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1.
Although child welfare caseworkers are responsible for facilitating mental health services access for maltreated children, little is known about caseworkers’ decisions to refer children to services. We aimed to identify factors associated with caseworker referral of children to mental health services after a maltreatment investigation. We analyzed data from 1956 children 2–17 years old from the Second National Survey of Child and Adolescent Well-being. We examined associations of children’s predisposing, enabling, and need-related factors and caseworkers’ work environment characteristics with referral to mental health services. Caseworkers referred 21.0% of children to mental health services. In multivariable analyses controlling for potential covariates, factors associated with increased odds of caseworker referral included: older child age; child sexual abuse (versus neglect); child out-of-home placement; caregiver mental health problems; prior maltreatment reports; clinically significant child behavioral problems; and child welfare agency collaborative ties with mental health providers (all p < .05). Factors associated with decreased odds of caseworker referral included child Black race (versus White race) and lack of insurance (versus Private insurance) (all p < .05). In summary, children’s need for mental health services was positively associated with caseworker referral to services but certain predisposing and enabling factors and caseworker work environment characteristics also correlated with services referral. Interventions to reduce disparities in services referral by race and insurance type are critically needed. These may include child welfare agency implementation of policies for mental health screening, assessment, and services referral based on clinical need and establishment of child welfare-mental health agency collaborative ties. 相似文献
2.
PROBLEM: Increased calls to "do something" about child protective services (CPS) have resulted in proposals or new "paradigms" for services to at-risk or abusive families. These new paradigms call for the reform or revamping of CPS through the development of a community-based alternative response to some reports of child abuse and/or neglect. METHOD: This article reports on outcomes for 1,263 "low" risk CPS referrals diverted to a community-based alternative response system. Data on child, family, and case characteristics and services provided are presented as well as outcomes associated with re-referral and placement post service provision. RESULTS: The risk level and severity of some of the referrals to alternative response systems seems inappropriately high. The rates of re-referral were similar for families who did or did not engage in assessment services, and were highest for families where domestic violence was present. CONCLUSIONS: Criteria for diversion to community alternatives to CPS must be clearly articulated and applied. Both CPS and alternative response system workers must have the skills required to address a family's recognition of the problem and degree of motivation to engage in problem resolution, and to understand their relationship to continued risk of CA/N. 相似文献
3.
Re-referral to child protective services: the influence of child, family, and case characteristics on risk status 总被引：2，自引：0，他引：2
INTRODUCTION: This study examines child, family, and case characteristics that impact rates of re-referral to Child Protective Services (CPS) using data on all closed CPS investigations for the state of Rhode Island between 2001 and 2004. METHOD: A longitudinal dataset of all referrals to CPS was created using state submissions to the National Child Abuse and Neglect Data System (NCANDS). After excluding children whose initial CPS investigation resulted in removal from the home, a Cox proportional hazards model was tested to examine factors impacting the likelihood of re-referral. RESULTS: Consistent with other research in this area, the initial 6-month period following case disposition is the period of greatest risk of re-referral. Approximately 13% of cases experienced a recurrent allegation during the first 6-month period; an additional 14% experienced a re-referral over the following 12-month period; 7% during the next 12-month period. Family poverty was the strongest predictor of re-referral, though a number of child and case characteristics were significantly related to recurrence. Cases that were substantiated at index were significantly less likely to result in a new allegation, though substantiated cases of physical abuse or those receiving post-investigation services were at higher risk. CONCLUSIONS: Children from families facing multiple stressors (e.g., low SES, parental substance abuse child disability) are at highest risk of re-referral to CPS and may benefit from the development of preventive services targeted immediately following case closings within CPS. 相似文献
4.
OBJECTIVE: This study identifies factors associated with child protective services (CPS) involvement among current and former welfare recipients after welfare reform legislation was passed in the US in 1996. METHOD: Data come from the Women's Employment Study, a longitudinal study of randomly selected welfare recipients living in a Michigan city in 1997 (N=541). In order to identify risk factors for CPS involvement among current and former welfare recipients, multinomial logit analyses with 29 independent variables were employed on a trichotomous dependent variable: no CPS involvement, investigation only, and supervision by CPS after investigation. RESULTS: The relationship between work and involvement with CPS differs by work experience prior to welfare reform. As the percentage of months working after welfare reform increased, the risk of being investigated by CPS declined among those with prior work experience but the risk increased among those without prior work experience. However, work variables were not significant predictors of supervision by CPS after an initial investigation. Further, race, cohabitation, childhood welfare receipt, having a learning disability, having a large number of children, being newly divorced, living in a high problem neighborhood, and being convicted of a crime were associated with one's probability of being either investigated or supervised by CPS. CONCLUSIONS: These findings suggest that employment could have increased the stress levels of current or former welfare recipients without prior work experience to the point where they were prone to minor child rearing mistakes that resulted in a CPS investigation, but were not severe enough to warrant opening the case for supervision. Supports should be provided to welfare mothers who are prone to involvement with CPS; expansions in the childcare subsidy and a reduction or delay in work requirements might also help these families. 相似文献
5.
