Screening for trauma and behavioral health needs in child welfare: Practice implications for promoting placement stability.

BACKGROUND: Although the child welfare field has initiated efforts to use standardized screening for trauma and behavioral health needs, research has rarely examined whether these screenings have influenced permanency outcomes. OBJECTIVE: Using data from three states' federal demonstration projects, we examined whether receipt of trauma and behavioral health screening and results of screening were associated with placement stability (i.e., fewer placements). Our inquiry focused on whether similar patterns of statistical associations would be observed in three distinct state settings. PARTICIPANTS AND SETTING: Samples comprised children in out-of-home care in three states newly implementing trauma and behavioral health screening. The states included a South Central state, New England state, and a Central Midwestern state. RESULTS: In all three states, findings showed children who received screening had a higher number of placements (i.e., placement instability). Likewise, all three states found that children whose screening results indicated greater need, such as higher number of trauma symptoms or lower behavioral health functioning, were more likely to experience a higher number of placements (i.e., placement instability). CONCLUSION: Despite differences in screening tools and state-specific approaches, findings suggest that early screenings may provide important information that could be used to identify children's needs, make appropriate service referrals, establish well-matched placements, and support resource parents and birth parents toward better permanency outcomes. Regardless of potential benefits of early screening, it may be underutilized in the field. Future research is needed to replicate these findings and continue to build an evidence base for trauma and behavioral health screening.

Exploring member perspectives on participation on child welfare Citizen Review Panels: A national study.

The year 2016 marked the 20th anniversary of the Child Abuse Prevention and Treatment Act (CAPTA) amendments (P.L. 104-235) that mandated Citizen Review Panels (CRPs). CRPs are citizen volunteer groups authorized by United States (U.S.) federal law to examine policies and procedures of state child welfare agencies. Despite the potential of CRPs to positively impact child welfare systems outcomes associated with child abuse and neglect, and the millions of dollars in resources allocated to these groups, there remains a dearth in the literature about CRPs. This exploratory study examined CRP member perceptions from across the United States. Researchers collected scaled survey data to examine member knowledge, engagement and assessment of panel influence and impact, membership composition, and meeting structure. Results revealed that panel members lack some knowledge related to the federal mandate guiding their work, and data suggest the need for panels to more adroitly recruit and retain members representative of the communities in which the panels are formed. After a brief review of background literature, this paper will explicate key results, discuss these findings, and identify salient practice, policy and research implications derived from the study.

Organizational supports used by private child and family serving agencies to facilitate evidence use: a mixed methods study protocol.

BACKGROUND: Challenges to evidence use are well documented. Less well understood are the formal supports-e.g., technical infrastructure, inter-organizational relationships-organizations may put in place to help overcome these challenges. This study will identify supports for evidence use currently used by private child and family serving agencies delivering publicly funded behavioral health and/or human services; examine contextual, organizational, and managerial factors associated with use of such supports; and determine how identified supports affect evidence use by staff at multiple levels of the organization. METHODS: We will use a sequential explanatory mixed methods design, with study activities occurring in two sequential phases: In phase 1, quantitative survey data collected from managers of private child and family serving agencies in six states (CA, IN, KY, MO, PA, and WI) and analyzed using both regression and qualitative comparative analysis (QCA) will identify organizational supports currently being used to facilitate evidence use and examine the contextual, organizational, and managerial factors associated with the use of such supports. In phase 2, data from phase 1 will be used to select a purposive sample of 12 agencies for in-depth case studies. In those 12 agencies, semi-structured interviews with key informants and managers, focus groups with frontline staff, and document analysis will provide further insight into agencies' motivation for investing in organizational supports for evidence use and the facilitators and barriers encountered in doing so. Semi-structured interviews with managers and focus groups with frontline staff will also assess whether and how identified supports affect evidence use at different levels of the organization (senior executives, middle managers, frontline supervisors, and frontline staff). Within- and between-case analyses supplemented by QCA will identify combinations of factors associated with the highest and lowest levels of staff evidence use. DISCUSSION: This study will inform efforts to improve sustainment, scale-up, and spread of evidence by providing insight into organizational and managerial strategies that facilitate evidence use, the contexts in which these strategies are most effective, and their effect on evidence use by staff at different levels of the organization.

