Reunification – Old and Reunification – Old and New InformationNew Information

Diana J. English PhDDiana J. English PhD

Child Welfare League of Child Welfare League of AmericaAmerica

May 30, 2007May 30, 2007

The research upon which this presentation The research upon which this presentation is based, “An Evaluation of Two Family is based, “An Evaluation of Two Family

Reunification and Stabilization Reunification and Stabilization Programs,” was supported by a grant Programs,” was supported by a grant (#90CW1128) from the Department of (#90CW1128) from the Department of Health and Human Services Children’s Health and Human Services Children’s Bureau, and by The Washington State Bureau, and by The Washington State

Department of Social and Health Department of Social and Health Services.Services.

Prior Research on Reunification Prior Research on Reunification and Re-entryand Re-entry

• Overall, prior research has found Overall, prior research has found little effect of FPS services little effect of FPS services

• This research has been criticized for This research has been criticized for design and methodological flawsdesign and methodological flaws– Lack of standardized assessmentLack of standardized assessment– Non-randomizedNon-randomized– Referral criteria Referral criteria (Frazer et al., 1997; Heneghan et al., (Frazer et al., 1997; Heneghan et al.,

1996) 1996)

Prior Research on Reunification Prior Research on Reunification and Re-entryand Re-entry

Across studies reunification rates 40-Across studies reunification rates 40-100% and re-entry rates 12-31%.100% and re-entry rates 12-31%.

Call for additional research on criteria for Call for additional research on criteria for referral to FRSS services and match referral to FRSS services and match between service and identified needbetween service and identified need

Factors That Predict Re-Factors That Predict Re-entryentry

• Child FactorsChild Factors– AgeAge– EthnicityEthnicity– Behavior problems/truancyBehavior problems/truancy– Medical problemsMedical problems– Ambivalence to reunificationAmbivalence to reunification

Factors That Predict Re-Entry - Factors That Predict Re-Entry - CaregiverCaregiver

• MotivationMotivation

• Substance AbuseSubstance Abuse

• Lack of Social Lack of Social SupportSupport

• Lack of Parenting Lack of Parenting SkillsSkills

• Caregiver History of Caregiver History of Abuse/Neglect as a Abuse/Neglect as a ChildChild

• Domestic ViolenceDomestic Violence

• StressStress

• Previous Experience Previous Experience with Interventionwith Intervention

• Multiple ProblemsMultiple Problems

• Prior Criminal HistoryPrior Criminal History

• (English et al., (English et al., 2006)2006)

Factors That Predict Re-Entry - Factors That Predict Re-Entry - SystemSystem

• Child in placement longer than 10 Child in placement longer than 10 weeks – 50% less likely to reunify weeks – 50% less likely to reunify (also predicted re-entry) (Goerge, (also predicted re-entry) (Goerge, 1990).1990).

• Reunification often occurs without Reunification often occurs without proper resolution of problems.proper resolution of problems.

Washington State – FRSS Washington State – FRSS StudyStudy• Included interviews with Included interviews with

approximately 500 Social Workers for approximately 500 Social Workers for FRSS referred and Non-FRSS referred FRSS referred and Non-FRSS referred familiesfamilies

• Data on:Data on:– Child CharacteristicsChild Characteristics– Caregiver CharacteristicsCaregiver Characteristics– ServicesServices– OutcomesOutcomes

Washington FRSS StudyWashington FRSS Study

• Non-FRSS – 41% reunificationNon-FRSS – 41% reunification

• FRSS – 52% reunificationFRSS – 52% reunification

- - within 15 months of placementwithin 15 months of placement..

• No difference in re-referral rate or re-No difference in re-referral rate or re-entry rate.entry rate.

• 15-18% re-referred15-18% re-referred

• 11-14% re-entered11-14% re-entered

Washington FRSS Study – Washington FRSS Study – General Characteristics of General Characteristics of Study Families Study Families • FRSS FRSS Reunification Reunification

ServicesServices

– Prior placementPrior placement– CA/N reason for CA/N reason for

removalremoval– Physical abuse index Physical abuse index

referralreferral– Permanency Plan of Permanency Plan of

return homereturn home– Parenting skills Parenting skills

problemsproblems– Children with some Children with some

developmental delaysdevelopmental delays

• Non-FRSSNon-FRSS– More infantsMore infants– Fewer 6-12 year Fewer 6-12 year

oldsolds– Younger caregiversYounger caregivers– Less social supportLess social support– Substance abuse Substance abuse

riskrisk

Selected Findings – Selected Findings – Characteristics of Outcome Characteristics of Outcome Groups of Groups of FRSSFRSS Families Families• More Likely More Likely

