ESSENTIAL COMPONENTS OF SUPERVISED VISITATION PROGRAMS IN
CHILD WELFARE FAMILY REUNIFICATION CASES
Janet Alicia Brown
B.A., University of California, Davis, 2002
PROJECT
Submitted in partial satisfaction of
the requirements for the degree of
MASTER OF SOCIAL WORK
at
CALIFORNIA STATE UNIVERSITY, SACRAMENTO
SPRING
2010
ESSENTIAL COMPONENTS OF SUPERVISED VISITATION PROGRAMS IN
CHILD WELFARE FAMILY REUNIFICATION CASES
A Project
by
Janet Alicia Brown
Approved by:
, Committee Chair
Joyce Burris, PhD, MSW
_________________
Date
ii
Student: Janet Alicia Brown
I certify that this student has met the requirements for format contained in the University
format manual, and that this project is suitable for shelving in the Library and credit is to
be awarded for the project.
__________________________, Graduate Program Director ______________
Teiahsha Bankhead, PhD, MSW
Date
Division of Social Work
iii
Abstract
of
ESSENTIAL COMPONENTS OF SUPERVISED VISITATION PROGRAMS IN
CHILD WELFARE FAMILY REUNIFICATION CASES
by
Janet Alicia Brown
The following research project is a qualitative research study of essential core
components and services found in supervised visitation programs providing services to
court ordered mandated family reunification clients. A content analysis was conducted of
four programs in Northern California, all serving similar clientele. Results showed that
the supervised visitation programs have similar structures and purpose to conducting the
visits. A difference exists in the services offered, ranging from observation to family
centered visitation rooms to therapeutic intervention. Funding was identified as the key
concern in implementing a quality program.
_____________________, Committee Chair
Joyce Burris, PhD, MSW
_________________
Date
iv
DEDICATION
This is for the people in my past, present, and future. No one does anything alone, and I
certainly did not, do not, and will not. My parents taught, nurtured, and sacrificed for me,
my godmother Millie loved me, the Cypress Lane gang inspired me, and my husband and
children provide all the future I can handle.
v
ACKNOWLEDGEMENTS
I would like to recognize that I could not have done this without the support of my
husband, Rob, my children, Dustin and Francesca, my mother, Judy, my father, Richard,
and my brother, Marc. I thank my circle of friends who have provided support: Becky,
Sharon, Lisa, and Sarah (in the order that I met them in life). My advisor in this endeavor,
Dr. Joyce Burris, has been a source of calm throughout this process.
vi
TABLE OF CONTENTS
Page
Dedication………………………………………………………………………...v
Acknowledgements………………………………………………………………vi
List of Tables……………………………………………………………………..xi
Chapter
1. THE PROBLEM………………………………………………………………1
Introduction………………………………………………………………..1
Background of the Problem……………………….………………………4
History……………………………………………………………….…….8
Statement of the Research Problem…………… ……………………….10
Purpose of the Study……………………… …………………………...11
Theoretical Frameworks……………………….. ……………………….11
Research Questions………………………………………...…………….15
Definition of terms……………………………………………………….15
Assumptions…………………………………………………………..….16
Justification………………………………………………………………17
Delimitations……………………………………………………………..18
Summary…………………………………………………………………19
2. THE LITERATURE REVIEW………………………..……………..………20
Introduction………………………………………………………………20
Child Welfare Policy………………………………….………………….21
vii
Foster Care Population…………………………….…………………..…24
Foster Care Outcomes…………………………….…………………...…26
Perspective of Parent(s)/Caregiver(s)……… …………….…………..…27
Family Reunification Challenges…………………...……………………28
Recidivism……………………………………………….………………29
Services……………………………………………..……………………30
Partnership……………………………………….………………………31
Supervised Visitation………………………………..……..…….………32
Programs………………………………………………………..………..34
Structured Decision Making (SDM)……………………………………..36
Theory……………………………………………………………………37
Summary………………………………………………………………....38
3. METHODS……………………………………………………………….….40
Introduction………………………………………………………………40
Study Design……………………………………………………………..40
Variables…………………………………………………………………41
Participants……………………………………………………………….42
Data Collection Procedures………………………………………………43
Instrumentation………………………………………………………….44
Validity/Reliability………………………………………………………44
Data Gathering Procedures………………………………………………45
Protection of Human Subjects…………………………………………...46
viii
Voluntary Participation…………………………………………………..47
Risk………………………………………………………..……………..47
Confidentiality………………………………………………..………….47
Data Analysis…………………………………………………………….48
Summary…………………………………………………………………49
4. FINDINGS……...………………………………………………………..…..51
Introduction…………………………………………………..…………..50
Participants…………………………………………………...…………..50
Specific Findings………………………………………………...………51
Experience of Administration……………………………………………51
Core Components of Programs………………………………………..…53
Definition of Success………………………………………………….…56
Services within the Supervised Visitation Programs…………….………57
Concerns and Limitations to Implementation……………………………58
Program Evaluation………………………………………………...……59
Identified Program Improvement Ideas……………………………….…60
Summary…………………………………………………………………61
5. CONCLUSIONS AND IMPLICATIONS FOR SOCIAL WORK …………62
Introduction………………………………………………………..……..62
Review of Findings and Relevance…………………………..…….…….63
Implications…………………………………………………………...….64
Recommendation for Further Research………………………………….65
ix
Summary………………………………...……………………………….66
Appendix A. Human Subjects Approval …………………………….....…….…68
Appendix B. Comparison of Programs and Core Components ……...……….…69
Appendix C. Permission Letter Template………………………………………..70
Appendix D. Participant Consent………………………………………..………71
Appendix E. Interview Questions………………………………………………..72
References………………………………………………………………………..73
x
LIST OF TABLES
Page
1. Table 1: Experience Level Demographics of Participants………...….……...52
xi
1
Chapter 1
THE PROBLEM
Introduction
Children are valuable. The convention on the Rights of the Child (1989)
established this as an international value through a sense of multilateral education,
drawing upon interrelationships between governments, internationally, and nongovernmental organizations, stemming out of concerns over children’s rights to survival,
safety, and child development, under the concept of human progress (Fuchs, 2007). This
premise supports the work of public child welfare departments throughout the world, to
ensure the belief that children are worth investing in for the promise of a future.
Families, however they are defined, are intended, by law, to be the support units
which instrumentally guide and mold children through their early years of development.
This research is focused specifically the supervised visitation service component for
families who have children in the care of public child welfare, and who are now engaged
in the process of court ordered family reunification. The family is the foundational
structure of concern in the mandated family reunification process in public child welfare
programs. In order for the child(ren) to be returned, a family is expected to correct all of
the concerns meriting the child(ren)’s removal by complying with and completing a case
plan, which is designed to help the parent(s)/caregiver(s) meet the minimum standard of
care for the child(ren). The Case Plan details the services that a family will participate in
for a six-month period.
2
At the first Juvenile Court dependency hearing, which is the Detention hearing,
families are court ordered to begin supervised visitation. Several weeks later, at the
Jurisdictional/Dispositional Hearing, families are court ordered a case plan and can
receive a myriad of additional services, such as: alcohol or drug rehabilitation (in-patient,
out patient, and/or testing), counseling (individual and/or family), psychiatric evaluations,
parenting classes, anger management classes, domestic violence classes and/or
counseling, and/or other services as fit the family. Services to support victims of sexual
abuse are also available; however, it follows a different track because visitation may not
be occurring until a counselor, medical, or other professional deems it safe.
The mandated family reunification process has profound impacts on all members
of the family, in that, how a person behaves, responds and complies with the public child
welfare department, governs the eventual permanency outcome. The act of the court
mandating services alone can be overwhelming to the parent(s)/caregiver(s)- a judge, a
social worker, attorneys, who are all informing the parent(s)/caregiver(s) what it is they
must do in order to have their children back. Services must be complied with, supervised
visits attended, housing maintained or obtained, and the list can go on and on. Complying
with court ordered services could often be about understanding concepts intellectually,
but then not knowing how to, conceptually, implement the new ideas. Case workers and
supervised visitation programs partnering with parent(s)/caregiver(s) in the supervised
visits to form a team and provide quality and effective supervised visits is an opportunity
to empower the parent(s)/caregiver(s) to demonstrate their abilities. Through a
3
partnership approach, the enhancement of this service/visit connection early on could
improve case plan commitment.
Specifically, the premise of this research is to examine the core components of
supervised visitation programs. It is crucial that our social service system qualify the
importance of providing mandated family reunification clients with quality supervised
visitation with their children because it is the one case plan component in which
parent(s)/caregiver(s) directly face their children. The parent(s)/caregiver(s) who visit
their child(ren) receives a set of rules to which they must abide during the visits, while
being monitored by an unknown, third person, who makes reports to a social worker.
Qualitatively speaking, supervised visitation can be a very emotionally charged event for
both the parent(s)/caregiver(s) and the child(ren) participating. The parent(s)/caregiver(s)
are under the observation of an unknown, and often changing, third party, such as a Case
Aide or Foster Family Agency visit attendant. Any behaviors that have been interpreted
as inappropriate are reported to the social worker about the parent(s)/caregiver(s), and
then the social worker will speak to the parent(s)/caregiver(s).
Quantitatively, the social worker records the frequency a parent attends visitation
and measures of appropriateness of the visit. The visitation monitor enters this
information into a computer program. Structured Decision Making is the most widely
used decision making tool throughout the investigative, removal and reunification
systems in California Public Child Welfare programs. In the reunification as
recommendation by the computer program, supervised visitation attendance is weighted
at 1/3 of the reunification recommendation. Overall, understanding the service of
4
supervised visitation is important. There are supervised visitation programs operating
around the United States, offering different approaches and services in their respective
programs. This research is primarily focused on identifying the essential core components
of various supervised visitation programs, the therapeutic services, and funding streams
for providing these services to the mandated clients residing in areas with these programs.
Background of the Problem
Across the state of California, as of October 2008, there are 66,496 children
reported to be foster youth (CWS/CMS Dynamic Report, October 2008). This number
encompasses every child the court views as a foster youth, whether that child is in a
foster home or living with a non-relative caregiver, or guardian. To be considered foster
youth, these children are not living with either one or both of their biological parents.
From October 2007 through September 2008, the number of children involved in the
family reunification process totaled 22,661 (CWS/CMS Dynamic Report, October 2008).
Of this number, 15,512 reunified with their family of origin within twelve months
(CWS/CMS Dynamic Report, October 2008). The remaining 7,149 reunified after more
than twelve months of services (CWS/CMS Dynamic Report, October 2008). The median
time for successful family reunification is 7.1 months (CWS/CMS Dynamic Report,
October 2008). These numbers represent the children and their families who are, or have
been, engaged in supervised visitations at some point of their family reunification
process.
Foster children are a unique population because they embody all the dynamics,
difficulties, and complexities of the adult population, but they lack the power of free will
5
and the ability to govern their own lives. Many foster children feel confused about such a
myriad of things, in that the foundation of their family has shifted. Often, when asked to
make choices or preferences about what they want out of the case, so many feel
conflicting loyalties between their original family, foster family, social workers, and/or
counselors. In serving the foster care population, it is vital that while decisions should be
made in the best interest of the child, the child also should be involved and understand
the decisions, as is age appropriate. It is important for Child Welfare staff to provide a
supportive supervised visit so that healthy attachment with parent(s)/caregiver(s) and
personal development can occur. Providing quality supervised visitation is a way to
recognize and improve the stresses that can occur from being in foster care.
