Interagency collaboration: Strengthening substance abuse resources in child welfare

Supporting child welfare (CW) workers’ ability to accurately assess substance abuse needs and link families to appropriate services is critical given the high prevalence of parental substance use disorders (SUD) among CW-involved cases. Several barriers hinder this process, including CW workers’ lack of expertise for identifying SUD needs and scarcity of treatment resources. Drawing from theories and emergent literature on interagency collaboration, this study examined the role of collaboration in increasing the availability of resources for identifying and treating SUDs in CW agencies. Using data from the second cohort of families from the National Survey of Child and Adolescent Well-Being, study findings highlight a lack of SUD resources available to CW workers. On the other hand, the availability of SUD resources was increased when CW agencies had a memorandum of understanding, co-location of staff, and more intense collaboration with drug and alcohol service (DAS) providers. These results provide evidence to support efforts to improve collaboration between CW and DAS providers and showcase specific collaboration strategies to implement in order to improve service delivery.     

SCAN: A method of community collaboration

Recent research has highlighted the complexity of the battered child syndrome. Clinical experience suggests that treatment of troubled families is a long-term process, draining financial resources of agencies and emotional resources of professionals. The need to provide support and case consultation to professionals working in the area of child abuse and neglect evolved in the establishment, in 1968, of the Suspected Child Abuse and Neglect (SCAN) Program at Children's Hospital, Pittsburgh, Pennsylvania. This program provides an effective method of intervention through identification, consultation, referral and follow-up of at-risk families. Weekly meetings offer multi-disciplinary case coordination, treatment recommendations, and a channel of communication for representatives of community agencies. This paper traces the history and present status of the SCAN Program, as well as the role of SCAN as a force for change of community attitudes.     

Perceptions of parental substance use disorders in cross-system collaboration among child welfare,alcohol and other drugs,and dependency court organizations

Cross-system collaboration among child welfare (CW), alcohol and other drugs (AOD), and court organizations shows promise in addressing the many needs of CW-involved families experiencing parental substance use disorders (SUDs). Research has suggested that differing perceptions of parents with SUDs among staff in these organizations may hinder the collaborative process. Using a sequential explanatory mixed-method approach, this study explored staff perceptions of parental SUDs among CW, AOD, and court organizations. Logistic regression analyses indicated that, compared to CW respondents, AOD respondents were: (a) less likely to believe that parents could provide effective parenting; (b) more likely to believe that abstinence should be a criterion for reunification; (c) more likely to agree that parents should receive jail time as a consequence for noncompliance with court orders; and (d) more likely to believe that parents could succeed in treatment. Thematic analyses of these focal areas identified two core themes (focus on the primary client and mandated time frames for permanency), as well as multiple subthemes, that provided a nuanced understanding of differing perceptions on these matters. Suggestions for the development of anticipatory cross-system training and practices and implications for policy evaluation are discussed.     

Creative pedagogies and collaboration: an action research project

This action research study involves nine elementary school teacher-researchers, one university faculty member, and one graduate student engaged in developing creative pedagogical practices in one elementary school in an urban school in Alabama, USA. Participants found that a teacher’s experience of agency and their ability to work creatively depended upon a clear articulation of structures and the identification of areas of flexibility and possibility. Further, participants endeavored to promote avenues for ongoing communication and collaboration between teachers and the principal with the view that creativity based in communication would sustain transformative dialogues in the school.     

Evaluating change in interagency collaboration of a state-level interagency education team: a social network approach within a utilization-focused framework

Improving collaboration among organizations is a goal of interagency educational teams, but collaboration is typically thought of as an ambiguous concept that cannot be quantified. To assess the collaborative strength of a state-level interagency team in a Midwestern state, team members completed the Levels of Collaboration Scale (Frey et al., American Journal of Evaluation 27(3):383, 2006) for three consecutive years. The team members then utilized the results of the social network analysis to support and sustain collaborative efforts. Findings revealed that the number of partnerships increased and the depth of collaboration expanded across the 3 years. Social network analysis results were utilized to develop collaboration strategies, thus influencing the expansion of the network across the 3-year period.     

