Expanding the conceptualization of re-entry: The inter-play between child welfare and juvenile services

Re-entry in child welfare is traditionally viewed as a child exiting to permanency and then reentering the child welfare system. Using this approach is effective for understanding child welfare practice from a single-system lens, but gives an incomplete picture of how children may move between related child serving systems. The present study expands the definition of re-entry by examining re-entry for 2259 children who either return to the child welfare system or move into the juvenile justice system after reunification from foster care. When measuring a broader concept of re-entry (into either system) the rate of re-entry went from 18% to 25% - a 33% increase. Regression analyses further suggested that many of the risk and protective factors associated with standard child welfare reentry were also predictive of multisystem re-entry such as having previous child welfare experience (OR = 1.79, p < 0.000), and child behavior as a factor at removal (OR = 1.75, p < 0.000). Findings of this study support the need to continue increasing the conceptualization of re-entry to be more inclusive of related systems as well as continuing to focus research efforts on understanding effective practices within child serving systems so that re-entry into either system is mitigated.     

Societal factors impacting child welfare: Re-validating the Perceptions of Child Welfare Scale

ObjectiveThis research examines the psychometric properties of the Perceptions of Child Welfare Scale (PCWS) by seeking to understand the differences between workers' perceptions of how society views them based upon job title by revalidating the PCWS with a sample of administrators and clinicians.MethodsConfirmatory factor analysis was utilized to analyze data on 165 administrators and 153 clinical child welfare workers.ResultsThe final model consisted of three latent variables with ten indicators related to stigma, value, and respect ([X²] = 167.6, [p] = 0.00; [RMSEA] = 0.07; 90% [CI]: 0.06–0.09; [CFI] = 0.95; [TLI] = 0.95).DiscussionThe factors found in the previous study were confirmed using an entirely different sample of child welfare workers. The factors value, stigma, and respect were confirmed across the sample based upon whether the workers were administrators or clinicians. This provides reassurance that measuring how workers perceive they are viewed by those outside the child welfare system does not vary based upon job title.     

Ethnic disproportionality in the child welfare system: A Norwegian national cohort study

This study of Norwegian child welfare clients examined the extent to which ethnic disparities in involvement with the child welfare system can be attributed to ethnic differences in sociodemographic background. Using logistic regression models and a unique dataset constructed by linking child welfare records to national administrative registers for the 1993–1994 birth cohorts, we computed ethnic disparities in the odds of child welfare involvement at age 6–12 (N = 122,894), both before and after adjustments for sociodemographic background. Compared with ethnic Norwegian cohort peers, non-Western children had twice the unadjusted odds of entering the child welfare system (odds ratio = 2.13). However, the data also indicated pronounced ethnic disparities in eight sociodemographic correlates of child welfare involvement. When adjustments for these background factors were modeled, we found no ethnic differences in the odds of child welfare involvement. Our findings suggest that the association between ethnicity and child welfare involvement is confounded by differences in socioeconomic status, maternal social assistance, family size and family structure.     

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.     

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.     

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.     

Exploring the self-care practices of child welfare workers: A research brief

Child welfare workers experience higher rates of vicarious trauma, workplace stress, and compassion fatigue, when compared to other social service workers. Increasingly, social service agencies, in general, and child welfare agencies, specifically, recognize the importance of self-care in assuaging these problematic employee outcomes. However, research that explicitly examines the self-care practices of child welfare workers in nominal. This study brief explores the self-care practices of child welfare workers (N = 222) in one southeastern state. Results reveal that child welfare workers only engage in self-care at moderate levels. Additionally, data suggests that variables such as health status, current financial status, and relationship status significantly impact personal and professional self-care practices, respectively. After a terse review of relevant literature, this brief will explicate findings associated with this study, and identify salient discussion points and implications for child welfare training, practice, and research.     

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.     

