Preparing Social Workers for Child Welfare Practice: An Innovative University–Agency Learning Collaborative

This paper describes the evolution of a university–community child welfare learning collaborative based on an adaptation of the teaching hospital concept. This partnership between an agency providing a range of child and family welfare services and two university units, the school of social work and outreach, was intended to accomplish multiple agency, university and community goals: implement best practices in the agency, enhance social work education, increase staff resources in child welfare, influence public policy, and improve the lives of children and families in the child welfare system. The major strategy was ‘Grand Rounds’ modeled after the system used to train medical students through multiple transactions with experts in a clinical setting. The first year was very successful, with students, agency staff and faculty giving the sessions high ratings in content, quality and utility. One key to the success of the initiative was that it was an agency‐driven process and was based on working relationships of mutual respect and trust. Building such relationships takes both time and effort. Future challenges will include garnering the resources, both human and financial, to sustain the collaboration over time.     

Assessing outcomes for sufferers of severe mental disorder: A conceptual framework and review

A conceptual framework is presented for classifying the outcomes of services for sufferers of severe mental disorders. The proposed classification framework contains three dimensions: (a) the respondent type; (b) the social context; and (c) the domain of treatment outcomes. Respondent types include the client, the family, the extended social network, the clinician and the scientist. Social contexts include the individual, the family, work/school and the broader community. Domains of treatment outcome include “clinical status,” “functional status,” “life satisfaction and fulfillment,” and “safety and welfare.” This multidimensional framework is used to organize an illustrative review of existing outcome measures. It is concluded that: (a) measures of safety and welfare raise important social and policy questions and these measures require considerable development in order for utility to be realized; (b) although a good beginning has been made, more attention needs to be focused on defining and measuring “life satisfaction and fulfillment” and combining this domain with others to produce “well being” or “quality of life” scales; (c) the functional status area requires additional research and development especially when measurement is conducted in contexts other than work/school; and (d) although measures of clinical status are relatively well developed, the family perspective and context must be integrated into these measures.     

An innovative child welfare pilot initiative: Results and outcomes

Successful family reunification is achieved only about 50% of the time when children are in foster care. Parents' ability to access and complete court ordered services are paramount in determining whether the family can achieve reunification. However, the research on how to best facilitate service access and utilization are sparse. A matched sample of 100 families with no prior child welfare involvement and at least one child in out of home care were selected from Department of Children and Family closed administrative case files. This study compared 48 families who received traditional child welfare services to 48 families who received a Family First model intervention (PFFP) from a large urban public child welfare agency. The independent variables were the elements that distinguished the Family First model from traditional child welfare services and included the number of caseworkers for the life of the case, caseload size, and service needs met through community partnerships. The dependent variables were the stability of the children's out of home placement, the time to reunification, the length of agency involvement, the stability of reunification at one year follow up, subsequent substantiated child maltreatment reports one year after the cases were closed, the distance a placement location was from the home of the family at intake, the match between identified needs and the timely access of services. Hierarchal regression and survival models were constructed to examine elements of the intervention for their impact on family outcomes. The results suggested that a community partnership model that incorporated family engagement, enhanced service provider accessibility, reduced caseloads, one caseworker for each family, are associated with successful reunification outcomes. Moreover, the intervention families were more likely to have their needs met with clinical or economic services, experienced fewer days in out-of-home placement, shorter involvement with the agency, reduced placement moves and were more likely to be reunified sooner compared to the group who received standard child welfare services. At one year follow up, the intervention families also had fewer substantiated child maltreatment reports and children were more likely to be living in the parental home. Implications for policy, research and practice are presented.     

Using administrative data to evaluate the effectiveness of the Healthy Families Oregon home visiting program: 2-year impacts on child maltreatment & service utilization

The present study used state administrative databases to examine the 2-year outcomes of a large-scale randomized study of the impact of the Healthy Families Oregon (HFO) home visiting program. 2727 eligible first-time mothers were randomly assigned to either the HFO program or to a community services-as-usual control group. Outcomes for the current study were tracked for 2 years post-random assignment for all study participants through administrative data linkages to Oregon's statewide child welfare system, self-sufficiency services, and substance abuse treatment programs. Results indicated that families assigned to HFO program were no more or less likely to have a substantiated child abuse report than were controls (6.3% vs. 6.0%), but were significantly more likely to have an unsubstantiated report (9.7% vs. 7.9%). Among HFO families who were reported to the child welfare system, 86.2% (94 children) were reported after they had exited the program, while 13.8% (15 children) had a report while enrolled. However, 50.5% of children with unsubstantiated reports were reported while families were receiving HFO services, suggesting a surveillance effect for unsubstantiated reports. HFO families, compared to controls, were also significantly more likely to have been enrolled in Temporary Assistance for Needy Families (TANF) services for the first time, to have received more days of Supplemental Nutrition Assistance Program (SNAP), and to be enrolled in publically-funded substance abuse treatment services. Results suggest that early effects of home visitation on outcomes that can be measured through administrative data are small to modest, and that findings related to documented child welfare systems involvement may require more nuanced data than are typically used and/or available from state agency systems.     

