Friday, 14 January 2005 - 4:00 PM

This presentation is part of: Qualitative Research on Client Experiences of Treatment

Workers and Clients: Different Visions of Preventive Services

Purpose: New York City has increasingly attempted to avert placement of children in foster care through provision of preventive services. However, a study of 71 foster care cases by the authors found that 31% of the families had children removed despite their receipt of preventive services. Goal-directed preventive practice suggests the need for a joint definition of the problem and a common agreement on solutions. This study explored how workers and clients define the purpose, and process of preventive services. A qualitative approach was selected due to the paucity of existing research on goal-directed preventive child welfare services.

Method: The sample consisted of 26 cases referred by New York City Administration for Children’s Services to a voluntary agency for preventive services to address abuse and/or neglect concerns. All were provided at least six months of preventive service. The sample reflected all the categories of case closings after a given date including: completed service; drop-outs; and closure due to foster care placement. Closed cases were "matched" with open cases in which families had received services for the same length of time to explore how time in treatment might impact the process. To avoid variance due to race and to identify how cultural definitions impact upon service the sample was limited to Hispanics. Each caretaker and their worker were interviewed independently for as long as it took for them to tell us the history of their experience with preventive services.

Results: Grounded theory methodology was used to analyze the data and a number of client/worker differences emerged. While ACS workers perceive themselves as having a dual focus on child safety and family preservation, clients universally perceived ACS as an agency focused on removing their children from the home. The basic definition of services also varied. Clients defined services as help in obtaining resources and workers viewed services in terms of monitoring compliance with the case goals and/or referring clients to outside resources.

Differences emerged about the perceived role of the worker. Clients often talked about workers as “friends” and, if satisfied with the services, spoke of the agency as being like “a family.” Workers define the role as one of professional distance and the demand for compliance. Finally some clients described their workers as providing them with a new vision of what is possible. Workers similarly talked about trying to leave their clients looking forward by setting personal goals. Also evident was the feeling on the part of both clients and workers that they and the voluntary agency would always serve as a resource for them.

Implications: The data indicates a need to work in the community, with clients and with workers to redefine the focus of the work on strengthening families to avert the need for foster care. Workers need to help find ways to bring worker and client visions of the treatment process in sync. Efforts must be put in place to highlight the very important function that hope can play in successful treatment.

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