Social science assignment i – see attachment for specific assignment

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The written assignment gives you the opportunity to situate the organization (structure and the social issue that is targeted), identify an organizational problem, challenge, or opportunity in your field placement (or human service organization you know well), determine a solution grounded in theory or practice model, strategize for implementing the solution (organizational change), and specify how you will evaluate/assess the change. Your choice for the topic MUST BE AN ORGANIZATIONAL ISSUE (e.g., staff turnover, agency-wide communication dysfunction, etc.). You will follow the logic model format for this change provided in this syllabus.

Assignment 1

The written assignment gives you the opportunity to situate the organization (structure and

The social issue that is targeted) identify an organizational problem, challenge, or opportunity in your

field placement (or human service organization you know well), determine a solution grounded

in theory or practice model, strategize for implementing the solution (organizational change), and

specify how you will evaluate/assess the change. Your choice for the paper/topic MUST BE AN ORGANIZATIONAL ISSUE (e.g., staff turnover, agency-wide communication dysfunction, etc.). You will follow the logic model format for this change provided in this syllabus.

ALL papers should have the following: (1) The writing should be clear and concise. (2) Cite

all references in the text. (3) Include a complete list of references at the end of the paper. (4) Cite

all references in standard American Psychological Association format. (5) DO NOT include

identifying names of the organization or persons.

The 5 written assignments are parts of a whole – each paper will include the paper that preceded it. You are required to revise the preceding paper according to the instructor’s recommendations before adding it to the next paper.

Part A – Provides the basis for analysis and understanding of the organization, describing the context of the organization within its marketplace and the social issue it is tasked with addressing. (See Appendix A) (3-4 pages)

·
Organization Structure –
https://msa.maryland.gov/msa/mdmanual/18dhr/pdf/18dhs.pdf (Appendix A) Attachment “Appendix A Organization” details what certain positions do – USE INFORMATION FOR EXECUTIVE DIRECTOR, DEPUTY EXECUTIVE DIRECTOR FOR PROGRAMS AND OFFICE OF CHILD WELFARE PRACTICE AND POLICY.

· Introduction – Introduce the agency/organization, type (public, not-for-profit, etc.) – https://dhs.maryland.gov/child-protective-services/

· Governance

· Revenue Streams

· Size (# employees, annual budget, etc.)

·
https://msa.maryland.gov/msa/mdmanual/18dhr/html/dhrb.html (budget)

·
https://www.linkedin.com/company/mdhumanserv/about/ (# employees)

· Structure (# departments, part of larger org., off-site centers, etc.)

·
https://dhs.maryland.gov/category/services/ (services)

· https://dhs.maryland.gov/local-offices/ (24 local offices – some offices have between 1-6 Public Assistance Centers)

· Population served (typed, #s, salient issues) –
https://dhs.maryland.gov/about-dhs/#:~:text=The%20Maryland%20Department%20of%20Human,over%20one%20million%20people%20annually (number of people served)

· Stakeholders (all internal & external who have a direct interest in the organization) –
https://ctb.ku.edu/en/table-of-contents/participation/encouraging-involvement/identify-stakeholders/main#:~:text=Parents%2C%20spouses%2C%20siblings%2C%20children,Social%20workers%20and%20psychotherapists.

Specific stakeholders – More specifically, DHS stakeholders include The Children’s Guild, Baltimore Child Abuse Center, Baltimore City Police Department, Baltimore County Police Department, Maryland Stare Police, group homes, and residential treatment centers (both in and out of state).

·
Social Problem –
Abuse and Neglect of Children

· Introduction – social problem

· definitions, as relevant

· statistics on prevalence or incidence of the issue – https://cwoutcomes.acf.hhs.gov/cwodatasite/pdf/maryland.html

· studies that look at risk and protective factors in the united states of America (more than one source)

·
https://www.cdc.gov/violenceprevention/childabuseandneglect/riskprotectivefactors.html (basic information) – still need 2-3 studies discussing risking and protective factors

· describe briefly the issues relevance to social work and – Social Work & Child Abuse and Neglect Brief attached

· social work interventions that have been utilized – ATTACHMENTS: Child Neglect: A Guide for Prevention, Assessment, and Intervention, Which Interventions do social workers believe are most effective when working with child abuse victims. (Many need to do additional research as well)

· present briefly an evaluation of the effectiveness of those interventions

· Significance of the Issue – describe why this is such a problem for families, group of communities –
https://www.kidsdata.org/pages/childabusewhytopicimportant,
https://www.childwelfare.gov/topics/can/impact/consequences-can/, https://www.childwelfare.gov/topics/can/impact/consequences/

1

APPENDIX A

Social Services Administration Organizational Units

Executive Director

The Executive Director of the Social Services Administration (SSA) is responsible for the
overall administration of the Administration with support from two Deputy Directors
(Programs and Operations). A number of specific child welfare programs and initiatives are
managed within the Administration. In addition, there are five other offices or units within
the Administration that provide an infrastructure to support the overall child welfare
mission.

The Executive Director’s scope of responsibility includes oversight for the provision of a
range of administrative supports to 24 Local Departments of Social Services (LDSS) in the
areas of policy development, training, foster and adoptive home recruitment and approval,
consultation and technical assistance, budgeting, data analysis, quality assurance, and also
some direct client services to children and families.

2

The Executive Director sets the vision for the Administration in establishing an
infrastructure to support service delivery and the capacity for ongoing sustainability of
these systemic improvements across all 24 local departments.

Coordination with the Secretary of the Department of Human Resources, Deputy
Secretaries, and Office of the Attorney General, other Administration Directors, and County
Directors takes place on a regular basis. The Director represents the Administration with
other state and federal agencies, advisory groups, legislators, Governor’s Office personnel,
and advocacy groups.

The Executive Office includes the Budget and Central Services Unit, which is responsible for
the management of SSA’s budget development and monitoring. The Budget and Central
Services Unit also is responsible for the development of regulations, legislative updates,
and personnel issues.

Deputy Executive Director for Programs

The Deputy Executive Director for Programs is responsible for the Offices of Child Welfare
Practice and Policy, Resource Development, Placement and Support Services, and Child
Welfare Organizational Development and Training. Each office includes programs and
services under their area of expertise:

Office of Child Welfare Practice and Policy,
o Child Protective Services (CPS) is a mandated program for the protection of

all children in the State alleged to be abused and neglected. Child Protective
Services screens and responds to allegations of child abuse and neglect via
investigative or alternative response, performs assessments of child safety,
assesses the imminent risk of harm to the children and evaluates conditions
that support or refute the alleged abuse or neglect and need for emergency
intervention. It also provides services designed to stabilize a family in crisis
and to preserve the family by reducing threats to safety and risk factors. This
program provides an array of prevention, intervention and treatment services
including:
 Operating a local jurisdiction based telephone hotline for receiving child

abuse/neglect (CAN) reports;
 Conducting CAN Response (investigative and alternative responses),

family assessment and preventive services screenings;
 Providing substance exposed newborn crisis assessment and services;
 Providing background screening checks on current or prospective

employees and volunteers for children/youth serving agencies;
 Preventive and increased protective capacity of families; and
 Family-centered services.

o In-Home Family Services are family preservation programs available within

the local departments of social services. These programs are specifically

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identified for families in crisis whose children are at risk of out-of-home
placement. Family preservation actively seeks to obtain or directly provide the
critical services needed to enable the family to remain together in a safe and
stable environment. Maryland provides three programs under In-Home
Services continuum: Services to Families with Children-Intake (SFC-I),
Consolidated In-Home Services (CIHS) and Inter Agency Family Preservation
Services (IFPS). SFC-I provides assessment for situations that do not meet the
criteria for a CPS response. Many of these cases stem from a family’s self
request for service. CIHS are cases referred from CPS, both IR and AR, or SFC-
where additional work is needed to bolster a families protective capacities to
improve safety and reduce risk. IAFP is similar except that referrals can come
from other child serving agency and the child must be at high risk for out-of-
home placement.

 Out-of-Home Services/Permanency
o Foster Care Services:

 Short-term care and supportive services for children that have been
physically or sexually abused, neglected, abandoned, or at high risk of
serious harm.

 Services to treat the needs of the child and help the family with the skills
and resources needed to care for the child. Children are placed in the
least restrictive placement to meet their needs, with a strong preference
for relatives as the placement of choice. Attempts are made to keep the
child in close proximity to their family; however, the child’s placement is
based on the treatment needs of the child and the availability of
placement resources.

 Time-limited reunification services using concurrent permanency
planning to reunite with the birth family or to pursue a permanent home
for the child within 12 months of the placement. Permanency planning
options that are considered in order of priority:

 Reunification with parent(s)
 Permanent Placement with Relatives (includes guardianship or

custody)
 Adoption (relative or non-relative)
 APPLA (Another Planned Permanency Living Arrangement)
o Voluntary placement services because of the child’s need for short

term placement to receive treatment services for mental illness or
developmental disability

o Adoption Services develops permanent families for children who cannot
live with or be safely reunited with their birth parents or extended birth
families. The Maryland Adoption Program is committed to finding “Forever
Families” for children in the care and custody of the State. Adoption services
include study and evaluation of children and their needs; adoptive family
recruitment, training and approval; child placement; and post-adoption
subsidy support.

4

o Ready by 21provide independent living preparation services
to older youth, ages 14-21 years of age in any type of Out-of-Home placement
(such as kinship care, family foster care or residential / group care) to assist
the youth in preparation for self sufficiency in adulthood.

o Guardianship Assistance Program serves as another permanency option
for children who best needs are not served via reunification or adoption. The
goal of this program is to encourage caregivers to become legal guardians of
children who have been placed in their home by the Local Department of
Social Services by removing financial barriers.

 Resource Development, Placement and Support Services

o Resource Development and Retention is responsible for services related
to the recruitment and retention of resource families. Program staff provides
technical assistance to local departments of social services in development of
their local recruitment plans. The Maryland Foster Parent Association also
receives technical assistance from this unit. The unit is responsible for
monitoring and coordination of the 24 local departments of social services’
resource home development plans.

o Placement and Support Services is responsible for assisting the local
departments of social services to facilitate barriers regarding the discharge
and placement plans for youth in State care from psychiatric hospitals in
Maryland and offer suggestions to the local departments for applicable
placements for youths in State care. Placement and Support Services is also
responsible for participating in a myriad of committee meetings to represent
DHR to maintain rapport with various State agencies, including in-state and
out-of-state providers. Program staff gleans updated knowledge of
programs and initiatives and assists the local Departments to ensure that the
youth in State custody are appropriately positioned at their recommended
placements and the placements are in the best interest of the youth. This
unit works with stakeholders to identify and develop strategies to improve
the array of services available to support children and families in achieving
safety, permanence and well-being. The services include education,
substance abuse treatment, health care and mental health. This unit is also
responsible for monitoring the placement of children in out-of-home care
placed in facilities out-of-state. They ensure that all efforts to place children
in-state have been exhausted prior to the child being placed out-of-state.

o Oversight of Education and Health Care for Foster Youth is managed within
the unit. These responsibilities include oversight of Education and Training
Vouchers (ETV), Maryland Tuition Waiver, Education stability, Health Care
and the utilization of psychotropic medication. Ongoing work with the
Maryland State Board of Education (MSDE) and the Department of Health
and Mental Hygiene (DHMH) is managed within the unit as well.

o Interstate Compact on the Placement of Children (ICPC) ensures that foster
children placed out-of-state from Maryland and children placed in Maryland
from other States receive the same protections guaranteed to the children
placed in care within Maryland. The law offers states uniform guidelines and

5

procedures to ensure these placements promote the best interests of each
child while simultaneously maintaining the obligations, safeguards and
protections of the “receiving” and “sending” states for the child until
permanency for that child is achieved in the receiving state’s resource home,
or until the child returns to the original sending State. Interstate Compact on
Adoption and Medical Assistance (ICAMA) removes barriers to the adoption
of children with special needs and facilitates the transfer of adoptive,
educational, medical, and post adoption services to pre-adoptive children
placed interstate or adopted children moving between states.. In addition,
the IV-E eligible Guardianship Assistance Program Medical Assistance
(GAPMA) provides a framework for interstate coordination specifically
related to permanency established with custody and guardianship awarded
to out-of-State IV-E eligible Foster Parents.