Ongoing child welfare services are put in place after completion of the initial maltreatment investigation when there is a perceived need to mitigate the risk of future harm. The knowledge of how clinical, worker, and organizational characteristics interact with this decision to provide ongoing child welfare services is not well integrated in the research literature. Using secondary data from the Canadian Incidence Study of Reported Child Abuse and Neglect-2008, this study’s primary objective is to understand the relationship of clinical, worker, and organizational characteristics to the decision to transfer a case to ongoing child welfare services and their relative contribution to the transfer decision in Canada. Findings indicate that several clinical level variables are associated with families receiving ongoing services. Additionally, organizational factors, such as type of services offered by the organization and the number of employee support programs available to workers, significantly predicted the decision to transfer a case to ongoing services. While no worker factors, such as education, amount of training, experience, or caseload, were associated with ongoing service receipt, the intraclass correlation coefficient of the final three-level parsimonious model indicated substantial clustering at the worker level. Results indicate that Canadian child welfare workers make decisions differently based on factors not available in the current study and that what would be deemed as important worker characteristics do not necessarily predict this outcome. Findings and implications for future research are discussed. 相似文献
6.
Sonia Hélie Catherine Laurier Catherine Pineau-Villeneuve Marie-Noële Royer 《Child abuse & neglect》2013
The objective of this study is to estimate the risk of a first recurrence over a five-year period following initial child protective services (CPS) intervention and identify the characteristics associated with the risk of recurrence for three different age groups. Recurrence is defined as the first substantiated report within the observation period after initial services have ended. The study involved a cohort of 25,897 Quebec children who received postinvestigation services for the first time and whose cases were closed between 2005 and 2009. Survival analysis was used to estimate the five-year risk of recurrence and Cox regression to model the risk of recurrence for three age groups. The covariates introduced into the regression analyses were characteristics of the child and initial services. The risk of recurrence in the five years following termination of initial CPS services was 36% for the entire cohort and varied depending on the child's age at the time of case closure. Children aged 6–11 when their cases were closed had the highest risk of recurrence. Although Aboriginal descent and prior CPS investigations have a consistent effect on the risk of recurrence in all three age groups, the effects of other covariates, such as out-of-home placement and court involvement, vary or are even reversed, depending on the child's age. These findings highlight the need to adopt a differential approach that takes into account the child's age, both in the provision of protective services and in research involving the population receiving such services. 相似文献
7.
OBJECTIVE: Building on a previous model of recurrence, this study examined the relationship of services on the hazard of child maltreatment recurrence during CPS intervention for families who were provided continuing intervention following a confirmed index report of physical abuse or neglect. METHOD: This nonconcurrent prospective study selected 434 subject families who met study eligibility requirements from 1181 families randomly selected from the 2902 families who had experienced a substantiated report of child abuse or neglect during the sampling year. Data were collected and coded from archival sources for 5 years following the index report. Each record was coded by two research analysts to increase inter-rater reliability. Data were analyzed with the Cox Proportional Regression Model. RESULTS: Case characteristics that predicted recurrence were: child vulnerability, family stress, partner abuse, and social support deficits. After examining the potential effect of nine service-related variables only attendance at services predicted recurrence while controlling for other variables in the model. Families who were noted to attend the services identified in their service plans were 33% less likely to experience a recurrence of child maltreatment while their case was active with CPS. CONCLUSIONS: Implications of this and other research suggests that actively engaging families in a helping alliance and helping them accept and receive services may reduce the likelihood of future maltreatment. 相似文献
8.
