Abstract
This study uses a key informant approach to understand the nature, extent, and quality of outpatient mental health services for children in the child welfare system (CWS) in the United States. We interviewed 89 county child welfare administrators to determine the status of outpatient mental health services and provide recommendations for enhancing care and service delivery. Developed for this study (Caring for Children in Child Welfare), the interview was incorporated in the second formal data collection wave (i.e., 18 months after study baseline assessment) of the National Survey of Child and Adolescent Well-Being. The results highlighted general variability in the degree to which these agencies used evidence-based interventions within outpatient services, demonstrated clinical expertise with this population, and met the needs of their families. Community agency use of evidence-based interventions was found to predict their effectiveness in improving clients’ mental health problems. Proposed suggestions for service improvement varied across domains and reflected the need for more communication/coordination, service access, options and resources, and practice refinements to accommodate families’ needs. We discuss the implications of these recommendations from CWS stakeholders for enhancing the service delivery system.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Auerbach, C. F., & Silverstein, L. B. (2003). Qualitative studies in psychology. New York: New York University Press.
Barth, R. P., Landsverk, J., Chamberlain, P., Reid, J. B., Rolls, J., Hurlburt, M. S., et al. (2005). Parent-training programs in child welfare services: Planning for a more evidence-based approach to serving biological parents. Research on Social Work Practice, 15(5), 353–371.
Bazeley, P., & Richards, L. (2000). The Nvivo qualitative project book. London: Sage.
Bledsoe, S. E., Weissman, M. M., Mullen, E. J., Ponniah, K., Gameroff, M. J., Verdeli, H., et al. (2007). Empirically supported psychotherapy in social work training programs: Does the definition of evidence matter? Research on Social Work Practice, 17(4), 449–455.
Britner, P. A., & Mossler, D. G. (2002). Professionals’ decision-making about out-of-home placements following instances of child abuse. Child Abuse and Neglect, 26, 317–322.
Bruns, E. J., Hoagwood, K. E., Rivard, J. C., Wotring, J., Marsenich, L., & Carter, B. (2008). State implementation of evidence-based practice for youths, part II: Recommendations for research and policy. Journal of the American Academy for Child and Adolescent Psychiatry, 47(5), 499–504.
Burns, B. J., Phillips, S. D., Wagner, H. R., Barth, R. P., Kolko, D. J., Campbell, Y., et al. (2004). Mental health need and access to mental health services by youth involved with child welfare: A national survey. Journal of the American Academy of Child and Adolescent Psychiatry, 43(8), 960–970.
Chambers, D. (2005, April 15) Improving the fit between evidence based treatment. Paper presented at the Outreach Partnership Program 2005 Annual Meeting. Retrieved December 31, 2008, from http://www. nimh.nih.gov/health/outreach/partnershipprogram/meetings/2005/improving-the-fit-between-evidence-based-treatment-and-real-world-practice.shtml. Saturday April 2, 2005
Darlington, Y., & Feeney, J. A. (2008). Collaboration between mental health and child protection services: Professionals’ perceptions of best practice. Children and Youth Services Review, 30, 187–198.
Franco, E., Soler, R. E., & McBride, M. (2005). Introducting and evaluating parent–child interaction therapy in a system of care. Child and Adolescent Psychiatric Clinics of North America, 14, 351–366.
Glisson, C., Dukes, D., & Green, P. (2006). The effects of the ARC organizational intervention on caseworker turnover, climate, and culture in children’s service systems. Child Abuse and Neglect, 30, 855–880.
Glisson, C., Landsverk, J., Schoenwald, S., Kelleher, K., Hoagwood, K. E., Mayberg, S., et al. (2008a). Assessing the organizational social context (OSC) of mental health services: Implications for research and practice. Administration and Policy in Mental Health and Mental Health Services Research, 35, 98–113.
Glisson, C., & Schoenwald, S. K. (2005). The ARC organizational and community intervention strategy for implementing evidence-based children’s mental health treatments. Mental Health Services Research, 7(4), 243–259.
Glisson, C., Schoenwald, S. K., Kelleher, K., Landsverk, J., Hoagwood, K. E., Mayberg, S., et al. (2008b). Therapist turnover and new program sustainability in mental health clinics as a function of organizational culture, climate, and service structure. Administration and Policy in Mental Health, 35, 124–133.
Hemmelgarn, A., Glisson, C., & James, L. R. (2006). Organizational culture and climate: Implications for services and interventions research. Clinical Psychology: Science and Practice, 13(1), 73–89.
Horwath, J., & Morrison, T. (2007). Collaboration, integration and change in children’s services: Critical issues and key ingredients. Child Abuse and Neglect, 31(1), 55–69.
Hurlburt, M. S., Leslie, L. K., Landsverk, J., Barth, R. P., Burns, B. J., Gibbons, R. D., et al. (2004). Contextual predictors of mental health services use among children open to child welfare. Archives of General Psychiatry, 61, 1217–1224.
Kazdin, A. E. (2008). Evidence-based treatment and practice: New opportunities to bridge clinical research and practice, enhance the knowledge base, and improve patient care. American Psychologist, 63(3), 146–159.
Kerkorian, D., McKay, M., & Bannon, W. M., Jr. (2006). Seeking help a second time: Parents’/caregivers’ characterization of previous experiences with mental health services for their children and perceptions of barriers to future use. American Journal of Orthopsychiatry, 76(2), 161–166.
Kolko, D. J. (2006). Studying usual care in child and adolsecent therapy: It’s anything but routine. Clinical Psychology: Science and Practice, 13, 47–52.