 Child Welfare Training and Organizational Development
 The Training and Organizational Development Unit oversees all aspects

of training activities in child welfare along with the strategic planning to
implement and integrate practice updates and innovation.

 The Child Welfare Training component oversees and coordinates the
contractual delivery and development of training activities with the Child
Welfare Academy (CWA) at the University of Maryland School of Social
Work. The CWA provides statewide training for caseworkers,
supervisors, administrators and resource parents. This partnership with
the Child Welfare Academy delivers pre-service training for new
employees and administers a competency exam at the end of pre-service
training. The CWA offers continuing education workshops to reinforce
the expertise and policy updates for the tenured staff. The oversight of
the Title IV-E Education in Public Child Welfare Program is managed by
this unit as well. This contract provides specialized child welfare training
for MSW (Master of Social Work) degree candidates to enhance the skills
of Maryland’s public child welfare workforce.

 The Organizational Development component uses theories of
organizational change to facilitate the overall strategic mission of the
Social Services Administration. The unit assesses training needs based on
policy development and outcome trends across the continuum of
program services. The training assessments inform the delivery method
and technical assistance to local departments to enhance the execution of
practice activities. The unit serves as lead on implementation of new
initiatives.

Deputy Executive Director for Operations

Research, Evaluation, and Quality Assurance
 Research and Evaluation is responsible for the collection and analysis of data for

SSA and Local Departments of Social Services. They are responsible for reporting
for SSA to StateStat, which collects data from all of Maryland’s Departments on

6

outcomes and trends within their organizations and reports to Governor Martin
O’Malley. The Research and Evaluation unit also prepares Federal reports such as
the Adoption and Foster Care Analysis and Reporting System (AFCARS), Caseworker
Visitation, the National Youth in Transition Database (NYTD), and the National Child
Abuse and Neglect Data System (NCANDS).

 Quality Assurance is responsible for regular on-site review and data analysis for
each the 24 local departments of social services, and develops the reports for these
reviews. . The unit oversees the development of local performance improvement
plans stemming from the reviews This unit works closely with the Federal
government to coordinate improvements to Maryland’s Continuous Quality
Assurance process for child welfare.

Systems Development

Systems Development is responsible for assisting with the development, maintenance,
training, and support of MD CHESSIE, Maryland’s SACWIS system. This unit works with
Central Office and local departments of social services staff to ensure accurate and
reliable data is input into MD CHESSIE. The unit works with the MD CHESSIE software
contractor on enhancements and troubleshoots any operational problems. This unit is
also responsible for assisting public and private providers with trouble shooting issues
with their payments that are to be received on behalf of the children in their care.
Systems Development also provides support to the SSA Office of Adult Services for its
database, the Client Information System (CIS).

Contracts (Purchase of Care)

The Contracts and Monitoring Unit is responsible for the development and monitoring
of contracts for all of Maryland’s licensed child placement agencies and residential child
care agencies. The unit also monitors contracts with Maryland’s Department of Juvenile
Services (DJS), Department of State Education (MSDE), Department of Developmental
Disabilities (DDA) and out-of-state placement agencies. The unit has implemented
performance based contracting and will be monitoring the progress of contracts to
ensure that they meet basic minimum standards of performance. As the unit moves
forward the goal of monitoring contractor performance will shift from a compliance
model to an outcome oriented model.

1

General Background

The social work profession has a long tradition of involvement with the child welfare
system, working to support thousands of children and their families who are victims
of child abuse and neglect every year. In 2001, more than 903,000 children suffered
from abuse or neglect, representing a rate of 12.4 maltreated children for every
1,000 children in the general population and nearly one-third of these children
were younger than three (NCCANI, 2003).1 Research indicates that poor and racial
and ethnic minority children and their families are disproportionately reported,
labeled, and mandated into the child welfare system. The nation’s protective
services system has long been stretched beyond capacity and child protection
agencies do not serve all of the abused and neglected children in their caseloads.

According to recent Health and Human Services data, almost 40 percent of the
900,000 child victims known to child protective services received no services
following a substantiated report of maltreatment.2 More federal investments are
needed to ensure that children receive these services.

Social workers know that working with the child means working with the whole
family and with other environmental factors in a culturally competent way. In fact,
social workers have battled child maltreatment for more than 100 years, and to the
battle we bring a unique body of knowledge. Social workers and other professionals
help families by identifying and addressing the individual, familial, and community
challenges they encounter.3 Further, social workers are taught that prevention
should be at the front end of all interventions and we applaud the commitment of
President Obama to promote the prevention of child maltreatment, to support
parents with young children, and to expand Early Head Start. Social workers are
on the front lines protecting children and assisting them in finding safe living
situations. However, many social workers in child welfare are overburdened with
high caseloads and mounting administrative details, while receiving low pay
relative to other professions.

Recommendations

• Allocate increased resources to support community-based child abuse
prevention activities through the full funding and quick reauthorization of
the Child Abuse Prevention and Treatment Act (CAPTA). CAPTA programs
support innovations in state child protective services as well as research,
training, data collection, technical assistance, and program evaluation.

• Promote professional involvement in child protection through incentives for
BSW and MSW students to pursue child welfare work through loan
forgiveness, educational leave for current child welfare workers and stipends
for students. For the system to be improved, social workers and those who
care for children and families must receive adequate salaries, appropriate
training, and manageable caseloads if the system is to be truly reformed.

• Provide greater family support resources by fully funding the Promoting Safe

Social Work & Child
Abuse and Neglect

2
750 First Street NE, Suite 700
Washington, DC 20002
www.socialworkers.org

and Stable Families (PSSF) program at its authorized level. Investments in
family support programs are an important strategy in reducing incidents of
child abuse and neglect.

• Expand school health education programs to include mental health
education and a curriculum that focuses on parenting and child development
to prevent child abuse and neglect.

• Build on programs serving children and families (such as Temporary
Assistance for Needy Families, Maternal and Child Health Block Grant,
Indian Health Service, and Early Head Start) to offer a variety of child
maltreatment prevention services. Integrate program services and blend
funding streams to achieve the maximum collaboration among various
systems including, child welfare, domestic violence, substance abuse, mental
health, and public health.

• Support efforts to address the importance of culturally competent and
linguistically appropriate services for children and families and support
analysis and evaluation of research- and evidence-based practices that are
effective across populations and well-suited to specific populations.

• Strengthen the capacity of the Children’s Bureau and the Office of Juvenile
Justice and Delinquency Prevention to address child protection issues
including the overrepresentation of children of color in the child welfare
system, cultural competency, advocacy for children and data collection and
coordination by courts.

––––––––––––––––––––––––––––
References
1 National Clearinghouse on Child Abuse and Neglect Information. (2003). Child Maltreatment

2001: Summary of Key Findings. Washington, DC: U.S. Department of Health and Human
Services.

2 U.S. Department of Health and Human Services, Administration on Children, Youth and
Families. Child Maltreatment 2006. Washington, DC, U.S. Government Printing Office, 2008.

3 National Association of Social Workers. (2004). If you’re right for the job, it’s the best job in the
world. The National Association of Social Workers’ Child Welfare Specialty Practice Section
members describe their experiences in child welfare. Washington, DC: Author.

––––––––––––––––––––––––––––
Additional Resources

National Association of Social Workers. (2005). NASW Standards for Social Work Practice in
Child Welfare. Washington, DC: NASW Press.

National Association of Social Workers. (2005). NASW Standards for the Practice of Social Work
with Adolescents. Washington, DC: NASW Press.

National Association of Social Workers. (2009). Child Abuse and Neglect. Social work speaks:
National Association of Social Workers policy statement, 2009-2012 (8th ed., pp. 42-48).
Washington, DC: NASW Press.

National Association of Social Workers. (2009). Foster Care and Adoption. Social work speaks:
National Association of Social Workers policy statement, 2009-2012 (8th ed., pp. 146-153).
Washington, DC: NASW Press

National Association of Social Workers. (2009). Public Child Welfare. Social work speaks:
National Association of Social Workers policy statement, 2009-2012 (8th ed., pp. 277-280).
Washington, DC: NASW Press.

Child Neglect: A Guide for Prevention, Assessment, and Intervention 55

The goal of the initial prevention or intervention

should be to address safety and other emergency

needs and to increase the caregiver’s readiness for

change-oriented practices or behaviors. By the time

families experiencing neglect come to the attention

of CPS agencies, they often have acute and chronic

needs that require long-term intervention. These

families are significantly more likely to experience

recurrence of child neglect than abusive families. In

some CPS agencies, families experiencing neglect are

given less priority than those dealing with physical or

sexual abuse, even though their risk of recurrence may

be particularly high. 224

Effective ways must be found to target and serve

these at-risk families as soon as they are identified to

minimize risks that could lead to child neglect and

abuse. This chapter discusses the principles comprising

the foundation of prevention and intervention, their

theoretical framework, and key steps in implementing

their practice. Examples of successful interventions

are also presented.

PRINCIPLES FOR EFFECTIVE PREVENTION AND

INTERVENTION

Efforts targeting single risk factors may be as effective

in preventing neglect and its recurrence as programs

that are individualized and offer multiple services.225

Either way, services must be based on principles

that empower families, build upon strengths, and

respect cultural diversity. The following are some

CHAPTER 6
Child Neglect Prevention

and Intervention

The Importance of Receiving Services at an Early Age

Programs that promote a positive and responsive parent-child relationship are desirable as prevention and

intervention strategies. Optimally, parents can be assisted when their children are very young and the families

are not yet presenting serious child behavior problems. Chances for better parent-infant relationships are

improved, and the likelihood of child neglect is diminished.226 The intensity of interventions required for

children to catch up is expensive and unlikely to be available. For children of families living in poverty,

the support needed for proper development often exceeds what their parents can provide. These children

may benefit from quality child care or preschool settings, such as Head Start, a component not typically

considered in most interventions for neglected children. These center-based programs can offer the parent

respite from child care and teach the child communication and problem-solving skills that may buffer the

child from some effects of neglect.227

56 Child Neglect Prevention and Intervention

basic principles for practitioners who intervene with

families when children’s basic needs are unmet:

Have an ecological-developmental framework. As

discussed in Chapter 5, Assessment of Child Neglect,

neglect may be viewed within a system of risk and

protective factors interacting at multiple levels,

including the individual, the family system, and the

larger social system. To be most effective, intervention

should be directed at these multiple levels, depending

on the specific needs of the family. Examples include

affordable child care, education and employment

opportunities, low-income housing, and large-scale

drug prevention and treatment initiatives.

Understand the importance of outreach and

community. Because families experiencing neglect

tend to be poor, socially isolated, and lacking access

to resources, interventions must include aggressive

outreach and be designed to mobilize concrete formal

and informal helping resources. Since in-office, one-

to-one counseling by professionals often has proven

to be ineffective with families experiencing neglect,

services provided in the home and within the local

community are essential to understand the family in its

daily environment. It must be a collaborative process

between the family and community in which people

plan and carry out goals together for strengthening

their neighborhood.228

Carry out a comprehensive family assessment.

Caseworkers should conduct an assessment to

determine the type of neglect that has occurred and

its contributing causes (e.g., the child’s parent has

a substance abuse problem or the child lives in a

dangerous neighborhood). Whenever possible, the

caseworker should include other service providers in

the assessment. A comprehensive assessment can be

made using standardized clinical measures of risk and

protective factors, as well as by assessing parenting

attitudes, knowledge, and skills.229 (See Chapter 5,

Assessment of Child Neglect, for more information.)

