Child Welfare Agencies Research Articles

Adoptive parents’ perspectives on adoption adjustment and post-adoption support

ABSTRACT This study investigated adoption adjustment and the honeymoon period through the perspective of adoptive parents. Parents who had adopted a child from a public child welfare system participated in interviews seeking information on their post-adoption experience. Parents’ voices are critical to understanding adoption adjustment and post-adoption needs due to their firsthand experience. The findings in this study build on the understanding of when challenges arise for children and families after adoption and how adoptive parents perceive these experiences. Implications for practice include guidance for pre-adoption training and expansion of post-adoption support through public child welfare agencies.

Algorithmic Harms in Child Welfare: Uncertainties in Practice, Organization, and Street-level Decision-making

Algorithms in public services such as child welfare, criminal justice, and education are increasingly being used to make high-stakes decisions about human lives. Drawing upon findings from a two-year ethnography conducted at a child welfare agency, we highlight how algorithmic systems are embedded within a complex decision-making ecosystem at critical points of the child welfare process. Caseworkers interact with algorithms in their daily lives where they must collect information about families and feed it to algorithms to make critical decisions. We show how the interplay between systemic mechanics and algorithmic decision-making can adversely impact the fairness of the decision-making process itself. We show how functionality issues in algorithmic systems can lead to process-oriented harms where they adversely affect the nature of professional practice, and administration at the agency, and lead to inconsistent and unreliable decisions at the street level. In addition, caseworkers are compelled to undertake additional labor in the form of repair work to restore disrupted administrative processes and decision-making, all while facing organizational pressures and time and resource constraints. Finally, we share the case study of a simple algorithmic tool that centers caseworkers’ decision-making within a trauma-informed framework and leads to better outcomes, however, required a significant amount of investments on the agency’s part in creating the ecosystem for its proper use.

Strive to enhance supervised family time visits for children in foster care: Outcomes from a pilot study with randomization

Child welfare system reforms are needed to help support families and prevent removal of children who may safely remain in the home. For those children who have been removed from their parents’ care, parent–child visits are a way to help maintain bonds and attachment and may help mitigate the trauma of removal. The primary goals of this randomized, controlled study were to assess the effects of the Strive Supervised Family Time Program on parental engagement, attendance, parenting skills in visits and the quality of the visits among parents involved with the child welfare system. Parents within Washington State having supervised visits with their children (from newborns to age eight) were randomly assigned to either the Strive program (n = 58) or a ‘supervised visitation as usual’ comparison group (n = 50) and then recruited to participate in the study. The Strive program is a manualized, evidence- and trauma-informed five session curriculum delivered one on one to parents by a Strive-trained “Strive Navigator” once a week over five weeks. The five sessions focus on engaging parents, emphasizing the importance of visits, building a positive rapport between the parent and the Strive Navigator, understanding and anticipating children’s feelings and behaviors in visits, creating routines to provide support and reassurance to children, creating a safe and healthy visit environment, strategies for positive and productive communication, and following their child’s lead in play. Survey data were collected from parents at the beginning and at the end of program. Strive Navigators documented program fidelity, and child welfare agency visit report forms provided data on visit attendance. Parents in the Strive program were more engaged in and had higher quality parent–child visits. There was no effect on visit attendance. Overall, the Strive program was well received by parents and showed promise in increasing the quality of parent–child visits through parent engagement, support, and skill development in areas associated with safety and attachment, stress management and communication. Strive provides a promising program of engagement and support uniquely tailored to the needs of parents involved in the child welfare system at a critical time. The contribution of the Strive program may, in addition to benefiting individual families, represent an important family time practice improvement for child welfare systems.

An examination of child welfare agency models that serve immigrant children and families

ABSTRACT Child welfare agencies often experience challenges in meeting the unique needs of immigrant families. In this qualitative study, semi-structured interviews were conducted with child welfare agency representatives to examine models used to effectively serve this population. Findings show that child welfare agencies utilize: 1) specialization of immigrant-related knowledge and skill sets; 2) formal and informal relationships with consulates and external stakeholders; and 3) innovative approaches to engage immigrant families. Implications highlight the importance of child welfare staff developing expertise on immigration policy, navigating international borders and systems, and training caseworkers in implementing culturally and linguistically sensitive transnational engagement strategies.

