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Dec/Jan 2011Vol. 11, No. 10Spotlight on In-Home Services

This month, CBX spotlights in-home services, which refer to all the services provided in the home and elsewhere that support families with children living at home. In-home services include early prevention services as well as postreunification services. Read about the new National Resource Center and about promising practices in in-home services.

Issue Spotlight

  • Strengthening Families Initiative in Texas

    Strengthening Families Initiative in Texas

    In January 2008, the Texas Department of Family and Protective Services (DFPS) began implementing the Strengthening Families Initiative (SFI), an in-home services program designed for families with neglect issues arising from poverty. The goal of the SFI is to prevent removals of children from their homes or, when removals are necessary, to speed the children's reunification with their families. Caseworkers provide participating families with frequent visits, targeted assessments, and program funds allocated for family enhancement (e.g., concrete items such as groceries) and family empowerment goods and services (e.g., educational enrichment). 

    Since the program's 2008 launch, 1,438 families have received SFI services in 24 counties, and the Texas DFPS has published two reports on the project. The original report assesses the success of the program's implementation, and the update focuses on the outcomes associated with program participation. The implementation report, published in September 2008, highlights how DFPS addressed issues with low program participation rates. The impact evaluation, published in December 2009, compares program participants with similar families receiving other in-home services, on a series of foster care entry and recurrence outcomes. Results indicate that removal rates from SFI family preservation cases were lower than traditionally served cases. However, analyses for the family reunification stage of service indicate that the percentages of SFI and non-SFI children who exited care were not different. A more comprehensive evaluation is ongoing. 

    Find the original implementation report, Strengthening Families Through Enhanced In-Home Support in Child Protective Services: Preliminary Evaluation: Implementation: 

    www.dfps.state.tx.us/documents/Child_Protection/pdf/2008-09-01_StrengtheningFamilies.pdf (262 KB)
     
    Link to the report update, Strengthening Families Through Enhanced In-Home Support in Child Protective Services: Status Update:

    www.dfps.state.tx.us/documents/about/pdf/2009-12-15_SFI_Report.pdf (203 KB)

  • Family Preservation Services in New Jersey

    Family Preservation Services in New Jersey

    The Rutgers School of Social Work's Institute for Families has published a brief on the significant role that family preservation services (FPS) play in keeping New Jersey children safe in their own families. Family Preservation Services: An Essential Partner in the Public Child Welfare System describes the history, evaluation, components, and utilization of FPS by the New Jersey Division of Youth and Family Services (DYFS) over the last several decades.

    In 2003, New Jersey's public child welfare system transformed its approach to addressing family problems and, by 2007, DYFS had adopted a new case practice model to change the way they engaged families. The Institute for Families, which had been providing training on FPS, was engaged to also provide training to DYFS staff in this new case practice model. In 2008, the Institute evaluated and revamped the FPS training materials, with the goal of promoting a specific approach to working with families that included:

    • An ecological orientation to problem definition and target of intervention
    • Family systems focus instead of child-only focus
    • Promoting problem-solving capacities instead of problem-only approach
    • Focusing on family-identified needs rather than professionally identified needs
    • Strengthening the family's social network support

    Analysis of data on the provision of FPS to 963 New Jersey families in 2009 indicated that, 1 year after FPS ended, 91 percent of children were still in their homes, and parents were generally satisfied with FPS.

    To read the full brief, by Kerrie Ocasio, David Williams, Katharine M. Bergacs, and Hasan Johnson, visit:

    socialwork.rutgers.edu/Libraries/IFF_Docs/FPS_June_2010_6_pages.sflb.ashx

  • Nurse-Family Partnership Program in Spokane

    Nurse-Family Partnership Program in Spokane

    To improve pregnancy outcomes, child health and development, and economic outcomes for children and families, Nurse-Family Partnership (NFP), an evidence-based home visitation program, uses trained nurses to visit and assist first-time mothers during and after pregnancy. One benefit of NFP is that it can reduce child maltreatment among families served. In 2007, the Spokane Regional Health District, in partnership with Catholic Charities of Spokane, the Spokane Child Abuse Network, and Washington State University, received a grant from the Children's Bureau to test the effectiveness of pairing an NFP program with evidence-based relationship and fathering curricula.

    The grant, named Summer's Project in honor of a 4-year-old girl from Spokane who died as a result of severe child abuse, serves first-time mothers in a community facing high rates of poverty and child maltreatment. Summer's Project finds potential clients, who can be no more than 28 weeks pregnant when starting the program, through a broad referral network, including schools, WIC, and medical clinics. The women and families can receive NFP services without participating in the research study, but they can also opt into the study and receive additional services. Women in the study are randomly placed into one of four groups:

    • Receiving NFP services only
    • Receiving NFP services and the fathering curriculum
    • Receiving NFP services and the relationship curriculum
    • Receiving NFP services and the fathering and relationship curricula

    Using the NFP curriculum, eight NFP-trained registered nurses visit the families' homes once or twice per week prior to the birth and then every other week until the child is 2 years old. The optional curricula also are based on evidence-based programs (Conscious Fathering, Nurturing Fathers, Within My Reach, and Within Our Reach). The fathering curricula, provided only to families in which the father is present or involved with the child, focus on infant care, the importance of fathers, and the father's relationship with the child. The relationship curricula, adapted for the mother's relationship status, focus on topics such as conflict resolution and communication.

    Summer's Project is a highly sought-after program in Spokane. It received 353 referrals this year, but its maximum capacity is 200 clients. Twenty-five clients have completed the project (i.e., participated from pre-birth through the child's second year), and 17 more are expected to complete it by the end of the year. Approximately 80 percent of clients remain with the nurse, and project staff noted that once families develop a relationship with the project, they tend to remain. In satisfaction surveys, clients have rated the services an average of 4.8 out of 5 on all questions.

