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April 2021Vol. 22, No. 4Spotlight on National Child Abuse Prevention Month

This edition of CBX highlights National Child Abuse Prevention Month (NCAPM). Read about the latest updates to the NCAPM website, Resource Guide, and more. We also spotlight resources and articles centered on scaling up title IV-E prevention programs, how educators can continue to prevent child maltreatment during virtual learning by supporting and engaging families, and the benefits of multidisciplinary collaboration in prevention efforts.

Issue Spotlight

  • Scaling Evidence-Based Prevention Programs Under the Title IV-E Prevention Services Program

    Scaling Evidence-Based Prevention Programs Under the Title IV-E Prevention Services Program

    A brief by Child Trends identifies four key factors that influence the scaling of evidence-based models (EBMs) in child welfare and what to consider when implementing services to prevent unnecessary entry into foster care. The Title IV-E Prevention Services Program, as amended by the Family First Prevention Services Act, includes provisions to keep children with their families, when it is safe to do so, with evidence-based services and provides federal funding to do so. The brief uses two EBMs as case studies and interviews the purveyors and community-based provider agencies that focus on purveyor capacity.

    Researchers selected child-parent psychotherapy (CPP) and brief strategic family therapy (BSFT) as the two program models. Both are mental health intervention programs but serve caregivers with children in different age ranges. CPP focuses on attachment and behavioral challenges in children who have experienced trauma, while BSFT focuses on children and youth who engage in or are at risk of developing behavior problems such as substance use. The case studies highlight the following four factors:

    • Purveyor capacity
    • Skilled workforce
    • Data monitoring and evaluation capacity
    • Leadership and support

    There are three findings that researchers found for states to consider when preparing for and implementing EBMs:

    • Strong infrastructure and capacity are needed to meet the expanded demands for these programs.
    • Successfully implementing EBMs into child welfare systems requires strong and sustained relationships across organizations and agencies.
    • Solid and continuous data collection is required to monitor program implementation and outcomes, especially as EBMs are adapted to cultural and agency contexts.


    Read Considerations for Scaling Evidence-Based Prevention Programs Under the Family First Prevention Services Act for a complete overview of the factors, examples of their implementation and limitations, and lessons learned and recommendations.


     

  • April Is National Child Abuse Prevention Month

    April Is National Child Abuse Prevention Month

    Every April, the Children's Bureau observes National Child Abuse Prevention Month (NCAPM) to raise public awareness of child abuse and neglect, recommit efforts and resources aimed at protecting children and strengthening families, and promote community involvement through activities that support the cause. The theme of this year's NCAPM initiative aligns with the theme of the 23rd National Conference on Child Abuse and Neglect (NCCAN), "Thriving Children and Families: Prevention With Purpose," and highlights what it can look like when prevention efforts are guided by the need to build protective factors and provide support to children and families.

    This year's campaign features several enhancements to the NCAPM website, including a new design to help showcase its informative and engaging content. Those visiting the website can learn more about NCAPM and the role the Child Abuse Prevention and Treatment Act plays in providing funding to states to support the prevention, assessment, investigation, prosecution, and treatment of child maltreatment. The website also provides current child maltreatment data, outlines the role protective factors and adverse childhood experiences have in prevention efforts, provides information about the 23rd NCCAN, and offers ways to help spread the word about NCAPM. 

    One of the key highlights for this year's NCAPM website is the new 2021/2022 Prevention Resource Guide, which continues to be rooted in the protective factors but now brings to the forefront how families, neighborhoods, communities, and states are successfully using them to protect children, strengthen families, and promote well-being.

    New additions and updates to the Resource Guide include the following:

    • Social-ecological model. This year's Resource Guide expands upon the tradition of addressing prevention from the perspective of a social-ecological model. This approach acknowledges that there are many factors beyond the individual child and family that affect caregivers' ability to nurture and protect their children.
    • New program examples. Throughout the guide, you will find an array of examples from numerous federal partners, Community-Based Child Abuse Prevention state lead agencies, communities, and others achieving real change for children and families.
    • Conversation guides. New interactive guides replace the tip sheets found in previous editions of the Resource Guide and help users engage parents and caregivers in more personalized conversations about how they care for their children and themselves to create a stronger, more resilient family. Each guide is available in English and Spanish and targets one of the six protective factors. The tip sheets from previous guides will continue to be available on the Child Welfare Information Gateway website.

