Uninformed, overwhelmed clients; unrealistic agency expectations
More than 1.2 million children in the United States receive services because they are mistreated and about 400,000 of them are placed in foster care annually. Prior studies have shown that only 23 percent of children in the child welfare or juvenile justice systems receive services, even though about 67 percent of them have mental health needs that warrant treatment.
Contracted private agencies provide approximately 33 percent of foster care placement services and 59 percent of family preservation services. State child welfare agencies are increasingly turning to them for a range of services.
Therapeutic service providers (therapists) provide most of the services contracted by these private agencies. While turnover and burnout among child welfare case managers is well-understood, little is known about the challenges private agency therapists experience working in child welfare systems.
Researchers from Florida Atlantic University collaborated with a private, community-based agency located in a metropolitan county in the southeastern U.S. to conduct a study to identify the primary challenges therapists face and determine strategies to improve service delivery for children and families.
Results of the study, published in the Journal of Behavioral Health Services & Research, are organized across system, agency, and client levels.
For the study, researchers focused their questions on how prepared therapists felt in their current role as well as their experiences in that role, particularly working with child welfare clients. Emphasis was placed on challenges encountered and if they required additional knowledge or skill development. Study participants had a range of professional degrees from master to doctoral degrees in social work, psychology, mental health counseling, and marriage and family therapy.
Researchers identified 11 primary challenges such as difficulty navigating numerous involved parties, an overwhelmed work environment, legal intersections common to child welfare cases, unrealistic agency expectations, and heightened case complexity. At the agency level, therapists felt they had inadequate support, supervision and preparedness. At the system level, they expressed concern for the significant amount of instability present with families in the child welfare system.
At the client level, study participants said that their child welfare clients are often overwhelmed, uninformed and confused, all of which pose challenges in their therapeutic work. As a result, therapists have the emergent need to serve as an educator and liaison to buffer their clients' experiences with the child welfare system. Because of the complexities of their cases, study participants also were concerned about the heightened competence and skills needed as therapists. Many of them felt unprepared at times and often find themselves in a "learn as you go" environment.
"Based on the feedback we received from our study participants, there is a critical need to provide targeted trainings to reduce the challenges therapeutic service providers encounter in their practice with vulnerable children and families," said Marianna L. Colvin, Ph.D., an assistant professor who co-authored the study with Heather M. Thompson, Ph.D., coordinator of the Bachelor of Social Work, both in the Phyllis and Harvey Sandler School of Social Work within FAU's College for Design and Social Inquiry. "Data from our study suggest that trainings should not be isolated within single agencies or single provider sectors, but include an inter-professional orientation to promote multiple perspectives."
Among the strategies study participants recommended include targeted caseload reduction, accounting for case complexity when assigning cases, and streamlining required documentation. Study findings also suggest the need for training and ongoing professional development within designated work hours. A particularly pertinent finding from the study illuminates the need for therapists to be prepared to act in a liaison role between clients and the child welfare and court systems.
"Using shared databases also could be effective within the parameters of confidentiality that allow access by multiple providers, which will promote sharing information and reducing barriers to communicating critical components of child welfare cases," said Colvin.