Children involved in stressful custody and visitation conflicts are considered to be
an at-risk group of their population and the literature well documents the trauma of the
child in foster care (Andersson & Arvidsson, 2008; Holcomb, 2004). With the emotional
trauma of removal from the home, the foster care population experiences many feelings
of uncertainty. It is important to avoid emotionally damaging incidents that often occur
during a supervised visitation, such as: discussion of the case, blaming, anger,
accusations, unease and discomfort, and/or the child(ren) maintaining the parental role.
The supervised visitation is the child(ren)’s only face-to-face contact with the caretaker
from whom they were removed and/or other family which may have come forward.
Currently, it is more common to employ a reactionary method to an incident by the
supervised monitor, and instead of preventing inappropriate, damaging incidents, the
6
parent/caregiver is chastised, the violation documented and often the parent/caregiver
does not understand what happened.
According to Holcomb (2004), visitation is important in family reunification
cases because it maintains family connections during this difficult period where public
child welfare is simultaneously working to reunify the family, and yet seek permanent,
alternative, placement. Visitation is defined as a way to maintain normal family contact,
despite the changing definition of family (Andersson & Arvidsson, 2008). The intent of
family visitation is to lessen the trauma of the out-of-home situation (Holcomb, 2004).
However, practical concerns revolve around the ability to carry out supervised visitation.
Nationwide, many states have shifted to using a visitation center, versus a contact or
trusted person (Andersson & Arvidsson, 2008). Research literature has focused on the
supervised program descriptions and client characteristics (Andersson & Arvidsson,
2008). In a study by Andersson and Arvidsson (2008), the social workers interviewed
expressed concern about the Court’s decisions regarding supervised visitation, where the
Child Welfare departments could provide information to the Court prior to the decision
regarding frequency and duration. The concerns that were identified included the
following: (1) six to eight hours was too much, four is more appropriate, (2) every
weekend is too much to commit for the visitation, and (3) a more realistic view at
distances to travel for the child, visitation monitor, and parent (Andersson and Arvidsson,
2008). Logistical concerns of complying with court ordered supervision is the primary
focus, versus concern over the quality of the visitation.
7
Supervised visitation programs do not exist widespread, but rather in pockets
throughout the United States. Supervised visitation programs provide an important
service to families involved in court ordered family reunification. Such visitation
programs are a crucial support to parents in how to build a framework for the supervised
visit in order for them and the children to make sure they have the support they need in
the visit. Many of the supervised visitation programs offer therapeutic services in
conjunction with the supervised visits. Therapeutic services may be important in reducing
negative occurrences which can frequently happen in visits, such as times when the stress
of the situation causes parent(s)/caregiver(s)/child(ren) to say words that cannot be taken
back, simply will not be said in the first place.
Supervised visitation programs are a newer component to providing safe visitation
outside of the immediate child welfare office. Florida has pioneered such supervised
visitation programs, starting in 1997 with 15 programs and a few thousand visits,
growing in five years to 42 programs which supervised about 40,000 visits (Oehme &
Maxwell, 2004). Florida’s Department of Children and Families recognized the need to
address issues within these supervised visitation programs, creating a manual to guide
supervised visitation. However, these supervised visitation programs are not required to
train on this manual (Oehme & Maxwell, 2004). Inconsistency in supervised visitation
programs indicates inconsistency in services the parent(s)/caregiver(s) are receiving.
Security, training, and informed referrals are the three identified factors affecting the
visitation programs (Oehme & Maxwell, 2004). While security is designed to protect the
participants and monitors, it is difficult to enforce and can be threatening to a parent
8
involved in the dependency system. Training is identified as an issue because high
turnover of employees has been identified in visitation programs (Oehme & Maxwell,
2004). A pitfall of the supervised visitation centers is that they can tend to be
disconnected from the child welfare case. A major concern of supervising visits is that
the programs are often unaware of the background of the case. Oehme and Maxwell
(2004) propose that (1) staff have complete pertinent background information in order to
allow/disallow brought objects to a visit, (2) allow only cleared persons to attend the
visit, and (3) better understand the dynamics of the visit.
Overall, parental participation in visiting can mitigate the traumatic effects of
separation for them, and helps parents assume the role of active participants in the
process of ultimate case disposition. Additionally, visitation is a crucial diagnostic tool
for the caseworker, assisting the case worker, the foster family, and the biological family
to assess the child’s needs. In this respect, visitation can empower both parents and child
that decisions made about their relationship will be completed with appropriate
consideration of their input. The desired positive outcome of visitation is to lessen the
trauma which occurs due to the child(ren) being removed from the home of origin
(Oehme and Maxwell, 2004). Therefore, lessening the trauma by increasing visitation
attendance rates and improving the quality is important.
History
Historically, public concern over child welfare clearly stems from behaviors
which are affected by circumstances stimulated by poverty. Policing of the poor began in
colonial times (Henderson, 2008). In the refusal by the larger community to understand
9
the causes of poverty, results were the use of almshouses to confine and stigmatize the
impoverished population. Poverty in the white immigrant group caused overcrowded
conditions in such almhouses, where orphanages were later created to save the white
children from such poverty in the late 19th century (Henderson, 2008; Hill, 2008).
Organizations such as charitable organizations, mutual aid societies, and settlement
houses were created to serve this white immigrant population (Hill, 2008).
Transnational organizations began to focus on child welfare through the use of the
profession of social work during industrialization, focusing on mentally ill, parents
engaged in deviancy, neglect, or on juvenile penal codes (Fuchs, 2007).
Through the course of child welfare law, Henderson (2008) references
Abramovitz, 1996; Davidson, 1994; and Mintz, 1992, stating the government has
specifically targeted children living in single parent homes, fatherless homes, and/or poor
families because societal standards are enforcing that these specific groups of people are
not capable of educating their children to the idealized standard. The advent of civil
rights laws in 1965 caused racial integration to be emphasized and created an increase in
the representation of black children in child welfare, currently there is a
disproportionality and over-representation of African American children in court
mandated child welfare cases (Hill, 2008). Further affecting child welfare in the past
thirty years is the shifting beliefs about the effectiveness of child welfare laws. Starting in
the early 1980’s, there have been several important shifts in child welfare law, ranging
from a focus on prevention through two sets of family preservation laws, to the current
focus of the 1997 Adoption and Safe Families Act (AFSA), which is based in child
10
safety, permanency, and well-being. These laws and how they affect families engaged in
family reunification is further explored in the review of literature.
Today, the risk factors for poverty and corresponding child abuse rates remain
similar to the nineteenth century: mental health and poverty, with race being a relatively
newer distinguishing factor. Families involved in family reunification are already facing
historical barriers, amid a myriad of difficulties prior to entering the child welfare system.
These macro barriers to family reunification set the stage in working with families
towards the goals of families providing their children a safe home.
Statement of the Research Problem
Holcomb (2004) clearly defines the problem: “Visitation may be the most
delicately complicated portion of a foster care plan, and yet the family visit is often not
afforded the attention it needs among workers.” Research indicates family visitation is a
predictor regarding the reunification outcome (Holcomb, 2004). Research shows that
positive, quality visitation leads to earlier family reunification and there is a reduction in
recidivism (i.e. re-entry into the child welfare system) (Oppenheim, 2009). Supervised
visitation programs have recently entered the social service arena and have been tasked
with providing a supervised visitation, but under a varying degree of definition on what a
supervised visitation should be designed to provide. The concern rests with the variety of
interpretation and implementation of the supervised visitation program. It is important to
understand the essential core components and services that these programs are offering to
the mandated clients in their areas, and whether or not these programs will continue to
grow and improve on the visitation component of the mandated court case plan.
11
Purpose of the Study
This research study will examine and identify essential components of successful
supervised visitation programs for mandated family reunification clients in Northern
California. The primary purpose of this research is to identify and compare services and
best practices of existing supervised visitation programs through a content analysis. A
secondary purpose of this research is to use the findings and results to determine how to
expand improved supervised visitation services for this target population on a more
widespread level, including the overall delivery of equal and reasonable services to
people involved in a court ordered process. The implications are that, potentially, if more
supervised visitation programs are delivering improved and quality services, the
following will increase: stronger case plan commitment, agency cooperation, visit
attendance, and improved observable visit quality. Improvement in these four factors
could lead to some families reunifying in a shorter period of time and/or sustaining the
reunification of the family. The overall implication of understanding this service delivery
through supervised visitation programs is bringing forth best practices in the service.
Improving quality and expanding the delivery as part of reasonable services could rebuild
and better prepare families for a permanent family reunification.
Theoretical Frameworks
Efficacy of social work theory has been difficult to assess in the past. The
evaluations of the profession of social work in the 1950s and 1960s struggled to provide
correlations because the wrong questions were being asked (Payne, 2005). Without
quantitative data, there has been a surge towards evidence-based practice. Payne (2005)
12
asserts that instead the research is in the effectiveness of the service providers versus
testing out a specific practice theory. Hence, measuring a service outcome is more
concrete than finding out if a specific theory is exactly right, more that theory provides a
foundation to social workers to help them best bring about successful outcomes for their
clients. With this in consideration, the theoretical perspectives which influence this
research study are: ecological systems theory, empowerment theory, and partnership
theory.
First, the ecological perspective includes the client and her or his environment, in
that the client is a product of her or his surroundings. The ecological perspective is a
framework for recognizing the clients’ accessibility to services, educational
opportunities, transportation barriers, and life history, as important considerations in the
problem at hand, which has brought the client forward for help (Payne, 2007). According
to McWey, Henderson, & Alexander (2008), “The ecological model provides a
mechanism for examining interactions between families and other systems: (a) the
microsystem, depicting the immediate individual and familial context (e.g., families); (b)
the mesosystem, representing the relationship or connections between several
microsystems, including families and other community organizations (e.g., local courts,
child protective services, work, school); (c) the exosystem, portraying environments distal
to the families but that might affect individual and family well-being (e.g., services); and
(d) the macrosystem, signifying broader environments, such as ideological values, norms,
and institutional patterns of a particular culture.”
13
The family reunification system can be framed in the ecological perspective, as a
concern for the well being of the child within a family unit which is involved at all levels
of other microsystems, exosystems, and macrosystems. In family reunification, the family
is working on the micro level, but according to McWey, Henderson, and Alexander
(2008), families are strongly influenced by the macro systemic factors of laws and
policies, which in turn influence families’ behavior and outcomes. The meso-system is
clearly represented by the total number of children in care, whether it is in long term
placement, guardianship, or adoption. The study by McWey, Henderson, &Alexander
(2008), suggests that microsystems are overwhelmed by such a multitude of factors that
they are especially vulnerable to laws which allow only a 12 to 15 month period to
remedy a multitude of issues.
The second theory of influence is empowerment theory, which is a position for
learning and strengthening to create desired change for the client (Payne, 2005). Fisher
and Owen (2008) further define empowerment as an individualized model, one where
self-sufficiency and inter-subjective recognition are combined. According to Fisher and
Owen (2008), national policies which label people as deficient, making individuals
personally responsible for each issue, is also negative because it assumes specific
individuals without appropriate parenting skills or the ability to fully participate in
society are at fault. Fisher and Owen (2008) cite the complexity of people’s lives as
problematic in viewing empowerment as the individual’s responsibility. Fisher and
Owen’s (2008) research places the value of empowerment theory in the role of client-asexpert, respect for ability, and partnership.
