Pendulum Swings In Child Welfare

(Originally published December 2017)

Jill Berrick is a distinguished child welfare scholar at the University of California, Berkeley. Berrick’s new book, The Impossible Imperative (2017), addresses the inherent tensions in child welfare decision making organized around several key principles: family integrity, child safety, a child’s need to be raised in a family, the preference for kin-care when children cannot safely remain in their birth parents’ home, a child’s need for permanence, respect for cultural heritage and the rights of “parents and children (of a certain age and maturity)” to “have a say in the decisions that affect their lives.”  Berrick maintains that “these principles form the basis for the conduct of child welfare workers, and they offer an essential guide to policy.” Berrick asks, “But what if, upon closer examination, we discover that these foundational principles collide with one another – not in the rare, exceptional cases, but in the average cases that …typify child welfare?”

The impossible imperative presents several lengthy perspectives of caseworkers employed in California regarding how they attempted to balance potentially competing principles in specific cases. Through these stories, Berrick develops her argument that “Child welfare workers are engaged with complicated families. … Nothing about the work is simple. Everything about the work is emotionally charged, much of it is intellectually demanding, and some of it can be morally compromised.”  Berrick asserts that “Child welfare requires deeply thoughtful professionals … ready to take on the challenge, prepared to embrace complexity, and poised to serve thoughtfully.” However, in my experience, child welfare caseworkers, supervisors and managers rarely engage in discussions, much less debates, regarding abstract principles such as child safety, family integrity and permanency.  Reflective thinking about concepts is rare in child welfare settings until these concepts are given an operational meaning.  Debates arise as child welfare practitioners consider the practices and policies associated with potentially conflicting principles.  Intense concern with child safety has typically led to an emphasis on child protection which is associated with CPS investigation, risk assessment, safety assessment, foster care, legal action, termination of parental rights and adoption.  Deeply felt concern with family preservation and family integrity usually leads to support for family preservation services (and other types of family support services), expanded use of kinship care, increased investment in reunification services and a powerful antipathy to foster care.

In recent years, the use of dual track differential response systems (DR- referred to as FAR in Washington State) in which a large percentage of families with screened in CPS reports receive family assessments rather than a CPS investigation, has become a part of ideological differences that play out in arguments over various research studies. The emotional intensity of these debates among scholars and advocates suggests that differences of opinion regarding research findings are often a mask for arguments over values and principles, e.g., child safety and child protection vs. family support and family preservation.  In child welfare, as in American politics, strongly felt social values tend to shape the interpretation of research findings rather than the other way around.  Berrick is right that fundamental principles provide a framework for child welfare practice, but only when these principles take on a concrete form.

Pendulum Swings in Child Welfare

For decades, child welfare policy and practice in the U.S. have swung back and forth between intense focus on child safety and child protection on one hand, and investments in family preservation and family support on the other.  Some of these pendulum swings have occurred at the national level and resulted in major child welfare legislation, for example the Adoption and Safe Families Act (ASFA-1997), while others have occurred in state child welfare systems. The large increase in foster care (much larger than the 10% increase during the past 4-5 years) that occurred in the late 1980’s and early 1990’s led to federal funding of crisis oriented family preservation (FPS) services which evolved into an uncivil scholarly debate among proponents and critics of FPS services, punctuated by publication of Richard Gelles’, The Book of David (1996), a fierce attack on FPS services which Gelles blamed for several high profile child deaths, including the death of Eli Creekmore in Washington State. The following developments occurred in a little more than a dozen years (1986-1999):

 

  • High profile child maltreatment deaths in many states; media stories about the mishandling of these cases by CPS prior to a child’s death

  • Child welfare reform initiatives that included development of risk assessment models

  • A substance abuse epidemic involving crack cocaine (Eastern U.S.) and methamphetamine (Western U.S. spreading eastward)

  • Doubling of the nation’s foster care population to 567,000 children

  • Federal funding of FPS services; publication of randomized controlled trials that questioned the effectiveness of these services

