SDM® and Critical Thinking in Child Welfare Assessment

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SDM® and Critical Thinking in Child Welfare Assessment
TRAINEE CONTENT
Table of Contents
Introduction ………………………………………………………………………... 3
My Learning Goal …………………………………………………………………..
5
Benefits of Standardized Assessment …………………………………………….
7
Decision Making ……………………………………………………………………
15
Minimum Sufficient Level of Care …………………………………………………
19
Safety and Risk ……………………………………………………………………..
23
Safety and Risk Worksheet ………………………………………………………... 25
SDM Flow Chart Worksheet ……………………………………………………….
27
Protective Capacity ………………………………………………………………...
29
Family Friendly Interview Sample …………………………………………………
33
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Introduction
This trainee content contains icons indicating content related to California’s themes of
practice:
Fairness & Equity
Family & Youth Engagement
Strength-based Practice
Outcomes-informed Practice
Evidence-based Practice
These themes are interwoven throughout the Common Core Curricula in California. Trainees
are encouraged to pay special attention to the themes and make efforts to incorporate the
concepts in their daily practice.
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My Learning Goal
Reviewing the learning objectives at the beginning of the training allows the adult learner to
identify priority learning goals and gain a better understanding of what to expect from the
training.
Select a priority learning goal for yourself. Use the space below to note the goal.
My priority learning objective is:
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Benefits of Standardized Assessment
Child Welfare Assessment Practice
Public child welfare agencies exist with one primary goal: to prevent the recurrence of
maltreatment of children who come to the agency’s attention. One key child welfare effort
toward meeting this goal is accurate and timely assessment. Our efforts to provide children
and families with the best possible assessments, those backed by research and supported by
ongoing quality assurance have led us to use standardized assessment tools.
Beyond the effort to use the best practice tools available to provide assessment, there are
six additional reasons we use standardized assessment tools:
1. The Law Requires It
 The Adoptions and Safe Families Act (ASFA), as well as prior legislation mandate the
goals for child welfare: safety, permanence, and well being.
 State law (Welfare and Institutions Code, Section 300, and related Penal Codes) and
state regulations (Division 31 and related regulations) provide the legal means and
policy and procedure for intervening in families where maltreatment is suspected.
2. Our Professional Standards and Values Support It
 The Standards and Values for Public Child Welfare Practice adopted by the County
Welfare Directors Association (CWDA) and the California Department of Social
Services (CDSS) in 1996 and revised in 2005 include many references to the
importance of high quality, fair, and equitable assessment (California Social Work
Education Center, 1997).
3. The Practice Defines Agency Parameters
 Effective assessment allows social workers to identify children in need of
intervention thereby limiting unnecessary intrusion in the lives of families where
safety and risk are not an issue.
4. The Practice Promotes Consistency in Decision making
 Using a tool to complete safety and risk assessment promotes consistent decision
making and interventions that “clarify the agency’s responsibility in the protection of
children” (Brittain, C.R., & Hunt, D.E. [eds.], 2004).
5. The Practice Supports Focused Interventions
 Assessment of safety, risk and protective capacity helps to focus in on the most
immediate issues and “drive” specific interventions. By identifying the factors that
lead to an unsafe household, the service plan specifically identifies the services
needed to alleviate risk.
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6. The Practice Supports Accountability
 Factors identified in the tools structure the assessment practice and help identify the
safety, risk and protective capacity concerns in behavioral terms. Once an
assessment has identified the concerns, subsequent assessments can determine
whether the services have helped to alleviate the safety concerns. “Well-constructed
assessment models assist in managing accountability” (Brittain, C.R., & Hunt, 2004).
The Value of Research-based Tools
Imagine a patient going to a doctor with an upset stomach and having the doctor
recommend immediate surgery without completing any assessment, testing or diagnosis.
The patient would want to know how the doctor arrived at that decision and would not be
happy if the doctor said, “On the surface it seems like a simple virus, but I have a gut feeling
it’s something far more serious” or “my mother and grandmother both died of cardiac
arrest because someone ignored their presenting problem of indigestion. I’m not going to
let that happen to any of my patients.”
Next, imagine that something went bad with the treatment plan and the doctor’s
explanation was, “I have experience and education, and based on that when I considered
this case I made my decision.” Imagine that in medicine, there were no research trials, no
diagnostic tests, no diagnostic decision trees, and no generally accepted standards of
practice.
In medicine, there can be differences of opinion--that’s why second opinions are sought. But
imagine the inconsistency being so great, that whether you were given an aspirin, a cast or
an operation depended more on who you went to see rather than on your medical need.
Critical Thinking Supported by Evidence Based Tools
The Structured Decision Making (SDM) assessment system provides social workers with a
standardized set of tools to help social workers make assessments at critical points in child
welfare cases. While social workers must use critical thinking and engagement skills to make
assessments, accurate use of the SDM model used in conjunction with critical
thinking and engagement provides an evidence based tool to guide social
workers in the decision making process.
