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.     

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.     

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.     

A case study in public child welfare: county-level practices that address racial disparity in foster care placement

Racial disproportionality has been a longstanding issue within child welfare. The continued overrepresentation of black children in the foster care system is troubling. The authors of this article conducted a case study of two counties in New York State that have steadily decreased the number of black children in foster care in an effort to identify what aspects of their child welfare practice impacted the decline. The case study employed document analysis, in-depth interviews, and focus groups with child removal decision makers. Utilizing a grounded theory approach to content organization and analysis, several themes emerged as noticeable factors. Some of the most salient themes included preventive services and resources, community collaborations, case practice development, family meetings, workforce diversity, the court system, and, the most unique, blind removal meetings. The themes found in this study present promising practices to assist in decreasing the racial disparity in child welfare removal decisions.     

Success on Their Own Terms: Youths' Perspectives on Successful Foster Care

Foster care is an integral component of the child welfare system. However, little is known about factors germane to conceptualizing successful foster care. This study utilized Concept Mapping (CM) to delineate a conceptual domain for what success in foster care means from the perspective of those most impacted: foster youth. CM couples multi-dimensional scaling with hierarchical cluster analyses to form factors relevant to an area of study. Pictorial representations of the data were generated using the Concept Systems software. Results indicate that youth conceptualize success based on several distinct domains. The final analyses yielded a multi-cluster solution, or Concept Map.     

Secondary traumatic stress and vicarious traumatization in child welfare professionals in Serbia

Child welfare professionals in diverse positions are exposed to a variety of traumatic events including family violence and child abuse and neglect. This secondary exposure puts child welfare workers at the risk of experiencing Secondary Traumatic Stress (STS) and Vicarious Traumatization (VT). For the first time in Serbia, this study quantitatively investigates whether STS and VT are present in child welfare professionals employed in the social welfare centers, foster care and adoption agencies, residential care programs, and shelters for children and youth. It attempts to identify whether the type of service, time exposure to clients, and supervision function as risk or protective factors for negative outcomes. A convenience sample comprised of 135 child welfare professionals completed a series of self-reported measures. Findings indicate that VT and STS are present in this population. Differences in the presence of STS and VT were found according to the types of services offered and length of exposure. Contrary to expectations, supervision was not a protective factor with regards to STS and VT in this population.     

Does the Money Matter? Examining the Source and Type of Child Welfare Dollars Through the Eyes of County Child Welfare Services Directors

Child abuse is addressed through a complicated design of federal, state, and local funds. Congress approved a new round of waivers permitting states to flexibly use funds, otherwise limited to foster care reimbursement, for other child welfare needs. Conducted in Ohio, this longitudinal study examined flexible funds from child welfare directors’ perspectives, including key informant interviews, a survey, and semi-structured interviews. Directors noted that improved discretion results in better child health outcomes and better community partnerships; community partnerships are essential to promoting the health and safety of vulnerable children; and federal child welfare success measures do not reflect directors’ perceptions of success.     

Barriers to Cross-Systems Collaboration in Child Welfare,Education, and the Courts: Supporting Educational Well-being of Youth in Care Through Systems Change

Cross-systems collaboration between child welfare, education, and the courts benefits when challenges and priorities are identified early. We measured perceptions of educational stability in foster youth with a statewide survey of 1,603 professionals in education, child welfare, and the courts. Results reveal commonalities among perceived challenges to collaboration across systems (e.g., multiple foster care placements; school changes) and differences in perceived importance or significance of a given issue by professional group. Results guided collaborative work in Kansas and may assist other states seeking strategies that inform cross-systems collaboration to improve educational well-being for youth in foster care.     

Children in Out-of-Home Care and Adult Labor-Market Attachment: A Swedish National Register Study

Using longitudinal national register data, we investigated labor-market attachment during the years 1993–1995 in Sweden for persons aged 25–35 years who had been in out-of-home care before the age of 18 in Sweden during the 1960s, 1970s, and 1980s. We consider whether an immigrant background has an additional influence on labor-market attachment. Compared to majority population peers, young persons who had been in foster care had shorter educations. Fewer had a strong labor-market attachment and more were dependent on social assistance. Results from multinomial regression models indicated that having been in foster care during childhood reduced the probability of high attachment to the labor-market and increased the probability of social assistance dependency, even after making adjustments for education, marital status, parenthood, domicile, and birth country. Few signs of additive effects from being both an immigrant and a former foster child are found.     