Establish a helping alliance and partnership

with the family. This is one of the most important

principles for effective intervention. It may be a

challenge, however, because many caregivers with

neglect problems tend to have difficulty forming and

sustaining interpersonal relationships. By attending

to the communication styles of family members, the

caseworker is more likely to engage the family in an

active partnership, thereby helping the family develop

communication skills and build more sustaining

relationships with others.230

Utilize an empowerment-based practice. Teaching

families how to manage the multiple stresses and

conditions of their lives effectively empowers family

members to solve their own problems and to avoid

dependence on the social service system. The role of

the helper becomes one of partner, guide, mediator,

advocate, and coach.231

Emphasize family strengths. A strengths-based

orientation addresses problems, helps build on a

family’s existing competencies, and promotes healthy

functioning of the family system. The intervention

enables caregivers to meet the needs of family

members who then will be better able to have the

time, energy, and resources for enhancing the well-

being of the family.232

Develop cultural competence. Risk and protective

factors for child neglect may differ according to

race and ethnicity. Because minority families are

disproportionately represented in the child welfare

system and neglect cases represent more than one-

half of the caseload of child welfare agencies, it is

imperative to increase the cultural competence of

service providers. Cultural competency requires

acceptance of and respect for differences, diversity

of knowledge and skills, and adaptation of services

to fit the target population’s culture, situation, and

perceived needs.233

Ensure developmental appropriateness.

Practitioners must consider the developmental

needs of the children, the caregivers, and the family

as a system in their assessments and intervention

strategies. Children whose physical and emotional

needs have been neglected often will suffer significant

developmental delays. If the caregivers are adolescents,

Child Neglect: A Guide for Prevention, Assessment, and Intervention 57

they may have difficulty assuming parental roles

and responsibilities. The family system also may be

stressed when the family includes caregivers across

generations.234

THEORETICAL FRAMEWORKS AND APPROACHES

The preceding principles of neglect prevention suggest

that when risk factors are present, community groups

or other agencies can assist families to reduce risk and

to strengthen protective factors, thereby preventing

future incidences of child neglect. Effective programs

focus on developing basic problem-solving skills,

providing for the family’s concrete needs, teaching

behavior management strategies, and addressing

environmental factors.235 Specific interventions

should be matched to address the most pressing

needs of each individual family member and to target

individualized family outcomes.

Within a single case of neglect, multiple approaches

and models may be employed depending on the

family members, the circumstances surrounding the

neglect, and local and agency practice standards.

Additionally, these approaches and models are not

mutually exclusive; the strategies employed in each

approach or model may overlap.

Differential Response Strategies

Reliance on an authoritative, investigative response is

not appropriate for many families, but this is often the

only means of entry into the child welfare system of

services. Traditional services often have been criticized

as being too invasive and focused on severe problems

while not providing enough services to children at

low or moderate risk of maltreatment.236 In response

to this concern, some States have implemented a

differential response system in which only families with

the most serious maltreatment or those at the highest

risk are subject to a mandatory CPS investigation.

Other families with less serious maltreatment and

who are assessed at low or moderate risk receive a

voluntary family assessment and a preventive services-

oriented response. Instead of an investigation that

concentrates on determining whether maltreatment

has already occurred, the assessment focuses on

what might happen in the future and on what types

of interventions will best meet the needs of specific

families.

Exhibit 6-1 lists appropriate responses to families

who are assessed by practitioners as being at mild,

moderate, or severe risk for experiencing neglect,

as well as the individuals responsible for providing

services.

This dual-track or multiple-response approach

provides greater flexibility to respond differentially,

considering the children’s safety, the degree of risk

present, and the family’s need for support services.

For example, in cases of severe abuse and neglect or

of criminal offenses against children, an investigation

will commence. In less serious cases where the

family may benefit from community services, a

comprehensive assessment will be conducted so that

the family’s strengths and needs can be matched with

the appropriate community services. States that

have implemented differential response systems have

shown that a majority of cases can be handled safely

through an approach that emphasizes service delivery

and voluntary family participation, as well as the fact-

finding of “traditional” CPS investigations.237

Child-centered Strategies

The focus of child-centered strategies is on providing

children at risk of, or already experiencing, neglect

with necessary services to ensure their safety and

to provide them with the skills and support to

overcome maltreatment successfully. Child-centered

interventions include pediatric care, mentoring,

or behavioral and mental health treatment. For

younger children, preschool interventions, such as

parent-child educational play and Early Head Start,

may be considered. Programs fostering an open and

educational climate are helpful for middle-school

children and can help them enhance self-control,

58 Child Neglect Prevention and Intervention

develop communication and problem-solving skills,

and learn how to resist negative social influences.239

Parent-centered Strategies

The focus of parent-centered strategies is on enabling

caregivers to meet the needs of all family members,

including themselves, in a balanced way, providing

parents with the resources to ensure the safety and well-

being of the family. Strategies focus on the enduring

and underlying protective factors, along with the risks,

to optimize a match of interventions. Examples that

show promise in improving parenting skills and the

parent-child relationship include parenting education

programs, such as Parents as Teacher and Parents and

Children Together (P.A.C.T.), and treatment programs

that address problems such as depression, substance

abuse, and domestic violence.240

Family-centered Strategies

Family-centered strategies involve parents, children,

and other members of the family system, where

appropriate. Coordination of multiple service

providers, as well as faith- and community-based

organizations, may be needed to support a family’s

various needs. Family-centered strategies focus on

enhancing parenting skills and helping families recover

from neglect. CPS caseworkers work with the family

by training parents in behavioral and social skills,

setting short-term goals with clearly defined action

steps, providing in-home teaching and skills training

to parents to improve parent-child interactions, and

teaching home management skills.

Neglectful families often show high rates of recidivism.

In-home instruction is often the best strategy to

prevent recurrence and is also a successful strategy

for working with families at risk for neglect. Parents

tend to respond positively to the more personalized,

outreach nature of the home-visitor approach.241

While providing in-home instruction, caseworkers

can teach behaviors that encourage attachment,

appropriate feeding and child care practices, infant-

Exhibit 6-1

Possible Responses to Families238

Types of Cases Responses Suggested Organizations Responsible

Mild Risk Early intervention, family support, formal

or informal services, parent education,

housing assistance, community neighborhood

advocacy.

Community programs

Moderate Risk Appropriate formal services, coordinated

family support, safety plans, community

support services.

CPS and community programs

Severe Risk Intensive family preservation or reunification

services, child removal, court-ordered services,

foster care, adoption, criminal prosecution.

CPS and law enforcement

For more on parent-centered and other strategies,

see Emerging Practices in the Prevention of Child

Abuse and Neglect at http://www.childwelfare.

gov/preventing/programs/whatworks/report/.

Child Neglect: A Guide for Prevention, Assessment, and Intervention 59

toddler stimulation, successful money management,

and proper nutrition. Providing information related

to child development characteristics and capabilities

is an important element of many in-home services.

When possible, training should be provided during

subsequent pregnancies for high-risk families and

during the postpartum period.242

Utilization of Concrete Resources

The lack of concrete resources and the stress of

poverty that come from living in neglected and unsafe

neighborhoods are risk factors for neglect. Helping

families access concrete resources is often essential

before they can deal with other factors in their lives

that may affect the care of their children. Examples

of concrete resources include housing; emergency

financial, food, and energy assistance; affordable and

quality child care; transportation; home management

assistance; and free or low-cost medical care. These

resources are needed to help families move beyond

mere survival to optimal functioning.243

Utilization of Social Supports

As discussed in Chapter 4, Risk and Protective

Factors, parents who experience loneliness, lack social

support, and are socially isolated may be more prone

to neglecting their children than families who have

a strong network of social supports. Building social

supports can serve as a means of stress prevention as

well as a stress buffer. Being in the company of others

can enhance self-esteem, provide a sense of belonging,

improve access to healthy role models, and provide

incentives to comply with social norms.244

Social support interventions include any activities or

programs that address social isolation, loneliness, or

other deficits in the social network of families. Social

supports provide the following:

Emotional support through affirmation,

compassion, and empathy;

Feedback, advice, encouragement, and guidance

in coping with demands such as managing

emotional stress and child rearing;

Access to information, services, and material

resources and assistance (neighbors and friends

may provide advice about schools and child care

or donate needed items, such as clothing or a car

seat);

Assistance in learning new job skills, making

home repairs, managing household needs, and

creating financial plans using an informal social

network of neighbors, friends, and workplace

colleagues.245

Research suggests that social support interventions,

in combination with casework and case management

services, are effective in improving the functioning of

neglectful families.246 Social support interventions

must be managed carefully to maximize the

advantages of the support while minimizing potential

disadvantages. Excessive social support may not only

foster dependency in the recipient, but also increase

feelings of indebtedness or the need to reciprocate.

Sometimes those offering emotional support find it

difficult to challenge the recipient’s behavior (e.g.,

substance abuse).247 It is crucial for CPS, as well

as community- and faith-based groups, to provide

assistance to the support network of troubled families

to prevent their exhaustion and burnout. Working

in teams on home visitations has been effective in

“supporting the supporters,” while organizing mutual

support groups may provide much needed assistance

for the informal support network.248

Utilization of Community Services

Both informal and formal provision of community

services can help reduce family stresses that can

contribute to child abuse and neglect. To be

effective, social support needs to be integrated with

community services, such as social skills training,

home-based family interventions, emergency

assistance, parenting education, intensive therapy,

60 Child Neglect Prevention and Intervention

and, in some cases, substance abuse treatment.

CPS typically is the lead agency in coordinating

communication between various parties and services

within the community. Other professionals involved

in community prevention and intervention efforts

include law enforcement, educators, early child

care providers, health care providers, mental health

professionals, legal and judicial system professionals,

substitute care providers, the faith community,

community organizations, support services providers,

and other concerned citizens. Integration of these

service systems and providers will help ensure that

families can be supported appropriately across their

developmental life span.249

Assistance programs are most likely to succeed when

they provide an array of benefits to the general

population so that recipients are not stigmatized by

identification with the program. If this is not possible,

assistance can be incorporated into programs that

target a wide-ranging population. Contracting with

community-based services can help meet the needs of

children and families within their own neighborhood,

reducing the amount of time and burden on families

who otherwise may need to travel long distances to

receive such services. Community-based programs

also attempt to do the following:

Prevent the accumulation of risk factors;

Focus on resilience and adaptation;

Facilitate active involvement of parents, children,

and others;

Ensure sufficient services to at-risk populations;

Provide timely, careful, and expert evaluation,

assessment, and follow-up services;

Build safe environments to permit families

to establish structure, routines, rituals, and

organization.250

Examples of community service strategies include:

Public assistance programs offering job

training, subsidized child care, and nutritional

support (e.g., the Special Supplemental Nutrition

Program for Women, Infants, and Children

[WIC] program).

Schools providing social support through

programs, such as Head Start, that incorporate

parental involvement into early childhood

education, or after-school programs that provide

social and educational assistance, peer counseling,

and tutoring as well as social support to children

with special needs.

Faith-based and community organizations and

recreational groups offering a variety of services

to assist high-risk families, including community

food pantries, clothing, soup kitchens, and

recreational and related activities.

In-home assistance in which formal helpers

provide families with the opportunity to consider

each person’s viewpoint on family problems and

the development of new modes of interaction.251

Cognitive-behavioral Interventions

Cognitive-behavioral interventions use behavior

modification techniques in individual therapy sessions

with caregivers who have neglected. They include:

Verbal instruction—providing information

about appropriate child care;

Social skills training—demonstrating methods

for managing child care tasks;

Stress management—teaching relaxation

techniques or cognitive coping skills;

For more detailed information on the roles and

responsibilities of various service providers within

the community, see A Coordinated Response to Child

Abuse and Neglect: The Foundation for Practice at

http://www.childwelfare.gov/pubs/usermanual.

cfm.

Child Neglect: A Guide for Prevention, Assessment, and Intervention 61

Cognitive restructuring—replacing self-

defeating thoughts with beliefs and behaviors

that lead to improved functioning.

These techniques are especially useful with neglectful

families if they target both the environment and

the individual. For example, Project STEEP (Steps

Toward Effective, Enjoyable Parenting), which was

developed at the University of Minnesota, is an

intensive, individual, in-home counseling and group

intervention program that seeks to change negative self-

perceptions and to break the intergenerational cycle

of maltreatment. (For more information on Project

STEEP, go to http://education.umn.edu/ICD/

harriscenter/STEEPinfo.htm.) Project SafeCare uses

an ecobehavioral approach and reports improvements

in nutrition, home cleanliness, personal hygiene, and

identifying and reporting children’s illnesses.253 (For

more information about Project SafeCare, visit http://

www.friendsnrc.org/downloads/05ConfPres/

Fidelity.pdf or http://www.cdc.gov/ncipc/pub-

res/parenting/ChildMalT-Briefing.pdf.)