The SDM tools were developed with a significant amount of research evidence and real
world experience:
 the Children’s Research Center (the developer of the SDM model) has long
standing roots, starting in 1986 to the present, in the United States and
internationally
 SDM has been implemented in California and over 30 other child welfare
jurisdictions, including Alaska, Florida, Georgia, Nevada, Illinois and parts of
Australia and Canada.
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Assessments and Improvement in Federal Outcomes
State and federal reviews focus on data indicators of improved safety, permanency and wellbeing and funding is tied to ongoing improvements in these outcomes.
The SDM model does not address every single one of these indicators, but it
does address many of them. In particular, the SDM model is designed to, and in
many instances has evidence that it does:
• Reduce future referrals and substantiations
• Reduce future foster placements
• Reduce time to permanency
Many programs are designed to achieve these same goals, and the SDM model alone does
not guarantee success. What makes the SDM model unique is the way it contributes to
meeting these goals. The SDM model helps improve assessments by increasing consistency
and accuracy. Good assessments, however, have no value unless the results directly affect
practice. In the SDM model, assessment results lead to presumptive case actions that are
designed to increase the effectiveness and efficiency of available resources. Finally, because
every assessment completed by a social worker contributes to a pool of rich aggregate data,
managers and administrators are given information they need to make good policy,
program, budget, and other decisions.
Social workers who use the SDM system accurately can expect the following benefits:
1. Reduced rate of subsequent abuse/neglect referrals and substantiations
through improved ability to identify and address key factors associated with
safety, risk and protective capacity.
2. Reduced rate of subsequent abuse/neglect injuries to children.
3. Reduced rate of subsequent foster care placement.
4. Reduced length of stay for children and time to permanency in foster care.
5. Improved assessments of family situations to better ascertain the protection
needs of children.
6. Increased consistency, accuracy, and equity in case assessment and case
management among child abuse/neglect staff within a county and among
counties through improved ability to focus on the same factors for all families.
7. Increased efficiency of child protection operations by making the best use of
available resources.
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8. Improved availability of data for program administration, planning, evaluation,
and budgeting.
Limiting the Effect of Random Chance
The absence of standardized assessment in child welfare allows chance to play a large role in
child welfare outcomes:
A 1997 study of child welfare removals found that social worker assignment better
predicted likelihood of removal than any information about safety. The study
concluded that chance played a key factor in predicting outcomes (Rossi et al, 1997).
The SDM model addresses this element of chance by focusing assessment on key factors
linked to safety and risk. Accurate use of SDM provides clear connections between safety
and risk factors in the home and decisions made by social workers to ensure safety and
mitigate risk.
Identifying Key Factors
In addition, the SDM model effectively helps social workers identify and address key factors
associated with safety and risk:
In 1995, several years after Michigan first implemented the SDM model in a group of
12 counties, outcomes were measured in SDM counties and compared to the
outcomes from a set of matched comparison counties (Wagner, D., Hull, S., &
Luttrell, J., 1995). Approximately 900 families entering CPS in each group were
followed for 12 months after the initial investigation. Families in SDM counties
were much less likely to experience subsequent referrals, substantiations, foster
placements, and abuse-related injuries.
Addressing Disproportionality
In order to be fair and in an effort to address disproportionality in child welfare outcomes, it
is important to use the same criteria for assessing all families. SDM helps social workers
ensure that all families are assessed on the same criteria.
Children of color, particularly African-American and Native-American children,
continue to be over-represented in the child welfare system relative to their
proportion of the population. According to the 2004 National Fact Sheet on
Disproportionality (Child Welfare League of America):
The challenge [in child welfare services is]…. the considerable evidence of the following
trends among children of color, particularly African-American and Native-American
children:


Greater likelihood to be removed from their mothers as infants
Higher rates of foster care entry
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


More time spent in foster care
Fewer services and less contact with child welfare staff
Lower reunification rates
Longer time to adoption and lower adoption rates
Part of this disproportionality relates to the ability of the child welfare system
to conduct fair and equitable assessments throughout the life of a case.
As you can see from the table below, data from 2009 reveal the continued
overrepresentation of African American and Native American children in the child welfare
system in California (Needell et al, 2010).
California:
Ethnicity and Path Through the Child Welfare System, 2009
(missing values & other race excluded from % calculations)
*includes children age 18
100%
90%
0.5
10.6
0.8
4.0
1.0
3.8
1.2
3.2
1.1
3.2
1.3
2.6
80%
70%
60%
52.9
53.4
49.7
45.9
48.3
Asian/PI
51.1
50%
Hispanic
40%
24.4
30%
20%
27.4
26.5
25.6
25.6
31.8
10%
0%
Native
American
6.0
Population
(9,992,333)
White
Black
15.0
15.3
Allegations
(471,809)
Substantiations
(92,231)
20.2
Entries
(31,588)
25.7
21.7
In Care
(59,509)
Exits
(37,382)
CRC (the developer of the SDM model) is committed to ensuring that SDM assessments are
equitable across ethnic groups and they have conducted research to show that the SDM
model does not disproportionately identify children from any ethnic or racial group as being
unsafe or at risk. Their research completed in California demonstrates that the
SDM™ Risk Assessment accurately classifies families into low, moderate, high,
and very high risk categories regardless of ethnicity (Johnson and Wagner,
2003).
