Susan J. Wells

The Meaning of Quality in Kinship Foster Care: Caregiver, Child, and Worker Perspectives

Though principles, guidelines, and procedures for assessing the quality of foster care in kinship settings have been introduced, research on the factors that mediate the quality and outcome of kinship care has been minimal. To provide insight into these factors from the perspectives of kinship stakeholders, this article presents findings from a qualitative study conducted with kinship caregivers, children living with relatives, and caseworkers of children in kinship placements. Their views on quality care in kinship homes, including factors to consider in the selection and evaluation of kinship placements and opinions of how kinship and nonkinship foster care differ, make unique contributions to the development of standards and measures for kinship foster care assessment. Findings confirm the salience of specific factors present in existing guidelines, build on existing recommendations for the selection and evaluation of kinship homes, and highlight important policy and practice issues for consideration with kinship families.

The decision to investigate: Child protection practice in 12 local agencies

Abstract This study examined child protective service (CPS) screening practices in twelve sites from five states, and sought to identify factors predictive of the decision to investigate a report. The authors found that few contacts with CPS agencies were determined clearly inappropriate for CPS investigation; 70% of the reports entailed specific allegations of maltreatment. Fifty- three percent of all reports were investigated. Of those concerning specific allegations of maltreatment, only 66% were investigated. When injury was alleged, reports were investigated 70% of the time, regardless of the specificity of the allegation. Study findings suggest that the most important problem for CPS intake and investigation is not that workers are over-investigating bogus reports. In this sample, very few clearly inappropriate reports were made, and of these, very few were investigated. Rather, with reports alleging specific types of maltreatment, intake was used to “screen out” reports which might be appropriate for further CPS investigation.

CAFFEINE: Implications of Recent Research for Clinical Practice

Caffeine is a central nervous system stimulant that has come under increasing scrutiny due to its effects on the health and mental health of those who consume it. This article summarizes the physiological effects of caffeine, reviews recent research on behavioral and mood changes associated with consumption, and discusses clinical implications for the mental health professional. Data on caffeine consumption and principal sources of caffeine are outlined.

Reducing Recurrence in Child Protective Services: Impact of a Targeted Safety Protocol

Statewide implementation of a child safety assessment protocol by the Illinois Department of Children and Family Services (DCFS) in 1995 is assessed to determine its impact on near-term recurrence of child maltreatment. Literature on the use of risk and safety assessment as a decision-making tool supports the DCFSs approach. The literature on the use of recurrence as a summative measure for evaluation is described. Survival analysis is used with an administrative data set of 400,000 children reported to DCFS between October 1994 and November 1997. An ex-post facto design tests the hypothesis that the use of the protocol cannot be ruled out as an explanation for the observed decline in recurrence following implementation. Several alternative hypotheses are tested: change in use of protective custody, other concurrent changes in state policy, and the concurrent experience of other states. The impact of the protocol to reduce recurrence was not ruled out.

Child Maltreatment and the Justice System: Predictors of Court Involvement

Objectives: Characteristics of the child victim, perpetrator, and maltreatment incident were used to examine predictors of court involvement in cases of serious child maltreatment. Method: Cases were drawn from those reported to: child protective services (n = 225), sheriffs office ( n = 225), prosecutors office ( n = 60), and dependency court ( n = 65). Logistic regression was used to calculate predicted probabilities of criminal court involvement and dependency court involvement Results: Cases involving female victims were more likely to be filed in criminal court, and sexual abuse had the highest likelihood of prosecution. Cases involving male perpetrators, older perpetrators, and multiple victims were more likely to be filed for prosecution. Physical neglect was the most common type of maltreatment to result in dependency court filings. Perpetrator gender had opposite effects in the two systems. Conclusion: Tracking cases even in the same jurisdiction is confounded by the lack of common identifiers across the agencies involved.

Indicators of Quality in Kinship Foster Care

Kinship care for at-risk children is an increasingly popular alternative to traditional foster care. Despite the rationale for such placements, questions remain about the quality of kinship care compared to other foster placement alternatives and about how to evaluate its quality. The purpose of this study was twofold: a review of the literature to explore the characteristics of children and caregivers in kinship homes, and an examination of existing tools for measuring kinship care quality. A total of 25 predictive, correlational, qualitative, and meta-analytic research studies were reviewed. Children in kinship care were found to experience unique circumstances that should be considered when developing a comprehensive instrument for measuring quality of kinship care. Development should include collaboration among kinship care stakeholders in order to address the unique real-life circumstances of both caregivers and their kin.

Cultural adaptations to augment health and mental health services: a systematic review

BackgroundMembership in diverse racial, ethnic, and cultural groups is often associated with inequitable health and mental health outcomes for diverse populations. Yet, little is known about how cultural adaptations of standard services affect health and mental health outcomes for service recipients. This systematic review identified extant themes in the research regarding cultural adaptations across a broad range of health and mental health services and synthesized the most rigorous experimental research available to isolate and evaluate potential efficacy gains of cultural adaptations to service delivery.MethodsMEDLINE, PsycINFO, CINAHL, EMBASE, and grey literature sources were searched for English-language studies published between January 1955 and January 2015. Cultural adaptations to any aspect of a service delivery were considered. Outcomes of interest included changes in service provider behavior or changes in the behavioral, medical, or self-reported experience of recipients.ResultsThirty-one studies met the inclusion criteria. The most frequently tested adaptation occurred in preventive services and consisted of modifying the content of materials or services delivered. None of the included studies focused on making changes in the provider’s behavior. Many different populations were studied but most research was concerned with the experiences and outcomes of African Americans. Seventeen of the 31 retained studies observed at least one significant effect in favor of a culturally adapted service. However there were also findings that favored the control group or showed no difference. Researchers did not find consistent evidence supporting implementation of any specific type of adaptation nor increased efficacy with any particular cultural group.ConclusionsConceptual frameworks to classify cultural adaptations and their resultant health/mental health outcomes were developed and applied in a variety of ways. This review synthesizes the most rigorous research in the field and identifies implications for policy, practice, and research, including individualization, cost considerations, and patient or client satisfaction, among others.