Child Welfare Settings Research Articles

Examining Spiritual Ecograms in Child Welfare Settings with Members of The Church of Jesus Christ of Latter-day Saints

Examining Spiritual Ecograms in Child Welfare Settings with Members of The Church of Jesus Christ of Latter-day Saints

Experiences of Becoming Emotionally Dysregulated. A Qualitative Study of Staff in Youth Residential Care

Trauma informed care (TIC) emphasizes the importance of professionals maintaining an emotionally regulated state. We interviewed eight staff members in a residential care unit for children and adolescents where TIC had been implemented, about situations wherein they experienced difficulty regulating their own emotions. We identified three major narratives in informants’ descriptions: (1) “Are we doing the right things?”, (2) “My childhood issues surfaced”, and (3) “Missing togetherness with trusted others.” The narratives illustrate the emotional strain that can be evoked when working in residential child welfare settings, and within TIC frameworks, and point to potential challenges to resolve when implementing TIC in similar organizations.

Feasibility and promise of community providers implementing home-based parent-child interaction therapy for families investigated for child abuse: A pilot randomized controlled trial

BackgroundDespite evidence supporting Parent-Child Interaction Therapy’s (PCIT) effectiveness for maltreatment prevention, its integration in child welfare services (CWS) has been challenging. ObjectiveUsing a pilot randomized controlled trial design, we evaluated the (1) feasibility of training therapists from CWS providers to implement home-based PCIT (2) feasibility of retaining parent-child dyads at-risk for child abuse in voluntary PCIT services, and (3) promise of PCIT for improving parenting skills. Participants and settingBetween 2015–2017, 23 therapists from CWS providers and 55 caregiver-child dyads who were determined to be at moderate-to-high risk for physical and/or emotional abuse, remained in the same home, and were referred for voluntary parenting services following a child protective investigation participated. MethodsWe trained 14 therapists in home-based PCIT and randomly assigned participating dyads to receive PCIT or services as usual (SAU). Dyads completed baseline and post-treatment assessments, including self-reported and observed parenting skills. ResultsAll therapists successfully completed the PCIT training; none completed full certification requirements. Of all randomized dyads, 51 % completed at least one treatment session, and the mean number of treatment sessions was 10.83. Caregivers assigned to PCIT used more self-reported (d = .72) and observed (d = .59) positive parenting skills post-treatment than caregivers assigned to SAU. Negative, inconsistent, and punitive parenting strategies and parenting stress did not significantly differ between caregivers assigned to PCIT and SAU. ConclusionsDespite several challenges to feasibly implementing PCIT in community-based child welfare settings, even a small dose of PCIT improved positive parenting skills among at-risk parent-child dyads.

Contradictions and Their Consequences: How Competing Policy Mandates Facilitate Use of a Punitive Framework in Domestic Violence-Child Maltreatment Cases.

Research shows child welfare cases involving caregiver domestic violence (DV) continue to produce punitive consequences for non-abusive adult victims. This occurs despite the adoption of a supportive policy framework that emphasizes perpetrator responsibility for DV-related harm to children. Risk assessment procedures have been implicated in punitive outcomes, but we know little about how they shape child welfare workers' decision-making practice. Focusing on a state with a supportive policy framework, this paper uses grounded theory to examine how policy contradictions, procedural directives around risk assessment, and informal interventions produce punitive consequences for adult victims of DV and unmitigated risk to children. Data include state policy and procedural documents and interviews with child welfare workers describing decision-making in their most recent completed case and most recent case involving DV. Findings point to the need for active alignment of policies and procedures, greater integration of knowledge across practice areas, renewed commitments to differential response, and greater inclusion of DV specialists in child welfare settings.

Just shut up and let them talk’: Participation, power and the parent voice in the child protection system

Participatory practice is acknowledged as increasingly important in empowering families in the decision-making process. Yet parental participation in child protection and welfare settings remains a complex and multi-dimensional practice, dependent on a range of individual factors including willingness to engage; understanding of need, as well as system factors including power dynamics and resource constraints (Darlington et al., 2010). Parents can feel ‘powerless and helpless’ when not involved in decision-making processes (Hardy & Darlington, 2008). In addition to practice wisdom emerging from literature in the field, this paper examines the findings of a research study commissioned by Tusla (the Irish, national, statutory Child and Family Agency) on parental experiences of Child Protection Conferences (CPCs) in Counties Galway and Roscommon. Analysis of findings of a series of qualitative interviews (n=14) with parents who have attended CPCs, found that parents in the study felt unprepared for CPC, unclear of the implications for their families and felt marginalised by the CPC process. While many parents recognised their right to reply, most reported wanting to appear cooperative. The paper proposes recommendations including the development of a protocol for CPC preparation; participation supports for parents to ensure their voices are heard throughout the process; debriefing as a structured phase of the CPC; and continuous intensive engagement with parents post-CPC.