Meeting the parenting skills needs of neglectful families by training child welfare workers as educators

A training program was devised for selected child welfare workers to conduct parent groups in the Missouri Neglect Demonstration Project. Welfare workers were trained to conduct parent groups that focused on parenting skills, self-advocacy, and social and economic resources. In contrast to case manager referrals, the workshops provided education directly and helped parents to develop resources. One of the goals was to have staff and parents collaborate to improve referral services and resources. The importance of this type of program was demonstrated by a literature review of parent trainings which found that: (a) few programs specifically addressed child neglect; (b) outcome evaluations of programs were scarce; and (c) a national extension study supported topics chosen.     

A confirmatory factor analysis of the evidence-based practice attitudes scale in child welfare

Despite the emphasis on evidence-based practice (EBP) in child welfare services (CWS) as an emerging and inevitable trend, implementation factors such as child welfare worker attitudes towards implementing EBP have received little attention in CWS. Aaron's (2004) Evidence Based Practice Attitudes Scale (EBPAS) has been used in multiple studies across mental health and healthcare settings. However, it has rarely been used in CWS. A-Mid Atlantic State implemented the EBPAS in all child welfare jurisdictions to measure workers' performance. The purpose of this study is to examine the EBPAS applied in a large urban child welfare services setting using a confirmatory factor analysis. Based on prior literature, three models were tested: a four factor model, a five factor model, and a second order four factor model. The second order model provided the best fit to the data, suggesting the EBPAS can measure workers' global attitudes, as well as four attitude types, towards EBP in a CWS setting. This study validates the use of the EBPAS with child welfare workers. Implications for effective evidence based practice in child welfare are discussed.     

Is There a Place for Extended Assessments in Addressing Child Sexual Abuse Allegations? How Sensitivity and Specificity Impact Professional Perspectives

Using data from a survey of perceptions of 932 child welfare professionals about the utility of extended assessments, the researchers constructed a scale to measure respondents' views about sensitivity (ensuring sexually abused children are correctly identified) and specificity (ensuring nonabused children are correctly identified) in child sexual abuse evaluations. On average, respondents scored high (valuing sensitivity) on the sensitivity versus specificity scale. Next, the researchers undertook bivariate analyses to identify independent variables significantly associated with the sensitivity versus specificity scale. Then those variables were entered into a multiple regression. Four independent variables were significantly related to higher sensitivity scores: encountering cases requiring extended assessments, valuing extended assessments among scarce resources, less concern about proving cases in court, and viewing the goal of extended assessments as understanding needs of child and family (adjusted R2 = .34).     

Sexual and reproductive health policies for foster youth in California: A qualitative study of child welfare professionals' experiences and perceptions of policies

Child welfare professionals and foster parents increasingly suggest the importance of establishing clear and consistent policies and procedures to address the sexual and reproductive health of youth in foster care. The present study examines the content and context of such policies across 18 California counties through a search of publically available county policy documents, and surveys and expert interviews with child welfare professionals (N = 22). A policy framework for agenda setting and policymaking was used to guide the data collection and analysis process. Child welfare professionals were aware of multiple sources of information, support and services for foster youths' sexual and reproductive health, though few practiced in counties with formal policies that outline the resources and support that youth should receive. Participants demonstrated widespread recognition that issues of youth sexual and reproductive health were significant; posing challenges to youth, foster parents and child welfare staff. Identified policy solutions included: 1) training for social workers and foster parents; 2) collaborative partnerships with public health nurses and community providers; 3) data tracking and monitoring of outcomes to assess youth needs and evaluate the impact of programs and policies; and 4) involvement by advocacy organizations in defining problems and advocating for improved services and support for youth in care. Social workers largely perceived that support from child welfare administrators and policy leaders is necessary to prioritize this issue and initiate policy formation. Additional research is needed to further examine the impact of policy mandates on social workers, foster parents and youth in foster care.     