Kolko, D. J., Baumann, B. L., & Caldwell, N. (2003). Child abuse victims’ involvement in community agency treatment: Service correlates, short-term outcomes, and relationship to reabuse. Child Maltreatment, 8(4), 273–287.
Kolko, D. J., Cohen, J. A., Mannarino, A. P., Baumann, B. L., & Knudsen, K. (2008). Community treatment of sexually traumatized children: Service description in the National Child Traumatic Stress Network. Administration and Policy in Mental Health and Mental Health Services Research (in press).
Maiter, S., Alaggia, R., & Trocme, N. (2004). Perceptions of child maltreatment by parents from the Indian subcontinent: Challenging myths about culturally based abusive parenting practices. Child Maltreatment, 9(3), 309–324.
McKay, M. M., & Bannon, W. M., Jr. (2004). Engaging families in child mental health services. Child and Adolescent Psychiatric Clinics of North America, 13(4), 905–921.
McKay, M. M., Hibbert, R., Hoagwood, K., Rodriguez, J., Murray, L., Legerski, J., et al. (2004). Integrating evidence-based engagement interventions into “real world” child mental health settings. Brief Treatment and Crisis Intervention, 4(2), 177–186.
Minkler, M., & Wallerstein, N. (2003). Community-base participatory research for health. San Francisco: Jossey Bass.
Prince, J., & Austin, M. J. (2005). Inter-agency collaboration in child welfare and child mental health systems. Social Work in Mental Health, 4(1), 1–16.
Raghavan, R., Leibowitz, A. A., Andersen, R. M., Zima, B. T., Schuster, M. A., & Landsverk, J. (2006). Effects of Medicaid managed care policies on mental health service use among a national probability sample of children in the child welfare system. Children and Youth Services Review, 28(12), 1482–1496.
Rivard, J. C., Johnsen, M. C., Morrissey, J. P., & Starrett, B. E. (1999). The dynamics of interagency collaboration: How linkages develop for child welfare and juvenile justice sectors in a system of care demonstration. Journal of Social Service Research, 25(3), 61–82.
Schoenwald, S. K., Chapman, J. E., Kelleher, K., Hoagwood, K. E., Landsverk, J., Stevens, J., et al. (2008). A survey of the infrastructure for children’s mental health services: Implications for the implementation of empirically supported treatments. Administration and Policy in Mental Health, 35, 84–97.
Silverman, W. K., Ortiz, C. D., Viswesvaran, C., Burns, B. J., Kolko, D. J., Putnam, F. W., et al. (2008). Evidence-based psychosocial treatments for children and adolescents exposed to traumatic events. Journal of Clinical Child and Adolescent Psychology, 37(1), 156–183.
Smith, B. D., & Donovan, S. E. F. (2003). Child welfare practice in organizational and industrial context. Social Service Review, 77(4), 541–563.
Smith, D. W., Witte, T. H., & Fricker-Elhai, A. E. (2006). Service outcomes in physical and sexual abuse cases: A comparison of child advocacy center-based and standard services. Child Maltreatment, 11(4), 354–360.
Stanley, N., & Penhale, B. (1999). The mental health problems of mothers experiencing the child protection system: Identifying needs and appropriate responses. Child Abuse Review, 8, 34–45.
Thomlison, B. (2005). Using evidence-based knowledge to improve policies and practices in child welfare: Current thinking and continuing challenges. Research on Social Work Practice, 15(5), 321–322.
U. S. Department of Health and Human Services Administration on Children Youth and Families. (2007). Child maltreatment 2005. Washington, DC: U.S. Government Printing Office.
Acknowledgments
This study was funded, in part, by NIMH Grant MH599672 (CCCW) to John Landsverk and Grant R01 MH074737 (PFF) to the senior author. The Caring for Children in Child Welfare project (CCCW) is a collaborative effort between the Child and Adolescent Services Group (CASRC) at the Children’s Hospital—San Diego, the Department of Psychiatry at the University of Pittsburgh (Pittsburgh), the Columbus Children’s Hospital, the Services Effectiveness Research Program at Duke University School of Medicine (Duke), and the Research Triangle Institute (RTI). Key personnel for the collaborative study include PIs John A. Landsverk (CASRC), Kelly Kelleher (Columbus Children’s Hospital), Barbara J. Burns (Duke), Paul P. Biemer (RTI); Co-PI Laurel K. Leslie (CASRC); Investigators Richard P. Barth (University of North Carolina), John A. Fairbank (Duke), Michael S. Hurlburt (CASRC), David J. Kolko (Pittsburgh), Don J. Slymen (CASRC); Project Coordinator Jennifer A. Rolls (CASRC). Key consultants include Jon B. Christianson (University of Minnesota), Anne M. Libby (University of Colorado), and Jan R. McCarthy (Georgetown University).
Disclaimer
The information and opinions expressed herein reflect solely the position of the author(s). Nothing herein should be construed to indicate the support or endorsement of its content by ACF/DHHS or NIMH and may not reflect the opinions of the researchers on the masthead.
Author information
Authors and Affiliations
Corresponding author
Additional information
We appreciate the assistance and consultation of Jennifer Rolls-Reutz, Barbara J. Burns, Barbara L. Baumann, Michael Hurlburt, and John Landsverk.
Rights and permissions
About this article
Cite this article
Kolko, D.J., Herschell, A.D., Costello, A.H. et al. Child Welfare Recommendations to Improve Mental Health Services for Children who have Experienced Abuse and Neglect: A National Perspective. Adm Policy Ment Health 36, 50–62 (2009). https://doi.org/10.1007/s10488-008-0202-y
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10488-008-0202-y