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July 2016Vol. 17, No. 5Spotlight on Secondary Trauma and Professionals' Well-Being

We feature a series of guest articles addressing the topic of secondary traumatic stress at three different levels of child welfare, as well as other resources focusing on secondary trauma and the well-being of child welfare professionals.

Group therapy session

Issue Spotlight

  • The Essential Role of Supervisors in Addressing Secondary Traumatic Stress

    The Essential Role of Supervisors in Addressing Secondary Traumatic Stress

    By Erika Tullberg, Assistant Research Professor, New York University (NYU) School of Medicine

    This article is part of a series of guest articles on the topic of secondary traumatic stress (STS). Each article in the series focuses on STS at a different level of child welfare—the worker/peer level, manager/supervisor level, and organizational level.

    Over the past several years, there has been an increased focus on the issue of STS within the child welfare field. This is a welcome development given the level of trauma exposure that comes with child welfare work1 and its potential impact on the quality of work2 and staff attrition.3,4 Many are also realizing that traditional approaches to managing STS—which have often focused on teaching frontline staff self-care strategies—do not adequately address the role organizations can play in mitigating or, alternately, exacerbating STS.5  

    This broader perspective on addressing secondary trauma in the child welfare context needs to include attending to supervisors' critical function. Supervisors play a key role in STS prevention and mitigation. Supervisors have the most contact with frontline staff and are often in the best position to identify and address their STS symptoms, including how they are impacting staff-client engagement and interactions. However, agencies cannot assume that this will happen without providing supervisors with specialized training in this area, and without providing the time needed to have supervision extend beyond a compliance focus. Without these two pieces in place, supervisors can become overwhelmed and ineffective.

    It is also important to remember that supervisors are not immune from the effects of STS themselves. In addition to hearing second-hand about trauma experienced by their staff's clients and bearing a higher level of accountability for client safety, they also have personal experiences of directly working with children and families—either in the past, as caseworkers, and/or in the present, assisting or covering for their staff—that they bring with them to their jobs. Supervisors need to be able to process their own experiences and reactions with their own supervisors before they are in the position to do so with their staff. Instead, supervisors are often caught in the middle, struggling to manage both their direct reports' stress and agency administrators' pressures and mandates, all in the midst of limited resources.

    This highlights an additional factor for child welfare programs to consider: that nearly everyone up the hierarchy is a supervisor of one kind or another, and that everyone is impacted in one way or another by the traumatic stress that is inherent in child welfare work. Just as narrowly focusing an agency's response to STS on frontline staff is insufficient, providing supervisors with additional skills will have a limited impact if their managers cannot or do not provide adequate support and guidance, or if the overall agency culture remains highly reactive and crisis-driven. Attending to supervisors' role in identifying and mitigating STS should be part of a broader organizational effort to understand and address the impact that traumatic stress has on overall agency culture and functioning. Members of the National Child Traumatic Stress Network and others have developed a number of resources (below) that may be helpful for child welfare programs seeking to address this important issue, which include:



    1 Horwitz, M.J. (2006). Work-related trauma effects in child protection social workers. Journal of Social Service Research. 32(3), 1-18.
    2 Regehr, C., LeBlanc, V., Shlonsky, A., & Bogo, M. (2010). The influence of clinicians' previous trauma exposure on their assessment of child abuse risk. Journal of Nervous and Mental Disease. 198(9), 614-618.
    3 Bride, B., Jones, J., & MacMaster, S. (2007). Correlates of secondary taumatic stress in child protective services workers. Journal of Evidence-Based Social Work (The Hawthorn Press, Inc.). 4(3/4), 69-80.
    4 DePanfilis, D., & Zlotnik, J.L. (2008). Retention of front-line staff in child welfare: A systematic review of research. Children and Youth Services Review. 30(9), 995-1008.
    5 ACS-NYU Children's Trauma Institute. (2012). Addressing secondary traumatic stress among child welfare staff: A practice brief. New York: NYU Langone Medical Center.

  • Addressing Secondary Traumatic Stress at the Worker, Peer Levels

    Addressing Secondary Traumatic Stress at the Worker, Peer Levels

    Kelly Sullivan, Ph.D., Assistant Professor, Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Licensed Psychologist, Center for Child and Family Health

    This article is part of a series of guest articles on the topic of secondary traumatic stress (STS). Each article in the series focuses on STS at a different level of child welfare—the worker/peer level, manager/supervisor level, and organizational level.

