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Toward Values Centered Practice



I have discussed various dimensions of transition as the
child protection paradigm shifts away from the traditional model relying on
legislative and administrative command and control toward standards focused,
best practice driven approaches, informed by generally accepted guiding
principles. The transition is nowhere more evident than with how we determine
practice effectiveness. In the traditional command and control structure,
effectiveness is understood in relatively simplistic terms. There are complex,
prescriptive rules and procedures child protection workers are expected to
consistently follow. Compliance with this expectation is the primary if not
exclusive measure of worker and program effectiveness. This approach is what is
typically referred to as Quality Assurance (Q.A.). Perfect performance at the
highest level of effectiveness is seen when workers’ activities comply with all
relevant rules and are consistent with all relevant procedures. If you do
everything you are expected to do in the ways you are expected to do them, you
are doing a good job.



The Q.A. paradigm was largely adapted from production or
assembly environments where the goal is to produce uniform products or
services. A child and his (or her) situation are first screened to determine
general eligibility for child protection services. If determined eligible, the
child and his family are then moved (assigned) to an appropriate service area
for further processing. The movement from service area to service area
continues until the child is moved out of the child protection environment,
exiting based on which service area he was in at the time of exit. Even though
individual workers may develop some attachments with the child, the child’s
movement from service area to service area and his eventual exit are primarily
determined by eligibility rules for the various service areas and the
established procedures for movement and exit.



There has been significant expansion beyond the
traditional Q.A. approach to evaluating child protection effectiveness. Over
time, it has become increasingly clear reliance on Q.A. is insufficient. Even
when there is high rule and procedure compliance, many children are still being
harmed and child protection’s legitimacy is suspect. Simply complying with
established rules and procedures finds significant numbers of children no
better off than they were before child protection involvement and others
clearly less well off. This stark reality has prompted a transition from focus
on compliance to focus on outcomes, on what really happens with children and
their families.



This new focus starts with safety and expands to include
permanence. (At this point, it has not yet expanded to embrace the ongoing
success of children.) Are children being kept from harm’s way and are they
living in stable, nurturing families permanently committed to them and their
welfare? The answer should be an unqualified Yes. There is a high level of
consensus for the correctness of both the question and the desired answer. The
point of child protection is to assure safety and permanence for all abused and
neglected children.



Child protection is again adopting a strategy from
elsewhere. It has incorporated Continuous Quality Improvement (CQI) into its
conceptual understanding of practice. In the child protection variant on the
strategy, a set of indicators is developed that are thought to be correlates of
safety and permanence for children. For example, the frequency of
re-maltreatment is understood as a correlate of safety. The lower the rate of
re-maltreatment within a population of abused and neglected children, the safer
the identified population is as a whole. By implication, agencies and programs
showing lower re-maltreatment rates are more effective than those with higher
rates. The children with whom they work are safer.



There are various sets of factors thought to be
associated with better safety and permanence outcomes for children, although
the most widely acknowledged set is the one used for the federal child and
family services reviews. With that set as with others, child protection
entities are rated using a percent strategy where each entity is given a score
on each element in the set. For example, an agency’s re-maltreatment rate might
be 6%, meaning 6% of children served by the agency experience re-maltreatment
within 6 months of the incident prompting initial agency involvement. Other
rated elements include events such as movement while in out-of-home care,
frequency of contact with families whose children were not removed, and the
length of time between initial reports to the agency and the agency’s first
response.



With CQI, the goal is to improve the percentage of
outcomes consistent with the presumed correlate of child safety and permanence.
Although this approach does not relate specifically to best practice or how to
achieve the desired outcomes, it clearly specifies what are thought to be best
outcomes and fairly accurately measures the extent to which those outcomes are
being achieved. For this reason, CQI is a major improvement over simple reliance
on Q.A. as discussed above.



Although I am not aware of any agencies or programs that
have achieved the next level beyond CQI, its nature is evident. Child
protection must move beyond CQI to reliance on value based practice and on
values that serve as both the prompts for action and the measure of
effectiveness. For example, a fundamental value must mandate child protection
do no harm. Children must never be worse off for having been served by a child
protection agency or program. A child’s experiencing re-maltreatment is always
an indicator of child protection failure, even if he (or she) is the only child
who is re-maltreated. Each child who is not currently safe or in a permanent
family where he is accepted and nurtured is the agency’s immediate, highest priority;
it is a crisis. The value is safety and permanence for each child, each time,
immediately. Practice is then evaluated in terms of adherence to the value for
every child, every time.






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Please send comments or questions to Gary A. Crow, Ph.D. GAC@leadershipshop.com || and visit www.leadershipshop.com.