The place of “think family” approaches in child and family social work: Messages from a process evaluation of an English pathfinder service

Findings are reported from a process study of an English multi-disciplinary team working with families with long standing and complex problems. The approaches and methods of the team are described and placed in the context of UK policy developments and of UK and USA research on professional practice with families facing multiple difficulties. Basic data are provided on all families referred in the first year and analysed with respect to the first 100 completed cases. A broadly ethnographic research approach is used for the observational study of the team interactions and decision-making on individual cases. For a one-third sub-sample of 33 cases, process and interim outcome data are analysed from information systematically extracted from case records. These are complemented by qualitative data from interviews with managers and caseworkers and by observation of ‘team around the family’ and professionals' meetings. The researchers conclude that the service succeeds in engaging a majority of the referred families who have been hard to reach or hard to change in the past and whose children are either ‘on the edge of care’ or likely to be significantly harmed without the provision of an intensive service. The researchers concluded that improvements were made in the life chances of children in 75% of the families. Aspects of the service identified as associated with more positive outcomes are: the allocation of two key workers (one for the child/ren and one for the parent/s); the centrality of relationship-based practice and flexibility of the approach rather than strict adherence to any particular practice model; the fact that the service is firmly embedded within the statutory children's services department, allowing for continuity of relationships with team around the family members when the intensive service ends; and flexibility about case duration and intensity.     

A qualitative study on the pros and cons of ethnically matching culturally and linguistically diverse (CALD) client families and child protection caseworkers

A review of the literature indicated that empirical research into the advantages and disadvantages of ethnically matching child protection caseworkers and culturally and linguistically diverse (CALD) client families is not extensive. The main aim of this study was to address this gap. Qualitative interviews were conducted with 29 CALD client families and 17 child protection caseworkers (as part of a larger study). It was found that if CALD families fear a breach of confidentiality (because of cultural reasons to protect the family's privacy and name), and this fear exceeds the two main benefits of ethnic matching – namely, that it helps overcome language barriers and provides (cultural) sensitivity – then they are likely to prefer a non-matched caseworker. This may be a challenge in child protection practice if the pool of culturally competent caseworkers is small. Another challenge identified was when CALD families preferred an ethnic match but was seen by case managers as a risk to the accurate assessment of a child's wellbeing because the caseworker was over-identifying with the client family. Thus, the provision of a culturally sensitive service can be at odds with the need to protect children from harm. This issue is seen as best addressed on a case by case basis. This study is significant because it has shown that ‘over-identification’ is an important work practice issue in this matter. It has also used empirical evidence to inform best practice principles regarding ethnic matching.     

“It's hard enough to deal with all the abuse issues”: Child welfare workers' experiences with intimate partner violence on their caseloads

Child welfare caseworkers (N = 19) were asked to discuss their experiences working with families experiencing intimate partner violence (IPV). The workers revealed that they found these cases particularly challenging, they had a difficult time collaborating with both battered women's services and law enforcement on these cases, and they lacked the training and education that they needed to understand and intervene when IPV was present. Workers talked about their fears for their own safety and discussed how their practice is impacted when they personally know a victim and/or perpetrator of IPV. The interviews also revealed a somewhat limited understanding of the impact of child exposure to IPV. Findings have important implications for the training and education of child welfare caseworkers, and highlight the important of improved cross-system collaboration when working with multi-problem families.     

Child-centered approach in the context of the assessment of children in need: Reflections of child protection workers in Estonia

Objective

This article describes empirical results on how practitioners understand the concept of child-centered approach and how it is applied in practice, extending knowledge of the unresearched phenomena in Estonian child protection practice.

Method

A small-scale study included twenty child protection workers from different regions in Estonia, exploring the child-centered approach in assessment practices through in-depth semi-structured interviews.

Results

Results indicate that child-centered approach in the child protection workers' practice is characterized, firstly, by doing work for the child, and less by working with the child, including the fact that some practitioners are somewhat unclear about the meaning of child-centered principle. Majority of the participants underscored the importance of child involvement and partnership in the decision-making process, nevertheless, their case reflections showed that most of them did not include the child in the assessment.

Conclusions and implication for practice

Findings highlight several challenges in Estonian child protection system and suggest a need to find ways to support child protection workers' competence and confidence to conduct comprehensive assessments based on the child-centered approach, including the child in the assessment process.     

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.     

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.     

Have child maltreatment and child placement rates declined?

It is argued that the actual incidence of child maltreatment remains elusive and is, in fact, indeterminate. Factors that might be reflected in variations in child maltreatment rates, other than child harm or endangerment at least partially attributable to caretakers, are explored. But since most children residing in foster care in the United States have been placed there for the alleged reasons of child abuse and neglect, we might expect trends over time in the rate of alleged maltreatment to have some bearing on the out-of-home placement population rate. On the contrary, it is shown that the child placement population rate has risen in recent years, even though the overall child maltreatment rate has not. Based on existing data, the child placement population in the United States is calculated to have been nearly one million children on any given day in 2011, higher than at any point throughout the previous century. Brief comparisons are made with child maltreatment and child placement trends in other countries.     

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 surprisingly weak evidence base for supervision: Findings from a systematic review of research in child welfare practice (2000–2012)

Objective

The objective of this study is to ascertain what is known about the effectiveness and cost-effectiveness of supervision in child welfare in relation to outcomes for consumers/service users, staff and organizations.

Method

This is a systematic review of the English language literature (2000–2012). Scoping study is followed by database searches of indexes and abstracts including Campbell Collaboration, CINAHL, the Cochrane Library, Medline, PsycInfo and Social Work Abstracts, journal hosts (EBSCO and IngentaConnect) plus specialist journals. Inclusion criteria: studies that reported on the associations between the provision of supervision and outcomes for service users/consumers, workers and organizations as well as intervention studies. Potentially relevant studies were independently screened by two reviewers (Stage 1) and if meeting the eligibility criteria proceed to full text review and data extraction (Stage 2). Studies were subject to critical appraisal by three reviewers using the Weight of Evidence approach (Stage 3). An analysis of included study characteristics is followed by a narrative synthesis of findings structured to answer the research objective.

Results

690 unique studies were identified at Stage 1, 35 proceeded to Stage 2 and, following quality appraisal, 21 were included in the review. Almost all of the studies were cross-sectional, providing evidence of associations between the provision of supervision and a variety of outcomes for workers, including job satisfaction, self-efficacy and stress and for organizations, including workload management, case analysis and retention. There was only one, poorly reported, intervention study and no studies of outcomes for consumers. No economic evaluations were found.

Conclusions

The evidence base for the effectiveness of supervision in child welfare is surprisingly weak. An agenda for research based on a framework for the development and evaluation of complex interventions is proposed.     

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.