Child Welfare Staff Research Articles

The Child Welfare Cartel

The probity of the Children’s Bureau’s National Child Welfare Workforce Institute (NCWWI) is examined with respect to the status of child welfare as well as the performance of social work education. By requiring that funding go only to accredited schools of social work, which is not authorized by relevant provisions of the Social Security Act, NCWWI effectively establishes a cartel that excludes other disciplines. Alternatives to improve child welfare services and staff training are considered.

Psychotropic medications in child welfare: From federal mandate to direct care

Background and objectiveChildren in the welfare system are prone to uncoordinated and unmonitored mental health care, including psychotropic medications. To address these issues, federal legislation mandated that state child welfare agencies improve the coordination and oversight of psychotropic medications. However, there is no clear guidance on how to improve these practices, particularly at the level of direct care. We aimed to identify specific areas for improvement through state-wide surveys of four groups. MethodsWe surveyed all known members of four groups working directly with children in foster care in one small northeastern state. Respondents included 209 foster and adoptive parents, 169 child welfare staff, 84 mental health therapists, and 33 clinical prescribers. Survey items addressed practices and perceptions related to sharing of information and cross-system communication and monitoring of medication effects and side effects. ResultsNearly two in five foster and adoptive parents reported not regularly receiving information about the purpose or side effects of psychotropic medications, and they disagreed among themselves on who was primarily responsible for monitoring safety and effectiveness. One-third of child welfare staff and two-thirds of mental health therapists reported that information about psychotropic medications is not regularly shared with the child's provider team. Half of clinical prescribers reported not regularly communicating with child welfare staff. ConclusionsWe identified specific areas for improvement related to communication, sharing of information, monitoring, and role clarification. Strategies to improving these activities are key to ensuring the safe and effective use of psychotropic medications in this population.

Building Capacity for Trauma-Informed Care in the Child Welfare System: Initial Results of a Statewide Implementation.

Exposure to childhood trauma is a major public health concern and is especially prevalent among children in the child welfare system (CWS). State and tribal CWSs are increasingly focusing efforts on identifying and serving children exposed to trauma through the creation of trauma-informed systems. This evaluation of a statewide initiative in Connecticut describes the strategies used to create a trauma-informed CWS, including workforce development, trauma screening, policy change, and improved access to evidence-based trauma-focused treatments during the initial 2-year implementation period. Changes in system readiness and capacity to deliver trauma-informed care were evaluated using stratified random samples of child welfare staff who completed a comprehensive assessment prior to (N = 223) and 2 years following implementation (N = 231). Results indicated significant improvements in trauma-informed knowledge, practice, and collaboration across nearly all child welfare domains assessed, suggesting system-wide improvements in readiness and capacity to provide trauma-informed care. Variability across domains was observed, and frontline staff reported greater improvements than supervisors/managers in some domains. Lessons learned and recommendations for implementation and evaluation of trauma-informed care in child welfare and other child-serving systems are discussed.

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

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

Role and Success of Finnish Early Childhood Education and Care in Supporting Child Welfare Clients: Perspectives from Parents and Professionals

Day care in Finland comprising care, education and teaching—called Educare or the ECEC model—can be used as an open care (community care) support measure for children whose development is at risk. The general aim of the study was to investigate whether the needs of child welfare client children and their parents are fulfilled in day care services from the perspective of parents and professionals. The questions were: (1) How are the individual needs of child protection client children met in day care? (2) In what way does day care support the parenting of child welfare client parents? (3) What kind of enabling and hindering factors, processes and mechanisms are there for good outcomes from day care for children and parents? The study uses both quantitative and qualitative approaches. The methods used were a questionnaire for parents (N = 42), group-level documentary materials from day care and social services officers about the problems faced by client children and parents, and interviews with ECEC and child welfare staff (N = 28). Parents experienced many problems, including exhaustion, poor mental health, substance abuse and parenting problems. Twenty percent of the children had individual support needs. The parents were very satisfied with the ECEC service their children were receiving and the parenting support provided. The ECEC professionals highlighted many positive changes in children in day care and they were also able to support parenting. The enabling and hindering factors for good outcomes were connected with the attitudes and problems of the clients, administrative processes within sectors, and cooperation between ECEC and child welfare staff. ECEC services can considerably increase the safety and well-being of child welfare client children and support their parents in their upbringing. The role and cooperation of ECEC and child welfare staff need clarification.

