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SuggestedCitation:Metz,A.,Bartley,L.,Farley,A.&Cusumano,D.(2018).EffectivelyImplementingEffectivePracticesfor SustainablePermanency:ASynthesisofResearchandPractice.ChapelHill,NC:National ImplementationResearchNetwork,UniversityofNorthCarolinaatChapelHill.
EffectivelyImplementingEffectivePracticesforSustainablePermanency:ASynthesisofResearchandPractice
SubmittedbytheNationalImplementationResearchNetwork
March2018
BackgroundPurposeoftheProject.TheColoradoDepartmentofHumanServices’(CDHS)DivisionofChildWelfareisengaginginworktocreateaSustainablePermanencyPracticeModelthatmeetstheneedsofchildren,youthandfamilies;reducesthelikelihoodofreentryintofostercare;andembedstheuseofpermanencybestpracticesthroughoutthestateforchildrenandfamilies.Drivenbythegoalofreducingthecurrentrateofreentryintooutofhomecarefrom19.2%to8.2%,CDHSiscommittedtousingapredictiveanalyticsandcoachingservicedeliverystrategytoensurecaseworkersandsupervisorsareabletoengagechildrenandfamiliesinservicesandprogramsmatchedtotheirspecificneeds.
PartnersintheProject.CDHSispartneringwithCaseyFamilyPrograms,theNationalImplementationResourceNetwork(NIRN),andEckerdConnectstodevelopandimplementaSustainablePermanencyPracticeModel.InpartnershipwithCDHS,NIRNwillsupportinitialdevelopmentandlong-termcapacitytouseandscalethepracticemodelacrossthestate.AlsoengagedinthiscollaborativeendeavorisEckerdConnects,whowillbeengineeringthepredictiveanalyticsmodelandbuildingthecapacityofsupervisorsandcasemanagerstousedatatoinformpracticedecisions.Thepracticemodelwillinclude:1)casemanagementpracticesspecificallyforchildrenidentifiedashighriskforre-entry;and2)permanencypracticesforallchildrenandfamiliesinoutofhomeplacement.Thepredictiveanalyticsmodelwillinformthepracticeapproachandalignmentofresourcesbasedonriskofreentrypriortocaseclosure.Coachingwillbeprovidedtosupporttheuseofpredictiveanalyticsandotheravailabledatatoidentifyhigh-riskchildrenandpotentialareasofneedforthesechildrenandtheirfamilies,andtousepermanencypracticeswithfidelitytoaddresstheseidentifiedneeds. Acrossthisproject,CaseyFamilyProgramsservesasthefunderandprovidesoversightandstrategicconsultationtoallpartners.
EffectivePracticesforSustainablePermanency:NecessarybutInsufficientTorealizeourgoalofreducingreentryintofostercareforchildrenandfamiliesrequiresasystemicapproachtoscale,sustain,andcontinuouslyimprovepermanencypracticesinchildwelfare.Thisapproachisparticularlyimportantforvulnerablechildrenandfamiliesimpactedbymaltreatmentasweknowthatfailedinterventionoftenleadstoreentryintooutofhomecare.Theformulabelowdescribesthecriticalpiecesneededtoscaleandbuildsustainablecapacitytouseevidence-informedandevidence-basedpracticesthatwillreducechildandyouth’sreentryintofostercare.
EffectivelyImplementingEffectivePracticesforSustainablePermanency:ASynthesisofResearchandPractice
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Inordertoobtainpositiveoutcomesforchildrenandfamilies,childwelfaresystemsneedtoselectanduseeffectivepractices,implementthepracticesinadeliberateandadaptivemanner,andcreateanenablingcontextthatsustainsandcontinuouslyimprovesthesepractices(Metz&Easterling,2016).Thesethreeconditionsrefertowhatisimplemented(effectivepractices),howitisimplemented(effectiveimplementation)andwhereandwithwhom(enablingcontext)itisimplemented.Theformulaismultiplicativebecauseweaknessinanyofthesethreeareaswillcompromisethepossibilityofachievingtheintendedoutcomes.
