California Social Work Education Center
C A L S W E C
Structured Decision Making®
and Child Welfare
Service Delivery Project
By:
Alice K. Kim
Devon Brooks
Hansung Kim
Jan Nissly
University of Southern California
School of Social Work
2008
TABLE OF CONTENTS
CalSWEC Preface
iv
Abstract
vi
Introduction
vii
CalSWEC Curriculum Competencies
ix
Chapter I: Decision Making in Public Child Welfare
Instructional Guide…2
Learning Objectives…2
Daily Agenda for Presenting the Curriculum Unit…2
Decision Making in Public Child Welfare…3
How Child Welfare Workers Make Decisions…4
Decision-Making Methods…5
Clinical Decision Making…6
Statistical Decision Making…9
Decision-Making Tools…12
Organizational Factors That Influence Decision Making…15
Conclusion…18
Instructor Aids…19
Decision Making and the Child Welfare Worker…19
Questions for Discussion…19
Assessment Tools and Approaches…20
Questions for Discussion…20
Decision Making and the Organization…21
Points to Consider…21
Question for Self-Reflection…23
1
Chapter II: Structured Decision Making® (SDM®) and the Los Angeles
County Department of Children and Family Services
Instructional Guide…25
Learning Objectives…25
Daily Agenda for Presenting the Curriculum Unit…25
Structured Decision Making® (SDM®) and the Los Angeles County DCFS…26
The Structured Decision Making® Model…26
SDM® in Theory…27
SDM® in Practice…28
The Research Project…31
Los Angeles Country…32
The Los Angeles County Department of Children and Family Services…34
The History of SDM® and Los Angeles County…35
Instructor Aids…39
The SDM® Model…39
24
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Questions for Discussion…39
The SDM® Tools…40
Questions for Discussion…40
Los Angeles County…41
Questions for Discussion…41
Chapter III: The Child Welfare Service Delivery Project: Methodology and
Results
Instructional Guide…43
Learning Objectives…43
Daily Agenda for Presenting the Curriculum Unit…43
Methodology and Results…44
Introduction…44
Project Background…44
Methodology…46
Overview of the Project…46
Key Informant Substudy…48
DCFS Social Worker Substudy…50
Administrative Data Substudy…56
Results…60
Key Informant Substudy Results…60
SDM® and DCFS Decision Making…60
Perceptions of SDM®’s Strengths…65
Perceptions of SDM®’s Barriers…66
DCFS Social Worker Substudy Results…69
Department Wide Analyses…86
Administrative Data Substudy (Utilization Component) Results…88
Instructor Aids…100
Questions for Discussion…100
42
Chapter IV: The Future Use of Structured Decision Making®
Instructional Guide…102
Learning Objectives…102
Daily Agenda for Presenting the Curriculum Unit…102
The Future Use of Structured Decision Making®…103
Discussion…103
Conceptual Model vs. Practical Application…104
Challenges to SDM® Implementation…105
Study Limitations…114
Implications for Policy and Best Practices…117
Conclusion…118
Instructor Aids…120
Questions for Discussion…120
Group Exercise…121
101
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
References
122
Appendixes
A. Study Results by Department…128
B. Study Results by SPA…136
C. Study Results by Office…144
127
Handouts
1. Reading List on Actuarial Risk Assessment…176
2. SDM® Assessment Tools, Definitions, and Practice Case Vignettes:
Response Priority…178
3. SDM® Assessment Tools, Definitions, and Practice Case Vignettes: Safety
Assessment…189
4. SDM® Assessment Tools, Definitions, and Practice Case Vignettes: Risk
Assessment…200
5. SDM® Assessment Tools, Definitions, and Practice Case Vignettes: Family
Strengths and Needs…214
6. SDM® Assessment Tools, Definitions, and Practice Case Vignettes:
Reunification Reassessment…230
7. Key Informant Substudy: In-Person Interview Template…244
8. DCFS Worker Substudy: Online Questionnaire Template…245
9. DCFS Worker Substudy: Online Questionnaire Cover Letter…254
175
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
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CalSWEC PREFACE
The California Social Work Education Center (CalSWEC) is the nation’s largest
state coalition of social work educators and practitioners. It is a consortium of the state’s
19 accredited schools of social work, the 58 county departments of social services and
mental health, the California Department of Social Services, and the California Chapter
of the National Association of Social Workers.
The primary purpose of CalSWEC is an educational one. Our central task is to
provide specialized education and training for social workers who practice in the field of
public child welfare. Our stated mission, in part, is “to facilitate the integration of
education and practice.” But this is not our ultimate goal. Our ultimate goal is to improve
the lives of children and families who are the users and the purpose of the child welfare
system. By educating others and ourselves, we intend a positive result for children:
safety, a permanent home, and the opportunity to fulfill their developmental promise.
To achieve this challenging goal, the education and practice-related activities of
CalSWEC are varied: recruitment of a diverse group of social workers, defining a
continuum of education and training, engaging in research and evaluation of best
practices, advocating for responsive social policy, and exploring other avenues to
accomplish the CalSWEC mission. Education is a process, and necessarily an ongoing
one involving interaction with a changing world. One who hopes to practice successfully
in any field does not become “educated” and then cease to observe and learn.
To foster continuing learning and evidence-based practice within the child
welfare field, CalSWEC funds a series of curriculum sections that employ varied
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
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research methods to advance the knowledge of best practices in child welfare. These
sections, on varied child welfare topics, are intended to enhance curriculum for Title
IV-E graduate social work education programs and for continuing education of child
welfare agency staff. To increase distribution and learning throughout the state,
curriculum sections are made available through the CalSWEC Child Welfare Resource
Library to all participating school and collaborating agencies.
The section that follows has been commissioned with your learning in mind. We
at CalSWEC hope it serves you well.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
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ABSTRACT
Child welfare is a complex field that is fraught with uncertainty. In the line of duty,
child welfare workers are called upon daily to make difficult decisions that will
profoundly affect the lives of children and families. This curriculum examines the types
of decisions child welfare workers are required to make, the factors that influence their
decision-making patterns, and various approaches that could potentially improve
decision making on both an individual and organizational level.
To further explore the issues surrounding decision making, the curriculum
focuses specifically on Structured Decision Making® (SDM®), a model that can be used
to assist social workers in making accurate and consistent decisions about the levels of
risk for maltreatment found in families, to provide guidance about service provision, and
to assist with reunification and permanency planning (Children’s Research Center
[CRC], 1999). In 1999, the State of California decided to make SDM® a required tool for
child welfare agencies statewide, and SDM® has since been implemented in several
counties, including Los Angeles. To explore the implementation and effects of SDM®
and its implications on child welfare decision making, this research team conducted a
multi-level study in conjunction with the Los Angeles County Department of Children
and Family Services. The study addressed three central questions:
•
What are the challenges related to implementing the full SDM® model in the Los
Angeles County Department of Children and Family Services (DCFS)?
•
What impact does implementation of the full SDM® model have on child welfare
service delivery?
•
What impact does implementation of the full SDM® model have on child
permanency outcomes?
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
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INTRODUCTION
This curriculum examines the issues and difficulties that child welfare workers
and administrators face when making case-related decisions for children and families,
and explores factors that can affect decision making at the worker level and throughout
all organizational levels. The following overview describes each chapter.
Chapter I: Decision Making in Public Child Welfare. This chapter presents a
range of issues regarding decision making in child welfare, including the types of
decisions that child welfare workers have to make, the difficulties that workers face
when making life-altering decisions for their clients, the importance of good decision
making in the field, and decision-making tools. Chapter I allows students to explore the
complex issues surrounding a very basic and essential skill—the ability to make sound,
consistent decisions—and to take a critical look at the tools that are available.
Chapter II: Structured Decision Making® (SDM®) and the Los Angeles
County Department of Children and Family Services. This chapter examines the
SDM® model, and its implementation in the Los Angeles County DCFS. Building upon
the discussion of decision making presented in the previous chapter, Chapter II
examines SDM® as a conceptual model, and explores how the SDM® tools may be
used to enhance worker decision making. Students can further familiarize themselves
with the SDM® model by utilizing the various SDM® tools and definitions, and applying
them to the practice case vignettes provided in Handouts 2-6.
Chapter III: The Child Welfare Service Delivery Project: Methodology and
Results. In this chapter, the methodology, instruments, and results of our research
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
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study of the implementation of SDM® in Los Angeles County are presented. Students
are challenged to critically examine all aspects of the study, and to explore their own
questions and data interpretations in light of the study’s parameters, methods, and
limitations. This chapter provides students the opportunity to become familiar with three
different types of complementary research methodologies and data: qualitative
methodologies and data, quantitative methodologies and data, and secondary
administrative data.
Chapter IV: The Future Use of Structured Decision Making®. This chapter
presents a discussion of the study’s findings, as well as implications of the findings and
recommendations for the future uses of SDM®. In addition to reflecting on the presented
results, students are encouraged to formulate their own interpretations and conclusions
of the study, and to think about real-world applications and implications of the study’s
findings.
Appendixes: Department-wide study results, by Department, SPA, and office.
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CALSWEC CURRICULUM COMPETENCIES
This curriculum can be used to promote the following competencies for public
child welfare work or study:
I.
Ethnic Sensitive and Multicultural Practice
1.2
Student demonstrates the ability to conduct an ethnically and culturally sensitive
assessment of a child and family and to develop an appropriate intervention plan.
1.3
Student understands the importance of a client’s primary language and supports
its use in providing child welfare assessment and intervention practices.
1.4
Student understands the influence and value of traditional, culturally based
childrearing practices and uses this knowledge in working with families.
1.5
Student demonstrates the ability to collaborate with individuals, groups,
community-based organizations, and government agencies to advocate for
equitable access to culturally sensitive resources and services.
II.
Core Child Welfare Practice
2.1
Student is able to identify the multiple family and social forces contributing to
child abuse and neglect.
2.2
Student demonstrates the ability to assess the interaction of factors underlying
abuse and neglect and the capacity to identify strengths that act to preserve the
family and protect the child.
2.3
Student recognizes and accurately identifies physical, emotional, and behavioral
indicators of child abuse, child neglect, and child sexual abuse in children and
their families.
2.4
Student is able to gather, assess, and present pertinent information from
interviews, case records, and other collateral sources required to evaluate an
abuse or neglect allegation.
2.6
Student understands the dual responsibility of the child welfare caseworker to
protect children and to provide services that support families as caregivers.
2.7
While incorporating knowledge of individual, family, and cultural dynamics, the
student recognizes signs and symptoms of substance abuse in children and
adults and is able to assess its impact.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
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2.8
Student understands the dynamics of family violence, and can develop
appropriate, culturally sensitive case plans to address these problems.
2.9
Student recognizes the need to monitor the safety of the child by initial and
ongoing assessment of risk.
2.10
Student understands policy issues and child welfare legal requirements and
demonstrates the capacity to fulfill these requirements in practice.
2.13
Student understands the principles of concurrent and permanency planning.
2.14
Student understands the importance of working together with biological families,
foster families, and kin networks, involving them in assessment and planning and
helping them cope with special stresses and difficulties.
2.15
Student understands the value base of the profession and its ethical standards
and principles, and practices accordingly.
2.19
Student is able to engage and assess families from a strengths-based “person in
environment” perspective and to develop and implement a case plan based on
this assessment.
2.20
Student understands and utilizes the case manager’s role to create and sustain a
helping system for clients, a system that includes collaborative child welfare work
with members of other disciplines.
IV.
Workplace Management
4.3
Student understands client and system problems and strengths from the
perspectives of all participants in a multi-disciplinary team and can effectively
maximize the positive contributions of each member.
4.4
Student is able to identify an organization’s strengths and limitations and is able
to assess its effects on services for children and families.
4.6
Student is able to seek client, organization, and community feedback for
evaluation of practice, process, and outcomes.
4.7
Student understands and is able to utilize collaborative skills and techniques in
organizational settings to enhance service quality.
4.9
Student is able to plan, prioritize, and effectively monitor completion of activities
and tasks within required time frames.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
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V.
Culturally Competent Child Welfare Practice
5.2
Student is able to critically evaluate the relevance of intervention models to be
applied with diverse ethnic and cultural populations.
VI.
Advanced Child Welfare Practice
6.2
Student demonstrates the ability to recognize abuse occurring in out-of-home
placements and to take appropriate action to protect children from abuse.
6.3
Student understands the requirements for effectively serving and making
decisions regarding children with special needs and the balancing of parental
and child rights.
VIII.
Child Welfare Policy, Planning, and Administration
8.4
Student understands how to use information, research, and technology to
evaluate practice and program effectiveness, to measure outcomes, and to
determine accountability of services.
8.5
Student demonstrates knowledge of how organizational structure and culture
affect service delivery, worker productivity, and morale.
8.8
Student understands how professional values, ethics, and standards influence
decision making processes in public child welfare practice.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
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CHAPTER I
DECISION MAKING IN PUBLIC CHILD WELFARE
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
CHAPTER I
DECISION MAKING IN PUBLIC CHILD WELFARE
INSTRUCTIONAL GUIDE
Learning Objectives
Chapter I provides students with an overview of issues related to making
decisions that affect the prevention and treatment of child maltreatment. It is designed
to provide students with a sense of the complexities involved in conducting
assessments of children and families, and how those complexities affect decisions
made by child welfare frontline workers and administrators. Students should also gain
an appreciation for the status of conceptual and empirical knowledge on decision
making in general, as well as on child maltreatment risk and protective factors and the
difficulties associated with assessing risk and protective factors. This chapter also
provides students with an overview of assessment approaches and tools associated
with child maltreatment.
Daily Agenda for Presenting the Curriculum Unit
Because of its importance and complexity, instructors are encouraged to present
the content in this chapter in modules that correspond with the major headings. For
each module or section, instructors are encouraged to emphasize the complexities
involved with each of the issues, and to emphasize the distinction between conceptual
and theoretical knowledge, and empirical knowledge. Instructors may want to discuss
decision making more generally before focusing on specific risk and protective factors
that affect decision making. Finally, we encourage instructors to help students
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
understand the implications of the decisions they will make as child welfare workers for
children and families, as well as the interplay between front-line and managerial issues,
decisions, and outcomes.
DECISION MAKING IN PUBLIC CHILD WELFARE
Child welfare workers are faced with the task of making difficult, potentially lifealtering decisions every day. Let’s take, for example, a child abuse case. A concerned
individual calls the child welfare agency to report that she believes a child has been
abused. From that moment, a child welfare caseworker must determine from the details
of the caller’s report, whether the report meets definitions of maltreatment, as defined by
the agency, State, and Federal regulations. If so, the caseworker must decide how
quickly a response must be made. An investigating caseworker determines whether the
report of maltreatment is substantiated, and if so, whether the child is safe immediately
and in the long term. Caseworkers also must try to discern how likely it is that additional
maltreatment will occur in the future.
One of the most difficult decisions a worker can make is whether to remove a
child from his or her home; however, the important questions do not end there. Once a
child is removed, there is the question of whether to place the child with relatives in
temporary out-of-home care, a foster family, or in a group home. Appropriate support
services must be chosen for the child and the biological family. The caseworker must
coordinate home visits, and make careful assessments regarding the biological parents’
progress. And most importantly, a worker must eventually decide whether to reunify the
child with his or her family, or whether it is best to terminate the relationship, and place
the child with another permanent, legal family, or in some other type of substitute care.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
As a society, we rely on child welfare workers to exercise well-informed and
consistent judgments in order to protect vulnerable children. And yet, too often the
caseworker is called upon to untangle complex and emotionally difficult situations with
limited information, time, administrative support, and resources. These limitations can
impair a caseworker’s capacity for good decision making; and unfortunately, the
consequences for poor decision making can lead to unnecessarily broken families, and
in the worst case scenarios, further child endangerment and death (Drury-Hudson,
1999).
Keeping this context in mind, this chapter focuses on the decision-making
process for child welfare workers. The topics covered include different ways that
workers make decisions, factors that influence the decision-making process, tools that
can aid decision making, and possible benefits and limitations of these decision-making
tools. This chapter also looks at worker decision making in the greater context of the
organization, and explores possible ways to support and improve caseworker decision
making.
How Child Welfare Workers Make Decisions
How do child welfare workers make decisions? As with many areas of social
work, solutions to problems and issues that arise in child welfare are not easily
discernable through the types of mechanized diagnostic tests that are available to other
types of professionals, such as doctors and engineers. Both on the caseworker and
client sides, situations are complicated by social and economic factors, personality
traits, psychosocial issues, relationship ties, and multiple other factors. Often it is
difficult to extract what the root causes of the problems are, let alone determine what an
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
effective solution might be. In the past, child welfare workers operated much like
psychologists, in that, after reviewing the available information, they made clinical
judgments solely based on their professional expertise and powers of discernment.
Over the years, however, tragic events occurred involving children in the child welfare
system, and these cases became widely publicized. This contributed to greater public
scrutiny of child welfare practices, and engendered a growing demand for more worker
and agency accountability, as well as overall improvements in child welfare policy. In
response to this demand, agencies began to adopt more rigid policies and standardized
models of assessment in an effort to minimize the risk of social worker errors.
Decision-Making Methods
There are two basic decision-making methods in the field of child welfare:
clinical and statistical. Many experts contend that there is a third type of decision
making, comprised of a combination of clinical and statistical techniques; however,
some experts argue that a combined decision-making method cannot be literally
possible (Dawes, Faust, & Meehl, 1989; Ruscio, 1998). According to Ruscio, when the
outcomes of clinical and statistical decision-making methods agree, the differences
between the two methods are irrelevant. However, when the outcomes of the two
methods do not agree, it is important to understand the merits and weakness of both
approaches, and to adhere to the method with superior predictive validity. Some feel
that employing a combined approach simply waters down the strength of either
decision-making method. For many years, there has been considerable debate
regarding clinical versus statistical decision making in the field of child welfare, and
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
there is a growing body of literature detailing the merits and limitations of each. In the
following sections, we will introduce you to both decision-making methods.
Clinical Decision Making
Clinical decision making refers to the decision maker observing a situation,
gathering what she or he feels is the pertinent information, and processing the
information mentally in order to come to a decision. While professionals using clinical
decision making may employ different types of tests and assessments to inform her or
his final decision, clinical decision making does not rigorously adhere to any formal
modes of testing. Rather, this method relies on the individual’s ability to process the
necessary information using her or his professional experience and powers of
discernment. Originating in the field of clinical psychology, this method can be informed
by a mixture of personal experience, retained knowledge, observations, beliefs, and
intuition (Dawes et al., 1989).
Clinical decision making in social work is appealing for several reasons. Social
workers, and especially seasoned social workers, are trained to look beyond the
superficial appearances of a situation and to tune in to the subtle human cues that are
often only discernible by intuition and observation. Particularly in emotional cases
involving child maltreatment, we look to social workers to search for narrative truth,
rather than sticking solely to just the facts of an account (Ruscio, 1998). Proponents of
clinical decision making also contend that there is no set formula for treating social
problems, and that individual cases should be weighed differently, based on their
particular circumstances. Only by being attuned to the characteristics and situations of
each case, can the particular needs of each individual be adequately met (Brissett6
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Chapman, 1997; Cohen, 1992; Garbarino, Kostelny, & Grady, 1993; Kelly & Milner,
1996).
While there is much to be said about the observational powers and professional
expertise of trained social workers, research has found that clinical decision making can
be a very inexact science (Camasso & Jagannathan, 2000; DePanfilis & Girvin, 2004;
Gambrill & Shlonsky, 2000; Knoke & Trocmé, 2005; Rossi, Schuerman, & Budde,
1999). As mentioned earlier, a variety of personal factors can greatly affect an
individual’s decision-making process. One factor that influences information processing
is the reliance on cognitive heuristics, or mental shortcuts (Drury-Hudson, 1999;
Gambrill & Shlonsky; Ruscio, 1998). Ruscio describes three common heuristics that
individuals often use while making decisions: availability, representative, and anchoring.
Availability heuristics are certain formative instances that are selectively recalled from
one’s memory and held up as examples, which can then bias a person’s judgment. An
individual employs representative heuristics when she or he makes decisions based
on the perceived similarity (or goodness of fit) of certain variables, rather than based on
how the variables actually relate to the situation at hand. An individual who uses an
anchoring heuristic takes a rough estimation or partial solution for a component of a
scenario, and incorrectly magnifies it to fit the entire scenario.
Social workers are often faced with an immense amount of conflicting facts and
variables that they need to process in order to make decisions about a particular case.
Because heuristics are derived from the worker’s own experience, the worker may feel
that she or he is employing experiential wisdom to process the information, when she or
he is actually falling back upon a mental shortcut that might incorrectly bias her or his
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
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decision. Researchers have also identified other biases that can result from the use of
heuristics: superstitious beliefs that result from perceived relationships in random
sequences of events, preconceived notions, illusory correlations formed from hunches
or suspicions, and the inflation of a small number of cases to exemplify the whole
(Gambrill & Shlonsky, 2000; Knoke & Trocmé, 2005; Ruscio, 1998).
In addition to personal factors, child welfare workers are influenced by the
agency environment, the greater legislative context regarding child welfare policy, and
characteristics of her or his clients. Studies also show that decision making can vary
greatly between novice and experienced social workers. Novice social workers, fresh
from school, may be well versed in prevalent theoretical concepts, policies, and
legislation surrounding child welfare; however, they often have difficulty connecting
these concepts and laws to their everyday work experience. On the other hand, while
seasoned social workers have the benefit of years of experience, they may also be
prone to rely more on practice wisdom and procedural knowledge to the exclusion of
theoretical or research knowledge (Drury-Hudson, 1999). According to Drury-Hudson,
professional knowledge is the accumulated information garnered through theoretical,
empirical, personal, practice, and procedural knowledge. A model of Drury-Hudson’s
professional knowledge is presented below:
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
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Model of Professional Knowledge
(Drury-Hudson, 1999)
Theoretical Knowledge
Empirical Knowledge
A set of concepts, schemes,
or frames of reference that
present an organized view of a
phenomenon and enable the
professional to explain,
describe, predict, or control
the world around him/her
Personal Knowledge
An inherent or spontaneous
process where the social
worker is necessarily
committing him or herself to
action outside of immediate
consciousness, or involves
action based on a
personalized notion of
common sense. Such
knowledge includes intuition,
cultural knowledge, and
common sense
Professional
The accumulated information
or understanding derived from
theory, research, practice, or
experience considered to
contribute to the profession’s
understanding of its work and
serving as a guide to its
practice
Practice Wisdom
Knowledge derived from
research involving the
systematic gathering and
interpretation of data in order
to document and describe
experiences, explain events,
predict future states, or
evaluate outcomes
Procedural Knowledge
Knowledge about the
organizational, legislative,
and policy context within
which social work operates
Knowledge gained from the
conduct of social work practice,
which is formed through the
process of working with a number
of cases involving the same
problem, or gained through work
with different problems which
possess dimensions of
understanding that are transferable
to the problem at hand
As suggested by the model, professional knowledge can be a very rich and extensive
resource for experienced social workers. However, given that it is dependent on an
individual’s experience, it can be very difficult to standardize levels of professional
knowledge across different social workers.
Statistical Decision Making
Statistical (or actuarial) decision making refers to the use of a mathematical
equation to make decisions. The equation is derived from quantitative information
collected from a sample of cases, and then tested on an independent sample of cases.
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These tests empirically establish relationships and associations, which can be used to
predict future outcomes. There are certain characteristics that define statistical decision
making. One of the essential factors that statistical methods take into account is the
validity of certain predictors. By testing quantitative data,
Validity
statistical methods determine which factors specifically predict
a certain condition, and which factors do not. The valid factors
are then weighted more heavily than the less important, or
invalid, factors. This testing essentially weeds out the factors
that are not related to the specific outcome being analyzed. In
the case of child welfare, social workers may be distracted by
A measuring
instrument is
considered valid
when it measures
what it is intended
to measure.
Synonyms for
validity include
accuracy and
precision.
certain characteristics of a case, which may or may not be
essential to the question at hand. If a child welfare agency was able to enact a perfectly
valid decision policy regarding, for example, when to place children into foster homes,
this would mean that by using this policy, the social workers in the agency would be
able to identify those and only those children who would be best served in foster care
(Ruscio, 1998).
Another
statistical
important
decision
characteristic
making
is
of
reliability.
Reliability refers the degree of accuracy or
precision the instrument provides over time,
and in different contexts. If a statistical
decision-making method is reliable, this means
Reliability
The reliability of a measuring
instrument depends on the degree
of accuracy or precision that it
provides across situations.
Synonyms for reliability include
stability, consistency, predictability,
dependability, reproductibility, and
generalizability.
that if cases share identified characteristics and factors, similar outcomes should result
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
if identical decisions are made, regardless of which worker made the decision, and
when and where the decision was made. For example, let’s say that a social worker
decides to reunite a child with her biological family in a certain case. Assuming that the
decision is made using a reliable statistical model, if the worker is secretly given the
same case again in the future, she or he would make the same decision. Likewise, a
different worker given the same case would also conclude that the child should be
reunited with her family. Because decision outcomes are based on empirically tested
factors, as opposed to personal judgment, workers would consistently apply the same
decision policy and expect similar results.
There are many obvious benefits to using statistical decision making. The
mathematical properties of this method, such as validity and reliability, greatly minimize
the risk of human bias or illusory correlations based on unrepresentative examples.
Important factors are determined by testing, rather than by professional judgment, and
can be checked for historical accuracy. Statistical decision-making methods also allow
for increased transparency in case decision-making processes, and more overall
accountability among workers.
Over the years, there has been a significant shift towards statistical (or actuarial)
decision making. Many studies have compared the two decision-making methods, and
the majority of the studies favor actuarial methods over clinical decision making (Baird &
Wagner, 2000; Baumann, Law, Sheets, Reid, & Graham, 2005; Dawes et al., 1989;
DePanfilis & Scannapieco, 1994; Gambrill & Shlonsky, 2000; Knoke & Trocmé, 2005;
Ruscio, 1998; Shlonsky & Wagner, 2005).
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Despite the overwhelming support for statistical decision making, it is important
to note that there are potential limitations to this method as well. In regards to actuarialbased decision-making tools, some experts argue that rather than supplementing social
worker skills, these tools can discourage workers from exercising their clinical judgment
and expertise. Others feel that actuarial methods lead to “cookie-cutter” responses that
do not ultimately meet individualized needs (Brissett-Chapman, 1997). In regards to
safeguarding against cognitive heuristics, Jagannathan and Camasso (1996) contend
that rather than using actuarial decision-making tools in conjunction with important
clinical skills, social workers may actually come to rely upon the tools as perceptual
shortcuts.
Decision-Making Tools
An ongoing debate regarding clinical versus statistical decision making largely
focuses on the use of decision-making tools, and in particular, safety and risk
assessment tools. One of the biggest challenges for child welfare workers is to not only
protect a child immediately, but to also protect a child in the future. Child welfare
workers must assess the current safety of the child, as well as predict the child’s risk for
future endangerment. In an effort to help workers make these difficult decisions more
effectively and consistently, many states and agencies have adopted standardized
assessment tools for decisions about safety and risk.
In 1994, Illinois was the first state to develop a tool for guiding child protective
service investigators when assessing risk (Fluke, Edwards, Bussey, Wells, & Johnson,
2001; Fuller, Wells, & Cotton, 2001). Since then, child welfare agencies in at least 42
states, including California, have adopted, adapted, or developed some form of risk
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
assessment and have made it an integral part of caseworkers’ decision-making
practices (Cicchinelli, 1991). Although the precise goals and approaches may vary
across or even within states, the basic assumption regarding risk assessment tools is
that they enable better case planning, thereby resulting in prevention of maltreatment,
unnecessary out-of-home placement, and appropriate services when needed (Gambrill
& Shlonsky, 2001; Hollinshead & Fluke, 2000).
There are three primary types of risk assessment models that are currently being
used (Baird & Wagner, 2000). The first type is the consensus model, in which specific
client characteristics are identified and agreed upon by a consensus judgment of child
welfare experts. These identified characteristics are used as parameters for
assessment, and the type of corresponding treatment is determined by the clinical
judgment of the assigned social worker. Early risk assessment tools were primarily
consensus based (Hollinshead & Fluke, 2000). In fact, the risk assessment tool
previously used throughout most of Los Angeles County was consensus based,
designed so that social workers could assess referrals for risk, and classify cases in
terms of the cause and nature of the harm or injury to the child. This method, like other
consensus-based assessments, is largely subjective and allows the worker to make
decisions according to her or his interpretation of the maltreatment.
The second type of assessment model is the actuarial (or statistical) model. In
actuarial assessment models, risk factors are identified by the empirical study of actual
cases, and statistically determined to be associated with future risk. These factors are
selected because they relate empirically to subsequent abuse and neglect reports,
substantiations, injuries, and out-of-home placements (Baird, Ereth, & Wagner, 1999;
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Baumann et al., 2005; Hollinshead & Fluke, 2000). The risk factors are also weighted,
so that child welfare workers can determine whether the child is at low, medium, or high
risk for future endangerment.
The final type is a combined model of assessment, in which risk factors are
chosen by a consensus of experts by case study. These chosen factors are then tested
statistically to determine levels of risk.
Similar to the ongoing debate about clinical and statistical decision making in the
field of child welfare, there has been considerable discussion and debate regarding the
use of the different kinds of risk assessment tools. Findings from many studies argue on
behalf of actuarial risk assessment over consensus-based or combined assessments
(Baird & Wagner, 2000; Cash, 2001; Dawes et al., 1989; Lennings, 2005; Ruscio, 1998;
Shlonsky & Wagner, 2005). A considerable body of research evidence in experimental
psychology and corrections suggests that actuarial assessment tools can estimate
future behavior more accurately than can an individual decision maker unaided by
actuarial information (Baumann et al., 2005; National Council on Crime and
Delinquency, 1999; Shlonsky & Wagner;).
Some of the reservations regarding actuarial risk assessment tools involve
practical aspects of implementation. Baumann et al. (2005) point out that there are very
important requirements for actuarial risk assessment tools. First of all, the tool must
demonstrate scientific integrity. The tool should be rigorous, and meet the necessary
standards of validity and reliability. Secondly, the tool should have practical utility. This
means that usage of the tool should produce actual results that are desired. Likewise,
the tool should be efficient, easy to use, and accessible. Risk assessment tools are not
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
intended to replace social worker judgment, but rather to enhance the worker’s ability to
make sound, consistent decisions. Many feel that given the relative predictive strength
of actuarial risk assessment instruments, it becomes too tempting for agencies and
workers to overly rely on and ultimately misuse these tools (Goddard, Saunders,
Stanley, & Tucci, 1999). Others feel that too many of the existing actuarial risk
assessment models lack the necessary scientific rigor, and require further testing. For
additional reading regarding actuarial risk assessments, please see Handout 1.
Organizational Factors That Influence Decision Making
Up to this point, we have discussed decision making in terms of the individual
child welfare worker, specifically, the extent to which internal factors and assessment
tools can affect a social worker’s ability to make good decisions. However, social
workers never operate in a vacuum. In order to gain a comprehensive picture of how
social workers make decisions, it is important to consider the context in which they
work. The culture and structure of the organization greatly influence how workers feel
about their jobs, their levels of motivation, and how they make their everyday decisions.
Problems that arise in child welfare agencies may often be the result of individual errors,
but poor organizational factors make it much more likely that individual errors will occur.
According to Manning (1982), elements that define organizations, such as rules,
goals, and products, can be confusing as they are often inherently contradictory in
nature. For example, organizations establish rules for different domains within the
organization that are often in conflict with one another. Certain policies created to
advance one department’s particular goals might impede the worker from meeting the
standards of a different department. Rules can be defined by the “spirit” of the rules in
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
situational contexts, as opposed to the direct letter of the rules. In other words, a worker
might be expected to operate differently in different situations. Defined goals for the
organization can be deemed irrelevant by its workers, and essentially replaced by
unwritten, understood goals. These types of conflicts are inherent to just about every
type of organization, and public service organizations tend to be especially susceptible
to this type of confusion.
Despite conflicting elements, however, the primary objective of any organization
is simply to survive. In an effort to protect against elements that could potentially harm
the overall organization, organizations often create conflicting safeguards that ultimately
affect and distort their original goals and objectives. Rzepnicki and Johnson (2005)
illustrate this issue using a child protection agency as an example. The objectives of a
child welfare agency are to ensure both child safety and agency survival. To do so,
agencies utilize rules and procedures that limit worker discretion in order to minimize
worker uncertainty and safeguard against poor outcomes. At the same time, however,
agencies rely on their workers to exercise their discretion in negotiating conflicting
goals, interpreting amorphous rules, balancing organizational and individual values, and
achieving certain outcomes. This inherent conflict becomes part of the organizational
culture.
Organizational culture, and especially the dysfunctional aspects of an agency,
can greatly affect how workers make certain decisions (Munro, 2005). Decision making
can be influenced by time constraints, staff shortages, increased caseloads, and
insufficient technology. Workers often receive limited or spotty information regarding
their cases, and are also required to accommodate the demands of other systems, such
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
as judicial courts, the police, and other service providers. Agencies often have
conflicting goals, or policies and procedures that do not provide sufficient guidelines for
practice. In the case of resource shortages and time constraints, workers are essentially
forced to choose which activities to focus on, and to deprioritize activities that are not
considered core responsibilities for their job (Smith & Donovan, 2003). The agency
culture may actually encourage workers to use shortcuts; and with repetition, these
shortcuts become part of the routinized practice of the organization. These routinized
shortcuts may not be in line with the stated rules and goals of the agency; however,
workers’ understanding about their job expectations is formed by their everyday
experiences, and workers will adopt practices that they feel are the most appropriate.
Organizational changes in child welfare agencies usually occur when a glaring
mishap is brought to light, and some sort of public response is required from the
agencies’ administrative boards. In an effort to limit individual worker errors, child
welfare agencies often respond by enacting greater regulatory measures that are
usually designed to limit worker discretion and impose more stringent checks and
balances. Too often, these types of sweeping policy changes lack the organizational
support that is necessary for the measures to take hold. Workers feel overloaded with
new written policies, and often the new policies require the worker to learn additional
skills on top of their caseloads. In-service trainings may be inadequate, and there may
be incentives that discourage sound practice and instead encourage task shortcuts
(Smith & Donovan, 2003).
The combination of conflicting agency goals, a lack of adequate organizational
support, and the difficult nature of the field itself, can lead to considerable job stress for
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
social workers. In his important analysis of the relationship between organizations and
public service workers (or street-level bureaucrats), Lipsky (1980) discusses the
different coping mechanisms workers adopt in an effort to mitigate these stressors.
Child welfare workers may choose to work predominantly with clients they deem most
likely to succeed (a process known as “creaming”). Workers also tend to ration services
and control clients in order to minimize the risk of disruption in the workers’ daily
routines. Because workers are held to conflicting standards, their decision making
becomes necessarily more influenced by the need to cope within a difficult situation
than by the best interest of the client. These patterns of practice are reinforced over
time, and eventually shape organizational policies.
Conclusion
As you can see, a myriad of complex and often conflicting factors can greatly
affect how child welfare workers make day-to-day decisions. Based on ongoing
research, the field of child welfare is now gravitating towards greater standardization of
practice, which means moving away from straight clinical assessments, and
implementing decision-making tools rooted in evidence-based research. In the next
chapter, we will examine one particular set of evidence-based decision-making tools—
SDM®—and look at how this model fits into the large, complex organizational structure
of the Los Angeles County Department of Children and Family Services.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
INSTRUCTOR AIDS
Decision Making and the Child Welfare Worker
Questions for Discussion
1. In your opinion, do you think that child welfare workers tend to make good
decisions?
2. What factors affect the way child welfare workers make decisions? Specifically,
how does each of the following factors affect worker decision making?
•
Characteristics of children
•
Characteristics of families
•
Characteristics of child welfare workers, such as…
− Training
− Knowledge
− Skills
− Attitudes
− Biases
− Values
− Past or present experiences
•
Organizational factors
•
Political factors
•
Funding factors
3. In Social Work Practice: A Critical Thinker’s Guide, Gambrill (1997) outlines
possible barriers that child welfare workers face when making decisions (see
Table 1). Do you agree with these barriers? What are some practical examples of
these barriers?
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Table 1
Possible Barriers to Good Decision Making
(Gambrill, 1997; DePanfilis & Girvin, 2004)
Barriers
Definition
Knowledge is
limited
Accurate knowledge about the circumstances may be limited
leading to faulty assumptions and decisions.
Information
processing
Information is not processed completely or contextually.
Perceptions may be selective and ignore all of the facts.
Memory of complex sets of facts may be faulty.
Task
environment
Decisions are influenced by the work environment.
Pressure to conclude in certain ways may influence the final
decisions.
Perceptual
blocks
The problem is defined too narrowly or the person overlooks
alternative views and sees what is expected, rather than the real
facts.
Expressive
blocks
Inadequate skills in writing, organizing, and communicating the
facts leading to faulty decision-making.
4. What other factors could potentially hamper a worker from making good
decisions?
Assessment Tools and Approaches
Questions for Discussion:
1. What is an assessment tool?
2. What is the difference between an actuarial and a consensus-based decisionmaking system?
3. What are the pros and cons of using an actuarial assessment tool-based
decision-making system for child welfare?
4. What are the pros and cons of a consensus-based decision-making system for
child welfare?
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
5. In general, how important are decision-making tools?
5.1 What are the strengths and limitations of decision-making tools?
5.2 How do decision-making tools compare with other resources, such as
continuing worker education, worker testing, different types of checks
and balances, higher level worker qualifications, and more worker and
office resources?
Decision Making and the Organization
Points to Consider
(Within a child welfare agency, consider the different players that are involved in
serving children and families:
•
•
•
•
•
Child welfare workers
Supervisors
Managers
Agency directors
Research staff
1. What are the different kinds of decisions that each type of agency player has
to make? How do these types of decisions differ? How do they affect one
another?
2. What if there are disagreements between the different agency groups (e.g.,
between workers and directors, workers and clients, supervisors and
research staff, among workers)? How should these disagreements be
resolved?
(Consider the following stages of the child protective services process:
•
•
•
•
•
•
•
Intake
Initial assessment or investigation
Comprehensive family assessment
Planning
Service provision
Evaluation of family progress
Case closure
Divide into small groups, with each group taking one of the stages of the child
protective services process. In your small group, discuss the following questions:
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
1. What decisions need to be made?
2. When should these decisions be made? (Develop an appropriate timeframe.)
3. On what information/factors should these decisions be based? How should
the necessary information be collected? How should the information and
factors be prioritized?
4. Who should be making these decisions (e.g., child welfare workers, agency
administrators, clients, community, law enforcement, health professionals,
educators, etc.)?
5. To what extent should the client be involved in making these decisions? In
what ways should she or he be involved?
6. How will cultural characteristics of the child, family, neighborhood or
community, or child welfare worker affect these decisions? How will these
characteristics affect the decision-making process?
(Thinking on a broader scale, collaborate with the other small groups to develop a
conceptual model that will incorporate all of the stages of Child Protective
Services. Consider the following questions:
1. What are the primary complexities in developing the process?
2. How should laws and policies be used?
3. How should decisions be communicated between departments?
4. How should disagreements be resolved?
5. How should empirical knowledge be used?
6. How should theories and conceptual knowledge be used?
7. How should statistical information be used?
8. How should practice knowledge be used?
9. What happens if there is a difference between conceptual, empirical, and
practice knowledge, and law? How should this be addressed?
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Question for Self-Reflection:
Decision-making issues go beyond just the agency and the child welfare worker.
What can be done to improve decision making at the following levels:
•
•
•
•
•
Families
Legislators
Media
Funders
Other levels (please specify):
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
CHAPTER II
STRUCTURED DECISION MAKING® (SDM®)
AND THE LOS ANGELES COUNTY
DEPARTMENT OF CHILDREN AND FAMILY SERVICES
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
CHAPTER II
STRUCTURED DECISION MAKING® (SDM®)
AND THE LOS ANGELES COUNTY DEPARTMENT OF
CHILDREN AND FAMILY SERVICES
INSTRUCTIONAL GUIDE
Learning Objectives
Building on the previous chapter, Chapter II provides students with background
information on the Structured Decision Making® (SDM®) model, from both conceptual
and applied perspectives. This chapter also explores how the SDM® tools may be used
to enhance worker decision making. Based on their knowledge of different types of
conceptual models and risk assessments, students should be able to analyze and
evaluate the SDM® model and tools, and to compare them with other modes of decision
making. Students should also get a sense of the practicality of using SDM® in an
everyday context, and the extent to which the implementation of a model like SDM®
may affect overall child welfare practice.
Daily Agenda for Presenting the Curriculum Unit
We encourage instructors to present the SDM® model from a conceptual
standpoint, and to discuss with students the difficulties of translating a model such as
this one into everyday practice that lends itself to empirical investigation. Students
should be encouraged to appreciate the utility of such a model while at the same time
developing their ability to think critically about SDM® and the implications of some of the
model’s limitations. Students can also familiarize themselves with the various SDM®
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
tools and definitions, and apply them to the practice case vignettes provided (Handouts
2-6).
STRUCTURED DECISION MAKING® (SDM®) AND THE LOS ANGELES COUNTY
DCFS
The Structured Decision Making® Model
Structured Decision Making® or SDM® is an actuarial-based model for making
structured decisions in the child welfare arena. The SDM® model was developed by the
Children’s Research Center (CRC), a division of a private research organization called
the National Council on Crime and Delinquency (NCCD). Based in Madison, Wisconsin,
the CRC was established in 1993 “to help federal, state, and local child welfare
agencies reduce child abuse and neglect by developing case management systems and
conducting research which improves service delivery to children and families” (CRC,
1999, preface).
The SDM® model is designed to assist social workers in making accurate and
consistent decisions about the levels of risk for maltreatment found in families, to
provide guidance about service provision, and to assist with reunification and
permanency planning. To do so, SDM® utilizes an empirically based tool for assessing
future risk for maltreatment, as well as empirically tested tools for assessing safety and
developing case plans for families. It is further designed to provide agency
administrators with information that can be used in agency planning and program
evaluation.
According to the CRC (2006), SDM® is based on two primary principles:
1. Decisions can be significantly improved when structured appropriately: that is,
specific criteria must be considered for every case by every worker through
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
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highly structured assessment procedures. Failure to define decision making
criteria and identify how workers are to apply these criteria results in
inconsistencies and, sometimes, inappropriate case actions.
2. Priorities given to cases must correspond directly to the assessment process.
Expectations of staff must be clearly defined and practice standards must be
readily measurable. Service standards differentiated by level of risk provide a
level of accountability that is often missing in human service organizations.
SDM® seeks to improve case assessment and decision making at each major decision
point in a child welfare case. SDM® assessments completed by child welfare workers
are intended to be linked directly to service needs and subsequent service provision.
SDM® in Theory
SDM® can be considered a conceptual model.
A conceptual model is a theoretical construct that
includes a set of variables that are defined by a set of
logical
and
quantitative
relationships.
Conceptual
models enable reasoning within an idealized logical
framework about specific processes.
The
SDM®
model
consists
of
five
basic
Conceptual Model
A theoretical construct
that includes a set of
variables that are defined
by a set of logical and
quantitative relationships.
Conceptual models
enable reasoning within
an idealized logical
framework about specific
processes.
components (CRC, 2006).
•
Highly structured assessments of family risk and family needs,
•
Service standards that clearly define different levels of case contacts, based on
risk levels,
•
A workload accounting and budgeting system that translates service standards
into resource requirements and helps deploy resources equitably throughout the
organization,
•
A system of case review and reassessment to expeditiously move cases through
the system, and
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
•
A comprehensive information system to provide data for monitoring, planning,
and evaluation.
