Mental Health Treatment Experiences and Expectations in Foster Care: A Qualitative Investigation

This study explores perspectives on mental health treatment experiences and expectations for youth in foster care and their foster parents. In-depth interviews were conducted and identified for major themes: (1) the dual stigma of foster care and mental health care; (2) the lack of engagement in mental health therapy; (3) trust issues with the therapist and other individuals; and (4) the desire to integrate mental health services with primary care services. These results have implications for mental health service delivery and suggest opportunities to improve mental health treatment through an integrated care approach.     

Strengthening Public-Private Partnerships in State Child Welfare Systems: Results of a Multi-State Strategic Planning Process

Dramatic growth in health and human service contracting over the past two decades has increased the need for managerial competency in the development and sustainment of effective cross-sector partnerships. Although the quality of relations between partnering agencies can affect client outcomes, few macro-level interventions for strengthening cross-sector partnerships have been described or tested in the literature. This article describes a facilitated, strategic planning process implemented in five different states and presents pre-post test results of its effect on different factors known to affect partnership success. Implications for child welfare administrative practice and research are discussed.     

Educational Services for Children in Foster Care

ABSTRACT

Most literature on the education of foster youth focuses on their individual outcomes and characteristics. A small body of literature documents a lack of collaboration between the child welfare and education systems. This study explores commonalities and differences in perspectives between child welfare and education system stakeholders. It draws on findings from a multi-county exploratory study on educational services for foster youth. The findings in this study identify several systemic barriers including placement instability within the child welfare system, limited financial resources of schools, and poor inter-agency communication. In addition, differences in the perceptions of school and child welfare agency personnel regarding the needs of foster children in school, problems encountered in enrolling children in school, and the role and motives of each agency in addressing these needs and problems are identified. These differences point to both the challenges involved in improving communications and collaboration between the two systems, as well as the opportunities to improve educational services to children in foster care.     

Characteristics of Youth Remaining in Foster Care Through Age 19: A Pre- and Post-Policy Cohort Analysis of California Data

This study examined factors associated with youth remaining in extended foster care. Cohorts of youth in care in California at age 17 years were defined for the period from 2003–2012. Multivariable generalized linear models documented factors associated with remaining in care through age 19. Findings indicate that: a) the population of youth in care at age 17 has declined over time; b) youth in care at age 17 in 2012 were qualitatively different from those a decade earlier; c) a larger proportion of youth who do not exit to permanency are remaining in extended foster care; and d) although the characteristics of youth who remain in foster care as non-minor dependents continue to vary relative to those who age out, differences have diminished. Findings highlight the potential to target subgroups of youth who may benefit from the extension of care but are remaining in care at lower rates.     

Child Welfare Assessment Practices in Scotland: An Ecological Process Grounded in Relationship-Building

Beginning with the initial contact with the family, Scottish child welfare policy and practice are grounded in ecological practice and community relationships. New guidance called “Getting it Right for Every Child in Scotland” (GIRFEC) is focused on universal child well-being and may have a significant impact on social work practice. This article explores the results of a multi-methods case study conducted in Scotland and highlights key aspects of new policy implementation and relational social work characteristics that are important to advance ecological child welfare practice. It may also have implications for other cultural contexts.     

Early Care and Education for Children in the Child Welfare System: Evaluations of Two Training Programs

Despite evidence that early care and education services benefit at-risk children, they remain underutilized by families in the child welfare system. This article describes two training programs developed to educate child welfare and childcare/preschool staff about the importance of early care and education for maltreated children and how to access these services. A combined total of 274 trainees completed knowledge tests about this topic and significant pre- to post-training improvements indicate that both training programs effectively increased participants' knowledge about this important topic. In addition, improvement in self-assessed competency was observed for participants in one program, and positive changes in attitudes and anticipated practice behavior regarding childcare for foster children were observed among participants in the other.     

Transferring MSW Education to Practice: A Qualitative Study With Public Child Welfare Employees

This study used a qualitative analysis of survey data collected from public child welfare employees (n = 168) as they completed master's of social work courses in a weekend/hybrid program, to examine their perceptions of ability to apply classroom learning to practice. The program, which combined a focus on direct practice and management, was developed in partnership with the state's public child welfare agency, during a period of systemic change and case practice reform. Findings indicate that students readily transferred knowledge and skills to the workplace, albeit with some challenges. In particular, management courses appeared to provide an important framework in understanding the organizational context of practice.     