    Below are several other preliminary observations and findings from the project:

    • The project initially had difficulty getting clients to participate in the optional fathering and relationship curricula. To increase participation, the project adapted and provided the curricula in clients' homes, which worked well. The clients later indicated that one reason for not attending the classes was that they did not want to discuss their issues in a group environment.
    • Preliminary data collected from clients after 12 months of services indicate that those who received optional curricula appear to be faring better than those receiving only NFP services. Project staff are trying to determine what may have caused the better outcomes: the curricula themselves; the additional, individual attention the clients are receiving; or other factors.
    • Participating families face a myriad of other issues. Approximately two-thirds of the mothers have unmet mental health needs. The families also have higher rates of domestic violence than other NFP sites, with the mother being the primary perpetrator in many cases. Additionally, the mothers have high rates of substance abuse, but the project has been successful at reducing smoking rates while pregnant.
    • The project staff also noted the importance of collaboration and community support for the success of Summer's Project.

    For more information about the project, contact Susan Schultz at SSCHULTZ@spokanecounty.org or Elaine Conley at ECONLEY@spokanecounty.org.

    Many thanks to Susan Schultz and Elaine Conley of the Spokane Regional Health District for providing the information for this article.
     

  • Families' Views on Intensive In-Home Services

    Families' Views on Intensive In-Home Services

    Understanding how families view the services they receive is an important component of assessing program effectiveness. A study in Arizona explored whether families perceived they were stronger after receiving in-home services. The results of the study, which used a mixed-methods concurrent triangulation design and included 103 interviews with 53 families, were published in a recent article in Children and Youth Services Review.

    Most families (75 percent) reported feeling stronger after receiving the in-home services, and 82 percent of those families credited their success to having received the services. Families identified improvements in parenting, communication and relationships, insight, and progress with addiction and substance abuse issues. Additionally, families believed that a combination of quality services and family strengths yielded the strongest results. When asked to comment about the services they received, some families stated that the parent aids providing the services lacked experience and knowledge and that they hoped for increased professionalism from the service providers, including case managers, counselors, and parent aids. The author suggests that in-home services programs may need to improve their training and supervision to help address these issues.

    The article, "Examining Families' Perceptions of Intensive In-Home Services: A Mixed Methods Study," by Cynthia A. Lietz, was published in Children and Youth Services Review, Vol. 31, and is available for purchase online:

    http://dx.doi.org/doi:10.1016/j.childyouth.2009.06.007

  • The National Resource Center for In-Home Services

    The National Resource Center for In-Home Services

    Funded in 2009, the Children's Bureau's National Resource Center for In-Home Services (NRCinhome) serves as a knowledge center for promising practices that can help children remain safely in their homes when families are at risk of involvement or actually involved with the child welfare system. With States and Tribes as its target audience, the NRCinhome conducts research and collects and disseminates information and provides training and technical assistance (T&TA) on the best approaches and services for stabilizing families and keeping children safely at home. In this case, "in-home services" refers to resources and services—provided in the home and elsewhere—that can support families with children living at home. The families include both those in which children are at risk of placement, as well as families that have reunified after the children have spent time in foster care.

    While there is a general consensus that most children fare better in their own homes, child welfare agencies are often challenged by how to best support families in order to keep children safely at home. The first round of the Child and Family Services Reviews (CFSRs) pointed out some of the safety challenges that States faced in providing services to families with children at home. Only six States met the Federal criteria for CFSR Safety Outcome 2 (children are safely maintained in their homes when possible). In Round 2 of the CFSRs, analysis of the first 32 States' final reports showed that States' performance on all outcomes was consistently stronger for foster care cases than for in-home cases. 

    Keeping these findings in mind, the NRCinhome aims to fill the knowledge gap regarding effective in-home services. In its first year of operation, the NRC has begun a nationwide assessment of in-home services promising practices. The project includes a literature search that has produced a database of more than one thousand relevant items, an assessment of CFSR final reports to determine what higher-performing States are doing and how they are integrating evidence-based practice into their service delivery approach, and interviews with program managers from States with promising practices.

    In addition to this extensive assessment, the NRC has begun or accomplished a number of other projects, including:

    • Convening a national advisory board of in-home services experts
    • Hosting a national meeting of State Promoting Safe and Stable Families program administrators
    • Conducting outreach to Tribes and the new NRC4Tribes
    • Identifying constituents in order to begin to build a peer network

    The NRCinhome has already been called upon to provide various kinds of TA, including informational TA, webinars, onsite TA, and group and offsite TA. Two States have requested that the NRC review their current in-home services against evidence-based practices to help them determine how they can improve. The NRC also is working with two Children's Bureau Regional Implementation Centers to (1) assist Tennessee in strengthening in-home services and (2) help the State of Alaska and 16 Native Alaskan Tribes reduce the disproportionate number of Native Alaskan children in foster care by strengthening in-home services for Tribes.

    All of this activity has started to define and even help fill the knowledge gap around in-home services. For instance, the NRC can point to the lack of a defined in-home services practice as a major barrier for States that want to enhance and document their in-home services. States also need to reach out to their community-based services partners, adapt and integrate evidence-based practices into their model, improve their safety management, enhance the quality of worker visits, increase their cultural competence, and strengthen their documentation—all practices that may contribute to quality in-home services.

    The NRC plans to help States and Tribes integrate and enhance these services so that families are strengthened and more children can remain safely with their families.

    Underpinning the NRCinhome efforts is a strong partnership led by the University of Iowa School of Social Work. The other NRC partners are ICF International and the National Indian Child Welfare Association. This diverse group includes staff from all over the country with extensive backgrounds in child welfare practice and research.

    For more information on the NRCinhome, contact Lisa D'Aunno, Project Director: lisa-daunno@uiowa.edu

    Or visit the NRCinhome website: www.nrcinhome.socialwork.uiowa.edu 

    Many thanks to Lisa D'Aunno, who provided the information for this article.

