Differential and Alternative Response: Implications for Fairness and Equity

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Differential and Alternative ResponseImplicatio
ns for Fairness and Equity

• Jill Duerr Berrick
• School of Social Welfare
• UC Berkeley
• Co-Authors
• Amy Price Amy Conley et al.

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Study inspired by CalSWEC Research AgendaFocus
on Safety
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Parallel Studies

• Alameda County Alternative Response Services
  since 2002.
• Contra Costa County Differential Response since
  2005.
• Slightly different models similar study designs
  and outcomes

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Alternative/Differential Response Putting it
in context

• 1) Screening by risk levels 2) voluntary
  provision of case management 3) less punitive
  approach
• Over 20 states have some form of DR
• Various approaches to delivering services
  through public child welfare agencies, through
  CBOs, or mixed

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Study Goals Reflect Program Goals

• Overarching goal Prevention of child welfare
  system involvement
• Proximal goals
• Increased connections with community resources
• Provision of temporary social support
• Elimination of unmet basic needs
• Improvement of parent-child relationship

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Methods Alameda County

• Process study
• Focus groups with line staff (n12)
• Interviews with managers (n16)
• Interviews with clients (n30)
• Outcome study (Survival Analysis)
• Treatment group 161 families who received
  intervention
• Comparison group 477 families eligible for
  intervention

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Methods Contra Costa County

• Process Client Satisfaction Study
• Interviews with CFS staff (n13)
• Interviews with CBO staff (n16)
• Interviews with clients (n51)
• Outcome Study
• Treatment 164 families offered Path 1 services
• Comparison 335 families eligible for but not
  offered Path 1 services

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Family Engagement

• ? A unique challenge
• Unlike other home visitation programs, where the
  providers point of entry is clear and services
  are invited by parents, AR/DR services often are
  prompted by family crisis.

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Rates of Client Engagement in Alameda

• ARS agencies have experienced varying rates of
  client engagement
• Agency Referrals Served
• ? FSSBA 2002-2007 337
  35
• ? La Familia 2002-2007 611
  33
• ? Prescott Joseph 2005-2007 84
  12
• As of February, 2007

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Rates of Family Engagement in Contra Costa

• ? 49 engagement rate in Path 1
• ? Hispanic families significantly higher
  engagement rate (66 vs. 33 for other groups)
• ? Initial allegation of substantial risk, or
  child welfare history less likely to engage.

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What Explains Low Rates of Engagement?

• ? Client mistrust
• ? Fear
• ? Uncertainty
• ? Resentment

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Why Parents Engage?

• Need help and see DR/ARS as an opportunity
• Feel they have no choice (Hispanic families in
  particular believe DR services are mandatory, but
  also welcome services in their language)
• Convinced by actions and/or qualities of case
  worker

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Program componentsProviding social support

• Theoretical support Perceived and enacted
  social support (House, 1981)
• Types of interventions
• Listening to clients share their feelings
• Giving reassurance and compliments
• Normalizing the experience of asking for help

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Providing Quality Social Support

• Begin by identifying and building from families
  strengths and goals
• Maintain frequent contact with families in their
  own homes, as it provides comfort and promotes
  trust
• Encourage parents to make their own decisions and
  acknowledge that they are experts in their own
  lives

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How Workers Offered Support and Built Positive,
Trusting Relationships

• ? He transmits confidence. And it doesnt
  matter the time he will find time to listen and
  help.
• ? She really cares. I feel like I have a new
  friend. I can tell her anything. She can help
  me.
• ? She would listen to my problems, help guide me
  about how to look at things, set goals like a
  coach, you could say.
• ? She speaks my language.