    In 2011, the North Carolina Division of Social Services (NCDSS), in partnership with the Center for Child and Family Health (CCFH) and the University of North Carolina at Chapel-Hill (UNC-CH) School of Social Work Jordan Institute, launched Project Broadcast, a 5-year initiative to develop a trauma-informed child welfare system through funding from the U.S. Department of Health and Human Services' Administration of Children and Families. NCDSS, serving in the role of child welfare experts, and CCFH, serving in the role of trauma experts, spent more than 700 hours developing (1) a Learning Collaborative on trauma-informed child welfare practice based on the National Child Traumatic Stress Network's Child Welfare Trauma Training Toolkit (CWTTT), and (2) a North Carolina-specific child welfare trauma screening tool. Eighty-four program managers, supervisors, and workers participated in county teams in the 9-month Learning Collaborative and were trained to complete the child welfare trauma screening tool. Since that time, NCDSS and CCFH have experimented with alternative versions of disseminating the CWTTT, reaching 21 counties and resulting in more than 9,000 completed trauma screens. Because workers are now exposed to even more child trauma (e.g., directly asking children trauma questions), addressing worker stress, in particular secondary traumatic stress, has emerged as paramount. Individual and peer-level strategies are an essential component of intervention.

    Self-care is most commonly referenced as an individual intervention strategy. While the typical self-care strategies (e.g., eating well, exercising) are important, they may not feel like self-care to some. One specific strategy that many workers have found appealing is the "three good things" activity (Seligman, Steen, Park, & Peterson, 2003). This strategy consists of an individual documenting three good things that happened during the day and their role in bringing them about. If done nightly in the 2-hour period before going to sleep for 2 weeks, it increases happiness and decreases depressive symptoms long-term better than a placebo. This approach is being disseminated in various service systems to promote workforce resilience. Take a survey to determine your own level of compassion satisfaction, burnout, and secondary traumatic stress symptoms. [Find more information on identifying secondary traumatic stress symptoms and self-assessments on the National Child Traumatic Stress Network website.]

    On the peer level, a simple strategy with a wide appeal is the use of low-impact debriefing to remedy "sliming," as described in The Compassion Fatigue Workbook by Françoise Mathieu. Sliming occurs when a professional, hoping to alleviate some of their mental/emotional burden, shares too much upsetting or disturbing detail of their client's stories with coworkers. When a coworker is not prepared to handle this burden, it can negatively impact his/her stress level. The terminology itself has resonated with workers who have felt slimed and who have recognized that they have slimed others. Instead, low-impact debriefing consists of first increasing one's self-awareness of the level of detail one typically shares. Then, when sharing is needed, the sharer provides the receiver with fair warning and an opportunity to consent or dissent and the sharer limits the disclosure to the details needed.

    A good resource for individual and peer-level strategies is Mathieu's workbook mentioned above. These strategies are important, but supervisory, senior staff, and agency-wide approaches are essential for fully addressing the stress of those who, through their work, experience others' and their own trauma, suffering, and loss. Please see the other articles in this series for more information.

  • Is Your Organization Secondary Traumatic Stress Informed?

    Is Your Organization Secondary Traumatic Stress Informed?

    By Ginny Sprang, Ph.D., Professor of Psychiatry, University of Kentucky (UK), Executive Director, UK Center on Trauma and Children

    This article is part of a series of guest articles on the topic of secondary traumatic stress (STS). Each article in the series focuses on STS at a different level of child welfare—the worker/peer level, manager/supervisor level, and organizational level.

    Transforming a child welfare organization into a trauma-responsive agency requires attention to how indirect trauma impacts workers and explication of the role and responsibility of the agency to protect its workforce. In addition to measuring the impact of child welfare activities on the safety, well-being, and permanency of children and their families, it is important to have evaluation systems that help organizations self-monitor and be sensitive to the impact of trauma on the workforce. The Secondary Traumatic Stress Informed-Organizational Assessment (STSI-OA) was designed for this purpose and is an example of a rapid assessment tool that can facilitate this developmental process and support trauma-informed care transformation in public child welfare. 

    The STSI-OA is a 40-item organizational assessment tool that categorizes STS prevention and intervention activities into six domains of activity:

    • An organization's promotion of resilience-building activities (7 items)
    • The degree to which an organization promotes physical and psychological safety (7 items)
    • The degree to which the organization has STS-relevant policies (6 items)
    • The degree to which an organization exhibits STS-informed leadership practices (9 items) and routine organizational practices (7 items)
    • How well the organization evaluates and monitors STS and STS policies and practices in the workplace (4 items)

    Each query is followed by choices that indicate the degree to which the organization is addressing the item, including "Not at All," Rarely," "Somewhat," "Mostly," and "Completely or "Not Applicable." Total scores range from 0–160, with higher scores indicating a higher level of competency in each of the domains assessed. Scoring the STSI-OA involves summing all items, across all domains (N/A = 0). The respondent pool was diverse in terms of geographic location and size of the organizations, service system represented, as well as the tenure, role, and function of the respondent. The national mean total score is 125.82 (SD = 57.5). 

