Child Protective Services Caseworkers Research Articles

Supporting Children Experiencing Family Violence During the COVID-19 Pandemic: IPV and CPS Provider Perspectives.

ObjectivesChildren experiencing family violence (child abuse and neglect and exposure to intimate partner violence) are at a particularly elevated risk for compounding challenges during the COVID-19 pandemic. In this study, we interviewed intimate partner violence (IPV) advocates, child protective services (CPS) caseworkers, and IPV and CPS administrators on the needs of children experiencing family violence during the pandemic.MethodsWe conducted semistructured interviews with IPV advocates, CPS caseworkers, and IPV and CPS administrators. Recruitment occurred through emails to national and state listservs, networks of the study team, and word of mouth. Interviews were completed through Zoom, took 45 to 60 minutes and were audio recorded. We used a mixed deductive-inductive content analysis approach.ResultsFifty-nine IPV advocates, 35 IPV administrators, 21 CPS workers and 16 CPS administrators participated in this study. Four themes emerged from this work. Participants discussed the role of social isolation, school closures, and distance learning on children experiencing family violence. They also noted child custody and visitation challenges, particularly in the context of abusive partners using custody to control IPV survivors and limitations to virtual visitation more broadly. Compounding challenges were described for children from marginalized communities due to structural-level inequities. Collaboration was discussed by participants from both IPV and CPS sectors.ConclusionThis study is one of the first to describe the way the COVID-19 pandemic has impacted children experiencing family violence. Future studies should triangulate these results with children, families, and other child-serving providers

The impact of the COVID-19 pandemic on child protective services caseworkers and administrators

BackgroundThe COVID-19 pandemic has impacted children and young people experiencing child abuse and neglect. Child Protective Services (CPS) has played an important role in supporting children and families during the COVID-19 pandemic. Few studies to-date have evaluated the impact of the pandemic on CPS caseworkers and administrators in the United States. ObjectivesWe conducted interviews to explore CPS caseworkers' and administrators' experiences working and serving families during the pandemic. MethodsParticipants were U.S.-based CPS caseworkers and administrators. We conducted semi-structured virtual interviews with participants and used an inductive thematic analysis approach. ResultsWe conducted 37 interviews. Participants discussed how the COVID-19 pandemic has changed the way they conduct investigations and provide services to families in the CPS system. Several services were adapted to occur virtually, providing challenges and unique opportunities. Participants also described the personal barriers they faced during the pandemic, including working remotely, experiencing burnout, and challenges obtaining personal protective equipment. Finally, participants shared creative solutions they engaged in to support children and families during the COVID-19 pandemic, including expanding collaborations with other community-based organizations. DiscussionThis study suggests the important role that CPS has played during the pandemic and challenges individual CPS workers felt, in terms of both experiencing burnout and difficulty obtaining personalized protective equipment. Inclusion of the CPS system in emergency preparedness planning for future pandemics or natural disasters will ensure continuation of these vital services.

We Have All Been Working in Our Own Little Silos Forever: Exploring a Cross-Sector Response to Child Maltreatment

ObjectiveA child protective services (CPS) investigation for maltreatment signals risk for childhood toxic stress and poor health outcomes. Despite this, communication between child welfare and health care professionals is rare. We present a qualitative exploration of experiences with, barriers to, and hopes for cross-sector collaboration for children with suspected maltreatment. MethodsWe conducted focus groups with child welfare and health care professionals participating in a cross-sector learning collaborative to improve care for children at high risk for toxic stress. Participants were asked to describe 2 phenomena: identifying and responding to childhood adversities in their professional settings and cross-sector collaboration in cases of suspected maltreatment. Analysis included an iterative process of reading, coding and comparing themes across groups. ResultsHealth care professionals shared positive experiences in screening for social risks in clinic, while child welfare professionals expressed mixed attitudes toward social risk screening during CPS investigations. Consistent with prior research, health care professionals reported limited communication with CPS caseworkers about patients but suggested that relationships with child welfare professionals might reduce these barriers. Child welfare professionals described the poor quality of information provided in referrals from medical settings. Caseworkers also recognized that improved communication could support better understanding of maltreatment concerns and sharing of outcomes of CPS investigation. ConclusionsOur project extends previously published research by describing potential benefits of child welfare and child health care collaboration in cases of suspected maltreatment. Lack of effective cross-sector communication and concerns about confidentiality present significant barriers to uptake of these collaborative practices.

