The “Practice” of
Practice Models
in Child Welfare
Who We Are
Anita P. Barbee, M.S.S.W., Ph.D.
Professor
University of Louisville
Consultant, NRCOI and NCIC
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Kentucky
Washington
Florida
New
Hampshire
New York City
Kansas
Oklahoma
North Carolina
Virginia
Indiana
Who We Are
• Information service for
the Children’s Bureau
Christine Tappan
• Experienced child
Deputy Project Director
welfare content and
Child Welfare Information
customer services
Gateway
team
• Provide the
information you need,
when you need it
www.childwelfare.gov
Mission
Promote the safety, permanency, and well-being of
children, youth, and families by connecting professionals
and the public to practical, timely, and essential
information on:
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Programs
Research
Statistics
Laws & policies
Management & supervision
Training resources
Children’s Bureau’s Support of Practice Models
Goals of Our Presentation
• To be practical in how
we share our
experiences with you
• To help you know how
you can choose and
create a Practice Model
• To offer a roadmap to
help you install and
maintain a Practice
Model
Four Key Questions
We will take you …
• From “A” to “A”
• Academic to Applied
• Through our primary message, which is…
• Be clear on what theories, values, and principles you want to
guide practice
• Make sure those theories, values, and principles are fully
fleshed out across casework practice, the entire organization,
and the system
• Understand the complexity of implementing a Practice Model
and the role that fidelity checking can have in installing and
maintaining desired practice
• Be clear on what the goals for your Practice Model are and
what you want to accomplish before you begin the rollout
“Start with the end in mind”
Theory, research and evidence
THE ACADEMIC LENS ON
PRACTICE MODELS
What Is a Practice Model?
A practice model for casework management in child welfare
should be theoretically and values based, as well as capable of
being fully integrated into and supported by a child welfare
system. The model should clearly articulate and operationalize
specific casework skills and practices that child welfare workers
must perform through all stages and aspects of child welfare
casework in order to optimize the safety, permanency and well
being of children who enter, move through and exit the child
welfare system.
Child Welfare Casework Practice Model Definition
(Barbee, Christensen, Antle, Wandersman & Cahn, 2011)
Keys to Intervention Success
 A theoretical base,
including a theory of
change
 A fully articulated set of
actions and skills that can
be observed for presence
and strength
 System supports
 Evaluation results,
including data benchmarks
to monitor the efficacy of
the model
Wandersman (2009)
Theory of Practice
Delineates how to think about or conceptualize the
practice with the population of focus. The theoretical
foundation can respond to four areas:
1) The conceptualization of the problem (e.g., child
maltreatment is embedded in the stage of a family’s
life development)
2) The change theory that informs how that problem can
be remediated (e.g., self-efficacy theory)
3) The theory that guides the critical contribution and
influence of the relationship alliance or partnership
(e.g., solution-focused theory)
4) The core practice values that underlie the approach to
clients and the problem (e.g., family-centered or
strengths-based)
Integrated Framework from:
Family Life
Cycle Theory

(Carter & McGoldrick, 1999)

Cognitive
Behavior
Therapy
Solution
Focused
Interviewing
Family Life Cycle Theory
Relapse Prevention
(Cognitive Behavioral
Theory)
(Marlatt & Gordon, 1985; Pithers, 1990;
Beck, 1993)

Solution-Focused Therapy
(Berg, 1994; DeShazer, 1988)
All three models have their own well-documented evidence base.
Justification
Denial
•Guilt and shame
• Wild promises
Triggering Events
•
Early Buildup
•
•
•
Negative thoughts
“Poor me”
Blaming others
High Risk
Situations
for Abuse
and Neglect
Harmful Incident
Late Buildup
Physical abuse
• Sexual abuse
• Substance use
• Lack of action
•
•
Physical signs
• Using fantasy
• Building excuses
What a Practice Model Is Not…
• Simply a philosophy of practice
or a series of philosophies or
principles
• Untethered from theory
• A technique; thus, only focused
on one piece of practice such as
intake, assessments, or working
with particular types of
challenges
• Executed without regard to
organizational culture and
climate
Family-Centered,
Strengths-Based,
Culturally Competent
Getting to Outcomes (GTO)
• This framework is embedded in empowerment evaluation
theory (Fetterman & Wandersman, 2005) and uses a
social cognitive theory of behavioral change (Ajzen &
Fishbein, 1977; Bandura, 2004).
