The Role of Self-Efficacy on Child Welfare Workers' Fetal Alcohol Spectrum Disorder (FASD) Training and Practice

Background and Purpose: Fetal Alcohol Spectrum Disorder (FASD) prevalence is higher among children in the child welfare system than among the general population, so the ability of child welfare workers (CWWs) to recognize FASD and provide appropriate services is vital. CWWs may also have more contact with FASD clients than other professionals.  Clearly, CWWS need effective training to promote knowledge and skills to address FASD.  Still, self-efficacy theory suggests that knowledge and skills are essential, but not sufficient, to produce  desired practice behaviors. Also, research suggests CWWs report a lack of confidence in their ability to identify FASD, and the majority of CWWs report low levels of self-efficacy to manage and/or coordinate treatment. This suggests that FASD training is not effectively promoting CWW’s knowledge and skills, and also raises a question of whether CCWs’ self-efficacy may mediate the relation between FASD training and practice. The purpose of the study was to (1) test whether CWWs who receive more training in FASD engage in more effective FASD practices; (2) examine whether CWWs who receive more FASD training report higher levels of FASD self-efficacy; and (3) test whether self-efficacy mediates the relation between training and practice.

Methods: This study involves secondary data analysis of a survey completed by a purposeful sample of 250 frontline CWWs in Tennessee. The survey included measures of training content, practice behaviors, and self-confidence.  Two multiple regression path models were conducted to assess the relation between the FASD training and practice variables, and to assess whether CWW self-efficacy mediates the relationship between training and practice.  Models control for gender, age, race and years in job position.

Results: CWWs’ level of self-efficacy was found to be a better predictor of desired FASD practice behavior than FASD trainings. Self-efficacy was also found to mediate the relationship between FASD training and practice. Finally, CWWs who reported having more years in their job position were significantly more likely to have an increased level of FASD self-efficacy to perform desired FASD practice behaviors.

Conclusions and Implications: Foster parents, in particular, report that it is difficult to get support from social workers when they lack knowledge about FASD because it makes it harder for them to make informed decisions.  This study’s findings suggest that CWWs with higher self-efficacy are more equipped to provide services to FASD-impacted families and to engage in desired practice behaviors. CWWs who are more knowledgeable about FASD – and more confident --can offer impacted families more support. Identifying self-efficacy as a significant mediator can encourage trainers to build self-efficacy exercises into trainings to improve training transfer and effectiveness. This knowledge is valuable not only to the social work profession, but also to healthcare providers and other parties interested in FASD training.