Child Welfare System Research Articles

The feasibility and acceptability of delivering a group trauma-focused intervention to children in care.

Young people in care (i.e., in the child welfare system) are a group who have often experienced very high rates of potentially traumatic events, including maltreatment. It is well-documented that they have high rates of trauma-related mental health difficulties, such as posttraumatic stress. To address the needs of the large number of young people who may benefit from support, scalable interventions are crucial. But also important is that they are effective and deliverable - particularly given the complexity of this group and services. We assessed a five-session group CBT-based intervention for PTSD. The primary goal was to understand core procedural and protocol uncertainties to address prior to a definitive trial. Participants were 34 10-17 year olds in care, with moderate to severe posttraumatic stress symptoms, and their caregiver. We ran seven groups (four online), delivered in social care and NHS-based mental health teams. Data were collected via pre-, post-, 3-month follow-up questionnaires and qualitative interviews. Of the 34 participants allocated to the intervention, 27 (80%) attended at least three of the five sessions (most attended all). Caregiver attendance was lower (50%). There was generally good completion of assessment measures. Qualitatively, most participants were positive about the intervention, and many reported improvements in areas such as coping, sleep, and willingness to talk about experiences. However, there were important concerns about the lack of ongoing support, given this was a low-intensity intervention for a group who often had complex needs. The intervention and research protocols were acceptable to most young people and carers. With modifications, a future definitive trial would likely be possible. However, key considerations include: how (and whether) to screen for PTSD; the trial design; and the option to embed high-intensity support (e.g., via assessing a stepped-care model).

Contaminated memories: How formerly incarcerated mothers remember their pasts and imagine their futures

In this article, we use 15 in-depth interviews with formerly incarcerated mothers to explore an understudied dimension of the punitive nature of system contact: its contamination of memory. Drawing on theoretical scholarship in the sociology of memory, we reveal how contact with both the criminal legal system and the child welfare system defined participants’ worst maternal memories and contaminated even their best maternal memories. In sharp contrast with their retrospective narratives, participants’ imagined futures were notably devoid of references to system contact, even in the form of desistance narratives. These findings, we argue, capture just how invasive contact with punitive state institutions can be, and they suggest that reentry represents a meaningful period during which participants can envision futures that are—at least in their imaginations—free from this intrusion.

Perinatal Economic Abuse: Experiences, Impacts, and Needed Resources.

Introduction: Economic abuse is one form of intimate partner violence (IPV) intended to control a survivor's ability to make, save, or spend money to gain power over them. Perinatal people may be more vulnerable to economic abuse due to changes in employment and finances. This study's aims were to explore how economic abuse manifests among pregnant and parenting survivors and how best to support pregnant and parenting survivors of economic abuse. Methods: We conducted virtual semistructured interviews with IPV survivors and IPV advocates. Participants were recruited through an online recruitment registry, national IPV organizations, and local domestic violence agencies. Interview audiorecordings were transcribed. We used a deductive-inductive thematic analysis approach. Two research team members individually coded each transcript and met to resolve discrepancies in coding. Results: We completed interviews with 18 advocates and 20 survivors. Participants described experiences of financial control, exploitation, and employment sabotage. Partners leveraged the criminal-legal, child welfare, and health care systems and cultural norms about pregnancy, including those related to gender and religion to financially harm survivors. Advocates described how economic abuse impacts marginalized survivors. Dream resources described include cash assistance, healthy relationship and financial education, and employer policies. Discussion: Survivors and advocates reported a variety of experiences with economic abuse during the perinatal period. Future interventions should focus on providing unrestricted cash transfers to survivors, developing education on economic abuse, and creating supportive policies in health care and employment settings. This study highlights the ways that economic abuse specifically impacts perinatal survivors and their children.

Experiences with and perceptions of the child welfare system during the perinatal period of mothers with intellectual and developmental disabilities

ABSTRACT This qualitative study explored the perceptions and experiences of 16 mothers with intellectual and developmental disabilities (IDD) regarding their interactions with the child welfare system during the perinatal period. Adverse themes included fear of child removal, wariness of the healthcare system, insufficient assistance, and trauma and stress. Positive themes included support from others and believing in one’s self. Findings underscore the need for disability cultural competence, non-discrimination, family preservation, enhanced support, self-advocacy, and family-centered care across perinatal and child welfare systems to improve equity for mothers with IDD and their children. Further research is warranted.