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Consistency
Ensuring that every social worker addresses a common set of factors appropriate at each
decision point is key to improving the consistency of decisions made by social workers. Each
decision point and each factor used to make the decision is defined so that there is less
chance of varied interpretations. Finally, each tool leads to a presumptive decision. In this
way, the relative weight of each item as it relates to the final decision is consistent.
It is important to remember that the objective is not uniformity. The field is too new and too
complex to expect that everything can be reduced to perfect uniformity. Still, it is
appropriate to increase consistency.
Consider the following evidence for how SDM tools help social workers improve consistency
in their decision making:
SDM’s research based risk tool used in Michigan was compared to the 1990’s Fresno
risk tool, and another risk tool used in the state of Washington. Four case readers
were trained in each model (trained by the proponents of the model to assure
adequate training). They were then asked to read case abstracts based on actual
cases from four jurisdictions across the country, including Alameda County. The
readers used their respective tools to assign a low, moderate, or high risk level to
each family.
The research based tool achieved perfect agreement in nearly 60% of the cases
reviewed. The other tools achieved this in less than 15% of cases.
A lower threshold of consistency was evaluated as well: perhaps 100% agreement is
too rigorous a standard, but perhaps we could expect that at least 3 out of 4 social
workers would agree on the family’s risk level. Nearly 90% of the cases evaluated
using SDM achieved 75% agreement. But only about half of the same cases, when
evaluated using one of the consensus based tools, had 75% agreement (Wagner, D.,
Hull, S., & Luttrell, J., 1995).
Accuracy
SDM tools also increase accuracy. For example, a risk tool’s job is to estimate the likelihood
of future maltreatment. So if we had a group of families the tool said were low risk and
another group called high risk and we followed those families for a year or two, we would
expect to see more incidents of subsequent maltreatment among the high risk families.
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Consider the following evidence of improved accuracy with the SDM tools:
Wagner et al (1995) examined accuracy by assigning a risk rating to families using
one of the three tools and then allowing readers to read the rest of the case record
to find out what actually happened.
The raters using the research based tool from Michigan’s SDM model had excellent
results. Families assigned into the low risk category had only half the recurrence
rate as moderate risk families, who in turn had only half the rate as high risk
families.
The Fresno risk assessment, however, had almost no distinction among families
assigned to different risk groups. The Washington tool did a little better at
distinguishing high from moderate risk groups, but even with this tool families
were only about a third as likely to experience future harm. There was no
difference between low and moderate risk. In other words, these tools required
work to complete, and labeled a family, but that label related poorly to what
actually happened.
More recent research looking at families over several years, found that social worker
assessments completed using the SDM California Family Risk Assessment Tool did a better
job at predicting risk than social worker assessments alone (Johnson, 2011).
Making the Best use of Limited Resources
SDM tools can help jurisdictions determine the best use of limited resources. SDM tools are
used to organize information about a family. That information is valuable only to the extent
that it matters in terms of what decisions are made. Every SDM tool has policies designed by
the jurisdiction (in this case, California), outlining how to use the tool’s results to shape
decisions in ways that increase the effectiveness and efficiency of CPS and have the greatest
potential to reduce harm to children.
Consider the following evidence that identifying high risk families through the use of an
assessment tool improves efficiency:
Research done in several urban Wisconsin counties revealed that providing CPS
services to families at low and moderate risk seemed to have virtually no impact on
reducing subsequent harm.
In contrast, providing services to high and very high risk families reduced
subsequent referrals in half. For example, very high risk families who did not
receive services had about double the re-referral rate as families with the same
initial risk levels that were opened for CPS services (Wagner, D. & Bell, P., 1998).
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As effective as SDM tools can be at guiding decisions at the case level, the same information
needed for those decisions in each case can be aggregated. This aggregated information is
extraordinarily useful for making decisions at the level of the agency and the community.
Multiple Benefits
Many programs are designed to achieve these same goals, and the SDM model alone does
not guarantee success. What makes the SDM model unique is the way it contributes to
meeting these goals. The SDM model helps improve assessments by increasing consistency
and accuracy. Good assessments, however, have no value unless the results directly affect
practice. In the SDM model, assessment results lead to presumptive case actions that are
designed to increase the effectiveness and efficiency of available resources. Finally, because
every assessment completed by a social worker contributes to a pool of rich aggregate data,
managers and administrators are given information they need to make good policy,
program, budget, and other decisions.
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Decision Making
Before attempting to employ the SDM tools for assessing children and families, it is
important to look closely at the process of making decisions and thinking critically about the
key factors involved in the decision making process.
