Multiple jeopardy: poor, economically disconnected, and child welfare involved

A Review of Screened-Out Families and Child Protective Services Involvement: A Missed Opportunity to Prevent Future Maltreatment With Community-Based Services

The objective of this article is to frame, understand, and draw implications from existing research on families screened out by child protective services (CPS) after a referral alleging child maltreatment. We review descriptive and outcome data together with emerging intervention research amidst a developing consensus that the current reactive role of CPS should be supplemented by supportive and preventative services that primarily address poverty. State-level data indicate that screened-out families are at high risk of re-referral and similar to higher-risk families reported to CPS. Intervention research is scant and mixed, but there is indication that providing community-based services may reduce future CPS involvement. Considering that screened-out referrals present an opportunity to prevent future maltreatment, CPS should identify and collaboratively engage screened-out families in community-based services. More research on the outcomes of these community responses is needed to identify best practices related to engagement and service provision.

Unintentional child injury in child welfare placements

BACKGROUND

Child welfare professionals are charged with protecting children from non-accidental caregiving behaviors resulting in intentional injuries as well as environmental risks and parenting behaviors resulting in unintentional injuries. Yet little is known about unintentional injury prevalence and risk factors by child welfare placement type.

OBJECTIVE

To examine factors related to unintentional child injury requiring medical attention, including child welfare placement type, child behavioral problems, caregiver characteristics, and neighborhood factors.

METHODS

Data from the second and third wave of the 2010 National Survey of Child and Adolescent Well-Being (NSCAW II) were used. Stable child welfare placements between waves 2 and 3 included investigated biological, reunified, adopted, licensed and unlicensed kin, and nonkin foster homes. Logistic regression analysis modeled injury as a function of placement type while controlling for other covariates. Interaction effects between placement and child behavioral scores were also modeled.

RESULTS

Children with more behavioral problems were at greater odds of an injury (OR = 1.05, p < .01) compared to children with fewer behavioral problems. However, interaction models showed that children with more behavioral problems were at decreased odds of injury if living with unlicensed kin (OR = .91, p < .05), licensed kin (OR = .92, p < .001), or foster care (OR = .92, p < .001) compared to biological homes.

CONCLUSION

The absence of a behavioral problem was associated with higher risk of injury for children placed in foster care. More research is needed to better understand injury type, prevalence and specific risk factors.

Exploring the Experiences of Child Welfare-Focused Therapeutic Service Providers

The importance of mental and behavioral health for child welfare clients is well-documented; yet, little is known about the challenges therapeutic service providers (TSPs) experience working in child welfare practice. To explore this topic, five focus groups were conducted with 40 TSPs in a contracted mental and behavioral health agency and data were analyzed following an inductive thematic process. Eleven primary challenges were identified, including the difficulty of navigating numerous involved parties, an overwhelmed work environment, legal intersections common to child welfare cases, unrealistic agency expectations, and heighten case complexity when working with child welfare populations. Findings are organized across system, agency, and client levels and add to the understanding of TSP perspectives working with child welfare. Targeted interventions are discussed, such as efforts to promote realistic expectations and training strategies, as well as directions for future research to improve the intersection between child welfare and mental and behavioral health.

Examining the association between suicidal behaviors and referral for mental health services among children involved in the child welfare system in Ontario, Canada

Although various studies have investigated factors associated with mental health service utilization, few studies have examined factors associated with referral for mental health services among maltreated children. The objective of this study was to examine the association between suicidal thoughts and self-harming behavior and referral for mental health services among children involved in the Child Welfare System in Ontario, Canada. Data for this study were obtained from the Ontario Incidence Study of Reported Child Abuse and Neglect 2013. An estimate 57,798 child maltreatment investigations was analyzed using binary logistic regression with referral for mental health service as the outcome variable. Of the 57,798 cases, 4709 (8.1%), were referred for mental health services. More than seven out of ten maltreated children who engaged in self-harming behavior and two out of three maltreated children who expressed suicidal thoughts were not referred for mental health services. In the multivariate logistic regression model, children who expressed suicidal thoughts had 2.39 times higher odds of being referred for mental health services compared to children with no suicidal thoughts (AOR = 2.39, 99% C.I. 2.05-2.77) and children who engaged in self-harming behavior had 1.44 times higher odds of being referred for mental health services compared to children who did not engage in self-harming behavior (AOR = 1.44, 99% C.I. 1.24-1.67), both after controlling for child demographic characteristics, maltreatment characteristics, and child functioning concerns. Given that referral is the initial step towards mental health service utilization, it is important that child welfare workers receive the necessary training so as to carefully assess and refer children in care who expressed suicidal thoughts or engaged in self-harming behavior for appropriate mental health services. The paper discusses the results and their implications for child welfare policy and practice.

