Norwegian Child Welfare Services Research Articles

Examining the Complexities of Conducting Randomized Controlled Trials in Child Welfare Settings

ABSTRACT Background Randomized controlled trials (RCTs) are considered the gold standard for assessing the effectiveness of interventions. At the same time, it is challenging to evaluate interventions using experimental designs in child welfare settings. Objective This study explores the facilitators and challenges faced when carrying out a pilot RCT of a home-visitation intervention, Family Partner, that was implemented within Norwegian child welfare services. Method This study draws on 29 qualitative in-depth interviews and four focus group interviews that were carried out with child welfare workers, managers and stakeholders. Results Results revealed one facilitator and four challenges with carrying out RCTs in child welfare settings: The main facilitator was the staff’s belief in the intervention, while the challenges were 1) ethical concerns in participant recruitment and information sharing, 2) resource management challenges in randomization, 3) emotional strains in response to randomization, and 4) contamination between the intervention and control participants. Conclusion While we present possible solutions to the challenges, our results also highlight the importance of careful planning, preparation, piloting, and using mixed method research approaches when conducting RCTs within child welfare services.

The practice of zero tolerance: emergency placement by child welfare services in Norway

The article discusses the emergency placement of children by the Norwegian Child Welfare Services. Nine mothers were interviewed about their experiences of the transfer of care of their children. Several of the mothers had their children removed due to an emergency decision. The article focuses on one of these stories and analyses the way in which emergency placement can be seen as a form of communication and practice. The purpose of this article is to generate knowledge about how the concept of ‘zero tolerance’ is used to legitimise emergency placements and how this practice might cause more harm than benefits for individual children. The article’s analytical perspective is grounded in the systems theory of Niklas Luhmann.

From Fear and Distrust to Trust and Collaboration: Exploring Transitions in the Quality of Relationships in the Encounters Between Immigrant Parents and Child Welfare Services

This article examines the characteristics of transitions in the quality of relationships from fear and distrust to trust and collaboration in the encounters between immigrant parents and child welfare services and explores what these changes demonstrate about trust and collaboration within such contexts. The study draws on empirical data from interviews with ten immigrant parents who have experience with the Norwegian Child Welfare Services due to allegations of child abuse and/or neglect. The findings show that the transition from fear and distrust to trust and collaborative relations does not evolve in clearly defined phases but rather unfolds as a complex cyclical process. This process appears to involve fear, distrust, and uncooperative behavior as a point of departure but can, in some cases, develop into trusting and collaborative relations with disruption and restoration during the process. The characteristics of the transitions seem to demonstrate that parents can engage in trusting and collaborative relations amid institutional distrust, fear, and vulnerability, if they experience the encounter as meaningful. The turning points in this regard include the following: (1) parents’ experience of positive interactions and relational trust with child welfare professionals and (2) defining moments in the subsequent intervention process, including parents’ awareness that the intervention will not lead to child removal and/or the positive impacts of therapeutic intervention measures like parental training courses, counseling, and financial support.

Parental Satisfaction With Child Welfare Services in Norway

ABSTRACTThis study aims to examine parents' satisfaction with Norwegian child welfare services (CWS) and factors associated with parents' satisfaction. Different factors were included in the analysis, such as characteristics of the contact with CWS, and service aspects, as evaluated by parents (accessibility, information quality, workers' skills and user participation). Data were collected from 412 parents in 20 different municipalities. Over half of the participants (56%) reported that they overall received the needed help to a great or very great extent, while 60% were satisfied to a great extent or more. The majority of parents (76%) reported that their case manager was courteous and respectful, while nearly half of the parents (47%) stated that the help they received made it easier for them to provide care. Hierarchical regression analysis showed that workers' skills, user participation and information quality were associated with both satisfaction with outcomes of CWS and overall satisfaction, while duration of contact was also associated with satisfaction with outcomes of CWS. These results highlight the importance of achieving and maintaining high workers' skills, information quality and user participation in CWS.

Which participation practices can be found in child welfare service records?

