A Network of Support
By DAVID BORNSTEIN
Fixes looks at solutions to social problems and why they work.Tags:
‘The problem is that we do not terminate biological families’ rights quick enough,’ one reader writes.
No, I can’t justify this. Nor would Youth Villages, as the article makes clear. In 2005, Youth Villages was enlisted by the state of Tennessee to devise placement plans for a randomized sample of 108 cases from the child welfare system. They determined that, for about 62 percent of the cases, it was in the child’s best interests to provide intensive in-home services and place the child with the family or other relatives, with supports. In the remainder of the cases, they determined that in-home services were not appropriate for the youths and the families at that point in time. “We don’t recommend in-home services if the kid’s behavior is so extreme and uncontrolled that we can’t predict when there are going to be problems with violence or runaways. Or if the family circumstances are so disruptive that there’s no consistent caregiver or if there is domestic abuse or violence,” explained Tim Goldsmith, Youth Villages’ chief clinical officer.
The question is: Why would it be best in more than 60 percent of cases to help children get reunited with their families? To begin with, both residential and foster care are supposed to be temporary measures on the road to permanency. But kids often spend years in the system because states don’t do the work necessary to find, vet or prepare suitable families for the youths in their care. It’s difficult to find permanent homes for them, especially as they get older.
Foster care is problematic for many reasons. As Dharitri from Brooklyn (32) observed, we need to “improve the vetting process of foster parents.” She added: “I have known too many youth[s] who were removed from one violent and abuse environment, only to be placed in another unhealthy environment.”
Why do we give the foster care system multiple chances with children?
A valid question. But Since the writer is from Oklahoma, I will note that a major study released this month by the Center for the Support of Families reports that one out of eight children in the custody of Oklahoma’s Department of Human Services suffered from confirmed abuse or neglect. Unconfirmed suspicions of maltreatment were reported for close to another 10 percent. In nearly 55 percent of cases studied, children experienced four or more different placements during their most recent stay in Oklahoma foster care, and of those children, 13 percent had 10 or more placements. About 30 percent of children had five or more primary caseworkers assigned to their cases. This is a disaster, not a system.
“Children coming into foster care often get terrible treatment by the state,” explains Marcia Lowry, executive director of Children’s Rights, which has filed class action lawsuits against Oklahoma and other states for abuse and neglect of children in foster care. “An awful lot of states don’t make good judgments necessary to decide whether the children need to come into foster care or can stay safely at home. Thousands of kids get caught up in child welfare systems where many are further damaged by their experiences. That’s what we see and we see it to a very extreme degree.”
Kurt from Knoxville (15), who identified himself as a former child protective specialist for New York City’s Administration for Children’s Services, wrote that “most of the children entering the foster care system did not require ‘removal’ in the first place. …The state routinely removes children who were not at risk. It also fails to recognize and remove children who are at risk.” He added: “[T]here are far more instances of overintervention than underintervention. However, because under intervention often results in tragic headlines, we focus more on those instances.”
One of the questions that got little attention was: Where do these young people want to live? Which gets to the point raised by Christine Coonen-Voillemin (3) of Green Bay, “I always wonder once these kids turn 18 where they go for Christmas? Who goes to their graduations?”
The biggest factor is helping families develop a web of relationships — like multiple nets under an acrobat.
How does change in a family actually happen? Through painstaking effort. As noted, Youth Villages’ counselors work with families for months, visiting sometimes every second day — practicing skills with parents and youths, doing role playing, setting goals, and gauging progress carefully. Progress is often seen through small changes — like when a mother calls up a counselor because she feels herself slipping into a bad habit, or explains how she averted a confrontation using a de-escalation technique she learned, or asks a counselor for help handling an upcoming parent-teacher meeting.
Perhaps the biggest factor is helping families develop a web of relationships — like multiple nets under an acrobat — that they can learn to call upon when in need. It’s reminiscent of the mutual support that programs like Alcoholics Anonymous are based upon. “We would never just send the kid back home with the only person involved with that child being that current caregiver,” notes Goldsmith. On average case counselors work with two to three family members, and two community members — school staff, neighbors, case managers from other agencies, family friends or employers. This is crucial because many families in the child welfare system are single-parent households.
All of this takes a great deal of time, training and supervision to do well. Which is why the federal government should provide far more federal matching funding that could be used to improve in-home intensive services, rather than concentrating the bulk of its spending on out-of-home care. States should have flexibility in exploring innovative new ways to help families deal with problems — provided they employ evidence-based practices and track long-term outcomes rigorously — something that doesn’t often happen now. Right now, states have to pay for much of this themselves, unless they get special foster care or Medicaid waivers, like Tennessee has done. A bill that would extend foster care waivers to more states got hung up in the Senate last year after being passed in the House. It should be revisited.
One of the intellectual leaders in this field, Fred Wulczyn, director of the Center for State Foster Care and Adoption Data, at Chapin Hall at the University of Chicago, noted that while “the boundary of what we believe can be accomplished in the home relative to what is best done in an alternative care arrangement has shifted over time” we’re still “very early on the learning curve” about what it takes to improve outcomes for children and families. “We are increasingly knowledge dependent on the delivery of these services,” he said, “but if you look at the national budget we haven’t invested in the knowledge. There are very few evidence-based practices.”
That’s why it’s worth closely examining Youth Villages experiences. It is one of the few groups that has made serious investments in this area. It has 16 full time researchers and a vast store of data that can help everyone move beyond gut-level judgments and prescriptions to practices and policies based on solid evidence.
“What every state needs is a system that measures every outcome of every child,” adds Patrick Lawler, Youth Villages’ chief executive. “We need a way to measure the services that a young person is receiving, how long that person is in care, how much it costs, and what happens after that young person leaves. We need governors to understand the impact this could have on their state. Not only will save them a tremendous amount of money, if we can keep kids out of the foster care and juvenile justice systems, their chances of happiness in life are so much greater.”
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