What Makes a Case Difficult: Definitions from Child Welfare Workers and Implications for Workload and Caseload Management

Background and Purpose: Creating manageable caseloads and workloads is a recurring challenge that contributes to the demanding and complicated nature of child welfare systems. Caseload and workload are often used interchangeably. However, caseload size and workload, the necessary tasks and responsibilities required, differ conceptually. While previous studies have examined the significance of caseloads and workloads, little is known about the attributes that make cases difficult for workers. This study examines attributes of difficult cases and whether perceptions change over time.

Methods: A mixed methods approach was utilized to analyze seven waves of data from the Florida Study of Professionals (N=1500). Participants were surveyed every six months and were asked to estimate the number of cases considered to be particularly difficult. This was followed by a short answer question about what constituted a difficult case during waves 2-5. Responses were independently coded using thematic analysis to create eight categories. Categories included: case attributes, parent/caregiver issues, case tasks, children’s issues, communication or logical issues, case type, agency-related issues, and non-compliance. These categories largely guided the construction of quantitative items used in waves 6-8.

At each wave, participants included current child welfare workers carrying a caseload. Due largely to workers exiting the field, sample sizes varied from wave 2 (n=936) to wave 8 (n=289). Descriptive statistics were completed on all waves of data to assess whether categories of perceived difficult cases changed over time.

Results: On average, workers considered 24% of their cases to be particularly difficult. In order of prevalence, case attributes (e.g., child injury/death, present danger, repeat clients, multiple family members cases), parent/caregiver issues (e.g., substance use, mental health struggles), and case tasks (e.g., removals, placements, court hearings, etc.) were the most common reasons of perceiving a case as difficult across all waves. Although the percentage of workers classifying a case as difficult due to parent/caregiver issues or case tasks were consistent across waves, the proportion of workers defining cases as difficult due to case attributes declined over time from 23% at wave 2 (6 months) to 18% at wave 8 (3.5 years).

Conclusions and Implications: Findings highlighted that workers’ perceptions of difficult cases over time varied. The most prevalent factors—case attributes, parent issues, and case tasks—provide insights into how individual cases (caseload) play a vital role in shaping workers’ workload and can inform practice and policy. First, case attributes can be assessed prior to case assignment to ensure difficult cases are assigned equitably and in rotation. Second, agencies can support workers by designating specialized support staff to offer workers assistance with case tasks (e.g., transportation, document retrieval, visitation). Finally, the pre-service training curriculum can provide real-world examples of the common challenges of casework to prepare them for their positions.