Important Factors for Evidence-Based Implementation in Child Welfare Settings: A Systematic Review

ABSTRACT Child welfare agencies are expected to implement research-supported interventions (RSIs) to serve youth and families. However, literature shows that the child welfare system has had less success in implementing RSIs than other fields (i.e., health care, schools, etc.). Purpose This systematic review synthesizes the common barriers and facilitators to implementing research-supported interventions with child welfare agencies using implementation frameworks. Methods For this systematic review, database searches, and quality assessments of relevant literature produced 24 studies that examined the implementation of RSIs in child welfare using an implementation framework. Results The studies were coded for themes and the thematic analysis found several common factors to RSI implementation across child welfare agencies including funding, collaboration with external stakeholders, agency culture, staff burden, leadership support, worker’s buy-in, client resistance, program fit, intervention clarity, supporting staff competency, and implementation teams. Discussion The findings provide important information on the most common barriers and facilitators of implementation in child welfare settings.

Dynamics of professional parental status disclosure in child protection work

ABSTRACT The topic of professional self-disclosure has been subject to uneven levels of attention in the social work literature. Although many writers and researchers have addressed the topic in the context of clinical social work, there has been limited dedicated attention to its use and role in routine practice in child protection and child welfare settings. This article is concerned with a specific type of self-disclosure: what social workers say to the parents they work with about whether they themselves are parents or not. Drawing on interview material from a research study concerned with how children’s services professionals experience the suffering of parents, it explores the psycho-social dynamics of social workers investing in different positions about making or refusing to make disclosures about their parental status. This allows for differentiated insight into the contexts that surround parental status disclosure and highlights how decision making around whether and what to disclose can be led more by anxieties and concerns about the maintenance of a particular professional identity than deliberation about potential benefits to parents and the working relationship.

“Fostering” Effective Foster Parent Training Programs : Parent-Child Interaction Therapy Adaptations for the Child Welfare Setting

Foster parents face considerable challenges in caring for children in the child welfare system, many of whom have significant behavioral difficulties [1]. Foster parents often lack the training and support needed to manage these externalizing behaviors, which contribute to parenting stress and are highly predictive of placement breakdowns [2, 3]. Although child welfare agencies provide foster parents with pre-service training experiences, they often lack the capacity and financial resources to implement gold standard, evidence-based interventions that address child behavior difficulties. Parent-Child Interaction Therapy (PCIT) has been well-established as an empirically supported treatment for disruptive behavior, yet standard delivery of PCIT to children in the foster care system is often impractical due to time, financial, childcare, and personnel constraints. Adaptations of PCIT for the foster care setting may remove some of these barriers to treatment. These adaptations have typically retained the parent-coaching principles inherent to PCIT but replaced the traditional 12- to 20-week format with a shorter, less intensive treatment regimen in order to maintain feasibility within the child welfare context. Preliminary findings from studies using abbreviated formats of PCIT suggest effectiveness of such adaptations in reducing externalizing behavior in foster children and maintaining behavioral improvements several months after the end of the treatment.

Setting the stage for family reunification

AbstractParents whose children are removed by the child welfare system are generally required to participate in a set of community‐based services as a condition for reunification. Often, these services are provided by outside non‐profit agencies. In this study, the authors analysed data from 27 interviews with parents whose children were removed by child welfare and four focus groups totalling 18 staff from a parent education service provider. The data suggest that while these non‐profit programmes are designed to improve the parental behaviours that led to their child welfare system involvement, staff and parents also describe the programmes as helping them develop a specific performance of self (Goffman, 1956) when interacting with child welfare agencies. This performance ultimately facilitates their capacity to build an effective working relationship with their social workers and thereby negotiate the process of reunifying with their children (Cheng and Lo, 2016; Reich, 2005). In keeping with Goffman's 1956 theory, staff from contracted non‐profit agencies help parents understand what is expected on the child welfare stage. This impression management is a critical skill for system‐involved parents, who often come from a class and cultural background that differs from those who work professionally in child welfare settings.

Measuring Family-Centered Practice in Child Welfare

Although family-centered practice has been implemented nationwide in child welfare, measures for evaluating family-centered practice have not been well-established. This study aimed to evaluate the factor structure of the Family-Centered Practice Questionnaire. Confirmatory factor analyses were conducted to examine the factor structure of the Family-Centered Practice Questionnaire. The five-factor and second-order five-factor models of the revised Family-Centered Practice Questionnaire with 31 items both demonstrated adequate fit. The higher order of this scale was family-centered practice and five factors were mutual trust, shared decision-making, family as a unit, strengths-based practice, and cultural competence and sensitivity. Findings suggest that the revised Family-Centered Practice Questionnaire may be helpful to practitioners and researchers seeking to measure the implementation of family-centered practice in child welfare settings.