Families that experience domestic violence and parental substance misuse are disproportionately involved with the child welfare system. Prior research suggests that child protective services (CPS) caseworkers are more likely to substantiate maltreatment allegations when domestic violence and parental substance misuse are identified during the investigation, pointing to one possible mechanism for this disproportionate involvement. While previous studies have relied on nationally representative data sets, the current study used administrative records from a large Midwestern child welfare agency that accounts for state-level variation in child welfare policy and practice. A total of 501,060 substantiation decisions made between 2009 and 2013 were examined to assess the influence of caseworker-perceived domestic violence and parental substance misuse on the decision to substantiate reported maltreatment. Results from multilevel modeling suggest that the identification of domestic violence and parental substance misuse during an investigation significantly increased the probability that an allegation would be substantiated. The implication of these findings for child welfare practice are considered in light of the fact that many child welfare agencies do not consider exposure to domestic violence and parental substance misuse in and of themselves to constitute child maltreatment. 相似文献
9.
Casimér R. Wichlacz John M. Lane C.Henry Kempe Casimer R. Wichlacz 《Child abuse & neglect》1978,2(1):29-35
The purpose of this study is threefold: first, to describe the characteristics of child abuse and neglect on a major Indian reservation; second, to examine the impact of a community team approach to child abuse and neglect as measured by the incidence of reported abuse and neglect and admissions for emergency foster care; and third, to make recommendations for actions to close the gaps in child welfare services to Indian children living on reservations. 相似文献
10.
PROBLEM: Greater awareness of the role of parental substance abuse in child maltreatment makes it imperative that the substance abuse treatment and child welfare systems coordinate services for these parents. Yet little is known about the characteristics of child-welfare involved parents (primarily mothers) who enter into substance abuse treatment. This paper compares the characteristics of mothers in substance abuse treatment who were and were not involved with child welfare services, and discusses the treatment implications of these differences. METHOD: Data were obtained from a statewide treatment outcome monitoring project in California. Clients were assessed at treatment admission using the Addiction Severity Index. Bivariate analyses and multivariate logistic regression were conducted comparing mothers who were (N=1,939) and were not (N=2,217) involved with child welfare. RESULTS: Mothers who were involved with child welfare were younger, had more children, and had more economic problems. They were more likely to be referred by the criminal justice system or other service providers, to have a history of physical abuse, and to be treated in outpatient programs. They had lower levels of alcohol severity, but did not differ with regard to psychiatric severity or criminal involvement. Primary users of methamphetamine were disproportionately represented among this group and had a distinct profile from primary alcohol- and opiate-users. CONCLUSION: Study findings suggest that mothers involved with child welfare enter substance abuse treatment through different avenues and present a clinical profile of treatment needs related to exposure to physical abuse, economic instability, and criminal justice involvement. 相似文献
11.
OBJECTIVE: This study examined whether children who received child welfare services (e.g., in-home or out-of-home placement) were more or less likely to become incarcerated as serious and violent youthful offenders than those children who were investigated as victims of abuse and neglect but received no further child welfare intervention. METHOD: Administrative data on child abuse reporting, foster care, birth records, and juvenile corrections (CYA) were linked to prospectively examine the risk of incarceration as an adolescent following an investigation of abuse or neglect after age 6. The 10 county California sample included 159,549 school-aged children reported for abuse and neglect after 1990. RESULTS: About 8 per 1,000 children in the sample were later incarcerated in CYA. African American and Hispanic children who received in-home or foster care services after the index investigation event had a lower risk of incarceration than those whose cases were closed after the investigation. Among females, the rate of incarceration was highest for those who experienced foster or group care placements. Children initially reported for neglect were more likely to be incarcerated than those reported for physical or sexual abuse. CONCLUSIONS: Public child welfare services have rarely been assessed in terms of future negative child outcomes. This study finds that one serious negative outcome, CYA involvement, can only be understood when a number of factors are considered. The importance of understanding the differences between how different subpopulations respond to services is highlighted. Specifically, our findings suggest that more attention should be focused on children who are now receiving no services after an investigated child abuse and neglect report, on females, and on victims of child neglect. 相似文献
12.
Despite the high rate of early parenthood among youth in foster care as well as the increased risk of child maltreatment among children whose adolescent parents have been neglected or abused, very little is known about child welfare services involvement among children whose parents were in foster care when they were born. This study uses administrative data from the Illinois Department of Children and Family Services (DCFS) to examine the occurrence of child abuse and neglect investigations, indicated reports and out of home care placements among the children of youth in foster. Thirty-nine percent of the children were the subject of at least one CPS investigation, 17 percent had at least one indicated report and 11 percent were placed in out of home care at least once before their 5th birthday. Cox proportional hazard models are also estimated to identify characteristics of parenting foster youth and their placement histories associated with the risk of child welfare services involvement. Implications of the findings for policy and practice are discussed. 相似文献
13.