14
The third theory affecting this current project is partnership theory, which
represents a renewed interest in community based care. The implications for partnership
are seen in health and social-care, reflecting a means to enhance collaborative practice
towards sustainable communities (Popple & Stepney, 2008). Viewing families as a the
smallest building block of the community, the respect of partnership is a way to begin
building community by strengthening families. The challenge of partnership is the
currently individualized state of care. Current policy mandates present a paradox, one
which is prescriptive, is involved in labeling families, and is end-goal oriented, which is
shaped by governmental compliance (Popple & Stepney, 2008). Family reunification is
strongly influenced by such policies where parent(s)/caregiver(s) are labeled as abusive
or neglectful, given a diagnosis, ordered to follow a case plan, and all be a certain date
they are to meet a set of standards, which is court ordered. Thinking towards a
partnership way has the ability to bring a creative flexibility to solve problems in a more
holistic manner; however, it must function under the current system. At the smallest
level, working with the parent(s)/caregiver(s) to connect this process and make meaning
of their supervised visitation, is a way to produce a stronger community. Empowerment
of parent(s)/caregiver(s) promotes partnership ideas, which utilizes the most important
professionals of family reunification: the parent(s)/caregiver(s), children, and extended
family members and friends. Partnership is a way to serve individuals as people, rather
than a label, recognizing them for who they were before the court mandated case and who
they want to become through the process, and what their family will look like once the
15
process is completed. Partnership also employs group accountability for the success of an
individual.
Research Questions
The study will focus on three research questions: The principle research questions
this study will seek to explore are: (1) the core components of the supervised visitation
programs and how similar or different they may be, (2) the various services offered
within supervised visitation programs, and (3) the possibilities and efforts of expansion of
services (i.e. funding sources).
Definition of Terms
The following terms are used throughout this research study and are relevant to
the study of court mandated family reunification in Public Child Welfare programs.
Public Child Welfare. The agency which is vested with the protection and care of
children, by a Juvenile Dependency Judge.
Juvenile Dependency Court. The authority vested with the power to place children
outside of their homes and order the caregiver(s)/parent(s) to comply within the orders
decreed on behalf of the child(ren)’s safety.
Family. Any grouping of people existing together, who self identify as a collective
unit, with a collaborative feeling of responsibility towards the other members.
Parent(s). A mother who gave birth to the child, biological mother, biological father,
father who donated sperm to a mother, or a person who has legally adopted the
child(ren). This definition includes both the biological and legal definition of parent(s)
16
versus the fact emotional connection the child(ren) may use in naming a person in their
life.
Caregiver(s). Any biological parent involved in the case, married step-parents,
extended relatives, a kinship provider with whom the child has been living, or any other
adult who has previously accepted the care of a particular child or the child refers to in a
parental nomenclature.
Mandated Family Reunification. When a child has been physically removed from their
home, and their safety and welfare has been vested in the Child Welfare agency by the
Juvenile Dependency Court, this process is initiated in order to rebuild a particular family
unit which must be stable enough to provide safety to the child without the assistance of
the agency.
Court Ordered Services. Services designated by a legal document, the family
reunification case plan, which the child welfare agency is required to provide to all
qualifying family members involved in the family reunification process.
Supervised visitation. A visit between a child and their caregiver and/or relatives,
which is supervised according to the specific rules outlined at the onset, and all of their
interactions are recorded and forwarded to the social worker on the case.
Structured Decision Making. A computer program which is used to standardize social
worker decisions throughout the Public Child Welfare process.
Assumptions
The assumptions that will be made throughout this research study are: (1) the
court ordered service of supervised visits in family reunification is an important aspect of
17
the case plan, (2) it is worthwhile to improve the quality of supervised visitation, (3)
family reunification is a valuable matrix of services which should be provided to families,
and (4) families of origin are a valuable resource for children.
Justification
There are social work implications which merit this study. First, there is a large
number of youth in foster care in California. Secondly, the family reunification rate and
corresponding recidivism rate indicate that families were not healed enough to meet the
minimum sufficient level of care in the first intervention. This research study is designed
to explore the variety of services which supervised visitation programs throughout the
United States are offering to the parent(s)/caregiver(s) involved in the court ordered
service of supervised visitation. The research study is designed to examine the essential
core components of the supervised visitation programs, the therapeutic aspects of the
services, and the funding streams providing the services. The reason it is important to
take a closer look at the quality of family visitation is because when a caseworker must
make a recommendation to the Court whether or not to return the child(ren) to the
parent(s)/caregiver(s) at the appropriate hearing, the decision is based on a computerized
assessment tool, one of which is Structured Decision Making, which is in widespread use
in California and other various states.
Social work is a profession designed to promote growth and change, discovering
new ideas through an ethical use of curiosity. This research study seeks discover the
services being offered throughout the country and examine them for their core
components and see if there are some best practices which could facilitate further growth
18
of such programs to a more widespread use. Supervised visitation is a critical element of
the case plan, such that there is potential for a parent(s)/caregiver(s), whom a judge has
deemed unfit to safely care for their children, to demonstrate growth and change. Family
is central in our culture, and it is important for the social work profession to forward the
strength of the family unit by treating these parent(s)/caregiver(s) with respect,
partnership, and appropriate service. The researcher believes it is imperative to
understand and develop best practices in supervised visitation programs for the purpose
of providing the mandated parent(s)/caregiver(s) the supportive environment to learn and
practice parenting in a quality supervised visit.
Delimitations
This research study looks at supervised visitation programs services through
family reunification court ordered requirements. The focus is on a select group of
supervised visitation programs within Northern California, and consists of a small sample
size; therefore, the study cannot be generalized to the entire population. However,
understanding the core components of these programs could lead to further development
and growth of supervised visitation programs by identifying best practices. It is important
to acknowledge that there are some limitations of this research study design inherent in
its use of a non probability purposive sampling design. Overall, this research study does
seek entry into examining the incongruous belief systems, specifically assessing the ideal
understandings of supervised visitation and how it is transferred into actual practice,
which is measured by the weight of the quantitative and qualitative factors of the
supervised visitation in the eventual family reunification decision.
19
Summary
Each culture establishes values, with an intrinsic recognition that the children are
the future. The history of child welfare identifies the lapse of this value, and its negative
impact on the children involved in the system. Supervised visitation is a component of
family reunification which has merited little attention, but could serve as an integrated
focal point of all services in a case plan. This research will examine the complexity of
child welfare and family reunification for the purpose of discovering core components of
service integration through supervised visitation programs. Quality of supervise visitation
is directly linked with a decrease the time a child may spend in out of home care. The
literature review will delineate and explain the myriad of factors affecting family
reunification and detail the intervention theories used under the ecological and social
construction theories. Applying the correct theory and carrying out the process correctly
is vital to the welfare of children and families, and can result in either reunification or the
termination of parental rights. However, according to Caspi (2008), there are limitations
in the practitioner-researcher approach because there is little research to help practitioners
develop empirically based models. Supervised visitation programs employ various
models. This research seeks to examine the modalities used by the programs and identify
commonalities, which may be at least, good, consistent, or best practices.
20
Chapter 2
THE LITERATURE REVIEW
Introduction
Through this review of current and pertinent literature, the issues surrounding
mandated parent(s)/caregiver(s) who are in mandated family reunification with a public
child welfare department are explored. According to Caspi (2008), researching and
analyzing a problem includes addressing whether or not the problem merits study, and the
program planning is to evaluate the problem in conjunction with an intervention. This
literature review explores and reviews family reunification services within Child Welfare
mandated services, narrowing down to the issue of supervised visitation as an actual
service, and examining the essential core components of supervised visitation programs
though the types of services delivered, therapeutic aspects, and funding streams for the
provision of services.
The review of the literature is divided into eleven subsections. The first section
describes federal Child Welfare laws and policy, specifically outlining the parameters
which the California public child welfare departments operate under, in order to provide
family reunification services. Subsequent sections explore the backgrounds of the child
welfare populations separately: foster children, foster outcomes, and
parent(s)/caregiver(s). Following, the challenges surrounding supervised visitation are
discussed in order to identify the concerns. Supervised visitation programs are explained
as a foundational concept of how the current operating programs are comprised. Overall,
21
public child welfare consists of a myriad of participants, which is why it is important to
explore each facet of family reunification.
Child Welfare Policy
Policy makers enact laws to create societal changes, address the needs and
concerns of citizens, and manage the behavior of citizens (Henderson, 2008). Child
removal from parent(s)/caregiver(s) occurs under the California Welfare and Institutions
Code §300, and is ordered by a Juvenile Dependency Judge upon the recommendation of
a public child welfare agency. Children are separated from their biological
parent(s)/caregiver(s), or de facto parent(s), based on a decision declaring that the
children’s safety is in imminent danger. Public Child Welfare programs were created in
the early 1900’s in order to protect and safeguard children (Terling, 1999). Initially, the
Social Security Act of 1935 provided the U.S. Children’s Bureau to support public child
welfare programs (Davidson, 2008). AFDC was created in 1961 to support the foster care
system; however, children were simply removed from their parent(s)/caregiver(s) with
little public oversight until the 1962 amendments requiring some evaluations (Davidson,
2008). Policy in regards to the practice and goal of child welfare began shifting in the
1980s. There are three defined periods of policy shift, spanning from 1980 to the current
policy of the Adoption and Safe Families Act (ASFA), enacted in 1997 (McWey,
Henderson, & Alexander, 2008). These three policy shifts are: family preservation, a
second attempt at family preservation, and then ASFA. These shifts are pertinent to how
current child welfare laws affect the family structure of parent(s)/caregiver(s) and
children.
22
First, the family preservation laws were enacted in 1980 and 1991, and have
changed the face of public child welfare programs (McWey, Henderson, & Alexander,
2008). In the 1980s, public child welfare programs shifted their focus to family
reunification from permanent placement because of the negative outcomes for children in
permanent care (Terling, 1999). The Adoption Assistance and Child Welfare Act of
1980 (AACWA) was put in place in order to provide quality foster care services and
increase permanency through the Administration for Children and Families (ACF), 2002
(Jennings, McDonald, & Henderson, 1996; McWey, Henderson, & Alexander, 2008).
The second shift in 1991 was a strengthening of the family preservation laws.
Congress funded family preservation services in the Omnibus Budget Reconciliation Act
1993 in order to provide connection between families and local community agencies
(Ansay, 2001). The intentions of Family Preservation and Support Services Act (1994)
were to support family strength and stability, improve parental functioning, and provide
crisis resolution to preclude child protective service intervention (McWey, Henderson, &
Alexander, 2008).
The third shift in law occurred in 1997, where, according to Leathers (2002) and
Cordero (2004), the Adoption and Safe Families Act (ASFA; P.L. 105-89) created a child
welfare system where child safety is the foremost concern with family reunification the
secondary concern. ASFA is designed to expedite and reduce barriers to termination of
parental rights in order to promote permanency (Johnson & Wagner, 2005; McWey,
Henderson, & Alexander, 2008). Permanency is imperative to stable and positive growth
of children. According to Strijker, Knorth, and Knot-Dickscheit (2008), the American
23
Adoption Safe and Families Act of 1997 singled out foster care drift as a performance
indicator, acknowledging the continued harm of foster care drift, where a child
experiences trauma due to a lack of permanency, be it with multiple placements,
reunification, adoption, or guardianship. Ansay (2001) explains the focus on safety as a
result of the high media coverage of child death cases, where the children had been
reunified and re-abused. Families charged with neglect versus physical abuse are much
more likely to reenter the system (Marquis, Leschied, Chiodo, & O'Neill, 2008). Family
reunification has become controversial because thirty seven percent of reunified children
re-enter the dependency system within three and a half years due to continued
maltreatment (Terling, 1999). Media outlets have influenced family reunification
advocates to become more critical of Child Welfare Services workers and the decisions
which are made, due to numbers showing that 30-50% of child deaths occur at the hands
of parent(s)/caregiver(s) who were known in the child welfare system (Ansay, 2001).