  • Development of family centered practice models in several states, including Idaho

  • Publication of A Nation’s Shame: Fatal Child Abuse and Neglect in the United States (1995)

  • Passage of the Adoption and Safe Families Act (ASFA) which set time lines for foster care stays and filing of termination actions, absent timely reunification with birth parents

  • Utilization of federally funded adoption incentives to increase adoptions

 

In discussions of child welfare policy and practice, an indicator of a pendulum swing is polarization and contentious debate among and between advocates of a child protection orientation vs. a family support and family preservation perspective.  However, within public child welfare agencies ideological differences tended to be muted, in part because most child welfare practitioners have little, if any, concern with ideological orientations or with debates over research findings. Child welfare caseworkers, supervisors and managers are usually far more interested in practical strategies, available services, placement alternatives and in outcomes than in ideological arguments.  Furthermore, child welfare practice is tough on ideologues. Caseworkers who have deep reservations regarding foster care may nevertheless be forced by circumstances to place children in foster care to protect their lives. Practitioners who have positive views of foster care are likely to be confronted with occasional examples in which children on their caseloads or in their unit or office have been harmed (including severely abused or neglected) in foster care or in adoptive homes.  Furthermore, effective practitioners will look for and eventually discover how and when to make best use of available services, such as FPS, various evidenced based parenting programs and foster care.

Nevertheless, the polarization of advocates and scholars matters a great deal in the realm of policy discussion and debate, both at the federal and state level. Currently, a family support/ family preservation orientation prevails in the federal Administration of Children and Families. Proponents of this orientation (for example, Commissioner Jerry Milner), advocate for a greatly increased investment in prevention/early intervention services, and appear to believe that the need for foster care (at least non-kin foster care) will wither away in a new and better child welfare world.  Given this orientation, there is likely to be a reluctance to make major new investments in foster care or in developing a new foster care business model.  In fact, some child advocates want to see non-kin foster care abolished.  On the other side of the ideological divide, some critics of DR insist that CPS investigation in all screened in cases is the only responsible approach to child protection.  In a polarized debate, it is difficult to search for the best use of DR or other approaches that attempt to make family support an integral part of child protection and reduce the coercive features of CPS investigations.

Alternatives to Polarization

Pendulum swings distort child welfare reform by creating a stubborn resistance among advocates for conflicting orientations to initiatives and investments on the wrong side (from their perspective) of the ideological divide, i.e., child safety and child protection vs. family preservation and family support.  However, it is urgent and essential that:

 

  • the supply of foster homes be greatly increased,

  • experiments with new models of foster parent recruitment and retention be developed,

  • public agency support for foster parents is strengthened,

  • use of hotel placements, 24-hour placements and overnight stays of children in offices be eliminated,

  • the use of psychiatric medications for children in foster care be reduced and more tightly regulated, and

  • bigger and smarter investments in therapeutic foster care models be funded.

 

Foster care systems in many states are in a downward spiral due to chronic and acute shortages of foster homes.  They are being forced to engage in practices that are arguably forms of system abuse of children.  Nevertheless, in the polarized world of child welfare policy discussion, there are influential voices who oppose doing anything to improve foster care on the grounds that non-kin foster care should be abolished through an all-out commitment to kinship care. The idea that kinship care can eliminate the need for non-kin foster care is a delusion.  Kinship caregivers have no greater ability on average to care for behaviorally troubled children and youth in a safe and therapeutic manner than do most non-kin foster parents.

