Supporting Documentation for CWLA's Statement on Optimal Child Welfare Service Delivery
Child Welfare League of America's vision for an optimal child welfare system encompasses a continuum of services ranging from prevention of abuse and neglect to permanency and stability for children who experience out of home care. Key ingredients of this system are a family-centered approach, an ample, stable, and highly professional workforce, and the availability and targeted application of services to prevent child abuse and neglect, maintain families when maltreatment has occurred and child safety can be reasonably assured, and to achieve permanency and stability for children who must experience foster care. These components are consistent with current research and with federal expectations associated with the Child and Family Service Review process.
Research in child maltreatment, juvenile justice, children's mental health, and parent education supports the effectiveness of interventions that involve the entire family over those targeting the individual parent or child alone (Bethea, 1999; Kumpfer, 1999). A family-centered approach engages families in addressing the problems that affect the care of their children. Such engagement has been linked to compliance with and completion of case plans (Dore & Alexander, 1996).
Stable, Professional Workforce
Effective child welfare services are based on accurate differential assessment and require knowledge of human behavior, of the factors underlying child maltreatment, and of the way in which both risks and protective factors interact to produce an overall picture of a family's needs (Macdonald, 2001; DePanfilis, 1999). Thus, it is not surprising that child welfare workforce research suggests the need for staff who have formal social work education (Albers, Reilly, & Rittner, 1993; Booz-Allen & Hamilton, 1987; Dhooper, Royse, &Wolfe, 1990; Ellett, 2000; Lieberman, Hornby, & Russell, 1988), especially that obtained through specialized child welfare programs such as those developed through Title IVE-supported agency-university partnerships (Huebner, 2004; Dickinson & Perry, 2002). Studies further point to the importance of consistent mentoring by competent supervisors (Dickinson & Perry, 2002), and to a supportive and flexible organizational environment (Rycraft, 1994). All of these factors have been linked to reduced staff turnover, which recent research suggests is critically important both to minimize costs associated with frequent hiring and training (Graef & Hill, 2000) and to improve outcomes for children and families (U.S. Children's Bureau, 2003; Potter & Klein-Rothschild, 2002; Flower, McDonald, & Sumski, 2005).
Greater amount of caseworker contact with children and parents has also been associated with better outcomes (Barth, et al., 1994; U.S. Children's Bureau, 2003). These findings suggest that it is imperative that agencies maintain staff in sufficient numbers to provide manageable workloads that do not require caseworkers to sacrifice the provision of direct services in order to complete administrative tasks and documentation.
Prevention of Abuse and Neglect
Studies have demonstrated the effectiveness or promise of several approaches to prevention of child maltreatment. Models such as Nurse Family Partnerships and Healthy Families have produced evidence that they positively impact a variety of outcomes for children and families, including prevention of abuse and neglect. Likewise, high quality pre-kindergarten programs like the Chicago Child Parent Centers and Headstart that include parental involvement and supports have also demonstrated effectiveness (Alexander, Baca, Fox, Frantz, & Huffman, 2003). Independent studies have found that the financial savings achieved by the most effective of these approaches far exceeds their cost (Alexander, et al., 2003). Rigorous cost-benefit anaylsis conducted by the Washington State Institute for Public Policy showed cost savings for several pre-kindergarten and home visitation programs as well as for Parent-Child Interaction Therapy, a center-based intervention that provides direct coaching to parents as they interact with their young children (Aos, Lieb, Mayfield, Miller, & Pennucci, 2004).
Several interventions that target older children and their families have also been demonstrated to have benefit in lessening children's problematic behavior and improving family functioning. Family-based therapeutic models such as Functional Family Therapy and Multi-Systemic Therapy have been rigorously tested in sites across the country and, despite some variation in findings, there is substantial evidence of their benefit to youth and their families (Aos, et al., 2004).
In prevention, as with intervention, quality control and ongoing evaluation are crucial. Many well-intentioned programs are not effective and even models that have been tested models such as those mentioned above may be ineffective if they are not implemented with strict adherence to design.
Many children can be safely maintained in their families through the timely application of interventions that correctly target the underlying causes of maltreatment. A number of studies support the benefits of interventions that have a behavioral, skill-building focus and that address family functioning in multiple domains including home, school, and community (Corcoran, 2000; Macdonald, 2001). Cognitive behavioral models have been demonstrated to reduce physical punishment and parental aggression in less time than alternative approaches (Kolko, 1996, cited in Corcoran, 2000). The most effective treatment involves all members of the family and addresses not only parenting skills, but also parent-child interaction and a range of parental life competencies such as communication, problem solving, and anger control (Corcoran, 2000; Dore & Lee, 1999). Attention to immediate, concrete needs has also been identified as a key factor in supporting family engagement and positive outcomes ((Berry, 1994; Dawson & Berry, 2002; Gaudin, 1993).