Risk assessment practices among home visiting nurses and child protection caseworkers in Colorado, United States: A qualitative investigation.

Nurses and caseworkers engage in assessments with the families they serve. Nurse home visitors from Nurse-Family Partnership (NFP) improve maternal-child health outcomes with first-time low-income mothers through care, education and support. In the United States, Child Protective Services (CPS) are state-level governmental agencies that protect children, including responding to reports of child maltreatment. This paper aimed to characterise similarities and differences in risk assessment practices between NFP nurses and CPS caseworkers in Colorado, United States. Using a grounded theory approach, we conducted in-depth qualitative interviews with 112 NFP and CPS workers from seven Colorado NFP sites from 2013 to 2015. Study sites were purposefully selected based on size, structure, geography and degree of collaboration with CPS. We conducted interviews first with NFP sites and used snowball sampling to recruit CPS workers. Interviews were recorded, transcribed, validated and then coded in NVivo 10. Memo writing was conducted to organise and link concepts within the theme of risk assessment. NFP and CPS workers emphasised the importance of risk assessment in their respective practices. Although there were similarities in the types of risks assessed, we found variations in work processes, operational definitions and methods of risk assessment between the two organisations that impacted inter-organisational collaboration to serve high-risk mothers and their children. NFP and CPS workers may have different roles and responsibilities but their underlying goals are the same - to keep children and their families safe and healthy. By understanding these similarities and differences in practice, there lies potential to improve collaboration between home visiting programmes and child welfare to provide integrated service delivery of high-risk families and prevention of future child maltreatment.

Adverse childhood experiences and their relationship to complex health profiles among child welfare-involved children: A classification and regression tree analysis.

To identify the clustering of adverse childhood experiences (ACEs) that best characterize child welfare-involved children with known complex health concerns. Multi-informant data were obtained from Wave I of the National Survey of Child and Adolescent Well-Being (NSCAW II). This study used a cross-sectional design and classification and regression tree (CART) analyses. Data were collected from families with children, aged birth to 17, investigated for child maltreatment and their child protective services caseworkers, including demographic characteristics of the children, their histories of adversity, and a wide range of health concerns. Results indicate that for children between the ages of six and 17, experiences of physical abuse alone, as well as experiences of physical abuse combined with having a caregiver with mental illness, are most strongly associated with complex health concerns. For children aged 2-5years, results suggest that caregiver mental illness is a key adverse experience associated with complex health concerns. Identifying specific combinations of ACEs may be a critical next step for child- and youth-serving agencies to allow providers to better calculate risk of health problems among children exposed to adversity.

Perceptions of child protective services among pregnant or recently pregnant, opioid-using women in substance abuse treatment

Pregnant, opioid-using women represent a challenge to healthcare providers attempting to engage them in prenatal and substance abuse services. Limited, primarily international research suggests that child welfare clients have mixed feelings about Child Protective Services (CPS) and that fear of CPS may present a barrier to care. Understanding how pregnant opioid-using women in substance abuse treatment perceive CPS may be useful in encouraging substance abuse treatment initiation. Participants were currently or recently (within past 12 months) pregnant women with current or recent (within past 12 months) abuse/dependence of pharmaceutical opioids at a drug treatment facility. Participants were recruited by treatment staff to participate in a comprehensive study across multiple domains. Data for this analysis were collected using semi-structured qualitative interviews. Transcribed data were thematically analyzed using in vivo and interpretive coding by three coders for purposes of inter-rater reliability. Following 2, two-hour meetings, consensus was reached on primary themes and sub-themes. Two major themes and several sub-themes were identified: 1) Participants’ feelings and attitudes about CPS (positive and negative); 2) Interaction-based perceptions of CPS’ function and performance. Participants’ feelings toward CPS were often conditioned by their experiences with individual caseworkers. While many pregnant, opioid-using women identify legitimate, and even useful features of CPS, fear of CPS can be a barrier to care. Making substance abuse treatment accessible to this population requires recognition of their complex feelings toward CPS, and coordination among CPS case workers and substance abuse treatment providers.