Beyond the state: Conceptualizing protection in community settings

In the last two decades, the child welfare system has undergone a series of dramatic changes. We have moved from a broad concern for the social welfare of children and families to a restricted focus on detecting, investigating and assessing instances of child physical and sexual abuse and neglect. Spiraling reports of suspected or actual abuse and neglect, higher caseloads, reduced resources and lack of support for both families and workers, have all contributed to narrowing the focus of contemporary child welfare to one more aptly characterized as child protection. Child protection discourse is concerned with the nature and extent of state intervention into family life for the purpose of protecting children at risk of harm. While much attention has been given to boundaries and procedures for state intervention, it is less common to critically examine the actual activities involved in protection of children. An exception to this is the feminist scholarship on the topic, illustrating that protection is very much a gendered activity entailing the scrutiny of women's mothering practices and often associated with mother-blame. In this paper, another dimension to protection activity is explicated, namely that which occurs in a community setting. Drawing on a qualitative case study of a community agency that serves young mothers, we document its implications in 'child protection' processes and its markedly different approach to protection from formal child welfare agencies. Given the community agency's emphasis on supportive services to mothers, we turn a critical eye on usual conceptions of protection, where it occurs, and how it is accomplished.     

Children with problems: focusing on everyday life

This article presents the results of interviews with 24 children who had been in contact with child welfare and protection, school counselling or the child psychiatric clinic in a suburban community in Norway. The interview was constructed to cover the children's daily life and positive and negative life events, as well as their contact with the child welfare services. The results showed that the majority of the children lived rather structured lives within a variety of family constellations. Many children had little information about their contact with the child welfare services, and consequently had difficulties evaluating the effects of the assistance received. Their confidence seemed to depend upon the personal relationship established with the counsellor. The results can be used to counterbalance the bias from ‘problem- or deviant-oriented' research by focusing on competence and resources to get a realistic representation of client children's lives. Copyright © 1999 John Wiley & Sons, Ltd.     

A Three-Pronged Approach to Addressing Racial Disproportionality and Disparities in Child Welfare: The Santa Clara County Example of Leadership, Collaboration and Data-Driven Decisions

Disproportionality and disparities in the treatment of children of color has been a growing concern in the child welfare system. System stakeholders have begun to recognize the problem through data, which help identify discrepancies within their jurisdictions. Nationally, the primary concern is the overrepresentation of African American children within the child welfare system, where African Americans represent proportions of the foster population at a level more than twice as high as they are represented in the community at large. In some jurisdictions, however, this is only one piece of the disproportionality concern. San Jose, for example, has both an overrepresentation of African American and an overrepresentation of Hispanic children in the child welfare system. Because San Jose’s child welfare population is unique, they have had to take a unique approach to addressing these concerns. This article outlines strategies and tools used to begin reducing disproportionality within the child welfare and juvenile dependency court system, using San Jose’s experience as an example. Some of the key approaches to addressing disproportionality include ensuring a systems approach (creating a Cross Agency Systems Team that prioritizes services for parents and children in various systems, e.g., mental health, substance abuse, etc.); addressing disproportionality from multiple perspectives and examining the roles’ of caseworkers, supervisors, service providers, judges, and attorneys; gaining community and system stakeholder buy-in by maintaining momentum and providing opportunities for dialogue about the complex issues facing families of color; using a data-driven approach to inform ongoing initiatives and changes in policy and practice (e.g., closely examining policies and practices such as the frequency of recommendations to by-pass reunification services); and implementing changes in practice at multiple levels including child welfare and on the bench. The examination of San Jose’s approach reveals challenges, successes, and lessons learned.     

Patterns of child maltreatment referrals among Asian and Pacific Islander families

Much of the available data on Asian American families who become involved with the child welfare system relies on global ethnic categories, such as the category Asian/Pacific Islander. To explore the diversity of experience that is hidden by such categories, this article analyzes two years of child maltreatment referrals for Asian and Pacific Island families in Washington state. The study findings show that considerable variation exists within the Asian and Pacific Islander population with regard to child protection referrals. Although Asian Americans as a whole were less likely to be referred to child protective services than other groups, the within group picture that these data capture is considerably more complex. Some Asian/Pacific Islander ethnic groups, particularly those which have experienced higher levels of social and economic stress, were more at risk of child welfare involvement than other groups. Such findings underscore the need for child welfare policies and practice that are sensitive to the considerable variability within the Asian/Pacific Islander community.     

Animal-human relationships in child protective services: getting a baseline

Inclusion of certain aspects of animal-human relationships (AHR), such as animal abuse and animal-assisted interventions, can enhance child welfare practice and there are resources available to promote such inclusion. However, there is little knowledge of whether this is being accomplished. This study sought to fill this gap by conducting a national survey of state public child welfare agencies to examine AHR in child protective services practice, their assessment tools, and cross-reporting policies.     