    The STSI-OA has excellent internal consistency at .97 for the total score, indicating that calculating a total score by summing the items in each domain is reliable. Domain scores are also in the excellent range from .88 (Promoting Safety) to .94 (Resiliency Building Activities and STS informed Leadership Practices). The STSI-OA has a significant, moderate, and positive relationship with a 30-item version of the Trauma System Readiness Tool, indicating convergent validity. Test-retest reliability at 90 days is good at .81.

    The STSI-OA was designed to operationalize an organization's role in addressing STS by outlining a series of policy, practice, and training activities that would enable a unit to address STS in the workplace based on its unique characteristics and needs. In this way, the tool describes what an STS-informed organization would look like, if all the activities were enacted fully, based on the current literature relevant to STS risk and protection and principles of organizational learning and development (Dodgson, 1993; Crossan, Lane, & White, 1999). Currently, the STSI-OA is being used nationally and internationally as part of structured implementation of trauma-informed care or STS response initiatives (i.e., learning collaboratives) and as one component of an organizational change process aimed at protecting the workforce. Field reports document the effectiveness of the STSI-OA in facilitating goal setting, formalizing and institutionalizing the monitoring of STS prevention and intervention efforts, and increasing administrative awareness of the role and responsibility of the organization in addressing indirect trauma in the workplace.

    The STSI-OA is available for download at http://www.uky.edu/CTAC and a free scoring program is available at http://www.stsinformed.com/.

  • Organizational Culture and Secondary Traumatic Stress

    Organizational Culture and Secondary Traumatic Stress

    Caseworkers who serve traumatic stress survivors are at particular risk for secondary traumatic stress and burnout, but organizational culture can play a key role in helping to reduce or elevate compassion fatigue, according to a recent study in the Journal of Social Welfare and Human Rights. Using data from a sample of 282 professionals who provide a variety of services to trauma survivors, the study found that while working with trauma survivors may be stressful, the workplace environment and working conditions were also main sources of stress and pressure for trauma caregivers.

    The study reports that organizations with compassion fatigue are often plagued with challenging personnel issues, such as high absenteeism and worker turnover, constant change in coworker relationships, lack of collaboration, and resentment toward management. The author suggests that trauma-informed organizational systems—those that promote the well-being of trauma survivors, caregivers, and organizational leaders—enhance organizations' resilience to trauma and improve organizational health. The research assessed four variables—supervisory support, peer support, organizational support, and trauma-informed caregiver development—and corresponding levels of burnout, secondary traumatic stress, and compassion satisfaction among those working with trauma survivors. The study surveyed workers, supervisors, and administrative staff in three different settings: a county child protection department, a homeless services organization, and a nonprofit organization supporting animal control officers.

    The study made several statistically significant findings—most notably that those workers who felt supported by their supervisors, peers, and organizations were at lower risk for secondary traumatic stress and burnout. Conversely, the lack of such support predicted burnout and secondary traumatic stress. The author suggests that there is a strong cost-benefits rationale to investing in organizational well-being, even amidst budgetary concerns: the costs associated with staff turnover may well be higher than investing in the health of the organization and its workers.

    "Trauma-Informed Systems of Care: The Role of Organizational Culture in the Development of Burnout, Secondary Traumatic Stress, and Compassion Satisfaction," by Joni Handran, Journal of Social Welfare and Human Rights, 3(2), 2015, is available at http://jswhr.com/vol-3-no-2-december-2015-abstract-1-jswhr.

  • Self-Care for Social Workers

    Self-Care for Social Workers

    Social work is a field in which professionals work tirelessly for the benefit of others. Those who dedicate themselves to this profession can know that they are truly making a difference in the lives of the children and families they touch. Social work professionals' lives are also often touched by the work they perform—but not always in positive ways. While the work can be deeply rewarding in many ways, social workers also often face challenges such as heavy caseloads, traumatic stress, and compassion fatigue. An article in The New Social Worker magazine shares the experiences of Deborah Lisansky Beck, M.S.W., L.I.C.S.W., in dealing with these challenges throughout her 20-year career in the field and her suggestions to other social workers for implementing mindfulness during their workdays.

