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.     

The impact of organizational support on the transfer of learning to practice

Child welfare professionals (CWPs) participate in trainings to facilitate the adoption of emerging and promising practices. Although organizational support has been argued to facilitate the association between training impact and transfer of learning, empirical examination of this process is limited. Based on data from 511 CWPs who completed a one-day training to offer relationship and marriage education (RME), we examined the moderating effects of organizational support on the association between learning impact (i.e., competency and utility reaction) and subsequent application of RME with clients within six months post-training. Results from structural equation modeling showed that perceived support from administrators and co-workers post-training was not as influential to trainees who demonstrated higher learning impact. However, those who reported lower levels of learning impact were more likely to apply the training materials if they perceived greater organizational support when compared to those who felt less support from administrators and co-workers. Implications for child welfare organizations and future trainings are discussed.     

Lessons from the courtroom: Perspectives from child welfare attorneys and supervisors

Despite a history of child welfare worker performance difficulty in the courtroom, there has been little documentation regarding specific training needs for worker courtroom practice skills. This study expands the literature on child welfare courtroom practice skills by documenting child welfare worker conduct via perspectives from courtroom attorneys and child welfare supervisors. Separate focus groups with child welfare attorneys and supervisors were held to ascertain best and concerning practices for child welfare workers in the courtroom. Focus group participants identified themes related to preparation, adversarial nature of court proceedings, testimony, reasonable efforts, appearance and mannerisms, esteem of workers, duality of worker roles, and support. Study results have implications for focusing and improving training and supervision.     

Family preservation or child safety? Associations between child welfare workers' experience,position, and perspectives

In child welfare, there is sometimes a false dichotomy between child safety and family preservation. In an evaluation of Family Group Decision Making in four child welfare jurisdictions, worker surveys were administered to caseworkers, supervisors, program directors, and program coordinators asking about worker perceptions, demographics, organizational culture and climate, and job characteristics. The surveys contained the Dalgleish Scale, an instrument designed to measure the perspectives of workers across the continuum of child safety versus family preservation beliefs. Assessing a number of worker characteristics, an analysis of the Dalgleish Scale revealed that staff who have worked in child welfare longer are more likely to be oriented toward family preservation, whereas staff working in the field for a shorter time period or rating the shared vision among staff higher are more likely to be oriented toward child safety. Evidence has demonstrated that caseworkers' perspectives influence disposition decision making, and that child and family outcomes, such as maltreatment recurrence or out-of-home placement, are not solely determined by family and case characteristics. The potential utility of developing a better understanding of staff orientation has implications for organizational culture, compliance with policy mandates, workforce development, and most importantly, outcomes for child welfare-involved families.     

Infusing Clinical Supervision Throughout Child Welfare Practice: Advancing Effective Implementation of Family-Centered Practice Through Supervisory Processes

Child welfare supervision is fundamental to advancing the quality of practice when seeking to ensure the safety, permanency, and well-being of children. Child welfare supervisors serve administrative, educational, and support functions as they oversee frontline caseworkers and direct service providers. Clinical supervision, a dialog-driven process of case review and consultation is situated within the educational function. The process of clinical supervision is essential to child welfare practice, because it prompts reflection and builds analytical thinking skills needed to address complex situations involved in child protection. Despite increased recognition regarding the importance of clinical supervision, child welfare supervision continues to focus primarily on administrative tasks. Organizational climate and external pressures push this administrative agenda. In addition, many child welfare supervisors lack experience, training, and therefore competency in facilitating clinical case reviews. Strengths-Based Supervision (SBS; Lietz 2013) is a model of clinical supervision that was developed to (a) increase child welfare supervisors’ intentionality regarding the importance of infusing clinical supervision into child welfare supervision and (b) advance the skills needed to implement this practice effectively representing one solution to this ongoing challenge.     

A National Survey of Child Advocacy Center Directors Regarding Knowledge of Assessment,Treatment Referral,and Training Needs in Physical and Sexual Abuse

Mental health services are a core component of child advocacy centers in the United States. Child advocacy center directors were surveyed about (a) trauma and posttraumatic stress disorder; (b) referral criteria for treatment of abuse victims; (c) evidence-based treatments for abused children; (d) reliable, valid, and normed measures helpful in assessment; and (e) training needs. Directors accurately identified posttraumatic stress disorder symptoms, but additional symptoms were misidentified. Directors identified best practices for assessment and treatment, but they misidentified non-evidence-based practices. Primary reasons for referral for services included severity of abuse and emotional response of the child. However, referrals based on assessment findings were not a high priority. Directors expressed some training needs for staff consistent with issues identified in the study.     