According to Henderson (2007), the goal of the Adoption and Safe Families Act
is to promote adoption, shifting from family reunification to original family dissolution
and recreation of a new family. Family reunification, as a secondary concern of ASFA, is
affected by legal time limits, of six or twelve months depending on the ages of the
children. It is up to the parent(s)/caregiver(s) to demonstrate they are fit to parent their
child(ren) within the twelve months as determined by their individual case plan (McWey,
Henderson, & Alexander, 2008). A child who is less than three, or is in a sibling group
including at least one child, who is under three, is eligible to have six months of services.
Under ASFA, permanency hearings are initiated after twelve months, versus the eighteen
24
month allotment in the family preservation focus policy period (Henderson, 2008).
Further, ASFA policy provides only twenty two months for parent(s)/caregiver(s) of
infants, with only 12 to 15 months of services for parent(s)/caregiver(s) to reunify with
children over three years of age (Henderson, 2008). Often, court continuances and
contested trials can extend this time frame.
However, ASFA challenged Child Welfare to uphold accountability standards,
because it mandated the U.S. Department of Health and Human Services to create
outcome measures based on seven standards in order to receive the State reimbursement
funds under Title IV-E of the Social Security Act, versus the previous family preservation
laws which simply required Child Welfare programs to keep records of the provision of
services (California Health and Human Services Agency, 2003). This shift is important
because it requires agencies to publicly provide information on children and their
outcomes within the child welfare system (California Health and Human Services
Agency, 2003).
Foster Care Population
The foster care population (inclusive of children court ordered out of their home
of origin) tends to experience emotional traumas and challenges in multiple placements,
breaks in attachments, and uncertainty of family construction, which all lend to a certain
emotional fragility, which is often overlooked by the general population. Bruskas (2008)
argues that the foster care population is marginalized because of the Juvenile Dependency
system which creates the child as a “dependent”. The system is intended to protect
children from abuses with safety being the primary focus and to set standard measures for
25
care. Bruskas (2008) discusses the trauma of removal and the fact that while child
welfare may meet federal and state requirements, they are typically only met to the
lowest level of the standard. Many foster children require extensive resources such as
behaviorists, mental health, ALTA Regional Center, Autism workers, Individual
Education Plans, Wraparound teams, and others are in competition for these resources
and funds to a degree that is severe. Bruskas (2008) writes that foster youth lack the
support needed to develop, and this deficit will lead to a feeling of oppression, which is
what defines their marginalization.
Developmental issues in children are outlined in a study by Nelson III, Furtado,
Fox, and Zeanah Jr. (2009), where experience is the true center of development. If
children lack certain experiences, there is a chance the brain will not fully develop and
sensory, cognitive, language, and social development can be delayed or sometimes,
compromised permanently (Nelson III, Furtado, Fox, & Zeanah Jr., 2009). Attachment
between an infant and minimally, one adult, contributes to lifelong healthy relationships
(Nelson III, Furtado, Fox, & Zeanah Jr., 2009). Resiliency is an impressive consideration.
Nelson III, Furtado, Fox, and Zeanah Jr., (2009) found that children who were placed in
quality, trained foster homes, were able to make significant developmental strides versus
children who were in an institutional environment. It is important to recognize that
children who enter care and whose basic needs were not met by a parent can be
experiencing the same sensory deprivation and attachment inexperience that
institutionalized children face.
26
Children tend to exhibit stressful adjustment behaviors in foster care, with just a
few being: acting out, lying, stealing, food hoarding, physical aggression, running away,
and/or stress induced encopresis and eneuresis. Marquis, Leschied, Chiodo, and O'Neill
(2008) noted distinct behavioral differences in foster children, dependent on the type of
abuse which led them to become dependents. Children from environments marked by
neglect tend to be younger and have parent(s)/caregiver(s) with a substance abuse
disorders and have been exposed to domestic violence, while children who were
physically abused tend to have a much more difficult time in foster care by exhibiting
more acting out behaviors (Marquis, Leschied, Chiodo, & O'Neill, 2008).
Foster Care Outcomes
The intent of foster care is to provide a temporary home to children while the
parent(s)/caregiver(s) stabilized the original family situation, correcting issues of neglect,
inability to supervise, or fix an actual threat to child safety; however, this system has
been strained (Johnson & Wagner, 2005). Strijker, Zandberg, and Van der Meulen (2005)
identify the most significant problem of long term foster care to be the breakdown of
placement, which tends to negatively affect the child, such as emotional and/or
behavioral problems, potentially causing a domino effect on placements. There is little
research on placement outcome because it tends to rely on computerized databases and
social worker input, rather than input from foster parents and foster children (Strijker,
Zandberg, & Van der Meulen, 2005). However, a history of foster care placement shows
the affects that adolescents sustain as they emancipate, experiencing this transition into
adulthood with more problematic complications to meet their needs, they are at a higher
27
risk to be homeless (Senteio, Marshall, Ritzen, & Grant, 2009; Yen, Powell Hammond, &
Kushel, 2009). In a study by Yen, Powell Hammond, and Kushel (2009), foster youth
identified housing instability as a major concern which impacted health care, and general
foster care experience led to suspicion of authority and distrust due to institutional life.
Perspective of Parent(s)/Caregiver(s)
Alpert (2005) cites the parental factors which have been examined in the
investigations of child re-entry and failed family reunification efforts, to include these
common factors among the parent(s)/caregiver(s) in the family reunification process:
unemployment, loss of welfare benefits after a child’s detention, mental health factors,
drug use, inadequate housing, and lack of social support. According to Henderson (2008),
a negative consequence of ASFA is that in order to prove capacity to care for their own
child, parent(s)/caregiver(s) must fix all the concerns, which must be accomplished
sometimes in one week, such as counseling, parenting, paid work, visitation, and other
tasks as assigned by the case plan. With this myriad of factors, it is important to consider
the approach by Tuttle, Knudson-Martin, Levin, Taylor, and Andrews (2007), whose
research is based in a collaborative ideal. Such an approach may assist the purpose of
studying the overall experiences of the parent(s)/caregiver(s). According to Alpert
(2005), the parent(s)/caregiver(s)’ service experience is largely unstudied and should be
regarded as an important component to complement the other more popular components:
case outcome, recidivism, and foster care experience.
According to Henderson (2008) current child welfare law uses a one-size-fits-all
approach by using the best-interests-of-the-child standard and clear and convincing
28
evidence, instead of recognizing and meeting the needs of parent(s)/caregiver(s) with
mental and cognitive challenges. In one study, by Tuttle, et. al. (2007), the researchers
examined parents seeking custody in child welfare cases and found that, predominantly,
parents felt conflicted about the overall reunification process and were often regarded by
the Child Welfare department as resistant and non-compliant. This resistance could be
explained, according to Henderson (2008), where or when termination rates of parental
rights is significantly predicted by poor mental health and limited IQs. The question of
equal partnership between the parents and the agency is generally unexplored. Manji,
Maiter, and Palmer (2005) also used grounded theory to examine parent(s)/caregiver(s) in
Child Welfare, finding that the participants lacked instrumental, educational, social, and
psychological social supports, causing feelings of isolation and depression. Both studies
examine the parent(s) as individuals in the system. It is important to build off these
studies and take a closer look at how the parent(s)/caregiver(s) are engaging with their
other services, viewing the family reunification process through the supervised visitation
component because that is the parent(s)/caregiver(s) direct opportunity to see their
child(ren) and employ a new way of being, whether it be new skills, sobriety, mental
health care, and other changes. The improvement in quality and partnership in the
supervised visits, may lead to improved case plan commitment.
Family Reunification Challenges
It is important to understand what a family looks like when it is at risk of
involvement in the child welfare system, and what challenges will need to be addressed
in order to either maintain or reunify the family. In a study of 22 parents who were at risk
29
of losing their children to child protective services, McWey, Bolen, Lehan and Bojczyk
(2009) identified risk factors concerning families, prior to intervention, to include:
boundary ambiguity, family of origin, and family functioning indicators. Their findings
were that a majority of the reunification families in their study had poor family
functioning and attachment. Kimberlin, Anthony, and Austin (2009) propose three
reasons for failed reunification, in sum: (1) a child was returned too soon without
appropriate support, (2) parent(s)/caregiver(s) are unable to provide an adequate home for
the child, and (3) unforeseeable factors such as circumstances, family composition,
and/or physical or mental health issues. According to Henderson (2008), the current
policies and programs which undermine family reunification must be assessed in order to
restore the intent and rights of the children and parents. A behavioral study by Reid
(1988) compared intact families with families who had a child in placement, and found
that a barrier to working with the families in reunification services is that the parent(s)
tended to see the child as the problem rather than being clear that the issues are a family
problem (U.S. Department of Health and Human Services (HHS), 2008).
Recidivism
Family reunification is the most recommended goal in most case plans for
children in care, and many children who are removed are able to reunify with their
families. However, a case cannot be judged successful until long-term safety and stability
is provided to the child, shown by the family not re-entering the system (Kimberlin,
Anthony, & Austin, 2009). The U.S. Department of Health and Human Services sets the
maximum re-entry rate at 9.9% (twelve months from reunification); however, many
30
states exceed this number substantially (U.S. Department of Health and Human Services,
2008). Kimberlin, Anthony, and Austin (2009) compare the re-entry rates reported by the
U.S. Department of Health and Human Services, and cite a re-entry rate in the 2005 fiscal
year with a median of 14.8%, ranging from 1.4% to 30%, to studies which report 9 to
32%, accounting for the variability in research methodology. Federal guidelines and
oversight personnel are holding all states accountable for the recidivism rate of family of
origin reunification, and California has recognized this concern in its’ Child Welfare
Redesign Workplan (California Health and Human Services Agency, 2003).
Services
Under the premise that families are important in our society, children, families,
communities, and courts, should expect support through high quality services, which are
regulated and funded appropriately, to provide care for the vulnerable members in our
society (Crook and Oehme, 2007). Choi and Ryan (2007) found that when services are
not provided appropriately, there is a decreased probability of family reunification, and
there is a current low level of family reunification. Service delivery is greatly affected by
weak service infrastructure and funding (Choi & Ryan, 2007; Crook & Oehme, 2007).
According to Wulczyn, Chen, and Orlebeke (2009), research on foster care reentry
suggests a shortening of the reunification period leads to reentry when agencies return the
children without preparing the families with adequate service. The adequacy of service
may be addressed by generating awareness, and partnering with the family for success.
Choi and Ryan (2007) studied the importance of matching families with services
finding this increased the probability of family reunification and concluding that further
31
research is needed for providing matched services. However, their study did not examine
the supervised visitation service. Supervised visitation is the first service that
parent(s)/caregiver(s) receive. Initially, supervised visitation is a requirement in a Court
Ordered Family Reunification Case Plan, and through progress and time, the number of
visitation hours and level of supervision becomes liberalized. From the initial removal of
a child, the caretaker’s/caretakers’ success or failure to attend supervised visitation is
recorded in order to establish records in the event the case leads to termination of parental
rights (Leathers, 2002). When adequate services are provided initially, fewer services are
needed at the end of a case, in contrast to the situation when children and families do not
receive services, which results in increasing their needs for services as the case continues
(Jennings, McDonald, & Henderson, 1996).McWey and Mullis (2004) cite a study
showing that less than one quarter of children in foster care have a regular visitation
schedule, and this is a critical gap in the attachment of foster children with their
biological parents. Therefore, the visitation attendance and quality of such visitation are
indicators of the positive or negative options for family reunification, indicating
supervised visitation should be included in collaborative, matched services.