ABSTRACT Several studies show insufficient practices regarding children’s participation in child welfare cases. This article is based on document analysis of 216 child welfare records from four Norwegian Child Welfare Services. Our study aims to investigate whether varying degrees and forms of participation are found in different phases of child welfare work: investigation, supportive measures, and in care. With whom the child talks, the topic, and the phase of the process are crucial for whether participation is documented. Individual conversations with the child welfare worker regarding child welfare topics enhance the probability of the child’s views being documented in their records.

If digitalization is the answer – what is the problem? An analysis of policy documents related to the digitalization of Norwegian child welfare services

ABSTRACT In this article, we have analysed policy documents related to the digitalization of the Norwegian child welfare services. The project ‘DigiBarnevern’ is a national initiative intended to develop and improve the digital tools in child welfare services. In our article, we explore which arguments for digitalizing child welfare are used in Norwegian policy documents. The analysis is inspired by Carol Bacchi’s analytical approach of ‘What’s the problem represented to be?’ This approach starts with the premise that policy documents are produced and implemented as answers to specific problems. Our analysis shows how the problems represented are inefficient services, a lack of systematization, arbitrary practices, and the lack of a quality system. Thus, digitalization seems to be the answer to comprehensive problems in child welfare services. By drawing on the literature of street-level bureaucracy and professional discretion, we discuss features of digital systems such as their potential to measure quality and how they can serve as tools to meet the aim of regulating frontline workers` room for discretion. Policy documents are not neutral tools. Instead, they are instruments and carriers of values that affect service provision and ultimately the clients.

The Janus face of supervision – quality control or learning? A study of supervision of employees in the Norwegian Child welfare service

ABSTRACT Supervision of employees in child welfare services (CWS) has many functions. Developments in recent years show that the function of supervision as an instrument for quality control has been strengthened. This can weaken the function of supervision as a source of learning and development. It appears that there is relatively little research on how managers and employees in the CWS perceive the balance between supervision as quality control, and supervision as a means of developing the CWS into a service that can continuously improve its practice, and become a learning organization. In our research we focus on in what way can supervision of employees in the CWS contribute to quality development and learning? We have interviewed both Child Welfare Managers and employees in Norwegian CWS. Both parts agree that case supervision is important for quality control, but this must be balanced against the need for a critical voice in supervision, and learning from each other in collective learning processes, where process supervision can play a very important role. In the Norwegian CWS, the employees in particular believe that process supervision must be better safeguarded than what they experience in current practice.

The decision-making ecology of child welfare emergency placements

Child welfare decisions are often made amid uncertainty, in which child welfare workers must consider a range of complex factors. Especially in emergency cases, the decision process is often challenging due to limited time and information. Based on individual interviews with child welfare workers from Norwegian child welfare services (n = 19) and emergency services (n = 7), this article examines what affects decisions being made in emergency cases. Interviews were thematically analysed. As a framework, the decision-making ecology is used as an inspiration. Results show that case factors influencing decisions were specifically the topic of concern; parents’ attitudes; family network, and the child’s wishes. One decision-maker factor was CW workers’ experience, and for organizational factors, the participants emphasized clear routines for what to do in emergency cases, working as a team, and considering family networks. For external factors, other agencies’ assessments of the case; guidelines, and available alternative measures were found to influence the decisions. These various factors seem to have a dynamic and, at times, competing influence in several cases.To facilitate better decision-making in emergency cases, child welfare leaders should foster an organizational culture that emphasizes reflection on and awareness of how different factors and their dynamics influence decisions. This could also serve as the foundation for policy changes related to external factors affecting these decisions.

Immigrant Parents’ Experiences of Child Welfare Assessment Processes in Child Maltreatment Cases: Implications for Trust

The purpose of this article is to contribute to an in-depth understanding of how immigrant parents’ experiences of the child welfare assessment process shape their trust in the Norwegian child welfare services (CWS). The study is based on qualitative data generated through semi-structured interviews with six immigrant parents who have previous or ongoing contact with the CWS. The study finds that the parents’ experiences of the child welfare assessment process influence their trust in the CWS in a variety of ways, with the central themes being: (1) interactions with child welfare workers; (2) transparency and (un)predictability of the process and outcome; and (3) the risk-oriented, problem-focused and adversarial nature of the assessments. Whilst the parents’ positive experiences of the assessment process are associated with trust, their ambivalent and negative experiences are related to mistrust and distrust in the services respectively.