Mental health services for children and caregivers remaining at home after suspected maltreatment

ObjectiveBehavioral problems are common among children remaining at home after suspected maltreatment, but the effectiveness of current mental health services to improve these behavioral problems is unknown. The objective was to determine whether receipt of child and caregiver mental health services was associated with improvements in behavioral problems in maltreated children remaining at home.MethodsWe retrospectively analyzed Second National Survey of Child and Adolescent Well-being data. We included 1117 children ages 2–17 remaining at home after a maltreatment investigation, excluding children with missing outcome, covariate, or survey weight data. We compared mean Child Behavioral Checklist (CBCL) change scores from baseline to 18 months between children who did and did not receive mental health services, before and after adjusting for child, caregiver, and child welfare agency factors using survey-weighted linear regression.ResultsNearly one-quarter (22.6%) of children and 16.0% of caregivers received mental health services. Children receiving services had worse unadjusted baseline and 18-month CBCL scores than children not receiving services (all P < 0.001). Adjusted CBCL change scores revealed behavioral worsening among children receiving services but improvement among children not receiving services (all P < 0.001). However, children had improved behavior, regardless of their own service receipt, if their caregivers received services and reported an absence of depression at 18 months.ConclusionsChildren receiving mental health services had worse behavioral changes than children not receiving services. Caregiver receipt of services was associated with improved child behavior, suggesting that a family-centered approach may be most influential in improving behavioral outcomes among this population.     

Psychotherapeutic care for sexually-victimized children – Do service providers meet the need? Multilevel analysis

ObjectivesSurprisingly little is known on the decision to refer sexually-victimized children to psychotherapy. Previous research on service provisions for victims of child maltreatment has analyzed the impact of case characteristics, like child or caregiver functional levels, lack of social support, and socioeconomic status. Findings, however, show that the decision to provide services is not only needs-driven, but also affected by external factors like provincial legislation, institutional policies, and the availability and accessibility of services. By analyzing characteristics behind the decision to refer sexually-victimized children to psychotherapy at the case and institutional level, we aimed to disentangle the complex interplay of factors driving this decision.MethodsThe data for this analysis were drawn from the first nationally-representative agency survey on reported child sexual victimization (CSV) in Switzerland. Over a 6-month data-collection period, 165 child protective services, 87 penal authorities and 98 agencies in the health and social sector documented a total of 911 incidents of CSV. Multilevel logistic regression was applied to analyze factors at both the case and contextual level.ResultsThe main finding was that the severity of consequences was strongly associated with the probability of psychotherapeutic service referrals (OR = 10.4; p < 0.001). However, one bias was identified at the individual level: sexually-victimized children born in Switzerland were more likely to be referred to psychotherapy than immigrant children. Institutional disparities in the decision to refer a sexually-victimized child to psychotherapy were large (median OR = 3.83), with penal authorities referring significantly fewer cases to psychotherapy than specialized agencies in the health and social sector. What exactly was driving the difference between psychotherapy referral in different types of agency remains largely unexplained.ConclusionsFuture research should invest in scrutinizing contextual factors of child protective service decisions. As we operationalize the need for psychotherapy as proxy-rated consequences of victimization, routine screening for mental health needs using standardized measures for children in contact with child protection agencies should be implemented, to help frontline workers to identify the psychotherapeutic needs of victimized children.     

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.     

Mental health outcomes among child welfare investigated children: In-home versus out-of-home care