Partnership
Cordero (2004) identified four family characteristics of concern in the
reunification process: levels of attachment, separation anxiety, reunification ambivalence,
and intergenerational family patterns. However, it is the reunification ambivalence which
is the most applicable in this review. The disconnection between parent(s)/caregiver(s),
children, and resource (foster) families can promote this ambivalence. Choi and Ryan
32
(2007) looked at matched services, where public child welfare and service providers
worked together to create case plans, with the purpose of understanding the
psychological, legal, medical, social and cultural barriers to receiving services. Barriers
may include such things as parental problems with mental health, housing, parenting
strategies or support in parenting, and substance abuse treatment. Essentially, matching
services is a collaborative team approach to solving the identified needs. Cordero (2004)
noted that the reunification ambivalence occurred across all study subgroups and
occurred towards the completion of the reunification effort. Partnership ideas will be used
to address this idea of ambivalence.
Supervised Visitation
The implementation and quality of supervised visitation is often an overlooked
piece of a reunification case plan and in current literature. The literature on supervised
visitation is separated into two categories: participant outcome and the programs that
conduct the visits (Crook & Oehme, 2007). There is substantial literature on other types
and concern for quality in supervised visitation, such as in family law matters. Family
law also involves caregivers and children in stressful situations, and this literature is a
relevant resource to examine the importance of supervised visitation.
The simple definition of supervised visitation success, according to Lee (2007), is
that a supervised visitation program is working if the program shows, quantitatively, that
the visit occurred. According to Pavao, et al. (2007) sibling bonds are imperative to
children of disorganized or dysfunctional families and it is a priority in the child welfare
system to provide either sibling therapy or clinically supervised visitation. For foster
33
children, supervised visitation is an emotionally charged event. A study by del Valle,
López, Montserrat, and Bravo (2009) found substantial difference in supervised visitation
for the children in kinship care, where a visit could occur in the home, versus non-kinship
care, where a supervised visit would need to occur at a neutral, designated location.
Haight, et al. (2002) point out that supervised visitation is about the face-to-face
contact, which is essential in maintaining parent-child relationships. Haight, et al. (2002)
recognizes there is limited research into how the parents and children perceive the
benefits and outcomes of the visitation process. Other court ordered family services, such
as anger management or therapy occur independently of visitation and necessitate
qualitative assessment skills to measure the context of the family dynamics which occur
in a visit (Lee, 2007). Many factors affect the quality of the visitation, and McWey and
Mullis (2004) highlight concerns of these visitations occurring in stressful settings, such
as the Welfare office or at the home of the parent. The Center For Family Connections
facilitates visitations, and their studies show that it is important to focus on relationships
and the need to address issues within the entire family system in order to promote stable
attachment and security for the child (Pavao, et. al., 2007). Also, Leathers (2002) cites
several studies showing there are significant logistical barriers to parents and children in
foster care receiving face-to-face visitation, such as policy barriers, transportation
resources, foster parent/parent time conflicts, and a social worker’s perception of what is
in the best interest of the child.
Research by Haight, et al. (2002), focuses on the one piece of the Court Ordered
Case Plan which lacks a framework for the family: visitation. According to Haight, et al.
34
(2002), the family visits are stressful psychologically and interpersonally for everyone
involved: parents, children, and foster parents. In order to visit more effectively, Haight,
et al. (2002) identifies five components which they believe should be addressed: (1)
support to resolve trauma of loss; (2) foster parent education to support the emotional
feelings of children before and after visits; (3) the need of child welfare workers setting
boundaries of their role during the visit; (4) a visit created to include the perspectives of
all people involved to work together; and (5) goals of the visitation to be identified prior
to it’s taking place. These components identify all the different groups that are needed to
participate in the family reunification process; however, this research study will look at
the fourth and fifth components. Inclusion of the parent(s)/caregiver(s) in a task-centered
brief treatment approach clearly matches up with gaining perspective and forming their
own goals of visitation prior to it occurring.
Programs
Supervised visitation programs have been set up to offer this service to those in
family reunification and family law custody disputes; however, they differ in
administration. Child Welfare agencies, foster family agencies, and supervised visitation
programs can provide supervised visitation services. The first two do not meet a goal of
neutrality. According to Crook and Oehme (2007), it is important that the visitation
monitor is neutral, which has been recognized as vital in child maltreatment cases where
the child no longer resides with the parent(s)/caregiver(s). In 1996, Florida’s legislature
established funding for supervised visitation programs as a neutral resource for
parent(s)/caregiver(s) and family members to visit with children, versus occurring at a
35
Child Protective Services office or less formal place (Ansay, 2001). Supervised visitation
programs provide parent(s)/caregiver(s) the opportunity to physically connect with their
child(ren), while being monitored by an independently neutral third party (Crook and
Oehme, 2007). Families requiring supervision are assessed to by high-risk and benefit
from trained observers who can monitor the environment (Ansay, 2001).
Crook and Oehme (2007) cite an increase in visitation programs from 28
programs in 1995 to 525 programs in 2007. The supervised visitation centers in Florida
have been successful at increasing visits, which is associated with earlier case closure
(Ansay, 2001). However, caseworkers continue to value the focus on the number of
visitations attended, cancellations, or no show, and not on the routine observations by the
monitor of the family interactions (Ansay, 2001). Quantitative measures continue to drive
the supervised visitation programs versus the qualitative features of the families
interactions.
However, there are clearly limitations in the variety of existing supervised
visitation programs, which could affect the level of service a particular family may
receive and potentially influence overall outcomes. In a study by Crook and Oehme (2007),
it was found that the visitation centers relied upon the use of unpaid staff (volunteers and/or
student interns) when funding is uncertain, fluctuating, or insufficient to meet the demand;
however, training is decreased and according to Crook and Oehme (2007), such staff may be illequipped to supervise visitations safely when violence and alcohol or drugs are involved.
Frequently, the issues of domestic violence and chemical dependency are components of what led
families into entering the mandated reunification process.
36
Structured Decision Making (SDM)
SDM is a formal tool to guide decision makers, with the intent to ensure fairness
and effective case management (Shook & Sarri, 2007). Johnson and Wagner (2005)
explain the three components of the reunification assessment based on SDM, where, “At
each subsequent case plan review, workers use a three-part, structured reunification
assessment to evaluate case plan progress. This includes (a) an evaluation of the family’s
current functioning and progress made in reducing the primary barriers to reunification
identified previously, (b) an assessment of parental visitation based on the frequency and
quality of contact during the preceding 90-day period, and (c) a safety assessment of the
family’s home environment.” This research is primarily concerned with the assessment of
frequency and quality of the supervised visitation.
According to Nguyen (2007), SDM provides social work practitioners with a
valuable tool to assess risk. Shlonsky and Wagner (2005) define child welfare assessment
as consisting of two types: risk (prediction) and context for developing case plans, for
which SDM is an effort to integrate predictive and contextual assessment. In the study by
Johnson and Wagner (2005), it was found that the use of SDM in nine pilot counties of
Michigan were successful in attaining higher permanency rates. However, in a study on
SDM in the juvenile probation system, Shook and Sarri (2007) found that, typically,
SDM recommendations are ignored on caseworker assessments because the worker did
not agree with the recommendation based on external information or other values.
Nguyen (2007) states that child welfare informatics is not a replacement for clinical
37
practice, but rather to be used to develop more effective tools to guide workers in
providing best social work practice to the most vulnerable populations.
Theory
Applying the correct theory and carrying out the process correctly is vital to the
welfare of children and families, and can result in either reunification or the termination
of parental rights. According to Lee and Stacks (2004), visitation is a valuable
opportunity for family therapy and collaboration with the agency in authority to include
the larger systems of court, foster care, education and mental health. Visitation and
therapy could be combined into one service versus holding the parent(s)/caregiver(s)
accountable for unrealistic concurrent appointments (Lee & Stacks, 2004). However,
according to Caspi (2008), there are limitations in the practitioner-researcher approach
because there is little research to help practitioners develop empirically based models.
Since supervised visitation programs employ various models and therapeutic approaches,
the difference is why it is important to compare and understand the core components of
the programs. This research seeks to examine the modalities used by the programs and
identify commonalities from which best practices may emerge.
Creating a new family story and way of being opens up possibilities to change the
context of the story (Bergmark & Söderquist, 2002). Family reunification is dependant on
this concept of change and who they will be in the future. However, the law is in place to
protect children by promoting permanency and the law is difficult to apply when working
with the mandated parent(s)/caregiver(s) because abuse or neglect do not occur in a short
period of time and it is difficult to expect such a myriad of problems to be resolved in the
38
shorter time period. An additional result of ASFA is that parent(s)/caregiver(s) are more
at risk to have their parental rights terminated due to concurrent planning and exhaustion
of the time limits (Cordero, 2004; Henderson, 2007).
Understanding the therapeutic aspects of the services some supervised visitation
programs is important because in and of itself, family reunification exists as a stressful
situation where many eyes are assessing and evaluating the parent(s)/caregiver(s).
According to Bouteyre, Maurel, and Bernaud (2007), engagement strategies are more
successful in stressful situations, versus disengagement strategies, and the engagement
activities may be linked to better outcomes where problem-centered coping correlated
with psychological well being and emotion-centered coping correlated with distressed
mental well being. McWey and Mullis (2004), address the effects of setting time limits
for the permanency of children through the Adoption and Safe Families Act (PL 105:89)
of 1997. Emotional stability is reflected through the direct progress of visitation and
attachment. Structured Decision Making is utilized by the State of California. In SDM,
the visitation requirement is weighed one-third in the decision to reunify a family
(Johnson & Wagner, 2005). It is necessary to have the knowledge of the qualitative
aspects of supervised visitation programs and understand the services being provided to
mandated family reunification clients.
Summary
Through understanding child welfare law and the populations involved, this
research seeks to identify the essential core components of supervised visitation
programs, such that a parent(s)/caregiver(s) is receiving reasonable services through
39
appropriate and quality supervised visitation, where the visitation is an opportunity to
demonstrate growth and change. This practical approach has implications to identify best
practices in supervised visitation programs, with the knowledge to implement and expand
more quality services. Quality visitation is specifically desirable to provide support and
stability to all members of the family during this difficult time when they are seeking to
create a new way of being a family. Time limits have been imposed on the length of time
a parent has to reunify, and with such rigid limits, providing quality visitation is critical
to the ability the family has to reunify. The level of quality in supervised visitation may
have the ability to alter the commitment and motivation a parent(s)/caregiver(s)’ is
experiencing. A higher level of quality could also encourage parents to ensure they attend
all of their visitations, which research shows increases the reunification effort.
40
Chapter 3
METHODS
Introduction
This chapter outlines the research design and methods to be used in this research
study. Next, the following sections detail the research question and study design,
variables, participants, data collection procedures, instrumentation, validity/reliability,
data gathering procedures, provisions for protection of the human subjects, and data
analysis. The human subjects’ application and approval letter (Appendix A) were
submitted with approval obtained prior to initiating data collection. Overall, the research
design and methods reflect social work principles and research methods.
Study Design
This qualitative research study examined the core components of currently operating
supervised visitation programs which serve families involved in court mandated family
reunification and family law. A matrix was used to examine several current operating
programs and their core components (see Appendix B). This researcher chose to engage
in a qualitative approach in an attempt to understand and address the unique needs of a
specific client population. A qualitative approach is appropriate for this research because
of its focus on observations by the program directors, administrators/management and
social workers from these supervised visitation programs, assessing the programs and not
the specific population, which is a court mandated population. Qualitative research is able
to focus on research which does not fit the overall generalizable population (Royse,
2004). The client population which the supervised visitation programs serve is clients
41
who are mandated to have supervised visitation with their children. Supervised visitation
has been identified as an outcome predictor in family reunification research; however,
visitation programs continue to offer varied levels of service (see Chapter Two- Review
of the Literature).