Family Partner: study protocol for a pilot randomised study of a home-visitation intervention in Norway.

Every year, about 5% of children in Norway experience severe child maltreatment and need support from the child welfare services. However, research-supported interventions for this group are lacking. The current study piloted an intensive home-visitation intervention, Family Partner, which aims to reduce child maltreatment among at-risk parents by improving parental skills, agency and trust in the welfare services, and children's well-being. The randomised controlled trial piloted in this study examines the acceptability of the Family Partner intervention for staff and families and evaluates its feasibility for a full-scale randomised controlled trial. This protocol outlines a prospective, parallel, pilot randomised trial of the Family Partner intervention in three Norwegian municipal child welfare services. The participants are families with children under 12 years of age, where the parents are identified as having challenges. Families in the treatment group receive the Family Partner intervention, while families in the control group receive ordinary child welfare services. Data are collected at baseline, and at 3, 6, 12 and 18 months after recruitment. The pilot study monitor retention and adherence to inform the feasibility of a future full-scale randomised study. To assess the acceptability of the trial and intervention, a subsample of the participating families, as well as the family partners and representatives of the child welfare services in each municipality, are invited to complete qualitative interviews. The results will guide the design of a fully powered randomised controlled trial of the Family Partner intervention compared with ordinary child welfare services. ClinicalTrials.gov identifier: NCT04957394; Pilot Trial of Family Partner: a Child Maltreatment Prevention Intervention (FAMPART); registered on 12 July 2021.

Factors affecting child welfare and protection workers' intention to quit: a cross-sectional study from Norway

IntroductionHigh turnover rates have been a problem for Norwegian child welfare and protection services for years. The main aim of this study was to identify which factors affect Norwegian child welfare and protection (CWP) workers intention to quit their job and whether there is a difference between experienced (< 3 years) and less experienced workers.MethodsA cross-sectional survey was performed among 225 Norwegian child welfare and protection workers. Data were collected using a self-report questionnaire. Turnover intention was examined using a variety of job demands and resources as possible predictors. T tests were used to study mean differences in variable scores between experienced and less experienced workers and linear regression analysis was employed determining predictors of intention to quit.ResultsFor the total sample (N = 225) the most important predictors for intention to quit were workload, burnout, engagement, and views on leadership. Higher emotional exhaustion and cynicism, and low professional efficacy predicted a higher score on the intention to quit scale. High engagement and leadership satisfaction predicted lower scores. The effect of workload was moderated, such that intention to quit among less experienced workers increased more with high workload than it did among more experienced child welfare workers.ConclusionsThe conclusions are that job demands affect experienced and less experienced CWP workers differently and that when designing preventive efforts to reduce turnover this must be considered.

From Polarizing to Shared Shame: Multicultural Daughters, Pakistani Mothers, and Norwegian Child Welfare Services in What Will People Say

ABSTRACT This article is a close analysis of the feature film What Will People Say (2017) by the Norwegian-Pakistani director Iram Haq through the lens of shame as a filmic emotion experienced both by the Pakistani mother in the film and by the Norwegian majority viewers. The film’s reception reveals a polarized discourse that pitches the Norwegian majority against minority women and builds up the myth that shame in contemporary Norway exists primarily as an import phenomenon in diasporic communities such as that of the Pakistanis. My analysis shows how paying careful attention to the Pakistani mother’s role in the story and the Pakistani family’s interactions with the Norwegian Child Welfare Services becomes a productive avenue to challenge the polarized discourse and build up a sense of mutuality and community in multicultural Norway. In essence, the article shows how Norwegian majority viewers can share the shame of Pakistani minority women when they are willing to approach the mother’s shame as more than simply a twin sister of honour and embrace their own embarrassment at the way the Norwegian Child Welfare Services treat the film’s main character, a Norwegian-Pakistani teenage girl whose family sends her to Pakistan against her own will.