• It has the advantage of being a results-based
accountability approach to change that has been used in
smaller organizations to aid them in reaching desired
outcomes for clients in such areas as preventing alcohol
and substance abuse among teens as well as developing
assets for youth (Fisher, et al., 2007) and preventing teen
pregnancy (Lesesne et al., 2008).
1
8
GTO Effectiveness
• Using a longitudinal, quasiexperimental design, Chinman et
al. (2008) examined the impact of
using GTO on (1) improvements in
individual capacity to implement
substance abuse interventions
with fidelity and on (2) overall
program performance in programs
that did and did not utilize a GTO
approach.
• They found that the programs
utilizing a GTO approach
performed significantly better at
both the individual and program
levels than those that did not
utilize the GTO approach.
1
9
Steps in GTO
1.
2.
Identifying needs and resources
Setting goals to meet the identified
needs
3. Determining what science-based or
evidence-based practices (EBPs) or
evidence-informed practices or
casework practice models exist to
meet the needs
4. Assessing actions that need to be
taken to ensure that the EBP fits the
organizational or community context
5. Assessing what organizational
capacities are needed to implement
the practice or program
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6.
Creating and implementing a plan to
develop organizational capacities in the
current organizational and environmental
context
7. Conducting a process evaluation to
determine if the program is being
implemented with fidelity
8. Conducting an outcome evaluation to
determine if the program is working and
producing the desired outcomes
9. Determining, through a continuous quality
improvement (CQI) process, how the
program can be improved
10. Taking steps to ensure sustainability of the
program
GTO Support System Model
Tools +
#2
Goals
To
Achieve
Desired
Outcomes
#3
Best
Practices
Training +
#4
Fit
#1
Needs/
Resources
Assessment
Current
Level of
Capacity
#5
Capacities
=
+
#10
Sustain
#6
Plan
#9
Improve/
CQI
QI/QA +
#8
Outcome
Evaluation
#7
Implementation
& Process
Evaluation
TA +
Actual
Outcomes
Achieved
GTO Steps 1-3:
CHOOSING A PRACTICE MODEL
GTO Steps 4-10:
INSTALLATION OF A
PRACTICE MODEL
Assessing “Fit” and Capacity and
Initiating Buy-in
• In Step 4 of GTO, leadership support for the Practice Model (PM) is
one of the first aspects of fit. In order to adopt a casework practice
model, agency leadership must make a clear commitment to the
model and express that commitment both inside the organization
and outside with external community partners (e.g., Martin, et al.,
2002).
• In Step 5 of GTO, assessing organizational capacity for change and
adoption of a PM is key. This includes identifying champions of
change and engaging them to help build buy-in among staff and
identify the resistors to change.
Implementation Team
Training & Coaching
Establishing and Maintaining
Fidelity
• In Step 7 of GTO, part of the process or implementation evaluation
should include creating and using several measures of fidelity,
including:
– A supervisor case consultation tool that guides discussion of
practice on a regular basis, reinforcing key behaviors in the PM
and serving as a measure to check implementation of the PM in
daily work with children and families
– An observational and case review measure to be used by a thirdparty evaluator to assess fidelity to the PM. The third-party
evaluator could be:
• The training evaluator to check on training transfer of PM
skills covered in training
• A coach checking on fidelity to help shape behavior to
improve fidelity
• Part of CQI or QA
Evaluating PM Impact
• In Step 8 of GTO, part of the outcome evaluation includes measuring
and ensuring fidelity to the PM; otherwise, outcome effects can be
attributed to other variables.
• Build a chain of evidence by answering:
– Does training of PM lead to attitude congruence with PM
philosophy, values, and theories or attitude change?
– Does training of PM lead to learning of concepts necessary to
engage in the practices?
– Do supervisors engage in case consultation and other training
reinforcement behaviors to ensure fidelity to the PM?
– Do coaches help staff practice with fidelity to the PM?
– Do staff transfer what they learned in training about PM to field
practice?
– Do staff continue to improve and practice PM with fidelity?
– Is there a link between adherence to PM and child outcomes?