Facilitators and barriers of using mental health services among children in foster care: insights from foster parents in a Southeastern state

ABSTRACT This study explored facilitators of and barriers to mental health services for children in foster care in a Southeastern state. We thematically analyzed 10 interviews with foster parents. Throughout the interviews, a wide range of facilitators and barriers that promote the use of mental health services among children in foster care at the child welfare system, children in foster care, foster parents, biological parents, and mental health provider levels, were identified. Findings suggest that all stakeholders must collaborate to address both systemic and individual barriers to improve the use of mental health services among children in foster care.

Preventing foster care entry at the community, systems, and societal levels: Recommendations from the child-serving workforce

Child welfare policy and practice in the United States is increasingly concerned with the prevention of child maltreatment and foster care entry. Expanding prevention capacity through new programs and supports will require the buy-in of the current child-serving workforce both in child welfare systems as well as other settings such as mental health, schools, and early childhood services. The purpose of this qualitative study was to identify a set of recommendations for preventing foster care entry from members of the child-serving workforce to gauge their alignment with current strategies and to better understand workers’ priorities for reforming our current approach to promoting child and family wellbeing. Data were collected via interview, focus groups, and open-ended survey questions from a total of 614 participants working in child-serving settings. Through theoretical thematic analysis, we identified a set of 14 recommendations for preventing foster care entry across the community, systems, and societal levels. Broadly, recommendations focused on promoting community connectedness, adopting a public health approach to child maltreatment prevention, shifting child welfare practice to be more proactive in providing resources to families, enhancing cross-systems collaboration, and passing a range of policies to enhance family and child wellbeing with a particular emphasis on income supports. Findings from the study suggest that the current child-serving workforce is strongly committed to the national shift toward maltreatment prevention, and that they endorse strengths-based, data-informed strategies for achieving this objective.

Dalgleish scores difference amongst professional roles within the greater child welfare community

BackgroundThe central tension of the child welfare system is the need to protect children while also encouraging the stability of families. Researchers have attempted to capture this conflict through the use of the Dalgleish Scale (Fluke et al., 2016), which measures attitudes about family preservation versus child safety. ObjectiveThough used multiple times by researchers over the last decade to test state agency child protection worker's beliefs, the Dalgleish Scale has never before been given to the wider child welfare community. Participants settingTaken from data collected from more than a 1000 U.S. participants as part of two separate online child welfare decision making survey vignette experiments, this present research is the first to administer the Dalgleish to people from multiple professional roles within the child welfare system. MethodsDalgleish scores for 13 child welfare professional roles were compared using Mann Whitney U to test for significance and Cohen's d for effect size, while demographic variables within the roles were tested using ANOVA. ResultsThe results demonstrate significant differences in beliefs about child safety and family preservation between the roles within the child welfare system. On average lawyers tended to rate family preservation higher than any other role. Foster parents, CASA/GAL workers and former foster youth tended to score the highest on child safety scores. State agency caseworkers scored in the middle though still on the child safety side of the scale. ConclusionsThese significant variances in the Dalgleish score based on role suggest that participants’ professional role within child welfare has an impact on how they view the central dynamic question of family preservation and child safety.

Ethnic Disproportionality in the Child Welfare System: A Welsh Linked Administrative Data Study for 2011–2020

Abstract Children’s chances of contact with the child welfare system at different stages vary significantly by their ethnicity. This study goes beyond recent UK studies on the scale of ethnic differences in children in care or on protection plans by improving data completeness through data linkage, considering the ethnic patterns in the wider population of children in need or receiving care and support, and reporting trends over time. We contribute to the literature on ethnic disproportionality in the child welfare system by reporting the patterns in Wales from 2011 to 2020. The trend of ethnic disproportionality was distinct from the changes in the absolute number of children in the child social welfare system by ethnicity. Over the ten-year period, Mixed-heritage children were the most overrepresented and Asian children the most underrepresented, with fluctuations in the level of overrepresentation between 1.1 and 1.5 and underrepresentation between 0.5 and 0.7. The level of representation for Black children fluctuated considerably between 0.8 and 1.2 over the years. The overall level of ethnic disproportionality in Wales increased from 2011 to 2016 and then decreased from 2017 to 2020. Ethnic disproportionality appeared more pronounced amongst girls and in age groups zero to four and sixteen to seventeen.