‘Disability is not a word we use’: Social workers' professional judgements about support for disabled young people leaving care

Disabled young people leaving care often experience a more complex transition to adulthood than other youths. Still, policy and services can fail to recognize the intersection between a young person's care experiences and disability. Drawing on data from a qualitative interview study with 14 social workers who work with aftercare in the Norwegian child welfare services, we investigate social workers' professional judgements about support for this subgroup of the leaving care population. Our analysis uses the theoretical construct of institutional logics and shows that social workers did not include concepts of disability in their judgements about support for these young people. Instead, the social workers' considerations were guided by three other organizing principles: a ‘medical logic’, an ‘activation logic’ and an ‘aftercare logic’. We discuss these findings in light of critical disability studies and argue for a more nuanced understanding of disability in social work practice with care leavers. Highlighting disability rights and going beyond diagnosis and categorisations of disabled people can challenge a medical model approach to service provision.

Transporting attachment and biobehavioral catch‐up to Norwegian child welfare services: A feasibility study

AbstractTransportation of evidence‐based programs (EBPs) to a new cultural setting is often preferred over the comprehensive process of developing a new program. Intervention fidelity has been suggested as a predictor of successful transportation. The present study examined whether fidelity and parent behavior improved when implementing the U.S.‐developed Attachment and Biobehavioral Catch‐up (ABC) intervention in Norwegian child welfare services (CWS). 11 child welfare workers received training and supervision to become ABC parent coaches. Fidelity was assessed through video‐recordings of parent coaches' in vivo feedback at each home‐visit session. Parent sensitive behavior was assessed using video‐recordings of parent–child interactions, recorded before each ABC session. Mixed effects modeling showed that ABC fidelity increased over the course of training and supervision. Furthermore, parent behavior improved over the course of families' exposure to the intervention. These demonstrate that an EBP transported to a novel cultural setting can obtain promising levels of fidelity and intervention outcomes.

Implementing attachment and biobehavioral catch-up in Norway: experiences from CWS parents, clinicians and leaders

ABSTRACT There is a pressing need in the Nordic countries for evidence-based programmes for young children who have experienced early adversity. One such programme, Attachment and Biobehavioral Catch-up (ABC) was implemented in seven Norwegian child welfare services (CWS). The aim of this study was to interview families, CWS workers and their leaders to explore their experiences in implementing ABC and to make recommendations for future use. Semi-structured interviews were conducted with 10 parents, 11 parent coaches and eight CWS leaders. Data were analysed using the framework method. The findings showed that ABC’s core elements such as in-vivo commenting and video feedback, were considered important for bringing about change. The intervention’s strengths-based approach helped reduce parents’ resistance towards coaches and strengthen the therapeutic relationship. There were diverging perspectives regarding the duration of the intervention, though most agreed on the need to make adaptations to suit the needs of individual families. Coaches viewed ABC as a welcoming addition to their service, due to the lack of interventions for infants in the CWS, although an expanded age limit would enable the recruitment of more families. Recommendations for future implementation include addressing recruitment and how to address issues outside the scope of ABC sessions.

Trust and Power in the Space Between Visibility and Invisibility. Exploring Digital and Social Media Practices in Norwegian Child Welfare Services

ABSTRACT In this article, we explore how caseworkers in the Norwegian Child Welfare Services and their clients use digital and social media in information sharing. By applying Foucault’s description of Bentham’s Panopticon as an analytical tool, we show how caseworkers’ use of digital and social media without the client’s knowledge, while making themselves invisible, contribute to increase the power asymmetry of a professional–client relationship. The clients, on the other hand, have less possibilities of making themselves invisible. If they discover that caseworkers have invaded their private information, this is experienced as a breach of trust. While some studies discuss the equalising potential of using digital and social media in welfare communication, this study reveals some of the pitfalls in using these medias for communication and information exchange. Regardless of the type of media in question, their use becomes vital for visibility, trust and power. Our findings underscore that it is not only the digital tools that needs regulation. Regulations should address the participation of clients in deciding on communication tools and the all-important openness and non-covert practices necessary to build and maintain trusting relationships between caseworkers and clients.