Role of Training and Evaluation in
Workforce Development
RECRUITMENT AND
SELECTION
People with best skills,
abilities, values
• B.S.W. students (e.g.,
PCWCP)
• M.S.W. students
(e.g., stipend)
• Those with related
degrees
• Use of Realistic Job
Previews (RJPs)
• Use of resumes,
interviews
• Tests
• Tasks
TRAINING/TA
SUPERVISION
CQI/QA
• Pre-Service
• In class
• Online
• Field placement
• In-Service
• In class
• Online
• Reinforcement
• On the job (OTJ)
• Coaching and
mentoring
• Set expectations
before training
• Reinforce during &
after training
• Model/shadow
• Observe
• Coach/feedback
• Educational
supervision
• Clinical supervision
• SBC casework
• Measure observable
behaviors using
behavioral anchor
system while in
learning mode to show
progress
• Conduct case reviews
• Employee evaluation
• Tie to organizational
outcomes
• Job performance
• Retention
• Tie to client outcomes
• Safety, permanency,
and well-being
Using the CQI Process to
Track and Ensure Fidelity
• In Step 9 of GTO, fidelity measures should be incorporated into the
CQI case review process to give additional feedback on individual
fidelity and overall agency fidelity.
• These data can be used to tie adherence to the PM with client
outcomes, since both are measured in one tool.
• The CQI/QA team can give feedback on training to enhance modules
where practice in the field is weak.
• The CQI/QA team can give feedback to leadership about the
consequences of being slow in developing the infrastructure to
support the PM.
• The CQI/QA team can give feedback to supervisors about how their
workers compare to State averages.
• In Step 10 of GTO, sustainability can occur only if fidelity is maintained
and outcomes affected; otherwise, there will be mutiny.
Evaluation Research
Seven major studies over 12 years
• Study 1: Chart File Review (Martin, Barbee, Antle & Sar, 2002,
Child Welfare)
─ To explore issues with implementation and short-term
outcomes
• Study 2: Qualitative Interviews With Workers and Clients
─ To explore client and worker experiences with the model
(Antle, Christensen, Barbee, & Martin, 2008, Journal of
Public Child Welfare)
• Studies 3 & 4: Training Evaluation (Antle, Barbee, & van Zyl,
2008 Children and Youth Services Review; Antle, Sullivan,
Barbee & Christensen, 2010 Child Welfare)
─ To identify the most effective strategies to promote transfer
of the model
Evaluation Research (continued)
• Study 5: Management Data (van Zyl, Antle, & Barbee, 2010
chapter; Antle, Barbee, Sullivan, & Christensen, 2010,
Children and Youth Services Review)
─ To examine the impact of general model use on safety,
permanency, and well-being
• Study 6: Continuous Quality Improvement Data (Antle,
Christensen, van Zyl, & Barbee, 2012, Child Abuse and
Neglect)
─ To examine the impact of specific model skills at various
stages of the casework process on CFSR items and ASFA
outcomes
• Study 7: Particular practice behaviors that had the biggest
impact on outcome achievement (van Zyl, Barbee, Antle &
Christensen, in preparation)
IMPACT OF SOLUTION BASED
CASEWORK (SBC) ON
CHILD WELFARE OUTCOMES
Study 5: van Zyl, Antle, & Barbee, 2010, chapter;
Antle, Barbee, Sullivan, & Christensen, 2010,
Children and Youth Services Review
Overview of Study
Research Questions
 What is the impact of using SBC on child welfare outcomes of safety,
permanency, and well-being?
Sample
 Over 1,000 cases tracked for outcome data
Design: Experimental-Control Pre-Post
 Experimental group received training in model
 Control group received NO training
 Data were collected 6 months post-training (and equivalent period for
control group) and linked CFSR outcomes
Procedure
 Outcome data on child safety, permanency, and well-being obtained
through standardized State data reports and the Kentucky Foster Care
Census
Outcomes: Child Safety
Positive impact of training on child
safety.
The SBC group had significantly fewer
recidivism referrals for child
maltreatment than the control group,
F (2,112) = 18.63, p<.0001.
 SBC: n=350.00
 Control: n=538.00
Outcomes: Permanency
• There was no impact of training on
permanency outcomes.
• There is a significant negative correlation
between number of placements and number
of strengths identified,
r (105) = -.199, p<.05.
Outcomes: Well-Being
There was a significantly longer
period of time since the last dental
visit for the control group than the
training groups,
t (30) = -18.45, p<.0001.
 SBC: x=1.53
 Control: x=3.40
3.5
Number of Months
3
2.5
2
1.5
1
0.5
0
Time Since Visit with Parent
Training Control
There was a significantly longer
period of time since the last visit
with biological parents,
t (30) = -5.48, p<.0001.