“We should be treated like we are somebody”: Building supportive relationships with LGBTQ foster youth

AbstractObjectiveThis study uses in‐depth interviews and ecomapping techniques to explore LGBTQ youths' relationships with child welfare professionals and other affiliated, nonparental adults (CWP/ANPAs) who play a primary role in providing them with care and services.BackgroundSupportive relationships with caring adults are essential in reducing minority stress impacts and improving outcomes for LGBTQ foster youth, who often face victimization affecting their access to support. However, limited knowledge exists regarding LGBTQ foster youths' relationships with CWP/ANPAs and the role of relational support in their identity disclosure and access to appropriate care and services.MethodTwenty‐one LGBTQ foster youth, aged 17 to 21, participated in interviews and constructed visual diagrams of their relationships with CWP/ANPAs. Data were analyzed using directed content analysis.ResultsFindings highlight the need for CWP/ANPAs to improve relationships with LGBTQ foster youth. These improvements can be achieved through engagement in attitudes and practices that facilitate relationship development (e.g., empathy, respect, affirmation, knowledge, responsiveness), and reduce existing barriers (e.g., neglect, discrimination, mistreatment, lack of knowledge, fear of rejection).ConclusionsTo provide better support LGBTQ foster youth, CWP/ANPAs and child welfare agencies should increase their knowledge and skills, be more responsive to LGBTQ youths' specific needs, and implement inclusive policies and practice standards.ImplicationsCWP/ANPAs and agencies working with LGBTQ foster youth must develop an awareness and understanding of the strengths, needs, and challenges of LGBTQ foster youth to reduce stigma, bias, and discrimination in the foster care system and engage in affirming actions and practices that create a more inclusive environment for this population.

Advancing a prevention-oriented support system for the health and safety of children

Child welfare and child protection systems are entrenched institutionally and their value stances on working with marginalized groups are, at times, antithetical to the value framework of public health approaches. Differences are sufficiently wide as to render these child welfare systems incapable of advancing a robust prevention agenda focused on child safety and well-being. In this article, we argue for institutionally distinct, yet cooperative approaches focused on universal and secondary-level family and community supports, aimed at breaking down silos and shifting our attention from child welfare reform to community-based systems that are better positioned to proactively meet the needs of children and families before they find themselves in crisis. Within the article, we focus on key tensions and arguments for separate yet cooperative approaches across systems and organizational silos, including the divide between preventive and responsive frameworks, the capacity constraints on existing–reactive–child welfare systems, and shifting the dial to population-wide prevention strategies to address the growing awareness that child maltreatment is a far wider problem than indicated by the number of children reported to child welfare agencies.

A balancing act: partnering with the media to provide a trauma-informed approach to U.S child welfare

ABSTRACT The United States (U.S.) media often scrutinizes and sometimes explicitly vilifies child welfare practices, particularly when the case attracts the public’s attention. In such cases, the public’s perception of child welfare skews negatively, fostering a culture of blame ascribed to the system. In turn, families are disinclined to work with child welfare workers, who make efforts to mitigate the trauma inflicted on children. This framework aims to provide a trauma-informed practice model that explores how child welfare agencies can partner with the media to improve public perception of child welfare practices and ensure the safety of children. This proposed model draws from a United Kingdom (U.K.) reform effort, which addresses the importance of dialogue between child welfare and the media to create a trauma-informed partnership for reporting. The U.S. child welfare agencies and media can benefit from a trauma-informed partnership, promoting mutual understanding and respect, advancing the profession, and increasing public knowledge of child welfare.

Predictors of Identity Crime Victimization of Adolescent Youth in Foster Care

ABSTRACT Identity crimes pose serious risks and challenges for youth in foster care. As young people move through various out-of-home placements and schools, their personal data are often widely disseminated, difficult to secure, and thus vulnerable to theft and misuse. When they transition from foster care to adulthood, identity crime victims with compromised credit histories may be denied loans, employment, and/or housing during the already-precarious period of emerging adulthood. Even though federal law requires state child welfare agencies to conduct annual credit checks for adolescent youth in foster care, little is known about the factors contributing to risk of identity crime victimization among foster care-involved youth, either before or after their initial entry into care. To address this knowledge gap, we analyze linked child welfare and consumer credit records for a population cohort of 4,670 youth (age 14 to 17) in foster care in a southeastern state who received credit checks from November 2015 through December 2021. Using gradient boosted machine learning, we find that prior identity crime victimization before the youth first entered care is the strongest predictor of victimization while in foster care. Implications of these findings for policy and practice are discussed.