Family Assisted Contingency Management within the Context of Evidence-Supported Treatment for Child Neglect and Drug Abuse.

Contingency management (CM) has extensively been shown to be effective in reducing substance use disorders, but its effects in reducing child maltreatment have yet to be determined. The current study provides preliminary support for the utilization of an innovative family-assisted CM component in 18 mothers who were referred to an evidence-supported behavioral treatment for concurrent child neglect and drug abuse by Child Protective Service caseworkers. In the examined CM, participants were invited to indicate from a list of common actions incompatible with child neglect (i.e. positive parenting actions), the extent to which these actions had been experienced utilizing a 3-point scale (almost never, sometimes, almost always). For each item that was indicated to be almost never or sometimes experienced, the participants were queried to indicate if the neglect incompatible action should be targeted as a therapeutic goal. Contingencies were subsequently established in which the participants were rewarded by involved family members for their completion of therapeutic goals. At baseline, results indicated that there was a negative association between the number of neglect incompatible parenting actions that were infrequently experienced and child abuse potential. A hierarchical multiple regression analysis showed that the number of neglect incompatible actions targeted as therapeutic goals at baseline, but not the number of positive parenting actions experienced infrequently at baseline, predicted reduced child maltreatment potential following treatment. These findings suggest the examined CM may assist evidence supported behavioral treatment specific to child neglect and drug abuse.

Profiles of Child-Welfare-Involved Caregivers Identified by Caseworkers as Having a Domestic Violence Problem: Then and Now.

Over the past 10 years, there has been a significant decline in the rate of domestic violence (DV) experienced among caregivers involved with the child protective services (CPS) system. It is unclear whether this shift is related to changes in caregiver characteristics. Furthermore, despite evidence that suggests CPS caseworkers poorly identify DV and fail to link families to DV services, limited research exists on whether the current CPS interventions that are known to improve caseworkers' DV identification will also improve chances for DV service receipt. The present study uses data from the first and second cohorts of the National Survey of Child and Adolescent Well-Being (NSCAW) to compare differences in demographic characteristics and DV experiences between caregivers in NSCAW I (1999-2000; n = 2,758) and NSCAW II (2008-2009; n = 2,207). We also examine the effects of CPS interventions on NSCAW II caregivers' receipt of DV services external to the CPS agency (i.e., external DV services). Caregivers with caseworker reports of active DV in NSCAW I and II were similar in their demographic characteristics and external DV service experiences. However, caregivers in NSCAW II generally reported lower rates of victimization for specific types of violence than NSCAW I caregivers. Finally, caregivers with active DV involved with an agency that used DV assessment tools were 7.03 times more likely to receive external DV services than those in agencies without DV tools (95% confidence interval [CI] = [2.33, 21.22]). Whereas caregivers in agencies that sometimes (odds ratio [OR] = 0.16, 95% CI = [0.03, 0.99]) or always (OR = 0.15, 95% CI = [0.02, 0.98]) had a DV specialist available were less likely to receive external DV services than those in an agency that never/rarely had a DV specialist available. We recommend CPS agencies use specialized assessment tools to identify DV-affected families and link them to services. Additional research is needed to understand what types of services DV specialists offer within CPS agencies and whether these services meet caregivers' needs.

