensions between four long-standing perspectives in child welfare: expedient permanency, cultural continuity, family preservation, and social advantage. For each point of view, proponents' unique framing of the problem, use of research, and preferred intervention strategies are described. The emphasis of current federal policy on expedient permanency and transracial adoption is explored, followed by a detailed review of the literature evaluating the impact of this intervention on child and system-level outcomes. It is argued that conclusive evidence does not exist in support of transracial adoption and the expedient permanency perspective above others. Implications for policy and future research are discussed.     

Trauma-informed care training in a child welfare system: Moving it to the front line

The use of trauma-informed practices in the child welfare system is critically important to prevent system-induced trauma and encourage timely assessment, triage and referral for care when indicated. Ultimately, such measures have the potential over time to decrease the risk for mental health problems in children exposed to a trauma. This study evaluates an initiative in Arkansas to train child welfare front-line staff members in trauma-informed care practices. We evaluated the impact of the training on knowledge and use of trauma-informed care practices among three types of child welfare staff (Caseworkers, Program Assistants and Other front-line staff). Results suggest that this training process was highly successful in improving knowledge of trauma-informed care practices, especially among staff with the least formal education and training. We also found a significant increase in staff use of trauma-informed care practices at the three-month follow-up with little difference observed across staff groups. Barriers that may prevent staff from full implementation of training concepts are described and strategies to address barriers are proposed.     

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.     

Reducing turnover is not enough: The need for proficient organizational cultures to support positive youth outcomes in child welfare

Objective

High caseworker turnover has been identified as a factor in the poor outcomes of child welfare services. However, almost no empirical research has examined the relationship between caseworker turnover and youth outcomes in child welfare systems and there is an important knowledge gap regarding whether, and how, caseworker turnover relates to outcomes for youth. We hypothesized that the effects of caseworker turnover are moderated by organizational culture such that reduced caseworker turnover is only associated with improved youth outcomes in organizations with proficient cultures.

Methods

The study applied hierarchical linear models (HLM) analysis to the second National Survey of Child and Adolescent Well-being (NSCAW II) with a U.S. nationwide sample of 2346 youth aged 1.5- to 18-years-old and 1544 caseworkers in 73 child welfare agencies. Proficient organizational culture was measured by caseworkers' responses to the Organizational Social Context (OSC) measure; staff turnover was reported by the agencies' directors; and youth outcomes were measured as total problems in psychosocial functioning with the Child Behavior Checklist (CBCL) completed by the youths' caregivers at intake and at 18-month follow-up.

Results

The association between caseworker turnover and youth outcomes was moderated by organizational culture. Youth outcomes were improved with lower staff turnover in proficient organizational cultures and the best outcomes occurred in organizations with low turnover and high proficiency.

Conclusions

To be successful, efforts to improve child welfare services by lowering staff turnover must also create proficient cultures that expect caseworkers to be competent and responsive to the needs of the youth and families they serve.     

Dosage matters: The relationship between participation in the Nurturing Parenting Program for infants, toddlers, and preschoolers and subsequent child maltreatment

This article uses statewide data on caregivers of young children referred to the Nurturing Parenting Program (NPP) for allegations of abuse and neglect to examine the relationship between program dosage and subsequent maltreatment. At six months after participating in the program, caregivers who attended more sessions were significantly less likely to be reported for child maltreatment, holding other factors constant. At two years after participating, caregivers attending more sessions were significantly less likely to have a substantiated maltreatment incidence, controlling for other characteristics of families associated with maltreatment. These findings demonstrate the program is associated with preventing short-term allegations and longer-term substantiated incidences of maltreatment for a child welfare population. By demonstrating the importance of participation in the NPP, we increase the evidence about effective parent education programs for this population.     

A traumatised and traumatising system: Professionals' experiences in meeting the mental health needs of young people in the care and youth justice systems in Ireland

It is well recognised that children and young people in the care and youth justice systems typically present with significant and diverse mental health needs. Much has been written about this challenging area of professional practice but the focus has been primarily on the young people themselves rather than professionals' experiences of working in this challenging context. In this study, focus groups and individual interviews were conducted with 26 professionals working in the care and youth justice services in Ireland, representing a range of disciplines, to capture professionals' perspectives of working in this field. A thematic analysis was conducted on the transcribed data. Professionals described frustration and helplessness in the face of what they perceived as inadequate system responses and poor interagency working. Their experiences are conceptualised here as reflecting a traumatised and traumatising system. The implications for practice emphasise the need for staff support through training, collaboration between agencies, and addressing vicarious traumatisation.     

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.     

Adult well-being of foster care alumni: Comparisons to other child welfare recipients and a non-child welfare sample in a high-risk,urban setting

Research has shown that children placed in foster care fall below population norms on many indicators of well-being. Yet few studies have been designed to distill the effects of foster care from conditions that precede foster care. Based on the available evidence, it is also uncertain whether the purported effects of foster care are lasting. This study used data gathered prospectively from an economically disadvantaged, urban cohort to examine whether foster care is associated with decreased educational and economic attainments as well as increased criminality in adulthood. Individuals who were placed in foster care after an indicated allegation of maltreatment were compared to three naturally occurring groups: (a) maltreatment victims who did not reside in foster care, (b) individuals without an indicated maltreatment allegation who were raised in a household with a Child Protective Services (CPS) record, and (c) individuals without an individual or household record of CPS involvement. Using multiple estimation procedures, we found that all participants with a CPS record fared worse in adulthood than their peers without a CPS record. Despite their poor outcomes, foster children functioned as well as other CPS recipients who did not reside in foster care. Our findings indicate that caution is warranted when attributing dysfunction observed in foster children to the effects of foster care. Implications for prevention and intervention within the context of child welfare are discussed.     