The 5 step decision making process outlined below helps social workers go about decision
making in a way that encourages critical thinking and helps social workers avoid decision
making pitfalls such as red herrings, personal bias and crisis driven thinking. This process
(adapted from Stein and Rzepnicki, CalSWEC, 2007) can help social workers think about
making decisions in a more systematic way through gathering information, applying criteria,
using discussion/feedback, implementing a decision and reviewing outcomes.
Step 1: Information Gathering
The first step in any decision is to gather the relevant information. An important distinction
here is that we don’t need all the information, just the right information. The more
information we gather, the more confident we feel about our process, but the less accurate
our decisions are. Our memories can only hold a limited amount of information and we do
not necessarily keep the most important facts. We are more likely to have better recall of
facts that are similar to other familiar situations. Also, because gathering and considering
extraneous information can introduce bias in the decision making process, the more
information you collect the more biased you may become. For example, when preparing a
resume or completing a job application, it is best to avoid adding extraneous information
unrelated to the job. Such information (e.g.; a favorite movie) is irrelevant to the hiring
decision but may introduce bias in the employer (“If this applicant likes that movie, she is
probably nerdy or self-righteous. I don’t want to work with someone like that!”).
In addition to actively gathering the relevant information, social workers must assess the
reliability of the information. As noted by Brittain and Hunt (2004), “to make good
decisions, you must have reliable information.” Information for assessment and decision
making can be gathered from a variety of sources and people. A crucial activity will be
documenting and then further evaluating the information as it is received. In these activities
social workers demonstrate their accountability to children, families and the agency. It is
important to consider the point of view of the person providing information and gather
information from more than one perspective.
It is also important to avoid drawing conclusions while you are still gathering information. If
you gather information with a specific conclusion already in mind, you may be more likely to
interpret facts to support the conclusion you’ve already reached. This introduces bias in the
information gathering process.
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Consider the following activities as you gather information:
Preparatory Activities:
 Get needed training in interviewing adults and children.
 Read previous reports, case referrals, and dispositions if available.
 Discuss with your supervisor a strategy for interviewing adults and
children.
 Be prepared for adverse reactions from parents and families.
 Be clear about your role.
When Interviewing:
 Be open-minded and respectful of the person(s) you are interviewing. Be
mindful of cultural issues and use of language.
 Communicate your concern for family members.
 Acknowledge and clarify the information that is being told to you.
 Ask open ended questions to elicit more information.
 Watch for escalation of feelings and be prepared to de-escalate.
 Taking notes is recommended.
 Recognize that the interview process ebbs and flows.
When Documenting:
 Be aware of your county’s policy and procedure on documenting contacts.
 Documentation includes narrative, court reports, voice mail, email, letters,
and memos.
 When documenting, use facts and statements and only write conclusions
in assessment sections as designated by policy and procedure.
 The data you enter into a computer system is critical in providing accurate
information to the agency, state and federal government about outcomes
of children and families.
With only this first step to think about, the social worker already has a lot to do in gathering
information. As we will see when we apply this decision making process, the SDM system
helps the social worker by focusing on the most important factors to consider.
Step 2: Application of Rules or Criteria
After the relevant information is gathered for a given decision point, it must be analyzed by
the social worker making the assessment and compared to accepted rules or judgment
criteria. For child welfare social workers, this step requires that we apply the relevant facts
we have gathered to:
 a legal definition of abuse or neglect,
 the associated state and local policies, and
 an established standard such as a minimum sufficient level of care.
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In addition to considering individual pieces of information, we must also consider the way all
the pieces interact to create a whole. At times the combined effect of all the key factors is
significantly better or worse than any individual factor. Individual factors must be weighed
against a standard, but the big picture must also be considered in its relationship
to legal definitions, policies and minimum sufficient levels of care. This includes
considering strengths and mitigating factors.
As we learn more about the SDM tools, we’ll see that the tools have their own specific
criteria and definitions, which classify certain behavioral and historical factors in terms of the
level of risk to the child. When applying these specific criteria, social workers must adhere
closely to the SDM definitions in order for the tools to work properly.
Step 3: Decision/Professional Judgment
The fourth step in the process involves reaching a decision. This step is best achieved with
documentation of specific facts and observations and an explanation of how the specific
facts and observations lead to the identified conclusion. It is also important to identify how
the decision ensures the child’s safety and ensures that the family receives appropriate
services. This may mean justifying specific interventions, but it may also mean justifying the
lack of intervention indicated by the situation at hand. Both decisions should reflect that
information was gathered, applied to a specific standard and discussed with others. There
should be a clear relationship between the information gathered and the conclusion.
The SDM system supports this step in the process by walking the social worker through the
process of considering the right information, applying definitions and policy to the
information, facilitating review and documenting the conclusion. It is important to
remember that it is still the social worker making the decision; SDM only guides the process.