  • Safety Management in In-Home Services

    Safety Management in In-Home Services

    In-home safety management is a viable option to foster care placement for many families that become involved in the child welfare system, according to an article from ACTION for Child Protection. In-home safety management services are based on the least intrusive approach to intervention that will ensure a child's safety. ACTION for Child Protection conducted a number of case reviews that show the following common issues that child protection agencies face as they revamp their in-home services programs:

    • Clarity about defining an in-home services safety plan
    • Low use of in-home services as an option to manage impending danger
    • Distinguishing between in-home safety services and treatment services
    • Parental compliance with in-home services safety plans
    • Predisposition by CPS staff to remove children
    • The lack of in-home safety services

    The article concludes with a model of an in-home services safety plan adapted from a real case. The plan specified who would serve as safety providers, each safety provider's relationship to the family, their capacity to protect, and where and when they would provide safety services. Elements that contributed to the plan's success included the following:

    • The caseworker included the caregivers in deciding who participated in the plan to ensure the children's safety.
    • There was a good rapport among the caregivers and the caseworker.
    • The plan covered times when danger to the children was most likely to occur.
    • The plan included community members such as a teacher and church friends as safety providers.

    To read In-Home Services as Safety Management, visit the ACTION for Child Protection website:

    www.actionchildprotection.org/documents/2009/pdf/June_June_2009_In_Home_Services_for_Safety_Management_edited.pdf (94 KB)

  • Intensive In-Home Family Treatment

    Intensive In-Home Family Treatment

    The goal of family preservation programs is to improve family functioning so that children can remain safely at home. A recent journal article describes an intensive in-home family treatment program (IFT) in Missouri that contributed to the prevention of out-of-home placements. Some key aspects of the 4- to 6-week intervention program included:

    • Voluntary participation
    • Counseling delivered in the home
    • Availability of services 24/7
    • Treatment directed at resolving the specific crisis issue of abuse/neglect

    The Missouri Family Functioning Assessment was administered before and after the intervention to measure family functioning in the following areas:

    • Family environment
    • Family social support
    • Family interactions
    • Parent/caregiver's well-being
    • Child's well-being

    The IFT process provided specific criteria for successful completion of each week of treatment. Goals focused on engaging the family in identifying problematic behaviors, teaching effective parenting skills, assessing family needs, and facilitating access to community-level resources. Based on evaluation results for 123 families and their 217 children, IFT services positively impacted family functioning in all five domains of family intervention and would likely prevent the removal of a child from the home.

    "Evaluation of an Intensive In-Home Family Treatment Program to Prevent Out-of-Home Placement," by Sabrina Tyuse, Philip Hong, and John Stretch, appears in the Journal of Evidence-Based Social Work, Vol. 7, and is available for purchase through the website:

    www.informaworld.com/smpp/content~db=all~content=a922756116~frm=titlelink

  • Evidence-Based Home Visitation in Rochester

    Evidence-Based Home Visitation in Rochester

    Evidence-based home visitation (EBHV) has become an increasingly important model of improving families' outcomes in numerous areas, including child maltreatment, school readiness, self-sufficiency, and overall health. In 2008, the Children's Bureau awarded 17 cooperative agreements to implement EBHV programs. The Society for the Protection and Care of Children (SPCC), in Rochester, NY, received an award to study an integrated approach to EBHV that combines home-visiting programs with other services.

    SPCC, in partnership with Mt. Hope Family Center, the University of Rochester Medical Center Social Work and Pediatrics Departments, the Monroe County Departments of Human Services and Public Health, and the United Way, is just beginning its program to serve low-income, young mothers through two home-visiting programs: Nurse-Family Partnership (NFP) and Parents as Teachers (PAT). Pregnant teens eligible for NFP services will be encouraged to enroll in that program, and, based on the needs identified by experienced NFP nurses, they will also receive the following additional services: 

    • Child Parent Psychotherapy (CPP) to address parent-child attachment
    • Interpersonal Psychotherapy (IPT) to address maternal depression
    • Incredible Years for group-based parent education

    To determine if receiving the additional services has a significant impact, the project will compare outcomes for NFP participants receiving additional supports to previous NFP participants who did not have access to these additional services. (The project is awaiting approval from its institutional review board, the NFP National Service Office, and the Children's Bureau before enrolling families into the NFP component of the project.)

    Families not meeting the eligibility criteria for NFP will receive PAT home visitation, which is provided by social workers. For families receiving PAT home visitation, the project will evaluate the impact of receiving the additional CPP, IPT, and Incredible Years services in conjunction with the home visitation. Currently, a pediatric social worker randomly assigns these families into a treatment group that receives PAT services paired, when needed, with the additional services, or a comparison group that receives referrals to other community-based services. PAT services may also be made available to mothers who graduate from the NFP program and are in need of aftercare services.

    Another project goal is to establish a comprehensive, coordinated infrastructure in the community that supports EBHV. A critical aspect of this has been helping professionals from different backgrounds and disciplines, such as social workers, nurses, therapists, medical professionals, outreach workers, and local funders, to understand and value each partner's expertise within the project and to incorporate that knowledge into their practice. Laurie Valentine, the project director, noted, "Reaching that level of understanding was a noteworthy accomplishment in and of itself."

    Project staff are working closely with the medical community, especially pediatricians and obstetricians, to improve their awareness of EBHV, the range of services available, how to refer families, the best methods for sharing information on enrolled families, and strategies for integrating preventive health care with EBHV. The project based a social worker at the University of Rochester's Strong Pediatric Clinic, which has the largest pediatric practice in Monroe County, to review medical records, conduct assessments, make referrals, and document family participation. Additionally, when project staff realized that there was a shortage of community mental health services that effectively engaged the target population, Mt. Hope Family Center modified the CPP and IPT approaches to become more teen-friendly. Since the modifications, teen parents with mental health concerns are more likely to engage in and follow through with evidence-based mental health treatment. 

    The project's services and systems work have yielded promising results thus far, enrolling 303 families in the PAT branch, with 170 families in the treatment group. The mothers receiving enhanced services have made significant progress toward educational and career goals (e.g., enrolling in or completing high school or GED programs and obtaining employment) and have demonstrated reductions in parenting stress and depression as well as increases in parenting knowledge.

    For more information about the project, contact Laurie Valentine at lvalentine@spcc-roch.org.

    Many thanks to Laurie Valentine of SPCC for providing the information for this article.
     