BackgroundChild welfare has increasingly focused on alternatives to out-of-home (OOH) placement. In-home services, such as parent training, have increased and more maltreated children remain in-home. Yet, little is known about the effect on mental health of maintaining vulnerable children in-home vs placement in stable OOH care.ObjectiveTo evaluate and compare difference in mental health among children investigated by child welfare and who remained in-home vs. those who were placed in stable OOH care.Design/methodsWe examined a cohort of children (aged 1.5–18 years) from a nationally representative sample of children investigated by child welfare using the National Survey of Child and Adolescent Well-Being II (NSCAW II). We compared changes in mental health functioning over 18 months for children who remained in-home with parent training versus those placed in stable OOH care.ResultsAmong the 749 children in our sample, baseline characteristics of children who remained in-home with parent training and those placed in stable OOH care were similar. Among school-aged children placed in stable OOH care, mental health problems decreased from 26% to 13% (p = .003). This differed significantly from school-aged children who remained in home, for whom mental health problems increased (50% decrease stable OOH care vs. 23% increase in home; p = .007). Among pre-school aged children, mental health problems increased in both settings, particularly stable out-of-home care (p = .008).ConclusionsFor school aged children with a history of maltreatment, mental health outcomes improve following stable OOH placement, yet worsen when remaining in-home with parents. Pediatricians should be watchful for mental health problems among children who remain home after maltreatment and should advocate for high-quality stable OOH care when it is necessary. Child welfare may need to monitor the outcomes of children remaining at home more closely and provide more intensive preventive and treatment services to families.     

Association between social support and child abuse potential among Japanese mothers

Child abuse is a global public health problem and a serious social issue in Japan. Social support is beneficial for parents faced with childrearing challenges. The aim of this study was to clarify the association between social support and child abuse potential. A cross-sectional study was conducted using a structured questionnaire. The target population was mothers of children at nine public nursery schools. Bivariate and multiple linear regression analysis were performed to examine the effects of socio-demographic, social support and psychological distress factors on child abuse potential. Among 309 mothers, 29 (9.4%) had a high child abuse potential score. Bivariate analysis indicated that mothers with a higher child abuse potential score were more likely to be divorced or unmarried (P < 0.001); living in single-female-parent households (P < 0.001); have low perceived economic status (P < 0.001); have a low level of child care support (P = 0.01); have a low Multidimensional Scale of Perceived Social Support (MSPSS) score (P < 0.001); and/or a high General Health Questionnaire-12 score (GHQ-12) (P < 0.001). Important predictors of child abuse potential among the mothers surveyed included living in single-female-parent households, having low perceived economic status, low MSPSS score, and high GHQ-12 score. Improving approaches that help mothers build social support relationships and ease them into child rearing in a psychologically healthy condition is recommended to prevent child abuse.     

Who stays,who goes,who knows? A state-wide survey of child welfare workers

Child welfare workforce turnover remains a significant problem with dire consequences. Designed to assist in its retention efforts, an agency supported state-wide survey was employed to capture worker feedback and insight into turnover. This article examines the quantitative feedback from a Southern state's frontline child welfare workforce (N = 511), examining worker intent to leave as those who intend to stay employed at the agency (Stayers), those who are undecided (Undecided), and those who intend to leave (Leavers). A series of One-Way ANOVAs revealed a stratified pattern of worker dissatisfaction, with stayers reporting highest satisfaction levels, followed by undecided workers, and then leavers in all areas (e.g., salary, workload, recognition, professional development, accomplishment, peer support, and supervision). A Multinomial Logistic Regression model revealed significant (and shared) predictors among leavers and undecided workers in comparison to stayers with respect to dissatisfaction with workload and professional development, and working in an urban area. Additionally, child welfare workers who intend to leave the agency in the next 12 months expressed significant dissatisfaction with supervision and accomplishment, and tended to be younger and professionals of color.     