The following examples are cognitive-behavioral

methods for addressing child neglect that have been

• shown to improve home safety, affective skills for the

parents, and infant development stimulation.

Home safety. Hazardous physical environments

increase a child’s risk of injury from accidents and

from highly stressed parents who may become

physically abusive while trying to prevent a child

from injuring him or herself from a household

hazard. A safety assessment can be followed by

personalized training and educational activities.

These activities may include audiovisual

presentations of how to resolve safety hazards, use

of self-feedback stickers, and printed guidelines

(e.g., the proper use of safety plates and electrical

tape).

Affective skills training. Parents learn positive

ways of interacting with their children, including

developing the ability to provide corresponding

physical and verbal messages, assuming an equal

position of height with the child, and actively

initiating positive, nurturing physical contact

with the child.

Stimulating infant development. Teaching

parents how to nurture infants can reduce the

Helping Families Accept Assistance to Meet Their Needs

Families at risk of child neglect and in need of support are most likely to regard assistance positively when

they:

Have opportunities to reciprocate (or are required to repay) the aid they receive;

Accept assistance because they perceive the need for help rather than because of external judgments of

inadequacy or incompetence;

Perceive the benefactor’s intentions as a combination of altruism and self-interest (i.e., the benefactor

has a genuine interest in the family, but also is paid or provided other benefits for helping);

Believe that the assistance comes largely from an impersonal source (e.g., agency, organization);

Regard their need for assistance as externally instigated (e.g., job layoff) rather than as stemming from

personal inadequacies;

Receive assistance in circumstances that reduce stigma (e.g., benefits widely shared by community

members);

Obtain aid in a way that does not invade privacy or limit autonomy.252

62 Child Neglect Prevention and Intervention

risk of developmental or emotional difficulties

with their babies. Stimulation activities include

frequent use of affectionate words and child-

parent interactive play.254

Systems of Care

A Systems of Care approach is a collaborative effort

on the part of service agencies to support children and

families with complex needs in an integrated manner.

Systems of Care enable cross-agency coordination

of services regardless of where or how children and

families enter the system. Agencies work strategically,

in partnership with families and other formal and

informal support systems and can address neglect

based on a family’s unique needs. This approach has

been a catalyst for changing the way public agencies

organize, purchase, and provide services. It has been

applied across the United States in various ways at

the macro level (through public policy and system

change) and at the micro level (in the way service

providers directly interact with children and families

in need of assistance). To do so effectively, agencies

participating in Systems of Care must:

Agree on common goals, values, and principles

that will guide their efforts;

Develop a shared infrastructure to coordinate

efforts toward the common goals of safety,

permanency, and well-being;

Work within that infrastructure to ensure the

availability of an array of high-quality, community-

based services to support families and children

safely in their homes and communities.255

Interventions with Special Populations

CPS and other organizations that provide neglect

prevention and intervention services serve many

special populations, including families of color and

parents with intellectual disabilities.

Serving families of color through community-

based services. In response to concerns about

the over-representation of minority children in

the child welfare system, the Children’s Bureau

sponsored an exploratory, qualitative study of

the child welfare system’s response to children

of color, specifically, African-American children.

The study identified strategies that child welfare

agencies were using or should use to meet

the needs of minority children and families.

By providing prevention services within the

neighborhood or local community to support

families before they come to the attention of

the system, it is hoped that fewer minority

children would enter the system in the first place.

Establishing strong connections with minority

communities and engaging community leaders

may help child welfare agencies collaborate

more effectively and share resources with local

agencies and organizations. This will hopefully

empower communities to find solutions to their

own problems and build an internal support

system.256

Supporting parents with intellectual

disabilities. Parents with intellectual disabilities

often are identified as being at risk for physical

and psychological neglect of their children.

Expanded services are needed to enhance the

effects of parent education to improve parental

competencies and to reduce the risk of child

neglect and developmental or behavior problems.

For more information on minority children in the

child welfare system, see Children of Color in the

Child Welfare System: Perspectives from the Child

Welfare Community at http://www.childwelfare.

gov/pubs/otherpubs/children/index.cfm.

For additional information and to communicate

with other professionals about the Systems of

Care approach, visit http://www.childwelfare.

gov/systemwide/service_array/soc/.

Child Neglect: A Guide for Prevention, Assessment, and Intervention 63

Behavioral, performance-based teaching

strategies often work well with this population.

Practitioners should receive training on the

impact of intellectual disabilities on adults as well

as behavioral skills training. These techniques

include simple instructions, task analysis, pictorial

prompts, modeling, feedback, role-playing, and

positive reinforcement.

These same techniques also are effective in

teaching parenting skills to parents without

intellectual disabilities. Research has shown that

the rate of child removal dropped considerably

following interventions that increased parents’

child care skills. Furthermore, in-home services

for at-risk children that improve parenting skills

and knowledge of child development may be

more feasible and cost-effective than placing

children in specialized preschools.257 Exhibit 6-

1 summarizes various interventions that can be

used with neglected children and their families.

KEY STEPS IN THE INTERVENTION PROCESS

Regardless of which intervention approaches and

models are implemented, certain steps are necessary

Exhibit 6-1

Interventions for Neglect Cases258

Concrete

Support
Social Support Developmental

Cognitive and

Behavioral
Individual Family System

Housing

assistance

Emergency

financial,

food, or other

assistance

Transportation

Clothing,

household

items

Availability or

accessibility

to community

resources

Hands-on

assistance to

increase safety

and sanitation

of home (home

management

aids)

Free or low-cost

medical care

Available and

affordable

quality child

care

Individual

social support

(parent aide,

volunteer)

Connections

to faith-based

activities

Mentor

involvement

Social support

groups

Development of

neighborhood

child care and

respite care

services

Neighborhood-

centered

activities

Social

networking

Recreation

programs

Cultural

festivals and

other activities

Therapeutic child

care

Individual

assistance with

developmental

skills (e.g.,

parenting)

Home visits

with focus on

developmental

needs of family

members

Peer groups

(often at schools)

geared to

developmental

tasks

Mentors

to provide

nurturing,

cultural

enrichment,

recreation, and

role modeling

Social skills

training

Communication

skills building

Teaching of home

management,

parent-child

interaction, meal

preparation, and

other life skills

Individual or

group therapeutic

counseling

(e.g., regarding

childhood

history)

Parenting

education

Employment

counseling and

training

Financial

management

counseling

Problem-solving

skills training

In- and

out-patient

counseling

and

detoxification

for substance

abuse

12-Step

programs

Mental health

in-patient and

out-patient

counseling

Crisis

intervention

Stress

management

Play therapy

Home-based,

family-centered

counseling

regarding family

functioning,

communication

skills, home

management,

and roles and

responsibilities

Center-based

family therapy

Enhancing

family strengths

Building

nurturing

behaviors

Refining family

dynamics and

patterns

64 Child Neglect Prevention and Intervention

to make them appropriate for the needs of the child

and family, including:

Building a relationship with the family;

Developing case and safety plans;

Establishing clear, concrete goals;

Targeting outcomes;

Tracking family progress;

Analyzing and evaluating family progress.

Building a Relationship with the Family

Establishing good rapport with each family member

will help the caseworker understand the family

dynamics as well as build trust in the collaborative

process between the caseworker, family, and other

providers. When families believe their feelings and

concerns have been heard, respected, and considered,

they are more likely to be engaged in the planning

and actions necessary to change the behaviors and

conditions that contribute to neglect. CPS caseworkers

also should be prepared for the often emotionally

draining effect that the apathy of neglectful families

may have on professionals, volunteers, and community

paraprofessionals.259

Developing Case and Safety Plans

Interventions should be structured to increase

protective factors or to decrease risk factors identified

in the family assessment process. That information

can be used to tailor the intervention to facilitate

changes the family must make to meet a child’s basic

needs, to eliminate the risks of child neglect, and to

develop a safety plan, if needed. Flexibility is critical

in designing case plans so that they are responsive to

the family’s changing needs and resources.

The case plan that a CPS caseworker develops with a

family is its roadmap to successful intervention. The

purposes of case planning are to:

Identify strategies with the family that address

the effects of neglect;

Provide a clear and specific guide for changing

behaviors and conditions that influence risk;

Establish a benchmark to measure client progress

for achieving outcomes.260

Establishing Clear, Concrete Goals

In setting the goals of the intervention, family

members and their informal support networks

should be involved in developing plans to maximize

the chances for improving family functioning and

reducing the risk of neglect. Providing concrete,

measurable, and achievable goals with continuous

positive feedback will help families accomplish their

individualized outcomes and goals. Goals should

indicate positive behaviors or conditions that will

result from the change and not concentrate only on

reducing negative behaviors.

Once goals are identified, the next step is to break

them down into small, incremental tasks. These tasks

describe what the children, family, caseworker, and

other service providers will do and identify timeframes

for accomplishing each task. Families should be able

to understand what is expected of them and what

they can expect from the caseworker and other service

providers. Caseworkers should attempt to anticipate

potential obstacles to task performance and to devise

strategies for overcoming them.261

Targeting Outcomes

Outcomes should be targeted so that both the risks

and the effects of neglect are reduced due to changes

in the behaviors or conditions that contributed to

it. Outcomes should address issues related to four

areas—the child, the parents or other caregivers,

the family system, and the environment—and be

designed to contribute to the achievement of safety,

permanency, and family well-being.262

Child Neglect: A Guide for Prevention, Assessment, and Intervention 65

Child outcomes. Outcomes for children focus

on changes in behavior, development, mental

health, physical health, peer relationships, and

education. Examples of desired outcomes would

be improved behavior control (as evidenced by

managing angry impulses) or developmental

appropriateness and adjustment in all areas of

functioning (as evidenced by an improvement in

the child’s physical development within the range

of the chronological age).

Parent or caregiver outcomes. Outcomes for

parents or caregivers can focus on many areas,

such as mental health functioning, problem-

solving ability, impulse control, substance abuse

treatment, and parenting skills. A sample desired

outcome would be improved child management

skills, such as establishing and consistently

following through with rules and limits for

children.

Family outcomes. These outcomes focus on issues

such as roles and boundaries, communication

patterns, and the level of social support received.

A sample desired outcome would be enhanced

family maintenance and safety (as evidenced by

the ability to meet family members’ basic needs

for food, clothing, shelter, and supervision).

Environmental outcomes. These outcomes

focus on factors such as social isolation, housing

issues, or neighborhood safety. A sample desired

outcome would be utilizing social supports.264

Exhibit 6-2 provides some examples linking identified

problems to possible outcomes.

Goals Should Be SMART

Specific—The family should know exactly what has to be done.

Measurable—Goals should be measurable, clear, and understandable so everyone knows when they have

been achieved.

Achievable—The family should be able to accomplish the goals in a designated time period given the

resources that are accessible and available to support change.

Realistic—The family should have input and agreement in developing feasible goals.

Time limited—Time frames for goal accomplishment should be determined based on an understanding of

the family’s risks, strengths, and ability and motivation to change. The availability and level of services also

may affect time frames.263

66 Child Neglect Prevention and Intervention

Exhibit 6-2

Matching Risks to Outcomes265

Risk or Problem Desired Client Outcomes

Condemned housing (no heat or running water,

children diagnosed with lead poisoning, safety

hazards for young children)

Household safety

Financial management skills

Problem-solving skills

Acting out behavior (refusing to listen, throwing

temper tantrums, fights with peers)

Behavioral control

Social skills

Impulse control

Communication problems or conflicts (domestic

violence, parent-child conflict)

Conflict management skills

Decision-making skills

Impulse control

Family functioning

Frequent moves (in and out of placement,

numerous schools, numerous caregivers)

Financial management

Problem-solving skills

Parental addiction Recovery from addiction•

Inappropriately harsh parenting, inappropriate

expectations of children

Parenting knowledge

Emotional control

Fear of expressing feelings, verbally abusive, not

recognizing feelings of others

Communication skills

Empathy

Lack of social supports Supportive linkages with sources of formal and

informal support

For more on outcomes and interventions, see Child Protective Services: A Guide for Caseworkers at http://

www.childwelfare.gov/pubs/usermanual.cfm.

