Correlates of social worker decisions to seek treatment-oriented out-of-home care

doi:10.1016/S0190-7409(98)00008-5

Children and Youth Services Review

Volume 20, Issue 4, May 1998, Pages 281-304

https://doi.org/10.1016/S0190-7409(98)00008-5 Get rights and content

Abstract

This paper reports the results of a study of decisions by child welfare workers regarding the ideal placement type for 348 children placed in out-of-home care in California. The study examines factors associated with the preference to place a child in treatment foster care or group care as opposed to foster family or kinship care. Child age, behavior problems, and placement history were found to be strong predictors of social worker placement preferences.

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Cited by (27)

Children referred to foster care, family-style group care, and residential care: (How) do they differ?
2017, Children and Youth Services Review
Citation Excerpt :
Residentially placed children further showed the highest degree of school/learning problems. Both Courtney (1998) and James (2006) suggest that this high percentage of children with severe individual (behavior) problems in residential care would reflect the tendency of welfare workers to refer these children to more restricted (residential) care. Conversely, the ASEBA test results of substitute caregivers seem to argue against this hypothesis, since these results suggest that the children in family-style group care instead of residentially placed children have the severest behavioral problems.
To date, no evidence-based criteria are available to place children with multiple psychosocial risks and needs in the most appropriate type of (non-secure) out-of-home care. Due to this, other factors than just the clinical needs of the child and its family are in use, which can heighten the risk of both breakdown (i.e. unplanned terminated placement) and/or poor prognostic placement outcomes. To reduce adverse placement outcomes, insight into the risks and needs of the children at the time of referral can be helpful. To this end, this study explores similarities and differences in child, family and care history context of 200 Dutch school-aged children at the time of admission to foster, family-style group, and residential care. A cross-sectional design was used and data were collected through standardized questionnaires that were completed by the caregivers, substitute caregivers, and behavioral scientists. Case file information was also used. The results showed differences between the three subgroups in all three contexts, which suggest several setting-specific guidelines to promote positive outcome. Biological parents of foster children specifically are in need of support for their individual problems. In family-style group care, specifically, help is required for attachment and trauma-related problems. Residentially placed children are in particular need of specialized care for mental illness, behavioral and school/learning problems. Further research is needed to link the outlined specific characteristics at admission to the developmental pathways of out-of-home placed children. Such research may contribute to the development or refinement of a risk-need-responsivity model to support the decision making regarding out-of-home placement of children with serious psychosocial needs.
The role of race, socioeconomic status, and System of Care services in placement decision-making
2015, Children and Youth Services Review
Citation Excerpt :
Child welfare placement decisions can have significant implications for both children and society (Courtney, 1998).
A 2 × 2 × 2 experimental design was used to examine the potential influence of race (African American vs. Caucasian), socioeconomic status of the foster care environment (Low vs. High), and System of Care (SOC) services (System of Care/Wraparound Services vs. Treatment as Usual) on social workers' placement decisions within the child welfare system. Two hundred thirty-one social workers from Illinois (86.8% female, 85.4% European-American; mean age of 50.6 years) read a vignette of a child in foster care and were asked to recommend whether the child should remain in his current community-based foster care placement or be stepped up to a residential placement. Workers then completed a demographic form and rated the child's clinical and treatment needs. No main effects of race, SES of the foster care environment, or treatment history on placement decisions were found. Subsequent exploratory analyses indicated that clinical factors, environmental factors, participants' experience in child welfare, and vignette condition interacted in nuanced ways to predict placement recommendations. While clinical variables were the primary factors that social workers considered when making placement decisions, the decisions were also be influenced by perceptions of the availability of community and family resources. Future research should consider using more open-ended approaches in order to further assess the processes by which social workers make placement decisions in the child welfare system.
Social disorganization and the profile of child welfare: Explaining child welfare activity by the community-level factors
2014, Child Abuse and Neglect