Specifying cross-system collaboration strategies for implementation: a multi-site qualitative study with child welfare and behavioral health organizations

BackgroundCross-system interventions that integrate health, behavioral health, and social services can improve client outcomes and expand community impact. Successful implementation of these interventions depends on the extent to which service partners can align frontline services and organizational operations. However, collaboration strategies linking multiple implementation contexts have received limited empirical attention. This study identifies, describes, and specifies multi-level collaboration strategies used during the implementation of Ohio Sobriety Treatment and Reducing Trauma (Ohio START), a cross-system intervention that integrates services across two systems (child welfare and evidence-based behavioral health services) for families that are affected by co-occurring child maltreatment and parental substance use disorders.MethodsIn phase 1, we used a multi-site qualitative design with 17 counties that implemented Ohio START. Qualitative data were gathered from 104 staff from child welfare agencies, behavioral health treatment organizations, and regional behavioral health boards involved in implementation via 48 small group interviews about collaborative approaches to implementation. To examine cross-system collaboration strategies, qualitative data were analyzed using an iterative template approach and content analysis. In phase 2, a 16-member expert panel met to validate and specify the cross-system collaboration strategies identified in the interviews. The panel was comprised of key child welfare and behavioral health partners and scholars.ResultsIn phase 1, we identified seven cross-system collaboration strategies used for implementation. Three strategies were used to staff the program: (1) contract for expertise, (2) provide joint supervision, and (3) co-locate staff. Two strategies were used to promote service access: (4) referral protocols and (5) expedited access agreements. Two strategies were used to align case plans: (6) shared decision-making meetings, and (7) sharing data. In phase 2, expert panelists specified operational details of the cross-system collaboration strategies, and explained the processes by which strategies were perceived to improve implementation and service system outcomes.ConclusionsWe identified a range of cross-system collaboration strategies that show promise for improving staffing, service access, and case planning. Leaders, supervisors, and frontline staff used these strategies during all phases of implementation. These findings lay the foundation for future experimental and quasi-experimental studies that test the effectiveness of cross-system collaboration strategies.

Estimating the incidence of substance exposed newborns with child welfare system involvement

BackgroundPrenatal substance use can have negative health consequences for both mother and child and may also increase the likelihood of child welfare involvement. The rate of newborns with substance exposure has increased dramatically. As of 2016, federal law requires notification of all infants to child welfare agencies so that a plan of safe care can be developed and referrals to services can be offered. ObjectiveChild welfare agencies have not historically collected consistent, systematic data identifying substance exposed newborns. We utilized a unique strategy to identify substance exposed newborns with child welfare involvement. Participants & settingWe used data from the National Child Abuse & Detection System (NCANDS) which captures N = 3,189,034 unique child protective services investigations for children under the age of 1 between 2004 and 2017. MethodsWe calculated the incidence of substance exposed newborns investigated by child welfare agencies and compared with other administrative data on prenatal substance exposure. We also analyzed this rate by infant demographic characteristics (race/ethnicity, sex, rurality). ResultsBetween 2004 and 2017, approximately 13 % of infants reported to child protective services were likely reported because of substance exposure at birth, and the rate of substance exposed newborns with child welfare involvement increased from 3.79 to 12.90 per 1000 births, an increase of 240 %, over this period. ConclusionsUnderstanding the extent of the substance use crisis for child welfare involvement is important for policymakers to support children and families.

NAVIGATING “SAFETY” IN A PANDEMIC: A CRITICAL EXAMINATION OF ONTARIO CHILD WELFARE SAFETY INTERVENTIONS FOR NEWCOMER PARENTS AND OTHER FAMILIES DURING THE COVID-19 PANDEMIC

This study investigated circumstances surrounding the impact of COVID-19 on child protection investigations, particularly those affecting newcomer parents in Ontario, Canada. Recognizing that the pandemic inflicted substantial socioeconomic disadvantage on some people, the purpose of the study was to use an intersectional lens to examine challenges and solutions found by child welfare agencies when working with families. Insights for policy and practice are drawn from 11 virtual interviews with child welfare workers and managers in Ontario. Our findings reveal that some newcomer families encountered unique challenges: ineligibility for the available pandemic public assistance; inaccessibility to faith-based supports, which had often been their first key contact for mental wellness in the past; technological inequities; and language barriers. These intersecting conditions impacted newcomer families and led to innovative child protection interventions. Analysis of the interview data shows a gradual shift in Ontario from risk-focused approaches to supportive and preventative child welfare interventions in families. Furthermore, supervisors faced the dilemma of how stringently to enforce ongoing safety policies when some social workers were questioning the benefits of these rules for families with intersecting identities who were experiencing added burdens because of the pandemic.