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News From the Children's Bureau

Find links to the latest Children's Bureau and other Federal child welfare news, including the new adoption ad campaign, reports on Family Connections grantees, the latest from the T&TA Network, and more.

  • Updates From the T&TA Network

    Updates From the T&TA Network

    The Children's Bureau Training and Technical Assistance (T&TA) Network continues to produce resources that can help States and Tribes in their work with children and families. Some recent resources are listed below:

    • Child Welfare Information Gateway's Educators' Toolkit won a Silver Galaxy Award in the Educational category. The award signifies a product that has synthesized disciplines to create excellence in marketing. See the toolkit:
      http://www.childwelfare.gov/edtoolkit
      Information Gateway recently launched a new Related Organizations List, Kinship/Relative Care:
      http://www.childwelfare.gov/pubs/reslist/rl_dsp.cfm?subjID=238&rate_chno=W-00061
      Information Gateway recently launched a new web section on Evidence-Based Practice:
      http://www.childwelfare.gov/management/practice_improvement/evidence/index.cfm

    • The National Child Welfare Resource Center for Organizational Improvement (NRCOI) has released the fall issue of Child Welfare Matters, with a focus on "Taking Action: Keys to Using Data and Information." The issue highlights the use of quality improvement results with examples, insights, and stories of action drawn from several States with strong child welfare quality improvement systems. http://www.nrcoi.org/rcpdfs/cwmatters10.pdf (681 KB)

    • The National Data Archive on Child Abuse and Neglect (NDACAN) has produced its fall NDACAN Updata newsletter, which lists newly archived Federal data, two launches of collections of citations, forthcoming datasets, and a call to data users for citations.
      http://www.ndacan.cornell.edu 

    • The National Quality Improvement Center on Differential Response in Child Protective Services has announced a "Request for Applications for Doctoral Dissertation Support." Four doctoral students whose proposals are approved will each receive $25,000 a year for up to 2 years to support their research as it applies to differential response. For applications received by January 14, 2011, awards will be announced on March 15, 2010.
      http://www.differentialresponseQIC.org

    • The National Quality Improvement Center on Non-Resident Fathers and the Child Welfare System has posted several PowerPoint presentations from the October 2010 conference in Seattle, WA. The presentations focus on spreading the message of father involvement. In particular, "Engaging Fathers in Child Welfare Proceedings" includes charts and data on the effects of father absence in costs and benefits. Access the presentations from this resource page:
      http://www.fatherhoodqic.org/nrf_lesson_1_slides.ppt

    • The National Resource Center for Child Protective Services (NRCCPS) has posted its fall issue of Citizen Connections, a newsletter for and about State Citizen Review Panels (CRPs). In this issue are updates on CRP accomplishments in States such as Minnesota, South Carolina, and more. Find all of the newsletter issues on the NRCCPS website:
      http://nrccps.org/?s=%22Citizen+Connections%2C+%22

    • The National Resource Center for Child Welfare Data and Technology (NRC-CWDT) has added a subgroup to its group blog site for State data managers. The subgroup is for any State employee who works with a State automated child welfare information system, Federal data systems, or the National Youth in Transition Database, or who is an information technology director, analyst, report programmer, or program manager. The site publishes State-only discussions, announcements, and alerts. The site also has a subgroup for discussing Tribal child welfare data implementation and case management systems. Access the groups at this site:
      http://nrccwdt.groupsite.com/main/summary

    • The National Resource Center for Permanency and Family Connections (NRCPFC) has compiled several resources on parent and family leadership on its website. The collection includes successful strategies, legal issues, family engagement strategies documented in CFSRs, and more.
      http://www.hunter.cuny.edu/socwork/nrcfcpp/info_services/family-leadership-and-perspectives.html
      The NRCPFC also has published an information packet, "LGBT Foster and Adoptive Parenting," to help those working with lesbian, gay, bixsexual, and transgender (LGBT) foster and adoptive parents. It also includes a list of online resources. Download the packet here:
      http://www.hunter.cuny.edu/socwork/nrcfcpp/info_services/download/TSudol_LGBT%20Issues_InfoPacket.pdf (381 KB)

    • The National Resource Center for Recruitment and Retention of Foster and Adoptive Parents at AdoptUsKids offers a new PowerPoint on its website, "Barriers and Success Factors in Adoption From Foster Care: Perspectives of Lesbian and Gay Families." This presentation is a follow-up to the NRC's 2008 report that provided perspectives of family and staff. Find the new presentation on the NRC's website:
      http://www.adoptuskids.org/images/resourceCenter/LGBT-Barriers-and-Success-Factors-in-Adoption.pdf (279 KB)

    • The National Resource Center on Community-Based Child Abuse Prevention (FRIENDS) has added "Home Visitor Safety Training" to its website, developed by the Oklahoma State Department of Health. The training consists of a Safety Guideline Manual for Home Visitors and seven video segments.
      http://friendsnrc.org/cbcap-priority-areas/home-visitation/oklahoma-home-visitor-training 

    • The National Technical Assistance and Evaluation Center for Systems of Care (NTAEC) has posted its first series of webinars. Topics include:
      • Understanding Systems and Organizational Change
      • Developing the Infrastructure for a System of Care
      • Meaningful Family Involvement: Beyond the Case Plan
      Access the dialogues, transcripts, and slides from this link:
      http://www.uta.edu/mpcwic/wp-content/uploads/SOC-Webinars_Save-the-Date.pdf
  • New! On the Children's Bureau Site

    New! On the Children's Bureau Site

    The Children's Bureau website carries information on child welfare programs, funding, monitoring, training and technical assistance, laws, statistics, research, Federal reporting, and much more. The "New on Site" section includes grant announcements, policy announcements, agency information, and recently released publications.

    Recent additions to the site include:

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

  • Children's Bureau Express Wins Marcom Award

    Children's Bureau Express Wins Marcom Award

    The Association of Marketing and Communication Professionals recently awarded a gold Marcom Award to Children's Bureau Express in the electronic newsletter category. MarCom Awards is an international competition for marketing and communication professionals involved in the concept, writing, and design of marketing and communication programs and print, visual, and audio materials. Each year, more than 5,000 entries are judged in a variety of categories.

