Family Preservation Research: Where We\u27ve Been, Where We Should Be Going

Although the literature has provided many critiques of research done on family preservation programs, these critiques have usually been limited to the studies \u27 assumptions, approach, or methodology. Because of the nature of these critiques, suggestions for future research in this field of practice have been scattered throughout the literature and have not benefitted from a wider historical perspective. This paper examines the historical evolution of family preservation studies in child welfare and suggests future directions for research in the field. Among the suggestions the authors posit are (1) research questions should be framed by what we know about improvements in the lives of families and children served by family preservation programs; (2) future explorations should include areas that have received relatively little attention in current research, including the impact of organizational conditions on service fidelity and worker performance; (3) newer treatment models, particularly those that provide both intensive services during a crisis period and less intensive services for maintenance, should be tested; (4) data collection points in longitudinal studies should be guided by theory, and measures should change over time to reflect the theoretically expected changes in families; (5) complex measures of placement prevention and other measures that capture changes in family functioning, child well-being, and child safety, should be utilized to obtain a full picture of program effects; and (6) multiple informants should be used to provide data about program effectiveness. In addition, the authors will argue that the field should carefully consider the amount of change that should be expected from the service models delivered

Translating Rhetoric to Reality: The Future of Family and Children\u27s Services

These remarks were first prepared by the author for the inauguration of the Marion Elizabeth Blue Endowed Professorship in Children and Families at the University of Michigan School of Social Work. They were delivered on October 5, 1999, and originally appeared as a monograph published by the University of Michigan School of Social Work in December 1999. They are reprinted here by permission

Program Orientation as a Factor in Workers' Attitudes and Perceptions of the Need for Placement in Child Welfare

In recent years the child welfare system in New York City has come under criticism for placing most of its resources in providing services to the child away from home. Due to the reimbursement agreement between the public sector responsible for these children and the voluntary agencies which provide care, few "in home" or preventive services have been available. In response to this criticism the Preventive Service Demonstration Project was established, in which intensive family services were provided to families of children in jeopardy of being placed. Evaluation of this project showed that such services did, in fact, reduce the number of children entering foster care and the time spent in care of those who entered. This research investigates the impact of preventive service units on the workers' attitudes and perceptions of the need for placement. Five groups of child welfare workers were participants in the study. Two of the groups were primarily concerned with providing preventive services (n=55), while three provided traditional under care services (n=109). The subjects in the research were administered an instrument which collected social/demographic information and measures of six attitudes. In addition, the subjects were presented five case analogues and asked to judge six case elements and whether the child should be placed in an appropriate foster care setting. Results of the analysis showed that workers in preventive units were different in their attitudes than workers in traditional settings -- they were more likely to feel preventive services were useful, to see the continuing importance of biological parents and to feel that foster care was a damaging experience for children. In addition. while all workers saw the elements of the five cases in about the same way, workers in preventive units placed fewer of the five children in the case analogues (a Guttman scale of Placement Proneness) than other workers. The greatest variation in the placement decision occurred in the "mid-range" case, confirming the results in a number of other studies. Several of the social/demographic variables were also related to the workers' attitudes. and these variables as well as the workers' attitudes were related to the judgment of case elements and the decision to place a child. In order to determine the importance of the variables in explaining a workers' placement proneness score a number of regression analyses were performed. The worker's setting was shown to be a strong predictor of the placement proneness score. In addition, the worker's attitude toward preventive services, judgments of a number of case elements, attendance at courses, ethnicity and the client group with which he/she had contact were also found to be predictive of this score. A total of 34% of the variance in the placement proneness score and 48% of the variance in the placement decision on the mid-range case was explained by these variables. The research gave rise to the following recommendations: (1) the creation of educational preventive units which, at least initially, are administratively separate from the under care units of the agency and the establishment of new funding patterns in the foster care system in order to facilitate their creation; (2) the redefinition of jobs within the foster care system so as to encourage contact between all workers and all parties in· the foster care triangle; (3) the education and training of workers in the area of preventive services in order to increase the workers perceptions of their effectiveness; and (4) an increased emphasis in the training of workers on the skills needed to discern strengths in clients

Improving Family Functioning Through Family Preservation Services: Results of the Los Angeles Experiment

This article describes a study of the outcomes of home-based family preservation services for abusive and neglectful families in Los Angeles County. It focuses on changes in family functioning during the 3 month service period and one year after case closing. Families known to the public child welfare agency were referred to the project based on caseworker judgement of the need for services rather than on the criteria of imminent risk of placement. Two hundred forty families were randomly assigned to either the service group receiving family preservation services from two non-profit agencies or to the comparison group receiving regular public agency services. Both caseworkers and families reported small but significant improvements in family functioning for the service group families, but not for the comparison group families. Study findings also suggest the aspects of family functioning most changed by services, the characteristics of families most affected by services, and variables which predicted service success