Service navigation and concrete supports from a family Perspective: A preventative and community-based approach to child welfare

The child welfare system in the United States has historically focused funding on intervening after child maltreatment has occurred, with fewer resources allocated to prevention. However, research has found that families benefit from concrete supports, like financial payments, and when families are provided with these supports, child welfare involvement significantly declines. Less is known about the impact of preventative approaches, such as service navigation, which could act as a bridge between families and essential concrete supports and resources. Additionally, it is vital to incorporate family voice into decisions being made regarding the development and evaluation of prevention programming. This qualitative study explores family experiences and outcomes with community-based service navigation. The sample included 12 family members working with a community navigator at the time of data collection. Data were obtained through focus groups and interviews held in English, Spanish, and Arabic. A thematic analysis guided the researchers in better understanding participants’ perspectives on service navigation. Results indicate that participants found preventative service navigation to be a supportive and collaborative experience through which they were connected with concrete supports and other essential resources. Five themes were identified: (1) normalizing the need for support; (2) time as a limited resource for families; (3) service navigation as empowering and humanizing for families; (4) service navigation poses new challenges for families; and (5) service navigation creates new opportunities for families. Results from this study suggest that service navigation may represent a more socially just intervention to ensure child safety, permanency, and well-being.

The Cuyahoga youth count: one county’s prevalence of and experience data from LGBTQ+ youth in out-of-home placements

ABSTRACT This study aimed to better understand the experiences of LGBTQ+ youth in foster care in the Midwest. Of the youth who participated in the study, 32.2% indicated they were LGBTQ+. LGBTQ+ youth were more likely to have been hospitalized for physical illness and emotional reasons and experience a great number of discriminatory experiences. LGBTQ+ youth were less likely to report being treated well in foster care and that they could be themselves in their placement. Findings suggest the need for increased LGBTQ+ tailored prevention services for families and policy and practice shifts within the child welfare system.

Race differences in the impact of juvenile detention on likelihood of young adult incarceration of males aging out of care

Youth involved in the child welfare system are more likely to be involved in the juvenile justice system, and juvenile justice involvement is linked to increased likelihood of subsequent incarceration. For these reasons, overrepresentation of Black youth in the child welfare system contributes to racial disparities in incarceration rates. It is, therefore, important to study youth transitioning out of foster care to examine how their young adult outcomes differ by race. Employing the National Youth in Transition Database (NYTD), this study compared the incarceration experiences of non-Hispanic White and Black males aging out of foster care. Specifically, this study examined the impact of juvenile detention on the likelihood of incarceration ages 19 to 21and factors that mediated this relationship. Notably, 33.5% of White males and 30.7% of Black males in the sample experienced juvenile detention. Findings indicate that juvenile detention disproportionately impacts Black males who age out of foster care compared to their White counterparts. The direct effect of juvenile detention on reported incarceration between age 19–21 for Black males in the sample was OR = 2.31 compared to OR = 1.91 for White males. Reported incarceration between age 17–19 significantly mediated the relationship between juvenile confinement and incarceration age 19–21 for both Black and White males in the sample, although this effect was substantially stronger for Black males. Research and policy implications are discussed.

LGBTQ+‐affirming graduate education: Preparing and supporting future family court clinicians

AbstractLesbian, gay, bisexual, transgender, queer, and other sexual orientation and gender minority (LGBTQ+) youth and families have been under a social and legislative attack in the United States in recent years, marked by a stark increase in gender‐affirming care bans and religious rights cases before the U.S. Supreme Court. LGBTQ+ graduate students in mental health fields—particularly those who seek to work in family court settings—have specific needs that are often unmet in their educational and clinical training environments. Furthermore, the over‐representation of LGBTQ+ youth in the child welfare and juvenile justice systems necessitates specialized knowledge and skills that many clinicians and educators are currently lacking. This paper discusses the unique challenges facing LGBTQ+ graduate students and provides research‐based suggestions for professors, administrators, and supervising clinicians who seek to provide a holistic and humanizing educational experience that produces clinicians who can respond to the evolving needs of LGBTQ+ individuals in family court settings and beyond.