Developmental Disabilities in Children Involved with Child Welfare: Correlates of Referrals for Service Provision

Using data from the National Survey of Child and Adolescent Well-being (NSCAW), this study explores the characteristics of child welfare involvement for children (N = 639; aged 3–17.5 years) with at least one developmental disability. In addition, a central focus of this exploration was to examine respective differences in how caregivers and caseworkers initiated referrals for services for children with disabilities. The sample was divided into three exclusive groups based on type of developmental disability: learning disability (weighted percentage 70.3%); Mental Retardation (now referred to as Intellectual Disability), Downs Syndrome, or; developmental delay (weighted percentage 1.8%); and presence of multiple types of disabilities, including autism (weighted percentage 27.9%). Results from the logistic regression analyses indicate children in this population who are placed in out-of-home care receive more referrals than those residing in-home with biological caregivers; older children and children with multiple disabilities are also more apt to obtain referrals to formal assessments. On the other hand, children who were considered in the “other” race category (includes children who identify as: multi-racial; Asian; Pacific Islander; Native American) were significantly less likely to be referred for a formal assessment. Regarding the association between specific maltreatment type and assessment referrals, children with reports of emotional maltreatment had significantly higher odds of being referred for formal assessments.     

Kinship Guardianship,Adoption, and Foster Care: Outcomes from a U.S. National Sample

Using data from a national longitudinal survey of children referred to child protective services (NSCAW II), this article compares behavioral, child/caregiver relationship, and school performance outcomes for children residing in kinship and nonkinship settings. Up to three waves of data were gathered for each child. The analysis sample comprises 4,202 children and 10,881 observations. Two sets of regressions were completed. One represents family living settings using child-mean centered predictors while the other does so with dummy-coded variables. An advantage of the child-mean centered predictors is that omitted variables that vary between children but that are constant within each child do not introduce bias. The regressions using dummy-coded variables evidenced, on balance, somewhat better outcomes for kinship settings than for nonkinship ones. Good outcomes in these regressions were found for kinship adoption. Results with the child-mean centered regressions were more equivocal, though perhaps still favored kinship settings. Limitations and policy recommendations conclude the article.     

Psychotropic Medications for Youth in Child Welfare: Developing and Pilot-Testing A Field Guide for Team Decision-Making

High rates of children involved with the child welfare system are prescribed psychotropics. In response, federal legislation has mandated state child welfare agencies to develop policies to improve the coordination and oversight around the use of psychotropics. This project aimed to support such policies by developing and pilot-testing a field guide for team discussions and decision-making related to the use of psychotropics among youth in child welfare. We used a community-based participatory research (CBPR) framework to engage a team of local stakeholders, including former youth in foster care and parents, in the research. We developed a field guide to facilitate team discussions and decisions around the individual needs and preferences of youth and families, and we pilot-tested the field guide with child welfare staff, parents, and care team members in seven team meetings. Parents and care team members, in particular, highly valued the guide and found it useful to increase knowledge and improve practices such as side effect monitoring and information sharing. Child welfare responses were more mixed, and some reported feeling burdened by the additional tasks. More work is needed to integrate the guide into routine child welfare practice and reduce burden on staff.     

Implementing Developmental Screening Programs for Infants and Toddlers in the Child Welfare System

In 2003, revisions to the Child Abuse Prevention and Treatment Act required states to develop plans to refer children younger than 3 years of age with a substantiated case of abuse and neglect for developmental screening. A decade after legislation was passed, its implementation varies considerably across states. This article explains how research informs the need for careful developmental monitoring of young children, especially those experiencing trauma or living under stressful conditions. Finally, this article presents how one community used colocation to increase developmental screenings for young abused and neglected children.     

LGBTQ Youth in the Child Welfare System: An Overview of Research,Practice, and Policy

LGBTQ youth are largely overrepresented in the child welfare system. The experiences of LGBTQ youth have largely been overlooked. LGBTQ youth often encounter a number of challenges and disparities as they navigate the child welfare system. Many report experiences of discrimination, marginalization, and an overall lack of acceptance. The permanency and placement options have historically been limited for many LGBTQ youth, often leading to an over reliance on congregate settings and aging out of foster are. The current article provides a synthesis of the existing research on the experiences and outcomes of LGBTQ youth in care, as well as an exploration of the policy and practice initiatives aimed at creating a more inclusive system of care.     