Caregiver-relevant perspectives from a multi-stakeholder collaborative advisory board on adapting a child mental health intervention to be delivered in child-welfare settings

ABSTRACT Adapting evidence-based mental health interventions (EBI) to be provided in child welfare (CW) settings by CW workers could reduce barriers to families receiving mental health care. In order to promote implementation success, the adaptation of EBIs should include the perspectives of those who deliver and those who receive the EBI. The following study uses qualitative methods to elicit and analyze caregiver-relevant perspectives and adaption recommendations from CW stakeholders about the 4Rs and 2Ss Strengthening Families Program, an EBI for youth disruptive behavior disorders, to be implemented in CW settings. Recommendations included adjusting curriculum to better fit the culture of recipients and conveying the importance of openness and respect to providers.

Did we do our assessment holistically, thoroughly, and continuously?

ABSTRACTThis paper presents assessment work and practice of the welfare workers in assessing their service users in various child welfare settings in Sarawak, Malaysia. It draws on a qualitative research based on in-depth interview with respondents selected through purposive sampling. Thematic analysis was one of the major methods of data analysis in the study besides narrative analysis. Findings revealed that assessment work and practice of welfare workers are not being done holistically, thoroughly, and continuously. Issues concerning their assessment work and practice show that the underlying challenges are due to lack of proper training/courses specifically in assessment work provided for them and no assessment framework available as a guideline for their assessment work.

Lessons from the field: implementing a Trust-Based Relational Intervention (TBRI) pilot program in a child welfare system

ABSTRACT The current paper evaluates a pilot program implementing Trust-Based Relational Intervention (TBRI) among a sample of child welfare staff working across eight organizations in order to (1) describe the first year of implementation and (2) examine staff and organizational change. Staff completed assessments of trauma-informed care attitudes and organizational functioning at the start of the project and at the end of the first year of implementation. Results indicate improvement across scales, with implications for the importance of fostering key roles (e.g., mentors) and planning for workforce changes (e.g., recurring trainings) in facilitating implementations that will function in child welfare settings.

Barriers and Facilitators to Implementing Attachment-based Family Therapy into a Child Welfare Setting: A Qualitative Process Evaluation.

Child welfare systems (CWSs) worldwide show increased interest in adopting empirically informed clinical strategies to increase treatment effectiveness. Many empirically supported treatments (ESTs) exist, but little is known about EST implementation barriers and facilitators in CWS. This study explored CWS providers' experiences of implementing attachment-based family therapy (ABFT) in home-based services of the Flemish CWS (in Belgium). Sixteen CWS providers (twelve counselors and four supervisors) involved in three home-based services were interviewed. The Consolidated Framework for Implementation Research (CFIR) was used to guide collection, coding, and analysis of interview data. Findings revealed that implementation success was related to ABFT's fit with the CWS's mission, philosophy, and existing practices. CWS providers' belief in the compatibility between ABFT and CWS increased investment in implementation efforts and persistence to overcome challenges and setbacks. Some barriers pertained to the learning of ABFT and some barriers pertained to systems level challenges such as lack of leadership and support, poor coordination with referral sources and other youth care partners, and lack of policy support. For successful expansion of ESTs into CWS settings, various barriers at multiple systemic levels need to be addressed.

Exploring emotional aspects of care and control in social work with children and families - a single case analysis of conversation

ABSTRACTIn this article, I explore how emotions are displayed and dealt with on a communicative level in face-to-face encounters between social workers and parents in a child welfare setting. The analysis draws upon detailed analysis of a whole encounter between a social worker and a parental couple who have recently had their new-born daughter placed in foster care. By examining the way emotional stances are expressed and responded to I discuss how orientations toward institutional tasks and goals create constraints for the display, recognition and validation of clients’ emotion displays. I consider the communicative challenges this poses for the parents and the social worker and the implications these may have for the client–worker relationship.

Work Experiences of Rural Social Workers in the United States

Rural social workers face unique challenges and opportunities as they seek to address the needs of rural Americans. Using social media, rural social workers in the U.S. were recruited to describe their characteristics and explore factors related to their job satisfaction, burnout, and organizational commitment. Analyses included univariate descriptive statistics, bivariate correlations, and multiple regression. The sample (N = 192) represented 146 counties in 36 states. Participants tended to be White, female, MSW-degreed direct-service providers. Participants were moderately satisfied with their organizational environments and workloads. Age, being Black, and working in settings other than child welfare were most strongly related to satisfaction with workload. Personal burnout scores were highest followed by work-related and client-related burnout. Age and not working in child welfare were most strongly related to lower burnout scores. Being Black and having more tenure in one’s current job were associated with less client-related burnout. Participants indicated moderate levels of commitment to their organizations, with higher salaries and more tenure being the most strongly associated factors. Future research is necessary to examine more closely the work experiences of rural social workers who are younger, identify as racial or ethnic minorities, and employed in child welfare settings.