The intent of conducting a content analysis is to assist this researcher in gathering
information on a topic which has not yet been researched. While each program has
developed individual components of supervised visitation programs, it is not in
widespread or consistent practice. Content analysis is a means to compare programs in an
unobtrusive manner while analyzing key words, phrases, or concepts (Royse, 2004). In
this study design, it is imperative to consider that the mandated family reunification client
population is regarded as not being able to grant consent because they are involved in a
court mandated process. Hence, an unobtrusive examination and comparison of the
supervised visitation programmatic services they are receiving is an appropriate study
design. With the knowledge gained from this study, the researcher will be able to use the
findings to possibly improve, develop, and expand supervised visitation programs that
have been shown to be effective in working with the supervised visitation service for
mandated family reunification clients. Additionally, this researcher hopes this study will
expand the overall knowledge of best practices that serve the mandated family
reunification population, thereby enhancing family reunification success rates.
Variables
The principle research questions this study will seek to explore are: (1) the core
components of the supervised visitation programs and how similar or different they may
42
be from each other, (2) the various services offered within supervised visitation
programs, and (3) the possibilities and efforts of expansion of services. These research
questions will be analyzed through a content analysis, identifying the variables by agency
and core component. The topics which will be explored directly relate to the questions,
such as: (1) What therapeutic services are available as a variable in the core components?
(2) What are the current programmatic concerns and limitations to mitigating these
issues? and (3) If further funding is secured for the programs, what are the ideas to
expand the program in order to provide more benefits in the court mandated situation of a
supervised visitation program?
Participants
This research study examined the administrative or professionals view and
observations of components of successful supervised visitation programs serving
mandated clients either involved in court ordered family reunification of family law
orders. The sample population consisted of four initial professional administrative
representatives of currently operating supervised visitation programs, within Northern
California. The programs are serving populations which are court ordered mandated
clients (see Chapter Two- Review of the Literature). A non probability purposive
sampling and snowball design was used to select the programs for comparison in this
study. This method of sampling is inclusive of the sample population, or supervised
visitation programs, to serve clients with similar service needs and characteristics
(mandated by a Court). This research specifically focuses on the supervised visitation
services offered to mandated clients, either in mandated family reunification or family
43
law. While the non probability purposive sampling design is not regarded as scientific as
other sampling options, it is compatible to the intent of this research study, which is to
identify core components of existing supervised visitation programs. With the
marginalization of the population, difficulty of access in regards to consent of the
population, and the limited implementation of supervised visitation programs, it is
imperative that the programs being compared are similar.
Data Collection Procedures
The data in this research study was collected by identifying currently operating
supervised visitation programs through a non purposive and snowball sampling design.
Upon locating the four programs, a permission letter (Appendix C) requesting the
participation of their agency was sent directly to the agency administrators/program
managers. After obtaining the permission letters and obtaining human subjects approval,
this researcher contacted the various programs to schedule an interview time, at their
convenience. The program administrators/managers provided this researcher with
additional individuals within the organization to contact and request their participation in
this research. A written consent form (Appendix D) was obtained from each individual
interviewed prior to beginning the interview. This researcher disclosed to the participants
than any part of the conversation, specifically the administrative/staff person’s
communications regarding the program, will be used as data in a graduate level research
study and were confidential. Twelve subjects from four agencies were interviewed.
The collected data was then entered into the matrix being used by this researcher
(see Appendix B) in order to compare the components of various programs. Several
44
tables were used in order to categorize the data for further readability. The data has been
compared for content analysis by examining reoccurring themes and similar features
throughout the four programs. The findings of this analysis are reported in the Results
chapter of this researcher’s thesis.
Instrumentation
For the purpose of comparing the various components of different supervised
visitation programs for mandated clients, this researcher adapted two tools. A matrix was
used to compare the core components of ten currently operating supervised visitation
programs in the Northern California (see Appendix B). In addition, a brief questionnaire
was used in order for this researcher to obtain specific information on programs (see
Appendix E). The questionnaire is comprised of thirteen open-ended questions, and was
conducted through interviews scheduled based on participant convenience.
Validity/ Reliability
The selected instruments are purposeful in this research study because exploratory
content analysis discovers the similarities and differences which surface as a result of
conducting the research. Also, the instruments used in this content analysis are able to
mitigate the external threat of using instruments in a research study which does not apply
to the current study. Awareness and working to prevent variables from influencing the
research study results in a stronger study (Royse, 2004). This researcher is conducting the
study singly. Inter-rater reliability is therefore not applicable. The potential threat to
internal validity is the objectivity of this researcher. This researcher will strive to mitigate
this concern by analyzing the data in the same systematic order for each program, and
45
should it be necessary to contact program staff, this researcher will ask the questions in
the same order. Experimental mortality is not a concern in this research study because it
utilizes data from existing programs.
Once the supervised visitation programs have been identified, this research study will
conduct the content analysis of the administrative perspectives of the supervised
visitation programs in a timely manner. Conducting a study in a short amount of time
minimizes the internal threat of validity (Royse, 2004). Maturation is not a concern in this
research study because it is comparing existing programs in a short time period. The
researcher acknowledges that the selection of the ten supervised visitation programs
selected for this research study is not random in the use of a non probability purposive
sampling design. With the scarcity of programs across the United States, it is important to
gather quality content for analysis in order to gain insight into the services that supervised
visitation programs can offer to court mandated clients (i.e. family reunification or family
law). The internal threat of testing effects does not apply because this research study is a
content analysis of supervised visitation programs and the core components comprising
the program. Regression artifact also does not apply because of the qualitative aspect of
this research study. Other additional internal threats to validity are: diffusion and
demoralization because this study is exploratory and not experimental.
Data Gathering Procedures
The data in this research study was collected by comparing core components of
various agencies currently operating supervised visitation programs. Upon identifying the
programs, the program administrators/managers were contacted and their agencies
46
participation was requested. Ten programs were contacted, with four programs agreeing
to participate. Thirteen individuals were contacted and eleven participants were
scheduled to participate in the research interview. The collected data was then entered
into the matrix being used by this researcher (see Appendix B) in order to compare the
components of the various supervised visitation programs. The data was compared by
this researcher performing a content analysis designed to examine reoccurring themes
and similar features throughout the four programs.
Protection of Human Subjects
The Protocol for the Protection of Human Subjects was submitted to the Human
Subjects Review Committee of the Division of Social Work, California State University,
Sacramento, on November 2, 2009. Approval was obtained on: December 11, 2009. The
proposed research was deemed to be No Risk. This research project was approved at no
risk due to the fact that the research is comparing programs, and is interviewing human
subjects only about a program (Human Subjects Approval Number 09-10-068, see
Appendix A). This research project will compare existing supervised visitation services
available to mandated family reunification clients living throughout Northern California
through a content analysis of the responses obtained through the interview guide (see
Appendix E). If necessary, telephone or electronic contact with program staff may occur
only for the purpose of scheduling the research interview; however, no danger
whatsoever will occur to the human subjects. Standard social work ethical considerations
established by the National Association of Social Work were used to guide the ethical
principals of the research.
47
Voluntary Participation
In the event that this researcher would need to contact program staff with further
questions, the researcher will obtain oral consent from the participating program staff.
Confidentiality concerns are addressed in a subsequent section, titled as such. The
researcher will request staff member participation; however, should a staff member
decline to participate, it will simply be documented that program staff was not available
to participate in this research study.
Risk
The risk involved to the participants is determined to be No Risk, in that it is
comparing existing supervised visitation programs operating in Northern California. The
interview questions for this research are focused on the implementation, purpose,
components, and expansion ideals of supervised visitation programs.
Confidentiality
In the initial contact of each program, this researcher will immediately identify
myself as a graduate level student completing a thesis research project, which this
researcher is requesting their agency participation. This researcher will make it known
that any part of the conversation could be used as data in a graduate level research study.
Specifically, any staff person’s comments in regards to the supervised program could be
used. The researcher will clearly state the focus of the research study as well as the
location, California State University, Sacramento. The purpose of the study will be stated
as a comparison of currently operating supervised visitation programs in Northern
California and identifying best practices for supervised visitation programs with the
48
mandated family reunification population. Upon obtaining the agency permission letter,
the participant will be contacted and requested to participate in this research. Their
response will be documented appropriately. This researcher will protect the participant’s
confidentiality by setting up an interview time comfortable and confidential for the
interview process. Written consent (see Appendix D) will be obtained prior to the start of
the interview. This researcher will inform the participants that there will be no identifying
information or any personal information on the interview notes and the consent form will
be stored separately from the interview notes. Once the study is complete, the consent
forms and interview notes will be disposed of by shredding/deleting the materials. This
researcher will inform the interviewees that they may choose not to answer specific
questions or may cease to continue in the interview at any time. In addition, the
researcher will not discuss any client names and should the participant disclose any
names, these will not be recorded.
Data Analysis
The data for this research study was analyzed through a content analysis of the
responses to the interview guide (see Appendix C) designed by this researcher. The focus
of the content analysis is to learn about the best practices for supervised visitation
programs. Specifically, the content analysis will focus on (1) experience levels,
theoretical views, and beliefs about the purpose of visitation, (2) core components, (3)
concerns and limitations, (4) program evaluation, and (5) improvement ideas. The content
will be entered into the matrix (see Appendix B) for comparison. The responses to the
49
interview questionnaires were manually compared by this researcher and will be
documented in Chapter Four, Results.
Summary
The qualitative research methods used in this study examine the core components
of currently operating supervised visitation programs which serve families involved in
court mandated family reunification and family law. Through the detailed description of
the study design and variables, the design used clearly matches the goal of this case
study. The researcher identified how the supervised visitation programs were found for
comparison and how the data would be collected through the use of content analysis. The
research methods protect confidentiality and appropriate provisions were made for human
subjects’ protections. The data analysis section described the use of the content analysis
tool. The research will be conducted based on these identified premises and factors.
50
Chapter 4
FINDINGS
Introduction
The findings chapter of this research study outlines the collected data of the
research study as analyzed by this researcher. It is broken into overall findings and
specific findings. Overall findings are illustrated as experience level, demographic
characteristics, and backgrounds of the interviewees, specifically related to years within
an agency, social work experience, and individual belief systems around supervised
visitation. Specific findings will illustrate the common core components of the four
supervised visitation programs, including essential components of the programs, in what
is offered to the visitation clients, and the identified areas for improvement. Overall, this
chapter represents the culmination of the data gathered by this researcher.
Participants
All four of the supervised visitation programs chosen for this research study offered
supervised visitation services to families in court mandated family reunification, with
only one program offering this service to family law cases. In the comparison of these
four programs, it is clear there was a wide array of experience levels of the different
people who supervise the visitations (see Table 1). Four of the ten programs that were
contacted did choose to participate in the research. Thirteen individuals within the four
programs were contacted to participate, with eleven consenting to participate. The two
non-participants initially agreed to participate; however, after several attempts to contact
these potential participants to schedule an interview, it was determined by this researcher
51
that these individuals were no longer willing to participate, for unknown reasons. There
was no difficulty in identifying supervised visitation programs. Administrators readily
identified potential participants. There was no difficulty in contacting those who chose to
participate, scheduling the interviews, or conducting the questionnaire. In carrying out
this research, no changes were made to the initial proposed study.
Specific Findings
In Chapter One of this study, Holcomb (2004) is cited for the definition of
supervised visitation, such that supervised visitation is the most complicated portion of a
reunification plan, with little attention paid among the workers to this service. This
research is designed to better understand supervised visitation programs. The continuum
in which the supervised visitation programs are implemented range from monitoring-only
to therapeutic programs. There are also programs that are tasked as monitoring programs;
however, some additional therapeutic components are considered. Monitoring is the
minimally required basic component that is a requirement to fulfill the service as a Court
ordered obligation. Therapeutic components are additional efforts and concerns towards
improving the supervised visitation, and are rarely ordered by the Court, hence are not
often reimbursed by the Court. Overall, all programs evaluated in this research project
complied with Court orders by providing the monitoring of the supervised visitation.