Permanency and Stability
A wealth of research demonstrates the importance of children's being nurtured in a stable family environment (Harden 2004), confirming the need to move those who must enter foster care into permanent living situations as quickly as possible. Recent studies suggest that, when children must leave their families, well-supported kinship placements have the potential to provide more stable and normalizing environments than unrelated family care (Webster, Barth, Needell, 2000).
Most children who enter foster care are able to return to their families of orgin, often within less than one year (Wulczyn, 2004). However, when that is not possible, alternatives such as adoption or subsidized guardianship can offer long term stability (Mandel, Harrington, & Orlin, 2001; Testa, 2004). Cost analyses of child welfare services have linked kinship care and subsizidized guardianship to cost savings (Casey Family Programs, 2004). One study (Allphin, Simmons, & Barth, 2001) found the cost of effecting an adoption for children in foster care to range from $6,000 to $28,539, or an average of $19,141, suggesting that this permanency alternative has the potential to achieve a substantial savings over long term foster care. Findings concerning the stability of adoptions are also encouraging; overall, disruptions occur in 10% to 16% of adoptions, while rates may be higher for some placements such as those of much older youth or in families lacking prior experience in foster care or adoption (Barth, Gibbs, & Siebenaler, 2000).
While research supports the use of family care when deemed appropriate by a full assessment, group care is another placement option that may offer benefits for certain youth when used strategically, for relatively short periods of time, and as part of a plan to maintain or rebuild family and community connections (Barth, 2002). However, family care, even in therapeutic foster care settings with multiple supportive services, tends to be substantially less expensive (Barth, 2002; U.S. Department of Human Services, 2000).
Aftercare and Transitional Services
Data indicate that about 25 percent of all children who exit out-of-home care will return at some point, often within one year (Wulczyn, 2004). The likelihood of re-rentry is especially great when children or parents have more numerous or complex needs or when they are exposed to more extreme environmental stressors (Festinger, 1996; Terling, 1999). Although the likelihood of maltreatment recurrence and/or subsequent re-entry into foster care is undoubtedly related to decision making and services offered prior to reunification, these findings, as well as those of research that has documented problems in the functioning of reunified youth (Taussig, Clyman, & Landsverk, 2001), strongly suggest a need for aftercare services.
The limited research in family reunification aftercare, indicates that it is most successful when it is initially intensive and includes the availability of concrete services (Maluccio, 2000; Walton, Fraser, Pecora, & Walton, 1993; Wulczyn, Zeidman, & Svirsky, 1997) and ongoing assessment of risk (Kirk, 2001). The association of social isolation with failed reunification (Terling, 1999) also suggests the importance of linking with extended family, extra-familial social networks, and informal resources. Tapering off of services should be based on the family's needs rather than on an arbitrary time frame (Kirk, 2001).
Services during and after the adoption process are also an important part of the service continuum. Although the rate of adoption dissolution is quite low overall, research indicates that some placements may have greater needs for follow-up services and supports (Barth, et al., 2000; Barth & Miller, 2001). One study (Brooks, Allen, & Barth, 2002) reported that, while less than 30% of all adoptive families used post-adoption services other than informational resources, most families adopting through a public agency used some type of counseling. This finding was attributed to the larger number of special needs of children placed with these families. As in other types of child welfare intervention, family-focused approaches appear to be the most helpful in supporting adoption stability. Research suggests that adoptive parents may also value participation in support groups, access to literature and seminars, and concrete services like respite care, subsidies, and health benefits (Barth & Miller, 2001).
Services targeting youth who will exit foster care to independence are another important component of a continuum of care. Studies have identified four key elements: school completion, high-intensity supports over time, a work experience component, and the presence of a stable, caring adult (Baker, Olson, & Mincer,2000; Dale,2000) as factors leading to successful transition of youth to work and independence. Youth have been shown to benefit from a plan based on systematic assessment, combined with focused skills development, involvement of caregivers as teachers, and re-establishing or maintaining connections to birth/extended family and community (Courtney & Piliavin,1998; Nollan, 2000).
This document draws from literature reviews and from original studies to reflect the prevailing current research pertaining to the above sub-topics. Further research is ongoing and is needed in each area to build a more substantial knowledge base; accordingly, CWLA's description of an optimal child welfare service delivery system should be periodically revisited to ensure that it comports with the most current evidence. However, despite the limited nature of research in some areas, the use of the work cited here as a foundation for policy and practice is consistent with the accepted understanding of evidence-based practice as relying on the best available research (APHSA, 2005).
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Child Welfare League of America
September, 15, 2005
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