 SBC: x=1.17
 Control: x=2.17
Summary of Study 5: Findings
• Training had significant positive impact on child safety and
well-being.
─ There were fewer recidivism referral reports for the SBC
group.
─ The SBC group had more recent visits with biological
parents and dental professionals.
• There was no impact of training on permanency because
training did not target these outcomes (although placement
outcomes were significantly different in Study 1).
• Limitations in research design led to the next study, through
which implementation of specific elements of the SBC model
were linked to Federal measures of outcomes.
LINK BETWEEN MODEL AND
CFSR OUTCOMES
Study 6: Statewide Quality Assurance Data (Antle, Christensen, van
Zyl, & Barbee, 2012, Child Abuse and Neglect)
Overview of Study
Research Questions
• What is the relationship between SBC use and performance on CFSR items and
outcomes?
Sample
• 4,559 cases over 4 years (2004-2008)
Variables and Measurement
• Solution Based Casework
• Total, Intake/investigation, Case Planning, Case Management
• Safety 1 and 2
• Permanency 1 and 2
• Well Being 1, 2, and 3
Procedure
• CQI Review Process
• Merged data across 4 years
• Extracted SBC items from review tool
• CFSR items and outcomes mapped onto CQI tool by CFSR/PIP team in KY
SBC Items
Intake/Investigation
 Is the documentation of the Sequence of Events thorough and rated
correctly?
 Is the documentation of the Family Development Stages, including
strengths, thorough and rated correctly?
 Is the documentation of the Family Choice of Discipline (including
strengths) thorough and rated correctly?
 Is the documentation of Individual Adult Patterns of Behavior, including
strengths, thorough and rated correctly?
 Is the documentation of Child/Youth Development (including strengths)
thorough and rated correctly?
 Is the documentation of Family Support or Systems of Support, including
strengths, thorough and rated correctly?
Ongoing
 Same as above
 Was the parent involved when changes were made to any of the following:
visitation plan, case plan, or placement?
SBC Items
Case Planning
• Does the case plan reflect the needs identified in the assessment to protect family members
and prevent maltreatment?
• Were the individuals/family, child/ren, and foster parents/relatives/kinship caregivers engaged
in the case planning and decision-making process?
• Were noncustodial parents involved in the case planning process, if appropriate?
• Were the community partners and/or others invited by the family engaged in the case planning
process, or was there documentation that all efforts were made to engage the family in
accepting community partners?
• Are the primary Family Level Objective/s and Tasks appropriate and specific to the
Maltreatment/Presenting Problem?
• Have services been provided related to the primary Family Level Objective/s and Tasks?
• Do the secondary Family Level Objective and Tasks address all well-being risk factors identified
in the current CQA?
• Have services been provided related to the secondary Family Level Objective and Tasks?
• Are the Individual Level Objectives (ILO) based on the issues identified in the CQA?
• Do the Individual(s) Level Objective and tasks address the perpetrator’s or status offender’s
individual pattern of high-risk behavior?
• Have services been provided related to the Individual Level Objective and Tasks?
SBC Items
Case Management
• Is there documentation that the FSW has engaged the family and
community partners in the decision-making process?
• Is there ongoing documentation that comprehensive services were
offered, provided, or arranged to reduce the overall risks to the children
and family?
• Is the progress or lack of progress toward achieving EACH objective (every
FLO, ILO, and CYA objective) documented in contacts?
• Is the need for continued comprehensive services documented at least
monthly?
• Has the SSW made home visits to both parents, including the noncustodial
parent?
• Did the SSW make the parental visits in the parents’ home, as defined by
SOP 7E 3.3?
• Prior to case closure, was an Aftercare Plan completed with the
family/community partners?
• Was the decision to close the case mutually agreed upon?
Relationship Between SBC and
Outcomes/Review Items
There is a significant positive correlation between
SBC scores (Total, Intake/Investigation, Ongoing,
Case Planning, and Case Management) and all ASFA
outcomes/CFSR items:
The higher the SBC score (greater degree of
implementation), the better were the safety,
permanency, and well-being outcomes for each case.
Impact of SBC on Compliance with
Federal Standards for Safety
There is a significant difference between
high and low SBC groups for all Federal
outcomes.