Using concept mapping as a planning tool: Child welfare citizen review panels

Citizen Review Panels (CRPs) are groups of citizen volunteers authorized by U.S. federal law to examine state child welfare agencies. These groups inspect policies and practices related to child protection responsibilities and are tasked with making recommendations for systemic improvement. Despite the federal mandate for each state to develop a CRP and the potential of these groups to positively impact child welfare practices, there is a dearth in the literature related to CRPs. Consequently, planning and evaluation processes of these groups vary widely. This study reports on the use of concept mapping (CM) to outline a framework for planning and subsequently evaluating the CRP in one southeastern state. CM is a mixed-method research approach that uses multi-dimensional scaling and hierarchical cluster analyses to explore an area of study. Through these analyses, the method creates visual depictions of conceptual relationships between ideas. Data yielded a seven cluster concept map that CRP members (N = 36) utilized for planning processes, and subsequently for developing an internal evaluation tool. Results from this study offer a unifying framework by which CRPs, and similar groups in other areas can utilize for planning and evaluation purposes. After a review of pertinent literature on CRPs, this article explicates CM processes utilized in this study, describes results, discusses lessons learned, and outlines apposite areas for future CRP research.     

Factors that influence parent recruitment into prevention programs in early childhood: A concept map of parents', practitioners', and administrators' points of view

Given that parents are the main carriers of change in their child, their participation in programs for preventing behavior problems in early childhood represents a key element in ensuring the success of the intervention. That said, although at-risk families benefit the most from this type of program, they are identified as being hard to reach. This study aims at identifying the factors that influence parent recruitment based on the points of view of the actors concerned. To this end, a concept mapping operation was performed, which involved parents (n = 19), practitioners (n = 19), and administrators (n = 13) from community and public organizations. The participants generated 131 statements to complete the following sentence: In your opinion, parents would enroll more in prevention activities for their child if…. These 131 statements were classified into 12 groups representing the factors that influence parent recruitment, all of which were considered relatively important (between 3.51 and 4.42 on 5). The participants also agree on an understanding of recruitment that tends toward an ecological model. This study shows that parent recruitment into prevention programs targeting behavior problems in early childhood is complex and multifactorial (including factors that concern parents, practitioners, services, organizations, and policies). Because the map shows that the influencing factors in recruitment appear to be interrelated, they should all be considered to increase the chances of reaching at-risk families.     

Drivers of change: Examining the effects of gender equality on child nutrition

India has the world's highest burden of child undernutrition. Lack of income is considered as one of its primary causes. However, evidence suggests that despite steady economic growth and investments in social services directed towards child welfare, undernutrition rates continue to rise. Thus indicating, that there are other societal factors impacting child undernutrition. Previous studies indicate that countries with higher gender inequality have worse health outcomes for women and children. India, particularly in the northern states, has deep-rooted gender biases, leading to disproportionately worse outcomes for women and children. This study uses cross sectional data from the India National Family Health Survey Round-3 (NFHS-3) to examine the immediate and underlying effect of gender inequality on child nutritional status. The sample includes urban married women between 15 and 49 years (N = 9092) who have at least one living child between 0 and 5 years. Findings highlight the significant effect of autonomy and health related awareness on child nutritional status, when the relationship is mediated by maternal health. Implications for policy and practice are provided.     

Criminal conduct subgroups of “aging out” foster youth

Subgroups of adolescents drawn from the Midwest Study of the Adult Functioning of Former Foster Youth were identified on the basis of cluster analysis of self-reported criminal behavior: Cluster 1: No Criminal Activity (n = 204), Cluster 2: Moderate Criminal Conduct (n = 300), Cluster 3: Extensive Criminal Involvement (n = 87), and Cluster 4: Group Fighting (n = 139). Logistic regression analysis revealed higher proportions of foster youth with alcohol and drug diagnoses, male gender, out of school status, and limited caregiver closeness in each of the groups in which there was evidence of significant criminal conduct (Clusters 2, 3, & 4) in comparison to the no criminal activity group (Cluster 1). The same variables contributed to discrimination between the cluster subgroup with the most serious and pervasive pattern of criminal conduct (Cluster 3) and the two with less extensive criminal involvement (Clusters 2 & 4). Current findings and those of G. R. Cusick, M. E. Courtney, J. Havlicek & N. Hess (2010), help in identifying the differing needs of youth aging out of the child welfare system and should be useful in informing development of targeted interventions.     

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.