A qualitative study of collaboration between guardians ad litem and caseworkers in the child welfare system

Various agencies and professionals in the child welfare system work together to prevent and treat child maltreatment. Prior research suggests their ability to collaborate is related to outcomes for children and families and agencies often implement strategies to improve collaboration. However, a review of the literature indicated a lack of research on collaboration between Guardians ad litem (GALs) and child protective services caseworkers. Examination of this relationship is warranted considering federal law mandates GALs be appointed for children in all court-involved child protection cases. This qualitative study begins to address this gap by exploring the GAL perspective on factors that promote or inhibit collaboration between themselves and caseworkers. Interviews were conducted with 12 GALs in a mountain region state. Participants emphasized five individual-level factors that impact the frequency and quality of collaboration with caseworkers. These include frequent and open communication, mutual respect, understanding the other's role and responsibilities, having an open mind, and valuing collaboration. Participants described in detail how these factors facilitate collaboration despite the organizational and systemic obstacles to working together. The findings may help explain why collaboration does not necessarily occur in frontline practice despite the presence of organizational policies and procedures intending to improve collaboration. These findings have several implications for improving GAL–caseworker collaboration in order to better serve children and families in the child welfare system.

Evidence-Based Parenting Programs for Maltreating Parents: Views of Child Protective Services Caseworkers

Evidence based programs (EBPs) show great promise in reducing rates of recidivism in parents who have maltreated their child. Child Protective Services (CPS) caseworkers play a critical role in routing parents to such interventions, when available. However, caseworkers are often unfamiliar with EBPs, potentially impacting their likelihood of referring parents to these services. Focus groups were conducted to explore caseworker views of an EBP. Results suggested that caseworkers generally saw the program as a poor fit to the needs of maltreating families, particularly with respect to case complexities and cultural sensitivity, and when caseworkers were less familiar with the EBP.

Profiles of Intimate Partner Violence Victimization, Substance Misuse, and Depression Among Female Caregivers Involved with Child Protective Services.

Intimate partner violence (IPV) victimization, substance misuse, and depression are highly prevalent among female caregivers involved with child protective services (CPS). Understanding heterogeneity in the occurrence of these problems is essential to improving pathways to intervention for women in this population. Latent class analysis was employed to determine whether there exist homogeneous subgroups of female caregivers who experience different patterns of IPV victimization, substance misuse, and depression. A restricted three-class solution best fit the data, suggesting high risk, moderate risk, and no risk subgroups. A substantial number of female caregivers comprise the high-risk subgroup (33%) in which caregivers reported very high rates of IPV victimization, substance misuse, and depression. Only a very small proportion comprised the no-risk subgroup (9%). Findings emphasize the heterogeneity among subgroups of female caregivers based on these risk factors, which may have implications for practitioners, such as CPS caseworkers, and researchers alike.

Examination of Illicit Drug Use Frequency Using Multiple Drug Assessment Methods in Mothers Referred to Treatment by Child Protective Services

It has long been established that illicit drug use contributes to child maltreatment. However, investigators have yet to comprehensively examine illicit drug use in mothers referred to treatment by Child Protective Services (CPS). In this study, 77 mothers who were referred to treatment by CPS for co-existing drug abuse and child neglect were administered the Timeline Follow-Back measure to assess their substance use frequency during the four months preceding treatment. Reports of the mothers’ substance use were obtained for the same time period from the mothers’ significant others and CPS caseworkers, and mothers were administered urinalysis testing. The purpose of this study was to examine the concordance of these multiple reports, and identify unique predictors of different drug use reporting patterns. The practice of using urinalysis results as a prompt during the mothers’ Timeline Follow-Back administration may have contributed to greater frequency of drug use reporting in mothers. Mothers reported progressively more drug use for more distant time periods, as compared with caseworkers. Findings also suggested mothers’ reports of drug use were influenced by CPS investigatory case status (i.e., open or closed), ethnicity, and defensive responding. Implications of these findings for clinical practice and future research are discussed.

