Child and family needs profiles among cases substantiated by child protection services

A Multilevel Examination of Whether Child Welfare Worker Characteristics Predict the Substantiation Decision in Canada

The decision to substantiate a report of child maltreatment represents a key decision point in the child welfare service decision-making continuum. This decision has various potential implications for children and their families, which may include more intensive child welfare involvement or the cessation of services. The substantiation decision is determined by whether there is enough evidence to suggest that maltreatment or the risk of maltreatment has occurred. To date, there has been minimal exploration of whether child welfare worker characteristics might influence this critical decision point. The Decision-Making Ecology would suggest that indeed, worker characteristics play a role in how they carry out their role. Given the importance of this decision point, this study uses secondary data to examine whether worker characteristics, such as education level and type, ethnoracial identity, caseload, and experience, predict substantiation in the Canadian child welfare context. Furthermore, this study utilizes multilevel modeling, a theoretically important and unique method of analyzing organizational data that considers differences in decisions among child welfare workers. The final model included 4,327 children and 567 workers from across Canada. Several case level factors (e.g., child age and functioning, caregiver risk factors) predicted the substantiation decision. Furthermore, and most importantly for this study, worker characteristics significantly predicted their substantiation decision. Workers with fewer years of experience, those in an Ongoing Services role, and with a lower caseload substantiated significantly more often than those with more work experience, in another role, and with higher caseloads. Lastly, caseload and years of experience, and training and caseload both interacted to predict the substantiation decision. Implications for policy and practice and future research areas are discussed.

Swatantra Clinic: A descriptive study on the specialized child mental health service for children in difficult circumstances at a tertiary care center in India

In India, children in difficult circumstances, like institutionalized children have higher mental health morbidity and complex psychosocial concerns than the non-institutionalized children. To cater to the complex needs of these children referred by the Juvenile Justice System, a specialized service called 'Swatantra Clinic' was initiated by the Department of Child and Adolescent Psychiatry at the National Institute of Mental Health and Neurosciences, India. This article thereby aims to describe the psychosocial characteristics of these children, along with the array of specialized interventions provided during the first year of its inception in June 2018. It was found that majority of these children were girls and were from lower socio-economic, urban background, primarily referred for externalizing or internalizing concerns. The majority of them reported experiences of physical and verbal abuse along with family stressors and almost half of them had a diagnosable psychiatric condition. The nature of the psychosocial services rendered at the clinic mostly comprised of brief, individual and family counseling along with liaison work with various governmental agencies for rehabilitation services. These form the key components of a comprehensive, collaborative, time-bound and holistic care model to cater to the distinct psychosocial issues of this vulnerable population of children in low - middle resource settings. Policy implications are discussed.

Moderators and mediators of outcomes of parents with substance use problems: further evaluation of the Parents under Pressure programme

BACKGROUND AND AIMS

Family-focused interventions can improve family functioning when parents have substance use problems. However, there has been little focus upon potential predictors of change and analysis of mechanisms of change. This study aims to identify mediators and moderators of change in a pragmatic, multi-site, randomized controlled trial of the Parents under Pressure (PuP) programme, a family-focused intervention for parents with substance use and other problems, and treatment-as-usual (TAU).

DESIGN

Secondary analysis of data: multi-level modelling was used to investigate moderators of treatment outcome; mediation was tested with cross-lagged models.

SETTING

Community-based family support services in the United Kingdom.

PARTICIPANTS

Parents (n = 100) attending community-based addiction services with children aged 2.5 years or younger.

MEASUREMENTS

Predictors of the primary outcome, child abuse potential, were: baseline child age and gender, composite family risk score, parental substance use and parental emotional dysregulation. Mediation was tested across three time-points with the observed variables parental emotion dysregulation and child abuse potential.

FINDINGS

Increased child age [Z = 2.14, 95% confidence interval (CI) = 0.01, 0.33] at baseline was associated with greater reductions in child abuse potential for PuP programme participants compared with TAU. Poorer parental emotional regulation (Z = 2.48, 95% CI = -2.76, -0.32) was associated with greater reductions in child abuse potential for all participants. Parental substance use (either recent use or primary substance of concern) did not alter any treatment effects on child abuse potential. The mediation analysis showed that PuP produced greater improvements in emotional regulation at post-treatment (P < 0.001) compared with TAU, which predicted lower child abuse potential at 6-month follow up (P < 0.05).

CONCLUSIONS

For UK parents enrolled in a family-focused intervention, baseline measurements of higher child age appear to be associated with greater reductions in child abuse potential at 6-month follow-up in PuP participants compared with treatment as usual (TAU). Poorer parental emotional regulation and, potentially, higher family risk, appears to be associated with greater reductions in child abuse potential at 6-month follow-up in PuP and TAU. Emotional regulation appeared to act as a mediator as improvements in parental emotional regulation post-treatment appeared to be associated with greater reductions in child abuse potential at 6-month follow up. Notably, participation in the PuP programme led to better parental emotional regulation compared with TAU.