U.S. CWS Redesign – 1.3 Intervention: Redesigned CWS – Therapeutic Day Services

 

United States Child Welfare System Redesign

Strategic Action Plan

 

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1.3 Intervention: Redesigned CWS – Therapeutic Day Services

 

Prior to the Redesign of the Child Welfare System, when a child was “founded” as abused and/or neglected, there were three options from which CPS Caseworkers could choose:

  • Leave the child at home, without a Safety Plan or In-Home services, and Close the Case: unfortunately, this was the option selected in over two-thirds of the cases in some states. CPS recognized that the child had been abused and/or neglected, but basically left the child in the family and walked away. Case Closed.

 

  • Leave the child at home, with a Safety Plan and, possibly, In-Home services: this option at least tried to provide some safety guidelines and kept the case Open. CPS Caseworker follow-up and home visit scheduling varied among the states.

 

  • Remove the child from the home and place the child in foster care: this option was targeted as the most racially biased and most traumatic option for the child, and CWS in all states were told to reduce the number of children, particularly Children of Color, from being placed in foster care. CPS Caseworker follow-up and foster home visit scheduling varies among the states.

 

This Redesigned Child Welfare System also has three options for action when a child has been “founded for abuse or neglect.” However, none of the options can be compared to the previous 3 options available to CPS Caseworkers:

  • Leave the child at home, with a Safety Plan AND appropriate In-Home services AND mandatory weekly visits to the home where the child must been seen and talked to at every visit. The CPS Caseworker determines whether this option is best for the child, and a Family Services Worker is assigned to ensure the Safety Plan and the In-Home services are arranged, in place, and utilized. The Family Services Worker visits the child and family weekly, checking on the status of the Safety Plan and the In-Home services, meets and talks with the child, and includes in the child’s record pictures of the child and the home, notes from all discussions with the child and family, status of the Safety Plan and the In-Home services, and recommendations as to whether the plan appears to be in the best interests of the child, or if an alternative plan should be investigated. The CPS Caseworker is alerted if less than satisfactory results are indicated by the Family Services Worker in their instant automated report. If the Family Services Worker encounters a threatening or dangerous situation in the home during a visit, the Family Services Worker immediately alerts 911 via their CPS phone app, and law enforcement and the CPS Caseworker immediately arrive on the scene to address the issue.

 

  • Remove the child from the home, take the child to the hospital by ambulance for physical and psychological examination and treatment orders, and place the child in a Therapeutic Respite Home for recovery from physical and mental/emotional issues according to the physician and therapist guidelines. This option is explained in detail in Section 1.4 Removal to Recovery Care.

 

  • Leave the child at home, with a Safety Plan AND appropriate In-Home services AND Therapeutic “Day Camp” for the child during the day returning home at night AND mandatory weekly visits to the home where the child must been seen and talked to at every visit. This option is used when the child is believed to be safe at home (e.g., the abusing parent has been arrested, the abuser is actively working in an intensive behavior program, etc.). With this approach, the child gains extensive therapeutic care in a safe environment during the day, yet returns home to the family at night, retaining the family bonding while receiving more expansive care and treatment for the child. This section deals with this approach, called “Therapeutic Day Services.”

 

Therapeutic Day Services

The purpose of Therapeutic Day Services are:

  • Provide a safe environment for the abused or neglected child to recover and heal
  • Provide a trauma-based practice that teaches the child more healthy responses to situations they encounter at home
  • Allow the child to “remain at home” during the evening and weekends, if it is safe at home for the child

Example of Best Practice:

Trust-Based Relational Intervention (TCBI) is currently listed on the California Evidence-Based Clearinghouse (CEBC) registry for Child Welfare, and is rated as being “Highly” relevant in the child welfare system based upon the program being designed to meet the needs of children, youth, and families receiving child welfare services. Source: child.tcu.edu.

“Developed by Dr. Karyn Purvis and Dr. David Cross at the TCU [Texas Christian University] Institute of Child Development, Trust-Based Relational Interventions® (TBRI®) is an emerging intervention model for a wide range of childhood behavioral problems. It has been applied successfully in a variety of contexts, and with many children for whom numerous other interventions have failed (e.g., medications, cognitive-behavioral therapies.) TBRI® is based on a solid foundation of neuropsychological theory and research, tempered by humanitarian principles. It is a family-based intervention that is designed for children who have experienced relationship-based traumas such as institutionalization, multiple foster placements, maltreatment, and/or neglect. … It is a trauma-informed intervention that is specifically designed for children who come from ‘hard places,’ such as maltreatment, abuse, neglect, multiple home placements, and violence. TBRI® consists of three sets of harmonious principles: Connecting, Empowering, and Correcting. These principles have been used in homes, schools, orphanages, residential treatment centers and other environments. They are designed for use with children and youth of all ages and risk levels. By helping caregivers understand what should have happened in early development, TBRI® principles guide children and youth back to their natural developmental trajectory.” Source: https://www.attachmenttraumanetwork.org/trust-based-relational-interventions-tbri/

 

“TBRI uses Empowering Principles to address physical and environmental needs, Connecting Principles for attachment needs and engagement, and Correcting Principles to disarm fear-based behaviors. While the intervention is based on years of attachment, sensory processing, and neuroscience research, the heartbeat of TBRI is connection.” Source: https://creatingafamily.org/adoption-category/adoption-blog/beginners-guide-to-tbri/

 

TBRI is not the only Therapeutic Day Service available for abused and neglected children to attend while still remaining at home.  “The Title IV- E Prevention Services Clearinghouse was established by the Administration for Children and Families (ACF) within the U.S. Department of Health and Human Services (HHS) to conduct an objective and transparent review of research on programs and services intended to provide enhanced support to children and families and prevent foster care placements.” Source: https://preventionservices.abtsites.com/ 

See Section 1.2 New In-Home Services for a description of some of the programs and services that have been rated “well supported” or “supported” by the Title IV-E Prevention Services Clearinghouse.

 

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To submit questions or comments, please email Jo@Jo-Calk.com. I welcome all input, ideas, and suggestions. Thank you for caring for children.

Blessings,

Jo Calk