This article addresses the question of the structure of local child welfare activities in light of community-level factors. It poses the following research questions: how are different community-level factors related to child welfare client structures in communities and what is the extent to which these factors explain structural differences? The applied theoretical framework is based on social disorganization and strain theories as well as human developmental approach. The data has been collected from two Finnish national databases and it consists of variables containing 257 Finnish municipalities. The method of analysis is multinomial logistic regression. The results suggest that the local child welfare structures are tied to social disorganization, policing and culture as well as to the intensity of control in the communities. In general, the more fragile the communal structures, the more last-resort child welfare there is in the community. Combining fragile communal structures with weak dependency ratio and high proportion of social workers, the more intense the level of child welfare statistics indicated. The results indicate that the theoretical framework for the application of child welfare activity analysis is justified, but they also suggest that it requires further development through both context-bound reflection and application.
Predicting outcomes of children in residential treatment: A comparison of a decision support algorithm and a multidisciplinary team decision model
2012, Children and Youth Services Review
Residential treatment is the most intensive and costly component of all child welfare systems per episode of care. At the same time, decisions to place in residential treatment centers are prioritized by the practice of least restrictive setting and best interest for children. There are, however, no standard evidence-based criteria for placing children in residential treatment. Clinical judgment, staffing dynamics, and other system factors are part of the decision-making process. Thus, some residential placements may be unnecessary and may be even harmful. The present study compares two models of decision-making, a multidisciplinary team approach and an objective decision support algorithm, and assesses outcomes when the two models either concur or not. Concordant decisions predicted greater clinical improvement than discordant decisions, but no differences were found in length of stay in placement. Policy implications for the decision-making process in child welfare are discussed.
Transitioning from group care to family care: Child welfare worker assessments
2010, Children and Youth Services Review
Citation Excerpt :
In comparison, factors associated with higher relative odds of being placed in group care included having clinical levels of externalizing behaviors (5 times more likely) or internalizing behaviors (2.5 times more likely), medical concerns or disabilities (2 times more likely), and previous group care or TFC placement (3 times more likely). Surprisingly, family characteristics, including perceived parental availability and cooperativeness, were found to have no significant association with likelihood of group care placement (Courtney, 1998). As policy and practice preferences shift to family care over group care, the worker's role in helping youth transition from group care placement to family settings must also be understood.
This study explored the perspectives of child welfare workers of 232 youth currently placed in group care. Qualitative comments from workers were coded to identify barriers to placing youth in a family setting. Workers were also asked to assess the youth's readiness to transition to family care. Logistic regression identified several youth and family characteristics significantly associated with being assessed as a good candidate for family care. Worker assessment of good candidacy for family care was also significantly associated with being placed in a family setting six months later. Using discriminant function analysis, other variables were identified that more accurately predicted subsequent family care placement. Recommendations for designing efforts to transition youth from group care to family care are presented.
Different ecological perspectives for evaluating residential care outcomes: Which window for the black box?
2009, Children and Youth Services Review
Some conceptual and methodological issues in the evaluation of residential care for children and adolescents are discussed comparing different ways of understanding an ecological approach to outcome evaluation. An original Ecological Model for the Evaluation of Residential Care representing an example of a theory-driven approach based on developmental psychopathology and Bronfenbrenner's Ecological Theory is illustrated. This model provides a framework for analyzing and explaining the relationships between the intervention ecosystem and children's outcomes.

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ArticleCorrelates of social worker decisions to seek treatment-oriented out-of-home care

Abstract

Children and Youth Services Review

Journal of the American Academy of Child Psychiatry

Children and Youth Services Review

Children and Youth Services Review

From child abuse to permanency planning: Child welfare services, pathways and placements

Clinical judgement in foster care placement

Child Welfare

Assessing the needs of dependent children and wards: Analysis of the Level of Care Assessment pilot test

New challenges and opportunities in child welfare outcomes and information technologies

Child Welfare

Contributors to child placement outcomes: A longitudinal investigation

An analysis of the Behavior Rating Scale and Screening Profile as predictors of level of care

Comparison of basic data for the National Survey of Residential Group Care Facilities: 1966–1982

Child Welfare

Managed care and child welfare: Will it work?

Public Welfare

Admission and discharge criteria for chil-dren's mental-health services: A review of the issues

Journal of Clinical Child Psychiatry

Article
Correlates of social worker decisions to seek treatment-oriented out-of-home care