Child Neglect: A Guide for Prevention, Assessment, and Intervention 67

Tracking Family Progress

Determining the extent and nature of a family’s

progress is central to CPS intervention. Monitoring

change should begin as soon as the intervention is

implemented and continue throughout the life of a

case until the targeted outcomes have been achieved.

Caseworkers should evaluate family progress regularly

by following these steps:

Review the case plan. Outcomes, goals, and

tasks must be written so that they can be used

to determine progress toward reducing risk and

treating the effects of maltreatment.

Collect and organize information on family

progress. Once the case plan is established, each

contact with the children and family should focus

on assessing the progress being made to achieve

established outcomes and to reassess safety.

Collect information from all service providers.

Referrals to service providers should clearly specify

the number, frequency, and methods of reports

expected. The caseworker also must communicate

clearly any expectations for reporting concerns,

observable changes, and family progress. It is the

caseworker’s responsibility to ensure the submission

of these reports and to request meetings with the

service providers, if indicated.

Engage the child and family in reviewing

progress. Using the case plan as a framework

for communication, the caseworker should meet

with the family to review progress jointly. Family

members should be asked about their perceptions

of progress.

Measure family progress. Change is measured

during the evaluation of family progress on two

levels. The most critical risk factors (identified

during the family assessment) should be reassessed.

The second level of measurement evaluates the

extent to which specific outcomes have been

accomplished by the family, caseworker, and

service providers.

Document family progress. Thorough

documentation allows the caseworker to measure

family progress between the initial assessment

and the current evaluation. This documentation

provides the basis for case decisions.266

Analyzing and Evaluating Family Progress

Once the information has been collected, the

caseworker should analyze it to help determine

progress and to decide on further actions. The

evaluation of a family’s progress should address the

following issues:

Is the child safe? Have the protective factors,

strengths, or safety factors changed, thereby

warranting the development of a safety plan or a

change in an existing safety plan?

What changes have occurred in the factors

contributing to the risk of neglect?

What progress has been made toward achieving

the case goals and outcomes?

How effective have the services been in achieving

the outcomes and goals? Specific questions that

should be considered are:

Have services been provided in a timely

manner?

Has the family participated in services as

scheduled?

Has the service provider developed rapport

with the family?

Is there a need to alter the plan of service

based on changes in the family?

What is the current level of risk in the family?

Have the risk factors been reduced sufficiently

so that the parents or caregivers can protect their

children and meet their developmental needs,

allowing the case to be closed?

68 Child Neglect Prevention and Intervention

For children in out-of-home care, is reunification

likely in the required time frame, or is an alternate

permanency plan needed? 267

PROMISING PRACTICES FOR INTERVENTION

Several programs have shown promise in providing

effective interventions for reducing the risks and

effects of child neglect.

Family Connections Program

Family Connections in Baltimore, Maryland, was

designated by the Children’s Bureau as the only

nominated child maltreatment prevention program

proven effective by a rigorous evaluation (see

Emerging Practices in the Prevention of Child Abuse and

Neglect at http://www.childwelfare.gov/preventing/

programs/whatworks/report). Family Connections

targets families with children between the ages of 5

and 11 who are considered to be at risk for child abuse

and neglect, but have no current CPS involvement.

The program promotes the safety and well-being of

children and families by identifying and developing

formal and informal supports to address each family’s

individual needs and to build upon its strengths. Staff

members work with families on problem-solving,

positive disciplinary methods, coping strategies,

developmental social supports and community

connections, and opportunities for positive family

interactions through community activities.

• Evaluation results showed that children in 90 percent

of the at-risk families in the program served in 2000–

2001 were not suspected of being abused or neglected.

Other outcomes included:

A decrease in risk factors and an increase in

protective factors for neglect;

An increase in social support for caregivers,

caregiver satisfaction with parenting, and

appropriate parenting attitudes among

caregivers;

A decrease in caregiver stress, drug use, and

depressive symptoms;

A decrease in child behavioral problems.268

Nurse-Family Partnership

Nurse-Family Partnership (NFP) is a prenatal and

early infancy project that originated in Elmira, New

York and has been replicated in other cities. NFP

is one of the most well-known, evidence-based

programs addressing child neglect. The program

incorporated randomized clinical trials evaluating the

efficacy of intensive, nurse home-visitation during

pregnancy and the first 2 years of a child’s life. Initial

outcomes and analyses of a 15-year follow-up of

families who received home visitations indicated that,

in comparison to the control families, there was a 48

percent reduction in child maltreatment and a 59

percent reduction in arrests. Other program benefits

included better prenatal health and improved school

readiness.269

Although this study did not specifically target

neglect, the NFP project documented that providing

professional support in difficult transition periods

for high-risk families is an effective strategy for

developing family strengths and preventing negative

outcomes. Because of the encouraging findings, the

Office of Juvenile Justice and Delinquency Prevention

of the U.S. Department of Justice made NFP part of

its “Weed and Seed” Initiative. In 1999, the National

Center for Children, Families and Communities was

While listed in a U.S. Department of Health

and Human Services publication, a program or

organization’s inclusion does not in any way connote

its endorsement.

For more information on Family Connections, visit

http://www.family.umaryland.edu/community

_services/fc.htm.

Child Neglect: A Guide for Prevention, Assessment, and Intervention 69

established to disseminate the program nationwide.

Currently, more than 700 nurses participate in

NFP programs with more than 13,000 families in

approximately 250 counties.270 For more information

on NFP, visit http://www.nursefamilypartnerhip.

org.

Parent Empowerment Program

In 1996, the Child Protection Center of the Division

of Community Pediatrics at Montefiore Medical

Center in New York City initiated the Parent

Empowerment Program, a social support educational

intervention targeted to socially isolated and resource-

poor teen mothers in the South Bronx. The program

included a 6-month parenting group that focused

on accessing medical services and building a social

support system. Practices considered effective in this

program included home visitation that helped build

rapport between clinicians and the young women,

a flexible parenting skills curriculum that could be

modified to meet the pressing needs of program

participants, and the provision of immediate medical

and mental health services.271 For more information

on the Parent Empowerment Program, visit http://

montekids.org/programs/cpc.

Project SafeCare

From an ecobehavioral perspective, child neglect

is best addressed within the context of the family

environment. Project SafeCare has been tested

extensively to determine the key components of

effective intervention with parents at risk of child

maltreatment. The program is a modified version of

the model, Project 12-Ways. Whereas the original

project contained 12 areas of intervention, Project

SafeCare focuses on three areas that are particularly

relevant to neglect and young parents: home safety,

infant and child health care, and bonding and

stimulation.

The model, which involves 15 weeks of intervention

with 5 weeks concentrating on each area, is conducted

on a one-on-one basis with social workers or nurses

who often use videos. Parents are given instructions,

view modeling of various skills and activities, and

practice these skills with feedback from an in-home

counselor. Since child neglect often is associated with

dangerous or unclean conditions at home, parents are

taught about safety hazards, cleanliness, and creating

a safe and clean environment for infants and children,

including the use of latches and locks. They also are

taught specific tasks, such as recognizing when a child

is ill, seeking emergency treatment, calling the doctor,

and self-treating an illness. Project SafeCare also

trains parents to increase positive interactions with

their infants or children by learning skills to structure

activities and to plan stimulating play, interactions,

and daily living activities (e.g., bathing and dressing).

Program evaluation data have consistently shown

that families served by Project SafeCare are at lower

risk for recidivism during and after treatment than

matched comparison families who also are involved

with CPS agencies and who receive services other

than Project SafeCare.272 For more information on

Project SafeCare, visit http://www.cdc.gov/ncipc/

pub-res/parenting/ChildMalT-Briefing.pdf.

Head Start, Early Head Start, and the Early Head

Start/Child Welfare Services Initiative

Head Start (HS) is designed to foster healthy

development in low-income children. Program

grantees and delegate agencies deliver a range of

services that are responsive and appropriate to each

child’s and to each family’s heritage and experience and

that encompasses all aspects of a child’s development

and learning. For more information about Head Start,

visit http://www2.acf.dhhs.gov/programs/hsb.

Early Head Start (EHS) promotes healthy prenatal

outcomes, enhances the development of infants and

toddlers, and promotes healthy family functioning.

For more information about Early Head Start, visit

the Early Head Start National Resource Center at

http://ehsnrc.org/.

The Early Head Start/Child Welfare Services (EHS/

CWS) initiative provides a unique opportunity for

70 Child Neglect Prevention and Intervention

a select group of EHS grantees, in partnership with

their local CPS, to demonstrate how to serve children

in the child welfare system best using the Early Head

Start model. The EHS/CWS initiative was established

through a partnership between the Head Start Bureau

and the Children’s Bureau. The goal of EHS/CWS is

to expand the service network in local communities

so that it meets the needs of this unique population.

EHS/CSW target populations vary from site to site.

Some grantees serve infants and toddlers, while others

may target only infants or only toddlers. Programs

may also choose to focus on children in the child

welfare system who remain at home, but receive

ongoing services, children who were removed from

the home and placed in out-of-home care, or children

in the child welfare system because they are at-risk for

abuse or neglect. In addition, programs may choose

to focus on children whose parents have certain

problems, such as being incarcerated or being in a

substance abuse recovery program.

Although each grantee is developing its unique theory

of change and a locally designed evaluation, most

EHS/CWS projects are addressing outcome objectives

that include safety, permanency, and well-being for

children. Many of the grantees also have developed

evaluation plans to measure intermediate outcomes

that are expected to occur prior to these longer-term

outcomes. These include improved parenting skills,

parent-child interactions, and coping strategies for

dealing with stress.

While each of the grantees is expected to conduct

its own local evaluation and is being provided with

evaluation technical assistance, as necessary, the

Children’s Bureau is sponsoring an independent

evaluation of the initiative as well. For more

information about the EHS/CWS initiative, visit

http://www.ehsnrc.org/highlights/childwelfare.

htm.

Legal Intervention with Neglectful Families

The involvement of law enforcement and the courts occurs less frequently with neglectful families than in

cases of physical and sexual abuse and, therefore, is not always a key step. More often, the confrontation

that comes from the neglect report and the CPS investigation is sufficient to move the family toward

needed change.273 Legal intervention is sometimes necessary, however, to ensure the safety of the neglected

child and to bring about the needed changes in the family. Formal confrontation in court of the family’s

failure to meet minimally adequate standards of care may create the tension necessary to move the family

toward providing adequate care for the children.

CPS caseworkers must balance an official, authoritative stance with a helper role, which requires the

caseworker to incorporate the use of confrontation and challenging skills with empathy and supportive

help. A neglectful family must understand that the care of its child is unacceptable, yet still be encouraged

by the caseworker’s readiness to help them improve.

In extreme cases of child neglect, when persistent intervention efforts have failed to bring about a

minimally adequate level of care, and the family’s response offers little hope of providing adequate care,

court action to terminate parental rights is necessary to free the child for adoption or other permanent

placement. Termination proceedings in court require the CPS or foster care caseworker to be prepared

with factual observations, written documentation, and witnesses, if available, to convince the court of the

wisdom and justice of this action. The presumption in most juvenile and family courts is in favor of the

rights of the biological parent. Convincing evidence must be presented to prove that parental care is less

than minimally adequate, likely to remain so, and that adoption is the least detrimental alternative for the

child.274

Child Neglect: A Guide for Prevention, Assessment, and Intervention 71

CONCLUSION

Although child neglect is the most common type

of maltreatment, its causes, effects, prevention, and

treatment often are not as prominently discussed and

explored as are those for physical or sexual abuse.