A gap in the data: Defining, identifying, and tracking children with medical complexity in the child welfare system

BackgroundAmong nearly 400,000 children in US foster care, an estimated 10 % are medically complex. Yet, population-level data about children with medical complexity (CMC) served by the child welfare system, both for prevention and foster care services, are largely unavailable. ObjectiveTo understand how US child welfare agencies define, identify, and track CMC. Participants and settingChild welfare agencies across the US. MethodsAgencies were recruited to complete a survey as part of a larger study exploring how CMC are served by the child welfare system. Survey responses related to defining, identifying, and tracking CMC were included in analysis. Descriptive statistical analysis was conducted with Stata. Qualitative content and thematic analysis were applied to free text responses. ResultsSurveys were completed by agencies from 28 states and 2 major cities. Nearly half of the agencies did not have a clear definition to identify CMC; those that did have a definition often lacked standardization. The majority of agencies could not easily identify CMC or access CMC-related data within data systems. Agencies described lack of a clear definition as a barrier to collecting population level data. ConclusionsMany US child welfare agencies lack a clear definition to identify and track CMC, impacting the ability to tailor care and service delivery to meet their unique needs. To address this, a clear definition for CMC should be developed and consistently applied within child welfare data systems. Once CMC are identifiable, future research can collect population-level data and provide recommendations for best practices and policies.

Working With Immigrants Who Are Child Welfare Involved: Promoting Innovative Collaborations and Systems Involvement During a Public Health Crisis

The COVID-19 pandemic has had notable impacts on public child welfare systems and their ability to serve families. For immigrant families who enter the child welfare system, pandemic-related challenges were exacerbated on top of existing immigration-related stressors and barriers. This study used in-depth qualitative interviewing with child welfare agency staff and community-based service provider partners working with immigrants to explore their experiences in providing services to families navigating this unprecedented context. Results highlight the adaptations implemented to engage immigrant clients and facilitate interagency collaboration in light of barriers imposed by the pandemic. Practice implications center the need for child abuse and neglection prevention efforts to start in community and demand collaboration between government-based child welfare agencies and a range of grassroots, trusted community providers.

Assessing a measure of organizational environment among Indigenous child welfare agencies

BackgroundOrganizational environment is an important construct for child welfare agencies striving to support agency workers and provide the best care possible for their clients. Many assessments of organizational environment present difficulties for child welfare agencies, as they are often proprietary, costly, and may not fully cover important dimensions of organizational functioning. The Comprehensive Organizational Health Assessment (COHA) is a freely available assessment of organizational health that has been used in child welfare settings, but has not yet been tested with Indigenous child welfare agencies in Canada. ObjectiveThe aim of this article is to discuss the development and testing of a modified version of the COHA, the Comprehensive Organizational Environment Assessment (COEA). MethodsThe COEA was developed based on an extensive literature review, input from child welfare researchers, and guidance from an anti-colonial practitioner and community liaison. The COEA was completed by workers from three Indigenous child welfare agencies in Canada ResultsThe COEA was further refined and internal consistency was examined using polychoric correlations and ordinal alpha. The COEA showed strong internal consistency and convergent validity across select scales. ConclusionsThis study highlights the use of polychoric correlations and ordinal alpha when examining the reliability and validity of ordinal-level items. Findings can be used to better understand the assessment of organizational environment for Indigenous child welfare agencies.

The Mediating Role of Resilience and Living in Care on Psychosocial Outcomes

Purpose This study examined the mediating role of resilience and living in care experiences between risk exposure (victimization by community and adverse childhood experiences) and psychosocial outcomes (housing instability, delinquency, and post-traumatic stress reactions) for youth receiving child welfare and community services. Method Two hundred and fifty-one youths (14–19 years old) who are receiving interventions from the Department of Community Services in Nova Scotia, Canada, were recruited. Multiple measures were administered to the youth. Results and conclusion Resilience and experiences of living in care significantly mediated the relationship between risk factors and outcomes, with youth demographic characteristics influencing the pattern of these relationships. Findings suggested that resilience and living in care experiences could reduce the effects of risk factors on psychosocial outcomes. These findings demonstrate a role for Child Welfare agencies in promoting youth access to the resilience-enabling resources necessary to sustain well-being.

A preliminary view of the use of telehealth in a child welfare agency during the pandemic

ABSTRACT Introduction The child welfare system’s method of service delivery shifted abruptly during the pandemic to a telehealth modality. The perceived impact of this change upon service delivery is largely unknown, however. The purpose of this study was to describe how a large child welfare agency shifted to telehealth delivery, including investigating barriers and innovative strategies that were undertaken to resolve obstacles and enhance engagement and the provision of services. Method In September, 2020, direct service providers, supervisors and clinic directors at a large, Southeastern child welfare agency completed a survey that tapped into the perceived impact of telehealth on service delivery, and barriers and benefits of telehealth delivery. Twenty-six (n = 26) individuals completed the survey. Results Over half of participants reported an improvement in service delivery through the use of telehealth, and most saw it as being beneficial to both families and staff. Few participants believed that services were negatively impeded by telehealth.The main barrier to telehealth delivery was technology access and navigation (both on the part of families and staff). Discussion Telehealth was largely perceived as a facilitator to child welfare service delivery; implications and use of remote platforms are discussed.