Interdisciplinary collaboration needed in obtaining high-quality medical information in child abuse investigations

BackgroundDespite reporting legislation, healthcare providers (HCPs) do not always report and collaborate in cases of suspected child abuse. Recognizing this leaves children at risk, the Wisconsin Child Abuse Network (WI CAN) sought to understand barriers to mandated reporting and collaboration with child abuse investigators.ObjectiveThe purpose of the study was to investigate barriers for professionals in providing and obtaining high-quality medical information in child abuse investigations.Participants and settingParticipants included five discipline-specific focus groups: HCPs, child protective services (CPS), law enforcement, lawyers, and judges. All professionals had been directly involved in Wisconsin child abuse cases.MethodsThis qualitative study consisted of discipline-specific focus groups, directed by open-ended interview questions. Data analysis was completed through the narrative inquiry methodology.ResultsBarriers to providing and obtaining high-quality medical information in child abuse investigations were both discipline-specific and universal amongst all groups. Discipline-specific barriers included: HCPs’ discomfort with uncertainty; CPS’ perception of disrespect and mistrust by HCPs; law enforcement’s concerns with HCPs’ overstepping professional boundaries; lawyers’ concern of HCPs’ discomfort with court proceedings; and judges’ perception of a lack of understanding between all disciplines. Universal barriers included: value of high-quality medical information in child abuse investigations, burden of time and money; unequal resources between counties; a need for protocols, and a need for interdisciplinary collaboration.ConclusionFindings from this study suggest several ways to address identified barriers. Possible interventions include equalizing resources between urban and rural counties (specifically financial resources and access to child abuse experts); protocolizing reporting and investigations; and, increasing interprofessional education.     

The expert witness in child abuse and neglect: An interdisciplinary process

The legal system is an important part of a society's response to child abuse and child neglect. Courts need to be guided in their deliberations by experts from many different professions. Consultation and in-court expert testimony is necessary from medicine, psychology, psychiatry, social work and other professions both to prove child abuse and neglect and establish the power of the court to act on behalf of a child but also to guide the court in the intervention strategy most suited to the needs of the child and his family. Non-lawyers often feel uncomfortable in the legal setting. The adversary process is foreign to their training and professional experience. Collaboration with a lawyer greatly improves their effectiveness in court. Lawyers, on the other hand, need to make maximum use of medical and social-psychological experts in the court process in the interests of their clients; but to do so lawyers need a basic understanding of the other professions. With an emphasis on a process of mutual education, the paper presents a framework for collaboration between lawyers and expert witnesses in child abuse and neglect cases. “Expert witness” is defined; informal consultation is encouraged; suggestions for selecting a collaborator are made; initial contracts between lawyer and expert, case conferencing and preparation for trial are discussed; specific advice on direct and cross examination is provided.     

Childhood Maltreatment and School Problems: A Danish National Study

The association between child maltreatment (CM) and educational outcomes have been well documented. However, there is a paucity of research that explores the association between different types of maltreatment and other school problems that may affect the educational outcomes of maltreated children. This study examined the association between different types of CM and school changes, concentration problems, and special educational needs. Gender differences were also examined. Structured interviews were conducted with 2,980 participants. Significant associations emerged between CM, in particular, multiple maltreatment experiences and school problems. Males had higher concentration difficulties and special educational needs. More research attention is needed into optimal learning environments and interventions that support maltreated children more effectively.     

Physicians and medical neglect: Variables that affect reporting

Variables that affect the propensity to report medical neglect were surveyed among 52 physicians on the staff of a pediatric hospital. Death was one of the 52 potential consequences of neglect listed for 7 of the 46 diseases analyzed. The time allotted before neglect would be considered varied with the stage and seriousness of the disease. Caretakers were less likely to be considered neglectful if the symptoms of the disease were minor, not obvious, or required technical sophistication for recognition. The number of acceptable reasons for missing appointments varied. The natural course of the disease process, efficacy and safety of treatment, parents' religion, intellectual level, and economic situation affected neglect reporting propensity. Definitions of medical neglect for common diseases must be standardized. Training of lay caretakers of ill children and communication of clear and reasonable expectations are necessary to help prevent medical neglect.     