Neglect, like other types of maltreatment, has many

contributing factors at the individual, familial, and

community levels. The complexities of neglect

present difficulties not only for an overburdened

child welfare system, but also for community- and

faith-based programs, researchers, legislators, and

other service providers. It is key, therefore, that these

groups work collaboratively to develop promising

and effective practices for preventing neglect and for

mitigating its effects on children and society. Part

of this process is providing individuals, families, and

communities with the knowledge, resources, and

services to deal with the challenges associated with

neglect. Child welfare agencies can only provide a

part of the solution. Neglect must be viewed not only

as an individual or a family problem, but also as a

community issue requiring a community response.

California State University, San Bernardino California State University, San Bernardino

CSUSB ScholarWorks CSUSB ScholarWorks

Electronic Theses, Projects, and Dissertations Office of Graduate Studies

5-2021

WHICH INTERVENTIONS DO SOCIAL WORKERS BELIEVE ARE WHICH INTERVENTIONS DO SOCIAL WORKERS BELIEVE ARE

MOST EFFECTIVE WHEN WORKING WITH CHILD ABUSE MOST EFFECTIVE WHEN WORKING WITH CHILD ABUSE

VICTIMS? VICTIMS?

Ellen Davis

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WORKING WITH CHILD ABUSE VICTIMS?” (2021). Electronic Theses, Projects, and Dissertations. 1231.
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WHICH INTERVENTIONS DO SOCIAL WORKERS BELIEVE ARE MOST

EFFECTIVE WHEN WORKING WITH CHILD ABUSE VICTIMS?

A Project

Presented to the

Faculty of

California State University,

San Bernardino

In Partial Fulfillment

of the Requirements for the Degree

Master of Social Work

by

Ellen L. Davis

May 2021

WHICH INTERVENTIONS DO SOCIAL WORKERS BELIEVE ARE MOST

EFFECTIVE WHEN WORKING WITH CHILD ABUSE VICTIMS?

A Project

Presented to the

Faculty of

California State University,

San Bernardino

by

Ellen L. Davis

May 2021

Approved by:

Dr. Armando Barragan, Faculty Supervisor, Social Work

Dr. Armando Barragan, M.S.W. Research Coordinator

© 2021 Ellen L. Davis

iii

ABSTRACT

Child abuse is often a very traumatic experience that can create long-

lasting psychological and emotional effects for some individuals. Social workers

often provide treatment services, such as therapy and/or case management

services, with the goal of assisting child abuse victims in coping with and

overcoming the negative impact of the trauma they’ve experienced. This study

evaluates the types of interventions social workers utilize when working with child

abuse victims, how the interventions address the resulting trauma of child abuse,

which interventions social workers believe are most effective when working with

this population, and why those interventions are believed to be most effective.

Data was collected for this study using qualitative means via use of interviews

conducted via Zoom. The interviews were audio recorded and then transcribed

for data analysis. The findings of the study highlight the use of art therapy,

journaling, active listening, and talk therapy as the most preferred and effective

interventions to utilize when working with child abuse victims. These

interventions were noted to be most effective as they are grounded on the

principles of safety, trust, client choice, empowerment, and they promote

resiliency and use of positive coping mechanisms.

iv

TABLE OF CONTENTS

ABSTRACT ……………………………………………………………………………………………. iii

CHAPTER ONE: ASSESSMENT ………………………………………………………………. 1

Introduction …………………………………………………………………………………… 1

Research Focus …………………………………………………………………………….. 1

Paradigm and Rationale for Chosen Paradigm …………………………………… 2

Literature Review …………………………………………………………………………… 2

Child Abuse …………………………………………………………………………. 3

Trauma and its’ Effects ………………………………………………… 3

Trauma-Informed Care with Child Abuse Victims …………….. 6

Theoretical Orientation……………………………………………………………………. 7

Potential Contribution of the Study to Micro and/or Macro Social Work
Practice ………………………………………………………………………………………… 8

Summary ……………………………………………………………………………………… 8

CHAPTER TWO: ENGAGEMENT ……………………………………………………………… 9

Introduction …………………………………………………………………………………… 9

Study Site …………………………………………………………………………………….. 9

Engagement Strategies for Gatekeepers at Research Site ………………… 10

Self-Preparation …………………………………………………………………………… 11

Diversity Issues ……………………………………………………………………………. 12

Ethical Issues ………………………………………………………………………………. 13

Political Issues …………………………………………………………………………….. 13

The Role of Technology ………………………………………………………………… 14

Summary ……………………………………………………………………………………. 14

v

CHAPTER THREE: IMPLEMENTATION ………………………………………………….. 16

Introduction …………………………………………………………………………………. 16

Study Participants ………………………………………………………………………… 16

Selection of Participants ……………………………………………………………….. 17

Data Gathering ……………………………………………………………………………. 18

Phases of Data Collection ……………………………………………………………… 19

Data Recording ……………………………………………………………………………. 20

Data Analysis ………………………………………………………………………………. 20

Summary ……………………………………………………………………………………. 21

CHAPTER FOUR: EVALUATION …………………………………………………………….. 23

Introduction …………………………………………………………………………………. 23

Data Analysis ………………………………………………………………………………. 23

Participant Demographics ……………………………………………………. 23

Open Coding ……………………………………………………………. 24

Axial Coding …………………………………………………………….. 26

Data Interpretation ……………………………………………………………………….. 27

Implication of Findings for Micro and Macro Practice ………………………… 28

CHAPTER FIVE Termination and Follow Up ……………………………………………… 29

Introduction …………………………………………………………………………………. 29

Termination of Study …………………………………………………………………….. 29

Communication of Findings to Study Site and Study Participants ……….. 30

Ongoing Relationship with Study Participants ………………………………….. 30

Dissemination Plan ………………………………………………………………………. 30

Summary ……………………………………………………………………………………. 30

vi

APPENDIX A: DATA COLLECTION INSTRUMENT………………………………32

APPENDIX B: INFORMED CONSENT …………………………………………………….. 34

APPENDIX C: PARTICIPANT RECRUITMENT FLYER ………………………………. 36

APPENDIX D: INSTITUTIONAL REVIEW BOARD …………………………………….. 38

REFERENCES ……………………………………………………………………………………… 41

1

CHAPTER ONE

ASSESSMENT

Introduction

Chapter one provides an overview of the focus of this research study. The

post-positivist perspective and its’ incorporation into the research study is then

discussed. Next a literature review is provided to help one understand trauma,

its’ effects, and the importance of social workers utilizing trauma-informed care

within their practice when working with child abuse victims. The theoretical

orientation that frames the focus of the research study is then discussed. This

chapter concludes with a discussion on the study’s implications for micro and

macro social work practice.

Research Focus

Child abuse is often a very traumatic experience that can create long-

lasting psychological and emotional effects for some individuals. Social workers

often provide treatment services, such as therapy and/or case management

services, with the goal of assisting child abuse victims in coping with and

overcoming the negative psychological and emotional impact of the trauma they

have experienced. This research study is an exploratory qualitative study that

evaluates the types of interventions social workers utilize when working with child

abuse victims, how the interventions address the resulting trauma of child abuse,

2

which interventions social workers believe are most effective when working with

this population, and why those interventions are believed to be most effective.

Paradigm and Rationale for Chosen Paradigm

A post-positivist paradigm was applied throughout the research study. The

post-positivist paradigm employs an inductive approach to research, which

allowed the researcher to initiate the research process by focusing on one area

and then exploring patterns and additional aspects that began to emerge within

the data obtained. The post-positivist paradigm asserts that research is best

conducted in naturalistic settings, allowing researchers to obtain qualitative data

that best portrays how things occur in relation to the focus of one’s research

focus (Morris, 2013). Incorporation of this paradigm within the research study

helped the researcher identify key patterns related to focus of the study such as

common interventions utilized amongst social workers, how the interventions are

used, why specific interventions are selected to use over others, and clients’

responses and/or reactions to chosen interventions.

Literature Review

A literature review was conducted to help formulate a comprehensive and

thorough understanding of child abuse, trauma and its’ effects, and the

importance of social workers utilizing trauma-informed care within their practice

when working with vulnerable populations such as child abuse victims. The

3

following is a discussion of key information the researcher found when

conducting the literature review.

Child Abuse

Child abuse occurs when a caregiver’s actions and/or inactions result in a

child being seriously harmed or placed at substantial risk for imminent harm or

death (Child Welfare Information Gateway, 2020). The four common types of

child abuse are physical abuse, sexual abuse, neglect, and emotional abuse.

Freer, Sprang, Katz, Belle, and Sprang (2017) report 13.8% of children

are abused each year and that 25.6% of children experience at least one type of

abuse throughout their childhood. At least one in seven children have

experienced abuse in the past year, 84.5% of victims experienced one type of

abuse, and 15.5% are victims of two or more types of abuse (The Child Welfare

Information Gateway, 2020).

Trauma and its’ Effects. Trauma occurs when an individual is exposed to

an intense and unexpected experience that creates strong psychological and

physiological feelings of helplessness and fear (American Psychiatric

Association, 2013). Trauma experiences can vary, but they commonly involve

experiencing a sudden event outside of one’s control (Levenson, 2017). Natural

disasters, community violence, intimate partner violence, and child abuse are

some examples of traumatic events.

Individuals exposed to a traumatic event often suffer from emotional and

psychological distress after the event. Gipple, Lee, & Puig (2006) note anxiety,

4

confusion, agitation, flashbacks of the event, fatigue, dissociation, fear, a

heightened sense of arousal, and blunt affect as some of the emotional and

psychological distress symptoms individuals exposed to trauma may experience.

For those who are resilient and are able to identify effective coping strategies,

these symptoms may be mild and have a subtle impact. Others may experience

more severe and prominent symptoms that are difficult to cope with. Mirabito

(2017) notes three factors that predict the intensity of trauma reactions: one’s

level of available social support, the meaning of the trauma event to the

individual, and the amount of past trauma one has been exposed to.

There are three types of trauma: acute, complex, and chronic. Acute

trauma is when an individual experiences a single trauma incident in their life,

such as experiencing a natural disaster or being a victim of a crime. Complex

trauma is when an individual is exposed to multiple traumatic events. Individuals

who have experienced chronic trauma have experienced repeated and prolonged

abuse. Child abuse can fall into any of these three categories, as individuals may

experience abuse once, on multiple occasions, and/or continuously over long

periods of time.

The impact and intensity of the effects of trauma can vary depending on

various circumstances such as: the developmental status and age of the child

when the abuse occurred, the type of abuse experienced, the duration,

frequency, and severity of the abuse, as well as the relationship between the

victim and the perpetrator. Those who experience trauma have a higher risk of

5

developing various behavioral health and physical issues, such as depression,

diabetes, and obesity (Forkey, Morgan, Sagor, & Schwartz, 2016). Children who

experience abuse, may experience various developmental delays, such as:

social-emotional, speech, cognitive, and physical development delays (Culp,

Richardson, & Heide, 1987). The behavioral, emotional, and physiological effects

of trauma on children who have been abuse can extend into adulthood (Lee,

2017).

The Center for Disease Control and Prevention (CDC) and Kaiser

Permanente conducted the Adverse Childhood Experience study (ACEs study)

which evaluated the long-term impact on individuals who experienced childhood

adversities. The study found that individuals who experience one or more

adverse experience as a child are at greater risk of experiencing long-term

health, social, and emotional issues later in life compared to those who don’t

experience childhood adversities (Ford, Klevens, Merrick, Metzler, & Ports,

2017). Of the ten types of adverse childhood traumas that the CDC categorizes

as adverse childhood experiences within the study, child abuse makes up five of

the categories: emotional abuse, physical abuse, sexual abuse, physical neglect,

and emotional neglect (Ford et al., 2017).

6

Trauma-Informed Care with Child Abuse Victims. Social workers

frequently work with child abuse victims as they provide crisis intervention,

advocacy, and support services in various settings such as medical facilities,

child welfare agencies, community crisis centers, foster care agencies, mental

health departments, and counseling agencies. It is vital for social workers who

provide treatment services to child abuse victims to have a working knowledge of

trauma, its’ effects, and to incorporate trauma-informed care within their practice

in order to efficiently aid clients in overcoming the effects of trauma.

Providing trauma-informed care involves understanding that clients’

presenting issues are often directly correlated to their prior trauma experiences.