Step 4: Discussion/Feedback
Once the information has been gathered and criteria applied, additional resources and
feedback are sought to insure an accurate decision. Discussion and feedback may occur in a
variety of venues, including consultation with a supervisor, unit case consultations,
interdisciplinary meetings, family case conferencing, Team Decision Making and consultation
with County Counsel. This can be helpful in situations with no clear direction, but it is also
important to seek feedback when the answer seems obvious. Consultation provides an
opportunity to identify errors or bias in our decision making. This process involves
combining our professional judgment with the professional judgment of others in a
cooperative way that ensures multiple points of view are considered and multiple sources of
knowledge contribute to the conclusion.
This part of decision making is incorporated in the SDM system via the research behind the
tools and the supervisor approval process. In addition, if the social worker disagrees with
the recommendation of the tool, this opens the possibility of overriding the tool
recommendation and indicates a need for further discussion with a supervisor. This
provides a good check and balance in the decision making process.
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Step 5: Ongoing Review
As a final step in the process we highlight the continuous nature of information gathering,
assessment and decision making. Situations involving children and families are rarely static.
It is important to incorporate regular review of key factors and adjust actions as
circumstances change. The decision may change as new information is received or as family
members take steps to address factors. The SDM system and the court system have
identified key points for reassessment, but social workers must remain aware of ongoing
changes and adjust as needed to reflect new protective factors or new threats to safety.
In conclusion, please note that SDM does not replace clinical skills. Effective use of the tools
depends upon good interview and observation skills to conduct thorough assessments. It
depends on the skill of the social worker to recognize unique conditions. Rather than
replacing clinical judgment, SDM becomes a strong partner providing a research basis for
critical decisions related to risk, and structure for increasing consistency and accuracy of
other key decisions.
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Minimum Sufficient Level of Care
In order to effectively use the 5 step decision making process described above, social
workers must be able to understand and assess the minimum sufficient level of care (MSLC).
Correct application of the MSLC standard allows social workers to provide accurate
assessments and keep children safe while also interfering as little as possible in people’s
lives.
The MSLC can be challenging to define. For the purposes of the California Common Core
Curriculum for Child Welfare Social Workers, the definition is:
The minimum sufficient level of care is the social standard for the minimum of parent
behavior below which a home is inadequate for the care of a child.
This definition successfully conveys the basic concept that the MSLC refers to the worst
possible situation that still fits within the realm of acceptable care. The MSLC does not
represent optimum care; on the contrary, it is one step away from unacceptable. The terms
“minimum” and “sufficient” are crucial to this concept; the standard is related to the
objective of keeping children safe and protected. The terms “minimum” and “sufficient” are
used to explicitly differentiate from higher standards.
The definition does not convey HOW the social worker establishes the MSLC standard. In
order to understand this aspect of the MSLC concept, we have to consider the following:
 The MSLC is unique for each child and must address the child’s physical
safety, emotional well-being and development, including:
o Physical care (e.g., safety, protection, food, clothing ,
shelter, medical and dental care)
o Emotional wellbeing (e.g., attachment between child
and caregivers, sense of security)
o Development (e.g., education, special help for children
with disabilities)
 The MSLC is case specific. A variety of factors must be considered for each
child and family, and there are no fixed criteria for assessing when a home
falls below this minimum standard. This decision must be made by
informed judgment and individual evaluation of each case.
 The MSLC must reflect contemporary social standards. Many social
standards now are codified in law, e.g., definitions of child maltreatment,
compulsory school attendance, and child labor. Others are mainly
normative, e.g., expectations for how much work/chores children do in
order to contribute to the family’s well being. Social standards have
greatly changed over the last 100 and even 25-50 years so there is a wide
range of accepted social standards.
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

The MSLC must reflect community standards. Ours is a pluralistic society.
There are significant community differences present within a single town
or region, reflecting differences related to culture, class, and ethnicity.
The importance of community standards is explicitly identified in the
Indian Child Welfare Act (ICWA) which mandates that the standards
applied to a given Native American child reflect the tribe’s standards.
The MSLC must remain consistent for the duration of the case. Once the
MSLC is developed for a given child, it does not change throughout the life
of the family’s case unless the needs of the child change (e.g., child
develops a high risk health condition). When a child is in placement, the
decision about reunification must be based on the same MSLC baseline as
when the child was removed. It is important to avoid increasing the
minimum expectations as the case progress and the parents gain more
resources or the child’s foster home has a standard that differs from the
MSLC. Increasing the standard over time interferes with the reunification
plan and may lead to lengthy stays in foster care for children who could
safely return home.
Implementing the MSLC can be difficult. Establishing the MSLC involves exploration of
values and must include application of broader social standards and legal standards in
conjunction with community standards. Social workers must be aware that their own values
and attitudes may differ from the family or community and they must be vigilant about
separating their own individual values from the establishment and assessment of the MSLC.
Different cultures have different interpretations of what constitutes the MSLC. Some steps
to ensure fairness and equity might include:
 Developing the MSLC within a team that includes family members and
community members.
 Documenting specific behavioral expectations for meeting the MSLC so
the social worker and family will be able to assess progress along the way.
