Child Welfare Summary

SUMMARY

 

Day 1 and Day 2 meetings

Child Welfare and Mental Health -- Cross-training and team process

 

I. Day 1-- Child Welfare

A. Federal Law

1. Child Abuse Prevention and Treatment Act (CAPTA, 1974)

Delineates the key principles guiding child protection

2. Adoption and Safe Families Act (1997)

a. Safety

Children have a right to live in an environment free from abuse and neglect

b. Permanence

Children need to be a part of a family that provides a sense of continuity and connectedness

c. Wellbeing

Children deserve nurturing environments that meets their needs and promotes healthy development

3. Basic principles

a. Parents have a fundamental right to raise their children as they see fit

b. Society presumes that parents will act in their children’s best interest

c. Society has a responsibility to intervene when parents do not protect their children from harm and meet their basic needs

d. Interventions are guided by law, professional standards of practice, and strong philosophical underpinnings

e. Philosophy

Child maltreatment stems from a combination of factors

The responsibility for protecting children is shared by the whole community

Most children do best in their own families

Protective services focus on maintaining the family as a unit

When intervention is necessary it should be the least intrusive approach to get the job done

Interventions should build on family strengths and address risk factors

 

Reasonable efforts must be taken to keep the children with their families

Referral to court and removal from the home is done only if it is determined that the children cannot be kept safely in their own home

Parents usually can do better with adequate supports

Services must be individualized and tailored

Services should be respectful to the people involved while not condoning the behavior

Services should access the resources available in the natural support network

Services should be culturally competent

Timely efforts must be made to ensure a stable, secure, and permanent home

 

B. Wisconsin Law

1. Chapter 48 (updated in 1977)

Children’s code was first written in 1950

Contained part for CPS and part for delinquency

Codification of child welfare practice

CHPS

Intervention is called for when the parents are unable or unwilling to provide for the needs of the child

Served the "best interests" of the child

2. Chapter 938 (19

Juvenile justice code

Punishment oriented

C. Factors affecting child welfare practice

1. The peculiar effects of divvying up resources and money

Federal and state funding has decreased

Resources for voluntary child welfare activities have decreased

Courts have function of accessing costly services

Informal roles for child welfare workers have almost disappeared

2. Focus is on problems and deficits

Denigrate and then look for strengths?

Power differential in the relationship with the social worker

Need to have blood before you can intervene

3. The intervenors are county employees and the service providers are mostly from private agencies

Services are mostly court driven in Wisconsin

Creates high decision costs

Court orders may run out but services may continue

Services are ordered from a menu (alphabet soup or meaningful categories?)

The child welfare worker selects from the menu

Public and private split in objectives frequently occurs

4. Changing philosophies in child welfare

The pendulum swings between children’s rights and parent’s rights

A family focus, seeing the family as a unit, integrates these positions

Practitioners are often more family focused then are child welfare workers

In a family focus you are doing things with the family

Sometimes, however, you have to do things to the family

The complex dynamics of the history of the development of the child welfare system affect practice today

Permanency planning -- we do not do it well anywhere

Federal government is reviewing Wisconsin’s compliance with AFSA

Remedies for inconsistency between counties and between workers is often technological (SACWIS)

The child welfare worker’s job becomes filling out forms and checklists

5. Organizational and culture analysis (Edgar Schein)

Three levels of culture affecting child welfare worker

-- Artifacts

-- Espoused values (spoken and written)

-- Underlying/unspoken assumptions

Are the messages consistent?

Are we blind to the splits?

6. Models of organizing information

Algorithmic approach -- digital, either/or

Heuristic approach -- exploring and learning

Legal process favors algorithmic approach -- yes/no answers -- an attempt to reduce information and an attempt to guide a lot of people to the same outcome or conclusion

Heuristic approach comes out of professional training

Heuristic approach looks at complex interactions

Safety, permanence, and wellbeing issues lie on continuums

The heuristic approach is reflective of the complexity of nature

The heuristic approach contains "fuzzy logic"

All the plusses and minuses do not add up arithmetically

The heuristic approach describes patterns in space and time

At some point we have to move from a heuristic statement to an algorithmic statement

7. Child welfare worker as link between the legal and clinical worlds

The child welfare worker develops skills to testify in court

Connect the heuristic information to the general conclusion

Use this approach to make services more individualized

8. Innovations in child welfare

SACWIS -- attempt to standardize child welfare work -- involves a top-down bureaucracy

Real innovation comes from your ability to individualize services

Creating collaborative space -- developing shared meaning -- create a common vocabulary and a shared body of knowledge that transcends the individual disciplines

Factors that promote the development of collaborative space

-- progress by one = progress by all

-- acceptance of mutual discomfort

-- increased understanding through tolerance

-- willingness to set and seek common goals

-- free exchange of information

9. Integrated services

Provides a lens to get the right people there at the right time to get good outcomes

Organizes a unified response from the whole community

10. Field of care approach

Organize responses in terms of primary, secondary, and tertiary services

Primary services use first responders who address issues at point of contact; put most experienced staff at the front door; primary services include single service channels; resolve 65% of contacts

Secondary services are targeted services; these require more intensive follow-up, monitoring, and multidisciplinary coordination; resolve 25% of contacts

Tertiary services require a whole community response; single channel services and targeted services are inadequate to address issues; resolve 15% of contacts

 

 

