You can't legislate altruism, courage, ethical behavior, competence and caring.  Policy-making can't create the necessary conditions in which caseworkers and families work together toward achieving a better and maltreatment-free situation.  Isn't that a major reason why reform after so-called reform fails to bring about substantial change?

Legislation and policy can, however, provide the framework if within that the requisite conditions are present.   So, in the last blog article where I addressed the option of more training to improve the quality of child welfare work, and wrote that it is basically not the whole answer, I was pointing to the need to change the very nature, qualifications and the prestige of child welfare casework.   

What is needed is the transformation of the concept of child welfare work.  It should come to  be seen as both an intellectual and helping profession.   It should come to be thought of as a profession that requires, not only rigorous academic training, but also a combination of various ethical, altruistic and fine-tuned thinking skills.  Its prestige among professions should invite and attract comers in the same vein as do law, medicine and engineering.  There should be academic programs, either wholly dedicated to this profession, or, at least, with concentrations in existing psychology programs. 

Not the child-saving attitude, that so narrowly and often cruelly refuses to understand that helping a child means working as hard as possible to maintain the parent-child relationship, nor any other agenda based mind-set, will do.  Let's combine science and caring in the child welfare curriculum and let's graduate people who will approach their work with rigor and passion.

Let child welfare work become respected the way the teaching profession is in Finland.  I understand that teaching in Finland is thought of and respected in the same way medicine is.  Finnish teachers must earn advanced degrees in both education and in the academic discipline they will be teaching.  It's something to aspire to and to feel proud about.  Why can't child welfare work come to embody something similar? 

Can the acceptance of the plight of impoverished populations, racism, and a minimal concern for others in general, be contributing factors in the reluctance to transform child welfare in this way?  Can it be a shortsightedness in thinking that has never even considered these possible changes and has allowed the status quo to continue year after sad year?  Can it be a combination of these factors?

Is it what we see every day in the Saks-Wholesale Club Syndrome?  Shoppers at Saks are never sent through guard-check posts and asked to show their receipts as their purchases are inspected.  Not the case however for their poorer counterparts at the nation's various wholesale clubs.  Saks and other such establishments would never subject their customers to this treatment.  And they're right.  But one's bank account and resulting status should not determine how one is treated, not when shopping and not when receiving child welfare services.

This country would not accept a medical, law or financial system that was in a perpetual state of utter disarray with wide-ranging damaging outcomes.  Let's not accept that kind of child welfare system either. 

If, as I have previously said, caseworkers often do not understand the family situations they are looking at, is more training the answer?  I think that the correct response is yes and no.  Obviously, more training in response to the latest blowup is commonplace.  Has it made a real difference in the basic manner in which families are dealt with?  In how families are understood?  In what usually happens to families? 

What goes on during training?  What is being taught?  Are several training sessions adequate?

What caseworkers need to learn takes time and much study and in any case is probably not being covered in the training sessions provided by child welfare agencies.  Additionally, as I have said, the kind of knowledge necessary for child welfare work is not merely an accumulation of facts and data but the ability to flexibly use facts and stored knowledge to critically think about what is going on.  But even before that,  there is an ethical framework within which this all occurs.  So, even before caseworkers are hired, they should be required to attend, at least, several months of training which includes in depth discussion of the very nature of child welfare work and its expectations. 

Through in-class and in fieldwork training, prospective caseworkers must develop an understanding of the altruistic mind-set necessary for this work.  They must also accept that when dealing with families and often complicated dilemmas where difficult decisions are called for, only the interests of the families can be considered.  Never their own interests.  There is absolutely no place for decisions based on self-interest;  you can not bring a case to court or recommend the removal of a child because you want to play it safe and  avoid any possibility of problems for yourself.

This brings to mind a situation I once dealt with as a caseworker in the 1980's.  Our team worked with families whose cases (as they were called) were investigated by the department's child protective services division and then indicated as constituting either abuse, neglect or both.  The children either remained in their home with the parents, sometimes under Juvenile Court supervision; sometimes the children had been removed and were placed into foster care.   The goal was to work with the family to change the circumstances that led to the opening of their case. 

I received the case of a single mother of two children,  one,  a four year old who remained in the mother's custody, the other, an infant who had been removed and placed in a foster home.  The infant had a fractured femur and the mother was alleged to have intentionally caused it.  During my meetings with the mother she described how she took the child out of the infant swing that stood in the living room.  She told me that she believed that that was how the fracture occurred and that she had not directly or intentionally caused it.  I spoke with the investigator and with the physician who examined the infant.  The physician told me that the mother's explanation of how the fracture occurred was viable.  He also said that the investigator had "put words in his mouth."  

This had been the first and only abuse/neglect report about this mother.  There was no evidence of any maltreatment toward the four year old.  I spoke with the attorney from the Cook County Public Guardian's Office,  who represented children in Juvenile Court.  The attorney, who in this instance was the second in command, agreed with me that the infant should be returned to the mother's custody and agreed to support my recommendation to the court.  The infant was returned to the mother's custody under a one year court supervision order.  During my subsequent home visits there was never evidence of any maltreatment.

We will next discuss what can be learned from this.


   

Tour guide books, foreign language tutorials, months of preparation spent looking into several potential destinations, all part of the careful vacation planning with which many of us are familiar.  We plan for months for vacations that may last but a week.  We try to familiarize ourselves with different and sometimes novel customs so we can relate well to the natives.  Can we find comparable diligence in the manner in which child welfare professionals prepare for their work with families?  