Public child welfare staff knowledge, attitudes, and referral behaviors for an evidence based parenting program

Little is known about how the knowledge, attitudes, and behaviors of the public child welfare workforce influence implementation of evidence-based practice (EBP) as most research has focused on the private workforce. This paper reports on public child welfare staff knowledge, attitudes, and practices in a state implementing the EBP, SafeCare®. A survey of public child welfare staff (N = 222) was conducted to assess knowledge, familiarity, and referral barriers and practices. Knowledge of and familiarity with SafeCare were low, especially among front line staff (case managers). Attitudes toward SafeCare were fairly positive, but somewhat less so than attitudes toward a standard, non-evidenced based parenting program. Case managers were significantly less likely to have made a referral (15%) than other staff (46%). Job tenure had few effects on familiarity, knowledge, attitudes, or referrals. The strongest predictors of having made referrals were familiarity with SafeCare and job position.

Child abuse/neglect risk assessment under field practice conditions: Tests of external and temporal validity and comparison with heart disease prediction

Objectives(1) Identify validation design and accuracy assessment standards for medical prognostic models applicable to evaluation of child abuse/neglect (CA/N) risk assessment models. (2) Assess the accuracy of the California Family Risk Assessment (CFRA) in predicting CA/N using the foregoing standards. (3) Compare the prediction accuracy of the CFRA with the prediction accuracy of coronary heart disease (CHD) prediction models. Questions addressed(1) What validation design and accuracy assessment standards are used to evaluate medical prognostic models? (2) What is the evidence for the accuracy of the CFRA using those standards? (3) How does the accuracy of the CFRA in predicting CA/N compare with the accuracy of CHD prediction models, which are a reasonable exemplar for the CA/N prediction effort? MethodAn external validation sample of 236 California reports of CA/N from San Luis Obispo and Sutter counties, and a larger temporal validation sample of 6307 California reports from Orange, Los Angeles, and Humboldt counties were investigated and assessed with the CFRA by line child welfare staff and were followed prospectively statewide for two years to discover reported, substantiated CA/N in any California county. CFRA accuracy in predicting substantiated CA/N was assessed by calibration and discrimination. Calibration was measured as the ratio of predicted to observed cases of CA/N seen during follow-up, with a ratio of 1.0 registering perfect calibration. Discrimination was measured by the area under the receiver operating characteristic (ROC) curve (AUC), with values from .60 to .85 found typical for medical prognostic models. CHD prediction literature was reviewed to acquire values of these accuracy measures for CHD prediction models. CFRA CA/N prediction accuracy and CHD prediction accuracy were then compared. ResultsFindings from external and temporal validation samples support the accuracy of CFRA prediction of CA/N. CFRA accuracy in predicting CA/N compared well with CHD prediction accuracy: (1) in the external validation sample, 43.42 CA/N cases were predicted during follow-up and 47 were observed, with consequent 7.6% deviation from perfect calibration. (2) In the temporal validation sample 857.49 CA/N cases were predicted and 801 were observed, with 7.1% deviation from perfect calibration. (3) The best performing of 20 Framingham CHD prediction models identified by systematic literature review predicted 222 CHD cases and 206 were observed, with 7.8% deviation from perfect calibration. (3) The CFRA external and temporal validation sample AUCs were .74 and .64, respectively. (4) For 26 CHD prediction cohorts found by literature review, the AUC mean and median values were .72 and .71, respectively, with a range from .60 to .84. Conclusions/practice implications(1) External and temporal validation results support the accuracy of the CFRA. (2) CFRA CA/N prediction accuracy parity with that for CHD prediction is encouraging, suggesting that wide use of the CFRA, properly implemented, could improve risk assessment accuracy in child protection. (3) Findings underline the importance of ensuring that no risk assessment model or method, including actuarial and consensus models and clinical judgment, is used in the field unless it has passed a test of external, or at least temporal validation.

Child Welfare Agency Climate: Congruence with Practice Model Beliefs

This exploratory analysis considers the extent to which child welfare staff members' perceptions of organizational climate impact congruence with core beliefs for a specific practice model. The results suggest that measures of organizational climate may be associated with child welfare staff members' endorsement of specific practice model beliefs involving safety. As agencies implement and develop specific best practice approaches or more comprehensive practice models, administrators and managers can use these results to consider how to assess and respond to the influence of climate on the process.

Validation of the T-SAT-R-2: A Reaction to Training Scale for Use in Child Welfare and Human Service Trainings

ABSTRACTThis article reports on the validation of the Training Seminar Assessment Tool-Revised-Second Edition (T-SAT-R-2) instrument designed to measure participants’ satisfaction with training seminars and workshops. It was developed from an earlier version, the Training Seminar Assessment Tool-Revised (T-SAT-R), which was distributed following child welfare and social service staff development training sessions. Using confirmatory factor analysis with a sample of 656 trainees, the 25-item T-SAT-R was reduced to 13 items and is now named the T-SAT-R-2. The final model consists of 3 domains: transfer of knowledge, communication, and substance/access. The T-SAT-R-2 is in a user-friendly format and can be scored on each domain or combined to give a total score. The benefits of using the T-SAT-R-2 include that it is only 1 page, the wording is straightforward, and presenters can add additional items based on their specific presentation. Research is presented that shows the connection between satisfaction surveys and behavior change from trainings to be speculative; however, child welfare studies have indicated a link between satisfaction with training and job satisfaction and, possibly, turnover. Additional research on the effects of satisfaction with trainings for child welfare workers is warranted. For the full T-SAT-R-2 instrument, please contact the corresponding author at the listed address.