Child Welfare Practice within the Context of Public-Private Partnerships.

Frontline and managerial child welfare practice occurs within the context of a "partnership" among public agencies that have statutory mandate for child protection and related services and private agencies that provide an array of services to children and families through contractual or informal means. Empirical literature has begun to develop around key questions within this interorganizational system, including how public and private child welfare agency relationships and contracting procedures should be structured to promote effective service delivery; how performance measurement and management systems can be developed to promote child safety, permanency, and well-being; and how managers can help promote the delivery of effective and culturally appropriate services. Yet the impact of these organizational and institutional child welfare trends on practitioners has not been clarified. This article synthesizes the literature on these questions to draw implications for practice for the frontline staff, both public and private, driving service delivery.

Promoting outcome achievement in child welfare: predictors of evidence-informed practice.

The use of data and evidence to inform practice in child welfare is the subject of increased discussion in the literature as well as in agencies striving to achieve child safety, permanency, and well-being. Survey data was collected from workers and supervisors in private agencies providing out-of-home care case management and residential treatment services to children and youth across three states. Hierarchical linear modeling tested the role of goal-oriented teamwork and supervisory practice involving the use of data to assess practice effectiveness in predicting evidence-informed practice. The partially mediated relationship showed that a more goal-oriented approach combined with supervisory practice led to increased use of evidence-informed practice. Implications for promoting evidence-informed practice in child welfare are discussed.

Collaboration, Competition, and Co-opetition: Interorganizational Dynamics Between Private Child Welfare Agencies and Child Serving Sectors.

Human service agencies are encouraged to collaborate with other public and private agencies in providing services to children and families. However, they also often compete with these same partners for funding, qualified staff, and clientele. Although little is known about complex interagency dynamics of competition and collaboration in the child-serving sector, evidence suggests that competition can undermine collaboration unless managed strategically. This study explores the interrelationship between competition and collaboration, sometimes referred to as "co-opetition." Using a national dataset of private child and family serving agencies, we examine their relationships with other child serving sectors (N=4460 pair-wise relationships), and explore how variations in patterns of collaboration and competition are associated with several organizational, environmental and relational factors. Results suggest that most relationships between private child welfare agencies and other child serving agencies are characterized by both competition and collaboration (i.e. "co-opetition"), and is most frequently reported with other local private child welfare agencies. Logistic regression analyses indicate that co-opetition is likely to occur when private child welfare agencies have a good perceived relationship or a sub-contract with their partner. Findings have implications for how agency leaders manage partner relationships, and how public child welfare administrators structure contracts.

An empirical typology of private child and family serving agencies.

Differences in how services are organized and delivered can contribute significantly to variation in outcomes experienced by children and families. However, few comparative studies identify the strengths and limitations of alternative delivery system configurations. The current study provides the first empirical typology of private agencies involved with the formal child welfare system. Data collected in 2011 from a national sample of private agencies were used to classify agencies into five distinct groups based on internal management capacity, service diversification, integration, and policy advocacy. Findings reveal considerable heterogeneity in the population of private child and family serving agencies. Cross-group comparisons suggest that differences in agencies' strategic and structural characteristics correlated with agency directors' perceptions of different pressures in their external environment. Future research can use this typology to better understand local service systems and the extent to which different agency strategies affect performance and other outcomes. Such information has implications for public agency contracting decisions and could inform system-level assessment and planning of services for children and families.

Trends in local public child welfare agencies 1999-2009.

