How APS Makes a Difference in the Lives of Clients: Perspectives from Interviews and Focus Groups with APS Leaders, Workers, and Clients

Background/Purpose: The purpose of interview and focus group data collection was to capture the views of various APS stakeholders through virtual site visits to better understand key characteristics of APS program design and operations and to explore and explain the impact of APS programs on client safety, satisfaction, and well-being.

Methods: While survey data collection for the APS Client Outcomes Study was conducted in 27 counties, across nine states, virtual site visits were conducted in a subset of four states (12 counties). These states were selected purposively to capture a diverse representation of APS programs. During virtual site visits, the research team conducted four interviews with APS state leaders, 11 interviews with APS county leaders, 12 focus groups with a total of 36 APS workers, and 10 interviews with APS clients.

Virtual site visit data collection occurred from May to August 2021. All data collection was conducted via web-conference or phone call following semi-structured interview and focus group guides. These guides included questions and probes about APS program design, client population, case initiation, APS services, organizational partnerships, client self-determination, client outcomes, program policies, and recommended changes.

All interviews and focus groups were audio recorded and transcribed. Transcripts were uploaded to ATLAS.ti Version 8 for qualitative analysis. The research team developed and applied a standard coding framework, including a priori codes that mapped to the research questions and emergent codes created during the coding process to capture themes. The research team conducted consensus discussions to determine the final list of key themes and salient findings.

Results: Nearly all APS client interviewees reported positive views of APS. They often cited APS worker professionalism and kindness, resolution of their safety issues, and arranging help (e.g., legal support, health insurance, support services) as reasons for their positive views. Similarly, APS stakeholders overwhelmingly reported that APS makes a positive difference in the lives of clients. They explained that their main focus is to work with clients to improve safety by creating plans and taking actions to remove/reduce risk of maltreatment. When clients aren’t ready to address safety issues, or other barriers get in the way, the APS worker often shifts to focus on client well-being, in order to leave the client’s situation a little better than before so that the client may be willing to contact APS in the future when they need help. APS stakeholders tended to describe satisfaction as the least important of the three outcomes, or not an appropriate outcome at all for APS.

Conclusions/Implications: Achieving positive client outcomes hinges on the client’s readiness and willingness to participate in APS. APS workers stated that large caseload size was the key barrier to their ability to effectively engage and develop strong rapport with clients. Future efforts should focus on strategies for increasing client readiness to participate in APS and supporting workers in building strong relationships with their clients.