  • Evaluating the Effectiveness of Family Connections

    Evaluating the Effectiveness of Family Connections

    Family Connections (FC) is a multifaceted program that works with at-risk families in their homes to prevent child abuse and neglect. Piloted in 1996, the program showed such promising results that a replication was designed and sponsored by the Children's Bureau's Office on Child Abuse and Neglect (OCAN) with 5-year cooperative agreements at three sites. A recent special issue of the journal Protecting Children profiles lessons learned from these replication projects.

    Nine practice principles guide FC interventions: community outreach, individualized family assessment, tailored interventions, helping alliances, empowerment approaches, a strengths-based perspective, cultural competence, developmental appropriateness, and outcome-driven service plans. Individualized intervention is designed to increase protective factors (e.g., social support) and decrease risk factors (e.g., parental depressive symptoms) associated with child maltreatment.

    The core components of the FC Demonstration Program included (1) emergency assistance, (2) home-visiting family intervention, (3) advocacy and service coordination, and (4) multifamily supportive and recreational activities. Families were assigned to receive the same core services, but for different lengths of time (3 versus 9 months).

    The eight Protecting Children articles present outcomes from the replication sites and some overall analyses. Topics discussed in the articles include:

    • Cultural adaptations to FC for Cambodian refugee and Korean immigrant population groups
    • Clinical and programmatic processes associated with a helping alliance that were used by counselors to achieve a high level of engagement and successful outcomes with a high-risk family
    • Client characteristics and service use measures predicting families' successful completion of services
    • Implementation of therapeutic assessment as a technique to help high-risk families and as an avenue to collect data on program performance in a community-based mental health setting
    • Modifications made to FC to address the needs of grandparent families
    • The importance of involving and engaging program staff, including direct practice staff, in cost analyses
    • Methods for conducting rigorous programmatic cost analyses

    Protecting Children is published by American Humane. This issue (Volume 24, Issue 3) is available for free download on the website:

    http://www.americanhumane.org/assets/pdfs/children/protecting-children-journal/pc-24-3.pdf (1,720 KB)

    Related Item

    Children's Bureau Express last wrote about the Family Connections grantees in "Replicating Effective Prevention: Children's Bureau Grantees" (April 2009).

  • U.S. Signs Child Protection Convention

    U.S. Signs Child Protection Convention

    On October 22, 2010, the U.S. Ambassador to The Hague signed the Convention on Jurisdiction, Applicable Law, Recognition, Enforcement and Co-operation in Respect of Parental Responsibility and Measures for the Protection of Children, on behalf of the United States.

    This Convention contains a number of benefits for children and families. It provides for foreign recognition and enforcement of custody and visitation orders, thereby strengthening the Hague Convention on the Civil Aspects of International Child Abduction. It also includes provisions relating to runaway children and the cross-border placement of children in a foster family or institutional care.

    Secretary of State Hillary Clinton commented that the signing, ".  .  .  reaffirms the deep commitment of the United States to protecting the rights and welfare of children around the world."

    To read Secretary Clinton's full Statement, visit the Department of State website:

    www.state.gov/secretary/rm/2010/10/149860.htm

    To read the full text of the Convention, visit the website of the Hague Conference on International Law:

    http://hcch.e-vision.nl/index_en.php?act=conventions.text&cid=70

  • New PSAs Spotlight Adoption of Siblings

    New PSAs Spotlight Adoption of Siblings

    The Ad Council, in cooperation with the Children's Bureau and AdoptUsKids, recently unveiled its newest media campaign to raise awareness of adoption from foster care. These new public service announcements (PSAs) in the form of television commercials, print ads, and radio spots use gentle humor to promote the adoption of one of the most difficult groups to place—brothers and sisters.

    Research increasingly points to the importance of the connection that siblings share, a connection that is even more crucial to children in foster care, whose other family connections may be lost or tenuous at best. Siblings offer a lifelong connection to family, and child welfare best practice mandates that siblings be placed together in both foster care and adoptive homes, under most circumstances. The barrier to this best practice is the lack of adoptive families who are able or willing to take a sibling group.

    The new PSAs are designed to let the public know about the need for families for brothers and sisters. Building on the successful theme of "You don't have to be perfect to be a perfect parent," the campaign adds the tagline, "There are thousands of siblings in foster care who'll take you as you are." Commercials show parents struggling to make experiences, such as camping, "perfect" for their children, but when the perfect experience is rained out or otherwise falls flat, the children still love it. The ads drive home the message that children—brothers and sisters—need parents who care about them.

    Find the PSAs on the Ad Council website:

    www.adcouncil.org/default.aspx?id=17

    Visit the AdoptUsKids website for more information on using the media to promote adoption:

    http://adoptuskids.org/adoption-and-foster-care-advocacy/media 

    National Adoption Month is a coordinated effort by the Children's Bureau, Child Welfare Information Gateway, and AdoptUsKids. Visit the website to learn more:

    www.childwelfare.gov/adoption/nam/index.cfm
     

Child Welfare Research

Child welfare news includes two research reports on children in foster care: one on the use of psychotropic drugs and another on identifying social-emotional problems. Other articles look at a new practice model and updated outcomes for children of unmarried parents.

  • Social-Emotional Problems in Children in Foster Care

    Social-Emotional Problems in Children in Foster Care

    Many children and youth in foster care exhibit social-emotional problems due to childhood trauma and unmet mental health care needs. In an effort to improve screening for social-emotional problems, researchers at the University of Rochester Medical Center and Starlight Pediatrics, a pediatric medical home practice for foster children with special health care needs, conducted a retrospective study of young children. The results were recently published in The Journal of Child Psychology and Psychiatry.

