Forward Not Back: The Persisting Need for Relationship-Based Services in Child Welfare

Background and Purpose: Child welfare professionals are increasingly aware of the prevalence of parent-child relationship trauma, also referred to as relational trauma, amongst referrals to child welfare systems (CWS). While extant research has firmly established the efficacy of interventions to treat the parent-child relationship, it is unclear the extent to which these services have been adopted and implemented in CWS. This study aims to better understand how child welfare professionals perceive the need for interventions to address relational trauma. Additionally, professionals’ perceptions are useful for identifying the structural systems that facilitate and inhibit the implementation of parent-child relationship services.

Methods: Within a system-wide needs assessment of a state CWS seventeen focus groups, fourteen semi-structured interviews, and three surveys were conducted with child welfare professionals, resource parents, caregivers of origin, and service contractors to identify the needs of various stakeholders involved in the CWS. This study analyzed all focus groups with stakeholders (16 child welfare professionals groups and 1 parent group), fourteen semi-structured individual interviews with 9 service contractors and 5 agency administrators, as well as responses to 5 open-ended survey questions related to the needs of caregivers involved in the CWS. Focus groups and interviews were transcribed verbatim and coded using NVivo qualitative software. A deductive coding scheme was developed from extant literature and the authors’ clinical knowledge of parent-child relationship services and CWS. Content analysis of the data examined (1) professionals’ awareness of relational trauma, (2) perceptions of needs that would be best addressed through parent-child relationship services, (3) availability of these interventions, (4) the conditions under which clients were referred to parent-child relational services, and (5) structural and systemic facilitators and barriers to the provision of relationship-based interventions. Two coders independently analyzed the data. Disagreements were resolved using a consensus-coding process.

Findings: Despite calls in the literature for a robust implementation of parent-child relationship interventions in CWS, analysis of the qualitative data reveals a substantial gap between research, policy, and practice. The data demonstrates a knowledge deficit about relational trauma among child welfare professionals. While CW professionals demonstrate a basic awareness of trauma and the need to offer trauma-informed interventions, they do not identify relational trauma as either traumatic or requiring relationship-based intervention. Instead, they recommend individual treatment for parents and children. This was true across domains, with the exception being “Mommy and Me” programs that address maternal substance abuse.

Conclusion and Implications: Though the need to merge research, policy, and practice to effectively treat relational trauma is clear, the findings of this study reveal structural and knowledge gaps in CWS stemming from a lack of appropriate training and services. These gaps are mutually reinforcing: more knowledge about relational trauma is needed among CW workers at the same time that accessibility to relationship-based interventions should be increased. It is likely that the absence of relationship-based services drives CW professionals lack of awareness about this service need. Addressing structural barriers to the provision of relationship-based interventions will likely to facilitate better understandings of relational trauma among CW professionals.