How HIV-Positive Aboriginal Women (PAW) Talk About Their Mothering Experiences With Child and Family Services in Ontario

Aboriginal families are disproportionately involved with Children's Aid Societies (or CAS), which is of concern given the history of colonization, assimilation, and child welfare policies that fail to recognize Indigenous practices within Canada. There is no historical data regarding HIV-positive Aboriginal women's (PAW) experiences and interactions with the child welfare system, despite a high degree of HIV-related stigma and discrimination by CAS staff coupled with lack of HIV knowledge and sensitivity to provide culturally appropriate care to PAW and their children. This article is relevant to local and international child welfare practices, and specifically to CAS agencies across Ontario.     

Exploring Child Welfare Workers’ Experiences with Neglect Cases: A Qualitative Study

Child neglect continues to be a pressing concern in American society. However, child neglect is often found to be more difficult to assess than other forms of child maltreatment. This study explores how child welfare workers experience their day-to-day work with children and families, when neglect is the presenting concern. Convenience sampling was used to recruit former and current child welfare workers (N = 20). Three focus groups were conducted. The analyses identified four themes inherent in case workers' experiences in neglect cases: a dirty house isn't just a dirty house, dilemmas and professional judgment, different values, and ambivalence: compassion and frustration. Implications for practice and future research are discussed.     

Patient-centered psychiatric care for youth in foster care: a systematic and critical review

Youth in the U.S. foster care system are prescribed risky psychotropic medications at high rates. In response, state child welfare agencies have developed policies, yet there is little research to inform patient-centered care (PCC) approaches. To fill this gap, we aimed to identify (1) the perspectives of youth in or formerly in foster care and their caregivers and providers regarding how psychiatric care aligns or does not align with PCC, and (2) effectiveness of interventions aiming to improve PCC within this context. We conducted a systematic review of the literature based on PRISMA-P guidelines, searching four databases and gray literature. Eleven studies met inclusion criteria and quality appraisal benchmarks, none of which were interventions. We applied narrative synthesis techniques to six studies that described youth/former youth perspectives. They described a pervasive lack of knowledge, perceived little voice in decision-making, and described imbalanced power between patients and providers and weak therapeutic relationships, whereas feeling understood by providers and being provided autonomy in decisions were helpful. Systemic barriers also contributed to many concerns. We make a limited number of recommendations to leaders and policy-makers based on our synthesis, however, many critical research steps are needed.     

“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.     

Measuring the impact of public perceptions on child welfare workers

The Public Perceptions of Child Welfare Scale measures how the social environment influences child welfare workers, including their job satisfaction and intent to leave. Psychometric studies have validated the scale for private child welfare workers, but there are no validation studies with public agency staff. This study fills that gap, showing stigma and respect are important constructs that also predict worker intent to leave. This research found an additional construct, blame, which was not present in private worker validation studies. The scale provides an important tool for the field as we continue to build evidence for effective recruitment and retention.     

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.     

Antipsychotic Use and Foster Care Placement Stability Among Youth With Attention-Deficit Hyperactivity/ Disruptive Behavior Disorders

The objective of this study was to investigate the association between antipsychotic initiation and placement transitions among youth in foster care with attention-deficit/hyperactivity disorder and other disruptive behavior disorders (ADHD/DBD). Data were obtained from child welfare administrative records and Medicaid claims in one Mid-Atlantic state from January 1, 2010, through March 31, 2014. Cox proportional hazard model was conducted to estimate the risk of time to first placement transition during the 180-day follow-up among new antipsychotic users and propensity score matched nonusers. Results showed youth initiating antipsychotics had no significant reduction in foster placement transitions within the 180-day follow up (Hazard Ratio = 1.1; 95% CI = 0.7–1.6). Although antipsychotics are widely used for aggressive behaviors, a better understanding of clinical management of youth in foster care is needed to promote stable foster placement.     

What Happened?

ABSTRACT

This article presents an overview and historical analysis of child welfare from its inception in the 19th century through the Social Security Act of 1935 and into the present. An argument is made that the historical de-professionalization of child welfare is reflected in changing societal values and resultant legislation framing investments in child welfare, as well as the influence of child welfare on the quality of services to children and families. De-professionalization has resulted in lowering the professional credentials of child welfare staff, increasing levels of employee turnover, the formulation of questionable policies, all affecting the quality of services to children and families. Implications of the findings for the re-professionalization of child welfare and for policy and practice are discussed.     

信息化的挑战和青年工作应对策略

信息化改变了当代青年的生存方式，各级团组织要及时整合社会资源，加快建设青年工作网络平台，建立共青团干部通过信息网络平台与青年对话的正常机制，引领青年社会思潮，与青年观念、工作需求、生活方式同步，把握信息化时代的新潮话语权，积极应对信息化的挑战。     

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.