Levenson (2017) asserts that when social workers apply their working knowledge

of the effects of trauma and interact with clients in a compassionate and

empathetic manner, social workers in turn encourage clients’ self-determination

and their ability to develop positive coping strategies. Utilizing empathetic and

strengths-based interventions with child abuse victims, promotes trust within the

client-worker relationship and cultivates a strong safety and support network for

clients to work towards overcoming the effects of their trauma, feel empowered,

and to create the positive changes they desire (Wolf, Green, Nochajski, Mendel,

& Kusmaul, 2013).

The prevalence of trauma within the child welfare system emphasizes the

importance of social workers integrating trauma-informed care within their

practice. Ake et al. (2011) conducted a study that examined the complex trauma

7

histories and emotional and behavioral problems of youth involved in the foster

care system. Their findings note that conducting thorough assessments and fully

understanding foster youth’s trauma experiences can help social workers better

identify and address the various needs of foster youth.

The information found during the literature review highlights the necessity

for social workers to understand the effects of trauma in order to provide

appropriate treatment services to child abuse victims. The data obtained in this

research study can be utilized as an educational tool for social workers to

understand which interventions have been found by other social workers to be

effective when working with child abuse victims and may encourage social

workers to utilize new interventions and/or tailor current interventions they

already use within their own practice to better aid their clients in being resilient

and addressing and overcoming their trauma.

Theoretical Orientation

The theoretical orientation behind this study is trauma theory. Trauma

theory describes the correlation between traumatic experiences and the

emotional distress one experiences after experiencing a traumatic event. This

theory asserts that one must clearly understand the correlation between the two

in order to effectively address trauma symptoms. As such, having a clear

understanding of what trauma is will allow one better understand the impact and

effects trauma has on individuals.

8

Potential Contribution of the Study to Micro and/or Macro Social Work Practice

The data obtained from this study can potentially contribute to the field of

social work at both the macro and micro levels. On the micro level, the data

produced from this study can increase social workers’ use of empathy and

engagement with their clients and encourage social workers to employ trauma-

informed care within their practice when working with individuals whom have

experienced trauma. On the macro levels, this study can help contribute to the

understanding of the need for social service agencies to employ trauma-informed

services and policies.

Summary

This chapter provided an overview of the focus of this research study. An

explanation of the post-positivist perspective and its’ incorporation within the

research study was discussed. A literature review was provided, followed by an

explanation of the theoretical orientation that frames the focus of the study. The

chapter concluded with a brief discussion regarding the ways in which the

research study can contribute to micro and macro social work practice.

9

CHAPTER TWO

ENGAGEMENT

Introduction

Chapter two explores how engagement was performed throughout the

research study. Details regarding the research site and the researcher’s

interactions with site’s gatekeepers are discussed. A discussion regarding how

the researcher prepared for the study is then provided. Ethical, diversity, and

political issues of the study are then addressed. The chapter concludes detailing

how technology was utilized throughout the study.

Study Site

The research was focused on individuals located in a county in Southern

California. The study site was a non-profit organization that provides crisis

intervention services, counseling services, referrals and linkage to community

resources, and support and advocacy services and/or groups, to individuals who

have experienced child abuse. The primary goal of the study site is to aid clients

in addressing and overcoming the trauma associated with the abuse they have

experienced. The agency employs paid staff and also has volunteers whom work

directly with agency clientele. The agency provides services to clients on-site

within their various office locations, and also off site at locations within the local

community such as prisons, hospitals, and school settings. The agency services

10

a diverse clientele population that includes adults and children, various gender

identities, and various races and ethnicities.

Engagement Strategies for Gatekeepers at Research Site

The gatekeeper for the study site was the agency’s director. The director

is responsible for ensuring all program services are ran effectively and in

compliance with the agency’s goal and mission. The director oversees all staff

members within the agency, secures program funding, collects and organizes

data pertaining to agency statistics, and gives final approval of selection and

hiring of staff at the agency.

The researcher initiated engagement with the gatekeeper by placing a

telephone call to the agency and obtaining the gatekeeper’s contact information

(email address). An email was then sent to the gatekeeper in which the

researcher introduced them self and discussed the researcher’s desire to

conduct an exploratory qualitative research study at the agency site, with the

agency’s staff members acting as study participants. The researcher provided an

overview of the study, its’ purpose and focus, and detailed the role of study

participants partaking in interviews with the researcher. The researcher received

an email response from the gatekeeper noting the gatekeeper’s excitement and

interest in allowing the researcher to utilize the agency as the study site. During

this email exchange, an in-person meeting was scheduled with the gatekeeper to

discuss the study in further detail.

11

During the in-person meeting, the researcher and gatekeeper thoroughly

discussed all aspects of the study which included: how the researcher planned to

recruit and select study participants, how the research interviews would be

conducted, the interview questions, the researcher’s plan to provide informed

consent to study participants, how confidentiality would be maintained throughout

the study, and what assistance would be needed from the gatekeeper in linking

the researcher to the agency staff.

The researcher further explained to the gatekeeper how the study would

benefit the agency as the study’s findings would note which interventions their

employees used with agency clients, how successful the interventions were in

addressing clients’ trauma and aligned with the agency’s mission and goals,

provide insight into additional interventions staff members could incorporate

within their practice in the future, and stimulate discussion and brainstorming on

how certain practices and interventions could be expanded throughout the

agency to further aid and support the agency clientele. The gatekeeper gave

approval and provided written consent for the researcher to use the agency as

the research study site and to recruit study participants from the agency’s staff

members.

Self-Preparation

A literature review was conducted and provided the researcher with a

detailed understanding of the key elements pertaining to the research topic. The

literature review highlighted the importance of the researcher understanding child

12

abuse as a traumatic event, trauma symptoms, the impact of trauma, and the

importance of social workers employing trauma-informed care within their

practice when working with child abuse victims. The literature review further

provided an understanding that utilizing trauma-centered and empathetic

interventions can effectively aid child abuse victims in overcoming their trauma.

With the knowledge obtained from the literature review, the researcher

created a list of pre-determined questions to ask study participants in the

research interviews.

It was important for the researcher to remain cognizant and aware of

personal biases and values to ensure that they did not influence the researcher’s

data gathering process. As such, the researcher kept two journals throughout the

research study to aid the researcher in managing any biases. The researcher

utilized the journals to reflect on the research process, document the

researcher’s thoughts and feelings regarding the research process, and to

document the actual data obtained from study participants during the study.

Diversity Issues

A key diversity issue pertaining to this study was the minimal inclusion of

males in the research process. In general, there is a higher ratio of females

employed in the social work field compared to males; this was also the case

within the study site. To address this issue, the researcher constructed eligibility

requirements that included participants of all gender identities and the researcher

ensured recruitment efforts remained inclusive to all gender identities.

13

Ethical Issues

A proposal of the study was presented to the Institutional Review Board

(IRB) to obtain approval to conduct the study and for review in order to avoid any

possible ethical issues. To avoid ethical issues, informed consent was provided

to study participants to ensure they had a full understanding of the scope of the

research study, the type of information that would be obtained from them, the

steps that would be taken to ensure their confidentiality, and how their responses

would be used within the study. Due to the inability to conduct interviews in

person with study participants due to COVID-19 pandemic restrictions, each

participant verbally stated their consent to participate in the study, acknowledged

that they received proper informed consent regarding the parameters of study,

and stated their willingness to act as a study participant.

Another ethical issue that was taken into consideration was confidentiality.

In order to ensure the confidentiality of the study participants, the researcher did

not collect personal identifying information from study participants. Furthermore,

after each interview was completed with the study participants, the audio

recordings of the interviews were transcribed into Microsoft Word documents

using Trint transcription software, and then the audio recordings were deleted.

Political Issues

A key political issue pertaining to this study was society’s current focus on

human and social service workers’ incompliance with legal and ethical standards,

which has led to various lawsuits against child welfare agencies and social

14

workers. There may have been fear that the study could indicate that the agency

that acted as the study site wasn’t doing enough to assist clients or wasn’t doing

things in an appropriate ethical and legal manner. The researcher addressed this

issue during the engagement process with gatekeeper, as the researcher

explained the goal, intent, and potential for the study’s findings to highlight the

positive things the agency is doing when working with clients and to enlighten the

agency on practices they may want to expand on and improve in order to

increase client and agency outcomes.

The Role of Technology

Technology was used in the engagement process through telephone calls

and emails with the study site’s gatekeeper. Email exchanges also occurred

between the researcher and study participants to identify and select study

participants and to schedule the research interviews with the study participants.

The video conferencing application “Zoom” was also utilized to conduct the

research interviews with study participants, as COVID-19 restrictions prohibited

the researcher’s ability to conduct in-person interviews. The interviews were

recorded with a digital audio recording device.

Summary

This chapter explored how the researcher initiated engagement with the

gatekeeper of the study site and obtained approval to use the gatekeeper’s

agency as the study site for this research study. Details regarding the study site

15

and how the researcher prepared for the study were also discussed, followed by

potential issues the researcher needed to remain aware of and address

throughout the research process. The chapter concluded detailing how

technology was utilized in the study.

16

CHAPTER THREE

IMPLEMENTATION

Introduction

Chapter three discusses how the research study was conducted. First,

study participants are identified and an explanation of how study participants

were selected is noted. Next, the methods for data gathering, the phases in

which data was gathered, and how data was recorded are discussed. Then an

explanation was provided as to how the research data was analyzed. The

chapter concludes with a description of how termination and follow-up took place

and how the study’s research findings were distributed and communicated.

Study Participants

As the study sought to determine which interventions social workers

believe are most effective when working with child abuse victims, social workers

experienced in working with individuals who have experienced child abuse were

selected as study participants. The sample size for the study was six.

Participants were employees employed at the study site, as the study site

provides services to victims of child abuse. The study participants were

comprised of mixed genders and ages, and possessed at minimum a Bachelor’s

degree to ensure the participants had a thorough understanding of the key topics

pertaining to the research study (child abuse and trauma).

17

Selection of Participants

This study used homogeneous sampling to select study participants. This

sampling strategy is a purposive sampling technique that aims to acquire a

sample that has the same and/or similar characteristics (Morris, 2013). This

sampling strategy was utilized in order to allow data to be collected from a

sample of social workers that share the characteristics of having experience

working with child abuse victims and having a working knowledge of trauma.

The researcher created a recruitment flyer that detailed the study, its’

focus, the researcher’s desire to seek volunteer participants, the role of

participants in the study, listed the criteria participants needed to meet in order to

be selected as a participant (have at minimum a Bachelor’s degree and provide

direct treatment services to the study sites’ clients), and noted how those

interested in participating in the study could contact the researcher.

The gatekeeper distributed the researcher’s recruitment flyer to the study

site’s staff members prior to some of the study site’s staff meetings.

With the consent of the gatekeeper of the study site, the researcher

attended two of the study site’s staff meetings, met with the study site’s staff

members, discussed the research study (its’ objectives, purpose, how data would

be obtained and analyzed, and the benefits the study would have for the study

site and how the data could improve staff’s practices with the study site’s

clientele), explained the researcher’s goal of recruiting staff members from the

study site to act as study participants, explained the criteria to be considered and

18

selected as a study participant, and thoroughly explained what the study

participants’ role would be in the study (participating in an interview with the

researcher and answering a series of questions pertaining to the services they

provide and the interventions they utilize with their clients). The researcher

explained how those interested in participating in the study could contact the

researcher via email to inform the researcher of their interest, that they meet the

study’s criteria, and to schedule a date and time to complete the research

interview.

The researcher further explained that confidentiality would be maintained

throughout the study by not obtaining and/or including any personal identifying

information obtained from study participants throughout the research process.

Data Gathering

Semi-structured interviews were utilized as the data collection method

during this research study in order to obtain qualitative data. The interviews were

conducted via the video conferencing application “Zoom” in compliance with

COVID-19 protocols. Utilizing semi-structured interviews allowed the researcher

to ask study participants a series of predetermined questions that were created

prior to the interviews, as well as additional and/or follow up questions to seek

clarity of and explore participants’ responses. The researcher remained open and

flexible throughout the interview process and allowed participant responses to

guide the research and highlight additional aspects related to the research topic

19

that the researcher may not have originally considered or been previously aware

of.