    The article defines mindfulness as "the practice of paying close attention to what we are experiencing in the present, both inside our bodies and minds and in the external world." After a stressful career move negatively affected her health and well-being, Lisansky Beck enrolled in the Mindfulness-Based Stress Reduction Program, Center for Mindfulness in Medicine, Healthcare, and Society, University of Massachusetts Medical Center, Shrewsbury, MA. Some of the lessons and strategies she learned and applied to her own social work career include the following:

    • Awareness of breathing and body awareness: Focus your attention on your breathing. Notice whether your body is tense or relaxed. Being mindful of how your body is feeling and of practicing breathing techniques can help you maintain your focus on the present.
    • Awareness of thought: Take a moment to see where your thoughts are. Are they focused on what you are doing right now or are they somewhere else?
    • Mindfulness at work: Be sure to take breaks as needed to stretch, go to the bathroom, and hydrate. Take time to eat lunch, either with colleagues or on your own. Suggest to your instructors, supervisors, or agency administrators that they incorporate "mindfulness at work" or "wellness," as it is sometimes called, into the larger routine of classes, department meetings, and other school or agency activities.
    • Social support: The relationships you have with family, friends, and colleagues are a vital source of nurturance and comfort. Examine your willingness to be on the receiving end of social support, pay attention to your need for help when it occurs, and learn how to build interactions that foster support into your day.

    To read more tips and strategies about mindfulness for social workers, read the article "Mindfulness: 10 Lessons in Self-Care for Social Workers," by Deborah Lisansky Beck, The New Social Worker, Winter 2016, at http://www.socialworker.com/feature-articles/practice/mindfulness-10-lessons-in-self-care-for-social-workers/.

    Recent Issues

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    Spotlight on National Child Abuse Prevention Month

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News From the Children's Bureau

CBX highlights new joint guidance from the U.S. Departments of Education and of Health and Human Services, as well as an initiative working to end youth homelessness by learning from efforts geared toward veterans and the chronically homeless.

  • Family Self-Sufficiency and Stability Consortium

    Family Self-Sufficiency and Stability Consortium

    In 2013, the Administration for Children and Families' Office of Planning, Research and Evaluation (OPRE) developed the Family Self-Sufficiency and Stability Research Consortium (the Consortium) in an effort to help improve the lives of low-income families and children by integrating research, policy, and practice on family self-sufficiency and stability. This year, OPRE and Mathematica Policy Research published the Consortium's first "year in review" report, highlighting its members' individual and collective achievements in the field of family self-sufficiency and stability.

    The Consortium consists of the following:

    Some of the highlighted efforts and achievements include the following:

    • Project AWESOME developed a toolkit and practice brief for program administrators aimed at helping them identify and implement opportunistic experiments in family self-sufficiency and stability programs.
    • Scholars Network members worked on examining the gaps in family self-sufficiency and stability programs, policies, and research from a variety of angles, including authoring works exploring implementation analysis, the accuracy of State-level safety net policies' predictions of monthly income dynamics, and the connections between family self-sufficiency and increases in the city of Seattle's minimum wage.
    • The Data Center hosted a workshop for representatives from State human services agencies and other stakeholders interested in administrative data use. Participants were introduced to several opportunities for using administrative data to improve service delivery and performance management.

    Learn more about the Consortium and access the report, Family Self-Sufficiency and Stability Research Consortium Year in Review—2015, on OPRE's website at http://www.acf.hhs.gov/programs/opre/research/project/family-self-sufficiency-and-stability-research-consortium.

  • CB Website Updates

    CB Website Updates

    The Children's Bureau website hosts information on child welfare programs, funding, monitoring, training and technical assistance, laws, statistics, research, Federal reporting, and much more.

    Recent additions to the site include:

    Visit the Children's Bureau website often to see what's new at http://www.acf.hhs.gov/programs/cb.

  • New Federal Guidance: Educational Stability of Children in Foster Care

    New Federal Guidance: Educational Stability of Children in Foster Care

    For children in foster care already experiencing family trauma, separation, and instability, school interruptions can have adverse consequences on their educational achievement and long-term success. The Fostering Connections to Success and Increasing Adoptions Act of 2008 (Fostering Connections) included provisions designed to increase the educational stability of children in foster care. In December 2015, President Obama signed the Every Student Succeeds Act (ESSA), which reauthorized the Elementary and Secondary Education Act of 1965 (ESEA). Title I, part A of the reauthorized ESEA contains foster care provisions—complementing and mirroring Fostering Connections provisions—that focus on the vital role of collaboration and joint decision-making between child welfare and educational agencies in ensuring educational stability for children in care.