Experience of Administration
Each of the four programs have a wide range of experience in administrative and
monitoring activities. Specifically, it is clear that the programs are administratively
managed from a social work background with many years of direct practice work, but
52
with varying experience in the direct administration of supervised visitation. The
administrators are educated at the bachelor and master’s level with extensive social work
experience; however, the monitors range from very little social work education and
experience to highly experienced and educated. The differences are illustrated by both
comparing programs, and highlighting the roles by identifying the administrators and
monitors (Table 1).
Table 1
Experience Level Demographics of Participants
Experience Level Demographics of Participants
Program
Number
1
1
Role and Agency
Experience
Administrator,15
years
Administrator, 10
years
Social Work Experience
Supervisor, Senior Worker, and Public Health Nursing
County Child Welfare: supervised visitation program
(5 years) court investigations (5 years), and prior,
Probation Officer (15 years)
1
Administrator, 13
years
9 months. Prior, had filled in as a monitor. Previous
positions: placement (3 years) and emergency shelter
care (5 years)
1
Monitor, 2 years
Prior positions in child care program and non-related
field.
1
Monitor, 3 years
No social work experience.
2
Administrator and Social Work Supervisor, Group Home Supervisor
Monitor, 15 years
2
Monitor, 1.25
years, part-time
Stay at home parent, Child Welfare (Court Unit),
Foster Care Agency
53
Table 1 (continued)
Experience Level Demographics of Participants
Experience Level Demographics of Participants
Program
Number
3
Role and
Agency
Experience
Administrator,
5.5 years
Social Work Experience
Program manager over a County Human Service
Division, Program manager for
Adoptions/Court/Calworks, direct Child Welfare
caseworker.
3
Monitor, 2
years
Child Welfare worker for two counties, Foster Agency
social work
3
Monitor, 1.5
years
Administrator/
Monitor, 7
years
No prior social work experience.
4
Therapist, LCSW, supervised visitation program,
Child Welfare, adult services, supervision in social
work setting.
Core Components of Programs
The core components of the programs vary by the administrative approach used in
the agency: monitoring only and therapeutic, which are the extremes on the continuum
identified in this research project. A monitoring only program is defined as one that
provides a safe environment for a family to visit, under the observation of an objective
third party who takes notes and provides documentation to social workers and/or Court.
A therapeutic program is defined as one that provides a safe environment for a family to
visit, with the difference being that the monitor is trained to therapeutically promote
54
positive visitation through guidance, demonstration, and retreating to the background, as
appropriate to allow the parent/caregiver to practice new ideas.
The primary core component of all four programs is safety. Every program
identified policies around safety, with some having experienced safety issues in the past.
Some of the identified safety issues were threats by parent(s)/caregiver(s) to abscond with
the child(ren), along with some physical threats to the monitoring staff. The participants
strongly identified with the risk and safety, in reference to the child(ren), the monitor, and
the parent(s)/caregiver(s).
The core component of the monitoring only supervised visitation program is
specific to the safety for the child(ren) (both physical and emotional), parent/caregiver,
and the monitor. The main emphasis is observation and documentation. Specifically, this
program was identified as not having a social work component, not to teach parenting,
and not therapeutic. The auxiliary components are to follow Court orders and social
worker directives; meeting within the schedule of all parties possible. There was a
mention to the concern for providing a comfortable environment for the parents and kids,
where food is allowable in a designated area, but not in the visitation room. An
observation that was offered is that parents always want to feed their kids.
The core component of the monitoring only supervised visitation program, which
has some therapeutic influences, also recognized safety and observation. However, this
program had more concerns for the abnormal feelings of supervising a visit and the
concerns center around how the child(ren) behaves in reaction to the visit. This program
55
is influenced therapeutically because they work to address the child(ren)’s issues and
concerns around the supervised visitation, providing support to the child(ren).
The core component of the monitoring only/therapeutic mixed program is also
safety, observation and documentation. The therapeutic components of this program is
the modeling, redirection, options for suggestions, home-like environment, and a variety
of age appropriate toys and games. Interactive activities are encouraged, and with
teenagers, laptops are available so that kids can do their homework and surf the web with
their parents (controls set up). The vision for the program was reported to be: “Families
need to be treated as if they were family coming for a visit. We treat them like human
beings with needs.”
The core component of the monitoring only or therapeutic program provides for
the safety of all participants. The focus interest is the therapeutic program, which offers
either a licensed therapist, a registered Associate Social Worker or a Marriage and Family
Therapist, Intern. The therapist provides intervention and guidance; however, it was
specifically stated that it is not considered to be family therapy, such that the therapist
will move in and out of the background of the visit, only stepping in as appropriate to
promote positive communication and family building. However, when a child remains
placed in the home of a parent/caregiver, this process would be considered Functional
Family Therapy. This program also provides a comfortable, large room with couches and
some toys.
Overall, each program identified objective observation as important. The one
monitoring only/therapeutic mixed program identified their environment as an important
56
component in promoting successful visitation by creating a more home like visitation
room, filled with tables for the family to eat at, couches to sit on, arts and craft activities
and other age appropriate toys. This program emphasizes creating a nurturing context for
the supervised visitation, with the identified intent to foster a more relaxing atmosphere,
and minimize the presence of the monitor. This program also provides some re-direction
and intervention, as appropriate. The basic or therapeutic program provides different skill
level monitors, based on the reimbursement and court specific orders for a therapeutic
visit.
Definition of Success
The definition of a successful supervised visitation is also on the continuum
related to the service delivery ideals of the supervised visitation program. On one side,
there are the monitoring only programs that are concerned with the safety and well-being
of all participants in the visitation. If all visits occur, as requested by the Court, and
everyone remains safe, this is a successful visitation. However, one of the monitoring
only programs did express some concern for the affect of the child(ren) upon the
completion of the supervised visit and taking that into account for success.
Towards the therapeutic ideal, the monitoring only/therapeutic mixed program
defines success as promoting a normalized visitation, such as stimulating interactions
more similar to a positive home environment. The mixed program provides some
direction and encouragement, along with some verbal and structural modeling with the
parent/caregiver. The verbal modeling occurs by explaining alternative options or
responding when a parent/caregiver asks for assistance. The structural modeling refers to
57
the background guidelines, such as requiring the parent/caregiver to clean up the room
fifteen minutes prior to the end of the visit, or by the list of foods and activities the
program recommends the parent/caregiver to engage their child(ren). The list includes:
health food options, developmental age games, doing homework with the child(ren),
and/or discussing what was learned/occurred in school that day. The therapeutic program
actually provides direct feedback and interactive modeling to promote positive family
interactions in the supervised visitation. This program defines success as occurring with
healthy communication and continued building of the relationship.
Services within the Supervised Visitation Program
The identified services within the four programs are in line with their perception
of how they define supervised visitation practice. The two monitoring only programs
provide a safe, succinct practice by providing the opportunity for the supervised visit to
occur. Both of these programs identify that there are no additional services beyond
observing, monitoring, documentation, and one has support for bilingual accommodation.
The monitoring only/therapeutic mixed program provides for a Master’s level/highly
experienced social worker, when requested, to supervise closely intense cases that could
be legal, but it not necessarily therapeutic. This program has increased the training it
provides to the monitoring staff. Additionally, the program has paired Parent Project (a
common parenting program) with supervised visitation. Families can be referred to
Parent Project and the supervised visit, where the instructor will come in during the
supervised visits and reinforce some of the homework and practice techniques with the
help from the instructor.
58
The fourth program incorporates flexibility based on the family’s need, such that
it provides both: monitoring only or therapeutic program, designed to provide an
appropriate level of service based on the authorization referral (which varies in
reimbursement rates). Therapeutic visits are done with a licensed person. A therapeutic
visit the court may send to the program, for the purpose of interacting with the family,
helping them learn how to reengage with their children. Additionally, it is important,
therapeutically, to step back and allow the parents to interact, in an educated, therapeutic
process. Moving in and out of the visit, specifically to support the visitation is what
distinguishes this process from family therapy. The monitoring only visitation is provided
similar to the other two monitoring only programs.
Concerns and Limitations to Implementation
The consistent concerns about the supervised visitation programs was staffing and
funding for the programs. Frequently there is not enough staff to monitor the supervised
visitations at the ratio of one monitor per family, with a monitor often supervising two
families at once. Additionally, there are staff constraints in transporting the children and
the parent/caregiver being able to obtain consistent and adequate transportation to the
supervised visit.
Financial resources are the foundational component identified in improving
training (educational), increasing staffing and having alternative hours. The systemic
issues identified had to do with the children missing extended amounts of school,
excessive transportation times for the children, a loss of normal activities and daily
routine, and the general disruption of merging living in the foster family and visiting with
59
parent(s)/caregiver(s) (emotional and behavioral). The concerns and limitations focused
very much on funding, which raises the question on the value that is placed in supervised
visits.
Program Evaluation
The evaluation of the programs is extremely varied. Evaluation measures are also
on a continuum, with one program being data driven by safety and occurrence statistics,
to two other programs that do not have any specific program evaluation. The programs
without evaluation identified that time and funding prevent program evaluation, as it is
difficult enough to arrange and deliver the supervised visitation service.
The monitoring only programs evaluate success as the families are kept safe, they
are seeing progress (subjective), there is time for monitoring/reporting, an ability to hold
boundaries by the monitors, and visits are occurring regularly. The evaluation is done by
ensuring that Court orders are satisfied, and they are not receiving complaints from
anyone, including workers, parents, kids, or other programs. Once caveat to following
Court orders is that it also depends on parents’ compliance. The parents taking the
opportunity of the supervised visit dictate how the visit occurs, which places the
accountability on the parent(s)/caregiver(s) instead of the program. It is important that
this program is perceived as a well run program. This program does quantitative analysis,
by calculating the number of completed visits within court ordered compliance.
The second monitoring only program evaluates the visitation program on an
individual basis, such that each visit is evaluated by the outcome and affect of the
children after the visit. The parent(s)/caregiver(s) are not evaluated. Quality of the visit is
60
considered by the happiness of the child upon completion of the visit and the ability to
return to the foster home and integrate back with the substitute care providers (foster
caregivers).
The monitoring only/ therapeutic mixed program does not evaluate the outcomes
of the supervised visitation program. Additionally, the monitoring only or therapeutic
program also does not have any specific outcome evaluation. Both of these programs
expressed desire to change and begin evaluating their practices; however, the focus has
been more towards improving the quality of the supervised visitation. Each program
recognizes that it will need to evaluate practices in order to promote the importance of the
quality of the supervised visitation that they are providing.
Identified Program Improvement Ideas
As funding was identified as a main concern of all four supervised visitation
programs, the participants were asked about potential areas for development, if funding
was available. Many of the participants identified that an area for program development
would be to look at more planning for making the visitation more comfortable and safe
for the children, parents, and monitors. It was recognized by the basic monitoring
program that it would be helpful to have some therapeutic components available, utilizing
Bachelor’s and Master’s level social workers to provide therapeutic services. In fact,
many of the ideas concentrated on improving the quality of the visitation, by providing
monitors with training in parenting skills, including Parent Child Interactive Therapy
(which is currently restricted to children placed in the home of their parent/caregiver),
and improving the surroundings to encourage positive interaction. In the monitoring only
61
or therapeutic program, family law visitation would be provided free of charge to
encourage the many parents who cannot afford to pay the monitor fee to be able to see
their child(ren). The programs would like to see child and family centered visitation
rooms, specifically designed for the purpose of family visitation.