No one would dispute the merits of the perpetual calls for child welfare reform and yet in the end the basic problems continue.   So what would constitute real reform?  What would then be different?  And, how do we get there?

We  get there slowly.  Slowly and carefully.  Very carefully.  

Caseworkers' and investigators' first step when meeting with family members must be to gain an understanding of the nature of the maltreatment allegations.  This usually takes time and if rushed can lead not only to an inaccurate understanding of what has been going on but can also result in actions with detrimental consequences for children and parents.   The problem is that caseworkers and investigators arrive at conclusions believing that they in fact understand the nature of the allegations and what has been going on.  But so often they just don't know what they are looking at.  In addition to inadequate preparation for this work, they can be pressured by mandated timelines and fear of making a wrong decision that can effect their employment.

It is not merely a matter of asking the right questions.  The caseworker's very mind-set is crucial.  First, maltreatment may not have occurred.  But even when it has been determined that it may have happened,  viewing the parents as violators, or worse, criminals, or for that matter even a disdainful attitude about them, will contribute to the parents' view of the intervention as being adversarial.  And it will certainly influence the caseworker's work with the family.  Essential is a gentle, compassionate approach that views parents as people who may lack adequate parenting knowledge and/or whose problems have led to some aspects of substandard parenting.  This is where empathy---sometimes a lot of empathy--- comes in.

But the right questions do need to be explored.  To do so a store of knowledge is required which encompasses a broad understanding of the immense complexities of human behavior.  Not just facts, but the ability to place those facts into a context together with the, often, many resulting ambiguities.  This, I believe, is one of the most crucial aspects of child welfare work and one that is usually not present.  Much of the infamous mess that child welfare is well known for is the result of the absence of this critical ability.  

What follows is some of what usually may need to be looked into:
 
Under what circumstances did the maltreatment occur?  Was  it the first time?  How often has it occurred?  What happened before it occurred?  How old was the child?  What did the child do before it occurred?  What is the parent's explanation of what happened?  What is the parent's understanding about what happened?  What is the parent's understanding of the child's interpretation of what happened?   What is the child's understanding about what occurred?  What does the parent think he/she should do about what occurred?   What  factors and difficulties are present that may have influenced the parent's behavior?  What does the parent do throughout each day?  How does the parent describe his/her life satisfaction?  What are the
parent's aspirations?   How long will it take to gain an  understanding of what's going on?  What is the severity level of the  maltreatment?  Is there in fact maltreatment or is it merely poor
parenting?  Is it even poor parenting or can it be a chaotic situation  caused by economic, social, familial relations, parental--and/or child--behavioral patterns, chronic hopelessness, feelings of alienation, and more.

These and an array of additional  questions can not be answered by checking off boxes on a risk factor assessment list.  The checklist approach tempts one to consider  isolated behaviors or a combination of several behaviors without an in depth  understanding of the context.  Looking at the context can occur through give and take between the parties.  Rather than gathering
information as a reporter would, or worse, a cop, inherent in the interaction  had better be the mutual understanding that the goal is to help the family do  better.  When real problems are present they will work together, if  possible, to find a way to alleviate the harmful conditions, always with the  least disruption to the family.  This can sometimes become a lengthy
process.  But if the goal is to prevent harm to the child, then all manner of harm must be considered.  And that means that removal of a child from the parents' custody is a grave matter that should only occur if there is no other way. 


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Sweeping generalizations about the child welfare system's many problems usually fail to capture much of the daily interaction between its representatives and the families who become its clients.  Though backed by extensive policy and procedure guidelines, the investigator's and caseworker's approach with each family will be a major determinant in whether child maltreatment has occurred, its nature if it has,  and, later, in the possibility of continued risk, and in the recommendations for the manner in which to work with the family.  

The genesis of a child welfare case, the term generally used for these situations, is usually a report that a certain action or actions occurred, that a child has an injury, or has failed to receive an important aspect of care .   So, for example, a report may say that a child arrived at school with a bruised arm.  When questioned by the protective services investigator the child may say that one of the parents caused the contusion.  Further questioning reveals that in fact the bruise resulted from the parent's intentional action.  Is this child abuse?

The vast complexities of human behavior can make that a difficult question to answer.  Often, however,  just the presence of that one piece of physical evidence leads to the opening of a case.  

Generally, a huge impersonal, quickly moving behemoth, the child welfare system stands in oxymoronic contrast to the deliberate, insightful and conscientious approach necessary in dealing with these family matters.  And, it is not only a matter of knowledge but also a matter of knowing that there is much that is not known, that perhaps can not be known, but yet, needs to be factored in, as much as possible, when trying to understand what has happened and what can still happen in the future.

The majority of situations brought to the system's attention are not the extremely severe instances of life-threatening injuries nor the near starvation home alone scenarios.  Most can be categorized as various types of neglect and many involve some form of inappropriate use of physical punishment. The terms risk and danger connote many things and that's why it is so very imperative that they be seen and understood within a wide context, for the sake of the child and his or her parents.  That, however, has probably not been the child welfare experience of most families.

Before discussing ways to possibly improve this intervention, it is important to note that there very well may be investigators and caseworkers whose conscientiousness has led them to try their best to interact with families with just this kind of thoughtfulness.  But, overall, it would probably be safe to say that we can find a major source, if not the crux, of the well-known and chronic turmoil that is child welfare in the nature of interaction between family members and the system's representatives.