    The U.S. Departments of Health and Human Services and of Education developed joint, nonregulatory guidance to assist State and local education agencies in meeting their ESEA obligations. The guidance does the following:

    • Clarifies the new foster care provisions under title I, part A of the reauthorized ESEA—to include providing clarity on school of origin, the best interest determination, transportation plans, immediate enrollment and records transfer, State and local points of contact, student data and privacy, and interagency collaboration
    • Highlights the connections between the new provisions and Fostering Connections
    • Provides recommendations to strengthen collaborations between State and local educational and child welfare agencies
    • Includes promising practices from the field that have emerged since the passage of Fostering Connections

    To access Non-Regulatory Guidance: Ensuring Educational Stability for Children in Foster Care, as well as Dear Colleague letters on foster care guidance and timelines, visit the Children's Bureau's website at http://www.acf.hhs.gov/programs/cb/resource/ed-hhs-foster-care-non-regulatory-guidance.

  • Ending Youth Homelessness: Lessons From Veterans Homelessness

    Ending Youth Homelessness: Lessons From Veterans Homelessness

    The Family and Youth Services Bureau's National Clearinghouse on Families and Youth (NCFY) is a free information service that aims to educate the family and youth work field about the research and effective practices that can improve the long-term social and emotional well-being of families and youth. Recently, NCFY explored how current Federal efforts to support homeless veterans could help inform efforts to support unaccompanied homeless youth.

    Through a two-part interview with Matthew Doherty, executive director of the United States Interagency Council on Homelessness (USICH), NCFY delves into some of USICH's work with homeless veterans as part of Opening Doors, a national strategy to end homelessness. The interview also shares some strategies and lessons learned from USICH's efforts around veterans' homelessness and how they could be applied to its national effort to end youth homelessness in 2020. This may be of interest to child welfare professionals due to the connection between youth homelessness and involvement with foster care and/or child welfare.

    Lessons learned include the following:

    • Embrace data: Focusing on existing data helps communities project the number of people expected to experience homelessness, and to gauge the resources needed to respond to their needs. Understanding current data can also highlight the need for improvement.
    • Define success: USICH worked to develop criteria and benchmarks tied to the goal, such as communities identifying all veterans experiencing homelessness and providing shelter immediately to any unsheltered homeless veterans who wanted it.
    • Tap into a range of resources: While veterans may have access to a range of resources and services through the Department of Veterans' Affairs, USICH will promote homelessness education among a variety of systems of care funded by the Department of Health and Human Services (e.g., child welfare system), Temporary Assistance for Needy Families programs, schools, and others in order to meet the comprehensive needs of youth and families.

    To read the interview and learn more, visit http://ncfy.acf.hhs.gov/news/2016/02/qa-how-ending-veteran-homelessness-can-help-homeless-youth.


    Related Item

    The March 2015 issue of Children's Bureau Express featured a spotlight section on housing. Articles in the spotlight section focused on the relationship between housing insecurity and child welfare involvement.

Child Welfare Research

Find the latest issue of the Center for Advanced Studies in Child Welfare's CW360° and a brief presenting an updated theoretical framework for two-generation models for interrupting poverty cycles.

  • CW360°: A Comprehensive Look at Child Welfare Reform

    CW360°: A Comprehensive Look at Child Welfare Reform

    The spring 2016 issue of CW360° takes on the broad theme of child welfare reform, ranging from articles on the evolution of policy, practice, funding, and research methods to a variety of personal perspectives from long-time practitioners. The issue highlights innovative practices in the field and a discussion guide to encourage conversation among child welfare agency workers and administrators.

    CW360° is published by the Center for Advanced Studies in Child Welfare at the University of Minnesota. The spring issue includes the following articles, among many more:

    • "Do Federal Child Maltreatment Laws Effectively Keep Children Safe?"
    • "The Role of Privatization in Child Protection Reform"
    • "Performance-Based Contracting in Child Welfare: Lessons Learned to Date"
    • "Designing Your Front Door: Key Considerations in Child Protective Services Centralized Intake"
    • "A Life's Work: Reflections on Child Welfare Policy and Practice"

    This issue is available at http://cascw.umn.edu/featured/cascws-spring-2016-cw360o-child-welfare-reform-is-now-available-online/.

  • Framework for Combatting Intergenerational Cycles of Poverty

    Framework for Combatting Intergenerational Cycles of Poverty

    Targeted family goals should be the focus when designing an approach to intergenerational poverty, according to a report by the Urban Institute. The report draws on lessons learned from the Housing Opportunity and Services Together (HOST) demonstration project—a collaborative effort launched in Baltimore; Washington, DC; Chicago; and Portland—to test two-generation models in public and subsidized housing for their viability in helping vulnerable families.

    Because family strengths and weaknesses are unique and vary widely, the authors argue that the practice of setting uniform goals for families does not efficiently address two-generation poverty. The report also notes that many two-generation models have tended to favor one generation over the other, when what is needed is an approach more evenly focused on both generations. To achieve this, case managers must to consider the whole family when deciding where to focus efforts and resources. The report presents a theoretical framework for two-generation models that aims to create a "multiplier effect" to meet the needs of both adults and their children through intensive case management and supplemental supports. The goal is to promote better outcomes for all family members that will carry over into subsequent generations.

