Session: Implementing with Science: Integrating Research and Practice to Develop Trauma-Informed, Data-Driven Child Welfare Systems (Society for Social Work and Research 21st Annual Conference - Ensure Healthy Development for all Youth)

Background/Purpose: Behavioral health and trauma-related needs among children in foster care are significant and prevalent, affecting children’s social-emotional well-being and their permanency (Ai et al., 2013). In response, the Children’s Bureau invested in three grantee cohorts across approximately 20 sites to “develop innovative approaches to screen all children in child welfare for mental and behavioral health needs and to ensure that those needing services (especially those with trauma-related treatment needs) have access to services that work” (Pfennig, 2014, p.19). Following models of implementation science and evaluation (Fixsen et al., 2005; Framework Workgroup, 2014), the initiative began with an exploration of risk and protective factors related to the problem and target population, including the larger environmental context. This approach prioritizes systematic strategies to engage the field in building evidence for replicable interventions and integrating them into routine practice. Our symposium will share the methods and findings used to apply such an approach in real-world community-based settings.

Methods: Three studies will present results from multiple data collection and analysis activities including focus groups, key informant interviews, web-based surveys, and quantitative analyses of administrative data. In addition to child welfare outcomes data, the data sources represent multiple stakeholders and systems from across three states, including parent and youth consumers, public and private child welfare practitioners and administrators, mental health practitioners, and court personnel.

Results:  All three studies demonstrated that behavioral health needs were widespread among children in foster care. Other key findings follow. Study 1 showed that under-identified and untreated trauma and behavioral health needs of young children was most pressing. Study 2 indicated approximately 24% of children in out-of-home care had had six or more behavioral health diagnoses, and the overuse of psychometric drugs was of significant concern. Despite documented need, there is a lack of effective collaboration among child welfare and behavioral health staff in their treatment. Study 3 findings indicated that lack of collaboration in the relationship between mental health and child welfare systems appears to be systemic in nature, often originating in misunderstanding about policy, procedure, and resources, but playing out locally as inefficient and uncoordinated services and staff turnover.

Conclusion:  This symposium highlights three major themes.  First, there is compelling evidence that child welfare should integrate effective interventions into routine practices for children and youth with behavioral health and trauma needs.  Such interventions may begin with early and ongoing screening and assessment, continue through data driven case planning, and access to effective treatment and services. Second, community-based, participatory research is an advantageous approach for the exploration stage of implementation. University-agency partnerships are a vehicle for incorporating implementation science into data-driven practice and systems change efforts. Finally, initiatives that strive to build evidence are complex, and their success relies on strong collaborative relationships among multiple stakeholders and systems. This symposium demonstrates how various strategies for exploration can be used to integrate practice and research in real-world settings to successfully plan and implement diverse and locally-tailored initiatives.