Child Maltreatment Research, Policy, and Practice for the Next Decade Workshop Summary (2012) / Chapter Skim
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7 Design and Delivery of Services
7 Design and Delivery of Services
Pages 69-80
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From page 69... ...
Multiple effective service models exist, many of which are adapted from other service sectors (e.g., services to help parents of children with specific behavioral disorders)
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From page 70... ...
Parenting interventions can be focused either on the abusive and neglectful behaviors that put children at risk or on the behavior resulting from abusive and neglectful parenting behaviors, said Landsverk. In the latter category, not much diagnostic information exists about externalizing problems.
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From page 71... ...
"Parenting interventions that were developed for externalizing behaviors may now be a real possibility for use with the largest population in child welfare -- namely, neglect." Child welfare managers need decision tools that they can use to select age- and condition-appropriate parenting interventions and link parenting intervention outcomes to child welfare outcomes. In addition, parenting interventions should be extended downward in age, Landsverk said, with adaptation that makes them suitable for parents with younger children.
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From page 72... ...
Research supports the effectiveness of these interventions across cultural and ethnic groups and demonstrates that, in most cases, the evidence-based approach works better than usual care. Sources for learning about effective interventions include the CEBC and the Kauffmann Best Practices Project to Help Children Heal from Child Abuse.
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From page 73... ...
New approaches need to monitor both outcomes and the adherence to effective therapies, she said. A small randomized controlled trial in Washington state, which trained case workers in how to refer children to evidence-based practices, saw increased awareness as workers became more familiar with the options available to them (Dorsey et al., 2012)
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From page 74... ...
Also, reliable methods are needed for getting services to children with subclinical levels of internalizing disorders such as PTS who may not be able to get coverage through Medicaid. Child abuse and neglect require comprehensive approaches, she said.
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From page 75... ...
Dorsey suggested that counselors be trained in exposure, cognitive reprocessing, and other skills for addressing anxiety disorders and trauma. Angela Diaz from the Mount Sinai School of Medicine pointed out that many children have a history of abuse that is not known to the welfare or legal system, but is often discovered by primary care providers.
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From page 76... ...
A trial on Seeking Safety, a popular cognitive behavioral approach for women with a history of trauma and substance use, showed no difference between women assigned to that approach or a women's health education group (Hien et al., 2009)
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From page 77... ...
"When cooccurring risks are present, we should think carefully about the possibility of brief interventions with a single focus." Stepped and long-term episodic approaches, such as recovery management checkups and motivational checkups used in the substance abuse field, could also be a useful tool. Judicious use of technology also could greatly improve reach.
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From page 78... ...
The exploration phase involves consideration of implementing an evidence-based practice and about the "fit" of a given evidence-based practice with outer context (i.e., service system) and inner context (e.g., service organizations, providers, and clients)
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From page 79... ...
It also found that youth receiving MST plus ARC entered out-of-home placements at a significantly lower rate (16 percent) than youth in the control condition (34 percent)
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From page 80... ...
"The idea is to spread that expertise efficiently throughout the service system and then support it with the seed team. This is ongoing now, and we will be following these teams for the next 4 years to see if they maintain fidelity and if we get successive reductions in child maltreatment reports and recidivism," said Aarons.
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