There is a significant difference between
high and low SBC groups for SAFETY 1, t
(4,417)=-20.20, p<.0001. For SAFETY 1, the
Federal goal was 83.7%. The mean % for
the low SBC group was 76.50%, and the
mean % for the high SBC group was 89.98%
(exceeding the Federal standard).
There is a significant difference between
high and low SBC groups for SAFETY 2, t
(4,405)=-23.40, p<.0001. For SAFETY 2, the
Federal goal was 89%. The mean % for the
low SBC group was 80.66%, and the mean
% for the high SBC group was 95.53%.
Impact of SBC on Compliance With
Federal Standards for Permanency
There is a significant difference between
high and low SBC groups for PERMANENCY
1, t (3,513)=-24.62, p<.0001. For
PERMANENCY 1, the Federal goal was 32%.
The mean % for the low SBC group was
70.07%, and the mean % for the high SBC
group was 92.72%.
There is a significant difference between
high and low SBC groups for PERMANENCY
2, t (1,533)=-14.54, p<.0001. For
PERMANENCY 2, the Federal goal was 74%.
The mean for the low SBC group was
66.89%, and the mean for the high SBC
group was 89.57%.
Impact of SBC on Well-Being
There is a significant difference between high
and low SBC groups for WELL-BEING 1, t
(4,336)=-35.22,p<.0001. For WELL-BEING 1, the
Federal goal was 67%. The mean for the low
SBC group was 66.01%, and the mean for the
high SBC group was 94.29%.
100.00%
90.00%
80.00%
70.00%
There is a significant difference between high
and low SBC groups for WELL-BEING 2, t
(2,988)=-19.5, p<.0001. For WELL-BEING 2, the
High SBC Federal goal was not established in the reports.
The mean for the low SBC group was 61.59%,
Federal
and the mean for the high SBC group was
Standard 90.58%.
Low SBC
60.00%
50.00%
40.00%
30.00%
20.00%
10.00%
0.00%
Well Well Well
Being 1 Being 2 Being 3
There is a significant difference between high
and low SBC groups for WELL-BEING 3, t
(3,467)=-23.93,p<.0001. For WELL-BEING 3, the
federal goal was 78%. The mean for the low SBC
group was 60.38%, and the mean for the high
SBC group was 88.81%.
Summary of Study 6
Use of the SBC model is associated with significantly better scores on all 23
CFSR review items and the 7 outcomes of safety, permanency, and well-being.
There are differential effects of SBC on outcomes based upon the stage of the
case:
 The most critical points in a case for SBC use to promote safety
outcomes are in the intake/investigation stages.
 The most critical points in a case for SBC use to promote permanency
outcomes are in case management and case planning.
 The use of SBC during case planning, case management, and ongoing
stages is important for well-being outcomes.
 The SBC scales account for very high percentages of the variance in
these outcomes.
Higher degree of use of the SBC model (across all stages of the case) results in
exceeding Federal standards for each of the key outcomes of safety,
permanency, and well-being. When the model is not used or used to a
lesser degree, cases fail to meet these Federal standards for most
outcomes.
Practical, pragmatic, and poignant
THE APPLIED SIDE OF
PRACTICE MODELS
Choosing and Installing a
Practice Model
•
•
•
•
•
Kentucky
Washington
Florida
New York City
Kansas
• New
Hampshire
NH’s Experience
• Benefits of a Practice Model
• Reasons to Create a Practice Model
• Key Components of a Practice Model
– Theoretical Framework
– Core Values & Practice Principles
– Casework Components
– Practice Elements and Behaviors
– Organization and System Standards
Benefits
• Promotes alignment
– Statewide consistency in families’ experiences with child welfare
– With Juvenile Justice
– With Stakeholders
• Addresses all aspects of the agency
– Systemwide undertaking
• Guides daily interactions without prescribing a specific program
– “Super” clarity and articulation of beliefs and principles
• Describes behaviors, activities, and strategies in significant detail
– Sets the expectation for quality – a higher bar
• Defines outcomes
– Aligned with CFSR, CFSP/APSR
• Address “initiative” fatigue
– Creating a Practice Model MUST BE different
“This is not a new
initiative…it will be
our way of life”
Maggie Bishop, NH DCYF Director, May 2009
40
Reasons to Do a Practice Model
•
•
•
•
Reform
Legal mandates
Improvement effort
Address an identified
problem
• Proactive leadership
• Something was missing
• Go from good to great
“New Hampshire’s Practice Model outlines the Division for Children,
Youth and Families’ beliefs and guiding principles and creates a
framework for decision making and a practice structure to guide
work within all levels of the agency.
