Services
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