Queering child welfare and juvenile justice: Recommendations for affirming LGBTQ+ youth

AbstractLesbian, gay, bisexual, transgender, and queer (LGBTQ+) people have historically been subjected to maltreatment across multiple environments and systems – including their homes, schools, neighborhoods, workplaces, healthcare facilities, and more. The criminal justice and child welfare systems were built on the foundations of cisnormativity and heteronormativity, making LGBTQ+ youth susceptible to systemic oppression and discrimination when compared to their youth counterparts. As such, this paper examines the unique experiences of LGBTQ+ youth in the juvenile and child welfare systems by discussing the systemic inequities and unique challenges that exist for this population – beginning with the risk factors that make them susceptible to exposure to both systems in general. Furthermore, we provide practical recommendations for legal and clinical professionals to better serve their LGBTQ+ youth clients – ranging from changes in policies and legislation, increased staff training, and strategies to create safe and inclusive environments for all youth.

Child Maltreatment Profiles among Children and Adolescents in the Spanish Child Welfare System

Maltreatment is a complex and multidimensional construct. Several types of maltreatment exist, but not all of them necessarily co-occur. In the last decades, researchers have tried to untangle the heterogeneity of maltreatment. However, few studies have been carried out outside the U. S. and none of the previous studies had considered all stages of maltreatment. In this study, we aimed at exploring latent profiles of maltreatment in a sample of 635 children and adolescents enrolled at different intervention plans within the Child Protective Services (CPS) in the Valencian Community, Spain. Latent Profile Analysis (LPA) was performed. Profiles were based on the five types of maltreatment (physical abuse, emotional abuse, sexual abuse, emotional neglect and physical neglect), as measured by the Chilhood Trauma Questionnaire-Short Form. Moreover, associations between the emerging profiles and sociodemographic, health- and school-related variables were also examined. Three profiles of maltreatment were found: “Relative low maltreatment” (58.58%), “Neglected” (35.92%), and “Severely abused and neglected” (5.5%). Then, profiles were contrasted with the reasons why court dictated maltreatment status of the child/adolescent to validate the maltreatment profiles. Results regarding the cumulative nature of maltreatment and its severity suggest tailoring public policies by level of risk of maltreatment. This study further proposes moving the focus of action from individuals themselves to the elements that characterize different maltreatment profiles, with the aim of protecting them. Future research ought to expand knowledge on maltreatment profiles in other European countries so as to promote generalization of results.

The role of primary care in improving health outcomes in young foster children.

Children removed from their biological families because of abuse, neglect, and/or violence have increased healthcare needs and are susceptible to poor health outcomes compared with children who are not in the child welfare system. Developmental delays occur in about 75% of children in foster care. Up to 80% of children entering out-of-home care have at least one physical health problem and more than 40% experience educational challenges. In most US states, newly removed children are required to have a medical evaluation shortly after placement in a foster or kinship family. The initial evaluation is important for identifying urgent concerns and developing a rapport with children who may not have had regular medical care. In addition, the child's complete social, trauma, and medical history may be unknown because of system barriers such as inconsistent medical care by biological parents, privacy laws protecting records, and unavailability of birth histories and biological parents' medical and psychosocial histories. As a result, a series of visits is required to fully evaluate the child's development and healthcare needs. This article provides guidance for physician associates/assistants who provide care to children in foster care.