The New York City neighborhood-based services strategy

The New York City Administration for Children's Services (ACS) instituted a neighborhood-based services system through the realignment of all foster care, preventive, and protective services along community district lines. ACS, with its community partners, also formed neighborhood-based networks to improve service coordination and collaboration among key community stakeholders and to shape a multisystem strategy tailored to each district informed by child welfare data. Based on analysis of neighborhood-specific census tract child welfare data, ACS initiated the Community Partnership to Strengthen Families project to address the disproportionate number of foster care placements originating from a small group of high-need communities, including Manhattan's Central Harlem. This article describes examples of specific strategies based on the Central Harlem experience.     

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

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

The preoccupation with thresholds in cases of child death or serious injury through abuse and neglect

Thresholds into and between services emerged as a significant theme in the biennial analysis of cases of child death and serious injury through abuse and neglect ‘serious case reviews’ carried out in England for the (then) Department for Education and Skills between 2003–05. The preoccupation with thresholds was one of a number of interacting risk factors and many children's cases were on the boundary of services and levels of intervention. In most cases child protection did not come ‘labelled as such’ which reinforces the need for all practitioners, including those working with adults to be alert to the risks of significant harm. Policy makers should acknowledge that staff working in early intervention are working within the safeguarding continuum and not in a separate sphere of activity. The emotional impact of working with hostility from violent parents and working with resistance from older adolescents impeded engagement, judgement and safeguarding action. In the long term neglect cases that were reviewed, the threshold for formal child protection services was rarely met and some agencies and practitioners coped with feelings of helplessness by adopting the ‘start again syndrome’. Adequate resources are essential but not sufficient to redress the problems. Effective and accessible supervision is crucial to help staff to put into practice the critical thinking required to understand cases holistically, complete analytical assessments, and weigh up interacting risk and protective factors. Copyright © 2008 John Wiley & Sons, Ltd.     

Child welfare services and delinquency: the need to know more

This article describes the need for a better understanding of the moderating effects of child welfare services on delinquency. Although juvenile delinquency is a commonly studied issue, researchers have paid little attention to the degree to which child welfare services may be associated with changes in subsequent delinquency rates. Emerging evidence suggests that for certain groups of maltreated children, such as children of color and females, certain child welfare services are associated with variations in risk of delinquent outcomes. The article discusses key methodological, theoretical, and policy implications that help guide further research in this area.     

The Impact of Housing Instability on Child Maltreatment: A Causal Investigation

More than a half million children are confirmed as victims of maltreatment by the child welfare system each year. Children from unstably housed families are over-represented in child maltreatment reports, and a growing body of evidence links housing problems to maltreatment and Child Protective Services (CPS) investigation. The present study applies two propensity score analysis approaches—greedy matching and propensity score weighting—to data from the Fragile Families and Child Well-being Study to move toward a causal explanation of child maltreatment behaviors among mothers in low-income households. Utilizing two separate methods to correct for overt selection bias, the present study finds that housing instability leads to a small increase in maltreatment behaviors, yet this small positive net impact on child maltreatment does not fully explain the over-representation of unstably housed families in the child welfare system. Families experiencing housing problems likely have a range of needs that require earlier, targeted intervention to mitigate consequences of poverty, domestic violence, and maternal depression. Child welfare services should invest resources in housing assistance programs in-house as well as through partnerships with local public housing authorities to stabilize families, reduce housing-related strain on caregivers, and promote family preservation.     

Effects of Medicaid managed care policies on mental health service use among a national probability sample of children in the child welfare system

Children in the child welfare system are dependent upon Medicaid to finance services for their considerable mental health needs. This study examines the effects of Medicaid policies on mental health service use among a national probability sample of children in the child welfare system. Data for this study came from the National Survey of Child and Adolescent Well-Being, the Caring for Children in Child Welfare study, and the Area Resource File. Weighted multivariate logistic regression analyses were conducted to estimate effects of policy variables on children's use of mental health services, controlling for child-level covariates and county-level health resources. Children in counties with behavioral carve-outs under Medicaid managed care had lower odds of inpatient mental health service use. Medicaid managed care enrollment and variations in type of provider reimbursement did not affect use of mental health services. Older age, greater need for mental health services, and higher levels of caregiver education were associated with increased odds of service use. Restrictions on use of inpatient mental healthcare caused by behavioral carve-outs may disproportionately affect children in the child welfare system who have high rates of such use. Careful adoption of carve-outs is necessary to assure appropriate care for these children.     

Illinois's child welfare research agenda: an approach to building consensus for practice-based research

This article presents a consensus-building initiative to develop a statewide research agenda that responds to the needs of Illinois's child welfare community. Researchers conducted this process through a university-community partnership to engage those interested in child welfare services. The process and findings resulted in a living document that will guide child welfare research throughout the state. Findings of the inquiry suggest that the development of best practice models may be one of the most important contributions research can make to practice.