    The framework addresses four areas of focus:

    • Family goals: The framework addresses the fact that families have different strengths and needs, and it discusses a typology that could help practitioners think about the "types" of families with whom they work (e.g., striver, high-risk, and severely distressed families). Gaining a deeper understanding of individual families' situations and starting points can help establish an appropriate timeframe for treatment and services and inform both short- and long-term goals for each family.
    • Individual goals: Family goals can be used as a lens to help families and practitioners decide how to best target goals for individuals within a family so that the individual goals benefit not only the specific family member, but also feed into larger family goals.
    • Appropriate solutions: The framework advises that it may be advantageous to delay the selection of programs and services for families until a deeper and more nuanced understanding of a particular family's and family members' needs are achieved.
    • Outcomes: Having parents and their children participate in coordinated services may lead to increased multiplier effects that can encourage a family's success as a whole and its participation at higher programmatic levels.

    The report also suggests that child welfare providers should advocate for broad systems change that will enhance intergenerational upward mobility, such as access to enhanced health care, mental health, child care, education, and training services.

    Read the full report, A Theoretical Framework for Two-Generation Models: Lessons From the HOST Demonstration, by Molly M. Scott, Susan J. Popkin, and Jasmine K. Simington, at http://www.urban.org/sites/default/files/alfresco/publication-pdfs/2000578-A-Theoretical-Framework-for-Two-Generation-Models.pdf (312 KB).

  • Improving Outcomes for Children Affected by Parental Substance Use

    Improving Outcomes for Children Affected by Parental Substance Use

    Children in homes where one or both parents have a substance use disorder are at risk for experiencing abuse, neglect, and related physical and emotional issues. Parental substance use also substantially increases the odds for adolescent drug use. An article in Substance Abuse and Rehabilitation focuses on a study that performed a comparative literature review of controlled trials that examined various interventions targeting parents with substance use issues and/or children with at least one parent with a substance use disorder. The review used specific eligibility criteria to identify interventions that showed promise in improving the behavioral and mental health outcomes of affected children. Eligibility criteria included the following:

    • Study participants were randomly assigned to a treatment group.
    • The duration of the participant follow-up was at least 6 months after the completion of the intervention.
    • Participants who dropped out of the program were not excluded in the analyses.
    • The intervention was effective in improving at least one child outcome during the postintervention follow-up period.

    The article addresses the impacts of prenatal drug exposure, substance use in the home, and parental incarceration on children and families. Using the prescribed eligibility criteria, the study identified and examined four interventions designed to reduce substance use while improving overall family functioning and parental relationships and skills:

    • Parents Under Pressure, a weekly in-home intervention that teaches parents child management skills and how to build effective relationships with spouses and children
    • Focus on Families, a program for families affected by methadone addiction, which includes parenting skills and home-based case management in addition to standard methadone treatment
    • Behavioral couples therapy (BCT), a series of 12 sessions focused on effective communication skills and positive behavioral modifications
    • Parenting skills with BCT, which includes parenting skills in addition to the communication and behavioral focus

    While the authors emphasize that findings should be treated as very preliminary, the article concludes that interventions focused on improving family dynamics and parenting practices are most effective in improving outcomes in children impacted by parental substance use.

    Access "Improving the Outcomes of Children Affected by Parental Substance Abuse: A Review of Randomized Controlled Trials," by Stacy Calhoun, Emma Conner, Melodi Miller, and Nena Messina, Substance Abuse and Rehabilitation, 6, 2015, at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315541/.

Strategies and Tools for Practice

This section of CBX offers publications, articles, reports, toolkits, and other instruments that provide evidence-based strategies and other concrete help to child welfare and related professionals.

  • Special Focus: HIV Awareness

    Special Focus: HIV Awareness

    A diagnosis of HIV is stressful for the entire family, and HIV-positive parents who are anxious about their own health and functioning can become more stressed in their parental role. Minority groups, such as African-Americans and Latinos, are disproportionately affected by the epidemic, which can further exacerbate the already disproportional rates of involvement with child welfare systems these minority populations face.1

    The effect on children varies. Research shows they face unique challenges specifically related to their parents' HIV status, including misconceptions about transmitting HIV, fear of prejudice and discrimination, family disruption, and lack of planning for their future care.2 Some, like other children with a seriously ill parent, are vulnerable to emotional and behavioral difficulties. Others may assume a caretaking role, which could lead to missing school, poor school performance, and increased anxiety and distress from their new, adult-like responsibilities.