 Discussing the MSLC during case consultations with a supervisor or a multidisciplinary team.
 Taking additional training on how to apply MSLC to cases.
 Working in community partnerships to learn more about how different
cultures view MSLC.
 Systematically considering what the standard was for removal and what
the expectations are for return of the child, to assure that the standard is
not changing over the life of the case.
Although challenging to establish and employ, the MSLC is a key factor in child welfare
assessments. It is a valuable tool for social workers for several reasons:
 It maintains the child’s right to safety and permanence while not ignoring
the parents’ right to their children.
 It provides a practical way to interpret the reasonable efforts provision of
PL 96-272.
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






It is possible for parents to reach.
It provides a reference point for family members and social workers to
mutually assess progress and reach decisions about safety.
It protects (to some degree) from individual biases and value judgments.
It discourages unnecessary removal from the family home.
It discourages unnecessarily long placements in foster care.
It keeps team members focused on what is the least detrimental
alternative for the child.
It is sensitive across cultures.
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Safety and Risk
In order to effectively assess safety, risk and protective capacity we have to all be clear
about the difference between safety (immediate safety compromise) and risk factors
(likelihood of future maltreatment). We must also be aware that the SDM system has
specific definitions of safety and risk as they are assessed by the safety and risk tools.
First we’ll consider a broad definition of safety. Safety refers to:
 Currently dangerous family conditions that are severe in nature and specifically
affect the child
 A situation which will almost certainly result in severe negative effects on the
child (as opposed to something that could be a safety threat)
Risk is broadly defined as the likelihood of future maltreatment. Risk includes:
 Family functioning
 General child well-being
 Family situations and behaviors that may need intervention but do not require
immediate intervention
 All aspects of family life relevant to understanding the likelihood of maltreatment
Because SDM tools are research based, they use more specific definitions of safety and risk.
When assessing safety, SDM tools consider:
 Specific threats to a child’s imminent safety
 Evaluating family situations and behaviors that must be immediately managed
and controlled in order for the child to remain in the home now
When assessing risk, SDM tools consider:
 The likelihood of future maltreatment
 Decision making based on the likelihood of harm in the next 18-24 months
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Safety and Risk Worksheet
A 2 month old has sleep apnea and needs to use an apnea monitor
while sleeping. The family home has no electricity.
Safety or
Risk
A 6 year old child is sent to school every day in a t-shirt and jeans in
temperatures below 40 degrees.
Safety or
Risk
The mother of a newborn has been diagnosed with schizoaffective disorder and has been hospitalized in the past for
emotional problems.
Safety or
Risk
A 3 month old in the home has a spiral femur fracture and the
primary caregiver cannot explain how the injury occurred.
Safety or
Risk
The home has two children age 4 and 6 and is dirty with clothes all
over the floor, dirty dishes stacked in the kitchen and is infested
with rats and roaches
Safety or
Risk
The mother of 4 year old twins was arrested for DUI. The twins
were in day care at the time of the mother’s arrest
Safety or
Risk
There is a three year old child in a home with no water service.
There is evidence of human waste in the home.
Safety or
Risk
A four year old child reports that her stepfather comes in to her
room at night and touches her private area.
Safety or
Risk
A thirteen year old girl reports that her mother shouts at her and
slaps her. She has no visible injuries.
Safety or
Risk
A mother slaps a 2 month old baby on the face for crying and says
the baby has to be slapped or it won’t be quiet.
Safety or
Risk
An eight year old child is kept home from school several days a
month to care for her infant sibling while the mother and father
work.
Safety or
Risk
A 3-year-old child has brown spots between his front teeth and
has not been seen by a doctor or dentist in 12 months.
Safety or
Risk
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SDM Flow Chart Worksheet
Tool?
Tool?
Tool?
Is an inperson
response
needed?
Can the child
remain
safely at
home?
What is the
ongoing risk?
Should we
open a case?
(Response
Decision)
(Removal /
Placement
Decision and
Safety Plan)
(Allegation
Conclusion
Decision and
Case Opening
Decision)
Tool?
What are the
strengths and
needs?
Tool?
In home
cases
Tool?
Out of home
cases
(Service
Needs
Identification)
What are the
current safety
threats and
risks? How are
visits? How
much time is
left?
(Reunification
Decision)
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What is the
family
history and
what
progress has
been made
since the
last
assessment?
(Case
Closure
Decision)
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Protective Capacity
Definition
Action for Child Protection (2004) defines Protective Capacity as “the ability and willingness
to utilize internal and external resources to mitigate or ameliorate the identified safety and
risk concerns, and to support the on-going safety of the child.”
Action for Child Protection (2004) further clarifies that protective capacity is “a specific
quality that can be observed and understood to be part of the way a parent thinks, feels and
acts that makes him or her protective.”
Assessing parental and/or caregiver capacities allows the social worker to consider
systematically the strengths of the parent(s) or caregiver(s), and how they might mitigate
safety threats and risk factors. Cognitive, behavioral, and emotional factors are three such
characteristics.