• EffectivePractices:Strategiesorpracticesthataresupportedbyevidence,feasibletoimplement,fittheneedsofthechildren,families,andcommunity,andarewelldefined
• EffectiveImplementation:Intentionalandvisibleinfrastructuretobuildstaffcompetencyandcreateorganizationalandsystemsstructurestosupporteffectivepractices
• EnablingContext:Stakeholdercollaboration,communicationandfeedbackloops,andongoinguseofdatatocontinuouslyimproveeffectivepracticesinlocalcontexts
Thepurposeofthisresearchbriefistosynthesize:1)effectivepracticesrelatedtosustainingpermanencyforchildrenwhohavepreviouslybeeninanoutofhomeplacementthusreducingtheirlikelihoodofreentryintofostercare;2)effectiveimplementationsupportsforensuringthatpermanencypracticesareimplementedwithintegrity;and3)anenablingcontextthatsupportsauthenticstakeholderengagementanddatauseinservicetocontinuousimprovementofpermanencypractices.Thisbriefprovidesasummaryoffindingsforeachareaoftheformula.Tomeetthisneed,weconductedatargetedresearchreviewtounderstandandalignrelevantresearchwithformulacomponents.Initially,literaturewascollatedfroma2017CaseyFamilyProgramsbrief,SupportingLifelongFamilies:EnsuringLong-LastingPermanencyandWell-Being,andotheroriginatingdocuments,whichyieldedapproximately29documentsforreview.Next,atargetedliteraturesearchwasconductedusingtheUniversityofNorthCarolinaarticlesearchdatabasewiththefollowingsearchterms:permanency,re-entry/reentry,out-of-homecare,fostercare,reunification,andchildwelfare.Finally,relevantchildwelfareliteraturewasdrawnfromtheChildWelfareInformationGatewayandCaliforniaEvidence-BasedClearinghouse.Inordertoselecteffectivepractices,itisessentialtocomprehensivelyassesstheneedsofthetargetpopulation.Thisincludessecuringandanalyzingdataonthescopeoftheat-riskpopulationwithinthecommunityorjurisdiction,demographiccharacteristics,andrelevantriskfactorsandchildoutcomes—oftenthroughstateadministrativedata,localchildwelfaredata,andagencycasedata.Ideally,datawillbeexaminedlongitudinallyandconsidernuancessuchasgeographicaldifferencesanddisproportionaterepresentation.Buttheselectingentityshouldalsoconsiderbroader,moresystemicfactors,or“rootcauses”oftheproblem.Forexample,Akinetal.(2012)arguethatassessingtargetpopulationneedsinchildwelfarealsoencompassesunderstandingbarriersfacedbyparents—suchaspovertyandsocialsupports,parentalclinicalneeds,parenting,andhomeandenvironmentalstressors,aswellassystemsbarriers—suchasstaffingcapacityandturnover,siloedchildandparentservicesystems,orbarrierswiththelegalsystem—thatmayimpedepermanency(Metz,Bartley,&Maltry,2017).
EffectivelyImplementingEffectivePracticesforSustainablePermanency:ASynthesisofResearchandPractice
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Thus,webeginbysummarizingpossiblepredictorsofre-entryintofostercareconsistentlycitedacrossresearch.ThoughpredictiveanalyticsmodelingwillprovideCDHSwithafirsthandunderstandingofthecharacteristicscommontofamiliesexperiencingreentryintofostercarewithinitschildwelfaresystem,thissummaryalsoprovideshelpfulcontextasweillustratehowthesefactorshaveinformedpolicyandpractice.Higherratesofre-entryintooutofhomecarehavebeenlinkedto1)child,2)parentandfamily,and3)caseorservice-levelcharacteristicsasfollows(Bronson,Saunders,Holt,&Beck,2008;Carnochan,Rizik-Baer,&Austin,2013;Kimberlin,Anthony,&Austin,2009):
• ChildCharacteristicso Raceandethnicityo Infantageandpre-teen/teenagedo Medical,mental,orbehavioralhealthneeds
• Parent/FamilyCharacteristics
o Parentalambivalenceaboutparentingroleo Lackofparentingskillsandsocialsupporto Highnumberofparentproblemso Parentalsubstanceabuseo Highnumberofchildrenlivingthehomeand/orreturninghomeo Lowincome/povertystatus
• Case/Service-LevelCharacteristics
o Shortlengthofstayinfostercareo Neglectasmaltreatmenttypeo Highnumberofplacementso Placementingrouphomeorresidentialsetting(vs.kinshipcare,whichhasbeen
associatedwithlowerratesofre-entry)o Lackofparentinvolvementincaseplanningo Lackofparentvisitationandcontacto Unmetneed/continuingneedforservicesatthetimeofreunification.
EffectivelyImplementingEffectivePracticesforSustainablePermanency:ASynthesisofResearchandPractice
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EffectivePracticesStrategiesorpracticesthataresupportedbyevidence;feasibletoimplement;fittheneedsofthechildren,families,andcommunity;andarewelldefined.PracticestoSustainPermanency/ReduceReentry
DefinitionorCoreComponentsIdentified MainFindingsofResearch Citations
Therapeuticsupportstoenhanceparent-childinteractions
Corecomponentsinclude:• Extensivetrainingandongoing
consultation/coachingandsupportforcaregivers;
• Therapeuticsupportsforchildren;• Emphasisonconcrete
encouragementandpraiseforpositivechildbehavior;and
• Useofadevelopmentalframework.ExamplesofEBPsthatusethesecorecomponentsincludeTreatmentFosterCareOregon(TFCO-P)andParentChildInteractionTherapy(PCIT)
• Inastudyof54childrenrandomlyassignedtoafostertreatmentmodelorregularfostercare,permanentplacementsfailedfor36%ofthechildreninregularfostercarevs.only10%ofthechildreninEIFC.