Characteristics of effective collaboration: A study of Nurse-Family Partnership and child welfare

BackgroundIn February 2018, President Trump signed into law the Family First Prevention Act, legislation in the United States aimed at providing prevention services for families at risk of entering the child welfare system. The effectiveness of these prevention efforts is dependent on the formation of collaborative relationships between prevention-programs and child welfare.ObjectiveTo identify factors that influence the ability of the Nurse-Family Partnership (NFP) and Child Protective Services (CPS) to collaborate in serving high-risk mothers and their children.Participants123 NFP, CPS workers, and community partners.SettingSeven sites in the U.S. state of Colorado selected to include an array of community sizes, geographies, apparent levels of collaboration, and variations in internal structures and practices.MethodsUsing an adapted grounded theory approach, we conducted semi-structured interviews with frontline NFP and CPS workers and supervisors. Interviews were recorded, transcribed, validated, and coded in NVivo 10.ResultsAlignment of core organizational mission and methods was key in determining collaboration levels between NFP and CPS. Only when workers perceived there to be alignment in organizational mission, did other factors such as program eligibility, communication channels, and risk and safety assessment practices influence the perceived benefits and efforts undertaken to enhance collaboration.ConclusionsHigh-risk families frequently require services that go beyond the scope of any one organization. As programs that serve high-risk families refine their efforts to serve them effectively, collaborative efforts should focus on examining opportunities and challenges involved in creating greater mission alignment.     

Fatal child maltreatment: Characteristics of deaths from physical abuse versus neglect

This study examined victim, family, and alleged perpetrator characteristics associated with fatal child maltreatment (FCM) in 685 cases identified by child welfare services in the state of Oklahoma over a 21-year period. Analyses also examined differences in child, family, and alleged perpetrator characteristics of deaths from abuse versus neglect. Case information was drawn from child welfare investigation records for all FCM cases identified by the state Department of Human Services. Fatal neglect accounted for the majority (51%) of deaths. Children were primarily younger than age 5, and parents were most frequently the alleged perpetrators. Moreover, most victims had not been the subject of a child welfare report prior to their death. A greater number of children in the home and previous family involvement with child welfare increased children's likelihood of dying from neglect, rather than physical abuse. In addition, alleged perpetrators of neglect were more likely to be female and biologically related to the victim. These results indicate that there are unique family risk factors for death from neglect (versus physical abuse) that may be important to consider when selecting or developing prevention efforts.     

Overcoming Barriers: School Principals and SROs Collaborating to Create a Safe School Environment

Relationships between school administrators and School Resource Officers (SROs) are particularly important with the current emphasis on school safety. The majority of research in this area focuses on the effectiveness of SRO programs; however, there is a dearth of research involving the relationship between school administration and SROs. Understanding the need to overcome some of the existing barriers such as cultural and mission differences between the two organizations should enhance the possibility of creating an effective partnership. Focusing on the essential aspects of the interagency relationships in the context of school emergency readiness should allow this important partnership to be successfully implemented. This examination of the interagency relationship is important in navigating the barriers that exist in this dynamic relationship.     

Answering the big questions about differential response in Colorado: Safety and cost outcomes from a randomized controlled trial

Over the past 20 years, jurisdictions across the United States have implemented differential response (DR), which provides child protective services with the flexibility to tailor their response to reports of child abuse or neglect based on the level of risk. Given the widespread adoption of DR, there has been an increasing demand from policymakers, practitioners, and community stakeholders to build the evidence base for this innovative child welfare approach. This study was designed to answer the big questions regarding the effect of differential response on child welfare outcomes and costs using a randomized controlled trial in five Colorado counties. Specifically, the study examined the safety outcomes and costs of families who were randomly assigned to either a family assessment response (FAR) or an investigation response (IR). According to the regression results, there were no differences between the tracks on measures of system re-involvement. However, survival analysis findings indicate that FAR families were 18% less likely, over time, to have a high risk assessment after their initial accepted referral than were IR families. The cost study revealed no differences between the tracks on initial costs for caseworker contacts, services, and out-of-home placements. However, the results suggest that follow-up costs for IR cases were significantly higher (p < 0.001) than for FAR cases. The authors discuss policy and practice implications for jurisdictions considering DR.     