Unpacking “the pimp case”: Aging black masculinity and grandchild placement in the child welfare system

The child welfare system is responsible for identifying long-term caregivers for children whose biological parents are unable or unwilling to care for them. Although grandparents are increasingly identified as custodians for their grandchildren, little is known about how grandparents are assessed by state actors. Using ethnographic data, this article unpacks the failure of one 63-year-old African American grandfather and his wife to gain custody of his grandson from foster care. This case–known informally as ‘the pimp case’ because of the unverified but widely accepted belief that he had earned income through sexual solicitation–illustrates how men's aging bodies and histories undermine their efforts to be seen as competent caregivers. This article shows how this grandfather's aging body and its perceived limitations became problematic, how his illegitimate social history was at issue, how their family form as grandparents (and thus, non-parents) was deemed illegitimate, and how these came together to mark race, class, and gender in interrelated–but also contradictory–ways.     

Child-care burden and intentions to have a second child: effects of perceived justice in the division of child-care

Fertility rates have fallen dramatically in Western Europe during the last 50 years. Initially explanations were tied to women taking on work obligations and choosing to reduce their fertility. But this explanation is no longer valid in Western Europe because those countries where women are least likely to work, the Mediterranean countries, are also among the countries with the lowest fertility rates. A more recent explanation rests on the availability of child-care; for example, Sweden and France have universal child-care and fertility rates near replacement. Much of this discussion has focused on socio-political conditions and structural explanations outside of the family, e.g. state policies and programs to support working mothers, as well as institutional models of the family as a breadwinner family or as a non-breadwinner family (cf. McDonald 2000a). Clearly there have been many important changes in this area. But, perhaps, even more important to understanding fertility decisions may be what is happening to interpersonal relationships within the couple. One aspect of this decision which has not been fully explored is an understanding of the perceived justice of the couple situation after the birth of the first child and its impact on the decision for a second child. This research will review the concept of justice, with a focus on justice in the division of child-care, and indicate how it can be used to understand a woman's fertility plans after the birth of the first child.     

Understanding dissociation in relation to child trauma,mental health needs,and intensity of services in child welfare: A possible missing link

Abstract

While there is limited research on the role of dissociation among children and adolescents, emerging evidence links child trauma history, dissociation, risk behaviors, and other negative outcomes among youth. This study examined dissociation in relation to mental health needs and intensity of services among a large sample of youth in Illinois child welfare, upon entry into care and in residential treatment settings. The Child and Adolescent Needs and Strengths (CANS), a comprehensive, trauma-informed assessment strategy and information integration/planning tool was the primary measure. This study included two overall samples of child welfare-involved youth, ages 3–18: at entry into care (N?=?27,737) and in residential treatment (N?=?5,758). Findings indicated that rates of clinically significant dissociation were generally highest among younger youth (under age 14) and among youth with more cumulative and severe trauma. Dissociative youth were significantly more likely to exhibit several risk behaviors (e.g., fire setting and self-harm) and mental health symptoms (e.g., psychosis and somatization). Those youth with significant dissociation at entry into care were more likely to be psychiatrically hospitalized, placed into residential treatment, with greater likelihood of placement disruptions within the 2 years following entry into care. Implications of these findings are discussed in terms of the value of identifying and assessing dissociation and other trauma-related symptoms that may be less recognized but can be linked to high-risk behaviors and other negative outcomes within child welfare and across child-serving systems. Understanding dissociation may be an important component of training, service/treatment planning, and clinical care within child-serving systems.     

How child welfare workers view their work with racial and ethnic minority families: The United States in contrast to England and Norway

This study builds on in-depth, semi-structured interviews with 93 child welfare workers employed in public child welfare agencies in the United States, Norway and England, and examines their perceptions of working with racial and ethnic minority families in contrast to White service users. Almost all workers reported on differences. In the United States, workers regarded cultural pluralism as a given and considered it an inherent feature of their work, regardless of the racial and/or ethnic background of the family. Further, they identified poverty, racism, and lack of feelings of entitlement as dimensions to practicing with minority families. A few mentioned language as an issue. The views of workers in the U.S. stand in stark contrast to the perceptions of workers in both England and Norway. They thought that communication challenges constituted a major problem, and that minority clients' lack of language proficiency and knowledge about society and social systems made it difficult for workers to understand families' meaning and intent (Kri? & Skivenes, 2009; 2010b). We discuss how caseworkers' perceptions may influence their decisions and affect minority disproportionality in the child protection system and analyze what factors may account for the cross-country differences we found. We also relate our findings to the broader question of citizenship and social rights in American society.