Exploring Models of Service Delivery in Child Welfare Reunification: A Qualitative Study of Stakeholder Perceptions

Background and Purpose: Evidence suggests use of treatment services is important for reunifying parents (Choi, Huang & Ryan, 2012; Green et al., 2007). Yet use of services may be particularly challenging in the unique context of child welfare reunification, in which parents with multiple problems are asked to engage with a variety of service types offered by an array of different providers. Service delivery models that reduce the burden of accessing services may be more effective at facilitating reunification than service delivery models that do not. However, few models of reunification practice have been articulated or implemented (Westat & Chapin Hall, 2001), and few studies of “models” of reunification services delivery have been conducted. This study was part of a larger study examining reunification service delivery models and strategies in a large western state. The purpose of this component of the study was to provide an in-depth exploration of promising reunification service delivery approaches in four counties, including benefits and challenges involved with each approach, as these were understood by professional stakeholders involved in assisting parents to reunify.

Methods: This exploratory qualitative study used interview and focus group data gathered from four counties in one large western state. Counties were selected based on responses to a statewide survey indicating they used innovative reunification service delivery approaches. Stakeholders interviewed were parents’ attorneys (n=22), service providers (n=37), case workers (n=47) and managers (n=4). A semi-structured interview protocol was used, and interviews were recorded and transcribed for analysis. NVIvo 20.0 was the software used to conduct the thematic framework analysis (Lacey & Luff, 2007). A priori conceptualizations were used as initial codes, emergent themes were also coded, and a process of iterative review and revision was used to refine and analyze codes to identify thematic relationships across stakeholders and counties.

Results: Stakeholders did not describe distinct reunification programs or service delivery models. Stakeholders’ expressed serious concerns about service delivery: excessive service requirements on case plans, which may inhibit case plan completion; the cost, travel time, and limited availability of services; and the intensity of parental problems interfering with service use. Strategies that can ease service access for reunifying parents, such as co-locating, combining, or staggering services were described; however, these efforts were done at the discretion of individual workers and were sometimes interpreted as threatening agencies’ “reasonable efforts” to help parents reunify.

Conclusions and Implications: Participants’ responses did not suggest distinct models of reunification practice were in use in these counties; instead, findings suggest the need for such models is great. The “perfect storm” of parents’ problems, service access difficulties, and overloaded case plans caused professional stakeholders who assist parents grave concerns, and suggest that current practice of referring parents to multiple services throughout a community may be problematic. Specialized service delivery models for this population that facilitate frequent visitation, provide intensive treatment services, offer one-stop locations, and incorporate support around housing, transportation, and employment are recommended.