Child safety now! Towards effective case management in child protection and youth parole services

Research output: Doctoral thesisResearch external, graduation external

Abstract

The main aim of this dissertation was to acquire knowledge on the feasibility of an integrated and system-based case management approach in child protection and youth parole services. In order to examine the feasibility of an integrated and systems-based case management approach, we first evaluated the case management approach for child protection, designated as Delta Method, which is applied by Dutch Child and Youth Protection Services (CYPS). This provided insight in important elements for the development of a more effective case management approach, which were: a goal-oriented approach, a ‘one family one worker’ approach, and a high-quality application of the method. This empirical evidence supported an integrated approach to child protection and youth parole services.
CYPS needed to improve their approaches to address long-lasting supervision orders in child protection and high recidivism rates in youth parole, the lack of continuity of care, and the system’s fragmentation. This fragmentation is due to separate child protection and youth parole departments at CYPS. Due to this fragmentation of services, families ended up with multiple professionals at the same time, or a series of professionals when the legal context changed. Cases were built around each individual child, although many families had more than one child under a child protection or youth parole order, and often children were involved in child protection and youth parole services simultaneously or consecutively.
CYPS in the Amsterdam area decided to opt for a systems-based approach in all families that were in contact with CYPS. To be able to deploy a systemic approach completely, integration of child protection and youth parole services was essential. The empirical evidence on important elements derived from the evaluation of the Delta Method supported the decision for the integration of child protection and youth parole services.
Additionally, understanding was needed of how an integrated and systems-based approach should be designed, and what the core elements of such an approach would be. We found theoretical evidence for an integrated and systems-based approach to effectively support children and youth in child protection and youth parole services. The integration of child protection and youth parole services into one systems-based approach was based on three insights; both delinquency and child maltreatment can be explained by a bio-ecological perspective, there is an overlap in risk factors at the family level, and family involvement is needed for activation, motivation and change. Furthermore, activating and incorporating the network of the child and its family were of great importance for effective case management. It seems essential to regard the ecosystem in which interventions are deployed. This is needed to reach and maintain a safe and healthy developmental situation, as professional interference, especially from CYPS, is only temporary.
CYPS in the Amsterdam area developed and implemented an integrated and systems-based approach for case management in child protection and youth parole services called Intensive Family Case Management (IFCM). Here, the systems-based approach Functional Family Parole services (FFP) was customized for intensive casework with multi-problem families. FFP was developed for youth parole services in the United States, and regarded as an evidence-based practice. IFCM serves a broader target group. It aims to achieve child safety and decrease the risk for future unsafety, no matter whether this unsafety is caused by (lack of) parental child-rearing behaviour (in child protection families) or the youth’s own deviant or atypical behaviour (youth parole families).
This dissertation described the target group and core elements of IFCM, which together define how professionals work with the families to achieve positive outcomes. Important in IFCM, and distinctive with respect to other methods, are the more detailed elements of engagement and motivation to be able to motivate the family and activate and incorporate the network. These elements include several Cognitive Behavioural Therapy techniques. Engagement and motivation is required before families can be referred to interventions that they need, and to prevent drop-out and relapse during and after these interventions. The IFCM approach is guided by the Risk, Need, and Responsivity (RNR) model of Andrews and Bonta (2010). We explicated the ten core elements of IFCM and described the 55 necessary behaviour acts. The operationalization of the core elements of IFCM was an essential step towards research on the feasibility of the application of this integrated and systems-based approach in practice.
This dissertation examined whether an integrated and systems-based approach could be implemented with sufficient quality. The IFCM case management method is accompanied with focus on the implementation, to assure high-quality application in order to achieve outcomes. In this dissertation, knowledge was gained about what steps to follow when developing and implementing a new approach. First, we described that a valid instrument to measure program fidelity is needed. We examined the program fidelity instrument of FFP: the Global Rating Measure (FFP-GRM). Findings affirmed a good fit to the data and a good-to-excellent internal consistency of the FFP-GRM, which is considered sufficient to justify its use. Second, the results showed that sufficient levels of program fidelity of IFCM were not yet reached shortly after the implementation. However, it is known that it can take approximately up to four years to implement a new approach. The data showed that case managers used the tools to focus on child safety for almost all families, but they had difficulties in adequately applying the systems-based approach. With the provision of ongoing support, program fidelity ratings were expected to increase. As a final step, we explored how the reflective practices of a support system (program fidelity instruments and active learning methods) were applied, and what the facilitators and barriers for implementation were. The results showed that to provide support of professionals multiple and ongoing implementation efforts are essential.
To conclude, this dissertation showed that that there is empirical and theoretical support for an integrated and systems-based case management approach in child protection and youth parole services in order to effectively support children and youth whose safety is at stake. From a client’s perspective, integration of services seems preferable, as it prevents involvement of multiple or consecutively involved professionals. This dissertation provided empirical and theoretical arguments that when providing services, following a family’s perspective on service involvement needs to be the starting point. It is feasible to apply an integrated and systems-based approach as IFCM. However, the focus on implementation and quality assurance in daily practice is of uttermost importance. This needs ongoing attention, as high quality application of a systems-based model is not an easy task.
Original languageEnglish
QualificationDoctor of Philosophy
Awarding Institution
  • Universiteit van Amsterdam
Supervisors/Advisors
  • Stams, Geert Jan, Supervisor, External person
  • Boendermaker, Leonieke, Co-supervisor
Award date21 Nov 2018
Place of PublicationEnschede
Publisher
Print ISBNs9789402812015
Publication statusPublished - 2018
Externally publishedYes

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