There is also an urgent need to reduce the need for foster care through:

 

  • investments in prevention/early intervention programs,

  • housing programs for destitute and/or substance abusing parents seeking reunification

  • day treatment programs for pre-school children and their parents,

  • pregnant and parenting women residential care programs for substance abusing parents,

  • mentoring programs for parents of children in foster care and the creative use of foster care to support birth parents following reunification

 

Policymakers and advocates also need to understand that economic policies and social policies that leave almost one-tenth of U.S. children growing up in families with annual incomes of less than $ 10-11,000 per year is a root cause of child homelessness, compounding the effects of substance abuse, chronic mental illness and domestic violence in destitute families. It is ludicrous to consider large new investments in prevention of child maltreatment while passively accepting an increasing percentage of families with children living on the verge of destitution.  A family support/family preservation ideological orientation that has a narrow focus on child welfare is guaranteed to fail. Shredding the social safety net by setting up barriers to TANF eligibility, reducing or eliminating subsidized child care and housing, and (as of early December) eliminating federal support for medical care for children in low income families, has the potential to undermine any child welfare agenda committed to family preservation.

 

The use and misuse of foster care is at the center of much of the ideological debate in child welfare; but the ideological divide also has other dimensions. Scholarly opponents of DR have virtually identified a commitment to child safety with CPS investigations, despite evidence from most comparison group studies that suggest the opposite. There can be no conclusive resolution of this debate as long as child welfare systems and scholars depend on one or two inadequate measures of child safety, such as CPS re-report rates or maltreatment recurrence rates. The reality is that neither scholars, advocates or managers know whether CPS systems are doing a better or worse job of protecting children compared to 10-20 years ago due to inadequate measures of child safety utilized by public agencies.  This is a sad state of affairs that could be corrected without a large financial investment in agencies’ data systems. I am a supporter of the potential of DR systems to reduce coercive CPS practices without endangering children. However, I must admit that some state child protection systems I’ve reviewed have misused DR for workload management purposes.  It’s possible in these states that use of DR has endangered child safety, though I’ve yet to read studies demonstrating that this has occurred.

Questioning the Assumptions that Underlie Ideological Orientations

 The scholar, Gary Melton, once wrote that in the U.S.  “child protection is associated with a dramatic coercive act.” During the many years I worked in public child welfare systems, I was often surprised by the extent to which CPS decision making revolved around placement decisions.  A concern with child safety frequently led to a discussion of child placement because other good options were often not available in serious cases of child maltreatment. U.S. child welfare agencies have never emphasized or made large investments in in-home safety planning; and scholars have given the subject little or no attention.  As a consequence, in-home safety planning is arguably the weakest part of most states’ CPS programs.  In some states, in-home safety plans have been developed and implemented so ineptly that these plans left children in great danger. There is nothing inevitable regarding this state of affairs.  CPS programs could invest in and (with academic assistance) study in-home safety planning and safety oriented services rather than usually having to resort to foster care or unlicensed kinship care in extreme cases.

It should be obvious by now to most practitioners and advocates that unquestioning identification of child safety with foster care is highly dubious, especially when considering the placement of behaviorally troubled school age children or severely disabled children of all ages. In recent years, I have discovered that some child advocates are extremely reluctant to hear this message.  Practitioners and judicial decision makers are in urgent need of scholarly help in deciding how to best use foster care services. It is not enough to say, as Berrick does in the impossible imperative, that studies of foster care outcomes are “mixed”.

The view that CPS investigation confers a higher degree of child safety than family assessment in interventions with chronically referring families is highly doubtful. The idea that Homebuilder FPS programs “work” is unhelpful to practitioners who need to know for what families and situations these programs are most useful, and when FPS is dangerous to employ.

Pendulum swings and ideologically charged debates have made it difficult to learn these lessons both in public agencies and in policy making circles. It is time for a different more discerning approach to policy discussion.

 

References

 

A Nation’s Shame: Fatal Child Abuse and Neglect in the United States. A Report of the U.S. Advisory Board on Child Abuse and Neglect (1995),  Administration for Children, Youth and Families, Washington, D.C.

 

Berrick, J.D., The Impossible Imperative (2018), Oxford University Press.

 

Gelles, R., The Book of David: How Preserving Families Can Cost Children’s Lives (1996), Basic Books.

 

Heimpel, D., “Trump’s Top Child Welfare Official Speaks,” The Chronicle of Social Change, November 6, 2017, available on-line.

  

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