Collective participation of children and young people in child welfare services – opportunities and challenges

ABSTRACT This study explores opportunities and challenges for the participation of children and young people in Norwegian Child Welfare Services (CWS) through analysis from an action research project. The project aimed at collective participation in developing and improving child welfare services in a research circle in cooperation between young people, social workers from CWS and researchers. The researchers intended to involve the young people directly in the project, but the social workers opposed this. The project, therefore, proceeded with social workers and researchers in the research circle and parallel interviews and group conferences with young people with experience from CWS. The young people reported that they would have participated in the research circle if invited. This dichotomy between the social workers and the young people's opinions is the background for discussing opportunities and challenges for children and young people's collective participation in CWS. We conclude that a view of CYP and professional role characterised by protectionism and paternalism, together with a lack of knowledge and experience, hinder the collective participation of children and young people. We recommend that Child welfare services explore and develop working methods for collective participation in cooperation with children and young people.

The impact of case factors on the initial screening decision in child welfare investigations in Norway

BackgroundWhen a child welfare service agency receives a report of concern, there is an initial screening to decide whether an investigation needs to be initiated. In addition to the decision maker, case factors, external factors, and organizational factors have an impact on decision making in Child Welfare Services (CWS). Few recent studies have considered the impact of case factors on the initial screening. ObjectiveThis study examined case factors that have an impact on the decision to investigate in the Norwegian CWS. Participants and settingParticipants included randomly drawn samples of case files from 16 agencies (N = 1365). MethodsThe study was designed as a cross-sectional case file study. Researchers coded the data on site at the agencies. To examine the association between a decision to investigate and case specific variables, multilevel logistic regression (generalized linear mixed model) analysis was conducted to account for case clustering effects within agencies. ResultsThe rate of investigation was 82.3 %. Concerns of physical and sexual abuse (OR = 2.61***), parents' health and stressful events (OR = 2.20***), domestic violence or witnessing violence (OR = 2.52***), and concerns related to finances, housing, and employment (OR = 3.25**) lowered the threshold for investigation. Prior referrals were found to raise the threshold for investigation (OR = 0.88). (**p < .01, ***p < .001). ConclusionAlthough large differences between agencies exist in decision-making processes in the Norwegian CWS, there are common case factors affecting the initial screening of referrals.

High Conflicts as Wicked Problems from the Perspective of Family Counsellor and Child Welfare Services in Norway

This article explores professionals’ understanding and experiences of parental high conflicts in Norwegian family counsellor and child welfare services. The data were analysed using reflexive thematic analysis, examining four focus group interviews with a total of 24 professionals. We used tame and wicked problems as a theoretical frame of reference in order to discuss how high conflict cases can be understood. The analysis shows that the complexity and experiences of high conflicts challenge professionals in their assessments and development of solutions. Our conclusion is that the nature of the complexity, unpredictability, and instability of high conflicts fits within the framework of wicked problems.

Relational rights and interdependent wellbeing: Exploring the experiences of an ethnic minority girl with the Norwegian Child Welfare service

In this article, we draw on a case study where the Norwegian Child Welfare services placed an ethnic minority girl, Amara, into foster care. Her sensemaking around being moved into foster care is used as entry point to explore tensions between Amara, her family, and Child Welfare services. Amara’s responsibilities within the family conflict with the ideal childhood model in Norway. The case demonstrates a limited view on wellbeing and an ethnocentric understanding of what is in the best interest of the child among Norwegian social workers. We propose the use of ubuntu and African ethics in Child Welfare services to cater for more diverse understandings of childhood and upbringing. Furthermore, we approach children’s rights relationally to acknowledge how children’s lives and wellbeing are deeply entangled in interconnections and interdependencies.