Summary
Overall, the findings demonstrate a need to further develop best practices in the
implementation of supervised visitation. There is a wide range of the level of service
which supervised visitation programs provide to families involved in reunification. The
level of experience and education of the supervised visitation monitor has is widely
varied. The core components revolve around different philosophies, with safety being
paramount. Therapeutic visitation is not readily offered. Supervised visitation programs
report to be underfunded. Evaluation ranges from none to quantitative to individual
assessment. With further funding, the main theme that emerged is the need for making
the rooms for family visits more family friendly and age appropriate, while providing for
safety. The improvement and expansion ideas proposed reflect values of family, stability,
comfort, and care. Developing a consistent practice and program implementation to
provide these values would reflect a dedication to the belief that children and families are
valuable.
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Chapter 5
CONCLUSION AND IMPLICATIONS FOR SOCIAL WORK
Introduction
In this qualitative research study, the sample population included personnel in
four agencies, who provide a supervised visitation program. Of the four programs, there
are three programs that serve court mandated family reunification cases, and one program
that serves family reunification cases and family law cases. The clientele of these four
programs are all involved, at some level, in Court, ruling about some aspect of family life
that has created an unsafe environment for the child(ren). In sum, a judge has deemed the
parent(s)/caregiver(s) to be required to have supervised visitation with their child(ren).
Throughout the four programs, there were similar themes in their objectives and goals,
primarily including safety as a main concern and striving to provide objective observation
and documentation. The review of findings and the relevance of those findings details the
differences between the programs. One component this researcher found interesting is the
vast difference in levels of education a monitor is required to have in order to supervise a
visit. Education level of the monitors does not correspond necessarily to compensation
received by the agency. Only one program has official therapeutic components, while
another has some unofficial therapeutic perspectives, and two provide observation only
programs.
The implications of the research project highlight the benefits of furthering
awareness of the problem. The recommendation for further research forwards the hope
that a larger agency will examine the definition and processes behind supervised
63
visitation, services, and requirements for family reunification to be successful. Overall,
the research contributes to the interests and well- being of families who are in the
mandated family reunification process.
Review of Findings and Relevance
The main finding of this research project is that there are two ideals of supervised
visitation programs: a minimalist ideal and a therapeutic ideal. The minimalist ideal is
based on fulfilling court ordered supervised visitations to maintain the family bonds, and
emphasizes the parent(s)/caregiver(s) as the responsible person for the success of their
visitation. The therapeutic ideal is based on augmenting the court ordered supervised
visitations to improve the family bonds, and holds the therapeutic interventions, settings,
and participants accountable for the success of the family visitation.
This research project illustrates that there is a demonstrable difference in the
implementation of supervised visitation programs. The findings of this research project
are in agreement with the literature in regards to supervised visit programs, such that
there is not an across the board, standard interpretation of how to implement supervised
visits. The unexpected finding in the research is that everyone does not necessarily
consider that supervised visitation as a service. To some, it is a fulfillment of court orders
and to others, it is a service in which the parents are supposed to be learning, practicing,
and preparing for a reunited family. This is relevant, because the interpretation of
supervised visitation could be applied to a reasonable services argument by a
parent/caregiver. If a judge orders that the Child Welfare department did not provide
64
reasonable services, it can negate much of the Court action and the continuance of the
case.
This project has contributed to an awareness of the disparity in interpretation of court
ordered supervision and how some programs implement the supervised visitation as a
mandate (minimalist ideal) and some implement it as a service (therapeutic ideal). One
program striates the implementation of the level of expertise of their supervised visitation
monitor by how the judge makes the orders: supervised visitation (observations skills)
versus therapeutic supervised visitation, (licensed clinical social worker provides
interventions). In addition, another of the programs interviewed has since written a grant
on behalf of devising, implementing and evaluating a best practices supervised visitation
program. Also, each of the program administrators expressed verbal interest in the
outcome of this research project for the purpose of improving their supervised visitation
programs. Overall, the research of this project is applicable to the understanding of
supervised visitation program implementation. There are various interpretations of what
the supervised visitation orders mean. A specific example is that there were a variety of
ideals, or goals, to facilitate the improvement of the programs in which they work.
Implications
The findings of this research have the very practical use of identifying the best
setting for rebuilding families to be safe, healthy, and happy. The field of social work has
the ability to improve its practice within Child Welfare, simply by becoming more aware
of the disparity in services a family may receive, based solely on their supervised
visitation experience. An agency might specifically utilize this research in order to begin
65
developing a best practices program model for implementing a supervised visitation
program. This research easily lends to program creation, implementation, and evaluation,
by having identified essential characteristics and beliefs of supervised visitation
programs.
An unexpected setback was the initial lack of interest participants displayed when
it was recognized that this researcher is currently an intern in a Child Welfare Agency.
Participating agencies did need to be assured of their anonymity in that the agencies are
partnered with different child welfare departments. A larger sample would have more
easily ensured anonymity, despite numbering the programs. Further study would include
for a larger sample; however, as there are not many other types of programs, this would
continue to be a challenge. An unexpected outcome of the research study is that several
participants from three of the four programs requested feedback from this research to
improve their programs.
Recommendation for Further Research
This researcher’s experience in gaining in-depth knowledge about the problem
and conducting the research contributed to a growing concern for the problem. This
researcher has had a long-standing interest in the quality of supervised visitation, so it
was frustrating to see such a variety in the implementation and interpretation of the
supervised visitation programs. Further research is necessary to evaluate properly the
success rates of visitation programs, possibly as evaluated by the clients. While it is
difficult to conduct research with mandated clients, because they are not able to give
consent due to their mandated status, it is hopeful that some County agency, State
66
agency, or independent supervised visitation program would be willing to evaluate, at a
minimum, their own supervised visitation definitions and processes for implementation.
Summary
This research contributes to the belief that families are valuable, in that the family
merits our attention in the court mandated family reunification process. While supervised
visitation has not been universally defined as a service, it is a legal parental right. More
humanely, it is the either the maintenance or improvement of the family bond. This bond
has the potential to motivate parents to change their lives, becoming the parent/caregiver
which can meet the minimum sufficient level of needs of the child(ren) and maintain the
attachment and lifetime connection a child feels with a parent/primary caregiver. Upon
the child(ren)’s removal, supervised visitation is the only time the parent physically
connects with the child(ren), and this case study identifies that there are many practices in
implementing the legal right of supervised visitation. Additionally, this study identifies
ways to improve these supervised visitation programs, possibly considering and
evaluating supervised visitation as a service, rather than just a legal right. This study
proposes merit and attention for the therapeutic ideal to be practiced in supervised
visitation programs.
67
APPENDICES
68
APPENDIX A
CALIFORNIA STATE UNIVERSITY, SACRAMENTO
DIVISION OF SOCIAL WORK
TO:
Janet A. Brown
Date: December 11, 2009
FROM: Committee for the Protection of Human Subjects
RE: YOUR RECENT HUMAN SUBJECTS APPLICATION
We are writing on behalf of the Committee for the Protection of Human Subjects from
the Division of Social Work. Your proposed study, “Essential Components of
Supervised Visitation Programs in Child Welfare Family Reunification Cases.”
__X_ approved as _
_EXEMPT _ X__ NO RISK _ _ MINIMAL RISK.
Your human subjects approval number is: 09-10-068. Please use this number in
all official correspondence and written materials relative to your study. Your
approval expires one year from this date. Approval carries with it that you will
inform the Committee promptly should an adverse reaction occur, and that you
will make no modification in the protocol without prior approval of the
Committee.
The committee wishes you the best in your research.
Professors: Teiahsha Bankhead, Chrys Barranti, Andy Bein, Joyce Burris, Maria Dinis,
Susan Eggman, Serge Lee, Kisun Nam, Sue Taylor
Cc: Dr. Joyce Burris
69
APPENDIX B
Comparison of Programs and Core Components
Component #1
Program
#1
Program
#2
Program
#3
Program
#4
Component #2
Component #3
Component #4
70
APPENDIX C
Permission Letter Template
Date:
Division of Social Work
California State University, Sacramento
6000 J Street
Sacramento, CA
Researcher:
Janet Brown
(530) 401-3623
Jab425@saclink.csus.edu
Thesis Advisor:
Joyce Burris
(916) 278-7179
dub@saclink.csus.edu
To Whom It May Concern:
I grant permission to: Janet Brown, a student at: California State University, Sacramento,
to speak via telephone or email to the director or designated person of our agency in
specific regards to the services, policies and procedures, and implementation of this
agency’s supervised visitation program. The director or designated person will schedule
the contact at a convenient time for them to participate in an interview by phone. I
understand this information is for the direct purpose of the above named researcher to
conduct a thesis/project which is an examination and comparison of the services, policies
and procedures, and implementation of supervised visitation programs throughout the
United States. The purpose of the discussion would only be in relation to the program,
such that no confidential information will be discussed or disclosed to the researcher.
Sincerely,
Director Name
Agency Name
Address
Telephone
Email
71
APPENDIX D
PARTICIPANT CONSENT
ESSENTIAL COMOPONENTS OF SUPERVISED VISITATION PROGRAMS IN
CHILD WELFARE FAMILY REUNIFICATION CASES
This is a request for your consent to participate in this research study, conducted by Jan
Brown, a graduate social work student at California State University, Sacramento. The
thesis advisor for this research project is Dr. Joyce Burris.
Contact information:
Researcher
Janet Brown
(530) 401-3623
jab425@saclink.csus.edu
Thesis Advisor
Joyce Burris
(916) 278-7179
dub@saclink.csus.edu
The purpose of this case study is to identify and compare core components of several
supervised visitation programs (i.e. four) for court ordered family reunification families
through a content analysis of reports from administrative members or professionals of
existing programs.
If you decide to participate, we will complete an interview, which will require
approximately forty five minutes. The benefit to participating in this study is contributing
to further social work knowledge in the area of supervised visitation programs. There is
no other compensation for participating in this research.
There will be no identifying information or any personal information on the interview
notes. The researcher will protect the participant’s confidentiality by setting up an
interview time comfortable and confidential for the interview process. The agencies
confidentiality will be protected by being identified in the results as numbers. The
consent form will be stored separately from the interview notes. Once the study is
complete, the consent forms and interview notes will be disposed of by shredding the
materials. If you decide to participate in the research process, you are free to discontinue
participation at any time.
There are no identified risks from participating in this study. Thank you for your
participation.
Signature of Participant
Date
72
APPENDIX E
Interview Questions
(1)
How long have you worked in this agency?
(2)
How long have you been working in supervised visitation/Child Welfare?
What are the last three jobs you have worked in (social work experience)?
(3)
What theoretical/philosophical orientation do you keep in mind when
providing these services?
(4)
What do you think the purpose or goal is of supervised visitation?
(5)
What are some of the core components of your supervised visitation program?
(6)
What initial trainings are provided for the people who monitor the supervised
visits? Is there in-service/on-going training?
(7)
What safety protocols are practiced for supervising visits?
(8)
Are there any specialized services your supervised visit program offers?
(9)
When a supervised visit is interrupted, what services are put in place to help
the parent/caregiver resume the visit?
(10)
Do you see any current problems with your program?
(11)
What are the limitations to improving these problems?
(12)
How do you evaluate your programs’ effectiveness in reaching its’ stated
objectives and goals? (i.e. annual program evaluations, success rates for family
reunification, replication and expansion of programs, etc.)
(13)
If you were given an unlimited amount of money to improve, expand, or
develop your program in any way-what would you do with it?
73
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