March 2020Vol. 21, No. 2How Family Visit Coaching Is Making a Difference in San Diego County

Written by Kimberly Giardina, director, County of San Diego Health and Human Services Agency Child Welfare Services, and Jorge Cabrera, senior director, San Diego Field Office, Casey Family Programs

Navigating past the toy aisles without a toddler meltdown can be a challenge for any parent shopping at a big-box store. In San Diego County, that trip to the local Walmart can double as a supervised visit with a coach who supports parents in practicing their parenting skills as they work to be reunified with their child.

"We might start at the child welfare office, and then we move to a park or library," explained Phyllis Carlson, a family visit coach with Home Start, one of four community-based organizations that contracts with the County of San Diego to provide family visit coaching (FVC). "Then, we could move from a park to a library to Walmart. The visit coach can work with the parent to figure out how they can go past a toy aisle without temper tantrums or the parent feeling like they have to buy something they can't afford."

Since 2015, the county has offered family visit coaching to families with complex child welfare needs as part of its title IV-E waiver demonstration project. The county was so pleased with the results that it decided to expand FVC countywide, even though its waiver expired in September 2019.

"We were looking at promising practices to implement as our IV-E waiver demonstration," said Laura Krzywicki, chief of agency operations for child welfare services at the county's health and human services agency. "We really wanted to focus on how we can improve our reunification in 12 and 18 months; how do we reunify kids faster?"

The National Council on Crime and Delinquency (NCCD) evaluated the San Diego program—the first such evaluation of the visit coaching model developed by child welfare and juvenile justice consultant Marty Beyer—and its effects on family reunification, reunification timeliness, and parenting efficacy.

"This model differs from the traditional supervised-visits approach used by most child welfare agencies in that parents interact with a coach during visits who focuses on the family's strengths and the children's needs," the evaluation explained.

The county hoped to look at its rates of reunification at 18 months, timeliness of reunification, and how often children reentered care.

According to Krzywicki, the county has not had enough time to evaluate whether children's reentry into care has been impacted. However, the NCCD evaluation found that 30 percent of families who were referred to FVC were reunified within 18 months if parents did not participate in the program compared with 47 percent for families with parents who completed the coaching program. Even parents who participated but did not complete the program had a higher reunification rate (32 percent) within 18 months.

The evaluation found that family visit coaching did not speed up the reunification process, but it did show a statistically significant improvement in parenting skills. With family visit coaching, parents meet with a coach before, during, and after supervised visits with their children. Together, they choose where to meet and decide what they want to accomplish.

"With visit coaching, it gives the parents opportunities to visit in a natural setting that's not in a child welfare office," Krzywicki said. "(Coaches) spend a lot of time helping the parent prepare for the trauma-related needs that come from visitation. Traditionally, in supervised visits when there's a removal, when the child first sees the parent, there might be behavioral problems. They might act out. The coach prepares the parents for this and how to respond in a trauma-informed way." After the visit, the coach and parents discuss what went well and what they can do better.

Coaches have a small caseload, which gives them flexibility to meet family needs. They, together with the parents, invest in 1- to 3-hour visits, one to three times a week, for 3 to 6 months.

The county is discussing how to expand the program beyond the 650 children served by the four community-based organizations. With support from Casey Family Programs, the county is consulting with Beyer on next steps. The county is hopeful that family visit coaching, which NCCD calls "promising," will be included as an intervention in the Family First Prevention Services Act Clearinghouse.

One surprising result of the NCCD evaluation was that social workers did not refer families to FVC until much later in their engagement (an average of 7.5 months from removal). As they consider expansion, the county will look at policies and practices that could support earlier referrals, according to Krzywicki.

Carlson, who became a coach in 2018 after retiring as a social worker for child welfare services, sees a distinct difference in her new role.

"I am very much focused on developing a relationship with (parents), helping them develop a trusting relationship with their child, and helping them find ways of being protective," she said. "I have found that through reframing some of the situations they share with us, we can break down some of their barriers/resistance with their social worker and with the system, and this helps propel them toward reunification, ultimately restoring their parental role."

Parents who were interviewed for the NCCD evaluation said they preferred the coaching format. When asked about traditional visitation supervision, one parent said, "Oh, it made me feel uncomfortable. She didn't talk or interact. I didn't know what she thought about how I was doing."

Carlson also sees the impact family visit coaching has on parents. "In the beginning, clients come and they're angry, they feel a little lost, they feel confused about how the system works ... and they often don't really understand the connection between the roles they played that led them there and the services that are being provided to them," she said. "As parents move forward with their case, they can't wait to call us with their accomplishments."

Coaches also help families build their own support networks. "By modeling a relationship that is trusting and supportive, they can go out and find relationships that have similar characteristics so they can support themselves," Carlson said.

By offering a more natural setting and working with parents to manage their sadness or anger, coaching makes family time more meaningful, Krzywicki said. "As long as you have kids in out-of-home care, this is a program you could be looking into."

The Administration for Children, Youth and Families recently issued an information memorandum that includes the County of San Diego's approach to family visit coaching, along with research, best practices, resources, and recommendations for providing children and youth in out-of-home care safe, meaningful, and high-frequency family time.

To learn more about family visit coaching, visit www.visitcoachingcommunity.com.