Implementation of a workforce initiative to build trauma-informed child welfare practice and services: Findings from the Massachusetts Child Trauma Project

Children involved with Child Protective Services experience high rates of chronic and cumulative interpersonal trauma and adversity, referred to as complex trauma, that can have a profoundly negative impact on well being across the life course. Child welfare agencies face myriad challenges in addressing the needs of children with complex trauma. In response, the Massachusetts Child Trauma Project (MCTP) was launched as a statewide initiative to enhance the capacity of child welfare workers and child mental health providers to identify, respond, and intervene early and effectively with children traumatized by chronic loss, abuse, neglect, and violence. Specifically, this large-scale multi-system improvement effort is driving practice change through three key mechanisms in all regions of the state: (1) training child welfare staff and resource parents to recognize and respond to child trauma, (2) disseminating three trauma-focused EBTs in community-based mental health agencies via sequential cohorts of intensive Learning Collaboratives, and (3) implementing child welfare-led Trauma-Informed Leadership Teams (TILTs) that bring mental health providers, child welfare workers, and consumers together to sustain efforts to implement, maintain and spread trauma-informed practices. The article describes the development and implementation of this multiyear initiative and a number of key lessons learned to date.

Diagnosing attention-deficit hyperactivity disorder (ADHD) in children involved with child protection services: are current diagnostic guidelines acceptable for vulnerable populations?

Children involved with child protection services (CPS) are diagnosed and treated for attention-deficit hyperactivity disorder (ADHD) at higher rates than the general population. Children with maltreatment histories are much more likely to have other factors contributing to behavioural and attentional regulation difficulties that may overlap with or mimic ADHD-like symptoms, including language and learning problems, post-traumatic stress disorder, attachment difficulties, mood disorders and anxiety disorders. A higher number of children in the child welfare system are diagnosed with ADHD and provided with psychotropic medications under a group care setting compared with family-based, foster care and kinship care settings. However, children's behavioural trajectories change over time while in care. A reassessment in the approach to ADHD-like symptoms in children exposed to confirmed (or suspected) maltreatment (e.g. neglect, abuse) is required. Diagnosis should be conducted within a multidisciplinary team and practice guidelines regarding ADHD diagnostic and management practices for children in CPS care are warranted both in the USA and in Canada. Increased education for caregivers, teachers and child welfare staff on the effects of maltreatment and often perplexing relationship with ADHD-like symptoms and co-morbid disorders is also necessary. Increased partnerships are needed to ensure the mental well-being of children with child protection involvement.

“Those Are Our People and That's Our Family”: Wabanaki Perspectives on Child Welfare Practice in Their Communities

In collaboration with the Maine Wabanaki-State Child Welfare Truth and Reconciliation Commission Convening Group, this study explored perspectives of Wabanaki community members and tribal child welfare staff on state child welfare involvement in Wabanaki communities. Qualitative analysis of three focus groups found that participants perceived fundamental differences between what guides the work of tribal child welfare staff and state child welfare staff, as well as differences in understanding the profound impact of removing a child from the community. These findings are suggested to be elements of a Wabanaki counter-narrative that contrasts with the historical dominant narrative about Native families and children.

In search of connection: The foster youth and caregiver relationship

Placement instability is an ongoing challenge for the 125,000 foster youth aged 14–18 that are living in foster care, with youth living in approximately 3 placements before aging out of the system. Despite the importance caring adult relationships can play in promoting positive youth development and resiliency, there has been limited inquiry into the characteristics of the foster youth and caregiver relationship. The goal of this paper is to provide a descriptive account of the foster youth and caregiver relationship, and explore what qualities and experiences foster youth desire from their caregivers. Qualitative data were gathered from 9 focus groups. Data were analyzed using thematic content analysis approaches. Foster youth, caregivers, and child welfare staff described relationships lacking in formative bonds and connection, where youth didn't “fit in”, and chaotic homes marked by reactivity and judgment. Characteristics of supportive foster homes include a sense of belonging, structure, guidance, and consistency. This research underscores the important role positive relationships can play in foster youth's feelings of well-being and points to the need for foster parent training to include tangible strategies to develop stronger bonds.