    Professionals can help families cope by providing comprehensive services and making sure attention is paid to cultural issues while serving families affected by HIV/AIDS. Given the high rates of HIV/AIDS among African-Americans and Latinos, interventions tailored to the unique needs of these populations are critical. Programs should offer multicultural staff, bilingual client materials, culturally relevant services, and culturally competent staff, among other things. In addition to catering to the unique cultural needs of different populations, child welfare professionals should:

    • Make sure that parents who test positive for HIV receive immediate counseling and support to help them understand and cope
    • Provide educational resources and ensure that children and parents know how HIV can and cannot be transmitted
    • Educate parents on ways to plan for their child or children's future through options like standby guardianship

    Resources

    Child Welfare Information Gateway

    National Abandoned Infants Assistance Resource Center

    Womenshealth.gov



    1 Murphy, D.A., Marelich, W.D., Armistead, L., Herbeck, D.M., & Payne, D.L. (2010). Anxiety/Stress among mothers living with HIV: Effects on parenting skills & child outcomes. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3000905/pdf/nihms226739.pdf (336 KB).
    2 RAND Health. (2009). How parental HIV affects children. Retrieved from http://www.rand.org/pubs/research_briefs/RB9372/index1.html.

  • Child Welfare, Housing Project Highlights New Funding Model

    Child Welfare, Housing Project Highlights New Funding Model

    A 2016 report shares the "lessons learned" from the 2015 launch of the Cuyahoga County Partnering for Family Success Program, the first family homelessness and child welfare project in the country and also the first county-level Pay for Success (PFS) project. As part of the program, Frontline Services, a nonprofit homeless persons and families service agency, will deliver intensive service to 135 families over a period of 12 to 15 months. The goal is to reduce stays in out-of-home care for children whose primary caregivers are either homeless or housing insecure by providing Critical Time Intervention, trauma-focused therapies, and housing resources.

    The PFS contracting model directs limited government resources to social programs such as poverty, education, child welfare, homelessness, recidivism, and wellness. Under the PFS model, when projects are successful in achieving positive outcomes, the government repays the private funders (e.g., foundations, banks, and businesses) for their initial investment in providing the necessary upfront capital. The report recognizes that each stakeholder in the project's launch process experienced the PFS process differently. It therefore shares experiences and lessons learned from each of their perspectives, including the following:

    • Government: Leadership from multiple levels of government agencies is essential. Assigning a staff member to operationalize the project with the evaluator and provider is also important.
    • Service provider: Individuals with expertise to examine/conduct due diligence on the intervention design should join the PFS project team as early as possible.
    • Advisor and intermediary: Intermediaries/advisors should leverage local relationships to increase morale and support for the project.
    • Funders: Funders bring social issue area expertise, connections, and can help the advisor/intermediary navigate the dynamics of developing a project in a local climate.
    • Evaluator: Establishing data-sharing agreements early on is critical. Many jurisdictions may benefit from preexisting agreements.

    To learn more about the program, how it was developed, more lessons learned, and how the program is moving forward, visit http://www.thirdsectorcap.org/cuyahoga/, or read Developing the Cuyahoga Partnering for Family Success Program: Partner Perspectives and Lessons Learned, available at http://www.thirdsectorcap.org/wp-content/uploads/2016/02/Final-Cuyahoga-Partnering-for-Family-Success-Program-Lessons-Learned-Report.pdf (1 MB).

  • Primer on Title IV-E Child Welfare Funding

    Primer on Title IV-E Child Welfare Funding

    In January of this year, Child Trends published a primer offering basic information on funding available through title IV-E of the Social Security Act. The primer explains what States typically do with title-IV-E funds, which are meant to support foster care, adoption assistance, and guardianship assistance programs, as well as the Chafee Foster Care Independence Program. A chart illustrates how funding has been allocated across the nation by program category during fiscal year 2012. Challenges in accessing title IV-E finds are also addressed, particularly regarding foster care programs, such as requirements that may disqualify many children in foster care. The primer also discusses title IV-E waivers, which aim to give States' more flexibility in approaches and strategies for child welfare service delivery and financing, and offers a list of resources for more information.

    Access A Primer on Title IV-E Funding for Child Welfare at http://www.childtrends.org/wp-content/uploads/2016/01/2016-04TitleIV-EPrimer.pdf (136 KB).

Resources

This CBX section provides a quick list of interesting resources, such as websites, videos, journals, funding or scholarship opportunities, or other materials that can be used in the field or with families.