    The Resource Guide was developed through a partnership between the Office on Child Abuse and Neglect within the Children's Bureau, Child Welfare Information Gateway, and the FRIENDS National Center for Community-Based Child Abuse Prevention. The information and resources available in the Resource Guide can be used all year to help professionals and families prevent maltreatment and work toward child and family well-being. For more information on NCAPM, or to view or order a copy of the Resource Guide, visit the NCAPM website.  


     

  • Ending Child Maltreatment Through Multidisciplinary Collaboration

    Ending Child Maltreatment Through Multidisciplinary Collaboration

    An article from the International Journal on Child Maltreatment: Research, Policy and Practice introduces reframing the traditional maltreatment prevention approach from one that focuses on individual professional roles to a comprehensive multidisciplinary collaboration that shares a collective responsibility.

    The authors suggest that this change be spearheaded through the formation of the EndCAN Academy, a multitiered educational approach that would create the foundation needed for this collaboration by restructuring the currently siloed educational system and redefining child maltreatment as a public health concern that requires a unified approach.

    Although progress has been made in utilizing multidisciplinary teams to address maltreatment and the surrounding factors, there is still room for growth in dismantling the silos around the individual professional fields. EndCAN would be positioned to provide students across disciplines with resources to help them form a comprehensive, interdisciplinary public health response to child maltreatment that would begin during their undergraduate studies and continue through their graduate and postgraduate education. To accomplish this, EndCAN would require sustained and substantial funding to ensure a broad reach across professionals as well as removing financial barriers to participation.

    The article references three training programs that embody the interdisciplinary training vision of EndCAN: Child Advocacy Studies (CAST), an undergraduate minor program originating at Winona State University; the Interdisciplinary Training Program in Child Abuse and Neglect (ITP), a graduate-level training offered at the University of Oklahoma Health Sciences Center; and and online course developed by the American Professional Society on the Abuse of Children and the New York Foundling.  

    Read the article, "Building Strong Children Together: Ending Child Maltreatment in Our Lifetime Through Disruption of Educational Systems and Approaches," to learn more about the EndCAN Academy proposal, educational programs, and more.

     
     

  • What Educators Can Do to Spot Child Maltreatment During the Pandemic

    What Educators Can Do to Spot Child Maltreatment During the Pandemic

    A podcast from Prevent Child Abuse America features a conversation with Dr. Bart Klika that explores how the role educators play in identifying maltreatment has changed during the past year and what opportunities have arisen from it.

    As educators have switched to a virtual platform, it is more difficult for them to see the subtle clues that may indicate child abuse or neglect or connect with a child in the same way they did in a classroom. However, virtual learning does allow an opportunity for a new window into a child's life and potentially greater interaction with the family. Teachers have an opportunity to directly interact differently with parents.

    Dr. Klika posited that educators can use this as an opportunity to shift from looking for indicators of maltreatment to playing a more supportive role, being open to seeing where families may need support, and hopefully connecting them with concrete resources. By taking a more proactive approach and not waiting until a report needs to be filed, educators can work with parents to create conditions where child abuse and neglect may not occur in the first place.

    Dr. Klika discussed the need to interact with and support families early on instead of waiting until child welfare is involved. All families need support, and Dr. Kilka suggests a need for a system of universal access and a shift in norms as we rethink support. By creating a shift in culture where accessing family supports is a norm without stigma—and where concrete supports such as food assistance or high-quality, affordable child care are readily available—an environment can be fostered where child maltreatment may never happen.

    The podcast also recognizes the stress and challenges that educators are facing, including secondary trauma and burnout. As trauma-informed systems are built, it is important to recognize that they should also serve those employed within it.

    Listen to "Child Abuse Is Harder to Spot During the Pandemic. What Can Educators Do?" to hear more.


     

News From the Children's Bureau

Read about the Children's Bureau's newly appointed Associate Commissioner, Aysha E. Schomburg; a project intended to help the Children's Bureau in its work to assist states, communities, and tribes in building, implementing, and evaluating proactive, strengths-based prevention strategies; information about new federal pandemic relief funding for youth and young adults involved with the foster care system; and a brief listing of the latest updates to the Children's Bureau website.

Training and Technical Assistance Update

We feature a guide from the Capacity Building Center for Tribes on obtaining title IV-E funding and lessons learned from tribes who have undergone the process, an article from AdoptUSKids on the barriers prospective foster and adoptive families face during the licensing process and how to overcome them, and a brief listing of the latest updates from the Children's Bureau's technical assistance partners.

