Team Decision Making - Moving from a Promising to a Supported Practice

A difficult task for child protection workers is deciding whether to separate a child from their family due to safety concerns. Team Decision Making (TDM), a practice created by the Annie E. Casey Foundation, is a meeting convened and facilitated by an objective staff member during which safety decisions are made collaboratively with family members.We will present findings from a multi-year process and outcome evaluation of the TDM model in two implementation sites in Missouri.

We used a randomized, controlled study design. Workers referred cases to TDM when a safety concern led them to consider removal of a child from their parents’ home. After being deemed eligible, cases were randomized into treatment or control conditions. The outcome study examined child welfare outcomes (i.e., subsequent allegations, custody episodes, kinship placement, and timely reunification) and the sample included 1,423 children clustered within 709 cases (268 control; 441 treatment). In addition, the research team administered a worker survey to examine TDM’s impact on workers’ perceptions of being informed and supported in their decision making (completion rate = 65%). We matched worker surveys with child welfare administrative data in 459 cases (172 Control; 287 Treatment). Depending on the outcome variable of interest and structure of the data, we conducted multinomial logistic, binomial logistic, or cause-specific hazard regression analyses to estimate impacts on outcomes.

Treatment group children were less likely to experience a custody episode within two weeks related to the initial TDM referral (OR=0.703; p=0.091), and within one year related to any allegation (i.e., if there was a subsequent allegation after the initial TDM referral; HR=0.776, p=0.034). Children receiving an initial TDM meeting were no more likely to experience maltreatment than children who received standard investigation services. We also found the impact of TDM was largely consistent among all race and ethnic groups of children, with a couple of variations. TDM reduced the likelihood of a subsequent allegation of maltreatment to a greater degree for children whose parents were not White (HR=0.219, p=0.003 at 6 months; HR=0.238, p=0.002 at 12 months; HR=0.315, p=0.004 at any point) and TDM reduced the likelihood of experiencing a kinship placement among children whose primary parent is Hispanic (HR=0.188, p=0.011). Finally, cases assigned to the treatment were more likely than cases assigned to the control group to have their worker report having sufficient information to make a decision (p=0.002).

Overall, the study found that children in families participating in TDMs experienced better child welfare outcomes compared to children in families who did not participate in TDMs. In addition, workers reported being better informed in cases in which a TDM was held. Workers also appreciated the TDM process and reported being better informed about the child and the family. This study provides needed evidence that TDM is a useful and helpful practice and one that is of benefit to the child welfare field.