• StudieshaveshownthatPCITiseffectiveinreducingchildbehaviorproblems,improvingparentingoutcomes,andreducingmaltreatmentrecurrenceamongphysicallyabusiveparents.
Fisher,Burraston,&Pears,2005Carnocahn,Rizik-Baer,&Austin,2013
Intensivein-homeservicesduringandafterfostercare
Corecomponentsinclude:• Interventionatthecrisispoint
(therapistsseefamilieswhentheyareincrisis,within24hoursofreferral);
• Treatmentinnaturalsettings;• Accessibilityandresponsiveness
(therapistsareoncall24/7;familiesaregivenasmuchtimeastheyneed);
• Intensity(servicesaretimelimitedandtypically4weeks-eachfamilyreceives40-50hoursofdirectservice);
• Inanevaluationofanintensivein-homefamilyreunificationprogram,familiesintheprogramexperiencedfewerre-referralstoauthoritiesthancomparisonfamilies24monthsafterprogramintake(25.2%vs.32.5%).
• Itisimportanttonotethatresearchoneffectivenessofsimilarservicemodelsinreducingsubsequentmaltreatmentandre-entryintofostercarehasbeenmixed,withsomestudiesnotinganincreasedrateofre-entryandothersfindingnosignificantdifferencebetweenprogramparticipants
Kimberlin,Anthony,&Austin,2009Pine,Spath,Werrbach,Jenson,&Kerman,2009Fraser,Walton,Lewis,Pecora,&Walton,1996
EffectivelyImplementingEffectivePracticesforSustainablePermanency:ASynthesisofResearchandPractice
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EffectivePracticesStrategiesorpracticesthataresupportedbyevidence;feasibletoimplement;fittheneedsofthechildren,families,andcommunity;andarewelldefined.PracticestoSustainPermanency/ReduceReentry
DefinitionorCoreComponentsIdentified MainFindingsofResearch Citations
• Lowcaseloads(2-3familiesatatime);
• Useofresearch-basedinterventions;and
• Flexibility(servicesareprovidedwhenandwheretheclientwishes).
andcontrol/comparisongroupparticipants.
Carnocahn,Rizik-Baer,&Austin,2013Lee,Jonson-Reid,Drake,2012
Increasedcontactbetweenworkersandcaregivers
Corecomponentsinclude:• Establishingopen,honest
communicationwithcaregivers;• Requestingfamilyparticipationand
feedbackinplanningprocesses;and• Instructionandreinforcementinthe
performanceandcompletionofmutuallyagreed-uponactivities.
• AreviewofbothliteratureandpreviousCFSRFinalReportshavehighlightedtheimportanceoffamilyengagementinpromotingreunification.
• Someresearchhassuggestedthatincreasedcontactandtimespentbetweencaseworkersandfamiliesimprovesengagementandfacilitatessuccessfulreunification.
• Inanotherstudy,theonlysignificantpredictorsoftimelyreunificationwereage(eachyearyoungerachildwas,therewasa5%increaseinreunificationodds)andcaseworkerinclusionofcaregiverincaseactivitiesanddecisions.
• Childrenhadahigherchanceofreunificationwithin12monthsafterplacementinout-of-homecarewhenthecaseworkerinvolvedthecaregiverindecisionsandactivitiesimpactingthechildrencomparedtocaseswhereno
Bronson,Saunders,Holt,&Beck,2008ChildWelfareInformationGateway,2011Yampolskaya,Armstrong,Strozier,&Swanke,2017
EffectivelyImplementingEffectivePracticesforSustainablePermanency:ASynthesisofResearchandPractice
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EffectivePracticesStrategiesorpracticesthataresupportedbyevidence;feasibletoimplement;fittheneedsofthechildren,families,andcommunity;andarewelldefined.PracticestoSustainPermanency/ReduceReentry
DefinitionorCoreComponentsIdentified MainFindingsofResearch Citations
effortsweremadetoencouragecaregivers’participation.
ComprehensiveAssessments
Accurateassessmenttounderstandunderlyingcausesofmaltreatmentisdefinedasaprocessthat“involvesdevelopinganindividualized,family-centeredunderstandingofachildandfamily’scircumstances,environment,andpotentialinordertoidentifyeachfamily’suniqueneeds,determinetheextentoftherisktothechild,andtoconstructanappropriateinterventionplan.”