1) Cognitive characteristics as, “the specific intellect, knowledge, understanding and
perception that contributes to protective vigilance.”
2) Behavioral characteristics as “specific action, activity and performance that is consistent
with and results in parenting and protective vigilance.”
3) Emotional characteristics as “specific
feelings, attitudes and identification with the child and motivation that result in parenting
and protective vigilance”
Cognitive Characteristics
Questions to consider include:
 Is the caregiver oriented to time, place and space? (Reality orientation)
 Does the caregiver have an accurate perception of the child? Does the caregiver view
the child in an “integrated” manner (i.e. seeing the child as having strengths and
weaknesses), or do they see the child as “all good or all bad?”
 Does the caregiver have the ability to recognize the child’s developmental needs, or
if the child has “special needs?”
 Does the caregiver accurately process the external world stimuli, or is perception
distorted (i.e., a battered woman who believes she deserves to be beaten because of
something she has done)?
 Does the caregiver understand the role of caregiver is to provide protection to the
child?
 Does the caregiver have the intellectual ability to understand what is needed to raise
and protect a child?
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
Does the caregiver accurately assess potential threats to the child?
Behavioral characteristics
Questions to consider include:
 Does the caregiver have the physical capacity and energy to care for the child? If the
caregiver has any disabilities (i.e., blindness, deafness, paraplegia, chronic illness),
how has the caregiver addressed the disability in parenting the child?
 Has the caregiver acknowledged and shown action to get the needed supports to
effectively parent and protect the child?
 Does the caregiver demonstrate activities that indicate putting aside one’s own
needs in favor of the child’s needs?
 Does the caregiver demonstrate adaptability in a changing environment or during a
crisis?
 Does the caregiver demonstrate appropriate assertiveness and responsiveness to the
child?
 Does the caregiver demonstrate actions to protect the child?
 Does the caregiver demonstrate impulse control?
 Does the caregiver have a history of protecting the child given any threats to safety
of the child?
Emotional characteristics
Questions to consider include:
 Does the caregiver have an emotional bond to the child? Is there a reciprocal
connectedness between the caregiver and the child? Is there a positive connection to
the child?
 Does the caregiver love the child? Have empathy for the child when the child is hurt
or afraid?
 Does the caregiver have the ability to be flexible under stress? Can the caregiver
manage adversity?
 Does the caregiver have the ability to control emotions? If emotionally overwhelmed
does the caregiver reach out to others, or expected the child to meet the caregiver’s
emotional needs?
 Does the caregiver consistently meet their own emotional needs via other adults,
services?
Actions
When assessing the protective capacity of the caregiver, actions speak louder than words. A
statement by the caregiver that he/she has the capacity/will to protect should be respected,
but observations of this capacity are very important, as they may have serious consequences
for the child. When interviewing the caregiver, it is important to include questions that
provide answers and observations that support an assessment of behavioral, cognitive and
emotional functioning. Suggested questions and observations include:
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





A history of behavioral responses to crises is a good indicator of what may likely
happen. Does the caregiver “lose control?” Does the caregiver take action to solve
the crisis? Does the caregiver believe crises are to be avoided at all costs, and cannot
problem solve when in the middle of a crisis, even with supports?
Watch for caregiver’s reactions during a crisis. This often spontaneous behavior will
provide insight into how a caregiver feels, thinks and acts when they themselves are
threatened. Does the caregiver become immobile to the point of inaction (failure to
protect)? Does the caregiver move to protect him/herself rather than the child? Does
the caregiver actively blame the child for the crisis?
Recognition of caregiver anger or “righteous indignation” at first is appropriate and
natural. How a caregiver acts beyond the anger is the important key. Once the initial
shock and emotional reaction subsides, does the caregiver blame everyone else for
the “interference?” Can the caregiver recognize the protective and safety issues?
What are the dynamics of the relationship of multiple caregivers? Does the
relationship involve domestic violence? What is the nature and length of the domestic
violence? What efforts have been made by the victim to protect the child? Does the
victim align with the batterer?
Does the caregiver actively engage in a plan to protect the child from further harm?
Is the plan workable? Does the plan have action steps that the caregiver has made?
Does the caregiver demonstrate actions that are consistent with verbal intent or is it
contradictory?
Information from Other Sources
Detailed interviewing and information gathering from other sources is critical for an
accurate assessment. Suggestions for additional activities include:
 What do others say about the caregiver’s parenting and ability to protect the child/
 What do others say about the caregiver’s history of protecting the child?
 What is the documented history that indicates the caregiver’s actions toward
protecting the child?
Assessing Environmental Protective Capacities
While the assessment of the caregiver’s protective capacities is critical, an assessment of
environmental capacities may also mitigate the safety concerns/risk of harm to a child.
Below are several categories of environmental protective capacities, along with questions
and considerations that may be considered when assessing them.


