What works in child welfare

Social worker contactThe heart of the job

What works?

• The relationship between the caseworker and the family

• Parent child visits

• Involvement of foster parents

Hubble Duncan & Miller (1999) APA4 Common Factors in Treatment

Compare to fed studyWhat specific actions work?

-Establishing open, honest communication with parents

-Requesting family participation and feedback in the planning process

-Providing instruction and reinforcement in the performance and completing of mutually agreed upon activities.

Family Reunification: What the Evidence Shows at www.childwelfare.gov

So lets start with the concept of motivation

• We have changes our thinking about it• Used to think that they are motivated or not

and there is not much you can do about it• A person is motivated if they agree with the

social worker• Confrontation, Advice, or threats of

consequences are the best way to bring about change

Let’s see if persuasion worksPersuasion Exercise

• Explain why a participant should make a change.

• List at least 3 specific benefits to make this change

• Tell the participant how to change• Emphasize how important it is for them to

make the change• Tell the person to do it!

Persuasion Exercise Part 2Using an engagement motivational approach

• Ask “ Why do you want to make this change?”• “How might you go about it in order to

succeed?”• “What are the 3 best reasons to do it?”• Summarize what you heard?• Ask “What will you do next?

Engagement is aboutSeeing the Motivators and

Talking Motivators

WII-FM

What are people’s motivators?

• They are deep, what really matters– Different strokes for different folks

• They can be what you are, want to be, dreams– They are how you engage people– How you facilitate hope– Reasons to make the change?

• What questions do you ask to find them?

Where to start

Change is about the ERR

Elicit RecognizeReinforce

ElicitHow do you get people to talk!

Open ended questions

Questions the encourage discussion and leave a broad latitude for how

to respond

Got it right when:

They are the ones talking

Let them do the heavy lifting

Requires us to be

In the moment

Thinking only about what they are saying

ThenExplore

and Recognize

• Reflect what you hear.• Wonder with them, explore, look for

ambivalence and reflect both sides• Trust the process, this is actually faster• Look for what has worked, build confidence,

look for solutions

What if we are stuck on “I will not...”

Focus on both your interest

Interest vs. Position

• Position is What I want– I want an orange– I don’t want to go to parents ed– I want my drugs

• Interest is Why I want it– Why the orange– What don’t you like about parent ed? – What does the drug do for you?

Which was more successful?

• Changing behavior changes people

• Focus on what needs to happen

• Ask questions that look for solutions from their world

Solution Focused interviewing

• “When” rather than “If”• Coping Questions• Exception Seeking Questions• Scaling questions• Miracle Question

What questions can I ask that assess for safety, permanency and well-being and remember the

child’s development

TOOL: Developmental Approach to Assessing Safety, Permanency and Well-being with families

• For each of the major child developmental groups– Quick reminder child development– ? assess well-being and permanency– ? To review Safety concern

• Age appropriate questions for worker to ask children in the home– ? Ask well-being– ? Ask Safety

Prepare

Review plan, identify goals, plan questions

Wrap- up • r

eview & summarize

Contact with children

Relationship of Caseworker Visits with Children and Outcomes in the CFSR

A “strength” rating for caseworker visits with child was significantly associated with “substantially achieved” ratings for 5 of the 7 outcomes.

• Children are safely maintained in their homes when possible and appropriate.

• Children have permanency and stability in their living situations.

• The continuity of family relationships and connections is preserved for children.

• Children receive appropriate services to meet their educational needs.

• Children receive adequate services to meet their physical and mental health needs.

Relationship between Caseworker Visits with Children and Other Indicator Ratings

in First Round of CFSR

Significant relationships were also found between caseworker visits with children and . . .

Achieving the permanency goal of other planned living arrangement

Achieving placement with siblings

Preserving children’s connections while in foster care

Maintaining the child’s relationship with parents

Assessing needs and providing services to children and families

Relationship between Caseworker Visits with Children and Other Indicator Ratings

in First Round of CFSR

Significant relationships were found between caseworker visits with children and . . .

Providing services to protect children in the home and prevent removal

Managing the risk of harm to children

Establishing permanency goals

Achieving reunification, guardianship and permanent placement with relatives

Relationship between Caseworker Visits with Children and Other Indicator Ratings

in First Round of CFSR

Finally, significant relationships were also found between caseworker visits with children and . . .

Involving children and parents in case planning

Caseworker visits with parents

Meeting the educational needs of children

Meeting the physical health needs of children

Meeting the mental health needs of children

Child and Family Services Improvement Act of 2006

Requires at a minimum –

That children in care are seen at least once a month by their

case carrying worker That the visits be purposeful and

focus on issues pertinent to case planning, child safety, permanency and well-being

The majority of those visits occur in the child’s residence.

Federal Target

At Least

90% Of Children in Care Are Visited Every

Month

50% Or More Of The Visits Occur In The

Home

Goal by Oct 1, 2011

The Cycle of Conducting Purposeful and Meaningful Caseworker/Child Visits

Preparation

Engagement/The Visit

AssessmentCommitments

Next Steps

Step One: Preparation Schedule visit. (Some unannounced visits?) Review case information. Identify issues related to safety, permanency and

well-being. Review case plan goal Prepare an agenda –your goal and prepare

questions. Inform the child and caregiver about the agenda. Prepare yourself.

Worker/Child Contact

Step Two: Engagement/The Visit

• Warm-up • Establishing the purpose of the visit• Making the connection with the child

– Alone time• Gathering the information

Worker/Child Contact

Activity: “Interpersonal Skills with Children”

Think about a child who is of the age assigned your group.

How can you demonstrate genuineness, empathy and respect in your work with him/her?

Write one question engage the child

TOOL: Safety, Well-being and Permanency checklists

• For each of the major child developmental groups

• Questions for worker contact with caregivers– Assessing the caregiver’s ability to help the child

through the transitions, parent child visits, etc.• Age appropriate questions for worker contacts

with children– Assessing the child’s transition, quality of out of

home care

Ensuring Safety, Permanency and Well-Being: Suggestions for conducting contacts

with children and caregivers

• Tool based on a child’s developmental age• Suggestions on how to talk to the child about

safety, permanency or well-being issues• Look at your age group’s tool.• What's different • What’s the same

Step Three:Assessment and Commitments

1. Assessing information gathered during visit.

2. Making commitments and plans with the child.

3. Sharing information with the caregiver.

Worker/Child Contact

Step Four: Next Steps

1. Consulting with supervisors and other experts.

2. Documenting visit. 3. Implementing case plan decision/services.4. Beginning the preparation step for the next

visit.

Worker/Child Contact

Basic Elements

5 questions• Who participated in the visit?• What was the purpose of the visit?• What type of contact• Where did the visit occur?• When did the visit occur?

page 5

The w’s

• Who

WHYWhat

Who

Where

When

What do you want to take back?

• What do you want to try?

• On what case? What would be the benefits?

• What would be the first steps, who could help you?

You are doing such important work!!!!Thank-you for what you do!