• StateexperiencesascapturedinCFSRreportsindicatethatinitialfamilyassessmentsplayavitalroleininformingcaseplans,whichcaneitherfacilitateorhinderreunification.
• Asnotedabove,unmetfamilyneedsatthetimeofreunificationhavebeenlinkedtohigherratesofre-entryintofostercare,andsimilarly,onestudyonfailedreunificationshighlighted“poorassessmentordecision-makingbythecaseworkerorserviceprovider”asafactorinnearlytwo-thirdsofthecases.
• Comprehensiveandtimelyfamilyassessmentcanbeusedtoassessafamily’sstrengthsandneedsadequatelytomatchthemappropriatelytoservicestomeetthoseneeds.
PromisingassessmentsidentifiedinliteratureincludetheNorthCarolinaFamilyAssessmentScalesforReunification1andtheStructuredDecisionMakingReunificationReassessment2.
Bronson,Saunders,Holt,&Beck,2008ChildWelfareInformationGateway,2017ChildWelfareInformationGateway,2011
1http://www.nfpn.org/assessment-tools2https://www.nccdglobal.org/assessment/structured-decision-making-sdm-model
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EffectivePracticesStrategiesorpracticesthataresupportedbyevidence;feasibletoimplement;fittheneedsofthechildren,families,andcommunity;andarewelldefined.PracticestoSustainPermanency/ReduceReentry
DefinitionorCoreComponentsIdentified MainFindingsofResearch Citations
Caregiverskilldevelopment
Definedas“servicestoincreaseparents’skilllevelsinanumberofareas”includingbutnotlimitedto:
• Behavioralmanagementtechniques;• Copingskills;and• Problem-solvingskills.
• Reviewsofexperimental/quasi-experimentalstudiesandconceptualliteraturerelatedtoreunificationandre-entryidentifiedparentskilltrainingasacommonfeatureacrossprogramsandasaserviceoftenassociatedwithimprovedreunificationandreducedre-entryintofostercareoutcomes.
• AnannualreportfromtheCaliforniaDepartmentofSocialServicesreportedmaltreatmentrecurrenceratesforchildrenwhoseparentscompletedtheIncredibleYearsprogram(achild,parent,andteachertrainingprogram)as2to6percentagepointslowerthanchildrenofparentswhodidnot.
Bronson,Saunders,Holt,&Beck,2008ChildWelfareInformationGateway,2017Carnocahn,Rizik-Baer,&Austin,2013
Mentalhealthandsubstanceabuseservices
Threepromisingtypesofservicedeliveryinclude:
• Intensivecasemanagementincluding“recoverycoaches”tofacilitateassessments,conductserviceplanning,andeliminatebarrierstoaccessingtreatment;
• Tailoredprogramsforchild-welfareinvolvedmothersandtheirchildren;and
• Stronguseofsocialsupport.
• Inastudyofmorethan6,000childrenwhore-enteredfostercareinCalifornia,childrenwhosecaseplanincludeddrugoralcoholservicesweremorethantwiceaslikelytore-entercare.
• Severalstudiesreportthelikelihoodofreunificationincreaseswhenmothersinsubstanceabusetreatmentprogramsalsoreceivematchedservicestoaddressco-occurringproblems.
Shaw,2006Bronson,Saunders,Holt,&Beck,2008ChildWelfareInformationGateway,2011
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EffectivePracticesStrategiesorpracticesthataresupportedbyevidence;feasibletoimplement;fittheneedsofthechildren,families,andcommunity;andarewelldefined.PracticestoSustainPermanency/ReduceReentry
DefinitionorCoreComponentsIdentified MainFindingsofResearch Citations
Anti-povertyandconcreteservicesforfamilies
Materialsupportsweredefinedas“anyreceptionoffinancially-relatedassistance,includinghousing,rent,utilities,foodorclothing,appliances,furnitureorhomerepairandotherfinancialhelp.Traditionalservicesincludereceptionofthefollowing“medicalordentalcare,disabilitycare,cookingorcleaninghelp,mentalhealthservices,alcoholordrugtreatment,parentingclasses,maritalfamilycounseling,childcounseling,legalservices,daycare,respitecare,discussiongroups,educationclasses,andemploymentassistance”
• Familieswhoneedconcreteservicesandreceivethemaremorelikelytoreunifythanthosewithunmetneeds.
• Anti-povertyservicesthatincludedmaterialsupportsresultedinareductioninlaterreportsandplacementsofchildren.
• Effectiveprogramsorpracticesprovideservicestomeetafamily’sconcreteneedsandcoachfamiliesonhowtoaccesscommunityresourcestomeettheirneedsindependentlyinthefuture
ChildWelfareInformationGateway,2011Bronson,Saunders,Holt,&Beck,2008Simon&Brooks,2016Lowman&Siegel,2012
Socialsupport “Helpingparentsstrengthentheirsupportnetworksandbuildingcommunitypartnershipsforchildprotectionprovideinformalandformalopportunitiesforfamiliestodealwithstresses”
• Socialsupporthasbeenidentifiedasacriticalcomponentofpost-reunificationsupport,andlackofsocialsupportorasocialnetworkhasbeenlinkedtoincreasedriskofre-entryforchildren.