Trying to bridge the worlds of home visitation and child welfare: Lessons learned from a formative evaluation

Young children in families contacting the child welfare system are at high risk of recurrent maltreatment and poor developmental outcomes. Home visitation programs to support parenting may offer hope as a preventive resource but these programs are rarely linked with child welfare. This article describes findings from a formative evaluation of a program designed to connect child welfare-involved families to an existing evidence-supported home visitation program. The program, Early Childhood Connections (ECC), was developed by a field-university partnership including leaders from a public state child welfare system, regional early childhood education systems, and several local agencies providing family support services. Despite extensive and rigorous planning by the workgroup and collaborative refining of the intervention approach as agency needs changed, the continued structural and policy changes within both the home visitation agency and the child welfare agencies created significant ongoing barriers to implementation. On the other hand, child welfare-involved families were receptive to engaging with home visitation. Implications of lessons learned for ongoing program development in this area are discussed.

Dual-System Families: Cash Assistance Sequences of Households Involved with Child Welfare

Dual-system families, those involved with the child welfare system and receiving public cash assistance, may be more vulnerable than families only connected to either of the two systems. This study advances our understanding of the heterogeneous and dynamic cash assistance histories of dual-system families in the post-welfare reform era. With merged administrative data from [state name removed] over the period 1998 to 2009, we use cluster analysis to group month-to-month sequences of cash assistance use among households over the 37-month period surrounding child removal. Close to two thirds of families who received any assistance either had a short spell of Temporary Assistance for Needy Families (TANF) or lost TANF. Smaller percentages had steady support. Families who lose assistance are less likely than average to reunify while those who connect to benefits are more likely, suggesting coordination between systems may serve dual-system families well.

Trajectories of Economic Disconnection among Families in the Child Welfare System

This study examined economic disconnection, an extreme case of economic exclusion in which families lack both employment and cash assistance, among families in the child welfare system. To build hypotheses about the intersection of the child welfare system and economic disconnection we used a multilevel framework that considers federal policy, local practice, and processes within families. We hypothesized that child welfare intervention has the potential to be a mechanism of economic inclusion or exclusion for vulnerable families, with implications for family reunification. We utilized a novel administrative data set containing data from three state agencies to construct income histories of parents relative to their child's placement in foster care (N = 15,159 parents). We identified eight trajectories using group-based trajectory modeling. About two-thirds of parents experience economic disconnection over a three-year period; these families are least likely to reunify. Although providing economic resources to families is typically beyond the scope of child welfare, efforts to minimize the negative impact of child placement on parents' economic connection is likely to improve both the economic inclusion of poor families and family reunification.

The Challenge and Opportunity of Parental Involvement in Juvenile Justice Services

The active involvement of parents - whether as recipients, extenders, or managers of services - during their youth's experience with the juvenile justice system is widely assumed to be crucial. Parents and family advocacy groups note persisting concerns with the degree to which successful parental involvement is achieved. Justice system providers are highly motivated and actively working to make improvements. These coalescing interests provide a strong motivation for innovation and improvement regarding family involvement, but the likely success of these efforts is severely limited by the absence of any detailed definition of parental involvement or validated measure of this construct. Determining whether and how parental involvement works in juvenile justice services depends on the development of clear models and sound measurement. Efforts in other child serving systems offer guidance to achieve this goal. A multidimensional working model developed with parents involved in child protective services is presented as a template for developing a model for parental involvement in juvenile justice. Features of the model requiring changes to make it more adaptable to juvenile justice are identified. A systematic research agenda for developing methods and measures to meet the present demands for enhanced parental involvement in juvenile justice services is presented.