  • Infographic on Workforce Development and Retention

    Infographic on Workforce Development and Retention

    An infographic developed by the National Child Welfare Workforce Institute (NCWWI) illustrates why the child welfare workforce is so important to the lives of children and families and focuses on the importance of investing time, effort, and resources to developing the workforce and reducing turnover. Why the Workforce Matters highlights the high costs associated with caseworker turnover, putting a price tag of $54,000 on each caseworker that leaves an agency. To overcome the high rate of turnover in the field, NCWWI recommends investing in the workforce by improving in areas such as work conditions and incentives, organizational environment, professional development and training, and supervision and performance management. According to NCWWI, reducing caseworker turnover may increase chances for family stability and better permanency outcomes for children and lead to more timely investigations, enhanced service, and improved contact with children and their families.

    The infographic features a link to the NCWWI Workforce Development Framework, which includes multiple development strategies and links to related resources. Access the infographic at http://ncwwi.org/files/Why_the_Workforce_Matters.pdf (259 KB).

  • Summer Food Service Program

    Summer Food Service Program

    The National School Lunch Program, a federally assisted meal program available in public and nonprofit private schools and residential child care institutions, provides low-cost or free lunches to children during the school day. Many children and families, particularly low-income children, rely on these school lunches as an important part of their daily nutrition. The U.S. Department of Agriculture's (USDA's) Summer Food Service Program (SFSP) aims to help fill the gap in low-income children and families' nutritional needs over the summer months when school is out and school lunch programs are not available. SFSP sites may be sponsored by School Food Authorities, local government agencies, private nonprofit organizations, universities or colleges, and community and faith-based organizations. During the summer of 2016, USDA plans to serve more than 200 million free meals to children 18 years and under at approved SFSP sites.

    USDA's website offers many resources to help get the word out about SFSP and get families connected to programs in their areas. These include the following:

    USDA's website also offers information on its Seamless Summer Option, available to schools already participating in the National School Lunch or School Breakfast Programs. To learn more about SFSP and other options for ensuring children don't go hungry and continue to receive nutritious meals during the summer months, visit http://www.fns.usda.gov/sfsp/summer-food-service-program-sfsp.

Training and Conferences

Find trainings, workshops, webinars, and other opportunities for professionals and families to learn about how to improve the lives of children and youth as well as a listing of upcoming events and conferences.

  • Conferences

    Conferences

    Upcoming national conferences on child welfare and adoption through October 2016 include:

    July 2016

    August 2016

    • 2016 CWLA National Conference
      "Advancing Excellence in Practice and Policy: What Works for Families Affected by Substance Use"
      Child Welfare League of America (CWLA)
      August 1–3, Orange County, CA
      http://www.cwla.org/substanceuseconference/
    • 2016 North American Council on Adoptable Children (NACAC) Conference
      NACAC
      August 3–6, Nashville, TN
      http://www.nacac.org/conference/conference.html
    • 28th Annual Crimes Against Children Conference
      Dallas Children's Advocacy Center & Dallas Police Department
      August 8–11, Dallas, TX
      http://www.cacconference.org/
    • 2016 National Child Welfare, Juvenile and Family Law Conference
      National Association of Counsel for Children
      August 12–14, Philadelphia, PA
      http://www.naccchildlaw.org/event/2016_Conference
    • 20th National Conference on Child Abuse and Neglect
      "Building Community, Building Hope"
      U.S. Department of Health and Human Services Children's Bureau, Office on Child Abuse and Neglect
      August 31–September 2, Washington, DC
      http://www.2016nccan.com/

    September 2016

    October 2016

    Further details about national and regional child welfare and adoption conferences can be found through the Conference Calendar Search feature on the Child Welfare Information Gateway website at http://www.childwelfare.gov/calendar/index.cfm.

  • Human Trafficking Video Series

    Human Trafficking Video Series

    The Office for Victims of Crime, within the U.S. Department of Justice's Office of Justice Programs, developed a video series to help raise awareness of human trafficking among social, legal, and health-care service providers; law enforcement; related professionals; and other community members. The nine-part series includes information about sex and labor trafficking, multidisciplinary approaches to serving victims of human trafficking, effective victim services, victims' legal needs, and voices of survivors. Spanish subtitles are available for each video, and each also is accompanied by a discussion guide highlighting key points, providing discussion questions, and offering suggested supplemental training materials.

    Also available are four posters targeting specific audiences and four factsheets providing an introduction to human trafficking, information on the legal needs and rights of victims of trafficking in the United States, information on special considerations and needs of youth victims, and promising practices for building effective collaborations to address human trafficking.

    To access the video series, factsheets, posters, and more, visit the Office for Victims of Crime website at http://ovc.ncjrs.gov/humantrafficking/publicawareness.html.

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