The theory behind SDM® is that all of the basic components play an equally important
role in the success of the model (CRC, 1999). The CRC website (CRC, n.d.) states that
while the scope of services may vary by agency, the SDM® case management system
should incorporate all five of the basic components listed above. If these components
are implemented properly, then “SDM® will result in substantial improvements in case
decision making, budgeting, staff deployment, and agency accountability” (CRC, n.d., ¶
2). Given this premise, it is reasonable to expect that if some of the model components
are missing or implemented improperly, then there will be less potential for
improvements in decision making.
SDM® in Practice
The CRC is both a private research center and a contract-based service
provider. For a fee, the Center assists agencies in implementing SDM® by providing the
assessment tools, ongoing training, process evaluations, and technical support.
Although CRC’s literature states that the SDM® model essentially consists of its five
components, CRC allows the SDM® model to be modified to meet the preferences and
needs of each individual agency.
States and agencies that contract with CRC are not required to use all of the
basic SDM® components. Rather, agencies may choose which SDM® components to
use based on their individual needs; and the evidence-based SDM® tools may be
interchanged with pre-existing, non-evidence-based agency tools. According to the
Director of Children’s Research Center, regardless of whether a contracted agency is
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using the full SDM® model, or just a portion of the components, CRC may still consider
the agency to be “fully implementing SDM®” (J. L. Ereth, personal communication,
February 27, 2006).
To date, over 20 child protective service jurisdictions have implemented all or
part of the SDM® case management model (CRC, 2006). For the most part, anecdotal
evidence suggests that jurisdictions that use SDM® generally only implement a part of
the model. In particular, child welfare professionals and researchers have been paying
limited, but growing, attention to the assessment tools and service standards. There has
been less attention given to the other components of the SDM® model, namely, the
workload accounting and budgeting system, and data information system.
In many ways, the CRC’s dynamic approach to the SDM® model is in keeping
with their organizational philosophy. The CRC states that “state and county child welfare
agencies are not all organized to deliver services in the same way and do not always
share similar service mandates” (CRC, n.d., ¶ 4) and that “agencies with different
missions or legislative mandates require different case management approaches”
(CRC, ¶ 4).
This dynamic approach to structured decision making makes it difficult to
measure the empirical validity and overall effectiveness of SDM® as a full conceptual
model. Much of SDM®’s strength lies in its use of a combination of empirically tested,
predictive assessment tools (e.g., safety and risk assessments) with contextual
strategies that utilize clinical expertise (e.g., family strengths and needs assessment;
Shlonsky & Wagner, 2005). However, the beauty of the full conceptual model is that the
data collected with the tools can then directly and continuously inform management
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decisions and departmental policy changes, while taking into account practical
organizational issues such as worker caseloads and staffing needs. Decision-making
improvements are not limited to the caseworker level, but rather, they affect the entire
organization. In order to determine whether the full conceptual approach to structured
decision making is sound and whether the SDM® model is effective, it is important to be
able to test the full model used in the same manner in many different situations, and
to compare similar variables across these situations over time. By allowing jurisdictions
to tailor how they use SDM®, this type of valuable comparison data is essentially lost.
The research project discussed in this curriculum initially sought to evaluate the
implementation and impact of SDM® as a full conceptual model; however, given the
variability in the way SDM® is implemented, we shifted our focus to the specific SDM®
components that were implemented in Los Angeles County. Specifically, we examined
how Los Angeles County incorporated and utilized the following SDM® assessment
tools:
•
The hotline/response priority decision system,
•
The safety assessment tool,
•
The family risk assessment tool,
•
The family and child strengths and needs assessments,
•
The family risk reassessment tools, and
•
The reunification reassessment tool.1
The parameters of the research project are discussed in the following sections.
1
Since this report was submitted, CRC added a screen-in/intake tool and a foster care placement model
to SDM®.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
The Research Project
This project evaluates the implementation and impact of Structured Decision
Making® and the SDM® model in the Los Angeles County Department of Children and
Family Services (DCFS)—one of the largest and most complex child welfare agencies
in the country. The research team paid particular attention to the implementation
process as experienced by child welfare workers and administrators in DCFS, including
the extent to which the SDM® model is implemented, and barriers and successes
related to successful implementation, as well as outcomes related to using the model.
Defining “Full Implementation.” As discussed earlier, it is important to note
that the term “full implementation” of SDM® is defined differently by the Los Angeles
DCFS, the CRC, and the authors of this curriculum. According to the CRC’s current
working definition, full implementation of the SDM® model occurs when an agency
adopts and utilizes any portion of the SDM® components, provided that the framework is
established in conjunction with CRC approval (J. L. Ereth, personal communication,
February 27, 2006). As a contracted service provider, the CRC works with client
jurisdictions to develop an SDM® model that they believe best suits the clients’ specific
needs. Thus, for example, an agency may use a decision-making framework that
includes both SDM® tools and non-evidence-based agency tools, so long as this system
is created in cooperation with CRC.
According to one DCFS Key Informant, the Los Angeles County DCFS defines
full implementation to mean that all Department staff have completed training on the
SDM® tools which have been delineated by the State’s contract with the CRC, and that
the tools have been introduced and integrated into each DCFS office (M. Mason,
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
personal communication, February 7, 2006). The SDM® model consists of those SDM®
tools that are defined by the adopted contract between the State of California and CRC,
and does not require full utilization of all of the tools.
In the following sections, this curriculum defines full implementation as complete
and correct utilization of the full conceptual SDM® model. This includes all three of the
basic components of the original SDM® concept: a set of evidence-based decisionmaking tools to assess families and structure agency response, the use of service
levels with minimum standards for each level, and two management-related
components. Although the full conceptual SDM® model is not required by the State of
California, we feel that an assessment of how the Los Angeles DCFS model of SDM®
compares with and differs from the full CRC model would be necessary in order to draw
conclusions about the SDM® model that is generally used by child welfare agencies
across the country.
Los Angeles County
Los Angeles County is currently the most populous county in the United States.
According to the 2000 U.S. Census, Los Angeles County has a population of over 9.8
million—a population greater than that of 42 states combined. In addition to its size and
density, the population of Los Angeles County is also very diverse. Currently, Los
Angeles County has no ethnic majority (United Way, 2003). Over 50% of the county is
of color, and approximately 46% of the population identifies as Hispanic or Latino.
Thirty-six percent of Los Angeles County residents were born outside of the United
States, and approximately 54% speak a language other than English at home.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
In addition to cultural and ethnic diversity, Los Angeles County residents vary
widely in income level. As of 2002, 18% of all Los Angeles County residents live below
the poverty level—a poverty population that is the largest of any metropolitan area in the
United States. Poverty varies widely for different racial/ethnic groups, with African
American and Latino families having the highest poverty rates. Children and singleparent families are especially affected by poverty. Twenty-five percent of all children in
Los Angeles County, and 47% of female-headed households with children under age 5
are poor. This is an especially salient problem, given that Los Angeles is among the
nation’s most expensive urban areas. Los Angeles County ranks among the nation’s
least affordable housing markets, and an estimated 84,000 persons are homeless each
night (United Way, 2003).
Children comprise a significant portion of the county’s population. According to
the Los Angeles County 2006 Children’s ScoreCard (Los Angeles County Children’s
Planning Council, 2006), an estimated 2.8 million children and youth, or one third of
California’s child population, live in Los Angeles County. Eighty percent of these
children are children of color: 60% Latino, 10% African American, and 10% Asian. As
with the greater population, children in Los Angeles County vary widely in health factors
and economic stability. In 2005, 89% of Latino children, 76% of African American
children, and 64% of Asian children were considered low-income or poor
In regards to child maltreatment, African American children are disproportionately
at risk for foster care. Although foster care caseloads have decreased significantly over
the past few years, as of 2003, Los Angeles County has shown a higher rate of foster
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
care and a lower rate of permanency compared to the state of California as a whole
(Los Angeles County Children’s Planning Council, 2006).
The Los Angeles County Department of Children and Family Services
In 2003, the Los Angeles County DCFS re-worked its mission statement and
organizational goals. The new mission is to improve outcomes for children and families,
and to ensure that children grow up safe, physically and emotionally healthy, educated,
and in permanent homes. Three key goals of the Department are as follows:
•
Improved Permanence: Shorten the timeliness for permanency for children
removed from their families with a particular emphasis on reunification, kinship,
and adoption. Reductions in the emancipation population will also be critical.
•
Improved Safety: Significantly reduce the recurrence rate of abuse or neglect for
children investigated and reduce the rate of abuse in foster care.
•
Reduced Reliance on Detention: Reduce reliance on detention through
expansion of alternative community-based strategies (Los Angeles County
Department of Children and Family Services, n.d., ¶ 1-2).
Los Angeles County is divided into eight County Service Planning Areas (SPAs).
DCFS has adopted the SPA concept to define the geographic areas of service for all of
its regional office locations. Currently, there are a total of 18 regional offices scattered
throughout the SPAs. Foster care rates tend to vary significantly across the eight SPAs.
In many cases, these variations correspond to both the demographic compositions and
poverty rates of each SPA.
Although SDM® is currently being used in all of the SPAs in Los Angeles County,
at the recommendation of DCFS administrators, this research project focuses primarily
on the implementation of SDM® in SPA 6, also known as South. SPA 6 is located south
of the metropolitan and geographic center of Los Angeles County. Within SPA 6 are the
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
cities of Compton, Lynwood, and Paramount, and the Los Angeles County areas of
Crenshaw, Jefferson Park, Watts, and Willowbrook. In terms of geographic area, SPA 6
is relatively small compared to the other SPAs; however, it is a densely populated area
with an estimated population of 1 million.
For many years, this region has been economically and socially distressed. In
2002, over 350,000 youth (ages 0-17) resided in SPA 6 (Los Angeles County Children’s
Planning Council, 2004). Virtually all of the youth population was comprised of children
of color, with 71% identified as Latino and 27% as African American. Approximately
71% of the youth population lived in low-income households, and 34% lived in poverty.
In regards to child maltreatment, SPA 6 fared the worst of all the SPAs. In 2004, SPA 6
had 26,385 child abuse and neglect referrals to DCFS, of which 3,827 referrals were
substantiated (Los Angeles County Children’s Planning Council). Currently, there are
four DCFS regional offices serving SPA 6: Century, Compton, Hawthorne, and
Wateridge.
The History of SDM® and Los Angeles County
In 1998, through the collaboration of the Children’s Research Center (CRC) and the
State of California, the California Child Welfare Structured Decision Making® (SDM®)
system was piloted in seven California counties (CRC, 2005c). As part of California’s
statewide contract with CRC, Los Angeles County began working with CRC in 1999 to
develop an SDM® system appropriate for the area; and in November 1999, the SDM®
Response Priority tool was launched countywide (CRC). During this piloting period, the
Los Angeles County Santa Fe Springs office also began to integrate the safety
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
assessment, risk assessment, and reassessment tools in addition to the response
priority tool.
The U.S. Department of Health and Human Services (DHHS) conducted its Child
and Family Services Review (CFSR) of the California Department of Social Services
(CDSS) in September 2002. The CFSR examined three primary outcomes for children
and families: safety, permanency, and well-being. In order to measure these outcomes,
the CFSR focused on seven systemic factors:
1. A statewide information system,
2. A case review system,
3. A quality assurance system,
4. Staff training,
5. Service array,
6. Agency responsiveness to the community, and
7. Foster and adoptive parent recruitment, licensing, and retention (DHHS, 2003).
As part of the review, DHHS completed onsite case reviews of three California counties,
including Los Angeles. The CFSR concluded that, based on the information from the
case reviews and the State Data Profile, the State of California did not achieve
substantial conformity with any of the primary outcomes (DHHS).
As a response to the CFSR, the Los Angeles County DCFS Interim Director
committed to full utilization of the SDM® model (J. L. Ereth, personal communication,
March 14, 2005). Throughout the process of integrating SDM®, Los Angeles County
collaborated closely with a specially-designated CRC consultant in order to develop a
feasible working SDM® framework for Los Angeles County. During the initial evaluation
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
in 1999, the County conducted an SDM® workload study to determine staffing
projections for both front- and back-end tools. The front-end tools included the response
priority, safety, risk, and family strengths and needs assessments, while the back-end
tools included the range of reassessment tools. The study concluded that while there
was adequate staff to implement the front-end tools and some of the back-end tools,
there was not enough staff to implement certain management-related components and
contact guidelines due to high caseload levels.
As a result of the workload study, Los Angeles County and CRC decided to
initially focus on fully implementing a portion of the conceptualized CRC SDM® model—
namely, the SDM® assessment and reassessment tools. In February 2003, Los Angeles
County initiated an ambitious countywide SDM® roll-out plan, and began documenting
their findings in an online SDM® database, which was developed by CRC. The SDM®
assessment tools effectively replaced previous DCFS policy guidelines2. The SDM® rollout plan required a goal of countywide implementation by July 2004. According to the
CRC, Los Angeles County managed to implement the requisite SDM® tools within 1½
years—a very rapid timeframe, considering that historically, it has taken other
jurisdictions around 6 months to attain only partial use of SDM® tools (J. L. Ereth,
personal communication, March 14, 2005).
The Los Angeles County version of the SDM® assessment tools has undergone
various modifications since the initial application, which have included a revised version
of the risk assessment tool, and the inclusion of new case review standards for all
2
The policy guidelines which were replaced included: DCFS 180 Assessment Guide/Matrix, the DCFS
181 Assessment Guide for Infants Prenatally Exposed to Drugs, and the DCFS 182 Assessment Guide
for Release to Relative for Infants Prenatally Exposed to Drugs (DCFS internal memo, January 2003).
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
DCFS managers and supervisors. As of 2006, Los Angeles County is in its third year of
using a partial model of SDM®, which is comprised of the following components:
•
Hotline/Response Priority tool,
•
Safety Assessment tool,
•
Family Risk Assessment tool,
•
Family Strengths and Needs Assessment tool,
•
Family Risk Reassessment tool, and
•
Reunification Reassessment tool.
In addition to these six assessment tools, the Department has also incorporated case
review standards in order to monitor the quality of tool completion. Case reviews are
completed by assistant regional administrators (ARAs) and supervisors (SCSWs), and
are reported on a monthly basis to the appropriate Deputy Director.
The Department also tracks the utilization of the SDM® tools throughout the
county using an online SDM® data management system designed by CRC. Because all
of the tools are fully automated, the Department is able to track when caseworkers
complete each tool, when supervisors sign off on each tool, and whether the tool is
completed in a timely fashion. This information is compiled into monthly utilization
reports, which are made available to all caseworkers and management via the
Department intranet. Case management components such as a continuous workload
accounting system and a management information mechanism that directly links SDM®
data to management and policy changes are not being implemented.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Throughout the course of SDM® implementation, the Los Angeles County DCFS
has focused on providing extensive SDM® training for its staff. In addition to training all
caseworkers and management-level staff on the usage of SDM® tools, each DCFS
office has also designated two specially trained “SDM® experts” to serve as resources
for their respective locations. These experts meet more regularly regarding SDM® policy
changes and updates, and act as a liaison between staff and management regarding
SDM®-related issues.
At the time of the study, Los Angeles County DCFS was in the process of rolling
out an upgraded version of SDM®, known as SDM® 2.0. In addition to revising some of
the existing tools, version 2.0 also includes a new referral screening tool. The
Department planned to roll out the entire SDM® 2.0 application by Spring of 2006.
INSTRUCTOR AIDS
The SDM® Model
Questions for Discussion:
1. What is a conceptual model? What is a theory? How are theories different from
models? What is the difference between a model and a set of tools?
2. Should a conceptual model be rigidly defined and adhered to? Why or why not?
3. Consider CRC’s practice in which the SDM® model may be tailored to fit the
needs of individual jurisdictions. What are the strengths of this type of approach?
What are the limitations?
4. What kind of model is the Structured Decision Making® model? (choose all that
apply and explain):
•
•
•
•
Actuarial
Consensus
Conceptual
Other (please specify):
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
5. From a conceptual standpoint, how sound is SDM®?
The SDM® Tools
Questions for Discussion:
1. What tools are used with the SDM® model?
2. Among the SDM® assessment tools, which tools are actuarial-based and which
are consensus-based?
3. Are all of these tools required by CRC in order for the SDM® to be considered to
be “fully” implemented?
4. What are the implications of one or more tools not being implemented?
5. What are the implications of not using the tools completely or consistently?
6. If the tools are not used completely or consistently by different workers, is SDM®
being implemented? Why or why not?
According to the Children’s Research Center (2005a), a good decision system contains
the following properties: validity, reliability, equity, and utility (see Table 2).
Table 2
Properties for a Good Decision System
Property
Property characteristic
Validity
Does the system measure what it says it will measure?
Reliability
Do similar cases receive similar recommendations for placement and
services?
Equity
Is the system fair to various ethnic and socio-economic groups?
Utility
Does the system actually guide decisions at the individual case level
and at the agency level?
Is it easy to use and understand?
1. Does each of the SDM® assessment tools contain these four properties?
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
2. Is it possible that the tools can be used unfairly? Inconsistently?
3. Can the tools be used differently with children and families of different ethnicities
and cultures? Is this a good thing?
4. What are the implications of using the tools differently with children and families
of different cultures?
5. What are the implications of using the tools in the same way with children and
families of different cultures?
Los Angeles County
Questions for Discussion:
1. What are some of the major challenges for a large urban metropolis like Los
Angeles County in regards to child welfare?
2. From a State perspective, what are some of the reasons for implementing a
system like SDM®? What are the benefits of using this system? What are some
potential problems?
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
CHAPTER III
THE CHILD WELFARE SERVICE DELIVERY PROJECT:
METHODOLOGY AND RESULTS
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
CHAPTER III
THE CHILD WELFARE SERVICE DELIVERY PROJECT:
METHODOLOGY AND RESULTS
INSTRUCTIONAL GUIDE
Learning Objectives
This chapter aims to present students with our major research questions and the
background of the project, including the research methodologies used to conduct our
®
study on SDM . Specifically, the chapter aims to provide students with detailed
information about the design, sampling procedures, instrumentation, and data analysis
for each of the three substudies conducted in order to address the major research
questions. Findings from the substudies are reported so that students can examine the
findings and draw their own conclusions about their meaning. Students are encouraged
to critically examine the strengths and weaknesses of the methodologies employed by
the study, the limitations of the study, and the implications of these limitations. Finally,
students are encouraged to consider the strengths and weaknesses of three different
types of complementary research methodologies and data: qualitative, quantitative, and
analysis of secondary administrative data.
Daily Agenda for Presenting the Curriculum Unit
This chapter is designed so that instructors can present students with essential
components of the research methodologies used to carry out the study. Instructors are
encouraged to first provide students with the major research questions addressed by
the study, followed by an overview of the project and the study. Instructors may want to
relate the data collection approach to the research questions, since the goal of research
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
is to add to existing knowledge bases by addressing gaps and limitations in current
empirical knowledge. Next, instructors are encouraged to discuss the different
components of the methodologies that were employed, helping students to think
critically about the methods, their strengths, their limitations, and the implications of the
limitations. To help students comprehend this information, instructors may choose to
focus on one substudy at a time before discussing how the substudies compliment one
another. Finally, instructors may discuss each of the substudies as an example of three
distinct approaches to research and data, including qualitative and quantitative
methodologies, and analysis of secondary administrative data.
METHODOLOGY AND RESULTS
Introduction
The purpose of this project was to evaluate the Structured Decision Making®
(SDM®) model on child welfare service delivery and outcomes in the Los Angeles
County Department of Children and Family Services (DCFS). We investigated the
following three broad research questions:
1. What are the challenges in implementing the full SDM® model in the Los Angeles
County DCFS?
2. What impact does implementation of the full SDM® model have on child welfare
service delivery?
3. What impact does implementation of the full SDM® model have on child
permanency outcomes?
Project Background
The first year of this project was devoted to:
• Gathering information about decision making and the SDM® model,
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
• Learning about DCFS’ plan for implementation,
• Preparing the components of our research design,
• Receiving approval from the University’s Institutional Review Board (IRB), and
• Developing key relationships with DCFS, the Children’s Research Center (CRC),
and other interest groups.
During our “information gathering” phase, we developed a library that included
current and past literature on decision making within child welfare. This library informed
both the research design for the study as well as the curriculum developed as a result of
the project. In addition, we amassed the SDM® materials generated by both CRC and
DCFS, including policy and procedures manuals, training materials, program evaluations,
and demographic reports. During this time, we also focused on intensifying our
relationship with both CRC and DCFS. We met with DCFS administrators regularly to
discuss the Department’s needs and expectations of the project and to receive relevant
resources, as well as to learn more about the inner workings of the Department itself. In
October of 2004, we attended the 6th National Structured Decision Making® Conference,
hosted by CRC and DCFS. As hoped, not only did these meetings help build a working
relationship with the two organizations, but they also served to increase our
understanding of the organizational structure and culture of DCFS, and the particular
challenges in implementing the SDM® model in Los Angeles County.
A number of significant changes occurred in both the DCFS organizational
structure and the SDM® implementation plan over the course of the project. Over time,
the project design was modified accordingly to incorporate these changes. The initial
SDM® training and implementation roll-out period extended from 2002-2004,
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
overlapping with the inception of the project in 2003. During the roll-out period, various
SDM® tools were modified. A new version of the SDM® hotline tool was introduced in
August of 2005.
Various administrative changes also occurred within DCFS; and as a result,
many of our primary contact people changed, necessitating new relationships be built
during the course of the project, and adjustments be made in order to respond to
DCFS's changing expectations. Based on the initial recommendations and requests of
our DCFS contacts, for the purpose of this study, we focused mostly on SPA 6, and the
rate of SDM® implementation in the four offices that service this SPA.
Methodology
Overview of the Project
This project consisted of three component substudies: (a) a key informant
substudy, which involved in-person interviews; (b) a DCFS worker substudy, which was
comprised of a secure, web-based worker questionnaire; and (c) an administrative data
substudy, which examined administrative data collected from DCFS’ SDM® and
CWS/CMS databases. The project pays special attention to issues related to
implementing the SDM® model with a racially and culturally diverse, urban child welfare
population within a complex child welfare agency (i.e., the Los Angeles County
Department of Children and Family Services). Given the demands on child welfare
agency staff, the project is further interested in exploring the feasibility and necessity of
implementing the various assessment tools and model components.
Defining “Full Implementation.” As discussed in Chapter II, it is important to
note that the term “full implementation” of SDM® is defined differently by the Los
46
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Angeles DCFS, the CRC, and the authors of this curriculum. According to the CRC’s
current working definition, full implementation occurs when an agency adopts and
utilizes any portion of the SDM® components, provided that the framework is
established in conjunction with CRC approval (J. L. Ereth, personal communication,
February 27, 2006). As a contracted service provider, the CRC works with client
jurisdictions to develop an SDM® model that they believe best suits the client’s specific
needs. Thus, for example, an agency may use a decision-making framework that
includes both SDM® tools and non-evidence-based agency tools, so long as this system
is created in cooperation with CRC.
The Los Angeles County DCFS defines full implementation to mean that all of
Department staff have completed training on the SDM® tools which have been
delineated by the State’s contract with the CRC, and that the tools have been
introduced and integrated into each DCFS office (M. Mason, personal communication,
February 7, 2006). The SDM® model is defined by those SDM® tools that are required
by the adopted contract between the State of California and CRC, and does not include
full utilization of all of the tools.
This curriculum defines full implementation of SDM® as complete and correct
utilization of the full conceptual SDM® model. This includes all three of the following
basic components of the original SDM® concept:
•
A set of evidence-based decision-making tools to assess families and structure
agency response,
•
The use of service levels with minimum standards for each level, and
•
Two management-related components.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Although the full conceptual SDM® model is not required by the State of California, we
feel that an assessment of how the Los Angeles DCFS model of SDM® compares with
and differs from the full CRC model would be necessary in order to draw conclusions
about the SDM® model that is generally used by child welfare agencies across the
country.
Key Informant Substudy
Design. A pre-experimental design employing qualitative research methods
was used to collect individual data from key
DCFS agency staff. This substudy generally
addressed issues related to implementation of
the
full
conceptual
specifically,
the
SDM®
substudy
model.
More
provided
an
opportunity to learn about the complex issues
and factors involved in worker decision making
Pre-experimental Design:
A design that lacks the features
that give experiments and quasiexperiments their internal validity.
A pre-experimental design may
be implemented on a pilot study
basis, purely for the purpose of
generating tentative exploratory
or descriptive information.
(Rubin & Babbie, 2008)
primarily from a managerial perspective.
Participants. Participants in the key informant substudy were purposively
selected, upper-level DCFS managers and administrators who were involved in the
planning and/or implementation of SDM® within SPA 6 and, in some cases, departmentwide. A total of six interviews were conducted. For the two initial interviews, we
contacted the DCFS Child Service Administrator overseeing SDM® and the SDM®
Project Manager. In addition to responding to the interview questions, the Child Service
Administrator also provided us with a list of the department’s “SDM® experts”—
designated caseworkers in each office who are specially trained to be a SDM®
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
resource. From this list, we contacted one SDM® expert from each of the four SPA 6
offices. Three of these interviews were with Assistant Regional Administrators (ARAs),
and one was with a Supervisor Child Social Worker (SCSW).
Participants were diverse with regard to gender, age, and ethnicity. Female/male
representation was evenly divided among participants; their ages ranged from 30s
through 50s; and their ethnicities represented African American, Caucasian, and
Hispanic groups. Each participant demonstrated considerable longevity with the
Department, with employment tenure ranging from 9-25 years.
Instrument. A semi-structured in-depth
interview guide was developed and tested by
the evaluation team. This guide was piloted by
the first interview, which was held with the Child
Service Administrator (CSA). The CSA provided
feedback regarding the content and clarity of the
questions in the interview guide. The guide was
then modified and finalized for the subsequent
interviews. The final interview guide (Handout 7)
Semi-Structured Interviews:
Open interviews which allow for
focused, two-way
communication. Specific,
detailed questions are not
formed ahead of time. Rather,
relevant topics are identified
before the interview, as well as
possible relationships between
these topics and issues. These
types of interviews allow the
interviewer the flexibility to
probe for details or further
discuss particular issues that
arise.
consisted of 17 questions that examined the complex issues and factors involved in
social workers’ decision making at the various levels of the child welfare system and
issues related to implementation of the SDM® model. The questions fell under the
broader categories of worker demographics and background, implementation of SDM®,
and strengths and barriers.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Procedures. The interviews were conducted on a one-on-one basis with the
participants. The interviewer and the participant scheduled the interview, which was
conducted at the participant’s assigned DCFS office. For the initial interview, two
researchers attended; however, for the remainder of the interviews, only one researcher
conducted the interview.
Written informed consent was obtained from all participants prior to the start of
the interviews. The interview length ranged from 30-60 minutes, depending on the
participant’s responses. The interviewer took handwritten notes during the interview,
and later these notes were synthesized for analysis. After the interview, each participant
received a thank-you letter and a $30 Starbucks gift card as a token of appreciation for
their participation.
Data Analysis. After transcription and cleaning, interview data were content
analyzed using Atlas-ti qualitative analysis software. The researchers developed an
initial “start list” of codes, as recommended by Miles and Huberman (1994). The 19
codes were based on interview content and a priori ideas stemming from both the
conceptual underpinnings of the study and the nature of the interview questions
themselves. Due to the nature and scope of the study, primarily low inference coding
was used for analysis of study data. As the name implies, low inference coding involves
a relatively literal understanding of the data, providing more descriptive understanding
than subjective interpretation (Anastas, 2004). This form of coding exhibits greater
reliability than higher inference forms.
DCFS Social Worker Substudy
Design. A pre-experimental design was used for the social worker substudy
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
component of the project. This substudy surveyed both DCFS caseworkers and
managers through a web-based questionnaire that consisted mostly of closed-ended
items, with several open-ended items also included. The questionnaire was completed by
caseworkers and managers throughout Los Angeles County; however, for the purpose of
this curriculum, as requested by DCFS, we focused on participants from SPA 6.
Participants. Purposively selected participants in the social worker substudy were
76 Los Angeles County DCFS employees from SPA 6 who currently use or have used
SDM® in the past as a part of their regular job responsibilities. These employees were
classified as child social workers (CSWs) or supervisors (SCSWs). Participation in the
substudy, however, was open to any Los Angeles County DCFS employee with selfreported experience using SDM®.
Instrument. The questionnaire for the social worker substudy (Handout 8) was
developed by the research team and consisted of 18 closed- and open-ended questions
that were designed to examine the social workers’ experiences with the DCFS-led
training and implementation of SDM®, their feelings regarding the usability and perceived
effectiveness of the SDM® tools, and any changes in their decision-making techniques
overall. The time anticipated for the completion of the questionnaire was brief—
approximately 5 minutes—in order to minimize burden on workers.
The initial list of questions for the substudy was developed from empirical,
theoretical, and practice literatures relevant to SDM® and decision making in child
welfare. The questions were also informed by meetings with the Children’s Service
Administrator and the DCFS Chief Research Analyst, who gave feedback regarding the
content and clarity of the questionnaire. One section of the questionnaire focused on the
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
social worker’s perception of the tools’ effectiveness in attaining particular process and
system goals, as defined by the California Department of Social Services and the
Children’s Research Center (CRC, 2005a).
The process goals of the California Structured Decision Making® Model are to:
•
Improve assessments of family situations in order to better ascertain the protection
needs of children,
•
Increase consistency in case assessment and case management among child
abuse/neglect staff within a county and among counties,
•
Increase the efficiency of child protection operations by making the best use of
available resources, and
•
Provide management with data that is needed for program administration,
planning, evaluation, and budgeting.
The system goals are to:
•
Reduce the rate and severity of subsequent abuse/neglect complaints and
substantiations,
•
Reduce the rate of foster care placement, and
•
Reduce the length of stay for children in foster care.
Once the document version of the questionnaire was finalized, the questionnaire
was then placed in an online format, using a university-recommended online service
provider called Survey Monkey. The online questionnaire was piloted by four DCFS
caseworkers, who were recommended by the Children’s Service Administrator. The
administrator initially contacted six workers, but only four responded—one Hotline
SCSW, one Emergency Response (ER) SCSW, one Emergency Response (ER) CSW,
and one Family Maintenance/Reunification (FM/R) SCSW. Each pilot volunteer received
an emailed cover letter explaining the study, a link to the questionnaire, and a feedback
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
form to be completed and returned to the research team. Once the feedback form was
returned, the volunteers received a thank-you letter and a $20 Target gift card as a token
of appreciation for their assistance with the study. After the pilot feedback was
incorporated into the questionnaire, the finalized version of the questionnaire was
presented to the DCFS Deputy Directors for final approval.
Procedures. The questionnaire participants were recruited through a cover letter
(Handout 9) that was emailed to all of the DCFS workers by DCFS. The cover letter
informed potential subjects that their participation in the project was completely voluntary,
that their responses would be kept strictly confidential, and that they could decline to
answer any questions they chose. Although the letter was generated by the research
team (with feedback from DCFS staff who served as liaisons for the project), the team
was given approval to address the letter from the DCFS
Selection Bias:
Director, in order to improve the likelihood of worker
the study information sheet; see again Handout 8), the
A threat to internal validity
referring to the assignment
of research participants to
groups in a way that does
not maximize their
comparability regarding
the dependent variable.
questionnaire, and the requisite password. An email was
(Rubin & Babbie, 2008)
response and minimize selection bias. The letter
included the link to the informed consent materials (i.e.,
sent to all of the DCFS employees on the email list (10,488 email addresses).
The DCFS email address list that was provided by the DCFS Information Systems
Supervisor included all of the public child welfare employees throughout the State of
California. Although this was the most current list available to date, a percentage of the
addresses were incorrect or defunct. All of the email messages that were defaulted or
returned were tracked by a research assistant, and subsequently marked “declined” in
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
the master list. Likewise, workers who emailed to say that they did not qualify for the
study were also marked declined.
The participant response rate was tracked via email address and IP address by
the questionnaire service provider’s email-linked tracking mechanism. Workers who
clicked on the emailed link to participate were denoted in the database. Workers who
declined to participate in the questionnaire could do so by clicking on the opt-out link at
the bottom of the emailed message, and these individuals were also denoted in the
database. This information was reviewed only by the research team and only for tracking
purposes.
Participants who clicked on the questionnaire entry link were initially led into a
password-protected gateway. Once the correct password was entered, participants were
presented with the information sheet for non-medical research. The information sheet
described the study in full, detailed the confidentiality attributes and possible risks of the
study, and explained that filling out the questionnaire constituted consent to participate in
the study. After reading the information sheet, participants could proceed directly to the
questionnaire. Once the participant completed the questionnaire, she or he clicked on a
button indicating that the questionnaire was complete, and the information was
automatically stored in a secure, password-protected online database.
Participants with questions, concerns, or who were interested in learning the
results of the study were directed to email or call a designated member of the research
team. All questions were answered, and those requesting questionnaire results were
tracked in a separate database, to be contacted again in the future.
Two follow-up emails, also addressed from the DCFS Director, were sent
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
approximately 2 weeks after the initial email was sent. The first email message was sent
to all DCFS workers who currently work in Los Angeles County DCFS offices (5,963
addresses). This message served as a reminder for eligible workers to complete the
questionnaire, and included the password and link to the questionnaire. The second
email message was sent to all non-Los Angeles County public child welfare workers
(4,525 addresses). This email message clarified that all non-Los Angeles County workers
were not required to complete the questionnaire, and that any questions could be
directed to the research staff. The message did not contain a link to the questionnaire.
The Los Angeles and non-Los Angeles email lists were constructed from the master list
which had been cleaned after the initial mailing.
In order to track the flood of email messages resulting from the mass mailing, the
DCFS Information Systems Supervisor created a dummy mailbox in the DCFS server for
the study. All email messages addressed to this dummy mailbox were automatically
forwarded to an email address created specifically for the study, which was directly
accessible by the research personnel.
The questionnaire response data was stored in a secure, password-protected
online database hosted by the online service provider (Survey Monkey). One week after
the questionnaire was launched, the response data was downloaded onto a secure,
password-protected database, housed in the research office. The data were
subsequently downloaded at the end of each week, until the questionnaire response
period was closed.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Protecting Human Subjects:
Protecting the rights and welfare of human participants is extremely important when
conducting any sort of research study. For this study, the protocol for working with
human participants was determined by the University of Southern California's
Institutional Review Board (UPIRB).
"Guided by the principles of The Belmont Report: Ethical Principles and Guidelines
for the Protection of Human Subjects of Research, the UPIRB reviews all human
research protocols in accordance with federal regulations, State laws, and local and
University policies. The UPIRB is comprised of members from various disciplines in
the social/behavioral sciences, medical, and community/lay members to assure a
comprehensive review process. Through a collaborative partnership, the UPIRB
assists investigators in the protection of human subjects."
For more information about the UPIRB, and protecting human subjects, see:
http://www.usc.edu/admin/provost/oprs/
Data Analysis. The data, initially downloaded in an Excel spreadsheet format,
were cleaned and transferred into an SPSS database, where they were cleaned further.
Descriptive
and
inferential
analyses
were
conducted in order to gain an initial understanding
and impression of the quantitative study data.
Study data were analyzed using SPSS statistical
Quantitative Research
Methods:
Research methods that
emphasize precise, objective,
and generalizable findings.
(Rubin & Babbie, 2008)
software.
Administrative Data Substudy
Initially, there were two components to the administrative data substudy. The first
component was designed to examine the extent to which the SDM® model was
incorporated and utilized by the agency, using the monthly SDM® utilization data
generated from the DCFS SDM® database. These data were used to assess the
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
implementation of four of the six SDM® tools by the agency workers and administration
within each office in SPA 6. These tools included the Safety Assessment Tool, the Risk
Assessment Tool, the Family Strengths and Needs Assessment Tool, and the Case
Reassessment Tool. The utilization reports for the months of January to October of
2005 were provided by DCFS in November 2005.
In addition to providing a sense of the extent to which the SDM® tools were being
used within the SPA, we planned to use the utilization data to establish the point at
which the SDM® tools were “fully” integrated into the SPA offices. This would have
allowed us to assess the impact of the SDM® model on various permanency outcomes
(by pre/post comparisons). These assessments would have comprised the second
component of the administrative data substudy. However, as described in the results
section for the substudy, the utilization data revealed that although utilization of the
SDM® tools has increased dramatically since its initial implementation, there still exists
wide variation among the offices in SPA 6, and variation within offices in terms of the
tools that are completed. Thus, the pre/post analysis that we hoped to conduct was not
possible since there was essentially no clear “implementation” date (i.e., start-up date)
to demarcate pre-SDM® implementation from post-SDM® implementation, and because
there was no single SDM® model being implemented consistently across all four SPA 6
offices.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Subjects. Data for the administrative data substudy were initially comprised of
referrals made to SPA 6 as indicated in CWS/CMS—the case management and
tracking administrative database used by California child welfare agencies. The cohort
of subjects consisted of the population of unique child clients referred to DCFS for
maltreatment between January 2000 and
December 2005. Child clients were included
in
the
cohort
regardless
of
referral
disposition—substantiated, unfounded, or
inconclusive. Service component referrals
could be for Emergency Response, Family
Maintenance,
Family
Reunification,
or
Permanency Placement.
Substantiated:
A report which is determined by the
investigator, based upon some
credible evidence, to constitute child
abuse or neglect.
Unfounded:
A report which is determined by the
child protective services investigator
who conducted the investigation, to
be false, to be inherently improbable,
to involve an accidental injury, or not
to constitute either child abuse or
neglect.
These subjects were included since
the initial plan was to examine SDM
®
utilization, and outcomes pre- and postSDM® utilization, between January 2000
and December 2005. For purposes of this
Inconclusive:
A report which is determined by the
investigator who conducted the
investigation not to be unfounded, but
in which the findings are inconclusive
and there is insufficient evidence to
determine whether child abuse or
neglect occurred. Replaces the
previous term of “unsubstantiated.”
curriculum, however, only data for referrals
made to DCFS following the introduction of SDM® were examined. Data were examined
for a 10-month period between January-October 2005. Analysis of pre/post outcomes
will be possible in the future once it is determined that the SDM® tools and model are
more fully and consistently used across SPA 6.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Instrument. The evaluation team worked with DCFS research staff to obtain the
SDM® utilization data for SPA 6 offices. The utilization data were provided in the form of
monthly utilization status reports generated from DCFS’s SDM® database. These
reports specified to what extent each LA County DCFS office had completed the four
primary SDM® tools (safety assessment, risk assessment, initial family strengths and
need assessment, and case reassessment) in a timely manner during the previous
month. The reports also delineate the number of cases due, pending, and approved for
each DCFS office. This information, spanning from January 2005 to October 2005, was
collected for all four of the SPA 6 offices: Century, Compton, Hawthorne, and
Wateridge.
Procedures. For the administrative data substudy, we conducted a preliminary
analysis on the utilization of SDM®. This analysis was based on the monthly utilization
reports provided by DCFS.
Data Analysis. The data, initially downloaded in an Excel spreadsheet format,
was cleaned and transferred into an SPSS database for analysis and in order to
generate utilization figures. Because the DCFS-generated reports separate utilization
scores by individual SDM® tool, there was no overall score that indicated the extent to
which SDM® as a whole was being utilized in each office. Our analysis tabulated the
utilization of the four SDM® tools (safety assessment, risk assessment, family strengths
and needs assessment, and case reassessment), from which we derived an average
SDM® utilization value at the SPA level and at the office level.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Results
Results of the three substudies (key informant, social worker, and administrative
data) are presented next.
Key Informant Substudy Results
The interviews for the key informant substudy were structured around two major
topics: the implementation of the Structured Decision Making® model and the model’s
strengths and barriers. The purpose of the implementation-related questions was to
obtain a sense of the types of decision-making-related problems that existed prior to
SDM® implementation, the ways in which SDM® has been incorporated into decision
making practices, changes in performance witnessed since SDM® implementation, how
often and in what situations workers chose to override SDM® recommendations, and
workers’ thoughts and feelings regarding the use of SDM®. The strengths and barriersrelated questions were designed to elicit information about the perceived strengths and
liabilities of SDM® and its use, including unintended consequences, most effective
aspects of SDM®, barriers to effective use, and suggestions for overcoming those
barriers.
Several major themes emerged from the substudy, including SDM® and DCFS
decision making, and perceptions of SDM®’s strengths and barriers. Numerous
subthemes existed within each of these themes. A discussion of the major themes and
subthemes follows.
SDM® and DCFS Decision Making
Decision Making Problems Prior to SDM® Implementation. Nearly all
participants indicated that there was a lack of consistency in decision making prior to
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
SDM® implementation. Reportedly, this was due in large part to the subjective nature of
workers’ decision making, as the previous form used to assess risk (DCFS 180) was not
designed to inform decision making. One participant also suggested that previous
decision making directives from top administration were based on political concerns
(versus empirical findings), resulting in frequent shifts in directives.
SDM® Incorporation Into Decision-Making Practices. In general, the
participants felt that SDM® has been incorporated quite well into workers’ decisionmaking practices, and that they had witnessed an overall increase in the use of the
tools, as well as changes in decision making and in workers’ comfort level. One
respondent noted that workers are now making more “realistic” decisions. Several
participants reported that SDM® use was incorporated more quickly among the frontend workers (i.e., Hotline and Emergency Response), though the tools are required to
be used throughout the life of every case. One respondent pointed out that the
Department is now focusing on getting the back-end workers up to speed, and a case
review process that should address the issue of slow back-end incorporation is currently
underway.
Changes in Performance Observed Since SDM® Implementation. The
participants unanimously reported very positive changes in performance since the
implementation of SDM®. Additionally, several noted that they have not noticed any
negative changes in performance, though one respondent indicated that some line
workers complain that completing SDM® tools is more work for them, taking time away
from their direct work with families. Participants duly noted that the multiple positive
changes they have witnessed are due only in part to SDM® implementation, as other
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
recent DCFS initiatives (Point of Engagement, concurrent planning, and team decision
making) likely also have had a significant effect.
Among the specific improvements cited, participants mentioned improved
decision making. This is evident, they believe, in DCFS statistics that show lower rates
of substantiations, detentions, number of days in placement, and re-referrals.
Additionally, the interviewees expressed the belief that since the advent of SDM®, there
have been no increases in child deaths. One respondent also stated that there have
been positive changes in the rate of case openings, length of time to reunification, and
permanency rates.
A few participants reported having observed changes in service quality, as well.
For example, workers feel that they have been staying in touch with parents after
permanency, seemingly because SDM® tracks visitation patterns. Also, some of the
interviewees feel that SDM® has expanded the types of services that caseworkers offer
to clients. Because cases are remaining closed more frequently, more communitybased and voluntary services are being provided.
Despite the universal perception among participants in the key informant
substudy that SDM® has brought about positive changes in the Department, it is
noteworthy that administrators and managers have been asked by upper administration
not to draw any premature conclusions. As reported by one participant, the Director of
DCFS has cautioned that SDM® use has not been in place long enough to really be able
to ascertain what kinds of consequences may occur in the future. In particular, because
the back-end SDM® reassessment tools had not been fully incorporated into all of the
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delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
DCFS offices at the time of this study, the DCFS administration was hesitant to
speculate on the potential outcomes of using these tools.
Workers Overriding SDM® Decisions. There may be situations in which a
caseworker may disagree with an SDM® decision. For example, after completing a risk
assessment on a particular case, a caseworker may feel that the resulting risk level
does not accurately reflect the true situation of the family in question. In cases like
these, the worker may seek to override the SDM® decision. This study sought to explore
to what extent these types of overrides occurred, and whether the overrides were
applied appropriately.