Child Welfare Research

We highlight a study that compares child maltreatment statistics between urban and rural areas and an article that discusses the effectiveness of the Safe Environment for Every Kid prevention model.

  • The Effectiveness of the Safe Environment for Every Kid Prevention Model

    The Effectiveness of the Safe Environment for Every Kid Prevention Model

    Since funding for child maltreatment prevention is often limited, cost assessments can help agencies and organizations determine how to allocate funds. A recent article in Child Abuse & Neglect assessed the cost effectiveness of the Safe Environment for Every Kid (SEEK) child maltreatment prevention model.

    SEEK is a primary care-based intervention that involves training primary care providers, screening parents, assessing identified problems, and referring families to community agencies.

    To analyze cost-effectiveness, researchers studied 102 pediatric providers at 18 pediatric primary care practices. The practices and their providers were randomly asked to either implement the SEEK method or continue their usual care. To evaluate results, researchers recruited 924 families with children who have been receiving care from these providers for fewer than 6 years.

    Researchers collected data over a period of 2.5 years on the cost of implementing SEEK, including salaries for team members, provider time for training, and materials as well as the rate and cost of maltreatment incidents.

    The results showed that the SEEK method is cost-effective. It cost $265,852 to implement SEEK for 2.5 years in intervention practices, and an estimated 870 cases were averted. For every 34 children exposed to SEEK, one episode of maltreatment was prevented, meaning the cost of preventing one incident by implementing SEEK was $305.58.

    Each maltreatment incident cost an estimated $2,779 per child for medical and mental health treatment. Therefore, implementation of SEEK would save an estimated $2,151,878 for a population of 29,610 over 2.5 years. The researchers concluded that the cost savings are a strong argument for integrating SEEK into well-child care.

    To learn more, read "Cost Effectiveness of SEEK: A Primary Care-Based Child Maltreatment Prevention Model." 
     

  • Child Maltreatment Reporting in Rural vs. Urban Areas

    Child Maltreatment Reporting in Rural vs. Urban Areas

    Most of the research on child maltreatment focuses on children in urban areas since they outnumber those in rural areas. A recent article in Children and Youth Services Review emphasizes child maltreatment statistics in rural areas, comparing maltreatment reports, report sources, and service outcomes with those in urban areas.

    The study examines three research questions:

    • Do maltreatment reports differ between urban and rural areas during the study period (2003-2017)?
    • Do report sources differ between urban and rural areas?
    • Does the probability of substantiation and postresponse outcomes differ by report source and urban or rural area?

    Measuring report rates between 2003 and 2017, researchers found that rural populations had higher rates. Between 2013 and 2017, rates were about 60 per 1,000 children in rural areas and 40 per 1,000 children in large urban areas.

    Although both rural and urban areas had more reports by professionals than nonprofessionals, rural areas had a greater percentage of nonprofessional report sources than urban areas. The percentages of substantiated reports and of those who received in-home services were relatively similar in rural and urban areas.

    This is the first major study in recent years to examine and compare national data for child maltreatment reports, report sources, and services outcomes for rural and urban areas. It is important to note that there are several limitations to the study, such as that it relied on official child maltreatment data and screened-in reports, which may undercount the actual occurrence of maltreatment.

    To learn more, read "Rural Differences in Child Maltreatment Reports, Reporters, and Service Responses." 
     

Strategies and Tools for Practice

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

  • Seeking Equity Calls Us to Cultural Humility

    Seeking Equity Calls Us to Cultural Humility

    Written by the Capacity Building Center for States

    "Not only are Black children the most likely to enter the child welfare system but they also fare the worst under the state's supervision. Black children have the greatest odds of being removed from their homes and the smallest chance of being either reunited with their parents or adopted. They spend the most time in foster care and receive the least helpful services."—Dorothy Roberts, Shattered Bonds: The Color of Child Welfare (2015, p. 13-14)

    The movement toward prevention and racial equity requires a deep examination of the harm that children—particularly Black and Native American/Alaska Native children—have experienced in the child welfare system and an intentional adoption of culturally responsive services driven by the needs and expertise of children, youth, and families. Over time, the field has shifted from promoting the concept of cultural competence to exploring more comprehensive and responsive approaches. The term cultural competence can imply that full proficiency in another culture is an achievable goal and runs the risk of suggesting those who share culture have identical experiences. On the other hand, cultural humility assumes that others are experts in their own culture, culture is multifaceted, there are structural factors that influence people differently, and people hold multiple cultural and social identities.