Toronto multiagency child abuse research project: The abused and the abuser

Information from 422 cases of child mistreatment in Toronto was gathered from the files of a child welfare agency and a children's hospital. These data were compared to patterns reported in previous studies and clinical writings on child mistreatment to investigate similarities and differences in families whose children have been abused in Canada, England, and the United States. Findings from the present study were similar to others in many respects. The differences were primarily in the area of lower incidences of such problems as perinatal difficulties in the children and intellectual limitations and social isolation in the parents; however, there was a higher incidence of single-parent families. The results suggest that clinicians should bear in mind that child mistreatment cannot be ruled out on the grounds that no serious problems have been noted for the child or the family.     

Pathways from childhood abuse to prospective revictimization: Depression,sex to reduce negative affect,and forecasted sexual behavior

Research suggests that adverse events in childhood, such as childhood physical, sexual, and emotional abuse, confer risk for later sexual assault. Psychological distress, coping strategies, and sexual behavior may help explain the path from childhood abuse to revictimization. The present study explored how the use of sex to regulate negative affect (SRNA) operates independently, and in combination with other psychosocial factors to increase college women's (N = 541) risk of experiencing prospective adult sexual assault (ASA). Sequential multiple mediator models in Mplus were used to assess the effect of three different forms of childhood abuse on prospective ASA, both independently and while controlling for other forms of childhood abuse. The indirect effect of adolescent sexual assault (AdolSA), depressive symptoms, SRNA, and participants’ response to a sex-related vignette was tested using bias-corrected bootstrapping. In the full path model, childhood emotional abuse and AdolSA predicted ASA, while childhood physical and sexual abuse were directly associated with AdolSA, but not ASA. Additionally, depressive symptoms and participants’ estimate of their likely behavior in a sex-related vignette directly predicted prospective ASA. Results using bootstrapping revealed that a history of childhood abuse predicted prospective ASA via diverse direct and indirect paths, as well as through a similar multiple mediator path. Overall, findings suggest that a combination of affective, coping, and sexual expectancy factors contribute to risk for revictimization in adult survivors of childhood abuse. Future research directions and targets for risk-reduction programming are discussed.     

Levers of Management in University-Industry Collaborations: How project management affects value creation at different life-cycle stages of a collaboration

This paper reports a longitudinal multi-case research project encompassing 38 semi-structured interviews conducted in 2011 and 2012 with four students, 12 researchers and 22 companies relating to a total of 25 university–industry collaborations. The interviews covered the collaboration type, the initiation of the collaboration and details concerning the planning of the collaboration. In addition, the interviews focused on the relationships between the people involved in the collaboration and the effects of project management. We distinguish between project management success and project success, and identify potential good practice. The paper concludes that, whereas project management success was not found to be causally related to project success, there seems to be a clearer link between project management success and ensuring effective use of resources in both companies and universities. There is also evidence that it is problematic when corporate managers think they can run research projects like lean production companies.     

Urbanicity matters in self-reported child maltreatment prevalence: Findings from a nationally representative study

Despite indications that there are differences in rates of child maltreatment (CM) cases in the child protection system between urban and rural areas, there are no published studies examining the differences in self-reported CM prevalence and its correlates by urbanicity. The present study aimed to: (1) identify the distribution of self-reported childhood experiences of maltreatment by urbanicity, (2) assess whether differences by urbanicity persist after adjusting for known risk factors, and (3) explore whether the associations between these risk factors and CM are modified by urban-rural designation. Using nationally representative data from waves I and III of the National Longitudinal Study of Adolescent to Adult Health, the prevalence of six maltreatment outcomes was estimated for rural, minor urban, and major urban areas (N = 14,322). Multivariable logistic models were estimated identifying if risk associated with urbanicity persisted after adjusting for other risk factors. Interactions between urbanicity and main effects were explored. Prevalence estimates of any CM, poly-victimization, supervision neglect, and physical abuse were significantly higher in major urban areas. Those from major urban areas were more likely to report any maltreatment and supervision neglect even after adjusting for child and family risk factors. The association between race/ethnicity, welfare receipt, low parental educational attainment, and disability status and CM were modified by urbanicity. Significant differences in the prevalence and correlates of CM exist between urban and rural areas. Future research and policy should use self-reported prevalence, in conjunction with official reports, to inform child maltreatment prevention and intervention.