ChildWelfareInformationGateway,2017Bronson,Saunders,Holt,&Beck,2008Kimberlin,Anthony,&Austin,2009
Respitecare Definedasshorttermcareservicesprovidedinthetemporaryabsenceoftheregularcaregivertochildrenwhoa)arein
• Respitecarehasbeenfoundtolowerstressamongfamilies.AnARCHstudyfrom2007notedthatalthoughfamilieswithpriorCPS
Carnocahn,Rizik-Baer,&Austin,2013
EffectivelyImplementingEffectivePracticesforSustainablePermanency:ASynthesisofResearchandPractice
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EffectivePracticesStrategiesorpracticesthataresupportedbyevidence;feasibletoimplement;fittheneedsofthechildren,families,andcommunity;andarewelldefined.PracticestoSustainPermanency/ReduceReentry
DefinitionorCoreComponentsIdentified MainFindingsofResearch Citations
dangerofabuseorneglect;b)haveexperiencedabuseorneglect;orc)havedisabilities,chronic,orterminalillnessesinordertoenablethefamilytostaytogetherandkeepthechildlivinginhisorherhomeandcommunity.
historywerereferredmoreoften,theirsubstantiationratewaslower.
Familygroupdecisionmaking
Definedasprocesses(e.g.,familyteammeetings,teamdecision-making)duringwhichfamiliesarealignedwithagencypersonnelandothersasactiveparticipantsinidentifyingunderlyingissuesandmakingdecisionsandplanningforcareoftheirchildren
• Parentalinvolvementinsix-monthprogressmeetingsisassociatedwithlowerratesofre-entryamongyoungerchildren.
• Overall,familygroupdecision-makingprocessesarelinkedtogreaterfamilyengagement,increasedreunification,andreducedratesofre-entry.
ChildWelfareInformationGateway,2017Kimberlin,Anthony,&Austin,2009
Assessmentofparentalambivalence/readiness
Anassessmentofreadinessforreunification,suchastheNorthCarolinaFamilyAssessmentScaleforReunification(NCFAS-R),canbeusefulinhelpingcaseworkersdeterminewhenandwhethertoreunifyafamilyandidentifyandplanforsupportsthatmaybeneededduringthetransitionperiod
• Astudyexaminingtheimpactofvariousfactorsuponre-entryintofostercareforasampleof512childrenfoundthatchildrenwhoseparentswereviewedasmotivatedtoimproveparentingwere60%lesslikelytore-entercare.
• Conversely,parentalambivalenceabouttheparentingrolehasbeenlinkedtoincreasedratesofre-entry.
Wells&Correia,2012Bronson,Saunders,Holt,&Beck,2008
Mentalandbehavioralservicesforchildren
Programsshouldaddresschildtraumabothrelatingtothereasonforremovalandtheremovalitselfaswellasstressorsassociatedwithreturninghome.
• Childmentalandbehavioralhealthneedsarecommonlycitedaspredictorsofre-entryintofostercare.
Jedwab&Shaw,2017
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EffectivePracticesStrategiesorpracticesthataresupportedbyevidence;feasibletoimplement;fittheneedsofthechildren,families,andcommunity;andarewelldefined.PracticestoSustainPermanency/ReduceReentry
DefinitionorCoreComponentsIdentified MainFindingsofResearch Citations
Foryouthwithmorecomplexneeds,servicescaninclude:
• Carecoordination• Teammeetings• Youthmentoring• Afterschoolcare• Tutoring• Parentcoaching• Respitecare• Psychiatricservices• Outpatienttherapy• 24/7crisisinterventionfor
caregivers
• Inastudyof4,642childrenexitingfromcaretoreunificationoverathree-yearperiod,theauthorsfoundthatwhenchildbehavioralchallengeswereindicatedasareasonforremovaltheywere1.5timesmorelikelytore-entercarethanchildrenwithoutthisindicator.
Madden,McRoy,Maher,&Ward,2009Roberts,O’Brien,&Pecora,2017
Post-reunificationservices “Post-reunificationpracticesoccurafterachildisreturnedhomeandhelptosupportafamilyinmaintainingsuccessfulreunification.”
• Inareviewofstates’FinalCFSRReports,post-reunificationservicesarecitedasacrucialpracticeinreducingmaltreatmentrecurrenceandre-entrytofostercare.