ReunifiedReunified– Younger childrenYounger children– CaucasianCaucasian– Less risk associated Less risk associated

with caregiver with caregiver mental/emotional mental/emotional impairmentimpairment

– Less risk associated Less risk associated with recognition of with recognition of problem, lack of problem, lack of motivation to changemotivation to change

• Less Likely ReunifiedLess Likely Reunified– Children beyond Children beyond

infancyinfancy– Caregiver significant Caregiver significant

impairmentsimpairments• Parenting skillsParenting skills• Disciplinary practicesDisciplinary practices

– Caregivers lacking Caregivers lacking recognition of the recognition of the problemproblem

– Caregivers lacking Caregivers lacking motivation to changemotivation to change

Characteristics of Outcome Characteristics of Outcome Groups of Groups of Non-FRSSNon-FRSS Families Families

• More Likely More Likely ReunifiedReunified– Non-maltreatment Non-maltreatment

reasons for removalreasons for removal– Cooperation with Cooperation with

CPSCPS

• Less Likely Less Likely ReunifiedReunified– CA/N reason for CA/N reason for

removalremoval– Lack of cooperationLack of cooperation– History of violenceHistory of violence– Maltreatment as a Maltreatment as a

childchild– Caregiver lack of Caregiver lack of

empathyempathy

Selected FindingsSelected Findings

• Even though FRSS referred families Even though FRSS referred families “less risky,” only one-half reunified.“less risky,” only one-half reunified.

• FRSS services most successful at FRSS services most successful at reunifying infants, Caucasians, fewer reunifying infants, Caucasians, fewer risk factorsrisk factors

Selected FindingsSelected Findings

FRSS less effective at preventing FRSS less effective at preventing placement with:placement with:Non-CaucasianNon-CaucasianCaregivers with Caregivers with

mental/emotional/physical problemsmental/emotional/physical problemsLack of recognition of problemsLack of recognition of problemsChildren older than infantsChildren older than infants

Selected FindingsSelected Findings

• Need to re-examine services related Need to re-examine services related to:to:– Risks related to motivation/recognitionRisks related to motivation/recognition– African AmericansAfrican Americans– Families with multiple risk factorsFamilies with multiple risk factors

– Either concurrent planning faster or Either concurrent planning faster or different configuration of services neededdifferent configuration of services needed

Selected FindingsSelected Findings

• Children identified with service need Children identified with service need received services – except child received services – except child behavior problems – predicted re-behavior problems – predicted re-referral for older children.referral for older children.

• Lack of parenting skills associated Lack of parenting skills associated with non-reunificationwith non-reunification

• Domestic violence – male leaving Domestic violence – male leaving predicts reunification.predicts reunification.

Selected FindingsSelected Findings

• Low rate of engagement in Low rate of engagement in substance abuse services – need to substance abuse services – need to examine current approach and examine current approach and service arrayservice array

• The more time a therapist spent with The more time a therapist spent with family more likely to reunify (no family more likely to reunify (no evidence that paraprofessionals can evidence that paraprofessionals can substitute for work of therapist).substitute for work of therapist).

Selected FindingsSelected Findings

• Need to re-examine services related Need to re-examine services related to:to:– History of violenceHistory of violence– Caregiver mental/emotional functioningCaregiver mental/emotional functioning– RecognitionRecognition– MotivationMotivation

Selected FindingsSelected Findings

• Caregivers assessed as less connected Caregivers assessed as less connected to their children and less capable of to their children and less capable of caring for themcaring for them

• SW less comfortable that caregiver SW less comfortable that caregiver understood child’s needs, caregiver understood child’s needs, caregiver lacked demonstrated capacity to meet lacked demonstrated capacity to meet child’s needs, ability to parent other child’s needs, ability to parent other children impacted by child’s children impacted by child’s reunification.reunification.

Selected FindingsSelected Findings

• 20-25% did not resolve risk 20-25% did not resolve risk associated with removal prior to associated with removal prior to reunificationreunification

• FRSS may not be most appropriate FRSS may not be most appropriate for families with chronic, deep-seated for families with chronic, deep-seated problems associated with problems associated with maltreatment (particularly neglect).maltreatment (particularly neglect).

Selected FindingsSelected Findings• Caregiver active involvement in services Caregiver active involvement in services

was related to was related to lessless ambivalence and ambivalence and moremore readiness for reunification.readiness for reunification.

• Caregiver’s lack of active involvement in Caregiver’s lack of active involvement in services was related to services was related to re-entryre-entry of the child of the child into foster care within 6 months. into foster care within 6 months.

• Two independently significant predictors of Two independently significant predictors of less re-entry: less re-entry: Completion of case service plans Completion of case service plans Establishment of back-up supports and/or Establishment of back-up supports and/or

service plans.service plans.