    Cultural Humility in Practice

    Cultural humility shifts the focus from knowledge acquisition ("How are other cultures different from my own?") to a deeper exploration of power, norms, and values ("How can I ask the right questions to better understand how cultural and social identities are affecting the families I'm helping?") (Fisher-Borne et al., 2015).

    When woven into practice, cultural humility includes an examination of one's own biases, open dialogue with families, and proactive efforts to level the playing field and address systemic inequities. While race and culture are not synonymous, cultural humility with a racial equity lens can help address the stark racial disparities in the system and promote attention to the intersections of race and other cultural identities. 

    The following cultural humility practice principles (adapted from the National Child Welfare Workforce Institute [2019] and Ortega & Faller [2011]) can help engage youth, families, and colleagues:

    • Commit to lifelong learning. Educating yourself about the history of the child welfare system and its harmful impact on families of color is a necessary step toward reducing disproportionality and becoming a prevention-oriented, family-centered system.
    • Use a wide lens. People can hold multiple identities (racial, ethnic, social, religious, and more), which intersect in individual ways. Viewing others through a narrow lens of assumptions about their cultural identity limits our ability to see them as whole and complex.
    • Be open. The intersection of multiple identities leads to a variety of experiences and impacts opportunities. Step back and consider how these experiences and opportunities (or perhaps lack thereof) might differ from your own.
    • Reserve judgment. Majority (or dominant) cultures may be perceived as better than others. Think about—and avoid—placing more value on some cultures over others.
    • Communicate. Allow people to describe their experience in their own words. Engage in active and reflective listening.
    • Stay curious. Commit to cultural humility as a critical and ongoing part of your standard practice, in which you consistently seek to understand other perspectives.
    • Challenge yourself. Use self-reflection to understand and challenge your own biases and internal barriers to learning from others.
    • Partner. Work to level the playing field by authentically partnering with youth and families. Acknowledge and try to mitigate the power differential between youth, families, and systems that represent authority and expertise.
    • Build on assets. Focus on youth and family assets and strengths. Acknowledge and work against systemic barriers to opportunity.

    The Role of Leaders

    Agency leaders can consider the following ways to embed cultural humility into practice through training, coaching, and organizational change:

    • Prioritize cultural humility by consulting with youth and families, addressing structural barriers, embedding practice into policy, and reallocating funds to make practice possible at the direct service level.
    • Engage youth, families, community partners, and staff in assessing the organizational environment, policies, procedures, knowledge, and skills in order to identify areas for growth.
    • Model and normalize cultural humility as an ongoing process as opposed to an outcome. Cultural humility assumes that you don't have—and never will have—all the answers.
    • Build relationships with staff, community partners, youth, and families that are respectful, authentic, and reciprocal and that strive to proactively address power differentials. Expect and empower staff to do the same.
    • Provide professional development, coaching opportunities, and incentives for staff to develop an understanding of institutional racism, intersectional identities, implicit and systemic bias, and how dominant cultural values shape social norms.
    • Work in teams and one-on-one to build and strengthen cultural humility in practice through role plays, open-ended questions, and activities designed to prompt self-reflection and critical thinking.

    Moving Forward

    As a field, we are called toward better outcomes for the children, youth, and families we serve. Understanding and reckoning with the child welfare system's roots and its role in historical trauma is a necessary first step. Moving closer to an equitable system that strengthens families instead of separating them requires a new kind of partnership, built on the assumption that youth and families are experts in themselves. Organizations committed to changing outcomes are considering different ways of doing business and dedicating concrete resources and time to embed cultural humility into agency norms, values, and practice.

    References

    Fisher-Borne, M., Cain, J. M., & Martin, S. L. (2015). From mastery to accountability: Cultural humility as an alternative to cultural competence. Social Work Education, 34(2), 165-181. http://dx.doi.org/10.1080/02615479.2014.977244

    National Child Welfare Workforce Institute. (2019). Cultural humility practice principles. https://ncwwi.org/index.php/resourcemenu/resource-library/inclusivity-racial-equity/cultural-responsiveness/1415-cultural-humility-practice-principles/file

    Ortega, R. M., & Faller, K. C. (2011). Training child welfare workers from an intersectional cultural humility perspective: A paradigm shift. Child Welfare 90(5), 27-49.

    Roberts, D. (2002). Shattered bonds: The color of child welfare. New York: Civitas Books.
     