“Saying ‘I'm not okay’ is extremely risky”: Postpartum mental health, delayed help‐seeking, and fears of the child welfare system among queer parents

AbstractParent mental health challenges in the postpartum and early parenthood have profound implications for parent, child, and family well‐being. Little research has focused on postpartum mental health challenges and barriers to help‐seeking among queer birthing people, including members of this community who may be particularly vulnerable to mental health difficulties, such as queer cis women partnered with men, trans/nonbinary parents, and queer parents who are young, low‐income, and/or of color. This mixed‐methods study of queer parents (n = 99), all of whom were assigned female at birth (AFAB) and gave birth to a child within the past several years, explores parents' postpartum mental health difficulties and perceived barriers to seeking help. Using a structural stigma framework, this study found that participants reported high rates of postpartum mental health difficulties (89%) and reported various barriers to seeking support including fears of discrimination and being deemed “unfit” by providers, which might lead to child welfare system involvement. Young parents and low‐income parents were particularly fearful of child welfare system contact and potential child removal. Factors that encouraged help‐seeking (e.g., desire to be a good parent; partner pressure to seek help) and implications for family practitioners are discussed.

Beyond attachment theory: Indigenous perspectives on the child-caregiver bond from a northwest tribal community.

Healthy Indigenous child development is grounded in Indigenous ways of knowing and being. Attachment theory has been influential in understanding the significance of parenting for infant development in Western science but has focused on child-caregiver bonds predominantly within the parent-child dyad. To bring forth Indigenous perspectives regarding understandings of parenting, the attachment bond, and the well-being of Indigenous children, we conducted semi-structured interviews with 28 members of a Northwest tribal community (21 female) in spring and summer 2020. Themes included Community caregiving, Family value systems, Bonding, Traditional teachings, and Historical trauma. The need to expand the lens of attachment theory beyond the dyad is clear. Implications for improving the child welfare system and prevention programs within Indigenous communities are discussed.

Use of standardized decision support instruments to inform child welfare decision-making: lessons from an implementation study

Research has demonstrated children in out-of-home care have experienced trauma and a significant proportion are in need of behavioral health services (e.g. Casaneuva et al., NSCAW II baseline report: Child well-being, US Department of Health and Human Services, Washington, DC, 2011). Accessing services requires interagency coordination between child welfare and behavioral health professionals; however, challenges to coordination and collaboration may result in lack of service utilization for many youth (Hanson et al. 2016). Utilizing a mixed methodological approach, this paper describes the results of a study conducted five years after full state-wide implementation of processes designed to promote the use of evidence-based practices to inform decision-making for youth dually served by the child welfare and behavioral health systems. Outcomes from the study were used to develop strategies to address programmatic concerns and reinforce implementation supports. Study findings may aid organizations seeking to reinforce data-informed practices and employ strategies for addressing barriers at the worker and agency level.

Wie weiter mit der Aufarbeitung? Bericht über die Pressekonferenz zum Abschlussbericht „Helmut Kentlers Wirken in der Berliner Kinder- und Jugendhilfe“ am 23. Februar 2024 in Berlin

“Child endangerment under public responsibility” was how the Hildesheim research team summarized its 2020 review report on “Helmut Kentler’s work in Berlin’s child and youth welfare system”. On February 23, 2024, the team presented the final report of its subsequent research project at a press conference at the Senate Department for Education, Youth and Family. The results of the research project extend far beyond Helmut Kentler’s work in child and youth welfare in Berlin and can be summarized succinctly as “Child welfare endangerment in public and professional as well as scientific responsibility”.

How Effective Are Ireland's Monitory Mechanisms in Improving Its Child Protection and Welfare Services?

ABSTRACTChild protection and welfare systems are entrusted with significant power by governments and are therefore a significant focus of monitoring activities. Monitoring can help to build a better child protection system and to ensure child safety; track policy and legislative implementation and resource allocation; contribute to preventing systemic ‘failures’; provide data for system, policy, and legislative reforms; and support continuous improvement. The Irish system is worth examining for three reasons. First, Ireland has had a single state‐provided child protection and welfare service called the Child and Family Agency. Second, the system has been through a sustained period of development. Third, Ireland has one dedicated statutory authority called the Health Information and Quality Authority (HIQA). This article provides a case study of the strategies and mechanisms adopted by Ireland to monitor the operation, quality and development of its child protection and welfare system. We will show that there is significant direct and indirect monitoring and focus on child protection from regulators, civil society organisations, government agencies and committees and independent actors. Such monitoring has significantly influenced the development of policy, practice and the development of the child protection system in Ireland.