The System of Care (SOC) being implemented by the State Office for Services to Children and families (SOSCF) resulted from an agreement between the Juvenile Rights Project and SOSCF, and is intended to change the process by which services are delivered to families in the child welfare system throughout Oregon. The critical practice component of the system of Care is Strengths/Needs Based service delivery (S/NB), which was implemented in Phase I in six pilot branches in Multnomah, Deschutes and Polk Counties and is currently being implemented in nine additional Phase II branch offices around the state. This interim report presents findings from the second year of the evaluation, focusing on early contacts between protective service workers and families in the six Phase I pilot branches: Deschutes, Polk, and, in the metropolitan area, St. Johns, North/Northeast, Midtown, and East.

The Evaluation of Strengths/Needs Based Practice
The Strengths/Needs Based practice model emphasizes (1) achieving agreement between the division and the family about the needs of the child(ren) as a basis for service planning; (2) a planning process that builds on family strengths and the family’s perspective in identifying needs and planning services; (3) services identified or crafted to meet specific needs, and (4) flexible funding to ensure that services can be found or created as necessary to meet identified needs. It is intended to improve service effectiveness for all families involved with the division.

• To what extent were protective service workers able to implement Strengths/Needs Based services during the initial assessment and planning period?

• To what extent did Strengths/Needs Based service planning contribute to engaging families in work to meet the needs of children?

• From the families’ perspective, what aspects of Strengths/Needs Based services were helpful or not helpful?

Two additional questions are also addressed in the body of the report:

• From the workers’ perspective, how useful is the Strengths/Needs Based approach in protective service work, and what kinds of additional training or support would be helpful to them in their work?

• What structural or systems issues at different levels in the division appear to facilitate or impede workers’ abilities to implement Strengths/Needs Based services?
  

Findings in the report are based on a detailed examination of 93 randomly selected protective service cases in the six branch offices. Initial sampling resulted in a large number of cases that had been closed after a very brief assessment; sampling procedures were adjusted subsequently to ensure that the final sample would include a sizeable number of cases that remained open for services. Data came from interviews with families and their caseworkers, and from case file material at the agency. Interviews were semi-structured, designed to gather both qualitative and quantitative data and to be conducted between 30 and 45 days following case opening. All of the families who participated in the study did so voluntarily.

Major Findings
Though these were new cases judged serious enough for in-person investigation, as we sampled, we found:

• There was not enough information available to locate 57 of the 331 families identified for possible inclusion in the study; an additional 11 families had moved out of the area or could not be contacted by phone;

• Of the remaining 263 families, 54% agreed to be interviewed (n=143). Further attrition because of loss of contact or changing circumstances resulted in a final sample of 99, with data on 93 cases available in time for inclusion in this report;

• There were a number of cases in which there had been no contact with the worker within 30 days, and 2 that were dropped from the sample because there had been no contact after 60 days;

• An average of 5.4 days had elapsed from the receipt of protective service referral at the branch office to the date of the worker’s first contact with the family; there was variation in the length of this interval among the branch offices in the study.
  

A large proportion of the protective service worker’s time is spent in assessing a child’s need for intervention in the family system, with many cases being closed with the decision that there is no need for services. The families in the study whose cases closed after a brief assessment (n=30) generally had fewer problems and more resources than those families who received services, though domestic violence was present in nearly 40% of both groups.

In initial contacts with these ‘assessment only’ families, workers were more likely to use basic social work skills that are reflective of Strengths/Needs Based values than to use the specific techniques of explicitly identifying children’s needs or family strengths. Two-thirds of these families had a positive experience in interaction with the worker and two-thirds also reported that their views were considered and valued in the assessment process. What seemed to matter most was the caseworker’s ability to convey a respectful, caring attitude.

More extensive analysis was done of the experiences of the 63 families whose cases remained open. In this group, a little less than half of the families viewed their initial contact with the agency as positive. Analysis of qualitative data pointed to the high value families placed on : truthfulness and clear information from the worker; the presentation of options and consequences in a non-threatening way; empathy; a sense of being listened to; and respectful, non-judgmental behavior. When a child was removed as a result of the referral, attitudes of parents were somewhat more negative, but the difference was small, and in most cases the additional anger or anxiety were overcome so that a more positive relationship was established. The families who reported very negative initial experiences talked about feeling threatened, badgered, deceived, judged or intimidated by workers that they described as rude, authoritative, or cold.

Notable in the data are differences in perception between families and workers, particularly around the amount of collaboration in decision making.

• At the time of interview, a third of the families said they had seen their worker only once or twice; about a third reported somewhat more contact, but less than once a week; one in five reported quite intensive contact, and thirteen percent said they had seen their worker weekly since case opening. Workers and families disagreed on the adequacy of the amount of contact, with half of the families and three quarters of the workers thinking it adequate. Families’ and workers’ ratings on the adequacy of the amount differed among the pilot branch offices, from a high satisfaction rate of 71% to a low of 33%.

• About a third of the families reported attending a Family Decision Meeting. Caseworkers reported FDMs more often. Whatever planning process was used, however, about 70% of the time workers thought the process was empowering to families, while only about 40% of the families overall felt that their opinions counted "a lot" in the planning process. These ratings differed also among the branch offices, from a high of 79% to a low of 9%.
  

A collaboration scale was used to capture families’s views of their workers’ practices, including a strengths perspective, personal support, joint decision making, and helpfulness. Results suggest that many workers conveyed a positive focus on the children and on the parents’ care and concern for the children. Items that reflected a respondent’s sense of feeling understood and comfortable were rated lower, as were items pertaining to the recognition of family strengths. Responses from 44% percent of families were high, while about 20% were quite low. There was substantial variation among the pilot branches on the level of collaboration achieved in practice, based on this summary measure.

