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Evolving Child Welfare Practice — How Voice and Choice Is Bringing Everyone Into the Same Room
By Keith Rinier, MSW

I worked within family services at a state's child welfare department while acting as a middleman towards statewide policy overhaul. This meant that I acted in two very specific and yet oddly conflicting ways; I carried out the case management duties required of the family service social worker, and I proactively implemented policy measures in my case management work to test and integrate novel approaches for this particular practice context.

This new policy that I was to integrate, however, was met with enormous resistance from workers, managers, and administrators at the department not only for the typical reasons associated with policy change (noncompliance due to expertise with old skillsets, etc.) but on the founding principles of the new policy: family voice and choice, teaming strategies, and full-spectrum services.

Through a historical lens, child welfare practice in the state setting has assumed a position of authority in terms of its practice perspective, promoting the social work practitioner to the status of an authoritarian and away from her or his role as an informed and interested interventionist on behalf of the client family. With this lens, interpreting resistance to change is a simple procedure of recognizing that this power structure exists not only at the level of the direct practitioner but throughout the infrastructure of the state department, making the task of reformation, of restructuring practice standards around the client family, a formidable undertaking.

However, voice and choice practices speak for themselves in terms of ease of implementation and effectiveness. In my experience, requesting that the practitioner is to foster spontaneous contributions by the children and adult clients involved in the case-planning process, voice and choice practice realigns the practitioner to the pertinent issues facing the client, and, perhaps, away from issues surrounding expediency.

A pseudonymous example: Catherine is working toward the reunification of her family. She has three children. The oldest exhibits violent and difficult-to-control behaviors and has been placed in a therapeutic foster care setting so that he would receive the proper services. The other two children are younger, without problematic behaviors and residing together; however, their placement is a one-hour drive away from the mother.

In the traditional manner and for this example, case planning consisted of meetings with Catherine at her residence and creating case goals and outcome planning while her children remained in outside care. Perhaps some talk occurred during visitation that shaped minor aspects of case planning. Otherwise, Catherine acted as the primary client.

In the traditional sense, what is not accomplished is the use of queues and directives from any of the involved children. The oldest, though behavioral, most certainly is desirous of voicing his opinion — an opinion, no matter his behaviors, that would undoubtedly prove useful in the development of goals and outcomes in his section of the case plan. However, beyond the personal desire of an involved child, the question of to what extent case planning can be effective without establishing a narrative that is evaluative must be made; and in the instance wherein I am obliged to be evaluative and make decisions regarding the client, I want that client to be in the room.

In the above passage, I have described the benefits of voice and choice practice, and I must also highlight that a second novel policy approach was utilized in helping this family work toward reunification: teaming strategies. Teaming requires that all members of the client system (involved nuclear family, support systems, service providers, and the assigned child welfare practitioner) meet together in the same room to discuss progress and outcomes. Teaming is a hurdle (in terms of scheduling and time constraints associated with heavy case loads), but, again, from my experience, a necessary burden in order to develop a functional narrative.

When in the room with her nuclear family, supports, and services providers, Catherine was able to speak about her mental health and co-occurring substance abuse issues without having to worry about portraying herself in a self-criminalizing manner. Her substance abuse counselor was present, and the counselor provided clarification and guidance through this aspect of Catherine's narrative. Additionally, the eldest child was given room to discuss his progress, and with the incorporation of positive feedback and advice pertinent to behavior change aspects of his case plan from his presiding therapist, decisions regarding future services were made with more accuracy. Lastly all workers and family/support members were able to open their calendars while in each other's company and actively delegate a mutually inclusive date in which to meet in the future.

Voice and choice and teaming strategies augment the case-planning process in fundamental ways, and this augmentation is difficult to implement because concerns relating to burgeoning caseloads, time constraints, and spare material resource will always be factors. However, as I worked to incorporate voice and choice parameters in my casework, I began to understand that I was not only changing the way in which I performed case management duties but also developing a different evaluative frame. This evaluative frame was cemented in observations made, and data derived, from client contributions and through a service delivery system that was collaborative and focused on outcomes, not judgments or assumptions. As child welfare practice continues to evolve, I look to practice professionals and the literature with hope that voice and choice will continue to manifest itself in the day-to-day practice setting while finding a foothold in the theoretical. Social work practice that values the client whatever the context, and practice determining that the client's voice-in-the-room is worthy of hearing, are more effective than any attempt toward developing interventions in the absence of client input.       

— Keith Rinier, MSW, is a research assistant with the Child Welfare Institute at the Graduate School of Social Work at Rhode Island College and a recent recipient of a Damiano Fellowship from Brown University.