Child Welfare Caseworkers as Brokers of Mental Health Services

Youth in the child welfare system (CWS) have substantially higher rates of mental health needs compared to the general population, yet they rarely receive targeted, evidence-based practices (EBPs). Caseworkers play the critically important role of “service broker” for CWS youth and families. This study examines preliminary caseworker-level outcomes of Project Focus Colorado (PF-C), a training and consultation program designed to improve access to EBPs for CWS youth. PF-C evaluation occurred in four child welfare offices (two intervention [n = 16 caseworkers] vs. two practice-as-usual, wait-list control [WLC; n = 12 caseworkers]). Receipt of PF-C was associated with significantly increased caseworker knowledge of (a) EBPs, (b) child mental health problems, (c) evidence-based treatment components targeting mental health problem areas, and (d) mental health screening instruments, compared to WLC. Dose of training and consultation was associated with greater ability to correctly classify mental health problems and match them to EBPs. These preliminary results suggest that targeted training and consultation help to improve caseworker knowledge of children’s mental health needs, EBPs for mental health, and mental health screening instruments.

[1]  Kimberly Eaton Hoagwood,et al.  A literature review of learning collaboratives in mental health care: used but untested. , 2014, Psychiatric services.

[2]  Wendi Cross,et al.  Show Me, Don't Tell Me: Behavioral Rehearsal as a Training and Analogue Fidelity Tool. , 2014, Cognitive and behavioral practice.

[3]  R. Beidas,et al.  Consultation as an Implementation Strategy for Evidence-Based Practices Across Multiple Contexts: Unpacking the Black Box , 2013, Administration and Policy in Mental Health and Mental Health Services Research.

[4]  Families. Child Maltreatment 2012 , 2013 .

[5]  Abraham Wandersman,et al.  Toward an Evidence-Based System for Innovation Support for Implementing Innovations with Quality: Tools, Training, Technical Assistance, and Quality Assurance/Quality Improvement , 2012, American journal of community psychology.

[6]  S. Tueller,et al.  NSCAW II wave 2 report: Children's services , 2012 .

[7]  Kate L. Conover,et al.  Child Welfare Caseworkers as Service Brokers for Youth in Foster Care , 2012, Child maltreatment.

[8]  Anne-Marie R. Iselin,et al.  Evaluation of the sustainability and clinical outcome of Alternatives for Families: A Cognitive-Behavioral Therapy (AF-CBT) in a child protection center. , 2011, Child abuse & neglect.

[9]  Inger P. Davis,et al.  Bridging science and practice in child welfare and children’s mental health service systems through a two-decade research center trajectory , 2011 .

[10]  Bradley C. Stolbach,et al.  Addressing the impact of trauma before diagnosing mental illness in child welfare. , 2011, Child welfare.

[11]  P. Kendall,et al.  Training Therapists in Evidence-Based Practice: A Critical Review of Studies From a Systems-Contextual Perspective. , 2010, Clinical psychology : a publication of the Division of Clinical Psychology of the American Psychological Association.

[12]  Dean L. Fixsen,et al.  Core Implementation Components , 2009 .

[13]  A. Wandersman,et al.  Technical Assistance as a Prevention Capacity-Building Tool: A Demonstration Using the Getting To Outcomes® Framework , 2009, Health education & behavior : the official publication of the Society for Public Health Education.

[14]  D. Fergusson,et al.  Burden and consequences of child maltreatment in high-income countries , 2008, The Lancet.

[15]  B. Burns,et al.  Psychosocial interventions for children and adolescents in foster care: review of research literature. , 2009, Child welfare.

[16]  W. Gardner,et al.  Comparison of the PSC-17 and alternative mental health screens in an at-risk primary care sample. , 2007, Journal of the American Academy of Child and Adolescent Psychiatry.

[17]  Bruce F Chorpita,et al.  Understanding the common elements of evidence-based practice: misconceptions and clinical examples. , 2007, Journal of the American Academy of Child and Adolescent Psychiatry.

[18]  L. Isolan,et al.  Evidence-based psychotherapies for children and adolescents , 2007 .

[19]  D. Sloan,et al.  Treating Trauma and Traumatic Grief in Children and Adolescents , 2007, Journal of Contemporary Psychotherapy.

[20]  B. Kerker,et al.  Mental health needs and treatment of foster youth: barriers and opportunities. , 2006, The American journal of orthopsychiatry.

[21]  Sonja K Schoenwald,et al.  The ARC Organizational and Community Intervention Strategy for Implementing Evidence-Based Children's Mental Health Treatments , 2005, Mental health services research.

[22]  John R. Weisz,et al.  Modularity in the design and application of therapeutic interventions , 2005 .

[23]  L. Leslie,et al.  Relationship between entry into child welfare and mental health service use. , 2005, Psychiatric services.

[24]  B. Rounsaville,et al.  We don't train in vain: a dissemination trial of three strategies of training clinicians in cognitive-behavioral therapy. , 2005, Journal of consulting and clinical psychology.

[25]  B. Pescosolido,et al.  Building a Model to Understand Youth Service Access: The Gateway Provider Model , 2004, Mental health services research.

[26]  M. Chaffin,et al.  Evidence-based treatments in child abuse and neglect , 2004 .

[27]  H. Wagner,et al.  Mental health need and access to mental health services by youths involved with child welfare: a national survey. , 2004, Journal of the American Academy of Child and Adolescent Psychiatry.

[28]  J. Landsverk,et al.  Placement movement in out-of-home care: patterns and predictors , 2004 .

[29]  J. Weisz,et al.  Introduction: Context and background of evidence-based psychotherapies for children and adolescents , 2003 .

[30]  Alan E. Kazdin,et al.  Evidence-based psychotherapies for children and adolescents , 2003 .

[31]  Alastair Baker,et al.  Crossing the Quality Chasm: A New Health System for the 21st Century , 2001, BMJ : British Medical Journal.

[32]  E. Foa,et al.  The Child PTSD Symptom Scale: A Preliminary Examination of its Psychometric Properties , 2001, Journal of clinical child psychology.

[33]  W. Compton,et al.  The Service Assessment for Children and Adolescents (SACA): adult and child reports. , 2000, Journal of the American Academy of Child and Adolescent Psychiatry.

[34]  Inger P. Davis,et al.  Impact of child psychosocial functioning on reunification from out-of-home placement , 1996 .

[35]  A. Erkanli,et al.  Children's mental health service use across service sectors. , 1995, Health affairs.

[36]  B. Joyce,et al.  Student Achievement Through Staff Development , 1988 .