The interview participants noted that the appropriate use of an override is case
specific and tool specific, and needs to be used in consultation with a supervisory social
worker. In general, the participants expressed the beliefs that overrides are used
infrequently within the Department, and that the situations in which they are employed
are appropriate. One participant posited that the override function provides an important
“safety valve” for workers, allowing them to exercise good social work practice.
Regarding inappropriate use of overrides, however, another individual noted that
overrides were used incorrectly in the past, when workers thought that risk levels could
be manually increased or decreased. When it was clarified that an override can only be
used to increase a risk level, the problem was resolved.
Workers’ Thoughts and Feelings Regarding the Use of the SDM® Safety
Assessment. Nearly all the interview participants expressed the opinion that the SDM®
safety assessment is effective in accomplishing what it is meant to accomplish. Two
participants pointed out that the safety assessment provides objective guidelines upon
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
which the workers can conduct their assessments and base their decisions. One
participant indicated that while the tool is accomplishing what it was meant to in the
office, the participant was not sure how well it is working throughout the Department as
a whole, noting that sometimes other managers appear to be more focused on meeting
the required reporting percentages than on the quality of the assessment.
Considering their line staff’s views of the safety assessment tool, a few
interviewees indicated that the caseworkers generally feel positively about the tool.
Participants generally concluded that the tool is good for the workers, because “they
don’t feel like they’re making decisions alone.” Further, the participants felt that the use
of the tool helps workers to identify issues that they might otherwise have missed.
Though not universally recognized among these key informants, some problems
regarding use of the safety assessment were reported. One participant noted that the
presence of prior referrals pushes a family’s risk level up too high (because it does not
account for multiple referrals by the same “disgruntled individual”). Another cautioned
that the strength of the assessment is dependent upon the accuracy of the information
provided. This participant went on to report that while (presumably) infrequent in
practice, the safety assessment can be manipulated to say what the worker wants it to
say. For example, social workers with a personal bias toward detaining children can
complete the tool in a manner that reflects their judgment.
Views Regarding Case Opening Versus Closing Based on Risk. Citing
empirical support for the closure of low and moderate risk cases and the increase in
linkages to community-based services, the key informants all expressed a high degree
of comfort with the current policy of closing low and moderate risk cases, while opening
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
the high and very high risk counterpart cases. One participant mentioned that
previously, some of the line workers were concerned about not opening moderate risk
cases. With recent revisions to the way the SDM® tools tally individual risk factors, many
of these moderate risk cases are now being assessed as high risk, essentially resolving
the conflict.
Perceptions of SDM®’s Strengths
Unintended Consequences in the Use of SDM®. When asked to describe
some of the unintended consequences that are occurring as a result of using SDM®,
most of the participants indicated that any such consequences were positive ones. One
participant noted that because social worker resistance to implementation was
ultimately lower than expected, and because staff embraced SDM® quickly, the program
has now become somewhat of a model for how to implement a new initiative. Another
participant indicated that use of SDM® has increased CWS/CMS utilization, due to the
fact that workers must now follow through with their case plans because SDM® tracks
case-related contacts and completion of case plan objectives. The same participant
reported that the number of immediate referrals (versus 5-day referrals) has decreased
by 10%, so the Department’s numbers are now more in line with that of other California
counties.
Perceived Strengths of SDM®. The key informants were asked about the major
strengths of SDM® and the parts they believe to be most effective. Several benefits that
fell into the following three categories were mentioned: case-related benefits, benefits
for workers, and benefits to the organization.
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•
Case-related benefits. Participants commonly noted that use of SDM® has
resulted in more thorough investigations and better assessments. Both are now
more focused, more comprehensive, and less subjective, resulting in greater
consistency. One key informant noted the following benefits of the SDM® tools:
objective criteria for removal, ability to prioritize family needs and services, and
streamlining the array of recommended services to a focused three. Other caserelated benefits to the use of SDM® include helping workers to differentiate
between the important and less important factors, and moving cases through the
system more quickly (resulting in lower average rates of stay and quicker
progress toward adoption).
•
Benefits for workers. Participants almost universally noted that use of the tools
provides greater security for the workers. The burden of decision making is no
longer just on an individual worker. Hence, workers can feel more supported in
their decisions and know that they have backup in the event that something goes
wrong. One participant also reported that since SDM® was implemented, workers
understand Departmental expectations with greater clarity.
•
Benefits to the organization. The following organizational-level benefits to SDM®
use were also noted: use of an actuarial tool that is empirically supported and
more powerful; more focused use of resources (e.g., fewer immediate responses,
fewer detentions, greater case planning and use of community resources); and
consistent forward movement of cases, rather than stagnation.
Perceptions of SDM®’s Barriers
Unintended Consequences in the Use of SDM®. While several participants
mentioned various positive unintended consequences of using SDM®, two participants
mentioned some unintended negative consequences that have occurred. One
described an initial technology-related glitch, now resolved, in which the system that
prompts case reassessments was including children slated for permanency placement.
Another participant reported that use of SDM® requires that a risk assessment be
completed for a family, even if the alleged perpetrator is independent from the family
(such as a licensed daycare provider). Although this is currently not the official Los
Angeles County DCFS policy, the participant believed this to be the case, stating that
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delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
this practice is somewhat punitive toward the parents, who will have a DCFS record,
and also requires unnecessary efforts on the part of the worker.
Perceived Barriers to SDM® Implementation and Ongoing Use. Several
questions were asked in order to elicit the key informants’ perceptions of barriers to the
implementation and ongoing use of SDM®. Participants reported a variety of barriers,
falling into four distinct groups: time burden, tool-related difficulties, worker
attitudes and behaviors, and organizational-level barriers. As will be discussed
further in the next section, participants indicated that many of these reported barriers
have already been resolved.
•
Time burden. Implementing SDM® consumed a great deal of staff time,
especially prior to and early on in the implementation process. The staff was
required to take days away from their casework to attend SDM® trainings, and
additional time was subsequently spent learning how to use the tools correctly.
Participants reported that workers continue to experience difficulty meeting the
SDM® timeliness standards, especially since the system requires caseworkers to
write a complete narrative for each case. Additionally, the conversion of old
cases (pre-SDM®) into current SDM® standards requires considerable time and
effort.
•
Tool-related difficulties. Several tool-related barriers were cited, including
workers’ incorrect use of the override function, the risk assessment tool’s being
skewed toward high and very high risk levels, and the lack of benefit provided by
two of the SDM® tools: family and child strengths and needs assessment, and
reassessment. Further, one participant noted that the [risk assessment] tool does
not appropriately account for demographic and cultural factors that prevail in
some communities (e.g., with regard to the criminal history factor—a high
percentage of individuals in certain economically-depressed communities have
prior criminal histories, but should not necessarily be considered at any higher
risk for abuse).
•
Worker attitudes and behaviors. A few participants cited worker resistance to
SDM® use as a barrier to implementation. In particular, they reported that many
seasoned workers initially resisted relinquishing their decision-making power,
because they saw SDM® as a threat to their professional judgment. Also, workers
commonly expressed the view that SDM® simply added an additional paperwork
burden, and that some workers reportedly used the tools after-the-fact to satisfy
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the Departmental requirement instead of using them proactively to inform
decision making. Some participants noted that back-end workers in particular
continue to use SDM® sporadically and incorrectly.
•
Organizational-level barriers. Not surprisingly, the key informants noted barriers
related to the size of the Department and the sheer scale of such widespread
changes. One indicated that building an “SDM® friendly” culture posed
challenges, as did the simultaneous integration of SDM® with other DCFS
initiatives, including Point of Engagement, team decision making, and concurrent
planning. Further, given the Department’s history of frequent changes in
procedure policies, some workers saw SDM® as just another initiative that would
soon be discontinued with the next shift of political winds. Other organizationallevel barriers mentioned by participants included ongoing changes to the SDM®
tools (causing worker confusion, debate among managers and administrators,
and the need for re-training), and the practice of publicly posting SDM® utilization
rankings each month. While viewed by DCFS administration as a helpful
management tool, the latter practice has met with hostility from line staff.
Suggestions for Overcoming Barriers. When asked for their suggestions
regarding ways that the reported barriers might be resolved, several key informants
indicated that most of the problematic issues were an expected part of any new
program implementation process and that they have already been largely resolved.
Thus, these participants had no changes to recommend. One participant added to the
sentiment expressed by the others, citing the Children’s Research Center’s (CRC’s)
view that it usually takes 6 years for the staff to fully incorporate SDM®, whereas DCFS
is only in the second year of implementation. The few suggestions that were proposed
centered on changes to the tools themselves, and the processes involved in changing
the tools, as follows:
•
Waiting until SDM® is fully “entrenched” in the organization before making
changes, thus avoiding the confusion and need for constant re-training,
•
Involving workers in the redesign of SDM® tools and considering their input,
•
Tailoring the tools to the communities served, eliminating certain demographic
factors as risk factors (e.g., criminal history and previous unfounded referrals),
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delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
•
Refining and/or clarifying existing risk factors (e.g., differentiating between a
neglect referral and a substantiated neglect referral when determining the
severity of risk), and
•
Keeping an eye toward streamlining the tools, remembering that “improvements”
do not necessarily mean adding more items and greater tool complexity.
DCFS Social Worker Substudy Results
Data from the DCFS Social Worker substudy address various aspects of SDM®
implementation and effectiveness. Data for the substudy were collected using the webbased survey completed by line workers and supervisors. In this section, results are
presented at the SPA level, as well as by office. Frequencies in bold represent the
largest percentage(s) of responses for that particular item. A discussion of the results
from the countywide data can be found on page 86 of this chapter.
Characteristics of Participants. The characteristics of the participants are
presented in Table 1. Nearly half (n = 41; 49%) of the participants in the worker
substudy were from the Wateridge office. The remaining participants were from the
Century office (n = 11; 13%), the Compton office (n = 19; 23%), and the Hawthorne
office (n = 13; 16%).
Participants were asked to indicate their current “CSW file type,” that is, their
social worker job title. At the SPA level, participants indicated that their current file type
was one of the following:
•
Child protection hotline (0%),
•
Emergency response (17%),
•
Generic (29%),
•
Family maintenance/reunification (13%),
•
Permanency planning (1%),
69
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
•
Supervisor (21%),
•
Specialized program (4%),
•
Dependency investigation (2%), and
•
Other (12%).
For the Century and Compton offices, the largest percentages of participants were
Generic (36% and 37% respectively). For the Hawthorne office, the largest percentage
of participants were Generic (31%) and Emergency Response (31%). Finally, for the
Wateridge office, the largest percentage of participants were Supervisors (33%).
We also asked participants to indicate their job levels so that we could capture
which workers were front-line and which were supervisors. Front-line workers are
classified as either CSW trainees, or as CSW I, II, or III. Supervisors are classified as
SCSWs. Participants’ responses were recoded into a dichotomous variable indicating
either CSW or SCSW. As seen in Table 1, the majority of participants were front-line
workers (i.e., CSWs; 75%). The Wateridge office had the highest percentage of
supervisors (37%), followed by the Century and Compton offices (18% and 11%
respectively). No participants from the Hawthorne office indicated that they were a
supervisor.
We also asked participants about how long they had worked for DCFS and how
long they had worked in their current position. At the SPA level, participants generally
indicated that they had worked for DCFS for more than 1 year. Only 10% of participants
reported working for DCFS for less than 1 year. Nearly one quarter reported working for
DCFS for 1-4 years; one third for 5-8 years; and 31% for 9 years or more. Worth noting
70
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
is that over one quarter (26%) of participants from the Compton office indicated having
worked for DCFS for less than 1 year.
In response to the question regarding how long they had worked in their current
position, 29% of participants at the SPA level indicated less than 1 year, 43% 1-4 years,
19% 5-8 years, and 8% 9 years or more. Whereas only 9% of participants in the
Century office reported having worked in their current position for less than 1 year,
roughly one third of participants from Compton (37%), Hawthorne (31%), and Wateridge
(30%) reported working in their current position for less than 1 year.
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delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Table 1
Worker Characteristics by SPA and Office
SPA
SPA 6
N = 84
%
Century
n= 11
%
Primary office
Century
Compton
Hawthorne
Wateridge
13.1
22.6
15.5
48.8
100.0
0.0
0.0
0.0
0.0
100.0
0.0
0.0
0.0
0.0
100.0
0.0
0.0
0.0
0.0
100.0
Current CSW file type
Child Protection Hotline
Emergency Response
Generic
Family Maintenance/Reunification
Permanency Planning
Supervisor
Specialized program
Dependency Investigator
Other
0.0
17.1
29.3
13.4
1.2
20.7
3.7
2.4
12.2
0.0
9.1
36.3
27.3
9.1
18.2
0.0
0.0
0.0
0.0
21.1
36.8
5.3
0.0
10.5
5.3
0.0
21.0
0.0
30.8
30.8
15.4
0.0
0.0
7.7
7.7
7.6
0.0
12.8
23.1
12.8
0.0
33.3
2.6
2.6
12.8
Current job level
CSW trainee
CSW I
CSW II
CSW III
SCSW
Other
11.9
0.0
23.8
39.3
22.6
2.4
18.2
0.0
18.2
45.5
18.2
0.0
26.3
0.0
26.3
31.6
10.5
5.3
0.0
0.0
38.5
53.8
0.0
7.7
7.3
0.0
19.5
36.6
36.6
0.0
Current job level recoded
CSW
SCSW
73.6
26.4
77.8
22.2
84.6
15.4
100.0
0.0
60.5
39.5
Worked for DCFS how long
Less than 1 year
1-4 years
5-8 years
9 years or more
9.5
26.2
33.3
31.0
0.0
27.3
45.4
27.3
26.3
26.3
21.1
26.3
0.0
46.1
30.8
23.1
7.3
19.5
36.6
36.6
Worked in current position how long
Less than 1 year
1-4 years
5-8 years
9 years or more
28.9
43.4
19.3
8.4
9.1
45.5
27.3
18.2
36.8
42.1
21.1
0.0
30.8
61.5
7.7
0.0
30.0
37.5
20.0
12.5
CHARACTERISTIC
OFFICE
Compton Hawthorne
n= 19
n= 13
%
%
Wateridge
n= 41
%
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
SDM® Training and Utilization. To get a sense of the effectiveness of the SDM®
training provided by DCFS, we asked participants how well prepared they felt at the end
of their training. As presented in Table 2, most workers—about 94%—reported feeling
prepared. Eighty-two percent said they felt “somewhat prepared” and another 12% said
they felt “very prepared.” Approximately 1% reported feeling “not at all prepared.” The
remaining 5% indicated that they had not received SDM® training from DCFS.
Table 2 presents the SDM® tools that participants complete as part of their
current job duties. At the SPA level, these tools included the following:
•
Hotline/Response priority tool (0%)
•
Safety assessment tool (66%)
•
Family Risk assessment tool (67%)
•
Family Strengths and Needs assessment tool (80%)
•
Family Risk Reassessment tool (61%)
•
Reunification tool (49%)
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Table 2
Worker Preparedness for SDM® Implementation and Tools Used
by SPA and Office
CHARACTERISTIC
How well prepared at the end of
SDM® training
Very prepared
Somewhat prepared
Not at all prepared
Did not receive SDM® training
Tools completed as part of current
job duties*
Hotline/Response priority tools
Safety assessment tool
Family Risk assessment tool
Family Strengths and Needs
assessment tool
Family Risk Reassessment tool
Reunification tool
SPA
SPA 6
N = 84
%
Century
n = 11
%
OFFICE
Compton Hawthorne
n = 19
n = 13
%
%
12.0
82.0
1.2
4.8
18.2
72.7
0.0
9.1
5.3
89.4
0.0
5.3
15.4
69.2
0.0
15.4
12.5
85.0
2.5
0.0
0.0
65.6
66.7
79.8
0.0
90.9
72.7
81.8
0.0
52.6
52.6
73.7
0.0
61.5
69.2
76.9
0.0
65.9
70.7
82.9
60.7
48.8
72.7
54.5
52.6
52.6
53.8
30.8
63.4
51.2
Wateridge
n = 41
%
*
Totals for this question equal more than 100% due to multiple responses.
As summarized in Table 3, participants completing the web-based questionnaire
were asked to complete a series of questions pertaining to various aspects of utilization
of the SDM® tools. Based on their responses, participants seem to find the SDM® tools
easy to use and accurate. About 91% of participants find the tools either very or
somewhat easy to use, while 9% find them not at all easy. Approximately 95% of
participants find the tools to be either very or somewhat accurate, compared with only
5% who find the tools to be not at all accurate.
Included in the utilization questions was a question about how well participants
think SDM® helps them arrive at the same decision for similar types of cases. This item
was included in order to get a sense of how reliable the SDM® tools are. Approximately
74
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
84% of the respondents felt that SDM® was very or somewhat helpful in helping workers
arrive at the same decision for similar types of cases. Roughly 16% reported that SDM®
did not help them arrive at the same decision for similar types of cases.
When asked how often they agreed with risk levels assigned to cases prior to
overrides, about three quarters of participants at the SPA level said that they agreed
with the risk levels all or most of the time. Worth noting is that a sizeable percentage
(21%) of participants reported agreeing with the risk level only some of the time, while
about 5% never agreed with the level. When participants indicated that they agreed with
the risk level either most of the time, some of the time, or never, we asked them to
indicate whether they thought the risk levels were too high or too low. As illustrated in
Table 3, most participants (62%) indicated that they believed the levels assigned to
cases prior to overrides were too high.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Table 3
SDM Utilization by SPA and Office
®
SPA
SPA 6
N = 84
%
Century
n = 11
%
How easy to use worker finds SDM®
Very easy
Somewhat easy
Not at all easy
37.8
53.7
8.5
36.4
54.5
9.1
31.6
57.9
10.5
38.5
61.5
0.0
41.0
48.7
10.3
How accurate the worker finds SDM®
to be
Very accurate
Somewhat accurate
Not at all accurate
23.2
71.9
4.9
27.3
63.6
9.1
26.3
73.7
0.0
23.1
69.2
7.7
20.5
74.4
5.1
How well SDM® helps worker arrive at
same decision for similar types of
cases
Very well
Somewhat well
Not well at all
30.5
53.6
15.9
45.4
36.4
18.2
31.6
57.9
10.5
15.4
61.5
23.1
30.5
53.6
15.9
How often worker agrees with levels
assigned to cases (prior to overrides)
All of the time
Most of the time
Some of the time
Never
17.3
56.8
21.0
4.9
18.2
54.5
18.2
9.1
26.3
47.4
21.1
5.3
8.3
58.4
33.3
0.0
15.4
61.6
17.9
5.1
When worker does not agree with
assigned levels, thinks the levels are
too high or too low
Too high
Too low
Does not apply
62.4
7.2
30.4
60.0
0.0
40.0
60.0
6.7
33.3
81.8
0.0
18.2
57.6
12.1
30.3
CHARACTERISTIC
OFFICE
Compton Hawthorne
n = 19
n = 13
%
%
Wateridge
n = 41
%
SDM® and Decision Making. Child welfare social workers have to make a
multitude of important decisions that significantly affect the lives of children and families.
For this study, we were interested in looking at seven milestone decisions that child
welfare workers have to make in regards to determining a child’s well-being. These
decisions are whether:
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
1. A child is currently safe,
2. To promote a referral to a case,
3. To recommend a particular service or intervention to a client,
4. To remove a child,
5. To return a child to her/his family,
6. To terminate parental rights, and
7. To close a case.
These seven decision points, which essentially delineate the pathway of a case, are
determined by a series of front- and back-end workers and supervisors over time. Each
of these workers must make their decisions based on the information gathered and
presented by the previous workers. Although SDM® does not directly address all of
these seven decision points, we were interested in examining to what extent workers
felt that the model helped them to clarify the information and streamline the decisionmaking process overall. Table 4 summarizes participants’ responses to questions about
how helpful they find SDM® when making these decisions.
Overall, participants seem to find SDM® at least “somewhat helpful” in most
respects. However, 29% find SDM® “not at all helpful” when making decisions about
whether to recommend a particular service or intervention to a client and 40% find it “not
at all helpful” when making decisions about whether to terminate parental rights.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Table 4
How Helpful Worker Finds SDM When Making Decisions About…
by SPA and Office
®
SPA
SPA 6
N = 84
%
Century
n = 11
%
32.9
51.3
15.8
40.0
50.0
10.0
33.3
55.6
11.1
23.1
61.5
15.4
34.3
45.7
20.0
31.8
49.2
19.0
33.3
55.6
11.1
40.0
33.3
26.7
16.7
66.6
16.7
33.3
48.2
18.5
Whether to recommend a particular
service or intervention to a client
Very helpful
Somewhat helpful
Not at all helpful
23.7
47.4
28.9
50.0
40.0
10.0
22.2
61.1
16.7
7.7
61.5
30.8
22.9
37.1
40.0
Whether to remove a child
Very helpful
Somewhat helpful
Not at all helpful
31.9
50.0
18.1
60.0
30.0
10.0
47.1
29.4
23.5
0.0
72.7
27.3
26.5
58.8
14.7
Whether to return a child to her/his
family
Very helpful
Somewhat helpful
Not at all helpful
30.0
52.9
17.1
44.4
44.4
11.1
41.2
41.2
17.6
16.7
66.6
16.7
25.0
56.2
18.8
Whether to terminate parental rights
Very helpful
Somewhat helpful
Not at all helpful
26.8
33.9
39.3
57.1
14.3
28.6
38.5
30.7
30.8
0.0
50.0
50.0
23.1
34.6
42.3
Whether to close a case
Very helpful
Somewhat helpful
Not at all helpful
29.2
52.7
18.1
44.5
44.4
11.1
35.3
47.1
17.6
7.7
76.9
15.4
30.3
48.5
21.2
CHARACTERISTIC
Whether a child is currently safe3
Very helpful
Somewhat helpful
Not at all helpful
Whether to promote a referral to a
case4
Very helpful
Somewhat helpful
Not at all helpful
OFFICE
Compton Hawthorne
n = 19
n = 13
%
%
Wateridge
n = 41
%
3
For this question, Compton had one missing response (n = 18). The percentages shown are valid after excluding
the missing case.
4
For this question, Century had two missing responses (n = 9). The percentages shown are valid after excluding the
missing cases.
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
SDM® Goals. As stated in the Structured Decision Making® Policy and
Procedures Manual for California (CRC, 2005a), the California SDM® model has defined
a set of process and system goals to be attained by the State through the use of SDM®.
These goals or outcomes are presented in Table 5. We asked participants to indicate
how effective they think SDM® is in helping the Los Angeles County DCFS to achieve
these goals. Responses to these questions suggest that at least half of the participants
think SDM® is very or somewhat effective in helping to achieve all of the process and
system goals delineated by the CRC for the State of California. As indicated by the
percentage replying “very effective,” participants seem to think SDM® is most helpful
with respect to achieving the following four goals:
•
protecting children (30%),
•
improving assessments of family situations (25%),
•
increasing consistency in case assessment and case management (31%), and
•
providing management with data that is needed for program administration,
planning, evaluation, and budgeting (26%).
However, significant numbers of participants think that SDM® is not at all effective in
helping to achieve the following two goals: reducing the rate of foster care placements
(27%) and reducing the length of stay for children in foster care (27%). Also worth
noting is that significant numbers of participants reported being “not sure” about how
effective SDM® is in helping achieve the following five process and system goals:
reducing the rate of subsequent abuse/neglect complaints and substantiations (21%),
reducing the severity of subsequent abuse/neglect complaints and substantiations
(24%), reducing the rate of foster care placements (20%), reducing the length of stay for
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Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
children in foster care (24%), and providing management with data that is needed for
program administration, planning, evaluation, and budgeting (26%).
Table 5
How Effective Worker Thinks SDM® Is in Helping Achieve the Following Goals…
by SPA and Office
SPA
SPA 6
N = 84
%
Century
n = 11
%
Protecting children
Very effective
Somewhat effective
Not at all effective
Not sure
29.6
51.9
11.1
7.4
36.4
36.4
9.1
18.1
44.4
44.4
11.2
0.0
15.4
69.2
7.7
7.7
25.6
53.9
12.8
7.7
Reducing the rate of subsequent
abuse/neglect complaints and
substantiations
Very effective
Somewhat effective
Not at all effective
Not sure
13.7
46.3
18.7
21.3
18.2
27.3
18.1
36.4
16.7
44.4
11.1
27.8
15.4
46.2
23.0
15.4
10.5
52.6
21.1
15.8
Reducing the severity of
subsequent abuse/neglect
complaints and substantiations
Very effective
Somewhat effective
Not at all effective
Not sure
12.5
42.4
21.3
23.8
27.3
27.3
18.1
27.3
16.7
33.3
16.7
33.3
0.0
53.8
15.4
30.8
10.5
47.4
26.3
15.8
Reducing the rate of foster care
placements
Very effective
Somewhat effective
Not at all effective
Not sure
8.6
44.4
27.2
19.8
9.0
45.5
18.2
27.3
5.6
44.4
27.8
22.2
0.0
53.8
46.2
0.0
12.8
41.0
23.1
23.1
Reducing the length of stay for
children in foster care
Very effective
Somewhat effective
Not at all effective
Not sure
8.6
40.7
27.2
23.5
18.2
36.3
27.3
18.2
16.7
33.3
27.8
22.2
0.0
53.8
23.1
23.1
5.1
41.0
28.2
25.7
CHARACTERISTIC
OFFICE
Compton
Hawthorne
n = 19
n = 13
%
%
Wateridge
n = 41
%
80
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Table 5
How Effective Worker Thinks SDM is in Helping Achieve the Following Goals…
by SPA and Office (cont’d)
®
SPA
SPA 6
N = 84
%
Century
n = 11
%
Improving assessments of family
situations
Very effective
Somewhat effective
Not at all effective
Not sure
25.0
61.2
8.8
5.0
36.4
45.5
9.1
9.1
35.3
58.8
5.9
0.0
15.4
76.9
7.7
0.0
20.5
61.5
10.3
7.7
Increasing consistency in case
assessment and case management
Very effective
Somewhat effective
Not at all effective
Not sure
30.9
55.6
6.1
7.4
36.3
45.4
9.1
9.1
33.3
66.7
0.0
0.0
15.4
76.9
0.0
7.7
33.3
46.1
10.3
10.3
Increasing the efficiency of child
protection operations by making the
best use of available resources
Very effective
Somewhat effective
Not at all effective
Not sure
20.0
58.7
8.8
12.5
36.3
27.3
9.1
27.3
16.7
66.6
11.1
5.6
7.7
69.2
7.7
15.4
21.1
60.5
7.9
10.5
Providing management with data
needed for program administration,
planning, evaluation, and budgeting
Very effective
Somewhat effective
Not at all effective
Not sure
25.9
40.8
7.4
25.9
27.3
27.3
9.1
36.3
33.3
38.9
11.1
16.7
23.1
61.5
0.0
15.4
23.1
38.5
7.7
30.7
CHARACTERISTIC
OFFICE
Compton
Hawthorne
n = 19
n = 13
%
%
Wateridge
n = 41
%
In addition to assessing participants’ thoughts about the effectiveness of SDM®
on various State goals and outcomes, we were also interested in social workers’
assessment of the impact of SDM® on their own decision making. We therefore asked
participants to describe these effects. By and large, participants reported that their
decision making had improved as a result of using SDM® (see Table 6). About 44% said
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their decision making improved “somewhat” and another 19% said their decision making
improved “significantly.” Just under two thirds of participants (63%) felt that using SDM®
had improved their decision making; one third reported that using SDM® tools had “not
really changed” their decision making, and about 3% reported that their decision making
had gotten worse as a result of using the SDM® tools.
Table 6
Effect of SDM on Worker Decision Making by SPA and Office
®
CHARACTERISTIC
Effect using SDM® tools has had on
worker decision making
Decision making has improved
significantly
Decision making has improved
somewhat
Decision making has not really
changed
Decision making has gotten worse
SPA
SPA 6
N = 84
%
Century
n = 11
%
OFFICE
Compton Hawthorne
n = 19
n = 13
%
%
19.2
20.0
27.8
16.7
15.8
43.6
40.0
55.6
58.3
34.2
34.6
40.0
16.6
16.7
47.4
2.6
0.0
0.0
8.3
2.6
Wateridge
n = 41
%
Worker Satisfaction with SDM®. Finally, we asked participants about their
overall satisfaction with SDM® and whether they would recommend SDM® to other child
welfare agencies. As shown in Table 7, slightly more than half the participants said that
they were “very satisfied or satisfied” with SDM®. More than one third (38%) were
“neither satisfied nor dissatisfied,” and the remaining 13% were “dissatisfied or very
dissatisfied.”
In response to our question about whether they would recommend SDM® to
other child welfare agencies, over three quarters (79%) reported “yes,” while the
remaining 21% reported “no.”
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Table 7
Worker Satisfaction with SDM® by SPA and Office
SPA
SPA 6
N = 84
%
Century
n = 11
%
Overall, how satisfied worker is with
SDM®
Very satisfied or satisfied
Neither satisfied nor dissatisfied
Dissatisfied or very dissatisfied
50.0
37.5
12.5
45.5
36.4
18.1
61.1
27.8
11.1
30.8
61.5
7.7
52.6
34.2
13.2
Worker would recommend SDM® to
other child welfare agencies
Yes
No
78.5
21.5
81.8
18.2
83.3
16.7
69.2
30.8
78.4
21.6
CHARACTERISTIC
OFFICE
Compton Hawthorne
n = 19
n = 13
%
%
Wateridge
n = 41
%
The web-based questionnaire included two open-ended questions. The first was
a follow-up to the question about whether participants would recommend SDM® to other
child welfare agencies. We asked participants to explain why they would or would not
recommend SDM®. Table 8 synthesizes participant responses. Content analysis reveals
six distinct categories of responses for those who would recommend SDM® (n = 57;
72%), including:
1. Improves consistency,
2. Tools are helpful,
3. Validates/confirms decision making,
4. Relieves pressure of responsibility,
5. Easy to use, and
6. Facilitates outcomes research.
The most commonly cited reasons were: improvement in decision making consistency
offered by the tools (n = 14) and general helpfulness of the tools (n = 11).
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Content analysis revealed five distinct categories for those saying they would not
recommend SDM® (n = 17; 22%), including:
1. Tools are inaccurate,
2. Trained workers can do an equal or better job without the tools,
3. Problems with use of the tools,
4. Inadequate benefit in comparison to time costs,
5. Tools are susceptible to bias.
Among those who indicated that they would not recommend SDM® to other agencies,
the most commonly given reasons were: incompleteness or inaccuracy of the tools (n =
9), belief that trained workers can do an equal or better job (n = 8), and problems with
use of the tools (n = 6).
Table 8
Responses to Question:
“Would You Recommend That Other Child Welfare Agencies Use SDM®?”
“Why or Why Not?”
YES
Improves decision-making consistency
Tools are helpful
Validates/confirms decision making
Relieves pressure of responsibility
Ease of use
Facilitates outcomes research
No
Tools provide incomplete or inaccurate assessment,
frequently over-inflating the level of risk
Trained workers can do an equal or better job
Problems with use of the tools
Inadequate benefit in comparison to time costs
Tools are susceptible to bias
No Response
Frequency5
57
14
11
5
4
1
1
17
9
Percentage
72.2
21.5
8
6
3
3
5
5
Responses to “Why or why not?” question do not sum to N = 84 due to non-response and presence of
multiple responses.
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Responses to our second open-ended question are presented in Table 9. We
asked participants whether they had suggestions for improving the SDM® process within
the Department. A total of 26 participants responded, providing suggestions that fell into
three broad categories: revision of SDM® tools (n = 16), training (n = 4), and
organizational/procedural issues (n = 4). Suggestions regarding tool revision included
accounting for previous referral status and source, addressing the needs of young
children separately from older children and adults, reducing vagueness and subjectivity
in the usage of the tools, improving simplicity and relevance of the tools, and assessing
particular issues in greater depth. Regarding training, participants suggested adding
detail to the training, offering in-service updates on the impact of SDM® on service
outcomes, and providing follow-up training. Organization- and procedure-related
suggestions included increasing the staff-to-client ratio, improving the timeliness of
supervisory approvals, and refining the tool description chart. Six comments of a more
general nature were also provided in response to the invitation to share additional
thoughts regarding SDM®. Two responses provided praise for SDM®; another two
provided criticism. One comment noted the necessity of appropriate referrals and
resources for use of SDM® to be effective, and a final response indicated that the tool is
only an aid to worker decision making, and pointed out that the worker still inputs the
information.
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Table 9
Responses to Question:
“Do You Have any Suggestions on How to Improve the SDM® Process or Is There
Anything Else You Would Like to Share With Us About SDM®?”
(N = 26 respondents)
REVISION OF SDM® TOOLS
Account for previous referral status and source
Separately address the needs of young children (regarding
education and substance abuse questions)
Reduce vagueness
Eliminate subjectivity
Improve simplicity and relevance
Assess visitation in greater depth
Assess sex abuse in greater depth
TRAINING
Improve/add detail to training
Offer training/in-service regarding the impact of SDM® on service
outcomes
Provide periodic follow-up training
ORGANIZATIONAL AND PROCEDURAL ISSUES
Increase staff-to-client ratio, as overly large caseload interfere with
effective use of the tools
Improve timeliness of supervisory approval
Refine tool description chart so that it can assist workers at quick
glance
ADDITIONAL COMMENTS (NON-SUGGESTIONS)
Praise for SDM®
Criticism/skepticism regarding SDM®
Appropriate referrals and resources are necessary for use of SDM®
to be effective
Tool is only an aid to worker decision making; the worker still inputs
the information
Frequency6
16
6
3
3
1
1
1
1
4
2
1
1
4
2
1
1
6
2
2
1
1
Department-Wide Analyses
Though the focus of this curriculum is SPA 6, we conducted additional analyses
in order to determine whether SPA 6 is representative of the other SPAs and of the
6
Responses sum to greater than 26 due to multiple responses per individual respondent.
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Department as a whole. To compare SPA 6 to all the other SPAs combined in terms of
every variable presented in the tables above, either an unpaired t-test, a KolmogorovSmirnov Z test, or a chi-square test was performed, depending on the nature and
distribution of the data.
•
The chi-square test assessed the differences in participants’ current job levels
and CSW file types.
•
The unpaired t-test assessed the differences in participants’ organizational
tenure in DCFS, and job tenure for the current job position.
•
The Kolmogorov-Smirnov Z test assessed the differences in participants’
perceptions of the utilization, helpfulness, and effectiveness of their SDM®
training.
According to the test results, SPA 6 was not significantly different from the other SPAs
combined, with two exceptions. The results of the t-test show that participants in SPA 6
had worked for the Department and in their current positions for significantly less time
than their counterparts throughout the Department. More specifically, in SPA 6, social
workers had worked for DCFS for an average of 7 years, and for an average of 4 years
in their current positions, while social workers outside of SPA 6 had worked for the
Department for an average of 8 years, with an average of 5 years in their current job
positions. No other differences were found, which strongly suggests that the findings for
SPA 6 can, for the most part, be generalized for all SPAs in the Department.
In addition to these analyses, all of the analysis presented in the tables above
were replicated at the Department level (Appendix A), at the SPA level (Appendix B),
and at the office level (Appendix C). For these analyses, as well as the analyses
described above, all subjects who completed the online questionnaire were included. In
total, data from 699 subjects from across the Department were analyzed.
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Administrative Data Substudy (Utilization Component) Results
The administrative data substudy focused on implementation of the SDM® model
within SPA 6. In order to understand implementation, we examined data on the
utilization of the various SDM® tools in SPA 6 as a whole and within individual offices. It
is important to note that we define “implementation” and “utilization” differently than Los
Angeles County DCFS. In this curriculum, utilization refers to the extent to which each
DCFS office completes the full range of SDM® tools in a correct and timely manner.
Implementation, then, refers to full utilization of the prescribed SDM® tools by each
DCFS office—that is to say, full implementation occurs when each DCFS office is fully
utilizing the SDM® model as conceptualized. It is our understanding that DCFS’
definition of utilization is consistent with ours; however, DCFS considers implementation
as synonymous with the SDM® policy roll-out.
Though we present results by overall SPA and then by individual office, it is
important to point out that we were not interested in comparing individual offices, due to
the fact that there are a number of factors that may affect an office’s SDM® utilization
rate (e.g., differences in roll-out and training schedules, other concurrent initiatives,
variation in case backlog, and variation in the characteristics of DCFS clients and
workers). Utilization data, which are summarized in Figure 1, suggest that a conceptual
model of SDM®, consisting of the six caseworker assessment tools (Hotline/Response
Priority, Safety, Family Risk, Family Strengths and Needs, Family Reassessment, and
Reunification) had not yet been achieved during this study period.
The SDM® tool that was most often completed was the Hotline/Response Priority
assessment, with an average of 98% utilization across the SPA. The average utilization
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for the Safety assessment was 89%, and for the Risk assessment, 79%. As can be
seen in Figure 1, utilization of the Family Strengths and Needs assessment and the
Reassessment tools were 50% and 56% respectively. It is important to note that
average values are influenced by extreme scores. For example, months with low
utilization, such as 0%, will affect the average utilization. Further, the average value that
we calculated includes utilization for the initial months of SDM® implementation. Thus,
the final average utilization value does not necessarily reflect current or recent utilization
trends (which are detailed in subsequent figures).
It is also important to note that the full conceptual SDM® model as originally
conceived by the CRC (1999) consists not just of caseworker assessment tools, but
also caseload management components. These components are not yet integrated into
the SDM® model currently implemented by the Los Angeles County DCFS. According to
DCFS administrators (M. Mason, personal communication, February 22, 2006), staffing
levels, caseload levels, and funding have limited the Department’s ability to integrate
the full range of caseload management tools, such as workload study recommendations
and contact guidelines. Despite these limitations, certain components, such as
management reports and recommendations from CRC evaluations, have been
integrated. In addition, case review standards and a monthly reporting process have
recently been added as a way to monitor the quality of SDM® use.
Given this and the average utilization indicated by the percentage of tool
completion, particularly for the Family Strengths and Needs assessment and the
Reassessment, an analysis examining the impact of the SDM® model (consisting of the
caseload management tools and greater utilization of the caseworker assessment tools)
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on permanency outcomes would be premature. That is, because the model of SDM®
currently being implemented is a modified and diffused one, which may be appropriate
given its stage of use within DCFS, and given CRC’s endorsement of how the model
can be implemented, it may not be reasonable to expect this version of SDM® to have
the same effects as the full SDM® conceptual model.
The remaining figures and data illustrate the degree to which the individual tools
that are completed as part of the Los Angeles County DCFS model of SDM® are utilized
by SPA 6 and the SPA 6 offices. Results for each office are presented for the 10-month
study period, then the average utilization value for each tool is presented.
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Figure 1
SPA 6 Average Utilization
120%
100%
80%
60%
40%
20%
0%
Response
SPA
A
98%
Safety
Risk
79%
89%
FSN A
50 %
Reassess
56 %
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Figure 2a
10-Month Utilization
CENTURY
Hotline/Response Priority
Safety Assessment
110%
110%
100%
100%
90%
90%
80%
80%
70%
70%
60%
60%
50%
50%
40%
40%
30%
30%
20%
20%
10%
10%
0%
0%
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Jan
Family Risk Assessment
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Family Strengths & Needs
Assessment
110%
110%
100%
100%
90%
90%
80%
80%
70%
70%
60%
60%
50%
50%
40%
40%
30%
30%
20%
20%
10%
10%
0%
Jan
0%
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Sept
Oct
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Family Risk Reassessment
110%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Jan
Feb
Mar
Apr
May
June
July
Aug
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Figure 2b
Average Utilization
CENTURY
120%
100%
80%
60%
40%
20%
0%
Average Utilization
Response
Safety
Risk
FSNA
Reassess
98%
94%
91%
72%
85%
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Figure 3a
10-Month Utilization
COMPTON
Hotline/Response Priority
Safety Assessment
110%
110%
100%
100%
90%
90%
80%
80%
70%
70%
60%
60%
50%
50%
40%
40%
30%
30%
20%
20%
10%
10%
0%
0%
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Jan
Oct
Family Risk Assessment
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Sept
Oct
Family Strengths & Needs
Assessment
110%
110%
100%
100%
90%
90%
80%
80%
70%
70%
60%
60%
50%
50%
40%
40%
30%
30%
20%
20%
10%
10%
0%
0%
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Sept
Oct
Jan
Feb
Mar
Apr
May
June
July
Aug
Family Risk Reassessment
110%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Jan
Feb
Mar
Apr
May
June
July
Aug
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Figure 3b
Average Utilization
COMPTON
120%
100%
80%
60%
40%
20%
0%
AverageUtilization
Response
Safety
Risk
FSNA
Reass
98%
81%
67%
43%
45%
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Figure 4a
10-Month Utilization
HAWTHORNE
Hotline/Response Priority
Safety Assessment
110%
110%
100%
100%
90%
90%
80%
80%
70%
70%
60%
60%
50%
50%
40%
40%
30%
30%
20%
20%
10%
10%
0%
0%
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Jan
Family Risk Assessment
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Sept
Oct
Family Strengths & Needs
Assessment
110%
110%
100%
100%
90%
90%
80%
80%
70%
70%
60%
60%
50%
50%
40%
40%
30%
30%
20%
20%
10%
10%
0%
0%
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Sept
Oct
Jan
Feb
Mar
Apr
May
June
July
Aug
Family Risk Reassessment
110%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Jan
Feb
Mar
Apr
May
June
July
Aug
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Figure 4b
Average Utilization
HAWTHORNE
120%
100%
80%
60%
40%
20%
0%
Average Utilization
Response
Safety
Risk
FSNA
Reass
98%
89%
74%
65%
59%
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Figure 5a
10-Month Utilization
WATERIDGE
Hotline/Response Priority
Safety Assessment
110%
110%
100%
100%
90%
90%
80%
80%
70%
70%
60%
60%
50%
50%
40%
40%
30%
30%
20%
20%
10%
10%
0%
0%
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Jan
Family Risk Assessment
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Sept
Oct
Family Strengths & Needs
Assessment
110%
110%
100%
100%
90%
90%
80%
80%
70%
70%
60%
60%
50%
50%
40%
40%
30%
30%
20%
20%
10%
10%
0%
0%
Jan
Feb
Mar
Apr
May
June
July
Aug
Sept
Oct
Sept
Oct
Jan
Feb
Mar
Apr
May
June
July
Aug
Family Risk Reassessment
110%
100%
90%
80%
70%
60%
50%
40%
30%
20%
10%
0%
Jan
Feb
Mar
Apr
May
June
July
Aug
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Figure 5b
Average Utilization
WATERIDGE
120%
100%
80%
60%
40%
20%
0%
Average Utilization
Response
Safety
Risk
FSNA
Reasses
98%
90%
79%
43%
48%
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INSTRUCTOR AIDS
Questions for Discussion
1. What social work problems are being addressed by this project?
2. What research problems are being addressed by this project?
3. How sound is the approach that was used to carry out this project?
3.1
How appropriate was it to use different substudies? Is there another
approach that could have been used successfully?
3.2
How sound was the sampling approach—that is, the approach used to
select subjects/participants for the study? Are there other sampling
approaches that could have been used successfully?
3.3
How sound were the measures that were used? How valid were they (i.e.,
did they actually measure what was intended)? How reliable were the
measures (i.e., do you think the measures consistently yielded the same
results, assuming the measures were valid)? Are there additional
measures that could have been used successfully?