Children in twenty-six of the families were placed in foster care as a result of the referral; about half in the home of a relative or other biological parent. Among those placed in regular foster care, few were placed in their own neighborhood. Nevertheless, more than three-quarters of the families with children in foster care thought the quality of care good, and nearly all said that their children were safe. Seventy percent reported regular visits with their children, weekly or more often, although 40% said they waited longer than a week for their first visit. Two-thirds of the children had only one placement by the time of the interview.

A brief analysis of service delivery in the protective service phase of work indicated that services had been identified for at least 80% of the families in the sample, and that more than half of these services had begun or been completed by the time of the interview. Traditional services (parenting classes, substance abuse assessment or treatment, counseling) were more common than services that were individually crafted for a particular child or family. Referrals for assistance with basic needs were made for about a third of the families.

Engagement of the family in a helping process with the agency to meet the needs of the children was used as a proximate outcome of early protective services work. A measure of engagement was developed to capture the family’s investment in the helping process; expectation of being helped, capacity to acknowledge responsibility for meeting children’s needs, and ownership over the goals of service. Parallel items for family respondents and their caseworker’s were used to examine agreement, as were behaviors reflecting follow through or compliance with SOSCF expectations.

• The average rating on most dimensions is somewhat above the midpoint, reflecting the positive engagement of a substantial number of families, balanced against more adversarial relationships in other cases.
  

• Workers and families exhibited moderate agreement in overall assessments of degree of engagement (r=.57, p<.01).
  

• Workers were likely to consider the family to be engaged if they complied with worker’s expectations. However, compliance was not very strongly associated with families’ self-report of engagement. Workers reported generally compliant behavior from most families.

• The interpersonal relationship with the worker was the strongest predictor of the family’s self-report of engagement with the agency to meet the child’s needs (r=.70, p<.001).
  

Analysis of qualitative data suggest that most caseworkers thought it possible to focus on the needs of the child at the first contact, and that this focus often helped temper a client’s anger or defensiveness. Caseworkers also saw value in the focus on family strengths, and families reported that this was important to them. However, interviewers noted a tendency for some workers to report that their practice was strengths-based when families perceived it otherwise. Conversely, some workers who expressed reservations about the applicability of S/NB strategies with all families in protective services nevertheless clearly conveyed to families the attitudes of respect and empathy that reflect underlying S/NB values.

Examination of the agency context suggests that there are philosophical, organizational, and practice issues which need to be articulated and debated within the agency in order that workers receive a unified coherent message about the expectations for their work. Issues of workload and supervisory and administrative support for the implementation of the more complex elements of Strengths/Needs Based practice also surfaced as we talked with workers and other SOSCF staff.

Summary and Discussion Points
With respect to the three major research questions addressed this year:

• To what extent were Strengths/Needs Based practices implemented? The underlying values and philosophy of Strengths/Needs Based practice appeared to be reflected in roughly 40-45% of cases examined; much weaker practice appeared in approximately 20% of the cases. In general, services were not specially crafted to meet individual family needs during this early protective service work.

• To what extent did S/NB practices contribute to the engagement of families in services? The worker’s ability to defuse anger at the initial contact, collaborative practices, and a strengths-perspective were predictive of positive engagement in a helping process. Families that felt they had power in the planning process were more likely to be positively engaged. One specific worker behavior that was linked with engagement was requesting feedback from the family on the planning process itself.

• What practices did families find most helpful and important? Families especially valued truthfulness, clarity, respect, empathy, and choice.
  

Sample numbers are small, but data seem consistent, with themes emerging through the branches, and quantitative data substantiated by qualitative data. The fact that some families declined to participate or failed to return phone calls requesting their participation raises some question about the representativeness of the sample; it is hoped that for the final report SOSCF will be able to develop some basic data which will allow us to compare refusals with those who participated. Of almost more concern are the 57 families whom neither the caseworkers nor the project could locate; the serious practice implications are evident when one remembers that these are new cases, being investigated for maltreatment of children. The long delays in initial contacts with the family by worker in some instances also raises concern about the safety of children.

It is notable that the work done with the majority of the "assessment only" cases families felt fairly positive about the contact, and indicated that workers had been respectful and involved the family in decision making. The high proportion of these "assessment only" cases in the protective service caseloads may be of concern to the division, as it means that workers are spending much of their time with families who need few or no services.

The presence of patterns of service delivery which were not congruent with strength/needs based practice may signal a need for changed practice within the division. The limited use of family decision meetings early in case planning may be appropriate, but is troubling in the context of 60% of families who thought they had limited voice in decision making. Worker confusion of compliance with engagement, and differences in worker and client perception of family "empowerment", may signal a need for re-examination of the use of authority, and may indicate a need for increased supervisory teaching and support in the use of collaborative relationships. The failure to arrange early visits for children in foster care is also disappointing, but more information is needed to determine if the responsibility lies with workers, foster parents, or the families.

The strongest predictor of the family’s self-report of being engaged in services was a positive relationship with the caseworker. In this respect this interim report is an optimistic one, in that its findings illustrate the positive results which can be attained through sensitive implementation of practice skills. The relationship with the worker, the worker’s respect and empathy for the family, and the worker’s willingness to share decision making with the family emerged as the crucial variables.

In the next year, the evaluation will be following those cases which remained open for services. This longitudinal work will provide information about the extent to which early positive relationships influence the progress of a case, and about the extent to which early engagement predicts continuing investment in collaborative work to meet the needs of children.