The Practice Model does not dictate what our jobs are, rather it
influences the way individuals do their jobs. It serves as a
foundation designed to inspire the Divisions’ work and keep the
focus on providing services that are consistent. Furthermore, this
impact reaches far beyond the limits of DCYF. It extends to influence
the work that is done by providers and others who offer services for
children, youth, and families throughout the State of New
Hampshire.”
NH Practice Model Design Team February 2010
Beliefs and Guiding Principles
Prevention reduces child abuse
and neglect.
All children/youth should be safe.
Everyone deserves to be treated
with courtesy and respect.
All children/youth need and
deserve permanency.
All children, youth, and families
deserve a life of well-being.
All families have strengths.
Theoretical Framework
“New Hampshire has based our Practice Model on four
theories. These theories are anchors that ground our
Practice Model in a research-based framework. These
theories are:
• Family Development Theory
• Solution Focused Theory
• Restorative Justice Theory
• Parallel Process Theory”
NH Implementation Team, December 2010
Bringing It All Together
• Casework Components
• Practice Elements
Family
Engagement
Toolkit
Structured
DecisionMaking
Parent
Partners
SBC
Family
Meetings
Youth Action
Pool
Trauma
Informed
Organization and System Standards
Organizational Development
Systemic alignment
•Becoming a learning organization
•Viewing training as a system
intervention
•Developing the capacity for
change
• Assessing and measuring
organizational readiness
•Adjusting supervisory standards
•Using Appreciative Inquiry to
strengthen capacity
•Modifying organizational and
practice policies and standards
•Assessing workforce development
approaches
•Considering the impact on
Information Technology
•Reassessing budget priorities
•Clarifying impact on contracting
for services
•Progressing to Continuous Quality
Improvement
 Exploration & Installation
Leadership
Cross-functional project team
Communication
Resources
Implementation
Leadership
Communication
Cross-functional team
Resources
Coaching
Sustainability Implementation
plus Sustained Coaching
Communication & “Ownership”
Culture & climate monitoring
Support & Resources
Frequent monitoring and
evaluation
•
•
•
•
•
•
•
•
Sustainability starts from day 1
Leadership must live the Practice Model
Practice Model can generate organizational credibility
Creating a culture of learning is key
Practice Model = PIP = Practice Model
Communication: the Practice Model becomes the language
of the system
Time is a friend and a foe
Culture and climate need constant, careful, and
inspirational attention
GETTING AND MAINTAINING
BUY-IN
•
•
•
•
•
•
•
Transparency
Feedback loops
More is better
Use varying approaches
Go to the people
Demonstrate passion!
Youth, parents, and staff tell
the story best
• Partnerships are critical to
success
6
3
Establish a strong infrastructure
Cross-Functional Project Teams
Communication Team
Members
& roles
defined
Evaluation Team
Policy Team
Training Workgroup
Sustainability
linkages
identified from the
beginning
Project Team
Design
Team
6
4
5
Approach to Practice Model design
 Staff from across the agency
 Application and selection
 Monthly work sessions and
homework in between
 Commitment to a decisionmaking process
 “Spread” leaders
 Sustained engagement
 Youth and parent team
members
6
7
MAINTAINING FIDELITY
Impact
Practice Model = Program Improvement Plan = Practice Model
Identified PIP target areas and matched PM strategies
• Safety and assessment
• Family engagement
• Culture and climate
Most significant gains
Child and Family Well-Being Outcome 1: Families have enhanced
capacity to provide for their children’s needs.
• Item 17: Needs and Services of Child, Parents, and Foster
Parents
• Item 18: Child and Family Involvement in Case Planning
• Tem 20: Caseworker visits with parents (s)
Safety Outcome 2: Children are safely maintained in their homes
whenever possible and appropriate.
• Item 3: Services to Family to Protect Child(ren) in the Home
and Prevent Removal or Re-entry Into Foster Care
• Item 4: Risk Assessment and Safety Management
More effective together…
References
Ajzen, I., & Fishbein, M. (1977). Attitude–behavior relations: A theoretical analysis and review of
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Antle, B. F., Barbee, A. P., Christensen, D. N., & Sullivan, D. (2010). The prevention of child
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