4. How sound were the procedures that were used (i.e., how sound was the overall
approach used to select subjects and collect data)? Are there other procedures that
could have been used successfully?
5. Specifically, what are the limitations of this project?
5.1
Given these limitations, what might be some of the reasons the
researchers approached the study the way that they did?
5.2
What are the implications of the limitations for the findings?
5.3
Do the limitations prevent the researchers from addressing the social work
and research problems they set out to address?
6. If you were designing this study, what would you have done differently? Why?
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CHAPTER IV
THE FUTURE USE OF STRUCTURED DECISION MAKING®
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CHAPTER IV
THE FUTURE USE OF STRUCTURED DECISION MAKING®
INSTRUCTIONAL GUIDE
Learning Objectives
This final chapter should enhance students’ ability to integrate existing
knowledge with new knowledge—in this case, knowledge about decision making and an
applied, structured approach to making decisions. Students are presented with our
interpretation of the findings, in relation to existing knowledge and in the context of the
limitations of our study. Students’ ability to interpret results and to consider their
implications for practice, policy, and future research should also be enhanced. Finally,
this chapter will help students to appreciate the challenges of applying child
maltreatment interventions in a complex, real-world setting, as well as the challenges of
carrying out applied research.
Daily Agenda for Presenting the Curriculum Unit
Prior to presenting and discussing this chapter, instructors are encouraged to
review the previous chapters. Instructors should assist students with integrating
previously existing knowledge with new knowledge obtained through this study. Further,
instructors should help students to consider the various implications of the findings in
the context of the study’s limitations—both implications we offer as well as others
generated by students. Instructors may want to help their students think specifically
about implications of the findings for decision making in child welfare and about the
Structured Decision Making® model from a conceptual and applied perspective, as well
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as implications for future research.
THE FUTURE USE OF STRUCTURED DECISION MAKING®
Discussion
As stated in the previous chapter, this project set out to answer the following
three questions:
1. What are the challenges related to implementing the full SDM® model in the Los
Angeles County DCFS?
2. What impact does implementation of the full SDM® model have on child welfare
service delivery?
3. What impact does implementation of the full SDM® model have on child
permanency outcomes?
To answer these questions, we conducted three substudies, including a key
informant substudy, a social worker substudy, and an administrative data substudy.
Results from the three substudies provide complimentary data that help paint a
comprehensive picture of SDM® implementation and effectiveness in the Los Angeles
County Department of Children and Family Services.
Relying on both quantitative and qualitative modes of
data collection, this mixed methods approach, we
believe, lent itself to studying implementation and
effectiveness of a fairly young conceptual model of
decision making that has received only scant
Mixed Methods
Approach:
Use of both qualitative and
quantitative methods to
study phenomena. These
two sets of methods can be
used simultaneously or at
different stages of the same
study
empirical investigation to date. The approach was also useful for studying
implementation and impact in a large, complex, and culturally diverse agency such as
the Los Angeles County DCFS as it allowed us to explore some phenomena in more
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depth while describing other phenomena from a broader perspective.
Conceptual Model vs. Practical Application
Our evaluation represents application of a largely conceptual model that is still
arguably in its early stages of empirical investigation. Thus, it is entirely possible that
implementation of the full SDM® model, as originally conceptualized by CRC, may be
neither feasible nor necessary. Although the Los Angeles County DCFS is using a
modified version of the SDM® model, the Department should recognize the potential
drawbacks and benefits of attempting to adhere to the full conceptual model of SDM®.
For instance, a benefit to adhering to the model is that it allows for outcomes observed
in Los Angeles County to be compared with those from other jurisdictions implementing
SDM® in a similar manner. Adhering to the model also allows impact data to be
generally tested and shared. From a research standpoint, jurisdictions adopting SDM®
tools would be better served if the complete conceptual model could be rigorously
tested. In order to do so, however, different jurisdictions must implement the entire
model in the same manner. Once the model is tested and found sound, jurisdictions
using the model can then draw concrete conclusions about performance based on the
collected impact data.
Conversely, strict adherence by the Los Angeles County DCFS to the full
conceptual CRC model may be misguided in that even the full model is one that
continues to be refined and tested empirically. It is certainly possible that some aspects
of the full model are not necessary and that the model lacks other necessary
components. Moreover, it is possible that the CRC model as it currently exists is a
sound model, but one that is not applicable or effective with particular populations or in
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some locales due to the characteristics of clients, social workers, and/or agencies. In
fact, CRC encourages that the model’s components be tailored to the needs and
preferences of individual jurisdictions. As such, the Los Angeles County DCFS may
actually be better served by the modified version of the SDM® model so that it responds
to the uniqueness of DCFS and its client population. Further modifications to the model
should be accompanied by careful attention and documentation as to why changes
were necessary and exactly what modifications were made. This will allow the California
version of the SDM® model to be better understood, while the existing conceptual and
empirical knowledge about the full CRC model would still be relevant. It will also allow
the partial SDM® model being implemented by Los Angeles County to inform the CRC
model and the larger knowledge base of decision making in child welfare.
Challenges to SDM® Implementation
Notwithstanding the lack of full implementation of the conceptual SDM® model
(as we define "full implementation"), results from our key informant substudy and social
worker substudy reveal numerous implementation challenges worth discussing. These
challenges can generally be classified as relating to the design and use of the SDM®
model and tools, social worker attitudes and beliefs related to SDM®, and organizational
issues. In this section, we include worker quotes from the online DCFS worker survey.
Design and use of the SDM® model and tools. Our data suggest that not all of
the caseworker assessment tools are being used [as intended] and that they may not be
used consistently by social workers and across situations. For instance, participants in
both the key informant and social worker substudies acknowledged that, with respect to
a single case, tools are often completed by different social workers, depending on
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where in the system the case is at a given time. We were also told that the social
workers often use the tool to confirm their assessments, rather than using it to inform
their decision making, “I think that the SDM® is useful for validating decisions that the
CSW has made.” Similarly, participants acknowledged that the tools can still be
manipulated to yield the results desired by the social worker completing them:
If anyone thinks that the tools cannot be manipulated by burnt-out staff or less
committed staff, (they) are gravely mistaken. There are folks out there who are
manipulating it grossly because it really demands that the information going in is
accurate and will be used to provide the best service delivery. It isn’t a magic pill.
Participants also expressed feelings that the Family Strengths and Needs
assessment tool and the Reassessment tool are not useful. Although the full CRC
conceptual model advocates the usage of all the SDM® tools and components, it is
possible that these are aspects of the model that may not be necessary to the integrity
of the model and to SDM®’s overall utility. Or, this may just be the case for the Los
Angeles County DCFS. Utilization data reveal that these two tools have the lowest
utilization values of all the tools. Thus, it is possible that feelings about the usefulness of
the FSNA and Reassessment tools actually reflect lack of use of the tools, in which
case, it is possible that increased utilization will result in workers finding the tools more
useful. On the other hand, the low utilization values may reflect workers’ sense that
these tools are not effective and are burdensome to complete:
Because during the short time that I have been doing this job, I noticed that in
addition to my very hectic caseload and services I have to continuously provide, I
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have to constantly worry about updating my SDM®. In my opinion, it is necessary
to do SDM® at the beginning of the case. However, continuing to use SDM®
would be very time consuming. That's just my opinion because I can never keep
up with completing them when I am dealing with more important issues on the
case.
If this is the case, pressure to increase the utilization of the tools may lead to
increased utilization, but it may also lead to decreased quality of the tools and
information collected with them. Should this happen, it is possible that higher utilization
values will not accurately reflect the manner in which the tools are used or their
necessity for the overall model of SDM®. Being required to complete the tools may in
turn result in increased hostility from workers and greater administrative burden that will
translate into less time working with clients.
With respect to the actual tools themselves, some participants spoke of the time
burden that completing them poses for social workers. Other participants spoke of
problems in the design or use of the tools. For example, some participants expressed
concern about the family risk assessment tool—specifically that a referral for
abuse/neglect is considered a risk factor, as opposed to a substantiated referral for
abuse/neglect. Numerous participants addressed aspects of the tools that may reflect
the need for further consideration and incorporation of cultural differences:
The tool needs to be recalibrated to take into consideration the urban poor city
areas where the contact with the environment puts children at high risk. Families
in these areas have a set of unique factors (multi-generational poverty, poor
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education, negative contact with the law enforcement, young children, prior
contact with DCFS, undocumented) which causes the SDM® risk level to be too
high.
Certain demographic factors, such as having a criminal history and previous unfounded
referrals, for example, may be more common among clients living in particular
neighborhoods or with particular cultural backgrounds. These factors currently increase
risk scores, which may be more of a cultural artifact than an actual indicator of
increased risk.
Challenges related to social workers generally revolve around their perception of
the need or benefit of using SDM® in relation to perceived or actual burden required to
complete the SDM® tools. Some participants expressed concern that requiring the use
of SDM® tools inherently questions workers’ knowledge and abilities:
I think if individuals are clinically trained, the need for a SDM® tool is not required.
Educated individuals should not need a program to dictate to them how to make
decisions. It is far more effective to implement critical thinking skills.
Though not addressed directly, our results also suggest that workers whose knowledge
and/or abilities are in need of enhancement may not receive the training and
supervision they need, since they can rely so heavily on the tools. However, these
social workers may be the ones who benefit most from use of the SDM® tools.
In terms of the positive aspects of SDM®, study data suggest that there are some
concrete ways that social workers benefit by using the SDM® tools. As discussed above
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and in the Results sections, those who need assistance with decision making benefit
from the guidance and structure offered by SDM®:
It helps me to feel comfortable after I have given more consideration to areas of
importance that may have slipped my mind before making decisions without this
aid. Returning to the SDM® is an added assurance that all areas have been
considered and covered to ensure child safety.
Many participants mentioned that the tools help them to prioritize the needs of clients:
It improves upon our ability to conceptualize and assess the key factors, but is
intentionally vague to allow for enough wiggle room in the decision-making
process.
Still other participants were comforted by knowing that the Department would “stand
behind” their decisions when the SDM® tools were used:
The SDM® tool is helpful; in that, it provides some sense of standardization of
how cases can or should be directed. Further, when cases are up for review and
there are concerns of how or why a case was directed in one way or another, it
appears that the CSW and SCSW are not faulted for failures or other negative
outcomes.
As mentioned earlier, our data suggests that social workers benefit considerably
by having validation of their own assessments. The use of the SDM® model in this way
deviates somewhat from the way that the model was intended. Rather than having
decisions result from use of the assessment tools, it appears that some social workers
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essentially have a dialogue of sorts with the tools, which results in validation or
refinement of their assessments and subsequent decisions.
Regardless of the benefits to social workers, our data also suggest that the
burden to complete the tools at least necessitates an analysis of the costs and benefits
of mandating the use of SDM® by all social workers and in all situations. At the very
least, our data suggest that for most social workers, the tools are somewhat ancillary in
their utility and that in these cases, the tools should be easy to use and that the burden
to complete them should be commensurate with the benefits gained.
Social worker attitudes and beliefs related to SDM®. Another worker-related
challenge our data revealed has to do with workers not seeing the benefit of SDM® in
terms of its impact on service delivery and permanency outcomes. Data from our social
worker substudy indicate that many workers do not know whether SDM® helps the
Department achieve its specified process and system goals. This was particularly so
with respect to the goals of reducing the rate of subsequent abuse/neglect complaints
and substantiations, reducing the severity of subsequent abuse/neglect complaints and
substantiations, reducing the rate of foster care placements, reducing the length of stay
for children in foster care, and providing management with data that is needed for
program administration, planning, evaluation, and budgeting.
While workers felt more sure about the impact of SDM®, our data reveal they feel
it to be less effective in reducing the rate of foster care placements and reducing the
length of stay for children in foster care, compared with other goals. Given these
findings, it seems that workers would appreciate receiving regular feedback that speaks
to the effect that their efforts (i.e., utilizing SDM®) have on targeted outcomes.
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Unfortunately, at this point, it would be premature to attempt to attribute changes in
outcomes solely to the use of SDM®, especially given that there have been other
Department-wide initiatives implemented concurrently with SDM®. Yet, there may be
other data on more immediate outcomes that result from use of SDM® that can be
offered as reassurance to workers that their efforts are not in vain.
Our data suggest that some workers question the purpose of the utilization
reports. Rather than seeing them as an indicator of the extent to which tools are being
used, some participants reported feeling pressure to complete the tools for the sake of
completing them—at the expense of completing the tools accurately. Negative feelings
from social workers in this regard are likely exacerbated by the public posting of
utilization scores. The administrative staff participants that were interviewed for the Key
Informant Substudy expressed that the public posting of scores served as both a
reminder and an incentive for the workers; however, this practice was perceived by
some of our worker participants as punitive and unnecessary. For this reason, the
Department may want to consider the manner in which utilization of the tools is handled,
given the importance of creating an environment among workers that is supportive of
the use of SDM®. At the same time, it is important to acknowledge the benefit of
providing workers with real-time feedback related to utilization so that performance can
be [self-]assessed and adjusted or remedied as necessary by workers and/or their
supervisors.
Organizational issues. Finally, in terms of organizational challenges, findings
from our data stress the importance of the Department providing a well-defined and
articulated model of SDM®, a model that remains fairly stable and in place over time.
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Some participants commented on the numerous initiatives in place by the Department
and how new initiatives are tried frequently, often without allowing them ample time to
be integrated into agency practices or to be adequately evaluated. We are aware of
efforts by the Department to streamline its initiatives, which will certainly help in this
regard. Workers may also appreciate hearing that incorporating SDM® into the fabric of
its operations will be an effort carried out over many years, to which the Department is
fully committed.
The lack of implementation of the full conceptual SDM® model precludes the
direct analysis of the impact of SDM® on child welfare service delivery and on
permanency outcomes at an organizational level. Further, other initiatives in place make
it difficult to determine the impact—again at the organizational level—of using SDM®.
However, data from our key informant and social worker interviews provide some
indication of the effectiveness of SDM® with regard to organizational outcomes and to a
greater extent, indication of the effectiveness of SDM® at the individual social worker
level.
According to participants’ perceptions, use of SDM® has been most effective in
helping the Department achieve the greater State-defined goals of protecting children,
improving assessment of family situations, increasing consistency in case assessments
and case management, and providing management with data that is needed for
program administration, planning, evaluation, and budgeting. Because the present
analysis does not control for worker characteristics, it is not possible to say whether all
participants perceived the impact of SDM® in this way or whether this is a perception
held by certain workers. Future multivariate analysis of the data will examine the impact
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of worker job level, length of time working for the Department, and length of time
working in current position on the perceived effectiveness of SDM®.
Impact on decision making. Our data more directly address workers’
perceptions of the impact of SDM® on their own decision making and on the usefulness
of the SDM® tools. About two thirds of the participants indicated that using SDM® had
improved their decision making significantly or somewhat. About one third of workers
said that their decision making had not really changed, and 3% said that their decision
making had gotten worse. Participants who indicated that their decision making had not
really changed were overrepresented within the Wateridge office, which was also
overrepresented by SCSWs. Thus, it appears that line workers generally perceive
SDM® as having a positive impact on their decision making. Whether improvements in
decision making continue beyond the initial introduction and use of SDM® remains to be
seen. It is possible that improved decision making which results from receiving training
on SDM® and possibly limited initial usage is sufficient for improving outcomes beyond
the use of SDM®. That is, it is not clear whether improvements in outcomes that might
be observed in the future should be attributed to improved decision making (that
resulted from training on SDM®), to the sustained use of the SDM® tools, or to some
other unforeseen factor. If the former, the Los Angeles County DCFS and other child
welfare agencies may want to consider providing newly hired workers with extensive
training on SDM®. Additionally, SDM® may need to be more strictly adhered to by
workers with limited child welfare experience or by those exhibiting difficulties working
effectively with clients.
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Overall, participants in our study reported finding SDM® helpful when making
decisions about whether a child is currently safe, whether to promote a referral to a
case, whether to remove a child, whether to return a child to her or his family, and
whether to close a case. They reported finding SDM® not helpful when making
decisions about whether to recommend a particular service or intervention to a client
and whether to terminate parental rights. Further investigation of why SDM® was not
useful to participants in these two regards is necessary. As discussed above, utilization
data reveal that the Family Strengths and Needs assessment tool is among the two
tools utilized the least. This finding, then, could suggest problems with the validity,
reliability, and/or use of the tool. The findings regarding the helpfulness of the tool could
also simply reflect lack of familiarity with the tool as a result of low utilization.
Participants’ reports that they find SDM® not helpful when making decisions about
whether to terminate parental rights necessitates further examination of whether the
current tools are insufficient or problematic in some manner of its use, or whether this is
a goal that does not realistically exist within the realm of SDM®’s intended effect.
Study Limitations
Despite offering badly needed empirical data on SDM®, several limitations of our
study are worth noting. The initial proposal intended to provide an examination of the
impact of SDM® on child welfare service delivery and permanency outcomes. However,
to date, an idealized version of the full conceptual Structured Decision Making® model
has not been realized, nor may it ever be—nor possibly should it be. Additionally, other
initiatives are being implemented by the Department, which make it difficult to isolate
any observed effects and to attribute them solely or primarily to SDM®. Further, different
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workers are usually involved in completing different tools for a single case. Together,
these conceptual and logistical issues, along with the uniqueness of individual offices
(and SPAs) argue for examination of the impact of SDM® on immediate rather than
distal (i.e., organizational) outcomes. Our initial plan to examine the impact of SDM® on
organizational outcomes was hampered most significantly by low utilization of the
various SDM® tools and thus by a diffused or “weakened” model of SDM®. To address
this limitation, our study paid more attention than originally planned to the immediate
outcomes relating to the impact of SDM® utilization on the decision making of social
workers. However, we used a single self-reported item to assess impact on social
worker decision making, whereas a non-self-reported measure or series of items could
be more valid and reliable.
Other limitations of our study have to do with possible biases in our sample
related to the nature of our sampling procedures. Subjects for the key informant study
were selected using purposive and snowball sampling procedures based on potential
participants’ knowledge of and experience with SDM®. We were interested in selecting
key informants that could offer a wide variety of perspectives on SDM®, including
negative perspectives if appropriate. Our unsuccessful attempts to obtain more key
informants skeptical or critical of SDM® may have resulted in our findings from the key
informant substudy being skewed towards a more positive perspective of SDM®.
Similarly, the procedures we used to solicit participants from our social worker substudy
may have resulted in undetected biases. Potential participants were asked to voluntarily
take part in the study by completing a web-based questionnaire. Self-selection and the
nature of the survey may have yielded a sample comprised of participants who felt more
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positively and/or negatively about SDM®, and/or a sample comprised of participants
who felt more comfortable completing an anonymous, web-based questionnaire. Given
the variation in our responses, however, we feel that sample bias, though possible, is
likely minimal to non-existent.
Perhaps a more serious bias is related to the number of workers taking part in
the study from each of the offices. Nearly half the participants were from the Wateridge
office, which was also overrepresented by SCSWs. Hence, it is likely that our data from
the Wateridge office represents the views of supervisors, which may or may not
represent the views of line workers. Similarly, given its overrepresentation, it is likely
that our SPA 6 data largely represents the views of Wateridge, which may or may not
represent the views of the Century, Compton, and Hawthorne offices.
As alluded to above, there may exist some limitations of our data related to the
nature of measurement. For instance, in the social worker substudy, some outcomes
were reported and measured indirectly, rather than assessed directly. In these cases,
items were measured so that participants were asked to report their thoughts or
assessments, which may not necessarily reflect actual performance of the organization
or workers. Additionally, our web-based measure was constructed so that it posed
minimum burden on workers. This restricted our ability to more comprehensively follow
up and examine issues related to the implementation and impact of SDM®. We believe,
however, that the web-based questionnaire increased participation and allowed
participants to be more truthful in their responses since it was short, easy to access and
complete, convenient, and because it assured participant confidentiality.
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Data analyzed in our administrative data substudy were provided to us in report
format by the Department. The data used to summarize utilization may have contained
inaccuracies in terms of both the amount of utilization reported and the quality of the
tool utilized (thus, it can be argued that the utilization value was overinflated). This issue
is worth noting, but probably inconsequential since low utilization prevented us from
assessing impact on permanency, child welfare, and service outcomes, and because
the underutilization of several tools already revealed that there was low utilization of
SDM® (i.e., overinflation of these values would only mean that the low level of tool
utilization would appear even lower).
Implications for Policy and Best Practices
Overwhelmingly, data from our study suggests that the SDM® model is worth
pursuing in Los Angeles County and in other child welfare agencies. From a research
standpoint, given that CRC encourages jurisdictions to tailor the SDM® model to fit their
individual needs, it is essentially impossible to evaluate the effectiveness of the
complete conceptual SDM® model. Without a well-defined model, there is no real basis
of comparison for data collected from jurisdictions using SDM®. The State of California
currently requires the same basic SDM® structure for all its counties using SDM®;
however, further research is needed to determine whether the implementation of these
guidelines are comparable between the counties before any conclusions can be drawn
regarding the effectiveness of the California model, and to what extent any
improvements can be attributed to the use of SDM®.
Given these limitations, in this curriculum we focus less on the fidelity of the
conceptual SDM® model and its effect on long-term outcomes, and instead on more
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micro-level effects the model has had on caseworker decision-making skills. Findings
suggest that use of SDM® positively impacts worker decision making and that it offers
several other benefits to workers. Yet, despite any actual improvements in decision
making and benefits, it is necessary for the Department to consider whether other
issues, such as the time burden to complete the tools that is reported by some workers,
warrants continued use of the model. Even if the Department opts to continue usage of
SDM®, it may want to examine whether a further modified version of SDM® is more
appropriate and effective for Los Angeles County than what is currently being used.
Now that the Department is focusing on high and moderate risk cases it is possible that
the most useful tools are those that assess response priority, risk, and safety. Concerns
regarding the Family Strengths and Needs assessment tool and the Reassessment tool
require further investigation. Findings suggest that these tools may need further
refinement.
Conclusion
The primary goal of public child welfare agencies is to ensure the safety and
permanency of children, and to a lesser extent, to enhance child and family functioning.
Findings from our study suggest that the SDM® tools may be most effective in
addressing child safety and risk, and to a lesser extent in addressing permanency and
well-being. Indications of problems with the reassessment and FSNA tools may be a
function of permanency and well-being goals being more ill-defined and having to do
with processes and outcomes related to systemic and chronic problems. Because of the
intractable nature of the problems addressed by the permanency and well-being goals
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of child welfare, they almost certainly will be more complicated to assess and treat,
possibly requiring multidisciplinary efforts, greater resources, and more time.
Most immediately, our findings suggest that the focus of SDM® efforts in the near
future should be on implementation, with an eye towards examining impact down the
line. To this end, training efforts are critical (particularly with regard to the goals of
SDM® and how to accurately complete and be informed by the tools), as are
communications with workers about the benefits of using SDM®. Creating a culture that
appreciates and addresses workers’ legitimate concerns about the SDM® tools and
incorporating SDM® into the Department’s practices in a non-threatening and nonpunitive way is critical at this stage of implementation.
Ultimately, participants in our study were largely satisfied with SDM®. The
greatest percentage, just over half, reported being either very satisfied or satisfied, while
the next largest percentage, just over one third, reported being neither satisfied nor
dissatisfied. Only about 13%, the smallest percentage, reported being dissatisfied or
very dissatisfied with SDM®. At this stage in the development of Structured Decision
Making® and its implementation by the Los Angeles County DCFS, rather than
dismissing those who express concerns or negative opinions about SDM® as
naysayers, it seems important to consider these perspectives in future investigations of
SDM®. When asked whether they would recommend SDM® to other child welfare
agencies, about 80% of participants replied that they would. This finding suggests that
the social workers who participated in our study were able to discern between possible
limitations of the SDM® model and/or tools, and its overall benefit. Such an
endorsement, we believe, speaks strongly to the potential of the SDM® model and the
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importance of continuing to refine the model based on feedback from professionals
experienced in child welfare and the use of SDM®, like the line workers and supervisors
participating in our study. We also think it speaks to the Department’s success in
implementing SDM®.
INSTRUCTOR AIDS
Questions for Discussion
1. What are the major findings from this study?
2. Are there alternative explanations for these findings?
2.1 Which findings can be interpreted differently?
2.2 What do you think might affect the way that readers of this curriculum will
interpret the findings of the study?
3. What are the implications of these findings for:
a)
b)
c)
d)
social work practice,
child welfare policy,
theory or conceptual knowledge, and
practice knowledge?
4. What other conclusions can be drawn based on the findings of this study?
5. What research questions still need to be addressed?
6. What are the next steps for addressing these questions?
7. In your opinion, based on the findings from this study (and its limitations), and the
existing (conceptual, empirical, and practice) knowledge, how effective is SDM® in
general?
8. Specifically, in what ways is SDM® (a) useful and (b) effective?
8.1
In which situations or with what kinds of clients does SDM® appear to be
most (a) useful and (b) effective?
8.2
In which situations or with what kinds of clients does SDM® appear to be
least (a) useful and (b) effective?
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9. What do you think about SDM®?
9.1
How could SDM® be improved?
9.2
What knowledge would be necessary in order to result in a more effective
model?
9.3
What would be required of child welfare workers and agencies in order for
SDM® to be more effective?
Group Exercise
Consider the following question: What kinds of conceptual and empirical gaps in
knowledge still remain in regards to assessing child maltreatment?
Divide into small groups, and design a research project that could address one or more
of these gaps in knowledge. In the process, address the following questions:
1. What research questions would you try to answer?
2. What type of research design would you use?
2.1
Sampling method?
2.2
Measurement procedure?
2.3
Qualitative vs. quantitative design?
3. What would be the major strengths of your research approach? What would be the
major limitations?
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REFERENCES
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REFERENCES
Anastas, J. W. (2004). Quality in qualitative evaluation: Issues and possible answers.
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delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
APPENDIXES
127
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
APPENDIX A
STUDY RESULTS BY DEPARTMENT
128
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Department
Appendix A
TABLE 1
WORKER CHARACTERISTICS BY DEPARTMENT
CHARACTERISTIC
N
%
Current CSW file type (N = 551)
Child Protection Hotline CSW
Emergency CSW
Generic CSW
Family Maintenance/Reunification CSW
Permanency Planning CSW
Supervisor CSW
Specialized Program CSW
Dependency Investigator CSW
Other
14
126
105
71
7
125
26
19
58
2.5
22.9
19.1
12.9
1.3
22.7
4.7
3.4
10.5
Current job level (N = 556)
CSW trainee
CSW I
CSW II
CSW III
SCSW
Other
36
11
90
238
136
45
6.5
2.0
16.2
42.8
24.5
8.0
How long has worked for DCFS (N = 557)
Less than 1 year
1-4 years
5-8 years
9 years or more
43
102
156
256
7.7
18.3
28.0
46.0
How long has worked in current position (N = 560)
Less than 1 year
1-4 years
5-8 years
9 years or more
114
210
143
93
20.4
37.5
25.5
16.6
129
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Department
Appendix A
TABLE 2
WORKER PREPAREDNESS FOR SDM® IMPLEMENTATION AND TOOLS USED
BY DEPARTMENT
CHARACTERISTIC
N
%
At the end of SDM® training, how well prepared (N = 548)
Very prepared
Somewhat prepared
Not at all prepared
Did not receive SDM® training
89
391
39
29
16.2
71.4
7.1
5.3
Tools completed as part of current job duties (N=699)1
Hotline/Response Priority tools
Safety assessment tool
Family Risk assessment tool
Family Strengths and Needs assessment tool
Family Risk Reassessment tool
Reunification tool
39
389
384
417
280
212
5.6
55.7
54.9
59.7
40.1
30.3
1
Totals for this question are more than 100% since participants were asked to answer all that apply.
130
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Department
Appendix A
TABLE 3
SDM UTILIZATION
BY DEPARTMENT
®
CHARACTERISTIC
N
%
How easy to use worker finds SDM® (N = 527)
Very easy
Somewhat easy
Not at all easy
201
291
35
38.1
55.2
6.7
How accurate the worker finds SDM® to be (N = 526)
Very accurate
Somewhat accurate
Not at all accurate
82
405
39
15.6
77.0
7.4
How well SDM® helps worker arrive at same decision for
similar types of cases (N = 522)
Very well
Somewhat well
Not well at all
123
327
72
23.6
62.6
13.8
How often worker agrees with levels assigned to cases (prior
to overrides) (N = 519)
All of the time
Most of the time
Some of the time
Never
52
294
163
10
10.0
56.6
31.4
2.0
When worker does not agree with assigned levels, thinks the
levels are too high or too low (N = 485)
Too high
Too low
Does not apply
299
61
125
61.6
12.6
25.8
131
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Department
Appendix A
TABLE 4
HOW HELPFUL WORKER FINDS SDM® WHEN MAKING DECISIONS ABOUT…
BY DEPARTMENT
CHARACTERISTIC
N
%
Whether a child is currently safe (N = 499)
Very helpful
Somewhat helpful
Not at all helpful
124
282
93
24.8
56.5
18.7
Whether to promote a referral to a case (N = 415)
Very helpful
Somewhat helpful
Not at all helpful
111
222
82
26.7
53.5
19.8
Whether to recommend a particular service or intervention
to a client (N = 476)
Very helpful
Somewhat helpful
Not at all helpful
90
232
154
18.9
48.7
32.4
Whether to remove a child (N = 471)
Very helpful
Somewhat helpful
Not at all helpful
121
236
114
25.7
50.1
24.2
Whether to return a child to her or his family (N = 413)
Very helpful
Somewhat helpful
Not at all helpful
100
231
82
24.2
55.9
19.9
Whether to close a case (N = 440)
Very helpful
Somewhat helpful
Not at all helpful
105
241
94
23.9
54.8
21.3
132
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Department
Appendix A
TABLE 5
HOW EFFECTIVE WORKER THINKS SDM® IS IN HELPING ACHIEVE THE
FOLLOWING GOALS…BY DEPARTMENT
CHARACTERISTIC
N
%
Protecting children (N = 524)
Very effective
Somewhat effective
Not at all effective
Not sure
106
320
64
34
20.2
61.1
12.2
6.5
Reducing the rate of subsequent abuse/neglect complaints
and substantiations (N = 517)
Very effective
Somewhat effective
Not at all effective
Not sure
54
230
149
84
10.4
44.5
28.8
16.3
Reducing the severity of subsequent abuse/neglect
complaints and substantiations (N = 522)
Very effective
Somewhat effective
Not at all effective
Not sure
53
207
157
105
10.2
39.7
30.1
20.1
Reducing the rate of foster care placements (N = 525)
Very effective
Somewhat effective
Not at all effective
Not sure
55
217
149
104
10.5
41.3
28.4
19.8
Reducing the length of stay of children in foster care (N = 521)
Very effective
Somewhat effective
Not at all effective
Not sure
45
164
172
140
8.6
31.5
33.0
26.9
Improving assessments of family situations (N = 521)
Very effective
Somewhat effective
Not at all effective
Not sure
117
315
65
24
22.5
60.5
12.5
4.6
133
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Department
Appendix A
TABLE 5
HOW EFFECTIVE WORKER THINKS SDM® IS IN HELPING ACHIEVE THE
FOLLOWING GOALS…BY DEPARTMENT (cont’d)
CHARACTERISTIC
N
%
Increasing consistency in case assessment and case
management (N = 522)
Very effective
Somewhat effective
Not at all effective
Not sure
138
276
69
39
26.4
52.9
13.2
7.5
Increasing the efficiency of child protection operations by
making the best use of available resources (N = 522)
Very effective
Somewhat effective
Not at all effective
Not sure
82
258
125
57
15.7
49.4
24.0
10.9
Providing management with data that is needed for program
administration, planning, evaluation, and budgeting (N = 522)
Very effective
Somewhat effective
Not at all effective
Not sure
113
215
71
123
21.6
41.2
13.6
23.6
N
%
58
206
235
9
11.4
40.6
46.3
1.7
TABLE 6
EFFECT OF SDM® ON WORKER DECISION MAKING
BY DEPARTMENT
CHARACTERISTIC
Effect using SDM® Tools has had on worker decision making
(N = 508)
Decision making has improved significantly
Decision making has improved somewhat
Decision making has not really changed
Decision making has gotten worse
134
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Department
Appendix A
TABLE 7
WORKER SATISFACTION WITH SDM®
BY DEPARTMENT
CHARACTERISTIC
N
%
Overall, how satisfied is worker with SDM® (N = 519)
Very satisfied or satisfied
Neither satisfied nor dissatisfied
Dissatisfied or very dissatisfied
244
188
87
47.0
36.2
16.8
Worker would recommend SDM® to other child welfare
agencies (N = 506)
Yes
No
358
148
70.8
29.2
135
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
APPENDIX B
STUDY RESULTS BY SPA
136
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by SPA
Appendix B
TABLE 1
WORKER CHARACTERISTIC BY SPA (N = 481)7
CHARACTERISTIC
Current CSW file type
Child Protection Hotline
CSW
Emergency CSW
Generic CSW
Family Maintenance/
Reunification SCW
Permanency Planning
CSW
Supervisor CSW
Specialized Program
CSW
Dependency Investigator
SCW
Other
Current job level
CSW trainee
CSW I
CSW II
CSW III
SCSW
Other
Worked for DCFS how
long
Less than 1 year
1-4 years
5-8 years
9 years or more
Worked in current
position how long
Less than 1 year
1-4 years
5-8 years
9 years or more
SPA 1
N = 42
%
SPA 2
N = 55
%
SPA 3
N = 89
%
SPA 4
N = 67
%
SPA 5
N = 31
%
SPA 68
N = 84
%
SPA 7
N = 48
%
SPA 8
N = 65
%
8.7
11.4
18.5
13.9
6.4
17.5
10.0
13.5
0.0
0.0
0.0
4.6
0.0
0.0
0.0
0.0
26.8
17.1
14.6
40.7
9.3
11.1
25.9
18.8
12.9
26.2
21.5
6.2
25.8
12.9
12.9
17.1
29.3
13.4
25.5
19.1
25.5
15.6
23.4
18.8
0.0
5.6
0.0
0.0
3.2
1.2
0.0
3.1
22.0
9.8
22.2
0.0
21.2
3.5
21.5
6.2
29.0
0.0
20.7
3.7
17.1
6.4
23.4
3.1
2.4
3.7
2.4
7.7
3.2
2.4
4.3
3.1
7.3
7.4
15.3
6.1
13.0
12.2
2.1
9.5
4.9
7.3
19.5
36.6
24.4
7.3
1.9
1.9
13.5
51.9
23.1
7.7
4.6
1.1
9.2
55.2
21.8
8.1
16.4
3.0
16.4
34.3
25.4
4.5
3.2
3.2
19.4
38.7
32.3
3.2
11.9
0.0
23.8
39.3
22.6
2.4
4.2
0.0
14.6
60.4
20.8
0.0
6.2
4.6
24.6
36.9
21.5
6.2
2.4
31.7
19.5
46.4
7.5
18.9
26.4
47.2
3.4
9.2
31.1
56.3
21.2
16.7
13.6
48.5
6.5
16.1
29.0
48.4
9.5
26.2
33.3
31.0
2.1
20.8
29.2
47.9
10.8
26.2
33.8
29.2
14.6
51.2
29.3
4.9
21.8
34.6
23.6
20.0
13.6
30.8
26.1
29.5
31.3
35.9
17.9
14.9
12.9
38.7
35.5
12.9
28.9
43.4
19.3
8.4
18.8
33.2
31.3
16.7
26.2
36.9
24.6
12.3
7
The total number of participants was 699. Among them, 136 did not indicate in which office they
currently work, and 82 were working in offices that were not in any SPA. Therefore, 481 participants who
were working in the eight SPAS were included in analyses by SPA.
8
The participant count for SPA 6 is greater than what was reported earlier in this curriculum. After the
preliminary analysis on SPA 6, additional survey responses were received. All of the tables from this point
forward reflect the final participant count for SPA 6.
137
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by SPA
Appendix B
TABLE 2
WORKER PREPAREDNESS FOR SDM® IMPLEMENTATION AND TOOLS USED
BY SPA (N = 481)
CHARACTERISTIC
SPA 1
N = 42
%
SPA 2
N = 55
%
SPA 3
N = 89
%
SPA 4
N = 67
%
SPA 5
N = 31
%
SPA 6
N = 84
%
SPA 7
N = 48
%
SPA 8
N = 65
%
16.7
69.7
9.1
4.5
23.3
63.4
10.0
3.3
12.1
81.9
1.2
4.8
6.3
85.3
6.3
2.1
4.8
72.6
16.1
6.5
1.1
66.3
64.0
70.8
6.0
73.1
73.1
74.6
6.5
71.0
77.4
80.6
0.0
65.5
66.7
79.8
6.3
77.1
83.3
93.8
1.5
69.2
64.6
78.5
48.3
47.8
54.8
60.7
62.5
56.9
32.6
32.8
41.9
48.8
50.0
40.0
At the end of SDM® training, how well prepared
Very prepared
9.8
18.9
21.2
Somewhat prepared
80.5
67.9
60.0
Not at all prepared
7.3
7.5
9.4
Did not receive SDM®
2.4
5.7
9.4
training
Tools completed as part of current job duties9
Hotline/Response Priority
2.5
3.6
Safety Assessment
73.8
80.0
Family Risk Assessment
76.2
78.2
Family Strengths and
83.3
80.0
Needs Assessment
Family Risk
45.2
38.2
Reassessment
Reunification
42.9
30.9
9
The sum of percentages for this question can be over 100 because participants answered all that
applied to them.
138
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by SPA
Appendix B
TABLE 3
SDM UTILIZATION BY SPA (N = 481)10
®
SPA 2
N = 55
%
SPA 3
N = 89
%
SPA 4
N = 67
%
SPA 5
N = 31
%
SPA 6
N = 84
%
SPA 7
N = 48
%
SPA 8
N = 65
%
34.6
59.6
5.8
48.8
39.7
11.5
42.6
52.5
4.9
33.3
66.7
0.0
37.8
53.7
8.5
29.8
68.1
2.1
23.7
67.8
8.5
How accurate the worker finds SDM® to be
Very accurate
15.0
7.7
Somewhat accurate
72.4
76.9
Not at all accurate
12.6
15.4
9.0
79.5
11.5
13.1
83.6
3.3
26.7
70.0
3.3
23.2
72.0
4.8
10.6
87.3
2.1
13.6
81.3
5.1
How well SDM® helps worker arrive at same decision for similar types of cases
Very well
25.0
17.6
15.4
28.3
30.0
30.5
Somewhat well
65.0
54.9
67.9
68.4
70.0
53.6
Not well at all
10.0
27.5
16.7
3.3
0.0
15.9
19.1
72.4
8.5
25.9
60.3
13.8
How often worker agrees with levels assigned to cases (Prior to overrides)
All of the time
7.6
11.8
7.7
5.0
23.3
17.3
Most of the time
46.2
45.1
46.1
60.0
46.7
56.8
Some of the time
46.2
43.1
43.6
33.3
26.7
21.0
Never
0.0
0.0
2.6
1.7
3.3
4.9
8.5
66.0
25.5
0.0
6.9
69.0
22.4
1.7
CHARACTERISTIC
SPA 1
N = 42
%
How easy to use worker finds SDM®
Very easy
30.0
Somewhat easy
62.5
Not at all easy
7.5
When worker does not agree with assigned levels, thinks the levels are too high or too low
Too high
70.3
70.8
65.3
65.6
55.6
62.3
72.1
57.1
Too low
18.9
8.4
10.7
17.2
14.8
7.2
7.0
3.6
Does not apply
10.8
20.8
24.0
17.2
29.6
30.5
20.9
39.3
10
This table contains valid percentages. Missing cases have been excluded.
