A Strength-based Approach to Supervised Visitation in Child Welfare

1. A Strength-based Approach to Supervised Visitation in Child Welfare To access the audio, please call: TOLL FREE: 866.740.1260 ACCESS CODE: 6430226#

4. Additional Acknowledgements • Devereux Center for Resilient Children (DCRC): Linda Likins, Jennifer Fleming, Karen Cairone, Deb Alleyne, & Debi Mahler. • Stop Child Abuse & Neglect (SCAN), Inc.: Rachel Tobin-Smith, Rob Pettibone, Bobbie Golani, Sarah McClure, & a generous Anonymous Donor. • The staff, parents, and children at SCAN Inc. in Fort Wayne, Indiana and Ireland Home-Based Services in Evansville, Indiana who were involved in this project.

5. Prevalence • Nearly three and a half million allegations of child abuse, involving over six million children, are made in the United States annually (US DHHS, 2012) • An average of four children per day die in the US due to abuse and neglect, which is estimated to be the worst fatality record of any wealthy nation (Gilbert et al., 2009)

6. Consequences • Increased likelihood of mental, emotional, and behavioral problems, developmental delays, academic difficulties, and criminal justice system involvement • The economic consequences that result from child abuse and neglect cost American taxpayers $124 billion annually (Fang, Brown, Florence & Mercy, 2012)

7. Dual System Aims • US child protection system was initially designed to manage risk by identifying and removing threats to physical and emotional safety • Recent emphasis on family preservation has complicated and expanded the system aims to include the broader goal of child welfare

8. Strength-Based Services (Rapp, Saleebey, & Sullivan, 2005) • goal-oriented • systematically assess strengths • view the environment as an important resource • create plans that leverage family / environmental strength • foster hope • provide meaningful choices in the provision of services

9. The failure to articulate specific practice models creates the gap between child welfare workers’ familiarity with the concepts of strengths-based practice and the provision of strengths-based services

10. Supervised Visitation • A safe environment for parenting time • An opportunity to document court order compliance and parent / child interactions to inform reunification decisions • Maintaining / growing child–caregiver relationships, and pursuing / recognizing caregiver skill acquisition

11. Research Indicates • The frequency of maternal visitation is associated with reunification (Davis et al., 1996; Leathers, 2002) • Supervised visitation services that (1) build strong alliances with families, (2) provide skills training, and (3) assist family members with concrete needs, result in sustained reunification more often than comparison services (Fraser, Walton, et. al, 1996)

12. Research & Practice Challenge • State regulations are varied and vague • Programs are challenged by small budgets that limit visitation hours, staffing by trained personnel, security, and the number of families served

13. Questions?

14. Development of a Collaboration • Stop Child Abuse and Neglect (SCAN): Large child welfare agency serving 13 counties in northern Indiana deciding to incorporate resilience building practices into an existing visitation program • Devereux Center for Resilient Children (DCRC): Non-profit organization that develops resources and provides training for the assessment and enhancement of resilience in children and caregivers.

15. Resilience • The ability to recover from or adjust to misfortune or change • The ability to bounce back • “Overcoming the Odds” • Better than expected outcomes in the context of adversity

17. By incorporating a resilience-focused approach, the agency administration hoped to give the children in their services tools to function better than might-be-expected, given their adverse life circumstances.

18. Development of a Strengths-based Approach to Supervised Visitation • 15 hours of staff training to become familiar with Devereux resources (e.g., DECA I/T, DECA P2, DESSA, strategy guides for parents and staff) • Drafted a book of family activities to help parents recognize and promote resilience in their children • 3 focus groups to consider implementation & adaptations

19. Questions?

20. Program Model

21. The theory of change underlying the Sherman Model posits that changes in the behavior of workers will result in changes in the behavior of parents, which will in turn promote resilience & permanency for children. Child Resilience Improved Parenting Supportive Coaching

22. Six Elements • The visitation environment • Strengths-based assessment • Resilience meetings between workers & caregivers • Stable visitation routines • Activities to promote resilience • Progress check-ups

23. Enhancing the Visitation Environment

24. Visitation Environment - Baseline • Visitation rooms were 10 feet by 12 feet, furnished with spare office furniture and portable televisions • Television watching was a common visitation activity • Toys could be retrieved from a locked, central cabinet • Worker: “rooms aren’t very warm or welcoming” • How family members felt about rooms: “They hate them”

25. Visitation Environment - Research • Comfortable, home-like, positive, child proofed, with clean, unbroken furniture, interesting toys, and developmentally appropriate activities (Haightet al. 2002) • Sufficient activities to encourage choice-making and to allow for engagement with all children equally (Mourikis, 2002) • Spaces that are organized and structured (Appelstein, 1998)

26. Visitation Environment - Enhancements • Created a checklist to guide preparation of the visit environment • Modified rooms to help the families feel comfortable and dignified (e.g., fresh paint, living room furniture, softer lighting, wall decorations, clean laminate floors with new area rugs, and fresh blankets for floor time) • Low shelves stocked with toys and materials to support developmentally appropriate, interactive activities

28. Visitation Environment - Feedback • Worker: “I believe that having the tools the parent needs to engage with their child, readily present and available, makes it easier for the interaction to take place.” • Worker: “The changes in the activities in each room has greatly enhanced engagement between the parent and child.” • Some agencies have found their local business communities generous in supporting environmental enhancements of this nature (Beyer, 2008)

29. Strength-Based Assessment

30. Norm-Referenced Behavior Rating Scales Measures the frequency of desirable child behaviors, reported by a parent • The DECA-Ifor Infants (Mackrain et al., 2007) children aged four weeks through 17 months. Two scales (Initiative and Attachment / Relationships) as well as a summary score (Total Protective Factors) are derived from 33 items. • The DECA-Tfor Toddlers (Mackrain et al., 2007)is used for children aged 18 through 35 months. Three scales (Initiative, Attachment / Relationships, and Self-Regulation) and the Total Protective Factors summary score are derived of 36 items.