    The researchers attempted to determine:

    • Whether the systematic use of an objective social-emotional screening tool improves the detection rate of social-emotional problems in foster children, compared to reliance on subjective clinical judgment
    • The relative effectiveness of two validated tools for detecting social-emotional problems
    • The patterns of social-emotional problems among children in foster care

    Researchers reviewed the medical charts of children in foster care between the ages of 6 months and 5 and a half years. At baseline, children were assessed for social-emotional problems by pediatricians relying on their clinical judgment. Later, the Ages and Stages Questionnaire (ASQ), which identifies general developmental delays, and the more specific Ages and Stages Questionnaire: Social Emotional (ASQ-SE) were used for screening. Results show that:

    • A validated mental health screening tool significantly increased the detection of potential social-emotional problems in foster care children when compared to diagnoses based on practitioner surveillance alone.
    • The more specific ASQ-SE detected more children at risk for mental health problems than did the more general ASQ.
    • Toddlers and preschoolers presented with more social-emotional problems than infants, and the prevalence of these problems appeared to increase with age.

    Despite initial assumptions, there was no difference in the detection rate of social-emotional problems for children new to the foster care system and those who had been in foster care for longer time periods.

    "Identification of Social-Emotional Problems Among Young Children in Foster Care," by Sandra H. Jee et al., was published in The Journal of Child Psychology and Psychiatry and is available for purchase online:

    http://onlinelibrary.wiley.com/doi/10.1111/j.1469-7610.2010.02315.x/abstract

  • Fragile Families Research Update

    Fragile Families Research Update

    The rate of out-of-wedlock births continues to rise, with statistics from the Centers for Disease Control and Prevention showing that 39.7 percent of U.S. children born in 2007 were born to single mothers. Along with the rise in single parenthood, there have been a number of research studies linking nonmarital childbearing to poorer outcomes for children. One of the most comprehensive, the Fragile Families and Child Wellbeing Study (FFCWS), began in 1998 by tracking 5,000 newborns. Researchers have continued to track those children and their parents, and the latest articles on the FFCWS comprise a recent issue of The Future of Children journal.

    This journal includes both findings and recommendations on how to best support these children and families, which tend to be at-risk for a host of poor outcomes related to poverty, lack of education, incarceration, father absence, and more. The articles fall into three categories of topics:

    • Parents' relationships with each other and their children and how these change over time
    • The impact of the fragile family status on children's well-being
    • Policy implications

    The articles include:

    • "Parental Relationships in Fragile Families" by Sara McLanahan and Audrey N. Beck
    • "Mothers' Economic Conditions and Sources of Support in Fragile Families" by Ariel Kalil and Rebecca M. Ryan
    • "Capabilities and Contributions of Unwed Fathers" by Robert I. Lerman
    • "Fragile Families and Child Wellbeing" by Jane Waldfogel, Terry-Ann Craigie, and Jeanne Brooks-Gunn
    • "Race and Ethnicity in Fragile Families" by Robert A. Hummer and Erin R. Hamilton
    • "An Ounce of Prevention: Policy Prescriptions to Reduce the Prevalence of Fragile Families" by Isabel Sawhill, Adam Thomas, and Emily Monea
    • "Incarceration in Fragile Families" by Christopher Wildeman and Bruce Western
    • "Unmarried Parents in College" by Sara Goldrick-Rab and Kia Sorensen
    • "Marriage and Fatherhood Programs" by Phillip A. Cowan, Carolyn Pape Cowan, and Virginia Knox

    All of the articles can be downloaded free of charge on The Future of Children website:

    http://futureofchildren.org/futureofchildren/publications/journals/journal_details/index.xml?journalid=73

  • Evaluating Solution-Based Casework in Washington State

    Evaluating Solution-Based Casework in Washington State

    The Children's Administration of Washington State is implementing a new practice model, Solution-Based Casework (SBC), to improve outcomes for the children and families it serves. SBC is a family-centered approach to child welfare that focuses on engaging and involving families in the helping process and building on their strengths. The three basic goals of SBC are:

    • Form respectful partnerships between families and caseworkers
    • Focus on pragmatic everyday family life tasks
    • Develop case plans that are specific to risk and safety concerns

    The Children's Administration teamed with Partners for Our Children (POC) to evaluate the implementation and impact of SBC. POC staff collected data on the demographics and needs of families involved with child welfare in Washington State. The surveys showed that parents were more likely than caseworkers to report unmet needs, particularly basic needs like food, clothing, transportation, and housing.

    A major focus of POC's evaluation to date has been determining the factors that affect family engagement. POC researchers conducted online surveys of parent perceptions, caseworker beliefs and attitudes, caseworker practices, and supervisor perceptions. The following characteristics were identified as having a positive influence on family engagement:

    • Parent/family characteristics
      • Older age and single
      • Child in the home
      • Greater need for assistance and number of hardships
      • Fewer unmet basic needs and psychological or health needs
    • Caseworker characteristics
      • Younger age and female
      • Master's degree or greater
      • Fewer years in current position
    • Organizational characteristics
      • Smaller caseload sizes
      • Medium office size
      • Positive attitudes about engagement
      • Fewer perceived obstacles to using new approaches

    POC plans to use these baseline data and perform additional research to analyze family outcomes as SBC is fully implemented in the State. Find the most current reports from the SBC evaluation in the Knowledge Center on the POC website:

    www.partnersforourchildren.org/knowledge-center

  • Psychotropic Medication Oversight in Foster Care

    Psychotropic Medication Oversight in Foster Care

    According to the Tufts Clinical and Translational Science Institute, psychotropic medication use in youth has increased significantly over the past decade, with the rates of use much higher for youth in foster care (estimated between 13 and 52 percent) than for youth in the general population (4 percent). In an effort to address this trend, Tufts researchers surveyed key staff in State child welfare and affiliated agencies between March 2009 and January 2010 to gather current policies and guidelines on psychotropic medication use in foster care and examine challenges and innovative solutions implemented by States. The results are published in a new report, Multi-State Study on Psychotropic Medication Oversight in Foster Care.

    Of the 48 States that participated in the survey, 26 had written policy or guidelines on psychotropic medication use, and 13 were developing policy or guidelines. While most guidelines addressed all psychotropic medications and all youth in foster care, some focused on specific medications or certain age groups. The study examined the "red flags" States use to identify safety or quality of care concerns around psychotropic medication use and to initiate case reviews or additional oversight when necessary. The most common "red flags" were medication use in young children (up to 3-6 years of age), polypharmacy (multiple medications), and medication use and/or dosage levels inconsistent with recommendations.