Learning from child welfare staff experiences during the pandemic: Practices to maintain and discontinue

BackgroundThe COVID-19 pandemic led to multiple changes in the ways child welfare agencies operate. Child protection agencies had to make rapid changes that impacted where and how staff operate. Minimal research has examined child welfare workers' views of these practices. ObjectiveThis qualitative study seeks to understand CPS workers' perspectives regarding practices utilized during the pandemic. Staff provided input into practices they found beneficial and hope to see maintained and those they hope to see discontinued. Participants and settingThe full study involved 267 staff members from 50 agencies across Ohio; this study examines qualitative data from 100 staff members who responded to two open ended survey questions. MethodsThis qualitative study used thematic analysis to analyze two open ended questions from a survey sent to all the child welfare agencies in Ohio. ResultsThematic analysis of practices staff hoped to continue after the pandemic resulted in five themes: Nontraditional Site and Schedule, Remote Meetings, Safety Protocols, Communication and Support, and Helping Children and Families. Thematic analysis or practices staff hoped would end after the pandemic resulted in six themes: Masking, Virtual Meetings, Mandated Work Location, Unreasonable Policies, Overloading and Overwhelming Staff, and Separation from Coworkers. ConclusionsStudy results fill a gap in the research by asking CPS staff about their experiences and recommendations after practicing during COVID-19 restrictions. The most common recommendation from staff was to continue offering a nontraditional site and schedule. This study highlights the importance of soliciting and learning from staff perspectives.

Organizational supports for evidence use in child welfare

Despite its importance to achieving positive outcomes for vulnerable children and families, use of evidence by child welfare managers and practitioners remains limited. This study describes four types of organizational supports that child welfare agencies may use to facilitate evidence use. Data collected in 2016 from a six-state sample of private child welfare agencies are used to examine agency investment in different supports for evidence use and their association with managerial evidence use. We also identify contextual, organizational, and managerial factors associated with agency investment in these supports. Findings suggest that technical infrastructure is necessary but not sufficient for promoting managerial evidence use in the absence of other supports. Implications for policy and practice are discussed.

Partnering with a child welfare agency to design and deliver a BSW child welfare course: mixed results and lessons learned

ABSTRACT This paper describes a collaboration between a university and a local child welfare agency in the development and delivery of a Bachelor of Social Work (BSW) child welfare course featuring lived experience knowledge and learning situated in community-based child welfare sites. We present results of an exploratory mixed methods pre-post survey and focus group evaluation which examined changes in student general knowledge, perceptions of skills for decision- making and orienting beliefs about child welfare families. The results did not yield uniform significant results. The discussion delves into lessons learned about the importance of supporting students to develop skills for respectfully gathering and critically analyzing information and how to break through what we observed as student reluctance to learn about child welfare wrongdoings. We reflect on why, despite centering curriculum on lived experience knowledge, we were not successful in overturning students’ negative orienting beliefs about families and children receiving child welfare services. We conclude with considerations for new directions in BSW child welfare curriculum.

Predisposing, Enabling, and Need Factors Associated with Psychotropic Medication and Mental Health Service Use among Children in Out-of-Home Care in the United States: A Scoping Review.

This scoping review aimed to identify predisposing, enabling, and need factors associated with the use of mental health services, including psychotropic medications, among children in out-of-home care in the United States. We searched the PsycInfo, SocINDEX, Medline, and Scopus databases, and 22 studies met inclusion criteria and were systematically analyzed. Among the included studies, 7 studies examined predictors associated with taking psychotropic medications, and 16 examined factors associated with using other mental health services. Significant predisposing, enabling, and need factors associated with greater use of mental health services, including psychotropic medications, were identified. The most frequently identified predisposing factors were child race/ethnicity, age, gender, and maltreatment. Important enabling factors were out-of-home placement type and length of care, and need factors included children's mental/behavioral problems. The results provide insight into maximizing factors facilitating children's use of mental health services to address mental health problems of children in out-of-home care. Further, the results imply the importance of the appropriate use of psychotropic medication (e.g., the type and dosage of medications) among children in out-of-home care. The identified factors can inform child welfare agencies and stakeholders on ways to improve access to mental health services and the appropriate use of psychotropic medications among children in out-of-home care in the United States.