Reliable and valid: A procedure for establishing item-level interrater reliability for child maltreatment risk and safety assessments

Child protective service caseworkers need validated instruments to assist them in assessing safety and risk factors for child maltreatment. The literature provides growing evidence that actuarial risk assessments can be valid tools for classifying families according to risk of future maltreatment. However, compared to validity, we know less about the reliability of both whole assessments and individual items. In this study we tested interrater reliability for 108 individual risk and safety items. We used 31 realistic case vignettes for testing. Each item was completed six times for each vignette. Fifty-four caseworkers and supervisors participated in rating, generating a total of 20,088 ratings for analysis. To determine item reliability, we used measures of prevalence and percentage agreement and the Fleiss's kappa statistic. Results show that interrater reliability varies widely from item to item. Items with higher prevalence and items documenting demographics, current CPS system involvement, substance abuse, or mental health issues tend to be most reliable. We provide an overview of the testing process, which is replicable in other contexts. We also discuss implications for child protective services practice and for developing or revising risk and safety assessment instruments.

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.

Family Reunification of Youth in Foster Care with Complex Mental Health Needs: Barriers and Recommendations

This study presents findings of a formative evaluation of an innovative pilot program designed to reunify and reintegrate foster youth with complex mental and behavioral needs in residential treatment centers or therapeutic foster care with their families in the community. Data collection methods included in-depth structured case file reviews and semi-structured interviews with the youth, as well as their caregivers, Child Protective Services caseworkers, and pilot program staff. The participants provided important insights regarding system, program, and case-level barriers to the successful reunification of these youth back into the community. Training, practice, and policy recommendations are discussed.

Negotiating stigma: Understanding mothers' responses to accusations of child neglect

Current child protective service policies encourage family preservation and reunification. Yet little is known about how mothers accused of child neglect experience being labeled neglectful or how this influences compliance with child protective services (CPS) service plans. This paper reports the results of a case study of mothers' perceptions of being labeled neglectful. Drawing on symbolic interactionist theories of identity, interviews with sixteen mothers and sixteen child protective service caseworkers, and content analysis of interview data obtained, this paper describes the strategies mothers employ to resist the stigma of being labeled a neglectful mother, strategies that ultimately put them at odds with child protection goals. Findings suggest that mothers' identity preservation and maintenance have powerful implications for CPS policy.

Evaluation of the Siblings of Physically Abused Children: A Comparison of Child Protective Services Caseworkers and Child Abuse Physicians

Current theories suggest that all children in a home are at risk for physical abuse, when one child is abused. However, little evidence exists to guide decisions regarding the medical management of siblings of physically abused children (contact children [CC]). This study sought to compare child protective services (CPS) caseworkers' and child abuse physicians' (CAP) recommendations regarding the need for medical evaluation of CC in case scenarios of unequivocal physical abuse. In all cases, caseworkers and physicians disagreed on which CC warranted a medical evaluation. In addition, 25% of caseworkers did not think that physicians should make recommendations on the need for medical evaluation of CC. The findings of the authors suggest that the home visit is a critical part of the decision-making process for caseworkers and that it often acts as a substitute for a medical evaluation. Caseworkers indicated that visible injury to the contact child and severity of injury to the index child were among the most important factors in deciding which CC need a medical evaluation. Although caseworkers and physicians disagree on certain issues related to the evaluation of CC, it is clear that limited resources should be directed at CC at highest risk for physical abuse.

Exploring Factors Which Lead to Successful Reunification in Domestic Violence Cases: Interviews with Caseworkers

This exploratory study investigated factors that Child Protective Service caseworkers believe lead to change for the domestic violence abuser and victim, and ultimately lead to success in terms of reunifying children who have been removed from their parents due to domestic violence. In-depth interviews with six caseworkers examined both successful reunification cases and unsuccessful reunification cases. The interview was structured around three areas of interest: services, the caseworker’s relationship with the parents, and social supports, in order to identify variables that may influence the family’s ability (or inability) to make the necessary changes for reunification with their children. Results revealed that successful reunifications took place within the families who fully engaged in services, admitted the issues within the family home, set clear boundaries with each other, and sought and maintained an appropriate support system. Implications for caseworkers involved with families experiencing domestic violence, as well as directions for future research, are discussed.

