A New Direction in Child Welfare in North Carolina

In child welfare services there has always been a conflict between our need to protect children and our desire to engage and support families. Child protective services professionals probably experience this tension most. With others in the field, they struggle daily to answer questions such as: When are the indications of abuse and neglect so severe children must be removed from their homes? How can we build partnerships with parents where there is suspected or substantiated child maltreatment? What is the best way to help families change so that children can remain in their homes?

The sheer volume of their work makes it difficult for many CPS workers to investigate reports and engage parents. In 1996, the U.S. Department of Health and Human Services estimated that more than 3 million children were reported to child protective services (CPS), which represented a 40% increase since 1987 (USDHHS, 1997).

The traditional approach to CPS further complicates matters. Many believe the problem-solving, deficit-focused approach to investigating abuse and neglect is a barrier to family engagement. Some states, including North Carolina, are now working to eliminate this barrier, which is rooted in the history of social work.

A History of CPS

Since the beginning of their profession 100 years ago, social workers have taken a problem-solving approach to working with families. For example, the current CPS system in the U.S. grew out of Societies for the Prevention of Cruelty to Children (SPCCs). Most SPCCs focused on rescuing children and punishing those who abused them. In the early 1900s, the more than 300 SPCCs across the country gave little attention to helping or supporting parents who had abused their children.

In the 1930s and 1940s, stress caused by the Depression and World War II made it hard for many families to care for their children. During this time, public sympathy for struggling families led to welfare and other government support. At the same time, government began to assume the work of the SPCCs, making child protection a government function for the first time. In the 1960s and 1970s, child abuse began to be treated by the medical community as an illness. As concern about child abuse grew, abuse was studied and quantified. Eventually, the studies of the 1960s led to the passing of the 1974 Child Abuse and Prevention Treatment Act (CAPTA, PL 93-247). CAPTA encouraged states to have mandatory reporting laws and a state registry of perpetrators and victims.

Mandatory reporting laws and the national attention given to the issue of child maltreatment resulted in sharp increases in reports of abuse and neglect in the 1980s and 1990s. Reports of abuse and neglect rose 347% between 1973 and 1993 (Berg & Kelly, 2000). As agencies struggled to respond to the growing number of maltreatment reports, many children were removed from their homes, in part because most of the federal funding available for services 20 years ago was for foster care. In fact, the U.S. still relies heavily on crisis reporting and reactively-financed child welfare (Berg & Kelly, 2000).

Because of the numbers of children entering foster care, various laws were passed throughout the 1980s and 1990s to prevent unnecessary removals and to provide more prevention and early intervention services for struggling families. Some of these laws included the 1980 Adoption Assistance and Child Welfare Act (PL 96-272) and the 1993 Family Preservation and Support Act (PL 103-66). This new shift in thinking focused attention on the principles of family support and family-centered services. For the first time, the child welfare field began to move away from a problem-solving, symptom-based approach to its work.

Concerns About Child Rescue

In part, the traditional problem-solving approach to child welfare grew out of its historical “child rescue” mindset as well as the influence of the medical profession on the field. Based on a medical model, the problem-solving approach sets up the child welfare professional as the only expert. The professional assesses the problems of families, develops a plan for fixing the problems, and then has the family carry out the plan. For the most part, families are left out of the assessment and planning process.

Traditional CPS risk assessment tools, designed to provide a uniform way to determine levels of risk in vulnerable families, provide a good example of this approach. These expert-driven tools help professionals focus on the risk factors or negative behaviors of a family, leading to a conclusion about the level of risk for that family. If risk is a problem, the professional then decides what should be done to fix it (Berg & Kelly, 2000). Today the problem-solving approach is still the basis of many risk assessments.

In fact, it is only in the last 10 years that the principles of family support and family-centered services have been applied to child protection, allowing the field to move away from the traditional approach. This particular change has recently come to North Carolina. In April 2002 the N.C. Division of Social Services replaced the state’s former risk assessment tool with a new set of structured decision-making tools, which are much more family-centered (for more on this, see North Carolina Adopts New Approach to CPS).

There are other concerns about the traditional “child rescue” approach to CPS. Most parents or caregivers see traditional CPS investigations as adversarial and accusatory. The worker must focus on determining whether the abuse or neglect occurred and on identifying the person responsible. When workers substantiate maltreatment, fewer than 20% of children are removed, even temporarily. This means that most cases are opened for services, but the overall rate of service provision is low. Although immediate safety issues are resolved before the case is closed, often the underlying causes are not. With traditional CPS, it is not uncommon to have subsequent reports on the same family.

An Alternative Approach

To address the concerns they have about traditional CPS work, some child welfare agencies and professionals embrace an alternative approach that is solution-focused, builds on a client’s existing strengths and skills, and sees the client as a “repository of resources” (Berg & Kelly, 2000). Professionals applying this approach work with the client rather than on the client. In CPS work, solution-focused professionals look for exceptions to the problem and for “signs of safety,” rather than focusing on problems and deficits (Turnell & Edwards, 1999). In this model, professionals approach their work from the idea of partnership, not paternalism.

In child welfare, the most influential manifestations of this alternative approach are family support principles and family-centered practice. The family support movement (see Practice Notes, vol. 5, no. 1) has always been about promoting families’ optimal growth and development and ensuring safe and healthy communities for children and families. Family support services are focused on prevention and early intervention. Family-centered services include support for families coping with normal parenting stresses and family preservation services designed to help families facing serious problems and possible out-of-home placement (McCroskey & Meezan, 1998).

To Chuck Harris, chief of Children’s Services for the N.C. Division of Social Services, “family-centeredness means that the family is kept at the heart of the process. I think that too often in the child protective services part of our work we see ourselves as investigators and case managers and less as real service providers. . . . When we have reports that are not the kind that pose imminent physical danger to children, I think we need an approach that’s less investigatory in nature and more assessment and service provision in nature.”

Of course, the goal of child protection has always been to protect children and to ensure they are in safe and healthy environments. Many state child protection agencies have begun to see the value of community-based prevention strategies, as well as the value of having a strengths-based, family-focused assessment and planning process, rather than an incident-focused investigative process. States that have already moved to what are now being called “community child protection” strategies have found that applying family support and family-centered service principles does not compromise child safety.

In fact, keeping children safe, promoting lifelong relationships with caring parents and guardians, and supporting the developmental needs of children at all ages can only be accomplished through an appropriate mix of these services.

NC’s New Direction

North Carolina has been working to integrate a family-supportive, family-centered approach into its efforts since the early 1990s. Examples of this include the state’s involvement in the initiatives Families for Kids and Family to Family, an annual statewide conference that brings together traditional child welfare practitioners and those working in family resource centers and the family support community, and North Carolina’s commitment to expanding family support and family preservation services. To institutionalize its commitment to family-centered practice, in 1996 North Carolina adopted five family-centered goals for children’s services statewide.

Today North Carolina is exploring a different, less traditional approach to child protective services. According to JoAnn Lamm, policy and initiatives team leader for Children’s Services in the N.C. Division of Social Services, “There were several things that led us to look at a different approach. First, the counties were saying that one approach was not working—it did not fit all families. Second, as part of the federal review we learned we needed to focus on a much more family-centered approach. Third, we were finding that poverty was causing us to label families as perpetrators, which is not good.”

On August 1, 2002 North Carolina will pilot a new approach to child protective services in ten counties. This new approach, called the multiple response system, embraces family support and family-centered services principles, and has been rigorously tested and evaluated in other states. North Carolina’s new pilot and some other states’ programs are described in the next article in this issue of Practice Notes.

References for this and other articles in this issue