• Researchhighlightsthatservicesthatenhanceparentingskills,providesocialsupport,connectfamiliestobasicresources,andaddresschildren’sbehavioralandemotionalneedsarecriticalandcanhelptopreventre-entryintocare.
Carnocahn,Rizik-Baer,&Austin,2013ChildWelfareInformationGateway,2011
EffectivelyImplementingEffectivePracticesforSustainablePermanency:ASynthesisofResearchandPractice
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EffectiveImplementationMethodsIntentionalandvisibleinfrastructuretobuildstaffcompetencyandcreateorganizationalandsystemsstructurestosupporttheuseofeffectivepracticesforsustainablepermanency3Infrastructuresupportsthatbuildstaffcompetencytodeliverpermanencypracticesandcreateadministrative,data,andsystemssupportsforeffectiveimplementation
DefinitionorContext MainFindingsofResearch Citations
Caseworkertrainingtosupportuseofpermanencypractices
Trainingthatincludesbothworkersandsupervisorsatthesametimeandaddressesdefinitions,relationships,andpracticewasthetypeoftrainingmostrelatedtotransfertoskillsandknowledge.
• Trainingplusreinforcementwasthemostsuccessfulwaytotransfertrainingknowledgeandskillsinonestudyofchildwelfareworkforcetraining.Thereinforcementinvolvedahalf-dayofface-to-facecaseconsultation.
Antle,Barbee,Sullivan,&Christensen,(2008)
Accesstoongoingcoaching,supervisionandsupporttoensurefidelitytopermanencypractices
Effectivesupervisionwasdefinedas:• “Successfulapplicationof
knowledgetopractice,connectingcaseworkerstotheagencymission,buildingsupportiveorganizationalstructures,beinganeffectiveleader,andpromotionsuccessamongemployees.”
• Coachingandsupervisionthatreinforcesskills,includesobservations,reinforcesrelationships,andprovidesfeedbackandongoingsupporttostaff.
• Effectivesupervisionincreasesworkerretentionandstaffsatisfaction,andlikelihoodofeffectivepractice.
• Supervisoreducational,social,andadministrativesupportcancontributetoaworker’seffectivenessinqualityservicedelivery,improvingworkercapacitytodefine“nextsteps”,improveclientengagement,andimprovegoalattainmentamongclients.
• “Deliveryofqualitysupervisions,supervisorsbeingskilledinmentoringandprovidingfeedback,andsupportivepracticestandardshavebeenrelatedtosuccessfulchildwelfarecasecompletion,
ChildWelfareInformationGateway,2015Saldana,Chamberlain,&Chapman,2016
3Effectiveimplementationincludesmethodsdemonstratedtosupporttheuseofeffectivepracticesinpublicchildwelfare.Whilenotallmethodshavebeenempiricallytestedwiththeuseofeffectivesustainablepermanencypracticesspecifically,thesemethodshavebeenidentifiedthroughrigorousresearchtosupporttheuseofevidence-basedpracticesandprogramstoimproveoutcomesforchildrenandfamiliesincludingpermanency.
EffectivelyImplementingEffectivePracticesforSustainablePermanency:ASynthesisofResearchandPractice
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EffectiveImplementationMethodsIntentionalandvisibleinfrastructuretobuildstaffcompetencyandcreateorganizationalandsystemsstructurestosupporttheuseofeffectivepracticesforsustainablepermanency3Infrastructuresupportsthatbuildstaffcompetencytodeliverpermanencypracticesandcreateadministrative,data,andsystemssupportsforeffectiveimplementation
DefinitionorContext MainFindingsofResearch Citations
lowerre-entryintothesystem,aswellasCWSstaffretention”
Assessmentsofpermanencypractice(Fidelity)
Fidelitydataaredatathatmeasuretheextenttowhichtheevidence-basedorevidence-informedprogramorpracticehavebeenimplementedasintended.
• Fidelitymonitoringdemonstratedaprotectiveeffectonstaffturnover,thereforedecreasingthenumberofchildwelfarestaffonacase,inonestate-widerandomizedtrialinchildwelfare.
Aarons,Sommerfeld,Hecht,Silovsky&Chaffin,2009
Dedicationoffundingtosupportpost-reunificationservices
Fundingis:• Designatedspecificallyforpost-
reunificationserviceswithcleareligibilityrequirements;
• Flexible;and• Braidedtoleverageallexistingand
availablestreams(TitleIV-B,SSBG,Medicaid,TANF,etc.).