US public child welfare agencies have faced increasing pressure in the first decade of this century to demonstrate efficiency and accountability, even as the Great Recession increased pressures on millions of families and undermined human service funding. This paper reports on analyses of the two cohorts of local public child welfare agencies from the National Survey of Child and Adolescent Well-Being to identify changes in their structure and practice. Local agency adaptations have included some structural integration and apparently increased use of subcontracting, including investigations. Collectively, these trends appear to be fostering a tighter coupling of local child welfare agencies with other service providers. Some of these connections may improve families' access to a range of services. However, the increased reliance on private providers may also undermine accountability and flexibility to respond to changing needs.

Promoting cross-sector partnerships in child welfare: qualitative results from a five-state strategic planning process.

Little is known about effective strategic planning for public and private child welfare agencies working together to serve families. During a professionally facilitated, strategic planning event, public and private child welfare administrators from five states explored partnership challenges and strengths with a goal of improving collaborative interactions in order to improve outcomes for children and families. Summarizing thematic results of session notes from the planning event, this article describes effective strategies for facilitation of such processes as well as factors that challenge or promote group processes. Implications for conducting strategic planning in jurisdictions seeking to improve public/private partnerships are discussed.

Promoting supervisory practice change in public child welfare: lessons from university/agency collaborative research in four states.

This article describes qualitative findings regarding lessons learned from research and demonstration projects in four states focused on the implementation of clinical supervision within their public child welfare agencies. This was part of a larger mixed methods study of the effectiveness of these new clinical supervision models on practice, organizational, and client outcomes. Themes from 15 focus groups with frontline supervisors participating in the projects are provided; they focused on the challenges experienced while participating and working to use clinical supervision techniques, recommendations regarding implementing such projects in the public child welfare environment, and those aspects of the implementation that were most effective in supporting their work. These themes provide direction for states and localities wishing to shift frontline supervision to a more clinical model within the public child welfare setting.

Assessing systemic barriers to permanency achievement for children in out-of-home care: development of the child permanency barriers scale.

State and local child welfare agencies are engaged in multiple efforts to enact systems change to improve outcomes, particularly in regard to achievement of child permanency. The Child and Family Services Review process, conducted by the Administration Children and Families, requires states to implement program improvement plans designed to improve outcomes for which they are not meeting national standards. However, a tool has not been demonstrated as useful in assessing the barriers to achievement of permanency across the out-of-home service continuum, from recruitment of families to placement stability. This article reports on the development and refinement of such a tool in one Midwestern state. The Child Permanency Barriers Scale has four factors: kinship, placement and matching, adequate services and resources, and communication and collaboration. Implications for use in state-specific and multisystem assessment and system reform are discussed.

Collaborative research in child welfare: a rationale for rigorous participatory evaluation designs to promote sustained systems change.

Expansion of the child welfare evidence base is a major challenge. The field must establish how organizational systems and practice techniques yield outcomes for children and families. Needed research must be grounded in practice and must engage practitioners and administrators via participatory evaluation. The extent to which successful practices are transferable is also challenged by the diversity of child welfare systems. The U.S. Department of Health and Human Services' Children's Bureau funded Quality Improvement Centers (QICs) that were designed to promote collaborative, multisite research that would address these evaluation needs. This article, based on the findings of a regional and a national QIC, describes the challenges facing research collaboration and the strategies for achieving success.

One state's effort to improve recruitment, retention, and practice through multifaceted clinical supervision interventions.

The professional literature has described the critical role child welfare supervisors play in the recruitment and retention (R&R) of a competent workforce and in practice enhancement to produce positive outcomes for children and families. Building on findings from a federally funded demonstration project related to implementation of clinical supervision in the child welfare setting, this article provides a description of a comprehensive approach to achievement of these outcomes: an integrated implementation of an employee selection protocol, 360-degree evaluation and employee development planning, and peer consultation and support groups for supervisors. An outline of the evaluation designed to assess relative effectiveness of each component on organizational culture, staff R&R, and practice is provided.