    Based on States' survey responses, the report summarizes the components of a successful psychotropic medication oversight system:

    • Mechanisms to identify children needing psychotropic medication, including screening procedures, tools, and appropriate evaluator training
    • A specified decision-maker who renders an informed decision using active youth participation
    • Forms and procedures for documenting medication, rationale, informed consent, dose, response, and emerging side effects
    • A monitoring system for medication use of individual youth as well as population trends
    • Collaboration with youth-serving agencies and stakeholders

    The full report, by Laurel K. Leslie et al., is available on the Tufts website:

    http://160.109.101.132/icrhps/prodserv/docs/Executive_Report_09-07-10_348.pdf (283 KB)

    The Study Appendix lists State tools, related websites, and additional research and is also available online:

    http://160.109.101.132/icrhps/prodserv/docs/Study%20Appendix_FINAL.pdf (254 KB)

Strategies and Tools for Practice

CBX links you to useful tools for supporting LGBTQ youth and working with the courts to reduce overrepresentation of minority youth, and, for Tribes, some implications of Fostering Connections.

  • Tribal Title IV-E Data Collection and Reporting

    Tribal Title IV-E Data Collection and Reporting

    The Fostering Connections to Success and Increasing Adoptions Act of 2008 (P.L. 110-351) allows Tribes, Tribal organizations, and Tribal consortia to apply directly for title IV-E foster care and adoption assistance funds. The National Congress of American Indians (NCAI) National Policy Research Center recently published Key Considerations and Best Practices for Tribal Title IV-E Data Collection and Reporting to describe the Act's data collection and reporting components that affect Tribes and to provide guidance to Tribes on applying for funding. The paper includes feedback about current Tribal practices from surveys of 27 Tribes and interviews with eight Tribal program administrators.

    Challenges highlighted by nearly all the interviewees, included:

    • The high cost of creating a data management system
    • Lack of understanding about Federal requirements
    • Strained relationships with surrounding county and State programs

    The interviewees also provided planning recommendations that may be useful to Tribes that pursue direct funding:

    • Start small and focus on basic requirements when time and resources are limited.
    • Develop Tribal/State agreements that allow Tribes to provide IV-E services with IV-E funding from States.
    • Build upon existing internal data resources, such as IT staff and data systems for other agencies.

    The paper also outlines a strategic approach to funding and developing a data system.

    Key Considerations and Best Practices for Tribal Title IV-E Data Collection and Reporting was written by Erin Geary and Priscilla A. Day of the Center for Regional and Tribal Child Welfare Studies at the University of Minnesota Duluth. It is available on the NCAI Policy Research Center website:

    http://childwelfare.ncaiprc.org/documentlibrary/2010/04/Data%20Management%20Paper%20-%20Final.pdf (414 kb)

  • Toolkit for Supporting LGBTQ Youth in Care

    Toolkit for Supporting LGBTQ Youth in Care

    A new online toolkit provides information to ensure that lesbian, gay, bisexual, transgender, and questioning (LGBTQ) youth in the foster care system receive the support and services they need and deserve. Getting Down to Basics: Tools for Working With LGBTQ Youth in Care also offers guidance on a variety of issues that affect this population of young people and the organizations that serve them.

    Information is organized into topical areas, some of which are listed below:

    • Basic facts about being LGBTQ
    • Information for LGBTQ youth in care
    • Families supporting an LGBTQ child
    • Caseworkers with LGBTQ clients
    • Foster parents caring for LGBTQ youth
    • Attorneys, guardians ad litem, and advocates representing LGBTQ youth
    • Working with transgender youth
    • Basic LGBTQ policies, training, and services for agencies
    • Recommendations for training and education on LGBTQ issues
    • LGBTQ youth resources
    • Teaching LGBTQ competence in schools of social work

    In 2002, the Child Welfare League of America and Lambda Legal launched a Fostering Transitions partnership to positively affect the treatment of LGBTQ youth and adults in the nation's child welfare and juvenile justice systems. In addition to Getting Down to Basics: Tools to Support LGBTQ Youth in Care, this collaboration produced a number of other educational publications and advocacy tools.

    For more information and to order free copies of this toolkit, visit the Lambda Legal website:

    www.lambdalegal.org/take-action/tool-kits/getting-down-to-basics

    Related Item

    The U.S. Department of Health and Human Services (HHS) recently released a public service announcement video that shows the Secretary of HHS, Kathleen Sebelius, telling LGBT youth that "it gets better." The message is designed to support youth who are bullied because of their sexual orientation.

    Find the full press release on the HHS website: www.hhs.gov/news/press/2010pres/10/20101028b.html

    View the video message on the HHS YouTube page: www.youtube.com/watch?v=yXc-tc97XXA&feature=youtu.be

  • Judicial Strategies to Reduce Disproportionality

    Judicial Strategies to Reduce Disproportionality

    Research has demonstrated that children and families of color are disproportionately overrepresented in the child welfare system. Steps that judges can take to reduce disproportionality are the focus of a new technical assistance bulletin developed by the National Council of Juvenile and Family Court Judges (NCJFCJ). Right from the Start: The CCC Preliminary Protective Hearing Benchcard: A Tool for Judicial Decision-Making describes the development process, contents, and implementation of a benchcard designed to assist judges in asking the right questions when conducting preliminary hearings that decide the placement of children in dependency cases.