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Offering Referrals to Community Resources

• Find resources close to families homes
• Make initial calls prior to giving resources to
  the family let the family know what to expect
• Encourage families to access services
  independently, but also balance their needs for
  immediate services and assist or accompany them
  when necessary

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Referrals and Supports that are Helpful

• ? Low-income legal services
• ? Family and individual counseling and
  parenting classes
• ? Help baby-proofing the house
• ? Links to asthma, nutrition, and other health
  programs
• ? Assistance with resume and job search
• ? Assistance with housing search
• ? Advocacy for children at their schools and for
  parents at CalWorks

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Program componentsTargeting basic needs

• Theoretical support Hierarchy of needs (Maslow,
  1943)
• Types of interventions
• Use of basic needs fund to address one-time,
  acute needs
• Referral to community resources that address
  basic needs, such as food banks
• Assistance with transportation

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Providing for Basic Needs can Alleviate Stress

• ? Funding to support basic needs may help
  families overcome crises
• ? For financially stressed families, small
  contributions of diapers, clothes, and food can
  help to alleviate stress and have positive impact
  on parenting
• ?Assess whether the need is one-time or regular
  help families budget

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Families Received These Basic Services

• ? Donations of food and diapers
• ? Assistance with PGE and EBMUD bills as well as
  referrals for their low-income programs
• ? Transportation to childrens school and
  appointments
• ? Gift cards for groceries and clothing
• ? Help with an initial rent payment/ deposit

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Program componentsStrengthening parent-child
relationships

• Theoretical support Attachment theory (Bowlby,
  1969)
• Types of interventions
• Providing opportunities for parents to enjoy time
  with their children
• Modeling appropriate behavior with children
• Offering information on child development

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Naturally Occurring Semi-Structured Activities
that Support Families

• ? Organized activities can teach parents that
  playing with their children is important for
  family development.
• ? Relationships created among parents in
  semi-structured activities can create new,
  important sources of peer support.
• ? I really enjoyed the science classes.It
  was a nice experience and it taught me that the
  kids come firstthat day was cool, because I got
  to be with them.

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Analysis of client outcomes
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Alameda client outcomes Report of Maltreatment

• No difference in rates of re-report for treatment
  comparison groups.
• Slim possibility of modest differences for
  children w/prior report.

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CCC Path 1 Client Outcomes Re-Referral

• Engagement had no impact on re-referral 28
  engaged 30 not engaged
• Rates by race 42 Black, 37 Hispanic, and 9
  White
• Odds of non-white child being re-referred is 5.9
  times the odds of a white child
• Odds of referral for child from family with prior
  referral history 3 times higher

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CCC Path 1 Client Outcomes Removal
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Other CCC OutcomesPaths 1 2

• 94 of clients noted life changes as result of
  program
• Most reported a little (20) or a lot (73) of
  improvement in quality of family life
• 75 felt more connected to community after
  involvement in DR

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Implications

• Findings in-line with meta-analyses of child
  maltreatment prevention programs that show small
  treatment effects
• Findings also fit with other DR studies that have
  found no difference in re-reporting for DR and
  non-DR families
• Maltreatment prevention and placement prevention
  may be too narrow or inappropriate targets for
  intervention.

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Implications

• Child maltreatment may not be affected, but
  ARS/DR may have other benefits
• Access to resources
• Connections to community
• Basic parenting practices may improve.
• Serving families in need who wouldnt otherwise
  be served
• Improved trust and collaboration with CBOs
• Changing perception of CPS in the community.

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Positive Family Changes Identified by Parents

• ? I am more focused, self confident. I'm more
  comfortable in my own skin. I'm willing to do
  all the things I need to do to get things done.
• ? She allowed me to realize all the things I've
  overcome, and that made me feel proud.
• ? Im less suffocated. I can talk more, and
  sometimes about problems that I have had.
• ? They helped me to believe and gave me
  strength.

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Curriculum Title
Differential Response and Alternative Response in
Diverse Communities Available from CalSWEC
library website
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References

• Bowlby, J. (1969) Attachment and Loss Attachment
  (Vol. 1). New York Basic Books 
• Center for Child and Family Policy (2004).
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  (NCDSS). Retrieved online March 15, 2005 from the
  Center for Child and Family Policy web site
  http//www.pubpol.duke.edu/centers/child
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• Maslow, A.H. (1943). A theory of human
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• Van den Noortgate, W., Geeraert, L., Grietens,
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