Depression screening in youth: Multi-informant algorithms for the child welfare setting.

The Achenbach System of Empirically Based Assessment (ASEBA) represents the most widely used protocol for mental and behavioral health screening in the Child Welfare System (CWS). However, because past studies have (a) relied on the self- or parent report, (b) focused on the internalizing subscales, (c) focused solely on current or prospective depression, and (d) not assessed incremental validity, it is difficult to use the ASEBA to address recommended universal depression screening initiatives in the CWS. In response, the present study used an evidence-based medicine (EBM) framework to identify the best combination of subscales that predict adolescent depression outcomes within the CWS. Overall, we found that a combination of self-reported internalizing symptoms, and to a lesser extent, self-reported attention problems, delinquent behavior, and parent-reported social problems best forecasted concurrent depression status. Meanwhile, self-reported anxious/depressed and externalizing symptoms, in addition to parent-reported somatic complaints and withdrawn symptoms, were necessary to adequately forecast prospective depression outcomes. Using these algorithms, we were able to differentiate and classify youth at minimal, moderate, or substantial risk for current and future depression symptoms. Findings are contextualized with past research on the Achenbach scales and clinical implications for more targeted depression screening are discussed. (PsycINFO Database Record (c) 2019 APA, all rights reserved).

Without Wasting a Word: Extreme Improvements in Efficiency and Accuracy Using Computerized Adaptive Testing for Mental Health Disorders (CAT-MH)

We review recent literature on the adaptive assessment of complex mental health disorders and provide a detailed comparison of classical test theory and adaptive testing based on multidimensional item response theory. Adaptive tests for a wide variety of mental health traits (e.g., depression, anxiety, mania, substance misuse, suicidality) are now available in a cloud-based environment. These tests have been validated in a variety of settings against lengthy structured clinical interviews with excellent results and even higher reliability than fixed-length tests. Applications include screening and assessments in emergency departments, psychiatric and primary care clinics, student health clinics, perinatal medicine clinics, child welfare settings, and the judicial system. The future of mental health measurement will be based on automated screening and assessments. Adaptive tests will provide increased precision of measurement and decreased burden of measurement. Integration into the electronic health record is important and now easily accomplished.

Drug testing in child welfare: A systematic review

Although its true prevalence is unknown, drug testing is a common practice with child welfare-involved parents. In fact, the Center for Substance Abuse Treatment (2010) suggests that “some child welfare agencies have decided to conduct drug tests on all parents under court jurisdiction” (p. 6). Unfortunately, researchers have largely overlooked this practice. This paper presents findings from a systematic review of the studies that measured drug testing and utilized a child welfare-involved sample. Eighteen studies met inclusion criteria and were analyzed according to seven research questions, including drug test operationalization, testing frequency, and implications of testing.Reviewed studies reported using drug tests to measure an array of concepts beyond substance abstinence. Proportion of parents required to provide drug tests ranged from 29% to 88% across samples. Disparities in mandates to drug test were observed for parent gender and race/ethnicity. Reports of test frequency ranged from 1 to 10 tests over 15 months to three times per week. Non-compliance rates ranged from 23% to 62%. Drug test results were associated with a variety of outcomes, including maltreatment substantiation and parent-child reunification.Our findings suggests that best practices for drug testing found in family treatment court, criminal justice, and substance use treatment literatures are infrequently, if at all, implemented in traditional child welfare settings. Given the lack of generalizable existing studies, implications of test results at various time points in the child welfare trajectory for various child-welfare involved populations are unknown. Future child welfare-specific research is needed to fill the many gaps in knowledge identified in this review.

Taking an organizational approach to addressing secondary trauma in child welfare settings

ABSTRACTThe increasing focus on trauma-informed child welfare practice has expanded beyond children to include other stakeholders, including child welfare staff. Despite research showing high levels of trauma exposure and symptoms among child welfare staff, and the connection between secondary trauma and staff attrition, the field has lagged in developing interventions for child welfare professionals and agencies affected by secondary trauma. This paper describes efforts underway in New York City to better understand and address secondary trauma in a multi-service child welfare agency. Agency data showing the extent to which people in different roles (e.g., caseworker, supervisor) feel that secondary trauma is recognized and addressed, and findings from exit interviews with departing staff, are shared. Lessons learned include the importance of responding to secondary trauma organizationally; the value of data collection in destigmatizing secondary trauma and clarifying agency priorities; and the need to simultaneously address secondary trauma and burnout. Recommendations for future research, including better understanding the knowledge and skills that supervisors and administrators need to mitigate secondary trauma, are shared.