    The benchcard is built around two types of inquiry: internal and external. The internal inquiry contains questions designed to help judges examine potential biases that may affect their decisions. The external inquiry covers due process-related considerations as well as the actual judicial inquiry of hearing participants. Some of the determinations that should be made at hearings include:

    • Whether the Indian Child Welfare Act applies to the case
    • If the child has been removed from home, whether the agency met the legal threshold for removal
    • Whether reasonable efforts were made to prevent removal
    • If the child has been removed from home, whether anything prevents the child from immediately returning home
    • Whether the current out-of-home placement meets the needs of the child and family
    • Whether kinship care has been fully explored
    • Whether the placement is culturally and linguistically appropriate
    • What services, interventions, and supports would allow the child to safely return home

    The benchcard was developed as part of the Courts Catalyzing Change: Achieving Equity and Fairness in Foster Care (CCC) initiative. The CCC initiative is a project of NCJFCJ's Permanency Planning for Children Department as part of its Model Court national goal to reduce disproportionality and disparate treatment.

    The bulletin was written by Nancy B. Miller and Candice L. Maze. The CCC initiative was funded by Casey Family Programs and the U.S. Department of Justice, Office of Juvenile Justice and Delinquency Prevention. The bulletin is available on the NCJFCJ website:

    www.ncjfcj.org/images/stories/dept/ppcd/CCC/ccc%20bench%20card%20bulletin_web.pdf (1.33 MB)

Resources

  • Supporting Grandfamilies Through Respite

    Supporting Grandfamilies Through Respite

    The ARCH National Respite Network and Resource Center has published Respite Services to Support Grandfamilies, which explains the unique challenges facing grandparents who serve as the primary caregivers for their grandchildren ("grandfamilies") and the benefits of and common barriers to respite care. Maintaining a support system through respite services has proven to reduce stress, improve family relationships, and make caregivers more effective in raising their children.

    Grandparent caregivers may encounter a number of challenges after moving into a parenting role without gaining legal custody of the children. Some of these obstacles include not having the authority to consent to medical issues or access school information and difficulty in obtaining affordable housing when a larger house is needed for the new family. The cost of caring for the child or children can be another burden for grandfamilies: 70 percent of grandparents are under 60 years of age, making them too young to qualify for public benefits, such as Social Security and Medicare.

    Respite services often are overlooked by grandfamilies due to lack of knowledge and understanding about what these services include. Determining how to inform grandfamilies about available respite services is important and can be done through local support groups for grandparents, family service agencies, religious institutions, and senior centers, to name a few. The factsheet includes a list of respite programs that provide support for the grandfamilies.

    Written in collaboration with Generations United, the factsheet is available on the ARCH website:

    www.archrespite.org/images/docs/Factsheets/FS_45-Grandparents_Grandchildren.pdf (235 KB)

  • Free Volumes of Protecting Children

    Free Volumes of Protecting Children

    American Humane Association (AHA), which publishes the journal Protecting Children, has made all of the issues from 2001 through 2009 downloadable free of charge from the AHA website. Each issue is built around an important child welfare theme, such as engaging nonresident fathers, chronic neglect, or differential response.

    Access the free issues on the AHA website:

    http://www.americanhumane.org/children/professional-resources/protecting-children-journal

  • Native Horizons Points to Services for Tribal Youth

    Native Horizons Points to Services for Tribal Youth

    Native Horizons is a new, quarterly newsletter from ACF's National Clearinghouse on Families & Youth, which addresses topics and issues of interest to members of Tribal organizations and Native and non-Native programs that serve Tribal youth. Each issue will highlight successful Tribal and Native programs and initiatives, conferences and training opportunities, and funding sources relevant to Tribal and Native groups. Native Horizons also will offer a sense of the work that the Family and Youth Services Bureau (FYSB) does with and for Native communities, particularly youth who have left home or are without a home, are victims of domestic violence, have parents in prison, or are at risk of becoming parents.

    The first issue includes a request for members of Tribes and anyone who has worked with Native American youth and families to volunteer to review grant applications for FYSB's Personal Responsibility Education Program for teen pregnancy prevention.

    Access and subscribe to the newsletter:

    http://ncfy.acf.hhs.gov/user/register

    Related Item
    The National Clearinghouse on Families & Youth has launched a redesigned website. Visit the site to access resources, information on funding opportunities, tools and training, a library, and more:

    http://ncfy.acf.hhs.gov

  • Foster Youth Internship Program

    Foster Youth Internship Program

    The Congressional Coalition on Adoption Institute (CCAI) is accepting applications for its 2011 summer internship program. The program places youth in 2-month internships in Washington, DC, in the offices of the U.S. Congress. Many expenses are paid. Applicants must have spent at least 24 consecutive months in foster care during any point in their lives and must have completed four semesters of schooling at an accredited institution of higher learning, such as a college, university, or vocational school, by the start of the internship on May 31, 2011.

    The application deadline is January 7, 2011. For more information and to access the application, visit the CCAI website:

    www.ccainstitute.org

  • When Child Maltreatment and Domestic Violence Co-Occur

    When Child Maltreatment and Domestic Violence Co-Occur

    Acts of child abuse or neglect and domestic violence often co-occur within the same family unit. The latest issue of The Judges' Page newsletter presents an array of articles to inform court-affiliated organizations and members of the community about the prevalence of child abuse and domestic violence co-occurrence. Child abuse and domestic violence co-occur in 40 to 70 percent of dependency cases. The journal discusses the need for judges to be educated on the nuances of co-occurrence cases in order to exercise judicial leadership in developing a coordinated response and explains the need for appropriate services to address the child abuse and domestic violence aspects of such cases.

    The issue begins by presenting background information on understanding domestic violence issues in the context of child abuse cases. Other topics discussed include the importance of cross-system collaboration in providing for the safety of both children and adult victims of domestic violence, the role of court-appointed special advocate/guardian ad litem (CASA/GAL) volunteers in supporting children exposed to domestic violence, the safety concerns of domestic violence victims relative to parental and relative notification laws in dependency cases, and the problem of adolescent partner abuse when working with teens involved in dependency cases.

    The Judges' Page is a publication of the National CASA Association in partnership with the National Council of Juvenile and Family Court Judges and is available on the National CASA website:

    www.casaforchildren.org/site/c.mtJSJ7MPIsE/b.6279673/k.2370/October_2010.htm

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.

cbexpress.acf.hhs.gov

An official website of the U.S. Department of Health and Human Services, Administration for Children and Families and the Children's Bureau

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