II. Day 2 -- Mental health

A. Development of the mental health system in Wisconsin

1. The early days

Mendota opened in 1860

Winnebago opened in 1873

County hospitals, county farms, and county homes developed

Milwaukee County "asylum" started in 1880

Minimum standards were not set until 1944

Institutions segregated the mentally ill from the community

2. Movement toward community-based services

Chapter 51 was enacted in 1947

Placements from institutions began in 1955

Local mental health boards were begun in 1961

Services were permissive rather than mandatory

Comprehensive community legislation in 1967 to create boards in all 72 counties

51.42 Boards were made mandatory in 1974

3. Models of service

Until 1970 -- Institutional/campus/segregation

In 70s and 80s -- Development of specialized community services

In 90s -- client is member of community/services provide support

Late 1990s -- Focus on consumer self-determination and self- advocacy

B. Factors affecting mental health practice

 

1. Mental health professionals as specialists

List of skill sets

Choice of method (triage)

Primary problem

Medical necessity

Iatrogenic effects

Managing dangerousness

Accessibility to third part payors

2. Thinking rationally to solve problems

Defining rationality

Rationality is a tool for improving reality testing

Everyone has the capacity for reasoning

Spectacular examples of the failure of reasoning

Rational processes are a part of our everyday lives

Rational processes are only one tool for better living

Rational process is the foundation of our jurisprudence system

Rational systems contain error correcting machinery

3. The human cognitive apparatus

The power of hallucinations

Social influence in perception

Skeptical thinking

Require strong evidence

Baloney detection kit

Maintain an openness to new ideas

Creative thinking is followed by skeptical examination

Comparing the methods of the skeptical thinker with the methods of the ancient hunter

Information processing in the clinical setting

Perceptual aspects

Response aspects

Sources of error

A model for making rational judgments (Daniel Kahneman)

Perception

Intuition

Reasoning

4. The observation problem

The contributions of natural science to understanding the observation problem

Observation that interferes with behavior

The Newtonian model of the world

The new science model

The act of clinical observation

Countertransference

C. Comparison of mental health practice and child welfare practice

1. The role of law in practice

Child welfare practice is primarily court driven

The court identifies services to protect the child

The court action authorizes the expenditure of resources for protecting the child

Resources are unlimited if authorized by the court

Mental health practice is driven by concerns about efficiency

Resources are limited

Resources must be available to treat "casualties"

There is a concern with waste as it diminishes the capacity of the system to respond to those in need

There is a recognition that some interventions cause more harm than good, or will result in no benefit

Mental health seeks verifiable data on what works and what doesn’t work

2. Ways mental health people can help child welfare workers

Convey an understanding of professional liability when "things go wrong"

Recognize the importance of having a sense of good will toward the clients

Help distinguish between "acceptance" and "agreement"

Emphasize data-based decision making

Understand the function of triage

Provide clear, concise, and useful documentation to the child welfare worker

Dispel lingering myths about mental illness; help debunk fads

Emphasize the details and the complexities of the child’s daily life;

consider the impact of context on behavior

Emphasize that cooperation may have more impact than command and control approaches

 

Emphasize the importance of accurate assessments and good baseline data

Recognize the limits of the law’s ability to define what a child needs

Participate in the process of identifying what kinds of mental health services will actually make a difference

Promote ways of accessing resources in the natural support system

Help the child welfare worker identify strengths

Help the child welfare worker identify and interpret risk factors

3. Innovations that help bridge mental health and child welfare

Search Institutes 40 assets

Hawkins and Catalano’s risk factors

D. Integrated Services

1. Unified community response

Professional services

Family participation

Service coordination

Natural support network

Police, if applicable

2. Employ a team approach

The team does the planning

The focus is on supporting the person in the community

The team consists of all the major players in the child’s life

The parents participate in the planning throughout

The team follows a formal process

3. Team planning process

The plan represents a unified, cross-system approach to the child

All decision makers participate actively on the team

The assessment and plan are developed by the whole team

The team identifies the needs in the assessment

The team identifies the activities for addressing the issues

The needs of the child are addressed in a shared manner by team members

The assessment identifies strengths amongst the participants

The plan utilizes strengths to make changes

Team members are oriented to the team process

The plan focuses on accountability, timing, what will be done, and by whom

The team process promotes a comprehensive assessment that is accurate, and a plan that is meaningful in organizing people to do things that have an impact on the child at the point in time that the intervention is needed

 

The team process creates a balance between accountability, support, and personal development

The plan contextualizes the child’s behavior to take advantage of the forces in the community that can have a positive impact

The team process helps team members identify the forces in the situation that have an impact on the child’s behavior

The team monitors the progress, adjusts the plan, and reviews results

4. Aspects of formal collaboration

Set-up teams for individualizing plans and unifying the response from the community

Agencies in the community develop an interagency agreement

A coordinating committee oversees the operations of the program

The responsibilities of the coordinating committee are identified in s. 46.56, Wisconsin Statutes

5. Role of the service coordinator

Facilitate team meetings

Function as case manager (including targeted case management)

The case manager monitors and coordinates the team plan on-site

6. Crisis/safety plan

Plans for emergencies that can be anticipated

Identifies on-site activities that will contain the emergency

Focuses on the safety of the child and the safety of others

Uses crisis as an opportunity for learning

Original Published Date: 
December 5, 2003