139
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by SPA
Appendix B
TABLE 4
HOW HELPFUL WORKER FINDS SDM® WHEN MAKING DECISIONS ABOUT…
BY SPA (N = 481)
SPA 2
N = 55
%
SPA 3
N = 89
%
SPA 4
N = 67
%
SPA 5
N = 31
%
SPA 6
N = 84
%
SPA 7
N = 48
%
SPA 8
N = 65
%
18.4
49.0
32.6
19.4
55.6
25.0
24.1
65.6
10.3
24.1
72.4
3.5
32.9
51.3
15.8
20.8
62.5
16.7
27.6
58.6
13.8
Whether to promote a referral to a case
Very helpful
20.0
21.7
Somewhat helpful
51.4
43.5
Not at all helpful
28.6
34.8
16.1
51.6
32.3
33.3
56.3
10.4
26.1
69.6
4.3
31.7
49.2
19.1
28.2
61.5
10.3
31.8
59.1
9.1
Whether to recommend a particular service or intervention to a client
Very helpful
20.0
12.0
15.4
20.4
18.5
Somewhat helpful
40.0
44.0
42.3
59.2
63.0
Not at all helpful
40.0
44.0
42.3
20.4
18.5
23.7
47.4
28.9
14.9
51.1
34.0
25.5
50.0
23.6
Whether to remove a child
Very helpful
Somewhat helpful
Not at all helpful
CHARACTERISTIC
SPA 1
N = 42
%
Whether a child is currently safe
Very helpful
20.0
Somewhat helpful
62.5
Not at all helpful
17.5
20.0
50.0
30.0
16.0
38.0
46.0
21.1
43.7
35.2
28.3
62.3
9.4
25.0
60.7
14.3
31.0
50.0
18.1
20.0
62.2
17.8
32.1
53.6
14.3
Whether to return a child to her/his family
Very helpful
20.6
16.7
Somewhat helpful
50.0
54.7
Not at all helpful
29.4
28.6
19.6
57.4
23.0
25.0
62.5
12.5
23.8
66.7
9.5
30.0
52.9
17.1
20.5
65.9
13.6
25.5
60.8
13.7
Whether to terminate parental rights
Very helpful
21.4
11.4
Somewhat helpful
31.0
37.1
Not at all helpful
44.9
51.5
17.4
53.8
28.8
13.3
46.7
40.0
16.7
44.4
38.9
26.8
33.9
39.3
10.3
55.2
34.5
7.0
67.4
25.6
Whether to close a case
Very helpful
Somewhat helpful
Not at all helpful
19.7
50.7
29.6
25.5
61.7
12.8
30.0
60.0
10.0
29.2
52.8
18.0
22.0
65.9
12.1
30.0
54.0
16.0
16.2
51.4
32.4
18.0
48.0
34.0
140
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by SPA
Appendix B
TABLE 5
HOW EFFECTIVE WORKER THINKS SDM® IS IN HELPING ACHIEVING THE
FOLLOWING GOALS…
BY SPA (N = 481)
CHARACTERISTIC
SPA 1
N = 42
%
SPA 2
N = 55
%
SPA 3
N = 89
%
SPA 4
N = 67
%
SPA 5
N = 31
%
SPA 6
N = 84
%
SPA 7
N = 48
%
SPA 8
N = 65
%
Protecting children
Very effective
Somewhat effective
Not at all effective
Not sure
17.5
75.0
5.0
2.5
7.8
62.8
23.5
5.9
19.2
55.2
19.2
6.4
21.2
68.9
6.6
3.3
21.4
71.4
3.6
3.6
29.6
51.9
11.1
7.4
16.7
68.8
6.3
8.2
26.7
56.7
6.6
10.0
8.3
45.8
27.1
18.8
13.6
47.5
22.0
16.9
Reducing the severity of subsequent abuse/neglect complaints and substantiations
Very effective
10.0
5..9
6.5
9.8
13.8
12.5
10.6
Somewhat effective
35.0
31.4
41.5
50.8
41.4
42.5
40.5
Not at all effective
45.0
49.0
32.5
21.3
20.7
21.2
23.4
Not sure
10.0
13.7
19.5
18.1
24.1
23.8
25.5
13.3
40.0
26.7
20.0
Reducing the rate of foster care placements
Very effective
10.0
5.8
Somewhat effective
47.5
42.3
Not at all effective
37.5
40.4
Not sure
5.0
11.5
Reducing the rate of subsequent abuse/neglect complaints and substantiations
Very effective
12.5
7.8
5.3
6.7
10.3
13.8
Somewhat effective
42.5
39.2
45.3
55.0
51.7
46.2
Not at all effective
35.0
43.2
37.3
20.0
20.7
18.7
Not sure
10.0
9.8
12.1
18.3
17.3
21.3
10.3
39.7
28.2
21.8
16.4
41.0
16.4
26.2
13.8
41.4
27.6
17.2
8.6
44.4
27.2
19.8
8.5
34.1
38.3
19.1
13.3
46.7
18.3
21.7
Reducing the length of stay of children in foster care
Very effective
12.5
3.8
6.4
Somewhat effective
25.0
25.0
35.9
Not at all effective
47.5
46.2
32.1
Not sure
15.0
25.0
25.6
13.8
29.3
24.1
32.8
13.8
24.1
27.6
34.5
8.6
40.7
27.2
23.5
6.3
37.5
35.4
20.8
8.3
35.0
30.0
26.7
Improving assessments of family situations
Very effective
22.5
13.7
22.4
Somewhat effective
57.5
58.8
56.5
Not at all effective
20.0
23.5
13.2
Not sure
0.0
4.0
7.9
21.7
63.3
11.7
3.3
17.2
72.5
6.9
3.4
25.0
61.2
8.8
5.0
16.7
77.0
2.1
4.2
33.3
56.7
8.3
1.7
Increasing consistency in case assessment and case management
Very effective
17.5
18.4
26.0
26.2
27.6
Somewhat effective
52.5
46.9
50.6
59.0
65.5
Not at all effective
27.5
32.7
16.9
8.2
0.0
Not sure
2.5
2.0
6.5
6.6
6.9
30.9
55.5
6.2
7.4
20.8
62.6
8.3
8.3
28.3
53.4
8.3
10.0
141
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by SPA
Appendix B
TABLE 5
HOW EFFECTIVE WORKER THINKS SDM® IS IN HELPING ACHIEVING THE
FOLLOWING GOALS…
BY SPA (N = 481; cont’d)
CHARACTERISTIC
SPA 1
N = 42
%
SPA 2
N = 55
%
SPA 3
N = 89
%
SPA 4
N = 67
%
SPA 5
N = 31
%
SPA 6
N = 84
%
SPA 7
N = 48
%
SPA 8
N = 65
%
Increasing the efficiency of child protection operations by making the best use of available
resources
Very effective
15.0
7.8
15.4
21.3
10.3
20.0
10.4
Somewhat effective
40.0
41.2
47.4
52.5
62.2
58.7
60.5
Not at all effective
35.0
43.2
28.2
21.3
17.2
8.8
20.8
Not sure
10.0
7.8
9.0
4.9
10.3
12.5
8.3
18.3
51.7
20.0
10.0
Providing management with data that is needed for program administration, planning,
evaluation, and budgeting
Very effective
27.5
13.7
26.9
19.7
20.7
25.9
13.0
Somewhat effective
32.5
43.2
32.1
50.8
48.3
40.8
45.7
Not at all effective
22.5
17.6
12.8
13.1
3.4
7.4
17.4
Not sure
17.5
25.5
28.2
16.4
27.6
25.9
23.9
18.3
45.1
18.3
18.3
TABLE 6
EFFECT OF SDM® ON WORKER DECISION MAKING BY SPA
(N = 481)
CHARACTERISTIC
SPA 1
N = 42
%
SPA 2
N = 55
%
SPA 3
N = 89
%
SPA 4
N = 67
%
Effect using SDM® Tools has had on worker decision making
Decision making has
10.0
0.0
9.5
15.0
improved significantly
Decision making has
45.0
29.4
35.1
46.7
improved somewhat
Decision making has
40.0
66.7
55.4
38.3
not really changed
Decision making has
5.0
3.9
0.0
0.0
gotten worse
SPA 5
N = 31
%
SPA 6
N = 84
%
SPA 7
N = 48
%
SPA 8
N = 65
%
6.9
19.2
10.6
13.8
48.3
43.6
46.9
48.3
44.8
34.6
40.4
37.9
0.0
2.6
2.1
0.0
142
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by SPA
Appendix B
TABLE 7
WORKER SATISFACTION WITH SDM® BY SPA
(N = 481)
SPA 1
N = 42
%
SPA 2
N = 55
%
SPA 3
N = 89
%
SPA 4
N = 67
%
SPA 5
N = 31
%
SPA 6
N = 84
%
SPA 7
N = 48
%
SPA 8
N = 65
%
40.0
41.3
59.0
32.8
48.3
44.8
50.0
37.5
47.9
39.6
59.4
23.7
18.7
8.2
6.9
12.5
12.5
16.9
Worker would recommend SDM® to other child welfare agencies
Yes
62.5
53.1
62.5
80.0
82.8
No
37.5
46.9
37.5
20.0
17.2
78.5
21.5
79.5
20.5
72.4
27.6
CHARACTERISTIC
Overall, how satisfied worker is with SDM®
Very satisfied or satisfied
42.5
25.5
Neither satisfied nor
35.0
39.2
dissatisfied
Dissatisfied or very
22.5
35.3
dissatisfied
143
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
APPENDIX C
STUDY RESULTS BY OFFICE
144
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 1
Worker Characteristics by Office: Current CSW File Type
Office
N
%
CP
for within
Emerg. Generic FM/R
hotline
CSW
CSW
SCW
each total
CSW
office sample
PP Supervisor
CSW
CSW
Specialized Dependency
program investigator Other
CSW
SCW
Antelope Valley E.
15
2.7
0
40
0
20
0
20
6.7
6.7
6.7
Antelope Valley W.
27
4.8
0
19.2
26.9
11.5
0
23.1
11.5
0
7.7
Asian Pacific Project
10
1.8
0
0
40
0
0
10
40
0
10
Belvedere
27
4.7
0
25.9
22.2
25.9
0
18.5
3.7
0
3.7
Borax
20
3.6
16.7
5.6
16.7
0
0
22.2
22.2
0
16.7
Century
11
2
0
9.1
36.4
27.3
9.1
18.2
0
0
0
CPH
17
3
58.8
0
0
0
0
35.3
0
0
5.9
Compton
19
3.4
0
21.1
36.8
5.3
0
10.5
5.3
0
21.1
ERCP
9
1.6
0
33.3
0
0
0
55.6
0
0
11.1
Glendora
36
6.4
0
35.3
14.7
11.8
0
23.5
0
2.9
11.8
Hawthorne
13
2.3
0
30.8
30.8
15.4
0
0
7.7
7.7
7.7
Lakewood
38
6.7
0
21.1
23.7
21.1
0
26.3
2.6
0
5.3
Metro North
47
8.5
0
34
23.4
8.5
0
21.3
0
10.6
2.1
North Hollywood
30
5.3
0
41.4
13.8
6.9
3.4
20.7
0
6.9
6.9
Pasadena
23
4.1
0
31.8
13.6
22.7
0
27.3
0
0
4.5
Pomona
30
5.3
0
10.3
27.6
6.9
0
13.8
10.3
3.4
27.6
Santa Clarita
25
4.4
0
40
4
16
8
24
0
0
8
Santa Fe Springs
21
3.7
0
25
15
25
0
15
10
10
0
Torrance
27
4.8
0
7.7
23.1
15.4
7.7
19.2
3.8
7.7
15.4
Wateridge
41
7.3
0
12.8
23.1
12.8
0
33.3
2.6
2.6
12.8
West LA
31
5.5
0
25.8
12.9
12.9
3.2
29
0
3.2
12.9
Other
47
8.2
2.2
15.6
13.3
11.1
0
24.4
6.7
4.4
22.2
145
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 2
Worker Characteristics by Office: Current Job Level
N
for each
office
% within
total
sample
CSW
trainee
CSW I
CSW II
CSW III
SCSW
Other
Antelope Valley East
15
2.7
6.7
0
6.7
66.7
13.3
6.7
Antelope Valley West
27
4.8
3.8
11.5
26.9
19.2
30.8
7.7
Asian Pacific Project
10
1.8
10
0
10
60
20
0
Belvedere
27
4.7
7.4
0
22.2
51.9
18.5
0
Borax
20
3.6
15
0
0
50
20
15
Century
11
2
18.2
0
18.2
45.5
18.2
0
CPH
Office
17
3
0
0
11.8
41.2
41.2
5.9
Compton
19
3.4
26.3
0
26.3
31.6
10.5
5.3
ERCP
9
1.6
0
0
0
33.3
55.6
11.1
Glendora
36
6.4
8.6
0
14.3
42.9
22.9
11.4
Hawthorne
13
2.3
0
0
38.5
53.8
0
7.7
Lakewood
38
6.7
2.6
5.3
23.7
42.1
26.3
0
Metro North
47
8.5
17
4.3
23.4
27.7
27.7
0
North Hollywood
30
5.3
0
3.6
17.9
53.6
21.4
3.6
Pasadena
23
4.1
0
4.5
0
63.6
31.8
0
Pomona
30
5.3
3.3
0
10
63.3
13.3
10
Santa Clarita
25
4.4
4.2
0
8.3
50
25
12.5
Santa Fe Springs
21
3.7
0
0
4.8
71.4
23.8
0
Torrance
27
4.8
11.1
3.7
25.9
29.6
14.8
14.8
Wateridge
41
7.3
7.3
0
19.5
36.6
36.6
0
West Los Angeles
31
5.5
3.2
3.2
19.4
38.7
32.3
3.2
Other
47
8.2
0
0
9.1
25
24.5
40.9
146
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 3
Worker Characteristics by Office: How Long Has Worked For DCFS?
Office
N for each
office
% within
Less than 1
total
year
sample
2.7
0
1-4 years
5-8 years
9 years or
more
20
20
60
Antelope Valley East
15
Antelope Valley West
27
4.8
3.8
38.5
19.2
38.5
Asian Pacific Project
10
1.8
10
10
10
70
Belvedere
27
4.7
3.7
29.6
25.9
40.7
Borax
20
3.6
10
5
10
75
Century
11
2
0
27.3
45.5
27.3
CPH
17
3
0
5.9
35.3
58.8
Compton
19
3.4
26.3
26.3
21.1
26.3
ERCP
9
1.6
0
0
33.3
66.7
Glendora
36
6.4
8.6
11.4
25.7
54.3
Hawthorne
13
2.3
0
46.2
30.8
23.1
Lakewood
38
6.7
5.3
28.9
44.7
21.1
Metro North
47
8.5
26.1
21.7
15.2
37
North Hollywood
30
5.3
3.6
17.9
39.3
39.3
Pasadena
23
4.1
0
4.3
26.1
69.6
Pomona
30
5.3
0
10.3
41.4
48.3
Santa Clarita
25
4.4
12
20
12
56
Santa Fe Springs
21
3.7
0
9.5
33.3
57.1
Torrance
27
4.8
18.5
22.2
18.5
40.7
Wateridge
41
7.3
7.3
19.5
36.6
36.6
West Los Angeles
31
5.5
6.5
16.1
29
48.4
Other
47
8.2
4.4
8.9
31.1
55.6
147
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 4
Worker Characteristics by Office: How Long Has Worked In Current Position?
N for
each
office
% within
total
sample
Less than 1
year
1-4 years
5-8 years
9 years or
more
Antelope Valley East
15
2.7
6.7
46.7
40
6.7
Antelope Valley West
27
4.8
19.2
53.8
23.1
3.8
Asian Pacific Project
10
1.8
30
10
30
30
Belvedere
27
4.7
25.9
33.3
37
3.7
Borax
20
3.6
25
30
35
10
Century
11
2
9.1
45.5
27.3
18.2
CPH
17
3
11.8
47.1
23.5
17.6
Compton
19
3.4
36.8
42.1
21.1
0
ERCP
9
1.6
11.1
44.4
0
44.4
Glendora
36
6.4
17.1
28.6
22.9
31.4
Hawthorne
13
2.3
30.8
61.5
7.7
0
Lakewood
38
6.7
15.8
39.5
34.2
10.5
Metro North
47
8.5
34
38.3
10.6
17
North Hollywood
30
5.3
16.7
43.3
26.7
13.3
Pasadena
23
4.1
8.7
13
43.5
34.8
Pomona
30
5.3
13.3
46.7
16.7
23.3
Santa Clarita
25
4.4
28
24
20
28
Santa Fe Springs
21
3.7
9.5
33.3
23.8
33.3
Torrance
27
4.8
40.7
33.3
11.1
14.8
Wateridge
41
7.3
30
37.5
20
12.5
West Los Angeles
31
5.5
12.9
38.7
35.5
12.9
Other
47
8.2
6.7
40
40
13.3
Office
148
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 5
Worker Preparedness for SDM Implementation and Tools Used by Office:
at the End of SDM® Training, How Well Prepared?
®
N for
each
office
% within
total
sample
Very
prepared
Somewhat
prepared
Not at all
prepared
Did not
receive SDM
training
Antelope Valley East
15
2.7
6.7
80
13.3
0
Antelope Valley West
27
4.8
11.5
80.8
3.8
3.8
Asian Pacific Project
10
1.8
20
80
0
0
Belvedere
27
4.7
3.7
85.2
11.1
0
Borax
20
3.6
10.5
68.4
5.3
15.8
Century
11
2
18.2
72.7
0
9.1
CPH
17
3
41.2
52.9
5.9
0
Compton
19
3.4
5.3
89.5
0
5.3
ERCP
9
1.6
22.2
66.7
0
11.1
Glendora
36
6.4
25.7
60
2.9
11.4
Hawthorne
13
2.3
15.4
69.2
0
15.4
Lakewood
38
6.7
2.7
83.8
13.5
0
Metro North
47
8.5
19.1
70.2
10.6
0
North Hollywood
30
5.3
27.6
65.5
3.4
3.4
Pasadena
23
4.1
27.3
63.6
4.5
4.5
Pomona
30
5.3
10.7
57.1
21.4
10.7
Santa Clarita
25
4.4
8.3
70.8
12.5
8.3
Santa Fe Springs
21
3.7
9.5
85.7
0
4.8
Torrance
27
4.8
8
56
20
16
Wateridge
41
7.3
12.5
85
2.5
0
West Los Angeles
31
5.5
23.3
63.3
10
3.3
Other
47
8.2
27.9
65.1
0
7
Office
149
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 6
Worker Preparedness for SDM Implementation and Tools Used by Office:
Tools Completed as Part of Current Job Duties
®
N for
each
office
% within
total
sample
Hotline/
Response
Safety
Family Risk
Family
Strengths
and Needs
Family Risk
Reass.
Reunifi.
Antelope Valley East
15
2.7
6.7
86.7
86.7
86.7
33.3
33.3
Antelope Valley West
27
4.8
0
66.7
70.4
81.5
51.9
48.1
Asian Pacific Project
10
1.8
0
100
100
100
90
70
Belvedere
27
4.7
7.4
88.9
88.9
96.3
66.7
48.1
Borax
20
3.6
20
50
45
40
30
15
Century
11
2
0
90.9
72.7
81.8
72.7
54.5
CPH
17
3
94.1
11.8
11.8
5.9
5.9
5.9
Compton
19
3.4
0
52.6
52.6
73.7
52.6
52.6
ERCP
9
1.6
22.2
88.9
66.7
11.1
11.1
0
Glendora
36
6.4
0
75
72.2
75
44.4
27.8
Hawthorne
Office
13
2.3
0
61.5
69.2
76.9
53.8
30.8
Lakewood
38
6.7
2.6
78.9
73.7
86.8
55.3
44.7
Metro North
47
8.5
0
83
85.1
89.4
55.3
40.4
North Hollywood
30
5.3
3.3
73.3
76.7
80
36.7
26.7
Pasadena
23
4.1
0
78.3
73.9
78.3
52.2
43.5
Pomona
30
5.3
3.3
46.7
46.7
60
50
30
Santa Clarita
25
4.4
4
88
80
80
40
36
Santa Fe Springs
21
3.7
4.8
61.9
76.2
90.5
57.1
52.4
Torrance
27
4.8
0
55.6
51.9
66.7
59.3
33.3
Wateridge
41
7.3
0
65.9
70.7
82.9
63.4
51.2
West Los Angeles
31
5.5
6.5
71
77.4
80.6
84.8
41.9
Other
47
8.2
13
58.7
50
54.3
41.3
30.4
150
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 7
SDM Utilization by Office: How Easy to Use Worker Finds SDM®
®
N for each
office
% within
total sample
Very easy
Somewhat
easy
Not at all
easy
Antelope Valley East
15
2.7
28.6
57.1
14.3
Antelope Valley West
27
4.8
30.8
65.4
3.8
Asian Pacific Project
10
1.8
30
70
0
Belvedere
27
4.7
22.2
74.1
3.7
Borax
20
3.6
26.7
73.3
0
Century
11
2
36.4
54.5
9.1
CPH
17
3
64.7
23.5
11.8
Compton
19
3.4
31.6
57.9
10.5
ERCP
9
1.6
33.3
55.6
11.1
Glendora
36
6.4
53.1
43.8
3.1
Hawthorne
13
2.3
38.5
61.5
0
Lakewood
38
6.7
29.7
64.9
5.4
Metro North
47
8.5
47.8
45.7
6.5
North Hollywood
30
5.3
27.6
62.1
10.3
Pasadena
23
4.1
52.4
28.6
19
Pomona
30
5.3
40
44
16
Santa Clarita
25
4.4
43.5
56.5
0
Santa Fe Springs
21
3.7
40
60
0
Torrance
27
4.8
13.6
72.7
13.6
Wateridge
41
7.3
41
48.7
10.3
West Los Angeles
31
5.5
33.3
66.7
0
Other
47
8.2
48.8
48.8
2.4
Office
151
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 8
SDM Utilization by Office: How Accurate the Worker Finds SDM® to be
®
Office
% within
N for each
total sample
office
Very
accurate
Somewhat
accurate
Not at all
accurate
Antelope Valley East
15
2.7
7.1
78.6
14.3
Antelope Valley West
27
4.8
19.2
69.2
11.5
Asian Pacific Project
10
1.8
11.1
88.9
0
Belvedere
27
4.7
14.8
81.5
3.7
Borax
20
3.6
0
100
0
Century
11
2
27.3
63.6
9.1
CPH
17
3
11.8
76.5
11.8
Compton
19
3.4
26.3
73.7
0
ERCP
9
1.6
11.1
77.8
11.1
Glendora
36
6.4
12.5
81.3
6.3
Hawthorne
13
2.3
23.1
69.2
7.7
Lakewood
38
6.7
8.1
83.8
8.1
Metro North
47
8.5
17.4
78.3
4.3
North Hollywood
30
5.3
6.9
75.9
17.2
Pasadena
23
4.1
9.5
81
9.5
Pomona
30
5.3
4
76
20
Santa Clarita
25
4.4
8.7
78.3
13
Santa Fe Springs
21
3.7
5
95
0
Torrance
27
4.8
22.7
77.3
0
Wateridge
41
7.3
20.5
74.4
5.1
West Los Angeles
31
5.5
26.7
70
3.3
Other
47
8.2
29.3
64.3
7.3
152
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 9
SDM Utilization by Office:
How Well SDM® Helps Worker Arrive at Same Decision for Similar Types of Cases
®
N for each
office
% within
total sample
Very well
Somewhat
well
Not well
at all
Antelope Valley East
15
2.7
28.6
57.1
14.3
Antelope Valley West
27
4.8
23.1
69.2
7.7
Asian Pacific Project
10
1.8
20
80
0
Belvedere
27
4.7
18.5
70.4
11.1
Borax
20
3.6
21.4
78.6
0
Century
11
2
45.5
36.4
18.2
CPH
17
3
11.8
64.7
23.5
Compton
19
3.4
31.6
57.9
10.5
ERCP
9
1.6
22.2
44.4
33.3
Glendora
36
6.4
12.5
75
12.5
Hawthorne
13
2.3
15.4
61.5
23.1
Lakewood
38
6.7
21.6
59.5
18.9
Metro North
47
8.5
30.4
65.2
4.3
North Hollywood
30
5.3
21.4
50
28.6
Pasadena
23
4.1
19
66.7
14.3
Pomona
30
5.3
16
60
24
Santa Clarita
25
4.4
13
60.9
26.1
Santa Fe Springs
21
3.7
20
75
5
Torrance
27
4.8
33.3
61.9
4.8
Wateridge
41
7.3
30.8
53.8
15.4
West Los Angeles
31
5.5
30
70
0
Other
47
8.2
28.2
53.8
17.9
Office
153
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 10
SDM Utilization by Office:
How Often Worker Agrees with Levels Assigned to Cases (Prior to Overrides)
®
Antelope Valley East
N
for each
office
15
% within
total
sample
2.7
Antelope Valley West
27
Asian Pacific Project
Office
All of the
time
Most of the Some of the
time
time
Never
0
50
50
0
4.8
12
44
44
0
10
1.8
20
70
10
0
Belvedere
27
4.7
3.7
70.4
25.9
0
Borax
20
3.6
7.1
64.3
28.6
0
Century
11
2
18.2
54.5
18.2
9.1
CPH
17
3
0
76.5
23.5
0
Compton
19
3.4
26.3
47.4
21.1
5.3
ERCP
9
1.6
0
66.7
33.3
0
Glendora
36
6.4
6.3
43.8
46.9
3.1
Hawthorne
13
2.3
8.3
58.3
33.3
0
Lakewood
38
6.7
5.4
67.6
27
0
Metro North
47
8.5
4.3
58.7
34.8
2.2
North Hollywood
30
5.3
14.3
50
35.7
0
Pasadena
23
4.1
9.5
52.4
38.1
0
Pomona
30
5.3
8
44
44
4
Santa Clarita
25
4.4
8.7
39.1
52.2
0
Santa Fe Springs
21
3.7
15
60
25
0
Torrance
27
4.8
9.5
71.4
14.3
4.8
Wateridge
41
7.3
15.4
61.5
17.9
5.1
West Los Angeles
31
5.5
23.3
46.7
26.7
3.3
47
8.2
7.9
60.5
28.9
2.6
Other
154
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 11
SDM Utilization by Office:
When Worker Does Not Agree With Assigned Levels,
Thinks the Levels Are Too High or Too Low
®
N for each
office
% within
total sample
Too high
Too low
Does not
apply
Antelope Valley East
15
2.7
57.1
28.6
14.3
Antelope Valley West
27
4.8
78.3
13
8.7
Asian Pacific Project
10
1.8
28.6
14.3
57.1
Belvedere
27
4.7
73.1
7.7
19.2
Borax
20
3.6
61.5
23.1
15.4
Century
11
2
60
0
40
CPH
17
3
29.4
52.9
17.6
Compton
19
3.4
60
6.7
33.3
ERCP
9
1.6
55.6
0
44.4
Glendora
36
6.4
77.4
9.7
12.9
Hawthorne
13
2.3
81.8
0
18.2
Lakewood
38
6.7
68.6
2.9
28.6
Metro North
47
8.5
66.7
15.6
17.8
North Hollywood
30
5.3
72
4
24
Pasadena
23
4.1
65
10
25
Pomona
30
5.3
50
12.5
37.5
Santa Clarita
25
4.4
69.6
13
17.4
Santa Fe Springs
21
3.7
70.6
5.9
23.5
Torrance
27
4.8
38.1
4.8
57.1
Wateridge
41
7.3
57.6
12.1
30.3
West Los Angeles
31
5.5
55.6
14.8
29.6
Other
47
8.2
47.4
21.1
31.6
Office
155
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 12
How Helpful Worker Finds SDM When Making Decisions About…by Office:
Whether a Child is Currently Safe
®
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for each
office
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
% within
total
sample
2.7
4.8
1.8
4.7
3.6
2
3
3.4
1.6
6.4
2.3
6.7
8.5
5.3
4.1
5.3
4.4
3.7
4.8
7.3
5.5
8.2
Very
helpful
Somewhat
helpful
Not at all
helpful
21.4
19.2
50
25.9
21.4
40
20
33.3
25
21.4
23.1
25
25
11.5
20
16.7
26.1
14.3
31.8
34.3
24.1
30.6
50
69.2
20
59.3
78.6
50
46.7
55.6
50
60.7
61.5
52.8
61.4
57.7
45
58.3
39.1
66.7
68.2
45.7
72.4
50
28.6
11.5
30
14.8
0
10
33.3
11.1
25
17.9
15.4
22.2
13.6
30.8
35
25
34.8
19
0
20
3.4
19.4
156
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 13
How Helpful Worker Finds SDM When Making Decisions About…by Office:
Whether to Promote a Referral to a Case
®
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for
each
office
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
% within
total
sample
2.7
4.8
1.8
4.7
3.6
2
3
3.4
1.6
6.4
2.3
6.7
8.5
5.3
4.1
5.3
4.4
3.7
4.8
7.3
5.5
8.2
Very
helpful
Somewhat
helpful
Not at all
helpful
23.1
18.2
40
36
40
33.3
25
40
25
11.5
16.7
26.9
31.6
20.8
25
15
22.7
14.3
38.9
33.3
26.1
30.3
30.8
63.6
50
52
60
55.6
50
33.3
50
53.8
66.7
61.5
55.3
50
50
50
36.4
78.6
55.6
48.1
69.6
51.5
46.2
18.2
10
12
0
11.1
25
26.7
25
34.6
16.7
11.5
13.2
29.2
25
35
40.9
7.1
5.6
18.5
4.3
18.2
157
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 14
How Helpful Worker Finds SDM When Making Decisions About…by Office:
Whether to Recommend a Particular Service or Intervention to a Client
®
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for
each
office
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
% within
total
sample
2.7
4.8
1.8
4.7
3.6
2
3
3.4
1.6
6.4
2.3
6.7
8.5
5.3
4.1
5.3
4.4
3.7
4.8
7.3
5.5
8.2
Very
helpful
Somewhat
helpful
Not at all
helpful
14.3
23.1
10
18.5
27.3
50
0
22.2
12.5
14.3
7.7
22.9
18.6
11.1
10
21.7
13
10
30
22.9
18.5
23.5
35.7
42.3
70
55.6
63.6
40
0
61.1
50
50
61.5
45.7
58.1
59.3
45
30.4
26.1
45
60
37.1
63
47.1
50
34.6
20
25.9
9.1
10
100
16.7
37.5
35.7
30.8
31.4
23.3
29.6
45
47.8
60.9
45
10
40
18.5
29.4
158
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 15
How Helpful Worker Finds SDM When Making Decisions About…by Office:
Whether to Remove a Child
®
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for
each
office
% within
total
sample
Very
helpful
Somewhat
helpful
Not at all
helpful
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
2.7
4.8
1.8
4.7
3.6
2
3
3.4
1.6
6.4
2.3
6.7
8.5
5.3
4.1
5.3
4.4
3.7
4.8
7.3
5.5
8.2
21.4
19.2
50
30.8
30
60
20
47.1
25
24.1
0
32.4
27.9
14.8
20
18.2
17.4
5.3
31.8
26.5
25.6
30.3
35.7
57.7
20
53.8
70
30
60
29.4
50
44.8
72.7
47.1
60.5
44.4
40
45
30.4
73.7
63.6
58.8
60.7
39.4
42.9
23.1
30
15.4
0
10
20
23.5
25
31
27.3
20.6
11.6
40.7
40
36.4
52.2
21.1
4.5
14.7
14.3
30.3
159
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 16
How Helpful Worker Finds SDM When Making Decisions About…by Office:
Whether to Return a Child to Her/His Family
®
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for
each
office
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
% within
total
sample
2.7
4.8
1.8
4.7
3.6
2
3
3.4
1.6
6.4
2.3
6.7
8.5
5.3
4.1
5.3
4.4
3.7
4.8
7.3
5.5
8.2
Very
helpful
Somewhat
helpful
Not at all
helpful
23.1
19
40
26.1
37.5
44.4
0
41.2
14.3
20.8
16.7
23.3
21.9
17.4
23.5
15
15.8
14.3
28.6
25
23.8
36.7
38.5
57.1
40
65.2
50
44.4
66.7
41.2
42.9
58.3
66.7
53.3
65.6
56.5
52.9
60
52.6
66.7
71.4
56.3
66.7
36.7
38.4
23.8
20
8.7
12.5
11.2
33.3
17.6
42.9
20.8
16.7
23.3
12.5
26.1
23.5
25
31.6
19
0
18.8
9.5
26.7
160
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 17
How Helpful Worker Finds SDM When Making Decisions About…by Office:
Whether to Terminate Parental Rights
®
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for
each
office
% within
total
sample
Very
helpful
Somewhat
helpful
Not at all
helpful
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
2.7
4.8
1.8
4.7
3.6
2
3
3.4
1.6
6.4
2.3
6.7
8.5
5.3
4.1
5.3
4.4
3.7
4.8
7.3
5.5
8.2
30
21.1
11.1
11.8
28.6
57.1
0
38.4
25
27.3
0
4
8.7
11.1
15.4
5.9
11.8
8.3
11.1
23.1
16.7
16.7
10
42.1
44.4
64.7
14.3
14.3
33.3
30.8
25
50
50
60
56.5
38.9
61.5
52.9
35.3
41.7
77.8
34.6
44.4
50
60
36.8
44.4
23.5
57.1
28.6
66.7
30.8
50
22.7
50
36
34.8
50
23.1
41.2
52.9
50
11.1
42.3
38.9
33.3
161
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 18
How Helpful Worker Finds SDM When Making Decisions About…by Office:
Whether to Close a Case
®
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for
each
office
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
% within
total
sample
2.7
4.8
1.8
4.7
3.6
2
3
3.4
1.6
6.4
2.3
6.7
8.5
5.3
4.1
5.3
4.4
3.7
4.8
7.3
5.5
8.2
Very
helpful
Somewhat
helpful
Not at all
helpful
21.4
13
30
32
20
44.4
0
35.3
42.9
24.1
7.7
27.6
27
20.9
20
13.6
8.7
6.2
33.3
30.3
30
21.9
28.6
65.3
50
64
80
44.4
66.7
47.1
42.9
48.3
76.9
51.7
56.8
40.7
60
45.5
56.5
68.8
57.1
48.5
60
59.4
50
21.7
20
4
0
11.1
33.3
17.6
14.2
27.6
15.4
20.7
16.2
33.3
20
40.9
34.8
25
9.5
21.2
10
18.8
162
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 19
How Effective Worker Thinks SDM® is in Helping Achieve
the Following Goals…by Office:
Protecting Children
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for
each
office
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
% within
total
sample
2.7
4.8
1.8
4.7
3.6
2
3
3.4
1.6
6.4
2.3
6.7
8.5
5.3
4.1
5.3
4.4
3.7
4.8
7.3
5.5
8.2
Very
effective
Somewhat
effective
Not at all
effective
Not sure
14.3
19.2
30
18.5
31.3
36.4
11.8
44.4
0
18.8
15.4
24.3
17.8
7.1
23.8
16
8.7
14.3
30.4
25.6
21.4
17.5
85.7
69.2
30
70.4
62.5
36.4
64.7
44.4
66.7
59.4
69.2
59.5
71.1
64.3
47.6
56
60.9
66.7
52.2
53.8
71.4
60
0
7.7
30
7.4
0
9.1
17.6
11.1
33.3
12.5
7.7
10.8
8.9
21.4
28.6
20
26.1
4.8
0
12.8
3.6
12.5
0
3.8
10
3.7
6.3
18.2
5.9
0
0
9.4
7.7
5.4
2.2
7.1
0
8
4.3
14.3
17.4
7.7
3.6
10
163
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 20
How Effective Worker Thinks SDM® is in Helping Achieve
the Following Goals…by Office:
Reducing the Rate of Subsequent Abuse/Neglect Complaints and Substantiations
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for
each
office
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
% within
total
sample
2.7
4.8
1.8
4.7
3.6
2
3
3.4
1.6
6.4
2.3
6.7
8.5
5.3
4.1
5.3
4.4
3.7
4.8
7.3
5.5
8.2
Very
effective
Somewhat
effective
Not at all
effective
Not sure
7.1
15.4
20
11.1
6.7
18.2
0
16.7
0
9.7
15.4
8.3
6.7
10.7
0
4.2
4.3
4.8
21.7
10.5
10.3
21.1
42.9
42.3
40
44.4
53.3
27.3
29.4
44.4
55.6
41.9
46.2
47.2
55.6
42.9
50
45.8
34.8
47.6
47.8
52.6
51.7
26.3
35.7
34.6
20
33.3
13.3
18.2
47.1
11.1
44.4
35.5
23.1
27.8
22.2
32.1
45
33.3
56.5
19
13
21.1
20.7
31.6
14.3
7.7
20
11.1
26.7
36.4
23.5
27.8
0
12.9
15.4
16.7
15.6
14.3
5
16.7
4.3
28.6
17.4
15.8
17.2
21.1
164
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 21
How Effective Worker Thinks SDM® is in Helping Achieve
the Following Goals…by Office:
Reducing the Severity of Subsequent Abuse/Neglect Complaints and
Substantiations
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for
each
office
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
% within
Very
Somewhat Not at all
total
effective effective effective
sample
2.7
7.1
28.6
50
4.8
11.5
38.5
42.3
1.8
40
20
30
4.7
15.4
38.5
26.9
3.6
6.3
62.5
12.5
2
27.3
27.3
18.2
3
0
17.6
47.1
3.4
16.7
33.3
16.7
1.6
0
66.7
33.3
6.4
9.7
45.2
25.8
2.3
0
53.8
15.4
6.7
10.8
32.4
35.1
8.5
11.1
46.7
24.4
5.3
6.9
37.9
37.9
4.1
4.8
28.6
42.9
5.3
4
48
32
4.4
4.5
22.7
63.6
3.7
4.8
42.9
19
4.8
17.4
52.2
13
7.3
10.5
47.4
26.3
5.5
13.8
41.4
20.7
8.2
10
32.5
30
Not sure
14.3
7.7
10
19.2
18.8
27.3
35.3
33.3
0
19.4
30.8
21.6
17.8
17.2
23.8
16
9.1
33.3
17.4
15.8
24.1
27.5
165
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 22
How Effective Worker Thinks SDM® is in Helping Achieve
the Following Goals…by Office:
Reducing the Rate of Foster Care Placements
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for % within
Very
each
total
effective
office sample
2.7
7.1
15
4.8
11.5
27
1.8
10
10
4.7
11.5
27
3.6
12.5
20
2
9.1
11
3
0
17
3.4
5.6
19
1.6
11.1
9
6.4
12.5
36
2.3
0
13
6.7
10.8
38
8.5
17.8
47
5.3
6.9
30
4.1
9.5
23
5.3
8
30
4.4
4.3
25
3.7
4.8
21
4.8
17.4
27
7.3
12.8
41
5.5
13.8
31
8.2
12.5
47
Somewhat
effective
Not at all
effective
Not sure
42.9
50
30
30.8
43.8
45.5
29.4
44.4
33.3
37.5
53.8
43.2
40
34.5
33.3
48
52.2
38.1
52.2
41
41.4
40
50
30.8
40
46.2
18.8
18.2
23.5
27.8
33.3
25
46.2
21.6
15.6
44.8
33.3
28
34.8
28.6
13
23.1
27.6
27.5
0
7.7
20
11.5
25
27.3
47.1
22.2
22.2
25
0
24.3
26.7
13.8
23.8
16
8.7
28.6
17.4
23.1
17.2
20
166
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 23
How Effective Worker Thinks SDM® Is in Helping Achieve
the Following Goals…by Office:
Reducing the Length of Stay for Children in Foster Care
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for
each
office
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
% within
Very
Somewhat
total
effective effective
sample
2.7
7.1
28.6
4.8
15.4
23.1
1.8
10
40
4.7
7.4
40.7
3.6
14.3
28.6
2
18.2
36.4
3
0
6.3
3.4
16.7
33.3
1.6
0
44.4
6.4
9.4
34.4
2.3
0
53.8
6.7
5.4
27
8.5
13.6
29.5
5.3
3.4
24.1
4.1
9.5
28.6
5.3
0
44
4.4
4.3
26.1
3.7
4.8
33.3
4.8
13
47.8
7.3
5.1
41
5.5
13.8
24.1
8.2
12.8
17.9
Not at all
effective
Not sure
50
46.2
40
37
14.3
27.3
37.5
27.8
33.3
25
23.1
37.8
27.3
41.4
38.1
36
52.2
33.3
17.4
28.2
27.6
30.8
14.3
15.4
10
14.8
42.9
18.2
56.3
22.2
22.2
31.3
23.1
29.7
29.5
31
23.8
20
17.4
28.6
21.7
25.6
34.5
38.5
167
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 24
How Effective Worker Thinks SDM® Is in Helping Achieve
the Following Goals…by Office:
Improving Assessments of Family Situations
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for
each
office
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
% within
Very
Somewhat
total
effective effective
sample
2.7
7.1
71.4
4.8
30.8
50
1.8
40
40
4.7
14.8
81.5
3.6
18.8
62.5
2
36.4
45.5
3
6.3
43.8
3.4
35.3
58.8
1.6
22.2
44.4
6.4
29
51.6
2.3
15.4
76.9
6.7
32.4
54.1
8.5
22.7
63.6
5.3
17.9
50
4.1
20
55
5.3
16
64
4.4
8.7
69.6
3.7
19
71.4
4.8
34.8
60.9
7.3
20.5
61.5
5.5
17.2
72.4
8.2
24.4
61
Not at all
effective
Not sure
21.4
19.2
20
3.7
6.3
9.1
18.8
5.9
33.3
12.9
7.7
10.8
13.6
25
15
12
21.7
0
4.3
10.3
6.9
12.2
0
0
0
0
12.5
9.1
31.3
0
0
6.5
0
2.7
0
7.1
10
8
0
9.5
0
7.7
3.4
2.4
168
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 25
How Effective Worker Thinks SDM® Is in Helping Achieve
the Following Goals…by Office:
Increasing Consistency in Case Assessment and Case Management
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for
each
office
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
% within
total
sample
2.7
4.8
1.8
4.7
3.6
2
3
3.4
1.6
6.4
2.3
6.7
8.5
5.3
4.1
5.3
4.4
3.7
4.8
7.3
5.5
8.2
Very
effective
Somewhat
effective
Not at all
effective
Not
sure
21.4
15.4
40
18.5
18.8
36.4
18.8
33.3
33.3
25.8
15.4
29.7
28.9
14.8
33.3
20
22.7
23.8
26.1
33.3
27.6
36.6
64.3
46.2
50
66.7
75
45.5
18.8
66.7
55.6
51.6
76.9
48.6
53.3
55.6
38.1
60
36.4
57.1
60.9
46.2
65.5
43.9
14.3
34.6
10
7.4
0
9.1
12.5
0
11.1
16.1
0
13.5
11.1
25.9
19
16
40.9
9.5
0
10.3
0
14.6
0
3.8
0
7.4
6.3
9.1
50
0
0
6.5
7.7
8.1
6.7
3.7
9.5
4
0
9.5
13
10.3
6.9
4.9
169
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 26
How Effective Worker Thinks SDM® Is in Helping Achieve the Following
Goals…by Office: Increasing the Efficiency of Child Protection Operations by
Making the Best Use of Available Resources
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for
each
office
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
% within
total
sample
2.7
4.8
1.8
4.7
3.6
2
3
3.4
1.6
6.4
2.3
6.7
8.5
5.3
4.1
5.3
4.4
3.7
4.8
7.3
5.5
8.2
Very
Somewhat
effective effective
7.1
19.2
20
11.1
31.3
36.4
12.5
16.7
22.2
15.6
7.7
10.8
17.8
3.6
23.8
8
13
9.5
30.4
21.1
10.3
18.4
42.9
38.5
40
59.3
50
27.3
25
66.7
44.4
40.6
69.2
51.4
53.3
50
38.1
64
30.4
61.9
52.2
60.5
62.1
35.9
Not at all
effective
Not
sure
42.9
30.8
30
25.9
12.5
9.1
31.3
11.1
22.2
31.3
7.7
24.3
24.4
35.7
28.6
24
52.2
14.3
13
7.9
17.2
25.6
7.1
11.5
10
3.7
6.3
27.3
31.3
5.6
11.1
12.5
15.4
13.5
4.4
10.7
9.5
4
4.3
14.3
4.3
10.5
10.3
23.1
170
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 27
How Effective Worker Thinks SDM® Is in Helping Achieve the Following
Goals…by Office: Providing Management with Data that is needed for Program
Administration, Planning, Evaluation, and Budgeting
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for
each
office
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
% within
total
sample
2.7
4.8
1.8
4.7
3.6
2
3
3.4
1.6
6.4
2.3
6.7
8.5
5.3
4.1
5.3
4.4
3.7
4.8
7.3
5.5
8.2
Very
Somewhat Not at all
effective effective effective
35.7
23.1
30
12
25
27.3
12.5
33.3
22.2
21.9
23.1
8.1
17.8
3.6
47.6
16
26.1
14.3
34.8
23.1
20.7
25
7.1
46.2
50
52
56.3
27.3
18.8
38.9
44.4
25
61.5
45.9
48.9
50
28.6
44
34.8
38.1
43.5
38.5
48.3
42.5
21.4
23.1
0
12
12.5
9.1
18.8
11.1
33.3
21.9
0
27
13.3
14.3
0
12
21.7
23.8
4.3
7.7
3.4
7.5
Not
sure
35.7
7.7
20
24
6.3
36.4
50
16.7
0
31.3
15.4
18.9
20
32.1
23.8
28
17.4
23.8
17.4
30.8
27.6
25
171
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 28
Effect of SDM on Worker Decision Making by Office:
Effect Using SDM Tools Has Had on Worker Decision Making
®
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
Decision
N for % within
making has
each
total
improved
office sample
significantly
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
2.7
4.8
1.8
4.7
3.6
2
3
3.4
1.6
6.4
2.3
6.7
8.5
5.3
4.1
5.3
4.4
3.7
4.8
7.3
5.5
8.2
14.3
7.7
11.1
11.1
12.5
20
6.7
27.8
12.5
13.3
16.7
5.6
15.9
0
4.8
8.7
0
10
27.3
15.8
6.9
13.2
Decision
Decision
Decision
making has making has making has
gotten
not really
improved
worse
somewhat changed
28.6
53.8
44.4
48.1
50
40
13.3
55.6
37.5
30
58.3
52.8
45.5
35.7
47.6
30.4
21.7
45
40.9
34.2
48.3
31.6
42.9
38.5
44.4
37
37.5
40
73.3
16.7
37.5
56.7
16.7
41.7
38.6
57.1
47.6
60.9
78.3
45
31.8
47.4
44.8
55.3
14.3
0
0
3.7
0
0
6.7
0
12.5
0
8.3
0
0
7.1
0
0
0
0
0
2.6
0
0
172
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 29
Worker Satisfaction with SDM® by Office:
Overall, How Satisfied Worker is with SDM®
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for
each
office
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
Neither
% within
Very satisfied
satisfied nor
total
or satisfied
dissatisfied
sample
2.7
4.8
1.8
4.7
3.6
2
3
3.4
1.6
6.4
2.3
6.7
8.5
5.3
4.1
5.3
4.4
3.7
4.8
7.3
5.5
8.2
35.7
46.1
50
51.9
50
45.5
23.5
61.1
55.5
40
30.8
52.8
62.2
28.6
42.9
37.5
21.7
42.9
69.6
52.6
48.2
53.9
28.6
38.5
40
29.6
43.8
36.4
58.8
27.8
11.1
46.7
61.5
25
28.9
39.3
33.3
41.7
39.1
52.4
21.7
34.2
44.8
30.8
Dissatisfied
or very
dissatisfied
35.7
15.4
10
18.5
6.3
18.2
17.7
11.1
33.3
13.4
7.7
22.2
8.9
32.1
23.8
20.8
39.1
4.8
8.7
13.2
6.9
15.4
173
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Study Results by Office
Appendix C
Table 30
Worker Satisfaction with SDM® by Office:
Worker Would Recommend SDM® to Other Child Welfare Agencies
Office
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
CPH
Compton
ERCP
Glendora
Hawthorne
Lakewood
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Santa Fe Springs
Torrance
Wateridge
West Los Angeles
Other
N for each
office
% within total
sample
Yes
No
15
27
10
27
20
11
17
19
9
36
13
38
47
30
23
30
25
21
27
41
31
47
2.7
4.8
1.8
4.7
3.6
2
3
3.4
1.6
6.4
2.3
6.7
8.5
5.3
4.1
5.3
4.4
3.7
4.8
7.3
5.5
8.2
50
69.2
66.7
80.8
87.5
81.8
50
83.3
66.7
71.4
69.2
66.7
77.3
53.6
55
58.3
52.4
77.8
81.8
78.4
82.8
75
50
30.8
33.3
19.2
12.5
18.2
50
16.7
33.3
28.6
30.8
33.3
22.7
46.4
45
41.7
47.6
22.2
18.2
21.6
17.2
25
174
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
HANDOUTS
175
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Handout 1
READING LIST ON ACTUARIAL RISK ASSESSMENT
Baird, S. C., & Wagner, D. (2000). The relative validity of actuarial- and consensusbased risk assessment systems. Children and Youth Services Review, 22, 839871.