Although various studies have investigated factors associated with mental health service utilization, few studies have examined factors associated with referral for mental health services among maltreated children. The objective of this study was to examine the association between suicidal thoughts and self-harming behavior and referral for mental health services among children involved in the Child Welfare System in Ontario, Canada. Data for this study were obtained from the Ontario Incidence Study of Reported Child Abuse and Neglect 2013. An estimate 57,798 child maltreatment investigations was analyzed using binary logistic regression with referral for mental health service as the outcome variable. Of the 57,798 cases, 4709 (8.1%), were referred for mental health services. More than seven out of ten maltreated children who engaged in self-harming behavior and two out of three maltreated children who expressed suicidal thoughts were not referred for mental health services. In the multivariate logistic regression model, children who expressed suicidal thoughts had 2.39 times higher odds of being referred for mental health services compared to children with no suicidal thoughts (AOR = 2.39, 99% C.I. 2.05–2.77) and children who engaged in self-harming behavior had 1.44 times higher odds of being referred for mental health services compared to children who did not engage in self-harming behavior (AOR = 1.44, 99% C.I. 1.24–1.67), both after controlling for child demographic characteristics, maltreatment characteristics, and child functioning concerns. Given that referral is the initial step towards mental health service utilization, it is important that child welfare workers receive the necessary training so as to carefully assess and refer children in care who expressed suicidal thoughts or engaged in self-harming behavior for appropriate mental health services. The paper discusses the results and their implications for child welfare policy and practice. 相似文献
14.
《Child abuse & neglect》2014,38(11):1766-1777
Nonadherence to antiretroviral treatment has serious health implications for HIV-infected children, at times warranting referral to child protective services (CPS). The current study of 134 children with perinatally acquired HIV infection aimed to investigate rates of treatment adherence and CPS involvement, multilevel variables associated with nonadherence, and the manner in which these risks operated together in the prediction of adherence outcomes. Risk factors for nonadherence were grouped on the basis of confirmatory factor models, and factor score regression was carried out to determine which factors were uniquely predictive of adherence. A series of indirect effects models were then tested in order to examine how these factors operated together in the prediction of adherence. Results showed that almost half of the sample demonstrated suboptimal adherence to treatment, and in one-fifth, CPS was involved for medical neglect. Caregiver Health, Caregiver Involvement, Caregiver Acceptance, and Child Adaptation were predictive of nonadherence, and together explained 54% of the variance in treatment adherence. There were significant indirect effects of Caregiver Health on adherence that operated through Caregiver Involvement and Child Adaptation and an indirect effect of Caregiver Involvement on adherence through Child Adaptation. Findings extend current literature that has independently linked various factors predictive of medical adherence in pediatric HIV by showing separate but simultaneous associations with nonadherence and unique pathways to adherence involving multilevel risks. Healthcare and child welfare implications are discussed. 相似文献
15.
OBJECTIVE: To assess the predictive validity of continuous measures of problem recognition (PR), intentions to change (ITC), and overall readiness for change (RFC) among primary caregivers who received in-home services following substantiated reports of child abuse or neglect. METHOD: A modified version of the University of Rhode Island Change Assessment scale was included in interviews with a sample of 353 primary caregivers at 4 weeks, 16 weeks, and 1 year after referral for in-home services. Additional data were obtained from administrative records and caseworker surveys. Hierarchical linear and nonlinear models were used to assess relationships between PR, ITC, RFC and changes over time in measures of individual and family functioning (e.g., parenting behaviors, children's behaviors, housing and economic problems, social support, and life events). Bivariate probit regression analysis was used to examine relationships between PR, ITC, RFC and the likelihood of subsequent reports of child maltreatment and out-of-home placements within 1 year after referral. RESULTS: Initial problem recognition and intentions to change predict a few improvements in individual and family functioning, along with significant reductions in the likelihood of additional reports of child maltreatment within 1 year. Initial intentions to change also predict reductions in the substantiation of subsequent reports of maltreatment. An overall measure of readiness for change predicts reductions in the likelihood of out-of-home placement. CONCLUSIONS: Problem recognition and intentions to change predict somewhat different outcomes; hence, there are few advantages of a combined measure of readiness for change. Further inquiry is needed to determine whether and how these associations are mediated by intervention processes or other factors in child welfare services populations. 相似文献
16.