31. Norm-Referenced Behavior Rating Scales Measures he frequency of desirable child behaviors, reported by a parent • The DECA-P for Preschoolers (LeBuffe & Naglieri, 1999) is for children aged two through five years. Three scales (Initiative, Attachment, and Self-Control), a Total Protective Factors summary score, and a Behavioral Concerns Screener, are derived from 37 items. • The DESSA(LeBuffe et al., 2009) is used for children aged 5-14. Eight scales (Self-Awareness, Social-Awareness, Self-Management, Relationship Skills, Personal Responsibility, Decision Making, Goal-Directed Behavior, and Optimistic Thinking) and a summary score (Social-Emotional Composite) are derived from 72 items.

33. Why & How Research: A series of studies have demonstrated that these scales have excellent reliability and validity for identifying protective factors related to positive developmental outcomes in the context of risk (LeBuffe & Shapiro, 2004; LeBuffe, Ross, Fleming, & Naglieri, 2013) Practice: A standardized assessment is completed during intake to determine whether each of the child’s protective factors are typical relative to the national norms, high enough to be considered a strength, or low enough to be considered an area that needs to be developed

34. Resilience Meetings

35. Resilience Meeting - Purpose • Begin to develop an alliance between parent and worker • Discuss the child’s strengths • Set visitation goals • Select initial resilience-enhancing visitation activities

36. Resilience Meeting - Literature • The coaching of parents should begin before visitation starts • Take the time for parents and workers to build rapport • Agencies should to have a formalized process that requires workers to seek family input • Collaboratively develop visitation goals and plans (Beyer, 2008; Haight et al., 2002) Gerring, Kemp, & Marcenko, 2008; NTAECSC, 2008; Mourikis, 2002; New York State Office of Children and Family Services, 2004; Nesmith, 2013)

37. Resilience Meeting - Practice • The worker facilitates introductions, provides an overview of the Sherman Model and visitation routine, reviews the child’s assessment results with the parent, and assists with selection of child and parent goals and coaching supports • Workers were trained and provided with a sample transcript to assist (as desired) with facilitation

38. Resilience Plan Goals are set for the child, the parent, and the worker (coach) Children’s Goals: • 1-2 goals are selected based on assessment results • Older children are encouraged to be involved in setting goals • Typical goal topics include: building trust and connection, becoming curious and interested, improving confidence and decision making, cultivating relations with others, and extending learning from positive role models

39. Resilience Plan Goals are set for the child, the parent, and the worker (coach) Parent’s Goals: • 1-2 parenting goals are selected from a list • Intended to support the child goals and increase the parent’s competence and confidence in her/his parenting skills • Typical goal topics include: naming a child’s feelings, staying calm, or providing appropriate affection

40. Resilience Plan Goals are set for the child, the parent, and the worker (coach) Coach’s Goals: • Parent is encouraged to select 1-2 methods the coach can use to support and encourage the parent during the visit • The coaching supports typically include: asking questions, modeling, offering creative ideas, playing alongside, and cueing

41. Resilience Meetings Research: Only one-half of workers report actively helping parents prepare for the visit (Haight et al., 2002) Practice: Workers have responded positively to the format of the resilience meetings: “They really are an easy way to join the family as a team and all get on the same page. The structure really helps.”

42. Visit Routine

43. Stable Visitation Routines • Greetings • Family Circle • Resilience Activities • Meal or Snack (when appropriate) • Clean-up • Review and Planning time

44. Stable Visitation Routines

45. Activities to Promote Resilience

46. Activities to Promote Resilience Structured Activities from the Activities Book • Organized by goal, lists age range, parenting skill suggestions, a list of necessary materials, and step-by step instructions • Parent: “I can’t help but be a part of the fun activities. They bring more laughter out in all of us and it has been 4 to 5 years since my son belly-laughed like today, which reminds me of how he still is inside and how I am and how much I have learned.”

47. Activities to Promote Resilience • Parent-Planned Structured Activities Worker: “Parents feel much more in control when they come up with an idea of their own and then can receive validation and praise from the worker.” • Open-Ended Activities Parents are taught that everyday moments can be transformed into resilience-building experiences by keeping the goals in mind

48. Progress Check-Up

49. Progress Check-Up Rationale • Research suggests that more contact between parents and workers is associated with more frequent visitation and less child time spent in out-of-home placements (McWey & Mullis, 2004; White, Albers, & Bitonti, 1996) • Progress in the parent–child relationship and the growth of skills should be reviewed and celebrated (Fawcett et al., 1995) • Goals / plans should be adjusted regularly (Loar, 1998)

50. Progress Check-Up Meetings • After each intervention period of completed services (approx. 10 visits), the children are re-assessed with an age-appropriate Devereux strengths-based assessment • The coach schedules a Check-Up Meeting with the parent in order to review the family and child progress • A discussion with the parent is held to celebrate accomplishments and adjust goals, as desired, in the child, parent, and coaching domains