Formative Evaluation of an Evidence-Based Intervention to Reduce Long-Term Foster Care: Assessing Readiness for Summative Evaluation

As part of the federal Permanency Innovations Initiative, this local grantee implemented an evidence-based intervention to improve outcomes for children with serious emotional disturbance. The project approach integrates the tenets of implementation science and program evaluation. Formative evaluation used a small sample (n = 76) to assess implementation integrity and statistical association to recommend whether the intervention was ready for summative evaluation (SE). Results showed that most process expectations were met. Statistical findings suggested that the intervention was associated with higher rates of reunification for treatment families as compared to families receiving services-as-usual. Thus, the intervention was recommended for SE.     

Stopping the Cycle of Child Abuse and Neglect: A Call to Action to Focus on Pregnant and Parenting Youth in and Aging Out of the Foster Care System

Each year, a significant number of adolescents become pregnant in the United States, with more than half of these pregnancies resulting in live births. Adolescent parenting is associated with poor outcomes, including increased risk of child maltreatment. Youth “aging out” of the foster care system may be at greater risk of maltreating their children due to their experiences of child maltreatment, a lack of social support, and little preparation for parenthood. This article examines current programs and policies targeting pregnant and parenting youth aging out and presents a research agenda that focuses on pregnancy prevention and positive parenting.     

Development and Initial Findings of an Implementation Process Measure for Child Welfare System Change

This article describes a new measure designed to examine the process of implementation of child welfare systems change. The measure was developed to document the status of the interventions and strategies that are being implemented and the drivers that are being installed to achieve sustainable changes in systems. The measure was used in a Children's Bureau-supported national effort to assess the ongoing implementation of 24 systems-change projects in child welfare jurisdictions across the country. The article describes the process for measure development, method of administration and data collection, and quantitative and qualitative findings.     

Using Cost Analysis to Examine Variability in Replications of an Efficacious Child Neglect Prevention Program

This article reports on a program- and case-level cost analysis of five replication sites of an efficacious child neglect prevention program. Approximately one-third of all sites' total labor hours were expended on direct family services and casework support for a specific family, with the remainder spent on indirect implementation support and program administration activities. Including non-personnel costs, the all-site mean total cost per family was $6,276, ranging across sites from $2,245 to $10,260. Costs varied greatly among individual families within sites. More research is needed to understand factors associated with differences in cost.     

Child- and Family-Centered Practices in a Post-Bureaucratic Era: Inherent Conflicts Encountered by the New Child Welfare Professional

Various child welfare organizations are changing services by adopting child- and family-centered approaches and moving away from redundant bureaucracy, top-down strategies, and fragmented networks. This shift inevitably poses challenges. This article uses the case of intensive family case management in the Netherlands to explore conflicts perceived by professionals and associated coping strategies. Findings are that internal conflicts (leading to a relapse into old routines or to misinterpretation of purpose) and boundary conflicts (leading to a relapse into old collaboration agreements) cause challenges. Pioneering organizations need to provide support for learning and reflection between professionals, seeking alignment between accountability and learning.     

Issues Surrounding Post-Adoption Contact in Foster Adoption: The Perspective of Foster-to-Adopt Families and Child Welfare Workers

Current research on open adoption gives less consideration to issues surrounding post-adoption contact with birth parents for children adopted from care. Yet, it is widely recognized that the profile of the children and their birth parents, as well as the quality of post-adoption contacts, vary considerably depending on the context in which the adoption takes place. This article is based on interviews with 32 child welfare workers and 16 foster-to-adopt families. It focuses specifically on aspects and conditions that should be taken into consideration when determining whether or how contact between the adopted child and the birth family should be maintained. Our results show that there are distinctive challenges and dilemmas for open adoption in situations where the adopted child comes from a maltreating family, under the responsibility of child welfare services.     

Mixed Methods Study of the Effectiveness of Intensive Family Finding Services with Youth in Congregate Care

Helping youth in congregate care form healthy relationships and achieve stability is an ongoing concern among child welfare stakeholders. The purpose of this mixed methods study was to examine the effectiveness of a family finding intervention with youth with a history of congregate care placement and to explore factors related to the achievement of relational and physical permanency. Results from a logistic regression indicated that for youth previously in congregate care, intensive family finding increased the odds of achieving relational permanency, but not physical permanency. Qualitative analyses identified several themes surrounding successes and challenges to achieving relational and physical permanency.