Baird, C., Wagner, D., Healy, T., & Johnson, K. (1999). Risk assessment in child
protective services: Consensus and actuarial model reliability. Child Welfare,
78(6), 723-748.
Baumann, D. J., Law, J. R., Sheets, J., Reid, G., & Graham, J. C. (2005). Evaluating the
effectiveness of actuarial risk assessment models. Children and Youth Services
Review, 27, 465-490.
Camasso, M. J., & Jagannathan, R. (2000). Modeling the reliability and predictive
validity of risk assessment in child protective services. Children and Youth
Services Review, 22(11/12), 873-896.
Cash, S. J. (2001). Risk assessment in child welfare: The art and science. Children and
Youth Services Review, 23(11), 811-830.
Dawes, R. M., Faust, D., & Meehl, P. E. (1989). Clinical versus actuarial judgment.
Science, 243, 1668-1674.
DePanfilis, D., & Scannapieco, M. (1994). Assessing the safety of children at risk of
maltreatment: Decision-making models. Child Welfare, 73(3), 229-238.
English, D. J., & Pecora, P. J. (1994). Risk assessment as a practice method in child
protective services. Child Welfare, 73(5), 451-466.
Fluke, J., Edwards, M., Bussey, M., Wells, S., & Johnson, W. (2001). Reducing
recurrence in child protective services: Impact of a targeted safety protocol. Child
Maltreatment, 6(3), 207-218.
Gambril, E. (1997). Social work practice: A critical thinker’s guide. New York: Oxford
University Press.
Gambrill, E., & Shlonsky, A. (2001). The need for comprehensive risk management
systems in child welfare. Children and Youth Services Review, 23(1), 79-107.
Gambrill, E., & Shlonsky, A. (2000). Risk assessment in context. Children and Youth
Services Review, 22(11/12), 813-837.
176
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Handout 1
Goddard, C. R., Saunders, B. J., Stanley, J. R., & Tucci, J. (1999). Structured risk
assessment procedures: Instruments of abuse? Child Abuse Review, 8, 251-263.
Hollinshead, D., & Fluke, J. (2000). What works in safety and risk assessment for child
protective services. In M. Kluger, G. Alexander, & P. Curtis (Eds.), What works in
child welfare (pp. 67-73). Washington, DC: CWLA Press.
Jagannathan, R., & Camasso, R. (1996). Risk assessment in child protective services:
A canonical analysis of the case management function. Child Abuse & Neglect,
20(7), 599-612.
Knoke, D., & Trocmé, N. (2005). Reviewing the evidence on assessing risk for child
abuse and neglect. Brief Treatment and Crisis Intervention, 5(3), 310-327.
Lyle, C. G., & Graham, E. (2000). Looks can be deceiving: Using a risk assessment
instrument to evaluate the outcomes of child protection services. Children and
Youth Services Review, 22(11/12), 935-949.
Lyons, P., Doueck, H. J., & Wodarski, J. (1996). Risk assessment for child protective
services: A review of the empirical literature on instrument performance. Social
Work Research, 20(3), 143-155.
Rittner, B. (2002). The use of risk assessment instruments in child protective services
case planning and closures. Children and Youth Services Review, 24(3), 189207.
Ruscio, J. (1998). Information integration in child welfare cases: An introduction to
statistical decision making. Child Maltreatment, 3(2), 143-156.
Ryan, S., Wiles, D., Cash, S., & Siebert, C. (2005). Risk assessments: Empirically
supported or values driven? Children and Youth Services Review, 27, 213-225.
Shlonsky, A., & Wagner, D. (2005). The next step: Integrating actuarial risk assessment
and clinical judgment into an evidence-based practice framework in CPS case
management. Children and Youth Services Review, 27, 409-427.
177
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Handout 2
SDM® ASSESSMENT TOOLS, DEFINITIONS, AND PRACTICE CASE
VIGNETTES – RESPONSE PRIORITY
Questions to Consider:
1. What is the primary goal of a response priority assessment?
2. What are the key factors that should be examined when determining the
response priority?
3. What are secondary factors?
4. What should the time cut-offs for response be (e.g., 24 hours vs. 5 days)?
5. What resources does the worker need in order to make an informed decision?
6. What are the strengths and limitations of the response priority tool?
( Exercise: Response Priority Case Vignette
Divide into small groups. Using the case vignette, complete the response priority tool
within the groups. When you are finished, compare your results with those of the other
groups. Are there different responses?
Tools:
Harding/Layer Case Example, Part A
Response Priority Tool
Response Priority Definitions Sheet
177
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Handout 2
Harding/Layer Case Example (Part A)11
Referral: 10-26-04, 1:30 p.m.
Child Victim: Nelson Layer, DOB 04-19-03
Mother: Ann Harding
Father: Jay Layer
Siblings: None
University Hospital social worker called to report that Jay Layer brought his 18-month-old son,
Nelson Layer, to the ER with a black right eye and a bruise on his left cheek. According to the
father, he went to the mother’s house to care for Nelson for the weekend, because the mother,
Ann Harding, was going to Las Vegas with friends. He has no further information about her
whereabouts other than a cell phone number that she left with him. He noticed the bruises
immediately upon arrival. When he asked the mother how the bruises got there, she stated that
“he fell.” The father states he had not seen his son since last week. As soon as the mother left
on her trip, the father reports that he came straight to the hospital. The father further states that
the mother has a previous child, not his, who was adopted by relatives of the child’s father. He
does not know the details of that adoption. He states that the mother is 26 years old.
The medical staff has examined Nelson’s face and eye. They report that the bruise on the left
cheek and the black eye are both approximately 24-36 hours old. The eye alone might not have
raised concerns, but the cheek was unlikely bruised in a fall and could not have occurred during
the same reported fall as the black eye. The explanation that he fell is inconsistent with the
injuries and more likely a result of abuse. They will continue to examine the child and do a
skeletal survey.
Agency History:
Ann Harding:
One substantiated in 1999 for physical abuse of her child – rib fractures and bruises.
Victim: Adam Harding
One substantiated in 2000 for physical abuse of her child – fracture of right arm.
Victim: Adam Harding
Termination of parental rights by Ann Harding in 2001.
*Associated Case: Ann Harding as child victim – physical abuse by father.
Jay Layer:
No agency history. Criminal history includes a motor vehicle theft at age 18.
STOP: COMPLETE RESPONSE PRIORITY TOOLS.
11
Case example used with permission from CRC (2006, p.109).
178
Kim, A. K., Brooks, D., Kim, H., & Nissly, J. (2008). Structured Decision Making® and child welfare service
delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Immediate = Within 24 hours
C: 06/02
Neglect
Referral Name:
Referral #:
County:
Date:
Is the child a drug-exposed newborn?
Yes
No
Local Protocol
Does the child need
immediate medical/mental
health evaluation?
Yes
No
Are the child’s physical
living conditions immediately
hazardous to health or safety?
Immediate
Yes
No
Is the child currently
unsupervised?
Immediate
Yes
Immediate
No
Within 10 days
Policy Override:
Immediate Response whenever:
Law enforcement is requesting an immediate response.
Forensic considerations require an immediate response.
There is reason to believe a family will flee.
Response within 10 days whenever:
Forensic or safety considerations require a non-immediate
response.
Child is currently in a safe environment.
Child is hospitalized and will not be discharged within 10 days.
Discretionary Override (reason):
O:\657CA\Training Materials 1-05\Worker Training\P&P Manual.doc
© 2005, CDSS and CRC, All Rights Reserved
Immediate = Within 24 hours
C: 06/02
Physical Abuse
Referral Name:
Referral #:
County:
Date:
Does the child require hospitalization or
need medical evaluation or is child
under age two?
Yes
No
Immediate
Are significant injuries evident or were
extreme methods used suggesting the
possibility of serious injury?
Yes
No
Immediate
Is the child under age five or limited by
a disability?
Yes
No
Will perpetrator have
access to child within
the next 10 days?
Yes, or unknown
Yes
No
Within 10 days
Are there superficial injuries
located only on extremities?
Yes
Is the child afraid to
go home?
Immediate
Have there been prior
reports of abuse?
Yes
No
Have there been prior substantiated
reports of physical abuse?
No
No
Yes
Immediate
No
Can the child be protected
pending commencement of a
response within 10 days?
Yes
Within 10 days
Within 10 days
No
Immediate
Policy Override:
Immediate Response whenever:
Law enforcement is requesting an immediate response.
Forensic considerations require an immediate response.
There is reason to believe a family will flee.
Response within 10 days whenever:
Forensic or safety considerations require a non-immediate response.
Child is currently in a safe environment.
Child is hospitalized and will not be discharged within 10 days.
Discretionary Override (reason):
O:\657CA\Training Materials 1-05\Worker Training\P&P Manual.doc
© 2005, CDSS and CRC, All Rights Reserved
Immediate = Within 24 hours
C: 06/02
Sexual Abuse
Referral Name:
Referral #:
County:
Date:
Is there current abuse as evidenced by
disclosure, credible witnessed account, or
medical evidence?
Yes
No
Is caretaker willing and able to
protect, including seeking medical
attention if needed?
Yes
Within 10 Days
No, or unknown
Within 10 Days
Does the perpetrator have access
within the next ten days?
Yes, or unknown
Immediate
No
Within 10 Days
Policy Override:
Immediate Response whenever:
Law enforcement is requesting an immediate response.
Forensic considerations require an immediate response.
There is reason to believe a family will flee.
Response within 10 days whenever:
Forensic or safety considerations require a non-immediate response.
Child is currently in a safe environment.
Child is hospitalized and will not be discharged within 10 days.
Discretionary Override (reason):
O:\657CA\Training Materials 1-05\Worker Training\P&P Manual.doc
2005, CDSS and CRC, All Rights Reserved
Immediate = Within 24 hours
C: 06/02
Emotional Abuse
Referral Name:
Referral #:
County:
Date:
Has the child witnessed domestic
violence?
OR
Were emotional abuse incidents
severe, extreme, or bizarre?
Yes
No
Is there immediate danger due to
current domestic violence or
emotional abuse?
Does the child display severe
emotional/behavioral symptoms?
No
Yes
Yes
Immediate
Are resources in place to respond
to child’s emotional/
behavioral needs?
Yes
No
Within 10 Days
No
Within 10 days
Immediate
Policy Override:
Immediate Response whenever:
Law enforcement is requesting an immediate response.
Forensic considerations require an immediate response.
There is reason to believe a family will flee.
Response within 10 days whenever:
Forensic or safety considerations require a non-immediate response.
Child is currently in a safe environment.
Child is hospitalized and will not be discharged within 10 days.
Discretionary Override (reason):
O:\657CA\Training Materials 1-05\Worker Training\P&P Manual.doc
© 2005, CDSS and CRC, All Rights Reserved
Immediate = Within 24 hours
C: 06/02
Caretaker Absent/Incapacitated
Referral Name:
Referral #:
County:
Date:
Is there an appropriate plan for care
pending commencement of a response
within 10 days?
Yes
Within 10 Days
No
Immediate
Policy Override:
Immediate Response whenever:
Law enforcement is requesting an immediate response.
Forensic considerations require an immediate response.
There is reason to believe a family will flee.
Response within 10 days whenever:
Forensic or safety considerations require a non-immediate response.
Child is currently in a safe environment.
Child is hospitalized and will not be discharged within 10 days.
Discretionary Override (reason):
O:\657CA\Training Materials 1-05\Worker Training\P&P Manual.doc
© 2005, CDSS and CRC, All Rights Reserved
Handout 2
RESPONSE PRIORITY DEFINITIONS12
I. NEGLECT DECISION TREE
Use this tree for severe neglect, general neglect, and medical neglect allegations. Also
include inadequate supervision and children left alone if it is known that caretaker(s)
plans to return.
Is the child a drug-exposed newborn?
Mother and/or baby has/have positive toxicology screen at birth; or prenatal substance
exposure as evidenced by prenatal test or mother’s self-admission; or medical
diagnosis.
See local county protocols for drug-exposed newborns.
Does the child need immediate medical/mental health evaluation?
Directive from medical personnel that the child(ren) needs immediate medical/mental
health attention; or failure to thrive indicators (i.e., underweight, minor not fed,
listlessness); or refusal of caretaker(s) to meet the child(ren)’s medical/mental health
needs or treat a serious or significant injury/condition.
Are the child’s physical living conditions immediately hazardous to health or
safety?
Based on the child(ren)’s age and developmental status, the child(ren)’s physical living
conditions are hazardous and immediately threatening. For example:
•
Leaking gas from stove or heating unit;
•
Substances or objects accessible to the child(ren) that may endanger the health
and/or safety of the child(ren);
•
Lack of water or utilities (heat, plumbing, electricity) and no alternate or safe
provisions are made;
•
Open broken/missing windows;
•
Exposed electrical wires;
•
Excessive garbage or rotted or spoiled food which threatens the child’s health;
•
Serious illness or significant injury has occurred to the child due to living
conditions and these conditions still exist (e.g., lead poisoning, rat bites);
● Evidence of human or animal waste throughout living quarters;
● Guns and other weapons are not locked.
12
Definitions reproduced with permission from CRC (2005, p.9)
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delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Handout 2
Is the child currently unsupervised?
Based upon local community standards, the child(ren) is not receiving appropriate
supervision from his/her caretaker(s) and there is no appropriate alternative plan for
supervision pending commencement of a response within 10 days.
•
Child(ren) is currently alone (time period varies with age and developmental
stage);
•
Caretaker(s) does not attend to the child(ren) to the extent that need for care
goes unnoticed or unmet (e.g., caretaker[s] is present but child[ren] can wander
outdoors alone, play with dangerous objects, play on unprotected window ledge,
or be exposed to other serious hazards; a child with some suicidal ideation is not
closely monitored);
•
Child(ren) is presently receiving inadequate and/or inappropriate childcare
arrangements.
II. PHYSICAL ABUSE TREE
Does the child require hospitalization or need medical evaluation, or is child
under age 2?
Child(ren) requires immediate medical treatment and/or hospitalization. Are there
possible internal injuries/broken bones/fractures/injuries to the head or abdomen area?
Are there apparent burns requiring medical treatment or evaluation? This DOES NOT
include child(ren) who is currently receiving, or who has already received, medical
attention.
Are significant injuries evident, or were extreme methods used suggesting the
possibility of serious injury?
Are visible signs of abuse apparent: bruises, welts, abrasions, lacerations, old
scars/marks including healing wounds? Are there possible internal injuries/broken
bones/fractures/injuries to the head or abdomen area? Are there odd or bizarre
behaviors which could lead to injuries, such as hitting with hammers or boards, hitting
on the bottom of the feet, using restraints, placing objects or chemicals in eyes, etc?
Is the child under age 5 or limited by disability?
Does the child(ren) have a physical or mental disability that increases vulnerability?
Will the alleged perpetrator have access to the child within the next 10 days?
Will the alleged perpetrator have unsupervised, in-person contact, including visitation,
with the child(ren)?
Are there superficial injuries located only on extremities?
Are there injuries to the hands, arms, feet, or legs of the child which do not seem to
require medical evaluation or treatment and which do not include possible internal
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Handout 2
injuries, broken bones, other fractures, or apparent burns? Are the only injuries very few
in number and consist only of surface scrapes, abrasions, or bruises which do not
appear to be darkly colored or deep tissue bruises?
Have there been prior substantiated reports of physical abuse?
Have there been previous reports of physical abuse that have been substantiated and
made to a child protection agency, including law enforcement?
Is the child afraid to go home?
The fear expressed by the child(ren) is based on credible threats made by the
caretaker(s); child(ren) evidences behavioral indicators of fear; there is a history of
abusive behavior that is similar to the current allegation, and may suggest a higher
chance of recurrence.
Have there been prior reports of abuse?
Have there been previous reports of abuse (includes physical, sexual, or emotional
abuse), substantiated or unsubstantiated, made to a child protection agency, including
law enforcement?
Can the child be protected in the home pending commencement of a response
within 10 days?
Is there a caretaker in the home who is willing and able to protect the child(ren)?
III. SEXUAL ABUSE DECISION TREE
Is there current abuse as evidenced by disclosure, credible witnessed account, or
medical evidence?
Disclosure may be verbal or nonverbal (i.e., extreme sexual acting-out behavior).
Medical evidence includes actual medical findings related to sexual abuse as well as
suspicious findings such as sexually transmitted diseases in young children.
Is caretaker willing and able to protect, including seeking medical attention for
the child(ren) if needed?
Is non-offending caretaker supporting the child(ren)’s disclosure and demonstrating the
ability/willingness to prevent the suspect from having access to the child(ren)? Will the
non-offending caretaker not pressure the child(ren) to change statement? Will the nonoffending caretaker obtain medical treatment if needed?
Does the perpetrator have access to the child(ren) within the next 10 days?
Does the suspected maltreator have the ability to have physical, verbal, or written
contact with the child(ren)?
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Handout 2
IV. EMOTIONAL ABUSE DECISION TREE
Has the child witnessed domestic violence OR were emotional abuse incidents
severe, extreme, or bizarre?
Witnessed: Seen or heard incident(s) of domestic violence, or child(ren) has learned
about incident(s) in a manner that creates upset for the child(ren).
Domestic Violence: Definition in Penal Code.
Severe, Extreme, or Bizarre: Examples include:
•
Caretaker(s) threatens to harm self in child(ren)’s presence;
•
Unusual forms of discipline (e.g., child[ren] being made to stand in corner on one
leg, cutting child[ren]’s hair with intent to create trauma, forcing child[ren] to wear
inappropriate clothing such as a 10-year-old being forced to wear diapers; this
should NOT include incidents of inappropriate clothing due to poverty or current
fashion);
•
Murder or torture of people or pets in front of child(ren);
•
Child(ren)’s extreme rejection from family (e.g., abnormally long time-outs based
on child[ren]’s age and developmental level; family acts as if child[ren] does not
exist).
•
Child singled out for detrimental treatment;
•
Caretaker(s) is constantly belittling child or has unrealistic expectations of
child(ren).
Is there immediate danger to the child due to current domestic violence or
emotional abuse?
Are there weapons present, or is substance abuse involved, which could escalate
domestic violence? Does either partner require medical evaluation? Is there a
perception that emergency conditions exist (e.g., children locked in cage)?
Does the child display severe emotional/behavioral symptoms?
Examples include: suicidal ideation of child(ren); somatic complaints; enuresis/
encopresis not due to medical condition; long-term withdrawal/depression/isolation from
family or school activities; severe aggressive behavior; cruelty toward animals.
Are resources in place to respond to the child’s emotional/behavioral needs?
Child(ren) is hospitalized, in a group home, or in juvenile hall; is with safe caretaker,
such as grandparents; and/or is receiving appropriate mental health services.
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Handout 2
V. CARETAKER ABSENT/INCAPACITATED DECISION TREE
Use this tree when:
•
Caretaker(s)’ whereabouts are unknown.
•
Child(ren) has been left with no provisions for support.
•
Child(ren) has been left with another party and caretaker(s) has no known plan to
return.
•
Caretaker(s) has been hospitalized, incarcerated, or by other means is prevented
from being present to care for the child(ren).
•
Caretaker(s) is incapacitated due to mental illness, developmental disability, or
medical disability.
Is there an appropriate plan for care of the child(ren) pending commencement of
a response within 10 days?
An interim plan meets minimum standards for child(ren)’s physical, medical, and
emotional needs. A reliable adult has committed to provide for basic medical, mental
health, safety, physical needs (food, shelter, clothing), and supervision, and has the
means to do so.
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Handout 3
SDM® ASSESSMENT TOOLS, DEFINITIONS, AND PRACTICE CASE
VIGNETTES – SAFETY ASSESSMENT
Questions to Consider:
1. What is the primary goal of a safety assessment tool? (immediate vs. latent
danger)
2. How is it determined whether a child is safe?
( Exercise: Brainstorming Safety Factors
Before looking at the SDM® tool, as a small group, try to come up with a list of essential
safety factors that should be examined. What are the key factors that should be
examined when determining whether a child is immediately safe?
Now, compare your list of safety factors with the SDM® safety assessment tool.
Consider the following questions:
1. What are the strengths and limitations of this tool?
2. How should the safety assessment tool be used, ideally?
3. If the safety assessment tool is completed after the initial investigation, are
workers still basing their decisions on the assessment tool?
( Exercise: Safety Assessment Case Vignette
Divide into small groups. Using the case vignette, complete the safety assessment tool
within the groups. When you are finished, compare your results with those of the other
groups. Are there different responses?
Tools:
Harding/Layer Case Example, Part B
Safety Assessment Tool
Safety Assessment Definitions Sheet
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delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Handout 3
Harding/Layer Case Example (Part B)13
Child Victim: Nelson Layer, DOB 04-19-03
Mother: Ann Harding
Father: Jay Layer
10-26-04, 2:45 p.m.
The worker arrives at the ER. Hospital social worker reports that the child has been examined,
and he is now in X-ray. The child’s overall appearance is clean; he is appropriately dressed and
well nourished. Nursing staff report that he appears bonded to his father and relaxed in his care.
The father appeared to respond appropriately to Nelson’s curiosity and playfulness.
Hospital social worker has been unable to locate the mother using the cell phone number she
gave the father. They left a message for her to contact the hospital as soon as possible. They
report that Dr. Davis has seen the child in the past.
When the worker arrived at the hospital, he was unable to locate the father for an interview.
About 30 minutes later, the father showed up at his son’s examining room. When the worker
began interviewing the father, he could smell alcohol on father’s breath. When asked, the father
admitted to feeling great stress over this incident because he wants his son to live with him.
However, he is currently living in a halfway house for recovering drug addicts, and he can’t take
him there. He is proud to say that he has been clean from crack cocaine since completing detox
3 months ago. The alcohol was a slip, and he has had several slips since becoming clean. The
mother and staff at the halfway house know of only one other slip with alcohol, and he is afraid
that they may evict him from the program if they learn of this one. The father states that the
mother kept him from seeing Nelson while he was using drugs and that he just resumed his
relationship with Nelson 2 months ago following rehab. Hospital staff also filed a police report,
and police have now arrived at the hospital. The attending physician met with the father, the
worker, and law enforcement to report that there is no serious injury to the eye or cheek. The full
skeletal survey showed several healed fractures of varying ages. The doctor has contacted the
hospital where Nelson was born and learned that his birth was not at all traumatic and could not
have caused any of the fractures. There was also no sign or evidence at birth of drug usage by
the mother. It appeared to be a perfectly normal birth. There is a healed fracture to the left arm
and one to the right leg, but they present no ongoing impairment. The cut over the child’s eye
has been treated and he does not require hospitalization. The staff attempted to contact Dr.
Davis, but the on-call physician reports that Dr. Davis will not be available until Monday and that
she has no knowledge of this family or child. Tests will be conducted to rule out osteogenesis
imperfecta.
Law enforcement requested an interview with the father, to which he agreed. Following the
interview, observation of the father with the child, the timeline for the injuries, discussions with
the worker as to the mother’s history, and medical facts, the detective states that she does not
believe the father caused the injuries. The detective then went to the mother’s address, which is
approximately eight blocks from the hospital, in an attempt to locate her. There was no
response at the door, but the mother’s name is on the mailbox, and a DMV check finds no other
13
Case example used with permission from CRC (2006, p.113)
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delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Handout 3
address listed for her. The apartment manager came to speak to the detective to ask why she
was there. When told, the manager stated that he saw the mother and child alone yesterday,
and Nelson had the black eye and bruised cheek at that time. He asked the mother how Nelson
got the black eye, and she stated that he had hit himself in the eye with a toy truck. The
manager stated he often hears the mother yelling at Nelson, but he has not seen any physical
abuse. The manager said the mother has a girlfriend who lives in the building on the second
floor. He brought the detective to her apartment. Lisa Cash was home and invited the detective
in. She said that the mother was away for the weekend. She was in the apartment with the
mother and Nelson before his father arrived, and she saw the black eye and bruise. She has
only the same cell phone number that the father gave to the detective earlier and no further
information.
When the detective returned to the hospital, she met with the worker and the attending
physician. The physician determined that the injuries are not consistent with the mother’s
explanation, but they are consistent with abuse, as are the healing fractures. Based on the
medical findings, this case was substantiated for physical abuse. The detective and worker
agreed that based on information gathered so far, physical abuse will be substantiated as to the
mother. The detective said a criminal report will be made, but she is not confident that it will
result in criminal charges being brought unless additional information regarding the fractures
becomes available. This worker met with the father to come up with a plan for Nelson’s safety
and supervision. The father stated that he is listed on his son’s birth certificate and that he will
do anything he can to get full custody of his son, even if it means staying both clean and sober.
At this time, however, he cannot care for his son. He knows he needs to return to the halfway
house and get his act together for his son’s sake. The father said all he could do right now is try
to find his sister and ask her if she could care for Nelson while he finishes his treatment and
gets permanent full-time work to support his son.
While hospital staff fed Nelson prior to preparing his discharge, the worker attempted once
again to locate the mother. He called her home number and the cell number to no avail. The
worker also drove to the home of the mother and left a note under the door for her to call the
agency as soon as she returns.
STOP: COMPLETE SAFETY ASSESSMENT.
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c: 06/02
CALIFORNIA
SAFETY ASSESSMENT
Referral Name:
Referral #:
County:
Names of Children Assessed:
1.
4.
2.
3.
5.
6.
(If more than six children are assessed, add additional names and numbers on reverse side.)
Are there additional names on reverse?
1. Yes
/
Date of Child Maltreatment Referral:
Date of Assessment:
/
2. No
/
/
Worker:
SECTION 1: SAFETY FACTORS
Assess household for each of the following safety factors. Indicate whether currently available information results in reason to believe
safety factor is present. Check all that apply.
1.
Caretaker(s) caused serious physical harm to the child(ren), or made a plausible threat to cause serious physical harm in
the current investigation indicated by:
Serious injury or abuse to child(ren) other than accidental;
Caretaker(s) fears s/he will maltreat child(ren);
Threat to cause harm or retaliate against child(ren);
Excessive discipline or physical force;
Drug-exposed infant.
2.
Current circumstances, combined with information that the caretaker(s) has or may have previously maltreated child(ren)
in their care, suggests that the child(ren)’s safety may be of immediate concern based on the severity of the previous
maltreatment or the caretaker(s)’ response to the previous incident.
3.
Child sexual abuse is suspected and circumstances suggest that child(ren)’s safety may be of immediate concern.
4.
Caretaker fails to protect child(ren) from serious harm or threatened harm by others. This may include physical abuse,
sexual abuse, or neglect.
5.
Caretaker(s)’ explanation for the injury to the child(ren) is questionable or inconsistent with type of injury, and the nature
of the injury suggests that the child(ren)’s safety may be of immediate concern.
6.
The family refuses access to the child(ren) or there is reason to believe that the family is about to flee.
7.
Caretaker(s) does not meet the child(ren)’s immediate needs for supervision, food, clothing, and/or medical or mental
health care.
8.
The physical living conditions are hazardous and immediately threatening to the health and/or safety of the child(ren).
9.
Caretaker(s)’ current substance abuse seriously impairs his/her ability to supervise, protect, or care for the child(ren).
10. Domestic violence exists in the home and poses a risk of serious physical and/or emotional harm to the child(ren).
11. Caretaker(s) describes child(ren) in predominantly negative terms or acts toward child(ren) in negative ways that result in
the child(ren) being a danger to self or others, acting out aggressively, or being severely withdrawn and/or suicidal.
12. Caretaker(s)’ emotional stability, developmental status, or cognitive deficiency seriously impairs their current ability to
supervise, protect, or care for the child.
13. Other (specify):
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SECTION 2: SAFETY INTERVENTIONS
If no safety factors are present, skip to Section 3. If one or more safety factors are present, consider whether safety interventions 1-8 will
allow child(ren) to remain in the home for the present time. Check the item number for all safety interventions that will be implemented. If
there are no available safety interventions that would allow the child(ren) to remain in the home, indicate by checking item nine or ten, and
follow procedures for initiating a voluntary agreement or taking child(ren) into protective custody.
Check all that apply:
1.
Intervention or direct services by worker.
2.
Use of family, neighbors, or other individuals in the community as safety resources.
3.
Use of community agencies or services as safety resources.
4.
Have caretaker appropriately protect victim from the alleged perpetrator.
5.
Have the alleged perpetrator leave the home, either voluntarily or in response to legal action.
6.
Have the non-offending caretaker move to a safe environment with the child(ren).
7.
Legal action planned or initiated -- child(ren) remains in the home.
8.
Other (specify):
9.
Have the caretaker(s) voluntarily place the child(ren) outside the home.
10. Child(ren) placed in protective custody because interventions 1-9 do not adequately assure child(ren)’s safety.
SECTION 3: SAFETY DECISION
Identify the safety decision by checking the appropriate line below. This decision should be based on the assessment of all safety factors,
safety interventions, and any other information known about the case. Check one line only.
1.
No safety factors were identified at this time. Based on currently available information, there are no children likely to be
in immediate danger of serious harm.
2.
One or more safety factors are present, and protecting safety interventions have been planned or taken. Based on
protecting interventions, child(ren) will remain in the home at this time.
3.
One or more safety factors are present, and placement is the only protecting intervention possible for one or more
children. Without placement, one or more children will likely be in danger of immediate or serious harm.
All children placed.
The following children were placed: (enter number from page 1)
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Handout 3
SAFETY ASSESSMENT DEFINITIONS14
1.
2.
Caretaker(s) caused serious physical harm to the child(ren), or made a
plausible threat to cause serious physical harm in the current investigation
indicated by:
•
Serious injury or abuse to the child(ren) other than accidental - caretaker(s)
caused serious injury defined as brain damage, skull or bone fracture,
subdural hemorrhage or hematoma, dislocations, sprains, internal injury,
poisoning, burns, scalds, severe cuts, or any other physical injury that
seriously impairs the health or well-being of the child(ren) (e.g., poisoning,
suffocating, shooting, bruises/welts, bite marks, choke marks) which requires
medical treatment.
•
Caretaker(s) fears s/he will maltreat the child(ren) and/or requests placement.
•
Threat to cause harm or retaliate against the child(ren) - threat of action which
would result in serious harm; or household member(s) plans to retaliate
against child(ren) for CPS investigation.
•
Excessive discipline or physical force - caretaker(s) has used torture or
physical force, or acted in a way which bears no resemblance to reasonable
discipline; or punished child(ren) beyond the duration of the child(ren)’s
endurance.
•
Drug-exposed infant - drugs found in the child(ren)’s system; infant is
medically fragile as result of drug exposure; infant suffers adverse effects
from introduction of drugs during pregnancy.
Current circumstances, combined with information that the caretaker(s) has
or may have previously maltreated a child(ren) in their care, suggest that the
child(ren)’s safety may be of immediate concern based on the severity of the
previous maltreatment or the caretaker(s)’ response to the previous incident.
There must be both current immediate threats to child safety AND related previous
maltreatment that was severe and/or represents an unresolved pattern of
maltreatment. Previous maltreatment includes any of the following:
14
•
Prior death of a child(ren) as a result of maltreatment.
•
Prior serious harm to a child(ren) - previous maltreatment by caretaker(s) that
was serious enough to cause severe injury (e.g., fractures, poisoning,
suffocating, shooting, burns, bruises/welts, bite marks, choke marks, and/or
physical findings consistent with sexual abuse based on medical exam).
Definitions reproduced with permission from CRC (2005, p.18)
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Handout 3
3.
•
Termination of parental rights - caretaker(s) had parental rights terminated as
a result of a prior CPS investigation.
•
Prior removal of a child(ren) - removal/placement of child(ren) by CPS or
other responsible agency or concerned party was necessary for the safety of
the child(ren).
•
Prior CPS substantiation - a prior CPS investigation was substantiated for
maltreatment.
•
Prior inconclusive CPS investigation - factors to be considered include
seriousness, chronicity, and/or patterns of abuse/neglect allegations.
•
Prior threat of serious harm to a child(ren) - previous maltreatment that could
have caused severe injury; retaliation, or threatened retaliation against a
child(ren) for previous incidents; prior domestic violence which resulted in
serious harm or threatened harm to a child(ren).
•
Prior service failure - failure to successfully complete court-ordered or
voluntary services.
Child sexual abuse is suspected, and circumstances suggest that the
child(ren)’s safety may be of immediate concern.
Suspicion of sexual abuse may be based on indicators such as:
•
Child(ren) discloses sexual abuse either verbally or behaviorally (e.g., ageinappropriate or sexualized behavior toward self or others).
•
Medical findings consistent with molestation.
•
Caretaker(s) or others in household have been convicted, investigated, or
accused of rape or sodomy, or has had other sexual contact with child(ren).
•
Caretaker(s) or others in the household have forced or encouraged the
child(ren) to engage in sexual performances or activities (including forcing
child[ren] to observe sexual performances or activities).
● Access to a child(ren) by possible or confirmed sexual abuse perpetrator
exists.
4.
Caretaker fails to protect the child(ren) from serious harm or threatened harm
by others. This may include physical abuse, sexual abuse, or neglect.
•
Caretaker(s) fails to protect the child(ren) from serious harm or threatened
harm as a result of physical abuse, neglect, or sexual abuse by other family
members, other household members, or others having regular access to the
child(ren). Caretaker(s) does not provide supervision necessary to protect the
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Handout 3
child(ren) from potentially serious harm by others based on the child(ren)’s
age or developmental stage.
•
5.
6.
7.
An individual(s) with known violent criminal behavior/history resides in the
home, or caretaker allows access to the child(ren).
Caretaker(s)’ explanation for the injury to the child(ren) is questionable or
inconsistent with the type of injury, and the nature of the injury suggests that
the child(ren)’s safety may be of immediate concern.
•
The injury requires medical attention.
•
Medical evaluation indicates injury is the result of abuse; caretaker(s) denies
or attributes injury to accidental causes.
•
Caretaker(s)’ explanation for the observed injury is inconsistent with the type
of injury.
•
Caretaker(s)’ description of the injury or cause of the injury minimizes the
extent of harm to the child.
•
Factors to consider include age of child, location of injury, exceptional needs
of the child(ren), or chronicity of injuries.
The family refuses access to the child(ren), or there is reason to believe that
the family is about to flee.
•
Family currently refuses access to the child(ren) or cannot or will not provide
the child(ren)’s location.
•
Family has removed the child(ren) from a hospital against medical advice to
avoid investigation.
•
Family has previously fled in response to a CPS investigation.
•
Family has a history of keeping the child(ren) at home, away from peers,
school, and other outsiders for extended periods of time for the purpose of
avoiding investigation.
•
Caretaker(s) intentionally coaches or coerces the child(ren), or allows others
to coach or coerce the child(ren), in an effort to hinder the investigation.
Caretaker(s) does not meet the child(ren)’s immediate needs for supervision,
food, clothing, and/or medical or mental health care.
•
Minimal nutritional needs of the child(ren) are not met resulting in danger to
the child(ren)’s health and/or safety.
•
Child(ren) is without minimally warm clothing in cold months.
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Handout 3
8.
•
Caretaker does not seek treatment for the child(ren)’s immediate, chronic,
and/or dangerous medical condition(s), or does not follow prescribed
treatment for such conditions.
•
Child(ren) appears malnourished.
•
Child(ren) has exceptional needs, such as being medically fragile, which
caretaker(s) does not or cannot meet.
•
Child(ren) is suicidal and caretaker(s) will not/cannot take protective action.
•
Child(ren) shows effects of maltreatment such as serious emotional
symptoms, lack of behavioral control, or serious physical symptoms.
•
Caretaker(s) does not attend to the child(ren) to the extent that need for care
goes unnoticed or unmet (e.g., caretaker is present but child(ren) can wander
outdoors alone, play with dangerous objects, play on an unprotected window
ledge, or be exposed to other serious hazards).
•
Caretaker leaves the child(ren) alone (time period varies with age and
developmental stage).
•
Caretaker(s) is unavailable (incarceration, hospitalization, abandonment,
whereabouts unknown).
•
Caretaker(s) makes inadequate and/or inappropriate baby-sitting or childcare
arrangements or demonstrates very poor planning for the child(ren)’s care.
The physical living conditions are hazardous and immediately threatening to
the health and/or safety of the child(ren).
Based on the child(ren)’s age and developmental status, the child(ren)’s physical
living conditions are hazardous and immediately threatening, including but not
limited to:
•
Leaking gas from stove or heating unit.
•
Substances or objects accessible to the child(ren) that may endanger the
health and/or safety of the child(ren).
•
Lack of water or utilities (heat, plumbing, electricity) and no alternate or safe
provisions are made.
•
Open windows/broken/missing windows.
•
Exposed electrical wires.
•
Excessive garbage or rotted or spoiled food, which threatens health.
•
Serious illness or significant injury has occurred due to living conditions and
these conditions still exist (e.g., lead poisoning, rat bites).
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9.
•
Evidence of human or animal waste throughout living quarters.
•
Guns and other weapons are not locked.
Caretaker(s)’ current substance abuse seriously impairs his/her ability to
supervise, protect, or care for the child(ren).
Caretaker(s) has abused legal or illegal substances or alcoholic beverage to the
extent that control of his or her actions is significantly impaired. As a result, the
caretaker(s) is unable, or will likely be unable, to care for the child(ren); has harmed
the child(ren); or is likely to harm the child(ren).
10. Domestic violence exists in the home and poses a risk of serious physical
and/or emotional harm to the child(ren).
•
Child(ren) previously injured in domestic violence incident.
•
Child(ren) exhibits severe anxiety (e.g., nightmares, insomnia) related to
situations associated with domestic violence.
•
Child(ren) cries, cowers, cringes, trembles, or otherwise exhibits fear as a
result of domestic violence in the home.
•
Child(ren) is at potential risk of physical injury.
•
Child(ren)’s behavior increases risk of injury (e.g., attempting to intervene
during violent dispute, participating in the violent dispute).
•
Use of guns, knives, or other instruments in a violent, threatening, and/or
intimidating manner.
•
Evidence of property damage resulting from domestic violence.
11. Caretaker(s) describes the child(ren) in predominantly negative terms or acts
toward the child(ren) in negative ways that result in the child(ren) being a
danger to self or others, acting out aggressively, or being severely withdrawn
and/or suicidal.
Examples of caretaker actions include:
•
Caretaker(s) describes child(ren) in a demeaning or degrading manner (e.g.,
as evil, stupid, ugly).
•
Caretaker(s) curses and/or repeatedly puts child(ren) down.
•
Caretaker(s) scapegoats a particular child in the family.
•
Caretaker(s) blames child(ren) for a particular incident or family problems.
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● Caretaker(s) places child(ren) in middle of a custody battle.
12. Caretaker(s)’ emotional stability, developmental status, or cognitive
deficiency seriously impairs their current ability to supervise, protect, or care
for the child(ren).
•
Caretaker(s)’ refusal to follow prescribed medications impedes their ability to
parent the child(ren).
•
Caretaker(s)’ inability to control emotions impedes their ability to parent the
child(ren).
•
Caretaker(s) acts out or exhibits a distorted perception that impedes their
ability to parent the child(ren).
•
Caretaker(s)’ depression impedes their ability to parent the child(ren).
•
Caretaker(s) expects the child(ren) to perform or act in a way that is
impossible or improbable for the child(ren)’s age or developmental stage
(e.g., babies and young children expected not to cry, expected to be still for
extended periods, be toilet trained, eat neatly, or expected to care for younger
siblings or expected to stay alone).
•
Due to cognitive delay, the caretaker(s) lacks the basic knowledge related to
parenting skills such as:
ƒ
ƒ
ƒ
ƒ
not knowing that infants need regular feedings;
failure to access and obtain basic/emergency medical care;
proper diet; or
adequate supervision.
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Handout 4
SDM® ASSESSMENT TOOLS, DEFINITIONS, AND PRACTICE CASE
VIGNETTES – RISK ASSESSMENT
Questions to Consider:
1. What is the primary goal of the risk assessment tool?
2. Why is it important to examine future risk? To what extent should risk be
considered, when determining whether a child should be removed from her/his
home?
3. Is it important for a risk assessment tool to be actuarial? Why or why not?
4. Is it possible to have one risk assessment tool that is applicable to all
communities across the board? Should different types of risk factors be
considered for demographically-different communities or children/families from
different races? Ethnicities? Cultures?
( Exercise: Brainstorming Risk Factors
Before looking at the SDM® tool, as a small group, try to come up with a list of
essential risk factors that should be examined. What are the key factors that should
be examined when determining risk?
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( Exercise: Ranking Risk Factors
When trying to decide whether to remove a child from her/his home, which of the
characteristics do you feel are the most important to consider? Rate the characteristics
below:
Very
Somewhat
Not
important important important
Characteristic
Type of abuse or neglect (physical, emotional,
sexual, neglect)
Severity of abuse
Likelihood of reoccurrence
Duration/pattern of abuse
What services have been offered in the past
Stability in the family
Caregivers’ response to past services
Caregivers’ cognitive ability
Caregivers’ mental health
Caregivers’ socioeconomic status
Number of additional children in the home
Family’s race/ethnicity
Caregivers’ sexual orientation
Caregivers’ criminal history
Caregivers’ overall attitude
Caregivers’ alcohol/drug abuse
Child’s developmental level
Child’s ability to recount abuse
Child’s age
State of household’s physical environment
Other (specify):
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Compare your ratings with others in your group.
1. How similar or different are your ratings? What explains the differences between
raters? Now, as a group, rank the criteria.
2. Of this list, how many and which characteristics MUST be considered in order to
make a good decision?
3. How many and which characteristics must be considered in order to make a fair
decision?
4. How are decisions about physical abuse different from decisions about sexual
abuse? Neglect? Emotional abuse or neglect?
( Exercise: Risk Assessment Case Vignette
Divide into small groups. Using the case vignette, complete the risk assessment tool
within the groups. When you are finished, compare your results with those of the other
groups. Are there different responses?