The 1999 Leon and Josephine Winkelman Lecture, University of Michigan School of Social Work

The Leon and Josephine Winkelman Memorial Lecture was established at the U-M School of Social Work by the Winkelman brothers (Stanley J., John H., Frederick R., and Henry R.) as a memorial to their parents. The lecture provides a forum for presenting new and emerging knowledge from the social sciences and helping professions, and discussion of the application of that knowledge to the development of social policy, the organization and management of social welfare services, and the delivery of social work services. The selection of topics and scholars reflects the interdisciplinary character of the lecture. This is in keeping with the representation of several disciplines in the Social Work faculty, the School's links with social sciences through its interdisciplinary Joint Doctoral Program in Social Work and Social Science, and the School's collaborations with the School of Public Health, the Medical Center, and the Institute of Gerontology.The Leon and Josephine Winkelman Family; School of Social Work; alumni, faculty, and friends of the School of Social Workhttp://deepblue.lib.umich.edu/bitstream/2027.42/49501/3/1999 Winkelman Lecture Meezan.pd

Behavior Problems of Maltreated Children Receiving In-Home Child Welfare Services

This study evaluates the level of behavior problems in a previously little studied group—children with founded cases of abuse and neglect receiving child welfare services in their own homes. A sample of 149 maltreated children, living at home, were evaluated on the CBCL as they entered a service program to which they were referred by a large public child protective service system. These children were found to have elevated levels of behavior problems, with 43.6% scoring in the problematic range, a rate similar to children entering foster care. Practice and policy implications of these findings are discussed and highlighted

Governance in Motion: Service Provision and Child welfare outcomes in a Performance-based, Managed Care Contracting Environment

Examining the linkage between service provision and client outcomes is important in performance-based human service environments. Since most performance initiatives reward agencies for improving client outcomes rather than providing specific services, managers may have incentives to streamline workers’ efforts and reduce resources devoted to services considered nonessential. This article uses data from a performance-based child welfare initiative to examine the relationship between child permanency outcomes, the services provided by caseworkers, and the environment surrounding frontline service provision. Findings indicate that greater service efforts are required to reunify children with parents than to reach other outcomes, including adoption and placement with relatives. They also indicate that formal organizational responses to performance environments affect client outcomes partially through the services provided by frontline workers. These findings suggest that managers should attend to the interplay between the organizational environment, service technology, and client outcomes when designing performance-based systems in the human service sector

Market-based disparities in foster care outcomes

Managed care and performance-based contracting in state child welfare systems have appeared as a consequence of the increased attention that federal and state policymakers are paying to system performance and service costs. This study reports findings from a longitudinal natural experiment that examined the effects of a performance-based, managed care contracting mechanism on foster care outcomes. Multivariate analyses identified market-based disparities in some of the outcomes experienced by foster children: controlling for child, family, and caseworker characteristics, children served by agencies with performance-based, managed care contracts were less likely to be reunified and more likely to enter kinship foster homes, when compared to children served by agencies reimbursed through fee-for-service contracts. Analyses also suggested that there were few other variables consistently associated with foster care outcomes. These results call into question the evidentiary basis for the diffusion of managed care and performance-based contracting in the child welfare sector, and suggest that state child welfare systems ensure that foster care placement decisions are influenced more by child and family needs than by financial considerations. In addition, they suggest that managed care and performance-based contracts should include specific financial incentives for family reunification.

Interorganizational disparities in foster care service provision

Performance contracting and managed care have recently migrated from the behavioral and physical health care sector into child welfare, and are being introduced under the premise that the financial incentives embedded in market-based models will motivate agencies and their workers to improve the cost-effectiveness and quality of care to children and families. These models, however, have been associated with disparities in service provision and client outcomes. This paper reports new findings from a longitudinal natural experiment that examined the effects of a performance-based, managed care contracting mechanism on service provision to 243 foster children and families served by nine nonprofit agencies. It finds dramatic differences in the intensity of agencies' foster care service provision, both between agencies in different financial environments and among agencies within similar contracting regimes. While the finding of service disparities between contracting environments is similar to results from studies of the effects of market-based models in the health care sector, the identification of considerable interorganizational service disparities within the same contracting environment is novel in child welfare. This paper thus provides the first estimates of distributive inequities in foster care service provision both within and across contracting environments, and introduces questions of equity and fairness in how child welfare agencies organize services to foster children and families in market-based contracting environments.Foster care Managed care Performance contracting Service disparities Equity