Combining Abuse and Neglect Investigations With Intensive Family Preservation Services: An Innovative Approach to Protecting Children

Objective: Evaluate an experimental model for enhancing child protective service (CPS) investigations by teaming CPS investigators with family preservation services (FPS) caseworkers. Method: Using a posttest-only experimental design, high priority cases referred to a state child welfare agency for abuse or neglect were randomly assigned to an experimental or control group. During the interval between referral and case determination, families in the experimental group were served by a pair of caseworkers—CPS and FPS—who investigated the allegation and prepared a joint recommendation. Results: When compared 7 months later, families in the experimental group (a) had their children home for a greater percentage of time, (b) used a broader array of services, and (c) were more satisfied. Both CPS and FPS caseworkers felt that (a) better decisions were made, (b) families were strengthened, and (c) job satisfaction was greater. Conclusions: The model was effective and should be implemented on a broader scale.

Pregnancy: a time to break the cycle of family violence.

In an effort to raise the awareness and detection of domestic violence among pregnant women, the Child Protection Center, a child advocacy center at Montefiore Medical Center in the Bronx, New York, instituted an education and screening program for pregnant and parenting women who were using the OB/GYN clinic at the hospital. Pregnancy may offer a unique window of opportunity to engage women in promoting behaviors and attitudes that could help them reevaluate a violent relationship. A service and support network offered by medical centers with child advocacy center programs could provide a model for social workers and medical providers to address the serious needs of abused children and battered parents. THE CHILD PROTECTION CENTER Since 1984 the Child Protection Center (CPC) has evaluated over 12,000 sexually abused, physically abused, and neglected children. Using a family-centered approach, the CPC also provides support and counseling to family members. The CPC uses a multidisciplinary team of medical providers, social workers, police officers, child protective services caseworkers and the District Attorney's office staff to reduce systems trauma to children by coordinating the rapid assessment, investigation, arrest, and prosecution activities for serious child abuse cases. DOMESTIC VIOLENCE AND CHILD ABUSE CORRELATION The CPC's records indicate that there is a co-occurrence of child abuse and domestic violence in 60 percent of the cases evaluated at the center (Child Protection Center, 1999). Growing awareness of the correlation calls for new measures to identify victims and provide resources. An American Psychological Association report (1996) estimated that each year 3.3 million children are exposed to violence against their mothers or female caretakers. Case Examples Cases in which both child abuse and domestic violence are present are evaluated at the CPC on a daily basis. Domestic abuse includes physical battering, emotional abuse, and threats of murder. Child abuse includes sexual abuse, physical abuse, and death. Case examples illustrate the severity of issues encountered by these CPC patients. Example 1. During a psychosocial interview at the CPC, a woman described how her husband kicked her and hit her with a belt during her pregnancy. Her child was being evaluated for sexual abuse by the husband. Example 2. A one-year-old infant suffered head trauma resulting from blunt impact. During an argument, the boyfriend of the mother picked up the baby and threw the baby at her. The infant's head hit a table; he suffered a fractured skull. Example 3. During a dispute with a relative, a mother became so violently engaged that she did not realize that she had left her 18-month-old baby unattended in a bathtub until 15 minutes had passed. The child drowned during the argument. Example 4. Teen-age parents enrolled in the CPC's parent education support group cited frequent violent altercations with their boyfriends or husbands during their pregnancy and after the birth of their children. Punching, slapping, pinching, scratching, and kicking behaviors were common. Degrading remarks about the woman's appearance and intellect were frequently cited. Intervention in the OB/GYN Clinic In 1997 the CPC received a grant from the UJA Federation of New York to improve identification of potential domestic violence victims. Because of the CPC's focus on the prevention of child abuse and an interest in the positive dynamic that the period of pregnancy may offer for effective intervention, an education, outreach, and screening program was initiated in the OB/GYN clinic. Why OB/GYN? Domestic violence is a major health concern in the United States. The American College of obstetricians and Gynecologists (1998) defines domestic violence as a pattern of assaultive and coercive behaviors including physical, sexual, and psychological attacks, as well as economic coercion, used against current or former intimate partners. …