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Paper

Engaging birth parents in child welfare services: promising practices and policy opportunities

abstract

Background. Low and uneven levels of parental engagement in services have long been an issue of concern for child welfare policy makers and practitioners (Alpert, 2005). Even when faced with termination proceedings, large numbers of parents fail to undertake or complete court-mandated services. Particularly troubling is evidence that families of color generally receive and use fewer services and supports through the child welfare system than do white families. Calls for the increased use of tested child mental health interventions in child welfare practice add new urgency to the longstanding question of how to enhance parent engagement.

Parents' knowledge of their children, family circumstances, and cultural context is essential to valid assessments and appropriate intervention planning. If the plan is for children to return home, or if children are placed with relatives, parents and kin who are involved actively in mental health interventions will be better able to understand their children's developmental needs, to implement therapeutic strategies in the home setting, and to successfully manage their parenting responsibilities post-reunification. Although the empirical research base in child welfare is limited, several studies have shown that there are benefits when maltreating parents participate in mental health services with their children, including lower rates of re-abuse. And even if reunification is unlikely, research findings on youth transitioning out of foster care, and on the cultural and social value of sustained parental and family connections for children of color, underscore the importance of family involvement to children's longer term well-being.

Efforts to better engage parents in services, including their children's mental health services, must however be grounded in the best available information on barriers to engagement and promising practices for overcoming them. As a first step, this paper presents a research-based conceptual model for a more intentional and dimensional approach to engaging parents in child welfare, mental health, and other services.

Method and findings. Our conceptual model is informed by a detailed review of the available research literature on parent engagement in child welfare and related services, and by emerging evidence from research demonstration projects in child welfare and child mental health. It must be noted that the child welfare research literature on this issue is relatively sparse: many potentially promising strategies are in place, but few have been subject to systematic testing and research. However, several lines of mental health research have begun to focus, with promising results, on strategies to improve outreach, engagement, and retention of families in services. The model we present draws on these approaches along with available evidence from child welfare practice and research.

The approach to engagement presented here has two primary dimensions. First, it reframes conventional understandings of parent engagement. Second, it identifies 6 core interventive domains, and related intervention strategies, with the potential to enhance the engagement of birth parents and kin in needed services and supports.

1. Reframing parental engagement. Our proposed approach differs from prevailing discussions of engagement in two primary ways. First, it shifts accountability for engagement from parents, who typically are held responsible for participating or not in mandated services, to the service system. We view the child welfare system as having the organizational and programmatic responsibility both to provide responsive services and supports, and to ensure that parents have the skills and resources needed to navigate those complex systems, take advantage of needed services, and be empowered as clients and consumers. The model emphasizes interventions and services that assist parent to become and stay connected to systems and services that many of them experience as confusing, punitive, and culturally distant. Second, the model conceptualizes engagement in terms of the continuum of parents' involvement with child welfare services, from initial contact, assessment, and service planning through longer term involvement with services, social workers, and caregivers. This approach allows for a more intentional and nuanced approach to engagement interventions, including the opportunity to bring emerging evidence on the differential utility of various engagement strategies to bear within the child welfare context.

2. Mixing and phasing engagement strategies: The model focuses on strategies and interventions that a) are in themselves beneficial to parents, and b) show potential for creating and maintaining the conditions for parents to be more effectively engaged with core child welfare services (e.g. visitation), mental health and other services provided to their children, and services targeting parents' own needs (e.g. mental health and substance abuse treatment). Six overlapping interventive domains emerge from the research literature: 1) early and persistent outreach; 2) supportive relationships with peer advocates, foster parents, and workers; 3) parent empowerment and capacity-building; 4) practical help; 5) consultation and inclusion; and 6) family-centered, culturally responsive organizational practices.

Our review of the literature suggests that interventive strategies linked to these domains should be mixed and phased, depending on parents' needs and stage of involvement with services. In the beginning phase of child welfare involvement, engagement is enhanced by active worker outreach, connections with supportive peer advocates, and help with practical needs (e.g. housing, transportation to services, and financial support). Brief structured interventions may also be very helpful in enhancing both take-up and persistence in services. Promising models with empirical support in mental health services include intensive phone interventions that address practical, cultural, and psychological barriers to engagement (McKay & Bannon, 2004), and a one-session engagement intervention, derived from motivational interviewing and ethnographic interviewing, designed to address ambivalence about involvement in services (Swartz et al., 2007). Addressing parents needs for skills as well as support, the Parent Empowerment and Engagement Family Advocacy Model (PEP) (Jensen & Hoagwood, in press), which combines family engagement strategies and parent empowerment techniques, shows positive results in enhancing parents' collaborative skills and service self-efficacy. Over the longer term, programs that connect parents with birth parent peer and foster parent mentors show promise in helping parents to stay involved with their children and with needed services (Frame et al., 2006). Finally, as recent research by Glisson and his colleagues makes clear, inclusive, family-centered organizational cultures play an important mediating role in service delivery and client outcomes.

Implications and recommendations. The approach presented here lays an initial foundation for efforts to specify, implement, and test more intentional and well-supported approaches to engaging parents in child welfare services.

Although the complex and chronic needs typical of child welfare-involved families call for a range of engagement strategies, in general there has been a lack of specificity in child welfare services about which interventions are most appropriate, when, in what circumstances, and for what purposes. Rather than viewing engagement as a singular issue, we recommend a more differentiated approach, grounded in emerging research evidence and incorporating strategies ranging from brief intensive interventions to enhance initial engagement to longer term supportive relationships focused on sustaining involvement and positive progress towards permanency outcomes.

Key references

Altman, J. C. (2005). Engagement in children, youth and family services: Current research and promising approaches. In G. Mallon & P. Hess (Eds.). Child Welfare for the Twenty-First Century: A Handbook of Practices, Policies and Programs (pp. 72-86). New York, Columbia University Press.

Frame, L., Conley, A., & Berrick, J. (2006). The real work is what they do together: Peer support and birth parent change. Families in Society, 87(4), 509-520.

Jensen, P., & Hoagwood, K. (in press). Improving Children's Mental health through Parent Empowerment: A Guide to Assisting Families. New York: Oxford University Press.

McKay, M. M., & Bannon, W. M. (2004). Engaging families in child mental health services. Child and Adolescent Psychiatry Clinics of North America, 13(4), 553-566.

Swartz, H. A. et al (2007). Engaging depressed patients in psychotherapy: Integrating techniques from motivational interviewing and ethnographic interviewing to improve treatment participation. Professional Psychology: Research and practice, 38(4), 430-439.

Contacts: Susan P. Kemp PhD, University of Washington School of Social Work, 4101 15th Avenue NE, Seattle WA 98195, E-mail: spk@u.washington.edu, Phone (206) 543-8352.

 

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