• StatesareunabletodrawdownfederalTitleIV-Efundingforcasemanagementandsupportsonceachildisreunifiedwithhisorhercaretaker.OtherfederalfundingsuchasTitleIV-Bcanbeusedtosupportpost-reunificationservices,buttherearechallengingtimelimits(e.g.,uselimitedtoa15-monthtimeperiodbeginningwhenthechildisofficiallyplacedintofostercare).4
• Unmetserviceneedsatthetimeofreunificationhavebeenshowntoincreasetheriskofre-entry.Reunificationcanbeatimeofadjustmentforfamiliesandthatstresscanmakeitdifficulttomaintain
ChildWelfareInformationGateway,2011Sciamanna,2013Roberts,O’Brien,&Pecora,2017Bronson,Saunders,Holt,&Beck,2008
4AnalysisofhowtheFamiliesFirstActwillimpactpermanencyservicesisneeded.
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EffectiveImplementationMethodsIntentionalandvisibleinfrastructuretobuildstaffcompetencyandcreateorganizationalandsystemsstructurestosupporttheuseofeffectivepracticesforsustainablepermanency3Infrastructuresupportsthatbuildstaffcompetencytodeliverpermanencypracticesandcreateadministrative,data,andsystemssupportsforeffectiveimplementation
DefinitionorContext MainFindingsofResearch Citations
stability,especiallywhenthereareanumberofcomplexandco-occurringneeds.
EnablingContextStakeholdercollaboration,communicationandfeedbackloops,andongoinguseofdatatocontinuouslyimproveeffectivepracticesinlocalcontexts(e.g.,coordinationwithcourtsorJuvenileJustice)5Systemsalignmenteffortsincludingstakeholderengagementstrategiesanddatauseforimprovement
DefinitionorContext MainFindingsofResearch Citations
Effectivecollaborationamongstakeholderstosupportcoordinationandimplementationofpermanencypractices
Keyfindingsrelatedtoeffectivecollaborationincludedsharedvision,buildingonexistingrelationships,academicsupport,problemsolvingandresourcesharing,andmaintainingcollaborationsovertime.
• Inastudyof11childwelfaresystemsimplementingSafeCaretoreducechildneglectrecidivismrates,sitesthatwereabletofullysustainthemodelreportedsignificantlygreaterlevelsofeffectivecollaborationasmeasuredbyacollaborationscale.
Greenetal.,2016
5Promotinganenablingcontextincludesstrategiesdemonstratedtosupportsystemsalignmentinpublicchildwelfare.Whilenotallstrategieshavebeendemonstratedtosupportalignmentforsustainablepermanencypracticesspecifically,thesestrategieshavebeenidentifiedasbestpracticestosupportsystemsalignmentinservicetoimprovedoutcomesforchildrenandfamilies.
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Coordinationwithcourtstosupportpermanencypractices
Researchfindingsdemonstratedtheimportanceofcollaborationbetweenpublicagencystaffandfamilycourtinsupportingsustainablereunificationefforts.
• Youngerchildrenwhoseexitsfromcarewereinitiatedbythechildwelfareagencyasopposedtoacourtsystemwerelesslikelytore-entercare.
• Similarly,astudyanalyzing3years’worthofdatafromastate’sadministrativechildwelfaresystemfoundthatchildrenwhosereunificationwascourt-orderedagainsttheagency’srecommendationweretwiceaslikelytore-entercare.
Kimberlin,Anthony,&Austin,2009ChildWelfareInformationGateway,2011Jedwab&Shaw,2017.
Effectivedatasystemsforqualityimprovementofpermanencypractices6
Carefulanalysisofdatainchildwelfareisrequiredtounderstandhowwellservicesarebeingdelivered,whetherservicesaremeetingtheneedsofchildrenandfamilies,andifservicesresultindesiredoutcomesforchildrenandfamilies.Fidelity,monitoring,andfeedbackhavebeenidentifiedasessentialcomponentsofsuccessfulandsustainedimplementationofevidence-basedprogramsorpractices.
• ResearchhasindicatedanumberofbenefitsresultingfromeffectiveCQIprocessesincludingincreasedstaffretention,increasedinvolvementofstaffinusingdataforimprovement,improvedreferralprocesses,andimprovedoutcomesforchildrenandfamilies.
• Improvedoutcomesforchildrenandfamiliesincludereductionsinthenumberofchildrenplacedinout-of-homecare,increasedpercentagesofchildreninfamilyhomes,decreasednumberofchildreningrouphomes,increasedadoptions,improvedplacementstability,andincreasednumberofinvestigationsthatareopenlessthan60days.
Chovil,2009Aarons,Sommerfeld,Hecht,Silovsky&Chaffin,2009Sedler,Bruns,Walker,Kerns&Negrete,2015Packard,McCrae,Phillips,&Scannapieco,2015Ahn,Carter,Reiman,&Hartzel,2017
Policiesthatsupportpermanencypractice
Agencypoliciesandpracticesrefertopracticesagenciescanputintoplaceto
Agency-levelpromisingpracticesthatreducethelikelihoodofreentryinclude:
• Pre-Planning
Hatton&Brooks,2008
6Pleasenotethatpredictiveanalyticswouldbeincludedindatauseactivitiesdesignedtosupporteffectiveimplementationofeffectivepractices.