The interview questions consisted of open-ended questions that

encouraged participants to openly communicate and express their thoughts

within their responses. Several descriptive questions were asked, such as: What

is your understanding of trauma and its’ effects? How have you seen trauma

effect child abuse victims? When working with child abuse victims, what

interventions do you use and why? Structural questions were also asked. For

example: “What are the interventions intended to target, address, or treat?”

Contrast questions were also utilized during the interviews, such as: Are there

certain interventions you believe are more effective to utilize when working with

child abuse victims? If so, why? A complete list of the predetermined questions

that were asked in the interviews is attached and referenced herein (see

Appendix A).

Phases of Data Collection

When conducting the interviews with study participants, the researcher

structured the interviews into three phases that began with asking questions that

built engagement and rapport with participants. The researcher chose to start the

interviews with general questions to help participants become comfortable with

the researcher and the interview process. As the researcher transitioned into the

second phase, the developing portion of the interviews, the researcher

transitioned into asking essential questions focused on the research topic. The

20

final stage of the interviews was the termination stage in which generic and

minimal follow up questions were asked to help lower the intensity of the

interviews and conclude the interviews. At the end of the interviews, participants

were provided the opportunity to add information to any of their responses.

Data Recording

With the verbal consent of the study participants obtained prior to each

interview, an audio digital recorder was utilized to record interviews. The audio

recordings of the interviews were transcribed and reviewed after each interview.

Transcribing the interviews allowed the researcher to accurately note and refer

back to participants’ responses as needed when analyzing the data.

Two separate journals were also utilized to record data. The researcher

used one journal to take detailed notes regarding all aspects of the research

process such as: the researcher’s preparation and planning for the study,

interactions with the gatekeeper, study participants, and all of the data collected

during the study. This journal documented the research study from start to finish.

The second journal held more of a reflective purpose for the researcher, as it

included the researcher’s reflections pertaining to the research process and

decisions made throughout the study.

Data Analysis

A qualitative analysis of the data obtained during the study was

conducted. The units of analysis were social work practitioners who have

21

experience working with victims of child abuse and utilized interventions, as the

purpose of the study was to evaluate which interventions are believed to be most

effective in addressing trauma when working with child abuse victims.

A bottom-up approach was utilized to analyze the qualitative data

obtained. This was completed in three stages: open coding, axial coding, and

selective coding. During the open coding stage, the transcriptions of the

interviews were reviewed and broken down into smaller sections that allowed the

researcher to analyze the data more easily and in more detail. In doing so, the

researcher separated pertinent information found within the data into prevalent

categories and concepts related to the research focus. In the axial coding stage,

the researcher identified relationships and themes and that existed between the

previously identified categories and concepts that emerged in the open coding

stage. The researcher explored and tested these relationships as data continued

to be collected in subsequent interviews with study participants. In the selective

coding stage, the researcher identified a main theme that was present within the

study’s data and formulated a theory that focused on why social workers believe

certain interventions are most effective when working with child abuse victims.

The researcher then developed an overall statement regarding how the theory

identified during the selective coding stage applies to human interaction.

Summary

This chapter discussed how the research study was conducted. An

explanation of how study participants were identified and selected was noted.

22

The chapter then concluded by discussing the data methods that were used, as

well as how data was gathered, recorded, and analyzed.

23

CHAPTER FOUR

EVALUATION

Introduction

Chapter four begins with a description of the study participants’

demographics. The categories and concepts discovered during the open coding

stage of the data analysis are noted. The themes developed during the axial

coding stage are then provided. The data interpretations are discussed next. The

chapter concludes discussing the impact of study’s findings on social work

practice.

Data Analysis

Participant Demographics

The study included six participants that ranged in age from 23 to 53 years

old; the average participant age was 32. All participants with the exception of one

were female. 50% of the participants self-identified as Latino, 33% self-identified

as African American, and 17% self-identified as Native American. The

participants’ time frame of working in the social services field ranges from 3 years

to 10 years. The participants time frame of working at the study site ranged from

half a year to five years. Participants reported working with child abuse victims at

the study site that range in age from 10 to 81 years old.

24

Open Coding. The following concepts were identified during the first stage

of analysis: assessment tools, engagement, and common interventions.

Common interventions noted to be used by participants with their clients

were art therapy, journaling, talk therapy, and active listening. All study

participants reported using art therapy with their clients as a way to help their

clients communicate and express their thoughts and feelings. Participant 1

reported the following:

One of the best ways that I’ve seen in terms of dealing with children and

getting them to express their feelings is through art. So usually during the

first couple of sessions with clients, I’ll do an art project that helps them

metaphorically express their feelings via the art. So I’ll tell them, draw for

me what your world looks like, or what today looks and feels like for you. I

had one child who drew lightning bolts and raindrops on one side of the

paper and then on the other side they drew the beach. We then compared

the sides, and she explained that the side with raindrops is often how she

feels (sad and frightened) and the side with the beach is how she wishes

she felt more often (calm). I’ve noticed that’s it’s easier for my clients to

communicate their feelings when it’s done in that aspect; through art

(Personal Communication, November 2020).

Participant 3 reported the following:

I often have my clients draw a pair of eyes. One eye represents how they

see themselves now and where they currently are in life. The other eye

25

represents how and where they would like to see themselves. Sometimes

there’s a lot of split things going on…it’ll be dark and gloomy on one side

and then more hopeful on the other side. From there we talk about things

they feel they can do to reach the happy and hopeful side or where they

would like to be (Personal Communication, January 2021).

Five of the participants identified journaling as a main intervention they

utilize with their clients. Participant 1 described how they use journaling at times

with their teenage clients:

Dump journaling is another thing that I’ve recently started doing with the

teenagers and they really like it, especially right now with the situation

we’re in with COVID. A lot of them are getting very stressed with just

being at home…There’s a lot of distractions and often prioritizing stuff

causes anxiety for them. So the journaling is a way for them to kind of

doodle their feelings and get all their thoughts out, and it also helps them

organize their thoughts. So it can be used like an organizational type of

coping technique. It helps them eliminate those anxieties and feelings of

being overwhelmed (Personal Communication, November 2020).

All participants described the need to find the right way to engage with

each of their clients in order to establish and build rapport with them. Participant

6 described how the process of establishing and building rapport with their clients

often takes time:

26

During my first few sessions with them I really try to work to build rapport

and common ground with them so that they become comfortable working

with me and opening up to me. This can take a while some times, and

other times I get some clients who are completely okay with just talking

about things and jumping right into the reason of why they’re there to see

me. I really take it at their pace and let them choose what it is they want to

talk about (Personal Communication, January 2021).

Axial Coding. During the axial coding stage of analysis, the concepts and

categories identified in the open coding stage were further analyzed and the

researcher discovered that the concepts related to an overarching theme of using

interventions with child abuse victims that: promote empathy and empowerment,

enable one to confront their trauma, and help one find their power and voice to

create their own narratives. While analyzing the concepts discovered in the open

coding stage, the researcher found that the concepts provided a way for the

participants to show empathy to and empower their clients and provided an outlet

for participants to allow their clients to acknowledge the trauma they’ve

experienced and to develop the strength and ability to tell their trauma stories.

Participant 1 reported their goal of seeking to empower their clients:

More than anything it’s empowerment. I want them to feel like they’re in

this place where it’s safe and they feel good and they feel some sort of

relief. The other important thing is being able to validate their feelings.

Like, for instance, when we have talk therapy, a lot of clients seem to think

27

crying is a negative thing and something that just shows weakness. I want

them to understand that crying however can be a good thing and act as a

sense of release. So we have to kind of re-work their views so that they

don’t just see expressing their emotions as a vulnerability, but rather as a

powerful tool that they could use…Validating their feelings is also

important for me, but also allowing them to validate themselves is key

(Personal Communication, November 2020).

Data Interpretation

This study found that use of assessment tools, proper engagement

strategies, and interventions such as journaling and art therapy were primary

methods for participants to identify their clients’ needs, understand the intensity

and impact the trauma of abuse has on their client, and to address their clients’

trauma.

The main overarching theme discovered in the study was the use of

interventions that promote empathy and empowerment, aiding clients in

confronting their trauma, exploring and listening to victim narratives, and helping

clients find their power and voice. The data supports the assertion that use of

interventions based on the principles of safety, trust, choice, and empowerment

are effective in addressing child abuse victims’ trauma and helps aid in their

journey towards resiliency.

28

Implication of Findings for Micro and Macro Practice

The findings from this study can potentially contribute to the field of social

work at both the macro and micro levels. On the micro level, the data produced

from this study can encourage and increase social workers’ use of empathy and

engagement with clients and further encourage social workers to employ trauma-

informed care within their practice when working with individuals whom have

experienced trauma. On the macro levels, this study highlights the importance

and need for local and state governments to not only fund community programs

that provide assistance to trauma victims, but also to provide ongoing appropriate

training regarding trauma-informed care to employees within such community

programs.

29

CHAPTER FIVE

TERMINATION AND FOLLOW UP

Introduction

This study evaluated interventions social workers believe are most

effective when working with child abuse victims. This final chapter begins with a

description of how the termination process of the study occurred. Next, how the

study findings were communicated to the participants and study site is discussed.

This is followed by a description of the researcher’s ongoing relationships with

study participants. The chapter concludes with discussing how the study findings

were disseminated.

Termination of Study

Each participant was thanked for their time and participation after each

respective interview. Termination of the study at the study side was conducted by

presenting the study’s findings to the study site. The final termination of the study

as whole occurred upon submitting the study’s findings for open access in the

University’s ScholarWorks depository and presenting the findings at the

University’s Research Symposium Event.

30

Communication of Findings to Study Site and Study Participants

The researcher met with the study site’s gatekeeper via Zoom once the

study concluded and discussed the findings of the study. The researcher then

once again attended one of the study site’s staff meetings virtually, and

communicated the study findings via a PowerPoint presentation to the study site

and study participants.

Ongoing Relationship with Study Participants

Termination with study participants began at the end of each respective

interview and then concluded when the researcher communicated the study

findings to all staff at the study site.

Dissemination Plan

The findings of the study were submitted for open access in the

University’s ScholarWorks depository and were presented at the University’s

Research Symposium Event.

Summary

This chapter began by describing how the termination process of the study

occurred. The way in which the study findings are communicated to the

participants and study site was then discussed. Next, a description of the

researcher’s ongoing relationships with study participants was provided. The

31

chapter concluded with a discussion of how the study findings were

disseminated.

32

APPENDIX A

DATA COLLECTION INSTRUMENT

33

34

APPENDIX B

INFORMED CONSENT

35

36

APPENDIX C

PARTICIPANT RECRUITMENT FLYER

37

38

APPENDIX D

INSTITUTIONAL REVIEW BOARD

39

40

41

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Child Welfare Information Gateway. (2020). Definitions of child abuse and

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Culp, R., Heide, J., & Richardson, M. (1987). Differential developmental progress

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Ford, D., Klevens, J., Merrick, M., Metzler, M., & Ports, K. (2017). Adverse

childhood experiences and life opportunities: Shifting the narrative.

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Gipple, D., Lee, S., & Puig, A. (2006). Coping and dissociation among female

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Levenson, J. (2017). Trauma-informed social work practice. Social Work, 62(2),

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Mirabito, D. (2017). Social Work Theory and Practice for Crisis, Disaster, and

Trauma. In F. J. Turner, Social Work Treatment: Interlocking Theoretical

Approaches (pp. 117-130). New York, NY: Oxford University Press.

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Morris, T. (2013). Practice informed research methods for social workers.

Wolf, M., Green, S., Nochajaski, T., Mendel, W., & Kusmaul, N. (2013). We’re

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Journal of Social Service Research, 40(1), 111-120.

  • WHICH INTERVENTIONS DO SOCIAL WORKERS BELIEVE ARE MOST EFFECTIVE WHEN WORKING WITH CHILD ABUSE VICTIMS?
    • Recommended Citation
  • tmp.1620182913.pdf.P2Ab8

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