Tools:
Harding/Layer Case Example, Part C
Risk Assessment Tool
Risk Assessment Definitions Sheet
Additional Questions to Consider…
After completing the risk assessment on the Harding/Layer case vignette, compare your
list of risk factors with the SDM® risk assessment tool. Consider the following questions:
1. How much should each factor be weighted?
2. What are the strengths and limitations of this tool?
3. Is there anything missing from the current risk assessment tool, in your opinion?
Should any of the factors be eliminated or changed in the current tool?
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Handout 4
Harding/Layer Case Example (Part C)15
Child Victim: Nelson Layer, DOB 04-19-03
Mother: Ann Harding
Father: Jay Layer
Father’s Sister: Linda Layer
Continued Assessment/Investigation
This worker placed Nelson in an emergency shelter while the investigation continues into the
mother’s whereabouts, fitness, and/or potential relatives for placement. The worker reviewed
the mother’s previous abuse and service history. She was substantiated for similar abuse on her
older son. She is also reported to have said that she never wanted a son. She was hoping for a
girl. At the time of the previous termination of parental rights, she said, “That’s okay—I will have
my girl one day.” She has no known history for substance abuse or mental health issues.
10-27-04
This worker attempted again to reach the mother using the same phone numbers, but there was
no answer. An additional note was left in the mother’s mailbox.
The father called this worker to inquire about his son and to report that he has located his sister,
Linda Layer, and she is willing and able to care for his son. He gave his sister’s address as 137
Alger St., Anytown, California, with a phone number of 555-9090. He also provided her date of
birth and social security number.
Agency and criminal record checks on Linda Layer came back clean.
3:00 p.m.: The worker visited the home of Linda Layer. It is a rented ranch-style home with
three bedrooms and one bath. She lives there with her son, Gadiel, who is 6 years old. She
works full-time at a daycare center, and she has been given permission to bring Nelson to work
with her.
Her son’s father has joint custody, so Gadiel spends every other weekend and holiday with his
father. Linda has a spare bedroom and a twin bed that would be fine for Nelson with side rails
added. She stated she hasn’t seen Nelson in over 6 months since she confronted her brother
about stealing her rent money. She and her son are very pleased to be able to care for Nelson.
Linda agreed to comply with licensing requirements for relatives, and we made arrangements
for her to pick up Nelson from the emergency shelter.
10-28-04
The worker leaves a message under the door of the mother’s apartment and a voice mail on her
answering machine asking her to contact me regarding Nelson.
15
Case example used with permission from CRC (2006, p.112)
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10-29-04: Detention Hearing
Custody is granted to the agency and placement is made with the paternal aunt. The father was
present in court and was adjudicated as the father. The mother was not present.
Assessment with the father following court hearing: The worker asked about the father’s
history. He and his sister were very close, growing up in a happy home where there was no
abuse/neglect. He feels terrible about stealing his sister’s rent money when she had been so
good to him letting him live with her, feeding him, etc. He had a cocaine habit, but he states he
has not used since detox 3 months ago. He did admit to having a few beers when he gets
anxious. He was previously employed as a roofer before he got into drugs and fell off a roof. He
hopes to get full-time employment in that area again soon when he is physically able.
He describes the mother, Ann Harding, as having a lot of brothers and sisters, but they all ran
away as soon as they could to get away from their physically abusive father. He was a barber
who used his barber strap on them at least a couple of times every week. They all ran in
different directions, and she does not know where any of them are. Jay describes her as not
abusing drugs or alcohol.
The father states that he has seen the mother, and she blames him for overreacting to the
bruises and reporting her to the agency. She told the father she refuses to go through this again
with Nelson. She says all the agency will do is try to keep her from seeing her son. She also told
father that if he ends up taking care of Nelson for more than a few hours or a day that he better
learn not to be so lenient when disciplining him.
The worker goes to the mother’s house after the court hearing and finds her there. The
apartment is clean and neat and contains all the appropriate supplies to care for an infant. The
mother is extremely hostile and states that she does not trust anyone from the agency and will
not reveal personal information to them ever again. The last time she dealt with the agency, she
thought what she told the worker was confidential, but then they talked about it at court. The
worker went over the safety plan for Nelson, and the mother stated that she is okay with Nelson
being with Jay’s sister. She does not want Nelson in foster care, and she wants access to him at
Linda’s at any time. The worker explained the need for her having only supervised visits with
Nelson due to the substantiated finding of her abuse of him. The mother neither denied nor
admitted harming Nelson. She was fine with Linda doing the supervision and only occasionally
having this worker present. She agreed to meet with Jay and the worker to review a case plan
for reunification to the father and to establish a clear visitation agreement for her.
STOP: COMPLETE RISK ASSESSMENT
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CALIFORNIA FAMILY RISK ASSESSMENT
Referral Name:
County Name:
r: 11/2004
Referral #:
Date:
Worker Name:
NEGLECT
N1. Current Complaint is for Neglect
a. No..................................................................................... 0
b. Yes ................................................................................... 2
Prior Investigations (assign highest score that applies)
a. None................................................................................-1
b. One or more, abuse only.................................................. 1
c. One or two for neglect ..................................................... 2
d. Three or more for neglect ................................................ 3
N3.
Household has Previously Received CPS (voluntary/court-ordered)
a. No..................................................................................... 0
b. Yes ................................................................................... 3
N4.
Number of Children Involved in the CA/N Incident
a. One, two, or three ............................................................ 0
b. Four or more .................................................................... 2
N5.
Age of Youngest Child in the Home (Age =
)
a. Two or older .................................................................... 0
b. Under two ........................................................................ 1
N6.
Primary Caretaker Provides Physical Care Inconsistent with Child Needs
a. No..................................................................................... 0
b. Yes ................................................................................... 1
Primary Caretaker has a History of Abuse or Neglect as a Child
a. No..................................................................................... 0
b. Yes ................................................................................... 2
N8.
Primary Caretaker has/had a Mental Health Problem
a. None/Not applicable ........................................................ 0
b. One or more apply ........................................................... 1
During the last 12 months AND/OR
Prior to the last 12 months
N9.
Primary Caretaker has/had a Drug or Alcohol Problem
a. None/Not applicable ........................................................ 0
b. One or more apply ........................................................... 2
During the last 12 months AND/OR
Prior to the last 12 months
/
ABUSE
A1. Current Physical Abuse Complaint is Substantiated
a. No....................................................................................0
b. Yes ..................................................................................1
Score
N2.
N7.
/
Worker ID#:
N10. Primary Caretaker has Criminal Arrest History
a. No..................................................................................... 0
b. Yes ................................................................................... 1
N11. Characteristics of Children in Household (score 1 if any present)
a. Not applicable.................................................................. 0
b. One or more present (check all applicable) .................... 1
Developmental or physical disability
Medically fragile/failure to thrive
Positive toxicology screen at birth
Score
A2.
Number of Prior Abuse Investigations (number:
)
a. None ................................................................................0
b. One ..................................................................................1
c. Two or more....................................................................2
A3.
Household has Previously Received CPS (voluntary/court-ordered)
a. No....................................................................................0
b. Yes ..................................................................................2
A4.
Prior Injury to a Child Resulting from CA/N
a. No....................................................................................0
b. Yes ..................................................................................2
A5.
Primary Caretaker=s Assessment of Incident (score 1 if
any present)
a. Not applicable .................................................................0
b. One or more present (check all applicable)....................1
Blames child, and/or
Justifies maltreatment of a child
A6.
Two or More Incidents of Domestic Violence in the Household
in the Past Year
a. No....................................................................................0
b. Yes ..................................................................................1
A7.
Primary Caretaker Characteristics (score 1 if any present)
a. Not applicable .................................................................0
b. One or more present (check all applicable)....................1
Provides insufficient emotional/psychological support
Employs excessive/inappropriate discipline
Domineering caretaker
A8.
Primary Caretaker has a History of Abuse or Neglect as a Child
a. No....................................................................................0
b. Yes ..................................................................................1
A9.
One or More Caretaker(s) has/had Alcohol and/or Drug Problem
a. No....................................................................................0
b. Yes (check all applicable) ..............................................1
During the last 12 months:
[ ] Primary Caretaker [ ] Secondary Caretaker
Prior to the last 12 months:
[ ] Primary Caretaker [ ] Secondary Caretaker
A10. Primary Caretaker has a Criminal Arrest History
a. No....................................................................................0
b. Yes ..................................................................................1
N12. Current Housing
a. Not applicable.................................................................. 0
b. One or more apply ........................................................... 1
Physically unsafe, AND/OR
Family homeless
A11. Characteristics of Children in Household (score 1 if any present)
a. Not applicable .................................................................0
b. One or more present (check all applicable)....................1
Delinquency history
Developmental disability
Mental health/behavioral problem
TOTAL NEGLECT RISK SCORE
TOTAL ABUSE RISK SCORE
SCORED RISK LEVEL. Assign the family=s scored risk level based on the highest score on either the neglect or abuse indices, using the following chart:
Abuse Score
Scored Risk Level
Neglect Score
-1 - 0
0-1
Low
1-3
2-4
Moderate
4-8
5-8
High
9+
9+
Very High
POLICY OVERRIDES. Mark yes if a condition shown below is applicable in this case. If any condition is applicable, override final risk level to very high.
Yes
No
1. Sexual abuse case AND the perpetrator is likely to have access to the child victim.
Yes
No
2. Non-accidental injury to a child under age two years.
Yes
No
3. Severe non-accidental injury.
Yes
No
4. Parent/caretaker action or inaction resulted in death of a child due to abuse or neglect (previous or current).
DISCRETIONARY OVERRIDE. If a discretionary override is made, mark yes, increase risk by one level, and indicate reason.
Yes
No
5. If yes, override risk level (mark one):
Moderate
High
Very High
Discretionary override reason:
Supervisor=s Review/Approval of Discretionary Override:
FINAL RISK LEVEL (mark final level assigned):
[O:\657CA\Training Materials 1-05\Worker Training\P&P Manual.doc]
Date:
Low
Moderate
High
/
/
Very High
© 2005, CDSS and CRC, All Rights Reserved
Handout 4
FAMILY RISK ASSESSMENT DEFINITIONS16
The risk assessment form is composed of two indices: the neglect assessment and the
abuse assessment. Only one household can be assessed on a risk assessment form. If
two households are involved in the alleged incident(s), separate risk assessment forms
should be completed for each household.
The household includes all persons who have significant in-home contact with the
child(ren), including those who have a familial or intimate relationship with any person in
the home.
The primary caretaker is the adult living in the household who assumes the most
responsibility for childcare. When two adult caretakers are present and the social worker
is in doubt about which one assumes the most childcare responsibility, the adult with
legal responsibility for the child(ren) involved in the incident should be selected as the
primary caretaker. For example, when a mother and her boyfriend reside in the same
household and appear to equally share caretaking responsibilities for the child(ren), the
mother is selected. If this does not resolve the question, the legally responsible adult
who was a perpetrator or alleged perpetrator should be selected. For example, when a
mother and a father reside in the same household and appear to equally share
caretaking responsibilities for the child(ren) and the mother is the perpetrator (or the
alleged perpetrator), the mother is selected. In circumstances where both parents are in
the household, equally sharing caretaking responsibilities, and both have been identified
as perpetrators or alleged perpetrators, the parent demonstrating the more severe
behavior is selected. Only one primary caretaker can be identified.
The secondary caretaker is defined as an adult living in the household who has routine
responsibility for childcare but less responsibility than the primary caretaker. A partner
may be a secondary caretaker even though he/she has minimal responsibility for care of
the child(ren).
NEGLECT INDEX
N1.
Current Complaint Is for Neglect
Score 2 if the current complaint is for any type of neglect. This includes:
•
•
•
severe and general neglect,
exploitation (excluding sexual exploitation), and
caretaker absence/incapacity.
This includes referred allegations as well as allegations made during the course
of the investigation.
16
Definitions reproduced with permission from CRC (2005, p. 31)
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N2.
Prior Investigations
Score the appropriate amount based on the number of prior investigations and
the type of complaint investigated.
a) Score -1 if there were no investigations (do not include referrals that were not
assigned for investigation) prior to the current investigation.
b) Score 1 if there was one or more investigations (do not include referrals that
were not assigned for investigation), substantiated or not, for any type of
abuse prior to the current investigation. Abuse includes physical, emotional,
or sexual abuse/sexual exploitation.
c) Score 2 if there was one or two investigations (do not include referrals that
were not assigned for investigation), substantiated or not, for any type of
neglect prior to the current investigation, with or without abuse investigations.
Neglect includes severe and general neglect, exploitation (excluding sexual
exploitation), and caretaker being absent/incapacitated.
d) Score 3 if there were three or more investigations (do not include referrals
that were not assigned for investigation), substantiated or not, for any type of
neglect prior to the current investigation, with or without abuse investigations.
Neglect includes severe and general neglect, exploitation (excluding sexual
exploitation), and caretaker absent/incapacitated.
Where possible, history from other county or state jurisdictions should be
checked. Exclude investigations of out-of-home perpetrators (e.g., daycare)
unless one or more caretakers failed to protect.
N3.
Household Has Previously Received CPS (voluntary/court-ordered)
Score 3 if the household has previously received child protective services or is
currently receiving services as a result of a prior investigation. Service history
includes voluntary or court-ordered family services or Family Preservation
Services, but does not include delinquency services.
N4.
Number of Children Involved in the Child Abuse/Neglect Incident
Score the appropriate amount given the number of children under 18 years of
age for whom abuse or neglect was alleged or substantiated in the current
investigation.
N5.
Age of Youngest Child in the Home
Enter the age, in years, of the youngest child living in the home. Enter zero for
children under age 1. Score the appropriate amount given the current age of the
youngest child presently in the household where the maltreatment incident
reportedly occurred. If a child is removed as a result of the current investigation,
count the child as residing in the home.
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N6.
Primary Caretaker Provides Physical Care Inconsistent with Child Needs
Score 1 if physical care of the child(ren) (age-appropriate feeding, clothing,
shelter, hygiene, and medical care of the child[ren]) threatens the child(ren)’s
well-being or results in harm to the child(ren). Examples include:
•
•
•
•
•
•
•
•
repeated failure to obtain standard immunizations,
failure to obtain medical care for severe or chronic illness,
repeated failure to provide child(ren) with clothing appropriate to the
weather,
persistent rat or roach infestations,
inadequate or inoperative plumbing or heating,
poisonous substance or dangerous objects lying within reach of small
child(ren),
child(ren) is wearing filthy clothes for extended periods of time, and/or
child(ren) is not being bathed on a regular basis resulting in dirt caked on
skin and hair and a strong odor.
N7.
Primary Caretaker Has a History of Abuse or Neglect as a Child
Score 2 if credible statements by the primary caretaker or others, or state records
of past allegations, indicate that the primary caretaker was maltreated as a child
(maltreatment includes neglect or physical, sexual, or other abuse).
N8.
Primary Caretaker Has/Had a Mental Health Problem
a) Score 0 if the primary caretaker has no current or past mental health problem.
b) Score 1 if credible and/or verifiable statements by the primary caretaker or
others indicate that the primary caretaker:
•
•
•
has been diagnosed as having a significant mental health disorder as
indicated by a Diagnostic and Statistical Manual (DSM) condition
determined by a mental health clinician,
had repeated referrals for mental health/psychological evaluations, or
was recommended for treatment/hospitalization or treated/hospitalized
for emotional problems.
Indicate whether the mental health problem was/is present DURING the past 12
months, AND/OR was present prior to the last 12 months.
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N9.
Primary Caretaker Has/Had a Drug or Alcohol Problem
a) Score 0 if the primary caretaker does not have and never has had a drug or
alcohol problem.
b) Score 2 if the primary caretaker has a past or current alcohol/drug abuse
problem that interferes with his/her or the family’s functioning. Such
interference is evidenced by:
•
•
•
•
•
•
•
substance use that affects or affected:
ƒ employment,
ƒ criminal involvement,
ƒ marital or family relationships,
ƒ ability to provide protection, supervision, and care for the child;
an arrest in the past 2 years for driving under the influence (DUI) or
refusing breathalyzer testing;
self-report of a problem;
treatment received currently or in the past;
multiple positive urine samples;
health/medical problems resulting from substance use and/or abuse;
child was diagnosed with Fetal Alcohol Syndrome or Exposure (FAS or
FAE) or child had a positive toxicology screen at birth and primary
caretaker was birthing parent.
Legal, non-abusive prescription drug use should not be scored.
Indicate whether the drug or alcohol problem was/is present DURING the past 12
months, AND/OR was present prior to the last 12 months.
N10. Primary Caretaker Has Criminal Arrest History
Score 1 if the primary caretaker has been arrested or convicted prior to the
current complaint as either an adult or a juvenile. This includes DUI, but excludes
all other traffic offenses. Information may be located in the case narrative
material, reports from other agencies, etc. Also, review any police reports in the
file for this information.
N11. Characteristics of Children in Household
a) Score 0 if no child in the household exhibits characteristics listed below.
b) Score 1 if one or more of the following characteristics are present for a
child(ren) in the home, and check which are applicable:
•
Any child has a developmental or physical disability, including any of
the following: mental retardation, learning disability, other
developmental problem, or significant physical handicap.
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Handout 4
•
•
Any child in the household is medically fragile, defined as having a
long-term (6 months or more) physical condition requiring medical
intervention, or is diagnosed as failure to thrive.
Any child had a positive toxicology screen for alcohol or another drug
at birth.
N12. Current Housing
a) Score 0 if the family has housing that is physically safe.
b) Score 1 if any of the following apply:
•
•
The family has housing, but the current housing situation is physically
unsafe such that it does not meet the health or safety needs of the
child(ren) (e.g., exposed wiring, inoperable heat or plumbing, roach/rat
infestations, human/animal waste on floors, rotting food).
The family is homeless or was about to be evicted at the time the
investigation began. Consider as “homeless” people who are living in a
shelter and those living on a short-term basis with relatives or friends.
ABUSE INDEX
A1.
Current Physical Abuse Complaint Is Substantiated
Score 1 if a physical abuse complaint was investigated and substantiated. This
includes substantiation of referred allegations or allegations made during the
course of the investigation.
A2.
Number of Prior Abuse Investigations
Score the appropriate amount given the count of all investigations, substantiated
or not, which were assigned for child protective services investigation for any
type of abuse (physical, emotional, or sexual abuse/sexual exploitation) prior to
the complaint resulting in the current investigation. Where possible, abuse history
from other county or state jurisdictions should be checked. Exclude investigations
of out-of-home perpetrators (e.g., daycare) unless one or more caretakers failed
to protect.
A3.
Household Has Previously Received CPS (Voluntary/Court-ordered)
Score 2 if household has previously received child protective services or is
currently receiving services as a result of a prior investigation. Service history
includes voluntary or court-ordered family services or Family Preservation
Services, but does not include delinquency services.
A4.
Prior Injury to a Child Resulting from Child Abuse/Neglect
Score 2 if a child(ren) sustained an injury resulting from abuse and/or neglect
prior to the complaint which resulted in the current investigation. Injury sustained
as a result of abuse or neglect may range from bruises, cuts, and welts to an
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delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Handout 4
injury which requires medical treatment or hospitalization such as a bone fracture
or burn.
A5.
Primary Caretaker’s Assessment of Incident
a) Score 0 if none of the characteristics below is applicable, or if the incident is
neglect.
b) Score 1 if one or both of the following characteristics apply to the primary
caretaker:
•
•
The primary caretaker blames the child(ren) for incident. Blaming
refers to the caretaker’s statement that the maltreatment incident
occurred because of the child(ren)’s action or inaction (for example,
claiming that the child[ren] seduced him/her, or the child[ren] deserved
beating because he/she misbehaved).
The primary caretaker justifies maltreatment of the child(ren). Justifying
refers to the caretaker’s statement that their action or inaction, which
resulted in harm to the child(ren), was appropriate (for example,
claiming that this form of discipline was how they were raised, so it is
acceptable).
A6.
Two or More Incidents of Domestic Violence in the Household in the Past
Year
Score 1 if in the previous year, there have been two or more physical assaults or
multiple periods of intimidation/threats/harassment between caretakers or
between a caretaker and another adult.
A7.
Primary Caretaker Characteristics
a) Score 0 if the primary caretaker does not exhibit characteristics listed below.
b) Score 1 if one or more of the following characteristics apply to the primary
caretaker and check which are applicable:
•
•
The primary caretaker provides insufficient emotional/psychological
support to the child(ren), such as persistently berating/belittling/
demeaning the child(ren) or depriving the child(ren) of affection or
emotional support.
The primary caretaker employs excessive/inappropriate discipline.
Disciplinary practices caused or threatened harm to the child(ren)
because they were excessively harsh physically or emotionally and/or
were inappropriate to the child(ren)’s age or development. Examples
include: locking the child(ren) in closet or basement, holding the
child(ren)’s hand over fire, hitting the child(ren) with dangerous
instruments, or depriving a young child(ren) of physical and/or social
activity for extended periods.
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delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Handout 4
•
The primary caretaker is domineering, indicated by controlling,
abusive, overly-restrictive, or unfair behavior or over-reactive rules.
A8.
Primary Caretaker Has a History of Abuse or Neglect as a Child
Score 1 if credible statements by the primary caretaker or others indicate that the
primary caretaker was maltreated as a child (maltreatment includes neglect or
physical, sexual, or other abuse).
A9.
One or More Caretakers Has/Had Alcohol and/or Drug Problem
a) Score 0 if no caretaker has or has ever had an alcohol or drug problem.
b) Score 1 if any caretaker has a past or current alcohol/drug abuse problem
that interferes with his/her or the family’s functioning. Such interference is
evidenced by:
•
•
•
•
•
•
•
substance use that affects or affected:
ƒ employment,
ƒ criminal involvement,
ƒ marital or family relationships,
ƒ ability to provide protection, supervision, and care for the child;
an arrest in the past 2 years for driving under the influence or refusing
breathalyzer testing;
self-report of a problem;
received or is receiving treatment;
multiple positive urine samples;
health/medical problems resulting from substance use;
child was diagnosed with Fetal Alcohol Syndrome or Exposure (FAS or
FAE), or child had a positive toxicology screen at birth and secondary
caretaker was birthing parent.
Legal, non-abusive prescription drug use should not be scored.
Indicate whether the primary AND/OR secondary caretaker’s alcohol or drug
problem is present at this time or DURING the past 12 months.
Indicate whether the primary AND/OR secondary caretaker’s alcohol or drug
problem was present prior to the last 12 months. BOTH timeframes may be
marked if applicable.
A10. Primary Caretaker Has a Criminal Arrest History
Score 1 if the primary caretaker has been arrested or convicted prior to the
current complaint as either an adult or a juvenile. This includes DUI but excludes
all other traffic offenses. Information may be located in the case narrative
material, reports from other agencies, etc. Also, review any police reports in the
file for this information.
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delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Handout 4
A11. Characteristics of Children in Household
a) Score 0 if no child in the household exhibits characteristics listed below.
b) Score 1 if one or more of the following characteristics are present for a
child(ren) in the home, and check which are applicable:
•
•
•
Any child in the household has been referred to juvenile court for
delinquent or status offense behavior. Status offenses not brought to
court attention but that create stress within the household should also
be scored, such as children who run away or are habitually truant.
Any child has a developmental disability, including any of the following:
mental retardation, learning disability, or other developmental problem.
Any child in the household has mental health or behavioral problems
not related to a physical or developmental disability (includes
ADHD/ADD). This could be indicated by a DSM diagnosis, receiving
mental health treatment, attendance in a special classroom because of
behavioral problems, or currently taking psychoactive medication.
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delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Handout 5
SDM® ASSESSMENT TOOLS:
FAMILY STRENGTHS AND NEEDS ASSESSMENT (FSNA)
Questions to Consider:
1. What is the primary goal of the FSNA?
2. How should a case plan be created? How does a case plan address the following
factors:
•
•
•
Child protective factors
Child risk factors
Family and child resilience
3. Who should be involved in creating a case plan?
4. What are the key factors that need to be considered when developing an
effective case plan?
5. Should the development of a case plan be standardized?
6. What are the strengths and limitations of the FSNA?
7. Is a case plan the best way to meet the client’s needs? An agency’s needs?
8. Is improving child and family functioning required by federal or state law? Should
it be?
( Exercise: Family Strengths and Needs Case Vignette
Divide into small groups. Using the case vignette, complete the Family Strengths and
Needs Assessment Tool within the groups, and create a service plan for the
Harding/Layer family. When you are finished, compare your results with those of the
other groups. How different are the service plans?
Tools:
Harding/Layer Case Example, Part D
Family Strengths and Needs Assessment Tool
Family Strengths and Needs Assessment Definitions Sheet
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delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Handout 5
Harding/Layer Case Example (Part D)17
Child Victim: Nelson Layer, DOB 04-19-03
Mother: Ann Harding
Father: Jay Layer
Father’s Sister: Linda Layer
11-10-04: Family Conference
The mother, father, and aunt were present. The mother wants to be certain that Nelson is going
to stay with his aunt. The mother refused to provide any current information or work on any case
plan. She agreed to sign releases of information for Nelson. She came because she wants to
visit Nelson, and Linda told her that she had to have a visitation plan with the agency, so she is
here only for that. After discussion, it was agreed that the mother could see Nelson once a week
for a 1-hour supervised visit, with the aunt doing the supervision. The mother must call 24 hours
in advance to confirm that she will attend. The father will be allowed twice-weekly visits and
must also call to confirm his attendance.
When the discussion turned to developing a case plan for reunification, Ann left, but she said
she had no problem with Jay and Linda caring for Nelson as long as Jay cleans up his act first.
Jay stated that his and Ann’s relationship lasted about a year. They met when his company was
replacing the roof on her apartment building. They moved in together after a few weeks of
dating. He says their relationship fell apart because of his escalating drug usage. He would
disappear for days at a time until she packed his belongings and changed the locks. He reports
that there was never any violence in the relationship. He states he supported her in every way
during the pregnancy, but she refused him access to Nelson for 7-8 months before he
completed rehab.
Jay agreed that he needs to comply with his substance abuse treatment and random screens.
He suggested that he would like to attend the parenting education classes held at the detox
facility.
He admitted to being quite uncertain about how to care for Nelson full-time. Linda agreed,
stating Jay really has no idea how to care for a small child. For example, he has asked her why
Nelson is not potty-trained yet. He stated that he has several friends who have been clean and
sober for several years who are willing to help him by coaching him. The father also suggested
he would like the assistance of the job placement center so when he is medically cleared, he
can work full-time and have the resources to get a place for him and his son. Jay says he was a
licensed master roofer. He does temporary day labor work to cover his expenses while at the
halfway house, but that won’t be enough to support his son.
Jay agreed to keep the worker informed of his living arrangements at all times and have regular
contact with the worker. Jay will find out how to renew his roofing license to get full-time work to
support his son.
17
Case example used with permission from CRC (2006, p. 114)
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delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Handout 5
Since he fell from the roof, Jay has been under the care of an orthopedist for treatment of
broken ribs and a punctured lung. He has not been medically cleared to return to work, which is
why he is working as a day laborer. The doctor supplied a free sample of the antibiotic Jay was
on for a recurring infection in his lung, which had been aggravated by his cocaine use. Jay is
hoping that 3 months of being drug free will help the infection clear so he can return to work.
Linda described Nelson as developmentally on target. He is adjusting to his new environment
nicely. He especially enjoys being with Gadiel, and he likes having the dog sleep with him.
Nelson seems very anxious whenever voices are raised. He flinches and draws back if he is
approached quickly. He has had several incidents in which he has been violent toward Gadiel
or the dog. Nelson has seen Linda’s son’s pediatrician for follow-up, and the pediatrician said
his eye is healing well and there is no treatment needed at this time for the healed fractures.
Linda described her brother as having been an incredible source of support to her when she
went through her divorce, and that he is seen by everyone as willing to do for others.
The worker spoke with the halfway house staff, who report that Jay has good relationships with
the other residents and helps others whenever they need it. He has a strong support group
including his sponsor and friends in recovery. He has been diagnosed with chemical
dependency and is doing well in treatment, with his last relapse having been on the day Nelson
went to the hospital. They feel that the father is serious about recovery, but he still needs the
external support of the halfway house. He has started Antabuse to add a layer of protection
against another relapse and needs to learn ways to manage stress better. The father is
described as having pretty low self-esteem.
STOP: COMPLETE FAMILY STRENGTHS AND NEEDS ASSESSMENT
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delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
CALIFORNIA
FAMILY STRENGTHS AND NEEDS ASSESSMENT
(For Caretakers and Children)
Case Name:
Date of Referral:
c: 06/03
Case Number:
Initial or Reassess #: 1
Date of Assessment:
County:
2
3
4
5
Worker:
1. Child Name:
Case #:
4. Child Name:
Case #:
2. Child Name:
Case #:
5. Child Name:
Case #:
3. Child Name:
Case #:
6. Child Name:
Case #:
The following items should be considered for each family/household member. Worker should base score on their assessment for each item, taking
into account family’s perspective, child’s perspective where appropriate, worker observations, collateral contacts, and available records. Refer to
accompanying definitions to determine the most appropriate response. Enter the score for each item.
A.
CARETAKER - Rate each caretaker and enter lowest score.
SN1.
Substance Abuse/Use
(Substances: alcohol, illegal drugs, inhalants, prescription/over-the-counter drugs.)
a. Teaches and demonstrates healthy understanding of alcohol and drugs ......................................................................+3
b. Alcohol or prescribed drug use ......................................................................................................................................0
c. Alcohol or drug abuse...................................................................................................................................................-3
d. Chronic alcohol/drug abuse ..........................................................................................................................................-5
If C or D, check all that apply:
Heroin
Alcohol
Barbiturates
Other Sedatives or Hypnotics
Methamphetamine
Other Amphetamines
Other Stimulants
Cocaine/Crack
Marijuana/Hash
PCP
Tranquilizers
(Benzodiazepine)
Other Tranquilizers
Non-Prescription Methadone
Other Opiates and Synthetics
Inhalants
Over-the-Counter
Other (specify):
SN2.
Household Relationships
a. Supportive....................................................................................................................................................................+3
b. Minor/occasional discord...............................................................................................................................................0
c. Frequent discord ...........................................................................................................................................................-3
d. Chronic discord.............................................................................................................................................................-5
SN3.
Domestic Violence
a. Individuals promote non-violence in the home............................................................................................................+3
b. No threatening or assaultive behaviors among household members..............................................................................0
c. Physical violence/controlling behavior.........................................................................................................................-3
d. Repeated and/or severe physical violence ....................................................................................................................-5
SN4.
Social Support System
a. Strong support system..................................................................................................................................................+2
b. Adequate support system ...............................................................................................................................................0
c. Limited support system.................................................................................................................................................-2
d. No support system ........................................................................................................................................................-4
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Score
SN5.
Parenting Skills
Score
a. Strong skills .................................................................................................................................................................+2
b. Adequately parents and protects child(ren) ...................................................................................................................0
c. Inadequately parents and protects child(ren) ................................................................................................................-2
d. Destructive/abusive parenting.......................................................................................................................................-4
SN6.
Mental Health/Coping Skills
a. Strong coping skills .....................................................................................................................................................+2
b. Adequate coping skills...................................................................................................................................................0
c. Mild to moderate symptoms .........................................................................................................................................-2
d. Chronic/severe symptoms.............................................................................................................................................-4
SN7.
Household History of Criminal Behavior or Child Abuse and Neglect (CA/N)
a. Promotes positive values .............................................................................................................................................+1
b. No criminal behavior or child maltreatment history, or successful problem resolution.................................................0
c. Active involvement.......................................................................................................................................................-1
d. Chronic/severe involvement .........................................................................................................................................-3
If response is B, C, or D, identify household member involved and type of history (check all that apply):
(If criminal history is not available, write AN/A@ in the space provided.)
Criminal
CA/N
Primary Caretaker
Secondary Caretaker
Other Adult
Juvenile
SN8.
Resource Management/Basic Needs
a. Resources sufficient to meet basic needs and are adequately managed .......................................................................+1
b. Resources are limited but are adequately managed .......................................................................................................0
c. Resources are insufficient or not well-managed ...........................................................................................................-1
d. No resources or resources severely limited and/or mismanaged...................................................................................-3
SN9.
Cultural/Community
a. Strong cultural/community resources ..........................................................................................................................+1
b. Some cultural/community resources ..............................................................................................................................0
c. Some cultural/community conflict................................................................................................................................-1
d. Significant cultural/community conflict .......................................................................................................................-3
SN10.
Physical Health
a. Preventive health care is practiced...............................................................................................................................+1
b. Health issues do not affect family functioning ..............................................................................................................0
c. Health concerns/handicaps affect family functioning ...................................................................................................-1
d. Serious health concerns/handicaps result in inability to care for child(ren)..................................................................-2
SN11.
Communication Skills
a. Strong skills .................................................................................................................................................................+1
b. Functional skills.............................................................................................................................................................0
c. Limited skills ................................................................................................................................................................-1
d. Severely limited skills...................................................................................................................................................-2
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B. CHILD - Rate each child according to the current level of functioning.
Child 1
Score
Child 2
Score
Child 3
Score
Child 4
Score
Child 5 Child 6
Score
Score
CSN1. Emotional/Behavioral
a. Strong emotional adjustment .................................................... +3
b. Adequate emotional adjustment...................................................0
c. Limited emotional adjustment ................................................... -3
d. Severely limited emotional adjustment...................................... -5
CSN2. Family Relationships
a. Nurturing/supportive relationships ........................................... +3
b. Adequate relationships.................................................................0
c. Strained relationships................................................................. -3
d. Harmful relationships ................................................................ -5
CSN3. Medical/Physical
a. Preventive health care is practiced............................................ +2
b. Medical needs met .......................................................................0
c. Medical needs impair functioning ............................................. -2
d. Medical needs severely impair functioning ............................... -4
CSN4. Child Development
a. Advanced development............................................................. +2
b. Age-appropriate development......................................................0
c. Limited development ................................................................. -2
d. Severely limited development.................................................... -4
CSN5. Cultural/Community Identity
a. Strong cultural/community identity .......................................... +1
b. Adequate cultural/community identity.........................................0
c. Limited cultural/community identity ......................................... -1
d. Disconnected from cultural/community identity........................ -3
CSN6. Substance Abuse
a. No substance use ...................................................................... +1
b. Experimentation/use ....................................................................0
c. Alcohol or other drug use .......................................................... -1
d. Chronic alcohol or other drug use.............................................. -3
CSN7. Education
Does child have a specialized educational plan?
a.
b.
c.
d.
No
Yes, describe:
Outstanding academic achievement.......................................... +1
Satisfactory academic achievement .............................................0
Academic difficulty ................................................................... -1
Severe academic difficulty......................................................... -3
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Child 1
Score
Child 2
Score
Child 3
Score
Child 4
Score
Child 5 Child 6
Score Score
CSN8. Peer/Adult Social Relationships
a. Strong social relationships ........................................................ +1
b. Adequate social relationships ......................................................0
c. Limited social relationships ....................................................... -1
d. Poor social relationships ............................................................ -2
CSN9. Delinquent Behavior
(Delinquent behavior includes any action which, if committed by an adult,
would constitute a crime.)
a. Preventive activities.................................................................. +1
b. No delinquent behavior................................................................0
c Occasional delinquent behavior................................................. -1
d. Significant delinquent behavior ................................................. -2
C. PRIORITY NEEDS AND STRENGTHS
Enter item number and description of up to three most serious needs (lowest scores) and greatest strengths (highest scores) from Section A
(items SN1-SN11).
Priority Areas of Need
Priority Areas of Strength
1.
1.
2.
2.
3.
3.
Does family identify areas of needs or strengths that are not included in the categories assessed by this tool?
1.
No
2.
Yes, describe:
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Handout 5
FAMILY STRENGTHS AND NEEDS ASSESSMENT DEFINITIONS18
CARETAKER DEFINITIONS
SN1. Substance Abuse/Use
(Substances: alcohol, illegal drugs, inhalants, prescription/over-the-counter
drugs)
a. Teaches and demonstrates a healthy understanding of alcohol and drugs.
Caretaker(s) may use alcohol or prescribed drugs, however, use does not
negatively affect parenting skills and functioning; caretaker(s) teaches and
demonstrates an understanding of the choices made about use or
abstinence and the effects of alcohol and drugs on behavior and society.
b. Alcohol or prescribed drug use. Caretaker(s) may have a history of
substance abuse or may currently use alcohol or prescribed drugs,
however, it does not negatively affect parenting skills and functioning.
c. Alcohol or drug abuse. Caretaker(s) continues to use despite negative
consequences in some areas such as family, social, health, legal, or
financial. Caretaker needs help to achieve and/or maintain abstinence
from alcohol or drugs.
d. Chronic alcohol/drug abuse. Caretaker(s)’ use of alcohol or drugs results
in behaviors which impede their ability to meet their own and/or their
child(ren)’s basic needs. Experiences some degree of impairment in most
areas including family, social, health, legal, and financial. Needs intensive
structure and support to achieve abstinence from alcohol or drugs.
SN2. Household Relationships
a. Supportive. Internal/external stressors (e.g., illness, financial problems,
divorce, special needs) may be present, but household maintains positive
interactions (e.g., mutual affection, respect, open communication,
empathy), and shares responsibilities that are mutually agreed upon by
household members.
b. Minor/occasional discord. Internal/external stressors are present, but
household is coping despite some disruption of positive interactions.
c. Frequent discord. Internal/external stressors are present and household is
consistently experiencing increased disruption of positive interactions
coupled with lack of cooperation and/or emotional/verbal abuse. Custody
and visitation issues are characterized by frequent conflicts. Caretaker(s)’
pattern of adult relationships creates significant stress for the child(ren).
d. Chronic discord. Internal/external stressors are present and household
experiences minimal or no positive interactions. Custody and visitation
issues are characterized by severe conflict, such as multiple instances of
malicious reports to law enforcement and/or child protective services.
18
Definitions reproduced with permission from CRC (2005, p. 50)
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Handout 5
Caretaker(s)’ pattern of adult relationships places child at risk for
maltreatment and/or contributes to severe emotional distress.
SN3. Domestic Violence
a. Individuals promote non-violence in the home. Household members
mediate disputes and promote non-violence in the home. Individuals are
safe from threats, intimidation, or assaults by household members.
b. No threatening or assaultive behaviors among household members.
Conflicts may be resolved through less adaptive strategies such as
avoidance, however, household members do not control each other or
threaten physical or sexual assault within the household.
c. Physical violence/controlling behavior. Adult relationships are
characterized by occasional physical outbursts which do not result in
injuries, and/or controlling behavior which results in isolation or restriction
of activities. Both perpetrator and victim seek help in reducing threats of
violence. If only one party agrees to seek help, score “D” even though the
violence did not result in injury.
d. Repeated and/or severe physical violence. One or more household
members use regular and/or severe physical violence. Individuals engage
in physically assaultive behaviors toward other household members.
Violent or controlling behavior has resulted in injury (bruises, cuts, burns,
welts, broken bones, etc.), extreme isolation, humiliation, or restriction of
activities.
SN4. Social Support System
a. Strong support system. Family regularly engages within a strong,
constructive, mutual-support system. Individuals interact with extended
family, friends, cultural, religious, and/or community support or services
that provide a wide range of resources.
b. Adequate support system. As needs arise, family uses extended family,
friends, cultural, religious, and community resources to provide support
and/or services such as childcare, transportation, supervision, rolemodeling for parent(s) and child(ren), parenting and emotional support,
guidance, etc.
c. Limited support system. Family has limited support system, is isolated, or
reluctant to use available support.
d. No support system. Family has no support system and does not utilize
extended family and community resources.
SN5. Parenting Skills
a. Strong skills. Caretaker(s) displays good knowledge and understanding of
age appropriate parenting skills and integrates use on a daily basis.
Caretaker(s) expresses hope for and recognizes child(ren)’s abilities and
strengths and encourages participation in family and community.
Caretaker(s) advocates for family and responds to changing needs.
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Handout 5
b. Adequately parents and protects child(ren). Caretaker(s) displays
adequate parenting patterns that are age-appropriate for the child(ren) in
areas of expectations, discipline, communication, protection, and
nurturing. Caretaker(s) has basic knowledge and skills to parent.
c. Inadequately parents and protects child(ren). Improvement of basic
parenting skills is needed by caretaker(s). The caretaker(s) has some
unrealistic expectations and gaps in parenting skills, demonstrates poor
knowledge of age-appropriate disciplinary methods, and/or lacks
knowledge of child development that interferes with effective parenting.
d. Destructive/abusive parenting. Caretaker(s) displays destructive/abusive
parenting patterns that result in significant harm to the child(ren).
SN6. Mental Health/Coping Skills
a. Strong coping skills. Caretaker(s) demonstrates the ability to deal with
adversity, crises, and long-term problems in a constructive manner.
Caretaker(s) demonstrates realistic, logical thinking and judgment.
Caretaker(s) displays resiliency; has a positive, hopeful attitude.
b. Adequate coping skills. Caretaker(s) demonstrates emotional responses
that are consistent with circumstances; displays no apparent inability to
cope with adversity, crises, or long-term problems.
c. Mild to moderate symptoms. Caretaker(s) displays periodic mental health
symptoms including, but not limited to, depression, low self-esteem, or
apathy. Caretaker(s) has occasional difficulty dealing with situational
stress, crises, or problems.
d. Chronic/severe symptoms. Caretaker(s) displays chronic, severe mental
health symptoms, including but not limited to, depression, apathy, or
severe low self-esteem. These symptoms impair the caretaker(s)’ ability to
perform in one or more areas of parental functioning, employment,
education, or provision of food and shelter.
SN7. Household History of Criminal Behavior or Child Abuse and Neglect
a. Promotes positive values. No criminal behavior or child abuse and neglect
history and household members teach and demonstrate values that
promote respect for self and others.
b. No criminal or child maltreatment history, or successful problem
resolution. No history of prior criminal behavior or child maltreatment; OR
if there has been prior criminal behavior or child maltreatment history,
household members have demonstrated ability to resolve crises
appropriately through the use of community resources.
c. Active involvement. Household member’s caretaking role is negatively
affected by criminal behavior or child maltreatment such as outstanding
warrants, arrests, and/or history with CPS, which have not been
successfully resolved.
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Handout 5
d. Chronic/severe involvement. No household member is able/available to
safely assume caretaker role due to chronic criminal behavior/CPS
involvement with failed service plans.
SN8. Resource Management/Basic Needs
a. Resources sufficient to meet basic needs and are adequately managed.
Caretaker(s) has a history of consistently providing safe, healthy, and
stable housing; nutritional food; and clothing.
b. Resources are limited but are adequately managed. Caretaker(s) provides
adequate housing, food, and clothing to meet basic needs.
c. Resources are insufficient or not well-managed. Caretaker(s) provides
housing but it does not meet the basic needs of the child(ren) due to such
things as inadequate plumbing, heating, wiring, or housekeeping. Food
and/or clothing do not meet basic needs of the child(ren). Family may be
homeless; however, there is no evidence of harm or threat of harm to the
child(ren).
d. No resources or resources severely limited and/or mismanaged.
Conditions exist in the household that have caused illness or injury to
family members such as inadequate plumbing, heating, wiring,
housekeeping; there is no food, food is spoiled, or family members are
malnourished. The child(ren) chronically presents with clothing that is
unclean, not appropriate for weather conditions, or is in poor repair. Family
is homeless, which results in harm or threat of harm to the child(ren).