Cost calculator methods for estimating casework time in child welfare services: A promising approach for use in implementation of evidence-based practices and other service innovations

Estimating costs in child welfare services is critical as new service models are incorporated into routine practice. This paper describes a unit costing estimation system developed in England (cost calculator) together with a pilot test of its utility in the United States where unit costs are routinely available for health services but not for child welfare services. The cost calculator approach uses a unified conceptual model that focuses on eight core child welfare processes. Comparison of these core processes in England and in four counties in the United States suggests that the underlying child welfare processes generated from England were perceived as very similar by child welfare staff in California county systems with some exceptions in the review and legal processes. Overall, the adaptation of the cost calculator for use in the United States child welfare systems appears promising. The paper also compares the cost calculator approach to the workload approach widely used in the United States and concludes that there are distinct differences between the two approaches with some possible advantages to the use of the cost calculator approach, especially in the use of this method for estimating child welfare costs in relation to the incorporation of evidence-based interventions into routine practice.

Trauma-informed care training in a child welfare system: Moving it to the front line

Abstract 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.

Using Performance Measures to Manage Child Welfare Outcomes: Local Strategies and Decision Making

The federal child welfare performance measurement system exerts a profound influence over the design, delivery, and evaluation of child welfare services at the local level, with funding contingent upon participation in the federally mandated Child and Family Services Review. In this exploratory study the authors focus on local efforts to respond to and comply with the federal child welfare performance measurement system in 11 northern California counties. The authors review the System Improvement Plans of each county and the findings from focus groups with child welfare staff conducted in five of the counties that included the limitations of federal performance measures, the difficulty using these measures to inform decision making, and the continuing struggle to achieve the major child welfare goals of safety, permanency, and well-being. The implications include the need for: flexibility in the federal performance measurement system, opportunities to integrate local values and priorities, and child well-being measures so that timeliness does not take on more significance than well-being or the quality of relationships among local stakeholders in the child welfare system.

Compensation in Social Work: Critical for Satisfaction and a Sustainable Profession

Challenges with social worker satisfaction and subsequent high staff turnover rates are not new to the profession. For decades researchers have studied social worker satisfaction from several perspectives, though generally with child welfare staff. This exploratory study examined responses from a statewide survey of 838 social workers across a broad spectrum of employment settings to determine which variables had the greatest impact on satisfaction. Standard multiple regression results indicate that social workers' level of satisfaction with their jobs and employment benefits were best predicted by variables that translate into improved compensation. These findings suggest that efforts to improve social work satisfaction, and subsequently lower turnover rates, should focus on improving factors that directly or indirectly influence compensation to preserve this vital workforce. Limitations and next steps for future research are discussed.

North Carolina's Child Welfare Education Collaborative (NCCWEC): One State's Long-Term Commitment Toward an Improved Workforce

One state's Title IV-E child welfare social work education collaborative is delineated. This multi-year collaborative between public universities and the state's child welfare system has resulted in funding and field placements for 725 BSW and MSW students in 74 of the state's 100 counties. Further, 589 collaborative graduates have been hired in public child welfare. In addition, beneficial relationships among university personnel, local and state child welfare staff and administrators, and state legislators have enabled this collaborative to continue during difficult economic times. Finally, current challenges, lessons learned, and recommendations for future child welfare social work education initiatives are examined.

Promoting relationship building and connection: Adapting an evidence-based parenting program for families involved in the child welfare system

The high needs of youth involved in the child welfare system and the poor long-term outcomes of former foster youth represent a significant systemic challenge. As part of a process to adapt an evidence-based parenting program for a child welfare population, we conducted a series of focus groups with child welfare staff, foster caregivers, and young adults who were involved in the foster system as teens. From these focus groups we learned that, although there is a need for evidence-based parenting programs for families involved in the child welfare setting, one of the significant barriers to program implementation is the lack of meaningful connection between caregivers and youth in their care. We will provide an in-depth discussion on the proposed adaptations to make Staying Connected more relevant for foster families, including the addition of skills training to help overcome some of the barriers to connection. Staying Connected holds the promise of cultivating more supportive home environments that have the capacity to nurture youths' healthy development, including the avoidance of high-risk behaviors.

Work Attitudes and Intention to Quit Among Workers in Private Child Welfare Agencies Operating Under Performance-Based Contracts

Not much is currently known about how employment in child welfare agencies operating under performance-based contracts affects worker attitudes related to retention. This study focuses on the relationship of job satisfaction, organizational commitment, and conflict between work and family to quit among privatized child welfare staff. An online survey was completed by 152 workers employed by private child welfare agencies operating under performance-based contracts. Results indicate that job satisfaction and work-family conflict predicted intention to quit. Implications for agency practice and further research, particularly in the area of work-family conflict, are discussed.