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supportpermanencyandreducethelikelihoodofreentry.
• Postplacementservices• Settingupformalandinformal
services• Participatorycaseplanningpractices• Assessingfamilyreadinessfor
reunifyingchildren• Effectiveparent-childvisitation
Public-privatepartnershipsinservicetotheuseofsustainablepermanencypractices
Childwelfarepresentsuniquechallengesinensuringeffectivepublic-privatepartnershipssinceservicesareoftencoordinatedorprovidedthroughcommunity-basedorganizations,andpublicchildwelfareagenciesfrequentlyrelyonanetworkofserviceproviders.Additionally,manytreatmentsforfamiliesareprovidedthroughbehavioralandmentalhealthsystems.
• Effectivepublic-privatepartnershipsarestrengthenedthrougheffectiveteamingstructuresthatcansupportinformationsharing,problemsolving,andfeedbackandcoordinationamongthepublicagencyandnonprofitserviceproviderswhosupportpermanencyforfamilies.
Metz,Bartley,&Maltry,2017
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SummaryandNextStepsInpartnershipwiththeNIRN,CaseyFamilyProjects,andEckerdConnects,CDHSiscreatingaSustainablePermanencyPracticeModelthatmeetstheneedsofchildren,youthandfamilies.Acriticalpieceofthisworkinvolvesaligningcaseworkersandsupervisors’useofpermanencybestpractices,strengthenedbycoachinganddatafrompredictiveanalyticsthatidentifychildren,youth,andfamilies’needs.Inordertodevelopcapacitytoadoptandimplementapermanencypracticemodel,effectivepracticesmustbeselected,operationalized,andembeddedwithinasystemthatsupportstheiron-goinguseandcontinuousimprovement(Metz&Easterling,2016).Thisbriefsharedavarietyofbestpracticestosupportsustainablepermanencyandreducereentryintofostercare(e.g.,whatisimplemented)whilealsoidentifyingcriticalfactorsineffectiveimplementation(e.g.,howpracticesareimplemented)anddevelopmentanenablingcontext(e.g.,whereandwithwhom)thatsupportsthiswork.Withtheknowledgefromthisbriefinhand,nextstepstowardreachingthegoalofreducingreentryintofostercareincludeusingdatadrawnfrompredictiveanalyticstoidentifythemostfrequentbarrierstosustainedpermanencyandaddressingthesechallengeswithbestpracticesintheformofcasemanagementandtargetedservicesforchildrenandfamilies.Asthesebestpracticesareidentified,theyshouldbeexaminedandoperationalized(whatisitthatcaseworkersandsupervisorswill“sayanddo”tosupportsustainablepermanency?).Oncebestpracticesareidentifiedandoperationalized,systemsfortrainingandcoachingcanbedevelopedandemployedtofostertheabilitiesandskillsoffrontlinechildwelfarestaff.Atthesametime,attentionmustbegiventothesystemswithinwhichthesepracticeswillreside,soconditionstosupporton-goingimprovementandproblemsolvingareavailable.Asnotedearlier,identifyingandusingeffectivepracticesisanecessarybutinsufficientsteptoreducereentryrates.Attentionmustalsobedirectedatcreatingsystemstosupporttheiruseandcontinuousimprovementinordertoachievepositiveoutcomesforchildren,youth,andfamilies.ReferencesAarons,G.,Sommerfeld,D.H.,Hecht,D.B.,Silovsky,J.F.,&Chaffin,M.J.(2009).Theimpactofevidence-basedpracticeimplementationandfidelitymonitoringonstaffturnover:Evidenceofaprotectiveeffect.JournalofConsultingandClinicalPsychology,77,270-280.Ahn,H.,Carter,L.M.,Reiman,S.,&Hartzel,S.(2017).Developmentofaqualityassuranceandcontinuousqualityimprovement(CQI)modelinpublicchildwelfaresystems.JournalofPublicChildWelfare,11,166-189.Akin,B.A.,Bryson,S.A.,McDonald,T.,&Walker,S.(2012).Definingatargetpopulationathighriskoflong-termfostercare:barrierstopermanencyforfamiliesofchildrenwithseriousemotionaldisturbances.ChildWelfare,91,79-101.Antle,B.F.,Barbee,A.P.,Sullivan,D.J.,&Christensen,D.N.(2009).Theeffectsoftrainingreinforcementontrainingtransferinchildwelfare.ChildWelfare,88,5-26.Bronson,D.E.,Saunders,S.,Holt,M.B.,&Beck,E.(2008).ASystematicReviewofStrategiestoPromoteSuccessfulReunificationandtoReduceRe-entrytoCareforAbused,Neglected,andUnruly
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