When practice and policy collide: Child welfare workers' perceptions of investigation processes

This qualitative study examines variability in practices surrounding Child Protective Services (CPS) investigations regarding the allegations of child maltreatment. Working under the auspices of a community-research collaboration with Department of Human Services officials, university researchers conducted a series of focus groups with CPS caseworkers in a state that was under court-ordered consent decree to improve child welfare investigations. Focus groups with caseworkers sought to better understand caseworkers' common investigative practices and their perceptions of best practices in conducting child welfare investigations. Two main areas were noted for improvement: (1) the need for ongoing training of CPS workers, particularly at the stage of initial intake of the allegations of maltreatment, and cross-training of police and hospital staff who regularly work with CPS, and (2) implementation of an improved risk assessment tool. These recommendations are discussed in detail.     

Child welfare workplace: the state of the workforce and strategies to improve retention

Child welfare systems throughout the United States are being closely scrutinized as sensational cases appear in the media in nearly every state. At the federal level, with the Child and Family Service Review process, the government is documenting that states across the country are not conforming to federal child welfare requirements (DHHS, 2007) put in place to ensure the safety and wellbeing of children. One of the most crucial underlying causes of these inadequacies is a workforce that lacks the manpower for the tasks it confronts. To meet performance standards for the seven major Adoption and Safe Family Act child welfare safety outcomes, child protection agencies must stop the outward flow of staff from the workplace. This paper presents a study examining correlates related to retention. It was found supervisors and co-workers play a crucial role in the retention of workers. Strategies are presented aimed at assisting states in ways to slow the turnover rate of workers in child welfare.     

Training youth services staff to identify,assess, and intervene when working with youth at high risk for suicide

Youth in the child welfare system are often at increased risk for suicide due to the numerous physical and psychological challenges they face. This study was a longitudinal assessment of the impact of suicide intervention training on staff's abilities to identify, assess, and intervene when working with these youth in a child welfare setting. Participants received an adapted version of the “Youth and Depression” suicide intervention curriculum (Massachusetts Society for the Prevention of Cruelty to Children, 2010) designed to improve participants' attitudes toward suicide intervention, knowledge about suicide intervention, self-efficacy for engaging in intervention behaviors, and increased use of assessment and intervention behaviors over time. ANOVA tests yielded large effect sizes for increasing knowledge and self-efficacy. There were no statistical changes in attitudes and reluctance, but these were very positive even before training. Results for changes in the use of assessment and intervention skills were more modest but demonstrated some improvements from pre-training to post-training. Further refinement of the curriculum may yield larger and consistent improvements in intervention behaviors.     

Trauma-informed forensic child maltreatment investigations

Trauma-informed child welfare systems (CWSs) are the focus of several recent national and state initiatives. Since 2005 social work publications have focused on systemic and practice changes within CW which seek to identify and reduce trauma to children and families experiencing child maltreatment or other distressing events, as well as to the agency personnel working with these clients. Within the body of trauma-informed literature, little attention has been devoted specifically to the initial investigative response and its role in controlling for system induced trauma to the child, family, and caseworker. Training child protection services (CPS) workers on the impact of trauma in child maltreatment forensic investigations and the worker's role in anticipating and mitigating the effects of trauma during the investigative process is rarely addressed in the trauma-informed literature. This article reports on a training strategy to infuse trauma information into an existing forensic child maltreatment investigation curriculum with the goal of enhancing CPS caseworker's knowledge, skills, and values concerning the importance of viewing investigations and their associated tasks through a trauma lens.     

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.     

KVC's Bridging the Way Home: An innovative approach to the application of Trauma Systems Therapy in child welfare

This article presents implementation study findings from a large-scale evaluation of an intervention model for children in foster care, aimed to improve care within the services system. This Bridging the Way Home Initiative, funded by the Anne E. Casey Foundation, and conducted under the auspices of KVC Kansas (KVC) in Kansas created processes by which a defined trauma-informed intervention model (Trauma Systems Therapy-TST) could inform the work of all those involved in the care of a foster child (i.e., clinical and non-clinical providers, and foster parents). This study focuses on how effectively TST was integrated into the full continuum of care at KVC, an organization that provides out-of-home care to children served by the Kansas Department for Children and Families in the Kansas City Metropolitan and East Kansas regions. The implementation study helps explain findings from a complementary outcomes study—covered in a separate article also submitted for review. We found the process of implementing and expanding TST demanding, iterative and complex, yet ultimately TST was implemented across levels. The majority of staff and foster parents completed training in TST, and fidelity measures showed progress in TST use over time. KVC's implementation of TST provided both the knowledge and the tools necessary for foster parents to better care for the children in their homes. KVC's efforts show it is possible to infuse trauma-informed care into a large child welfare organization across all levels of care.     