SN9. Cultural/Community
a. Strong cultural/community resources. Caretaker(s) identifies with a cultural
or community group and it is a resource for them. They do not experience
conflict as a result of their identification, and they do not exhibit behavior,
rooted in their identification, that adversely impacts the child(ren).
b. Some cultural/community resources. Caretaker(s) does not identify with a
cultural or community group, or does identify with a cultural or community
group but it does not serve as a resource or source of conflict. They do not
exhibit behavior, rooted in their identification, that adversely impacts the
child(ren).
c. Some cultural/community conflict. Caretaker(s) identifies with a cultural or
community group and it may or may not be a resource for them. They
experience some degree of conflict as a result of their identification, OR
exhibit some degree of behavior, rooted in their identification, that
adversely impacts the child(ren).
d. Significant cultural/community conflict. Caretaker(s) identifies with a
cultural or community group and it may or may not be a resource for them.
They experience a significant degree of conflict as a result of their
identification, OR exhibit a significant degree of negative behavior, rooted
in their identification, that adversely impacts the child(ren).
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Handout 5
SN10.
Physical Health
a. Preventive health care is practiced. Caretaker(s) teaches and promotes
good health.
b. Health issues do not affect family functioning. Caretaker(s) has no
current health concerns that affect family functioning. Caretaker(s)
accesses regular health resources for him/herself (e.g., medical/dental).
c. Health concerns/handicaps affect family functioning. Caretaker(s) has
health concerns or conditions that affect family functioning and/or family
resources.
d. Serious health concerns/handicaps result in inability to provide care for
child(ren). Caretaker(s) has serious/chronic health problem(s) or
condition(s) that affects his/her ability to care for and/or protect the
child(ren).
SN11.
Communication Skills
a. Strong skills. Caretaker(s)’ communication skills facilitate successful
accessing of services and resources to promote family functioning. If
caretaker(s) requires translation services, he/she obtains such services
whenever needed.
b. Functional skills. Caretaker(s)’ communication skills are no barrier to
effective family functioning, accessing resources, or assisting child(ren)
in community or school. If caretaker(s) requires translation services,
he/she uses such services when provided.
c. Limited skills. Caretaker(s) has limited communication skills resulting in
difficulty accessing resources which interferes with family functioning. If
caretaker(s) requires translation services, he/she experiences difficulty
accessing such services.
d. Severely limited skills. Caretaker(s) has severely limited communication
skills resulting in an inability to access resources which severely affects
family functioning. If caretaker(s) requires translation services, he/she is
unwilling/unable to communicate even when provided with such
services.
CHILD DEFINITIONS
For each item, if not applicable due to child’s age, score as “0.”
CSN1.
Emotional/Behavioral
a. Strong emotional adjustment. Child displays strong coping skills in
dealing with crises and trauma, disappointment, and daily challenges.
Child is able to develop and maintain trusting relationships. Child is also
able to identify the need for, seeks, and accepts guidance.
b. Adequate emotional adjustment. Child displays developmentally
appropriate emotional/coping responses that do not interfere with
school, family, or community functioning. Child may demonstrate some
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Handout 5
depression, anxiety, or withdrawal symptoms that are situationally
related. Child maintains situationally appropriate emotional control.
c. Limited emotional adjustment. Child has occasional difficulty dealing
with situational stress, crises, or problems, which impairs functioning.
Child displays periodic mental health symptoms including, but not
limited to: depression, running away, somatic complaints, hostile
behavior, or apathy.
d. Severely limited emotional adjustment. Child’s ability to perform in one
or more areas of functioning is severely impaired due to chronic/severe
mental health symptoms such as fire-setting, suicidal behavior, or
violent behavior toward people and/or animals.
CSN2.
Family Relationships
For children in voluntary or court-ordered placement, score the child’s family,
not their placement family. For children in permanent placements, continue to
score the child’s family, basing assessment on visits and other contact such as
telephone contact or letters. If the child has no contact with his/her family,
score “0.”
a. Nurturing/supportive
relationships.
Child
experiences
positive
interactions with family members. Child has sense of belonging within
the family. Family defines roles, has clear boundaries, and supports
child’s growth and development.
b. Adequate relationships. Child experiences positive interactions with
family members and feels safe and secure in family, despite some
unresolved family conflicts.
c. Strained relationships. Stress/discord within the family interferes with
child’s sense of safety and security. Family has difficulty identifying and
resolving conflict and/or obtaining support and assistance on their own.
d. Harmful relationships. Chronic family stress, conflict, or violence
severely impedes child’s sense of safety and security. Family is unable
to resolve stress, conflict, or violence on their own and are not able nor
willing to obtain outside assistance.
CSN3.
Medical/Physical
a. Preventive health care is practiced. Child has no known health care
needs. Child receives routine preventive and medical/dental/vision care
and immunizations.
b. Medical needs met. Child has no unmet health care needs. Special
conditions may exist but are adequately addressed.
c. Medical needs impair functioning. Child has medical condition(s) that
may impair daily functioning. Special conditions exist that are not
adequately addressed and/or routine medical/dental/vision care is
needed.
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Handout 5
d. Medical needs severely impair functioning. Child has serious, chronic,
or acute medical condition(s) that severely impairs functioning, and
needs are unmet.
CSN4.
Child Development
a. Advanced development. Child’s physical and cognitive skills are above
chronological age level.
b. Age-appropriate development. Child’s physical and cognitive skills are
consistent with chronological age level.
c. Limited development. Child does not exhibit most physical and cognitive
skills expected for chronological age level.
d. Severely limited development. Most of child’ physical and cognitive skills
are two or more age levels behind chronological age expectations.
CSN5.
Cultural/Community Identity
a. Strong cultural/community identity. Child identifies with cultural and
community heritage and beliefs, and is connected with people who
share similar belief systems. Child knows cultural/community resources,
both formal and informal, and accesses them as needed.
b. Adequate cultural/community identity. Child identifies with cultural/
community heritage and beliefs, practices, and traditions within the
family. Child recognizes how to access resources in the greater
community. Child may experience some conflict and may struggle with
cultural/community identity, yet is able to cope.
c. Limited cultural/community identity. Child experiences inter-generational
and/or societal conflict surrounding values and norms related to
cultural/community differences. Child perceives services and supports
as unavailable or access as limited. Conflicts with cultural/community
identity create difficulties for child.
d. Disconnected from cultural/community identity. Child is disconnected
from cultural/community heritage and beliefs resulting in isolation, lack
of support, and lack of access to resources. Connections are
unavailable, or perceived as unavailable, due to child’s lack of
understanding of cultural and language differences of support networks.
Conflicts with cultural/community identity result in problematic behavior.
CSN6.
Substance Abuse
a. No substance use. Child does not use alcohol or other drugs and is
aware of consequences of use. Child avoids peer relations/social
activities involving alcohol and other drugs, and/or chooses not to use
substances despite peer pressure/opportunities to do so.
b. Experimentation/use. Child does not use alcohol or other drugs. Child
may have experimented with alcohol or other drugs, but there is no
indication of sustained use. Child has no demonstrated history or
current problems related to substance use.
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delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Handout 5
c. Alcohol or other drug use. Child’s alcohol or other drug use results in
disruptive behavior and discord in relationships in school/community/
family/work. Use may have broadened to include multiple drugs.
d. Chronic alcohol or other drug use. Child’s chronic alcohol or other drug
use results in severe disruption of functioning, such as loss of
relationships, job, school suspension/expulsion/drop-out, problems with
the law, and/or physical harm to self or others. Child may require
medical intervention to detoxify.
CSN7.
Education
Does child have a specialized educational plan?
(Specialized educational plan includes IEP, study team, etc.)
a. Outstanding academic achievement. Child is working above grade level
and/or is exceeding the expectations of the child’s specific educational
plan.
b. Satisfactory academic achievement. Child is working at grade level
and/or is meeting the expectations of the child’s specific educational
plan.
c. Academic difficulty. Child is working below grade level in at least one,
but not more than half, of academic subject areas and/or child is
struggling to meet the goals of the existing educational plan. Existing
educational plan may need modification.
d. Severe academic difficulty. Child is working below grade level in more
than half of their academic subject areas and/or child is not meeting the
goals of the existing educational plan. Existing educational plan needs
modification. Also, score “D” for a child who is required by law to attend
school and is not attending.
CSN8.
Peer/Adult Social Relationships
a. Strong social relationships. Child enjoys and participates in a variety of
constructive, age-appropriate social activities. Child enjoys reciprocal,
positive relationships with others.
b. Adequate social relationships. Child demonstrates adequate social
skills. Child maintains stable relationships with others; occasional
conflicts are minor and easily resolved.
c. Limited social relationships. Child demonstrates inconsistent social
skills; child has limited positive interactions with others. Conflicts are
more frequent and serious and child may be unable to resolve them.
d. Poor social relationships. Child has poor social skills as demonstrated
by frequent conflictual relationships or exclusive interactions with
negative or exploitive peers, or child is isolated and lacks a support
system.
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Handout 5
CSN9.
Delinquent Behavior
(Delinquent behavior includes any action which, if committed by an adult,
would constitute a crime.)
a. Preventive activities. Child is involved in community service and/or
crime prevention programs and takes a stance against crime. Child has
no arrest history and there is no other indication of criminal behavior.
b. No delinquent behavior. Child has no arrest history and there is no other
indication of criminal behavior, or child has successfully completed
probation and there has been no criminal behavior in the past 2 years.
c. Occasional delinquent behavior. Child is or has engaged in occasional,
non-violent delinquent behavior and may have been arrested or placed
on probation within the past 2 years.
d. Significant delinquent behavior. Child is or has been involved in any
violent or repeated non-violent delinquent behavior, which has or may
have resulted in consequences such as arrests, incarcerations, or
probation.
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Handout 6
SDM® ASSESSMENT TOOLS, DEFINITIONS, AND PRACTICE CASE
VIGNETTES: REUNIFICATION REASSESSMENT
Questions to Consider:
1. What is the primary goal of the reassessment tools?
2. Why is it important to complete reassessments?
3. What are the pros and cons of using reassessment tools?
4. How often should reassessments be completed? Who should complete the
reassessment tools?
5. What are the implications of different people completing reassessments? What
are the implications of completing reassessments at different times for different
families?
6. What are the strengths and limitations of reassessment tools?
( Exercise: Reunification Reassessment Case Vignette
Divide into small groups. Using the case vignette, complete the reunification
reassessment tool within the groups. When you are finished, compare your results with
those of the other groups. What are the different responses? Where did the differences
lie?
Tools:
Harding/Layer Case Example, Part E
Reunification Reassessment Tool
Reunification Reassessment Definitions Sheet
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Handout 6
Harding/Layer Case Example (Part E)19
Child Victim: Nelson Layer, DOB 04-19-03
Mother: Ann Harding
Father: Jay Layer
Father’s Sister: Linda Layer
6-Month Hearing
Nelson has continued to grow and develop and is experiencing no medical problems. Linda
reports substantial reduction in Nelson’s anxiousness and aggressive behavior. He is now upto-date on all immunizations. Nelson has been observed by this worker and his aunt to be
positively attached to his father and becomes very excited when his father comes for visits.
Recently, Linda reports, Nelson has begun to cry when his father leaves at the end of the visits
and must be consoled and assured that he will return. Linda has placed a picture of Jay and
Nelson on the bureau in his room.
The mother kept her first two visits with Nelson but has not been seen or heard from since. Her
phone number is no longer operable and she has moved from her previous address. Linda and
Jay have agreed that if they hear from the mother, they will tell her she has to contact one
worker before she can have contact with her son.
The father has continued treatment for drug and alcohol abuse. He has been drug free for
almost 9 months and sober for 2 months. He has had several relapses in his alcohol use, but he
called to reschedule his visits with Nelson during those episodes. He has attended 42 of the 48
scheduled visits and rescheduled as required. He has also not yet completed the parenting
education classes in which he is enrolled.
He continues to live at a temporary shelter and works as a temporary laborer. He has been
medically cleared to return to work. Once he has a letter from his counselor at the treatment
center that he has had a consistent 6-month period of sobriety, his master roofer license will be
reinstated and he can resume full-time employment in his area. He is eager to have full-time
care of Nelson. His visits with Nelson are going well, according to Linda and the worker. His
sister feels comfortable enough to leave Jay alone with Nelson for several hours at a time.
During visits, Jay has assumed feeding and changing Nelson and has taken him for his most
recent medical appointment for his immunizations.
Permanency Hearing
Jay has demonstrated sobriety from drugs for over a year and from alcohol for 8 months. He is
attending 12-step meetings at least three times a week and has a positive support system in
place. He has regained full-time employment in roofing, and he has rented a small apartment.
He has consistently visited and cared for his son, and visitation has progressed to overnight.
There was only one occasion when he rescheduled because of illness. Prior to the start of
overnight visits, the worker visited the apartment when Jay and Nelson were there. The
apartment is adequately furnished, clean, neat, and meets the safety needs of a 2-year-old.
19
Case example used with permission from CRC (2006, p. 142)
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delivery project. Berkeley: University of California at Berkeley, California Social Work Education Center.
Handout 6
He has obtained a crib that will convert to a twin bed when Nelson is ready. There is also a toy
box with toys appropriate for Nelson’s age and stage of development.
Jay completed the parenting classes at the detox center, and during visits he has demonstrated
his knowledge and skills at child rearing to his sister and this worker. With his father’s
assistance, Nelson is now potty-trained, and he will be able to continue to attend his aunt’s
daycare at a reduced rate if he is returned to his father.
The mother has not had any contact with this agency or the family. Jay states that should he
hear from Ann he will have no difficulty informing her that he will not let her have contact with
Nelson until she contacts this worker or obtains an attorney and has the matter heard in court.
STOP: COMPLETE REUNIFICATION REASSESSMENT
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CALIFORNIA
REUNIFICATION REASSESSMENT
Case Name:
Case #:
/
Household Assessed:
Is this the removal household?
A.
/
Date Completed:
Yes
No
Assessment # (circle):
1
2
3
4
5
6
REUNIFICATION RISK REASSESSMENT
Score
R1.
Risk Level on Most Recent Referral (not reunification risk level or risk reassessment)
a. Low .......................................................................................................................................................0
b. Moderate ...............................................................................................................................................3
c. High ......................................................................................................................................................4
d. Very high ..............................................................................................................................................5
R2.
Has there been a New Substantiation since the Initial Risk Assessment or Last Reunification Reassessment?
a. No..........................................................................................................................................................0
b. Yes ........................................................................................................................................................2
R3.
Progress Toward Case Plan Goals
a. Successfully met all case plan objectives and routinely demonstrates desired behavior..................... -2
b. Actively participating in programs; routinely pursuing objectives detailed in case plan;
frequently demonstrates desired behavior........................................................................................ -1
c. Partial participation in pursuing objectives in case plan; occasionally demonstrates desired behavior 0
d. Refuses involvement in programs or has exhibited a minimal level of participation with
case plan; rarely or never demonstrates desired behavior ..................................................................4
Total Score
REUNIFICATION RISK LEVEL
Assign the risk level based on the following chart.
Score
-2 to 1
2 to 3
4 to 5
6 and above
Risk Level
Low
Moderate
High
Very High
OVERRIDES (During Current Period)
Override to Very High. Check appropriate reason.
Policy Overrides:
1. Prior sexual abuse; perpetrator has access to child(ren) and has not successfully completed treatment.
2. Cases with non-accidental physical injury to an infant and caretaker(s) have not successfully completed treatment.
3. Serious non-accidental physical injury requiring hospital or medical treatment and caretaker(s) have not successfully completed
treatment.
4. Death of a sibling as a result of abuse or neglect in the household.
Discretionary Override: (Reunification risk level may be adjusted up or down one level)
5. Reason:
FINAL REUNIFICATION
RISK LEVEL:
1. Low
2. Moderate
3. High
4. Very High
Supervisors Review/Approval of Discretionary Override:
Date:
* To be completed for each household to which a child may be returned (e.g., father’s home; mother’s home).
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B.
VISITATION PLAN EVALUATION (See definitions below.)
Visitation Frequency
Compliance with
Visitation Plan
Quality of Face-to-Face Visit
Strong
Adequate
Limited
Destructive
Totally
Routinely
Sporadically
Rarely or Never
Shaded cells indicate acceptable visitation.
Overrides:
Policy: Visitation is supervised for safety
Discretionary (reason):
Definitions
Visitation Frequency - Compliance with Case Plan
(Visits that are appreciably shortened by late arrival/early departure are considered missed.)
Totally:
Routinely:
Sporadically:
Rarely or Never:
Caretaker(s) regularly attends visits or calls in advance to reschedule (90-100% compliance).
Caretaker(s) may miss visits occasionally and rarely requests to reschedule visits (65-89% compliance).
Caretaker(s) misses or reschedules many scheduled visits (26-64% compliance).
Caretaker(s) does not visit or visits 25% or fewer of the allowed visits (0-25% compliance).
Quality of Face-to-face Visit (Quality of visit assessment is based on social worker’s direct observation whenever possible, supplemented by observation
of child, reports of foster parents, etc.)
C.
Strong
Consistently:
C demonstrates parental role.
C demonstrates knowledge of child’s development.
C responds appropriately to child’s verbal/non-verbal signals.
C puts child’s needs ahead of their own.
C shows empathy toward child.
Adequate
Occasionally:
C demonstrates parental role.
C demonstrates knowledge of child’s development.
C responds appropriately to child’s verbal/non-verbal signals.
C puts child’s needs ahead of their own.
C shows empathy toward child.
Limited
Rarely:
C demonstrates parental role.
C demonstrates knowledge of child’s development.
C responds appropriately to child’s verbal/non-verbal signals.
C puts child’s needs ahead of their own.
C shows empathy toward child.
Destructive
Never:
C demonstrates parental role.
C demonstrates knowledge of child’s development.
C responds appropriately to child’s verbal/non-verbal signals.
C puts child’s needs ahead of their own.
C shows empathy toward child.
IF RISK LEVEL IS LOW OR MODERATE AND CARETAKER(S) HAVE ATTAINED AN ACCEPTABLE LEVEL OF
COMPLIANCE WITH VISITATION PLAN, COMPLETE A REUNIFICATION SAFETY ASSESSMENT. OTHERWISE GO TO
SECTION D.
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CALIFORNIA
REUNIFICATION SAFETY ASSESSMENT
SECTION 1: PROTECTIVE FACTOR IDENTIFICATION
(Assessment must include a home visit.)
This assessment covers the entire period of time since the last assessment was completed. It rates the current situation in the household.
Review each of the eight factors. These factors are protective behaviors or conditions that minimize the likelihood of a child(ren) being in
immediate danger of serious harm. Check all that apply to any child(ren) in the household, and to any child(ren) who is being considered
for return to the household.
1. Caretaker(s) protects child(ren) from serious physical abuse, sexual abuse, neglect, or threatened harm.
2. Caretaker(s) allows access to child(ren) and there is no reason to believe that the family is about to flee.
3. Caretaker(s) is willing and able to meet the child(ren)’s needs for supervision, food, clothing, and medical or mental health
care.
4. The caretaker(s)’ current physical living conditions are not hazardous or threatening to the health and safety of the child(ren).
5. Caretaker(s)’ ability to supervise, protect, and care for the child(ren) is not impaired by substance use.
6. Domestic violence does not exist in the home.
7. Caretaker(s) describes child(ren) in neutral or positive terms and acts toward child(ren) in positive or neutral ways.
8. There are no new household members who have a history of child maltreatment, sexual abuse, domestic violence, or a violent
record.
If any other condition exists in the household which places child(ren) in immediate danger of serious harm, check item nine and briefly
describe the safety factor:
9. Other (specify):
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SECTION 2: SAFETY INTERVENTIONS
If all eight protective factors are present AND item nine is not checked, skip to Section 3. If one or more protective factors are absent OR
item nine is checked, consider whether protective interventions 1-8 will allow the child(ren) to return to the home. Check the item number
for all protective interventions that will be implemented. If there are no available protective interventions that would allow the child(ren) to
return to the home, indicate by checking item nine or ten.
Check all that apply:
1. Intervention or direct services by worker.
2. Use of family, neighbors, or other individuals in the community as safety resources.
3. Use of community agencies or services as safety resources.
4. The caretaker(s) will appropriately protect victim from the alleged perpetrator.
5. The alleged perpetrator will leave the home, either voluntarily or in response to legal action.
6. The non-offending caretaker(s) has moved to a safe environment with the child(ren).
7. Legal action (specify):
8. Other (specify):
9. The caretaker(s) will voluntarily place the child(ren) outside the home.
10. Child(ren) remains in substitute care because interventions 1-8 do not adequately assure child(ren)’s safety.
SECTION 3: REUNIFICATION SAFETY DECISION
Identify the reunification decision by checking the appropriate line below. This decision should be based on the assessment of all protective
factors, safety factors, protective interventions, and any other information known about the case. Check one line only.
1.
All protective factors are present at this time, and no safety factor was identified. Based on currently available
information, there are no children likely to be in immediate danger of serious harm. Child(ren) will be returned home.
2.
One or more protective factors are absent or a safety factor was identified, and protecting interventions have been
planned or taken. One or more children will be returned home.
The following child(ren) will be returned home:
3.
One or more protective factors are absent or a safety factor was identified, and placement is the only protecting
intervention possible for all child(ren). Without remaining in placement, child(ren) will likely be in danger of immediate
or serious harm.
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D. PLACEMENT/PERMANENCY PLAN GUIDELINES
(Complete for each child receiving family reunification services and enter results in Section E. Consult with supervisor and appropriate
statutes and regulations.)
Use up to and including 6 month hearing
Final Reunification Risk Level
High or
Very High
Low or
Moderate
Intensify Concurrent
Planning
Age 3
or older*
Under age 3*
Is there a substantial
probability of reunification?
No
No
Yes
Recommend Termination of
Family Reunification Services,
Implement Permanency
Alternative
No
Do conditions exist to
recommend termination of
Family Reunification Services?
No
Continue Family
Reunification
Services
Yes
Recommend Termination of
Family Reunification Services,
Implement Permanency
Alternative
Is Visitation
Acceptable?
Yes
Safe?
Yes
Return Home
Override:
If at any age a child has been in placement for 15 of the last 22 months, it shall result in
termination of family reunification services and implementation of permanency
alternative.
* If child is part of a sibling group, consider WI code 361.5
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Use after 6 month hearing
Final Reunification Risk Level
High or
Very High
Low or
Moderate
Intensify Concurrent
Planning
No
Is this the 12 month
hearing?
No
Yes
Is there a substantial probability
of reunification?
Yes
Continue Family
Reunification Services
No
(18 month)
Terminate Family Reunification
Services, Implement
Permanency Alternative
No
Is Visitation
Acceptable?
Yes
Safe?
Yes
Return Home
Recommend Termination
of Family Reunification
Services, Implement
Permanency Alternative
Override:
If at any age a child has been in placement for 15 of the last 22 months, it shall result in
termination of family reunification services and implementation of permanency
alternative.
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E. RECOMMENDATION SUMMARY
(If recommendation is the same for all children, enter "all" under child # and complete row 1 only.)
Recommendation
Child #
Return
Home
Continue Family
Reunification Services
Terminate Family
Reunification Services;
Implement Permanent Alternative
1.
2.
3.
4.
F. CONTACT GUIDELINES
CONTACT GUIDELINES FOR FAMILY REUNIFICATION CASES
RISK LEVEL
DOCUMENTED CONTACTS WITH CARETAKER(S)
Low
One face-to-face per month with caretaker(s)
One collateral contact
Moderate
Two face-to-face per month with caretaker(s)
Two collateral contacts
High
Three face-to-face per month with caretaker(s)
Three collateral contacts
Very High
Three face-to-face per month with caretaker(s)
Three collateral contacts
DOCUMENTED CONTACTS WITH CHILDREN
At least one face-to-face per month with each child
ADDITIONAL CONSIDERATIONS
Contact Definition
During the course of a month, each caretaker(s) and each child shall be contacted at least once.
Designated Contacts
The ongoing worker must always maintain at least one face-to-face contact per month with the
caretaker(s). However, the ongoing worker may delegate remaining contacts to service providers
outlined in the case plan, or other agency staff.
OVERRIDES
A discretionary override to these contact guidelines is permitted based on unique case
circumstances that are documented by the ongoing worker and approved by the supervisor. All
case contacts must at least meet Division 31 regulations.
O:\657CA\Training Materials 1-05\Worker Training\P&P Manual.doc
© 2005, CDSS and CRC, All Rights Reserved
Handout 6
REUNIFICATION SAFETY ASSESSMENT DEFINITIONS20
1. Caretaker(s) protects the child(ren) from serious physical abuse, sexual
abuse, neglect, or threatened harm:
None of the following have occurred in this reassessment period:
● Serious injury or abuse to the child(ren) other than accidental: caretaker(s)
caused serious injury defined as brain damage, skull or bone fracture,
subdural hemorrhage or hematoma, dislocations, sprains, internal injury,
poisoning, burns, scalds, severe cuts, or any other physical injury that
seriously impairs the health or well-being of the child(ren) (e.g., poisoning,
suffocating, shooting, bruises/welts, bite marks, choke marks) and requires
medical treatment.
● Caretaker(s) fears s/he will maltreat the child(ren) and/or requests placement
continue.
● Threat to cause harm or retaliate against the child(ren): threat of action which
would result in serious harm; or household member(s)’ plans to retaliate
against child(ren) for CPS investigation.
● Excessive discipline or physical force: caretaker(s) has used torture or
physical force, or acted in a way which bears no resemblance to reasonable
discipline; or punished child(ren) beyond the duration of the child(ren)’s
endurance.
● Drug-exposed infant: drugs found in the child(ren)’s system; infant is
medically fragile as result of drug exposure; infant suffers adverse effects
from introduction of drugs during pregnancy.
2. Caretaker(s) allows access to the child(ren) and there is no reason to believe
that the family is about to flee.
20
•
Family currently allows access to the child(ren) and provides information
regarding the child(ren)’s location.
•
Family has not removed the child(ren) from a hospital against medical advice
to avoid investigation.
•
Family does not keep the child(ren) at home, away from peers, school, and
other outsiders for extended periods of time for the purpose of avoiding
investigation.
•
Caretaker(s) does not intentionally coach or coerce the child(ren), and does
not allow others to coach or coerce the child(ren), in an effort to hinder the
investigation.
Definitions reproduced with permission from CRC (2005, p. 85)
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3. Caretaker(s) is willing and able to meet the child(ren)’s needs for supervision,
food, clothing, and medical or mental health care.
● Minimal nutritional needs of the child(ren) are met and there is no danger to
the child(ren)’s health and/or safety.
● Child(ren) is provided minimally warm clothing in cold months.
● Caretaker(s) seeks treatment for child(ren)’s immediate, chronic, and/or
dangerous medical condition(s) and follows prescribed treatment for such
conditions.
● Child(ren) does not appear malnourished.
● Child(ren)’s exceptional needs, such as being medically fragile, are met.
● Caretaker(s) takes protective action to meet the child(ren)’s mental health
care needs.
● Child(ren) shows no effects of continuing maltreatment such as serious
emotional symptoms, lack of behavioral control, or serious physical
symptoms.
● Caretaker(s) attends to the child(ren) so that need for care does not go
unnoticed or unmet.
● Caretaker(s) does not leave the child(ren) alone (time period varies with age
and developmental stage).
● Caretaker(s) makes adequate and appropriate babysitting or child care
arrangements and demonstrates good planning for the child(ren)’s care.
4. Caretaker(s)’s current physical living conditions are not hazardous or
threatening to the health and safety of the child(ren).
Based on the child(ren)’s age and developmental status, the child(ren)’s physical
living conditions are not hazardous or threatening, including but not limited to no:
•
Leaking gas from stove or heating unit.
•
Substances or objects accessible to the child(ren) that may endanger the
health and/or safety of the child(ren).
•
Lack of water or utilities (heat, plumbing, electricity) and no alternate or safe
provisions are made.
•
Open windows/broken/missing windows.
•
Exposed electrical wires.
•
Excessive garbage or rotted or spoiled food which threatens health of
child(ren).
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•
Serious illness or significant injury has occurred due to living conditions and
these conditions still exist (e.g., lead poisoning, rat bites).
•
Evidence of human or animal waste throughout living quarters.
•
Unlocked guns or other weapons in the home.
5. Caretaker(s)’s ability to supervise, protect, and care for the child(ren) is not
impaired by substance abuse.
Caretaker(s) is not currently abusing legal or illegal substances or alcoholic
beverages to the extent that control of his or her actions is significantly impaired. As
a result, the caretaker(s) is able, or will likely be able, to care for the child(ren); has
not harmed the child(ren); and is not likely to harm the child(ren).
6. Domestic violence does not exist in the home.
•
No child(ren) has been injured in a domestic violence incident (during review
period).
•
Child(ren) does not exhibit fear of being in the home related to current
domestic violence.
•
Child(ren) is not at potential risk of physical injury.
•
No use of guns, knives, or other instruments in a violent, threatening, and/or
intimidating manner.
•
No evidence of property damage resulting from domestic violence.
•
No reports of domestic violence incidents during review period.
•
Household members who previously engaged in violent behavior are either
no longer in the household or have demonstrated completely nonviolent
behavior during the review period.
7. Caretaker(s) describes the child(ren) in neutral or positive terms and acts
toward the child(ren) in positive or neutral ways.
Examples of caretaker(s) actions include:
•
Caretaker(s) describes child(ren) in a neutral or positive manner.
•
Caretaker(s) does not curse or repeatedly belittle or degrade child(ren).
•
Caretaker(s) does not scapegoat a particular child in the family.
•
Caretaker(s) does not blame child(ren) for a particular incident or family
problems.
•
Caretaker(s) does not place child(ren) in middle of custody battle.
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8. There are no new household members who have a history of child
maltreatment, sexual abuse, domestic violence, or a violent record.
Either there are no new individuals living in the household, or new members have no
known record of previously maltreating a child, sexually abusing a child or adult,
domestic violence, or any other criminal history of a violent nature (e.g., battery,
assault, armed robbery, homicide).
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Handout 7
KEY INFORMANT SUBSTUDY: IN-PERSON INTERVIEW TEMPLATE
Demographics and Background
•
•
•
What is your current job title?
How long have you worked in this position?
How long have you worked for the Los Angeles County DCFS?
Implementation of SDM®
•
•
•
•
•
•
•
Before SDM® was implemented, what kinds of problems existed with decision
making within DCFS?
How has SDM® been incorporated into decision making practices within DCFS?
In what ways has the performance been affected? Probes:
▪ Decision making specifically?
▪ Improvements?
▪ No change?
▪ Gotten worse?
In what ways do you think that SDM® helps DCFS workers make better
decisions?
In what situations are overrides used? When do you think it is appropriate to use
overrides? To not use overrides?
How do you feel about the way the safety assessment is being used? Do you feel
that it accomplishes what it is meant to accomplish? Why or why not?
How do you feel about the current policy to close Moderate and Low-Risk cases,
and to open High and Very-High-Risk cases? Would you change anything about
the way risk levels are interpreted and used?
Strengths and Barriers
•
•
•
•
•
•
•
What are some difficulties the Department is experiencing with using SDM®?
What aspects of SDM® make you (or staff) uncomfortable? What aspects do you
(or staff) like or dislike?
Please describe some of the unintended consequences that are occurring as a
result of using SDM®.
What do you imagine might help to solve these difficulties?
What are some of the major strengths of SDM®? What parts of SDM® do you feel
are the most helpful for you as a worker?
What parts of SDM® do you feel are the most effective?
What would you like to see changed, if anything?
What other suggestions do you have for improving SDM®?
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DCFS WORKER SUBSTUDY:
ONLINE QUESTIONNAIRE TEMPLATE
Welcome to the Structured Decision Making® (SDM®) Worker Questionnaire!
For complete information about the study, click the button on the left to read the
Information Sheet for Non-Medical Research.
If you have already read the Information Sheet for Non-Medical Research, click the
button on the left to proceed to the questionnaire.
INFORMATION SHEET FOR NON-MEDICAL RESEARCH
DCFS WORKER SUBSTUDY QUESTIONNAIRE
You are asked to participate in a research study conducted by Devon Brooks, PhD,
MSW and Jan Nissly, PhD, MSW, from the School of Social Work at the University of
Southern California. You were selected as a possible participant in this study because
you are a current Los Angeles County Department of Children and Family Services
(DCFS) worker trained on the SDM® model. A total of approximately 1,550 workers will
be selected from all of the DCFS social workers to participate. Your participation is
voluntary.
PURPOSE OF THE STUDY
We are asking you to take part in a research study because we are trying to learn more
about the implementation and impact of the SDM® model on child welfare service
delivery and outcomes in DCFS. In order to assist DCFS in carrying out it’s mission of
ensuring safety and permanency for children, and to advance child welfare knowledge,
this study investigates the following broad research questions:
(1) What are the challenges related to implementing the full SDM® model?
(2) What impact does implementation of the full SDM® model have on child welfare
service delivery?
(3) What impact does implementation of the full SDM® model have on child
permanency outcomes?
Completion and return of the questionnaire or response to the interview questions will
constitute consent to participate in this research project.
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PROCEDURES
You will be asked to complete a brief, online questionnaire that should take between 5
and 10 minutes to complete. You are under no obligation to participate in this project;
participation is strictly voluntary. This questionnaire is comprised of multiple-choice,
closed-ended questions that deal with your experiences working with SDM®, the way
you make work-related decisions, and your opinions about the effectiveness of SDM®.
All information you choose to share will be kept in confidence. DCFS will not have
access to the information that you provide, nor will they be able to identify you as having
given a particular response.
POTENTIAL RISKS AND DISCOMFORTS
There are no foreseeable risks, discomforts, or inconveniences associated with your
participation, other than the minor inconvenience of filling out an online questionnaire,
which has been kept short in order to ensure that the least amount of time is taken from
your normal working schedule. You are free to skip any questions that you do not feel
comfortable answering. Please keep in mind that the information you provide in the
interviews will not be identified with you, and will in no way jeopardize your employment
with DCFS.
POTENTIAL BENEFITS TO SUBJECTS AND/OR TO SOCIETY
This study will contribute valuable information on the implementation and impact of the
SDM® model on child welfare service delivery and outcomes. Findings have the
potential to prepare graduate students in child welfare to appropriately assess the
needs of children and families when they begin employment in the public child welfare
system. DCFS staff may benefit by learning to conduct more accurate and reliable
assessments. DCFS administrators may benefit by becoming more knowledgeable in
the use of data to assist in planning, monitoring, budgeting, evaluation, and meeting
workload demands. The study has the potential to benefit students of child welfare, as
well as child welfare agency staff, by providing information and tools that will enhance
overall decision-making effectiveness. Service planning areas implementing SDM® in
Los Angeles County and other counties should benefit greatly from the evaluative
information produced from this project.
PAYMENT/COMPENSATION FOR PARTICIPATION
You will receive no financial compensation for participating in the project.
CONFIDENTIALITY
Any information that is obtained in connection with this study and that can be identified
with you will remain confidential and will be disclosed only with your permission or as
required by law.
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Sensitive information about subjects will be maintained in a database that will be
password protected and stored in a secure, locked project office; this information will
include a case number that is unique to each subject. Only the evaluation team will
have access to project data. All consent forms and original identifying information will be
stored in a secure, encrypted database with password protection. Data will be stored for
at least 3 years after the completion of the study, after which the data may be kept
indefinitely or destroyed.
When the results of the research are published or discussed in conferences, no
information will be included that could reveal your identity.
PARTICIPATION AND WITHDRAWAL
You can choose whether to be in this study or not. If you volunteer to be in this study,
you may withdraw at any time without consequences of any kind. You may also refuse
to answer any questions you don’t want to answer and still remain in the study. The
investigator may withdraw you from this research if circumstances arise which warrant
doing so.
IDENTIFICATION OF INVESTIGATORS
If you have any questions or concerns about the research, please feel free to contact
the following individuals:
Devon Brooks, Principal Investigator
669 W. 34th St., SWC 120
Los Angeles, CA 90089-0411
Phone: (213) 821-1387
Fax: (213) 740-0789
Email: devonbro@usc.edu
Jan Nissly, Co-Principal Investigator
669 W. 34th St., MRF 102E
Los Angeles, CA 90089-0411
Phone: (213) 821-3900
Fax: (213) 740-8905
Email: nissly@usc.edu
You may also contact Alice Kim, Project Specialist
669 W. 34th St., MRF 102D
Los Angeles, CA 90089-0411
Phone: (213) 821-1426
Fax: (213) 740-8905
Email: alicekki@usc.edu
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RIGHTS OF RESEARCH SUBJECTS
You may withdraw your consent at any time and discontinue participation without
penalty. You are not waiving any legal claims, rights, or remedies because of your
participation in this research study. If you have questions regarding your rights as a
research subject, contact the University Park IRB, Office of the Vice Provost for
Research, Grace Ford Salvatori Building, Room 306, Los Angeles, CA 90089-1695,
(213) 821-5272 or upirb@usc.edu.
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BACKGROUND
Please answer all of the questions. For each question, please mark the best answer.
1.
In which PRIMARY office do you currently work?
Antelope Valley East
Antelope Valley West
Asian Pacific Project
Belvedere
Borax
Century
Child Protection Hotline (CPH)
Compton
Emergency Response Command Post (ERCP)
Hawthorne
Lakewood
2.
Metro North
North Hollywood
Pasadena
Pomona
Santa Clarita
Sante Fe Springs
Torrance
Wateridge
West Los Angeles
Other:_________________
What is your current CSW file type?
Child Protection Hotline CSW (CPH CSW)
Emergency CSW (ER CSW)
Generic CSW (CSW)
Family Maintenance/Reunification CSW (FM/R CSW)
Permanency Planning CSW (PP)
Supervisor CSW (SCSW)
Specialized program CSW
Dependency Investigator CSW (DI)
Other (Please specify in the space below)
3.
What is your current job level?
CSW Trainee
CSW I
CSW II
CSW III
SCSW
Other (Please specify in the space below)
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4.
About how long have you worked for DCFS?
Less than 1 year
1 year
2 years
3 years
4 years
5 years
5.
6 years
7 years
8 years
9 years
10 years
>10 years (specify number of years): ______
About how long have you worked in your CURRENT position?
Less than 1 year
1 year
2 years
3 years
4 years
5 years
6 years
7 years
8 years
9 years
10 years
>10 years (specify number of years): ______
SDM® TRAINING & USE
6.
At the end of the SDM® training, how prepared were you to start implementing
SDM®?
Very prepared
Somewhat prepared
Not at all prepared
Does not apply – I DID NOT receive SDM® training from DCFS.
7.
Which of the following SDM® TOOLS do you complete as a part of your
current job duties? By "complete" we mean using, reviewing, and/or
approving tools. (Check ALL that apply)
Hotline/Response Priority tools
Safety Assessment tool
Family Risk Assessment tool
Family Strengths and Needs Assessment tool
Family Risk Reassessment tool
Reunification tool
I DO NOT complete any of the SDM® tools as a part of my job duties.
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THE SDM®PROCESS
8.
In general, how EASY TO USE do you find the SDM® tools?
Very easy
Somewhat easy
Not at all easy
9.
In general, how ACCURATE do you find the SDM® tools to be?
Very accurate
Somewhat accurate
Not at all accurate
10. In general, how well do the SDM® tools help you to arrive at the same
decisions for similar types of cases?
Very well
Somewhat well
Not well at all
11. After completing the SDM® tools, how often do you agree with the levels that
are assigned (prior to overrides)?
All of the time (skip question 12 and click the NEXT>> on the bottom of the page)
Most of the time
Some of the time
Never
12. In situations when you DO NOT agree with the assigned levels (prior to
overrides), do you usually think that the levels are too HIGH or too LOW?
Too high
Too low
Does not apply - I usually agree with the SDM® assessment levels.
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EFFECTIVENESS OF SDM®
13. Please indicate how EFFECTIVE you think SDM® is in helping to achieve the
goals listed below:
(Answer choices: Very Effective, Somewhat Effective, Not At All Effective, I
am not sure)
a. Protecting children
b. Reducing the rate of subsequent abuse/neglect complaints and
substantiations
c. Reducing the severity of subsequent abuse/neglect complaints or allegations
d. Reducing the rate of foster care placements
e. Reducing the length of stay for children in foster care
f. Improving assessments of family situations
g. Increasing consistency in case assessment and case management
h. Increasing the efficiency of child protection operations by making the best use
of available resources
i. Providing management with data that is needed for program administration,
planning, evaluation, and budgeting
14. What effect has using the SDM® tools had on YOUR decision making?
My decision making has improved significantly
My decision making has improved somewhat
My decision making has not really changed
My decision making has gotten worse
15. Please indicate how HELPFUL you find the SDM® tools to be when making
decisions about the following:
(Answer choices: Very Helpful, Somewhat Helpful, Not At All Helpful, Not
Applicable)
a.
b.
c.
d.
e.
f.
g.
Whether a child is currently safe
Whether to promote a referral to a case
Whether to recommend a particular service or intervention to a client
Whether to remove a child
Whether to return a child to her/his family
Whether to terminate parental rights
Whether to close a case
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16.
Overall, how satisfied are you with SDM®?
Very satisfied
Satisfied
Neither satisfied nor dissatisfied
Dissatisfied
Very dissatisfied
17a. Would you recommend that other child welfare agencies use SDM®?
Yes
No
17b. Why or Why Not? (Fill in the blank)
18.
Do you have any suggestions on how to improve the SDM® process or is
there anything else you would like to share with us about SDM®? If so,
please write your comments in the box below.
The End! Thank you for completing this questionnaire. We greatly appreciate
your time, and value your input. If you would like to receive a copy of the results
of this study, please send an e-mail with your name and contact information to
SDMsurvey@usc.edu.
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Handout 9
DCFS WORKER SUBSTUDY:
ONLINE QUESTIONNAIRE COVER LETTER
From: sdmonline@dcfs.co.la.ca.us
Subject: From the Desk of Dr. Sanders
Dear Colleague:
I would like to strongly encourage your participation in this brief, online Structured Decision
®
Making questionnaire for a study that is being conducted by researchers at the University of
Southern California (USC). IF YOU ARE AN SCSW, A CSW, OR IF YOU USE SDM®AS A
PART OF YOUR REGULAR JOB DUTIES, PLEASE COMPLETE THE QUESTIONNAIRE. As a
DCFS worker who has been trained on SDM® and has experienced its impact firsthand, your
feedback is critical for helping us to better serve children and families.
The questionnaire should take approximately 5 minutes to complete. Your questionnaire
responses will go directly to the USC research team for further tabulation and evaluation. The
USC researchers will keep all the information you provide strictly confidential. DCFS WILL NOT
HAVE ACCESS TO YOUR INFORMATION, NOR WILL YOU BE IDENTIFIABLE BY YOUR
RESPONSES.
Complete information regarding the study can be found on the Information Sheet for NonMedical Research, which should be reviewed before completing the questionnaire. PLEASE DO
NOT REPLY TO THIS MESSAGE. If you have any questions about this survey, please contact
Alice Kim, Project Specialist, at (213) 821-1426 or alicekki@usc.edu.
To review the Information Sheet and begin the online SDM® questionnaire, please click on the
link below:
[SurveyLink]
The case-sensitive password is: SDM®
I would like to thank you in advance for sharing your SDM® experience with the USC
researchers and helping in this very important effort. Please be very honest and open when
taking this online survey. Based on your responses, the USC team will be able to provide an
impartial evaluation of SDM® and come up with specific recommendations on how it can work
better for the benefit of DCFS families and children.
Sincerely,
Dr. Sanders
To decline participation in the SDM® questionnaire, click the following link: [RemoveLink]
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