Formal family/kinship relationships that contribute to the protection of the child
o What are the formal kinships within a family? (Grandparents, aunts, uncles,
siblings, stepparents and their families, half siblings, gay partners raising children,
etc.)
Informal family/kinship relationships
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






o What are the informal relationships? (friends of the family, godparents, tribal
connections, “pseudo” relatives, mentors, divorced step parent who maintains
parental relationship with the child, etc.)
Formal agency supports
o What are the agencies that have been or are currently involved with the family?
Previous agency involvement may have been seen as beneficial and can be called
upon again (i.e. drug treatment, children’s hospital, Regional Center, non –profit
agencies, food banks, schools, employment training, parenting classes, DV
programs, etc.)
Informal community supports
o What are the community supports that may or may not be readily apparent? (local
parent support groups, informal mentors, neighbors, neighborhood
organizations, babysitting clubs, library reading times, etc.)
Financial supports
o Employment, unemployment, disability, retirement benefits
o TANF, GA/GR, SSI
o Scholarships, grants
Spiritual or congregational/ministerial supports
o Churches, ministries, prayer groups, synagogues, temples, mosques
o Spiritual leaders within a faith
Native Americans (the tribe)
o Is the family a member of a tribe locally, or elsewhere? Are there ICWA agencies
that can provide services? (Elders within a tribe, tribal chairpersons, liaisons to the
tribes, Indian health agencies)
With all families, it is important to consider the parents’ behavior in light of cultural
considerations. Is our assessment of a parent’s behavior based on our own cultural
beliefs or are we taking into account the cultural appropriate customs, traditions,
history, etc.
Concrete needs being met such as food, clothing, shelter
o Low income housing, food banks, clothing stores, emergency shelters, subsidized
housing.
It is the interplay of safety, risk and protective capacity (both internal and external
elements) that constitutes the elements of the assessment process.
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Family Friendly Interview Sample
This interview sample involves a mother, Serena, and a social worker discussing an injury to
Serena’s infant daughter, Santana.
The concern is that Santana has a fractured leg and there is no clear explanation for the
injury. The social worker must ask questions about the specific incident, but is also
gathering information about all the safety threat factors.
The interview is adapted from interview samples in Turnell, A., and Edwards. S. (1999). Signs
of Safety.
Serena:
I don’t have any answers about what happened. I love my baby and I don’t
want you to take her away.
Social Worker: Well, I am hoping we can discuss a few things, including what may have
happened to Santana and what your life together is like so that I can get a
clear picture of your family. I hope that you will work with me to get an idea
of Santana’s safety with you. I want to make sure you know that I can’t
predict what will happen following our discussion, but I may ask you to help
me make a plan for Santana’s safety.
Serena:
I can keep her safe. I have been taking care of her by myself her whole life.
She has always been safe.
Social Worker: Let me start this conversation by saying I see for myself and have heard
from the nurses and doctors here that you and Santana have a strong
relationship. Her weight is good and she looks to you for comfort. Those
things tell us that you are working hard to take good care of your baby.
Serena:
I took a class about baby care, so I know about feeding and changing her.
Social Worker: That’s great. I know the doctors here have said she is clean and her weight
is good. Let’s talk about the injury to Santana’s leg. Do you know what type
of injury she has?
Serena:
They told me it was a spiral fracture, but I don’t know what that means. I
don’t think it is all that serious because she doesn’t have a bruise and since
she doesn’t walk yet it probably doesn’t hurt her very much.
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Social Worker: Well a fracture means a broken bone and a spiral fracture means the bone
broke during a twisting movement. For people who don’t walk, like
Santana, this almost always means some twisting was done to the leg. If
you think of a stick being twisted until it breaks, you can imagine the way a
spiral fracture happens.
Serena:
Oh! That sounds like it would hurt a lot! Poor Santana! I really didn’t
understand what they meant. I haven’t ever twisted her leg, though.
Social Worker: Is there anyone else who takes care of her?
Serena:
Well, sister and my cousin, but they wouldn’t hurt her. They love her.
Social Worker: Is it possible that someone twisted her leg not knowing it could hurt her in
this way?
Serena:
I guess it is possible. I’m not sure.
Social Worker: OK. I think we will have to talk to them about it. Would that be OK?
Serena:
I guess so.
Social Worker: Now, I have some questions about other topics that might seem a little
unrelated, but we need to ask about some other things that could be
affecting your family. We ask these questions of all the families we
interview. Can I go through these questions with you?
Serena:
OK.
Social Worker: Do you have problems with alcohol or drugs?
Serena:
No. I saw what crank did to my sister and I have stayed away from drugs.
Social Worker: OK. Is there any domestic violence involving you or anyone else in your
house?
Serena:
I guess my sister has had some trouble with her boyfriend a few times, but
she wouldn’t let that happen around Santana. I just don’t think my family
would ever let anything happen to my baby.
Social Worker: OK. Let’s keep talking about it and let’s bring the family into the
conversation so I can get a clear picture of the whole support system and
how everyone works together.
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