Pregnant, opioid-using women represent a challenge to healthcare providers attempting to engage them in prenatal and substance abuse services. Limited, primarily international research suggests that child welfare clients have mixed feelings about Child Protective Services (CPS) and that fear of CPS may present a barrier to care. Understanding how pregnant opioid-using women in substance abuse treatment perceive CPS may be useful in encouraging substance abuse treatment initiation. Participants were currently or recently (within past 12 months) pregnant women with current or recent (within past 12 months) abuse/dependence of pharmaceutical opioids at a drug treatment facility. Participants were recruited by treatment staff to participate in a comprehensive study across multiple domains. Data for this analysis were collected using semi-structured qualitative interviews. Transcribed data were thematically analyzed using in vivo and interpretive coding by three coders for purposes of inter-rater reliability. Following 2, two-hour meetings, consensus was reached on primary themes and sub-themes. Two major themes and several sub-themes were identified: 1) Participants’ feelings and attitudes about CPS (positive and negative); 2) Interaction-based perceptions of CPS’ function and performance. Participants’ feelings toward CPS were often conditioned by their experiences with individual caseworkers. While many pregnant, opioid-using women identify legitimate, and even useful features of CPS, fear of CPS can be a barrier to care. Making substance abuse treatment accessible to this population requires recognition of their complex feelings toward CPS, and coordination among CPS case workers and substance abuse treatment providers. 相似文献
17.
18.
OBJECTIVE: This study uses results from a large community survey to examine the relationship between a history of child maltreatment and self-reports of contact with Child Protection Services (CPS). METHODS: The Ontario Health Supplement was a province-wide, probability-based survey of household dwellings in the province of Ontario, Canada. A random sample of residents aged 15 and older participated in the Ontario Health Supplement (N=9953). A face-to-face interview included a question about contact with Child Protection Services (CPS), and the Child Maltreatment History Self-Report, a self-administered questionnaire, was used to assess history of child physical and sexual abuse. RESULTS: Only a very small percentage of respondents with a history of child abuse reported contact with CPS; 5.1% of those with a history of physical abuse, and 8.7% of those with a history of sexual abuse. Contact with CPS was associated with younger age of respondent for both types of abuse and female gender for physical abuse. In the case of sexual abuse, younger respondents whose parental employment classification was in the lower socioeconomic group were more likely to have contact with CPS. CONCLUSIONS: Interventions that target only those who come in contact with CPS will not reach most persons exposed to child abuse. 相似文献
19.
Jackson SL 《Child abuse & neglect》2004,28(4):411-421
OBJECTIVE: Child Advocacy Centers (CACs) are designed to improve the community collaborative response to child sexual abuse and the criminal justice processing of child sexual abuse cases. CACs, in existence for 16 years, now have standards for membership developed by the National Children's Alliance (NCA) that include nine core components. And yet no systematic examination of the CAC model exists. The purpose of this paper was to assess the variations within these core components as they exist in the field. METHOD: Using a stratified random sampling design, 117 CAC directors were interviewed using a semi-structured interview that was based on the NCA's standards for membership. The eight core components of the CAC model examined in this study include: a child-friendly facility, a multidisciplinary team, an investigative child interview, a medical examination of the child, provision of mental health services, victim advocacy, case review, and case tracking. RESULTS: Results reveal the CAC model has been widely adopted by both member and nonmember centers, although variations in implementation exist. CONCLUSIONS: Future developments in the CAC model must include evaluation of the model. 相似文献
20.
OBJECTIVE: Recent years have been fraught with investigations into the deaths of children receiving child welfare services throughout North America, Europe, and Australia. These inquiries have attracted considerable media attention and public outrage. Added to this have been increases in attempts to hold social workers in child welfare responsible for the abuse and deaths of children through the criminal and civil courts. As a result of fears regarding liability, many child welfare professionals are resorting to defensive practice strategies. METHOD: This article reviews recent court decisions and legislation in Canada regarding this issue in order to assess actual risks. RESULTS: Social workers who act according to accepted standards of practice and who in good faith make difficult judgments to the best of their abilities, will not be held to be criminally culpable or civilly negligent. CONCLUSION: It is concluded that child welfare professionals who exercise reasonable caution and engage in good clinical social work practice, good record keeping, effective communication and verification of information, can continue to strive to offer the high quality services to children and their families as they have always done without any serious fear of recrimination. 相似文献