  • Trust-Based Relational Intervention Offers Trauma-Informed Approach to Meet Children's Needs

    Trust-Based Relational Intervention Offers Trauma-Informed Approach to Meet Children's Needs

    Trust-based relational intervention (TBRI) is an attachment-based, trauma-informed intervention designed to meet the needs of children who have experienced trauma, toxic stress, or other hardships.

    These children have had experiences that make it difficult for them to trust the adults in their lives. TBRI provides parents, caregivers, and others who work with children tools to build that trust and help them thrive and that can be used to address a wide range of childhood behavioral problems, especially in cases where other interventions have failed.

    TBRI is based on years of neurodevelopmental research and uses three main principles:

    • Empowering principles for physical needs
    • Connecting principles for attachment needs
    • Correcting principles for addressing fear-based behaviors

    The Karyn Purvis Institute of Child Development offers TBRI practitioner training for child welfare professionals, including four training sessions in 2021. This training is divided into two phases:

    • Phase 1: Conducted through an online platform, this phase is designed to introduce participants to TBRI and includes nine units of coursework and an interpersonal interview in the 10 weeks prior to the live portion of TBRI training (phase 2). 
    • Phase 2: This phase includes 5 days of live, intensive training that focuses on the application and implementation of TBRI.

    Participants who successfully complete both phases are recognized as TBRI practitioners. Continuing education credits are also awarded upon completion of the training.

    More information is available on the institute's website.  

     

Resources

This section of CBX 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.

  • CDC Resource Addresses Pandemic-Related Youth Mental Health Challenges

    CDC Resource Addresses Pandemic-Related Youth Mental Health Challenges

    Few in the world have been untouched in some way by the coronavirus; it is undiscriminating, affecting people of all ages, races, nationalities, and strata. While its impact has been quite visible through the news media and the restructuring of family, work, and school life across the globe, less visible are the mental health effects the pandemic has had on individuals, particularly children, youth, and young adults. Recognizing the social, emotional, and mental health challenges facing this young population, the Centers for Disease Control and Prevention (CDC) developed a resource kit for parents, caregivers, and other adults to support their efforts to identify and respond to these challenges and ensure the well-being of the young people in their lives. This toolkit is also beneficial for those caring for and working with families involved with child welfare, as these families are already experiencing increased stress and trauma made worse by the loss of face-to-face supports, meaningful family visits, and school and work adjustments.

    Resources are organized by age—early childhood (0-5 years), childhood (6-12 years), adolescence (13-17 years), and young adulthood (18-24 years)—and include information on the challenges associated with changes in routine, breaks in continuity of learning and health care, missed significant life events, and loss of security and safety as well as steps and guidance adults can take to help. The kit also provides a tabbed list of related resources, including an activity book and board game for children, conversation starters, social media graphics, and a Get Immediate Help section with links and phone numbers to a variety of support services.

    To learn more, access the COVID-19 Parental Resource Kit: Ensuring Children and Young People's Social, Emotional, and Mental Well-Being, available in a variety of languages, on the CDC website.

     

  • Talking to Youth About Human Trafficking

    Talking to Youth About Human Trafficking

    A new guide seeks to educate caregivers and youth-serving adults on the exploitation and human trafficking of youth with the goal of enabling them to effectively reach and protect a vulnerable young population. The guide, released by the Blue Campaign, a national public awareness campaign that works closely with the U.S. Department of Homeland Security to detect and combat human trafficking, contains information intended for use with middle school- and high school-aged youth.

    Content is thorough, yet concise, and is organized in a digestible topical format. Sections discuss what human trafficking is; how to recognize it, including the physical, behavioral, and social indicators; the associated risk and protective factors; tips for talking to youth about exploitation; and how to report suspected human trafficking. Youth may particularly connect with the section that presents fictional, relatable examples of human trafficking that include scenarios such as youth desiring to fit in and those with too much freedom. The information is adaptable and can be easily used by adults in virtually any youth setting or program, such as classrooms, camps and clubs, community- or faith-based programs, and sports leagues.

    The Blue Campaign was created to educate the public, law enforcement, and other community partners to recognize and respond to possible cases of human trafficking. Children and youth involved with child welfare are especially vulnerable to this type of maltreatment, so this guide is also beneficial for child welfare professionals. How to Talk to Youth About Human Trafficking: A Guide for Youth Caretakers and Individuals Working With Youth and additional campaign publications and awareness materials are available on the Blue Campaign website.
     

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.

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