Training in Depth Interviewing,William H. Banaka,New York: Harper and Row, 1971. 196 Pages, $3.95, Paperback

This paper reports on a communication assessment/development and evaluation program for directors, managers, and supervisors of a large metropolitan welfare department, with the involvement of the School of Social Work faculty at the University of Minnesota and a communications consultant, through the mechanism of a staff development project. In addition, it points out three significant future challenges oriented toward: (1) school of social work curriculum development, (2) responsibility of welfare agencies to provide training opportunities in management and communication, and (3) the support needs of governmental agencies.     

New roles for families in child welfare: Strategies for expanding family involvement beyond the case level

This paper examines the strategies and approaches child welfare agencies used to integrate meaningful family involvement into their service delivery systems, under the Children's Bureau Improving Child Welfare Outcomes Through Systems of Care demonstration initiative. Through a series of retrospective interviews with child welfare agency staff, systems of care project staff, family members actively involved in implementing the systems of care initiative, and local program evaluators, researchers investigated the family involvement planning and capacity building activities of child welfare agencies during the initiative's implementation. Findings indicate that child welfare agencies' capacity building efforts primarily centered on human resource development, focusing on three areas: program staffing, family engagement, and agency buy-in. These findings illustrate the importance of developing the capacity of child welfare agency staff and family members before fully implementing family involvement programs and activities. Although more research is needed to document the impact of family involvement, the lessons learned from these grant communities' experiences provide critical information and can inform development of policies and practices to help child welfare and other child- and family-serving systems promote and implement meaningful and sustainable family involvement.     

Hurdling the Artificial Fence Between Child Welfare and the Community: Engaging Community Partners to Address Disproportionality

As with many national and state social service systems, child welfare agencies have traditionally functioned in isolation. A multitude of federal and state laws and policies direct the functions and practices of child welfare systems, setting up an artificial fence around the agency that has created a culture lacking in interprofessional collaborations. However, recent reform efforts have emphasized the importance of engaging the community in discussions and decisions regarding child welfare practice. Child welfare agencies are now expected to work with community leaders, key stakeholders, affiliated service providers, and families to address issues impacting children and families. A major obstacle is determining where to begin, how to proceed, and what is needed to develop those partnerships. This article reports the efforts of one state agency in hurdling that artificial fence to address the overrepresentation of minority children in the system. Through focus group interviews with community members, child welfare staff, and legal professionals, barriers to community engagement are identified, and recommendations are provided for facilitating meaningful relationships and partnerships between child welfare agencies and the communities they serve.     

Supporting child welfare supervisors to improve worker retention

Recent child welfare research has identified supervisors as key to retaining qualified and committed workers. This paper describes implementation of a federally funded child welfare training initiative designed to improve worker retention largely through developing, implementing, and evaluating a statewide supervisor training program in a Midwestern state. Unique to this collaborative effort was involving all child welfare supervisors in identifying needed content components, developing competencies, and conducting self-assessments.     

Do child welfare job preview videos reflect evidence on retention and turnover?

To maintain a well-trained, competent work force and reduce turnover, child welfare agencies must use effective recruitment and retention practices. Many states use realistic job preview videos to recruit and retain appropriate, well-matched staff. The purpose of this study is to assess the content of child welfare realistic job preview videos to determine whether the content reflects current evidence on child welfare retention and turnover, and the mechanisms through which realistic job previews are most effective. The study involves content analysis of realistic job preview videos posted at the Child Welfare Information Gateway. A comparison of video content to findings from research on child welfare retention and turnover, and to research on realistic job preview effectiveness reveals some ways that the content of child welfare recruitment and retention efforts could be strengthened.     

Innovations in child protective services inservice training: commitment to excellence

The overwhelming obstacles to effective CPS intervention created by increasing reports of abuse and neglect, funding shortfalls, and the lack of qualified workers have prompted national efforts to reform the public child welfare system in the United States. Organizations such as the American Public Welfare Association, the Children's Defense Fund, the Child Welfare League of America, and the National Association of Social Workers are currently working closely with other national organizations to develop legislative proposals that will enable child welfare agencies to be more responsive to the needs of children and families. A critical component of this reform is the need to recruit, train, and retain qualified and competent CPS workers. The four training programs described in this article are examples of innovative programs seeking to enhance service delivery by enhancing the knowledge and skills of their staff members. Although the four programs were developed in very different political and social climates and within diverse organizational structures, they all provide useful lessons in how to develop efficient and effective training for workers delivering protective services for children. Any national, state, or local efforts to design and develop new CPS training programs should take into account the significant strides made by these agencies.