Child and Family Safety inChild and Family Safety inFamily Preservation ServicesFamily Preservation Services

A training module for FPS therapists created byCheri Johnson, MSW

Central Washington University

for Children’s AdministrationOlympia, Washington

IntroductionIntroduction

This training will focus on the FPS therapist’s responsibility in ensuring the safety of families, particularly children, with whom we work.

Prior to reviewing this material, it will be helpful if the therapist has viewed the CA video, “Making a CPS Referral: A Guide for Mandated Reporters.”

Before beginning this training….

Please have the following items handy:

Your copy of RCW 26.44.030

Copies of handout, “Legal Definitions of Child Abuse and Neglect”

Highlighter

Note-taking implements (pen and paper, sticky notes)

As we begin to explore issues related to family and child safety in FPS, we’ll be taking a look into four major areas:

• Mandated reporting

• Differences between safety and risk

• Safety planning (provider/family)

• The FPS therapist’s role in enhancing family and child safety

Given that families are not referred to FPS unless there is a substantial risk that a child may need to be removed from his/her home (or that they have already been in out-of-home placement and reunification is soon to occur)…

…it should be clear that the safety of children in or returning to their homes is of primary importance to our work in Family Preservation.

Providers of FPS need to understand, support, and be prepared to act upon the legal and philosophical framework underlying these services.

Accordingly, we’ll begin by examining the role of the FPS provider as a mandated reporter of suspected child abuse/neglect (CA/N).

Mandated ReportingMandated Reporting

What is mandated reporting?What is mandated reporting?

“Mandated reporting” refers to the statutory requirement (RCW 26.44) to report suspicions of child abuse or neglect to the designated agency, Children’s Administration.

[NOTE: reports may also be made to law enforcement.]

What is meant byWhat is meant by “child abuse or neglect (CA/N)”? “child abuse or neglect (CA/N)”?

From RCW 26.44.020 (12): “the injury, sexual abuse, sexual exploitation, negligent treatment, or maltreatment of a child by any person under circumstances which indicate that the child's health, welfare, and safety is harmed…..”

Legal Definitions of Child Abuse Legal Definitions of Child Abuse and Neglectand Neglect

The accompanying handout includes definitions and examples to help clarify both the broader and finer definitions of child abuse and neglect.

This may also assist you in determining whether any safety concerns you may have fall under the heading of CA/N and thus must be reported to CPS.

While the handout provides statutes, definitions, and examples, this brief training cannot encompass such vital topics as identifying signs/symptoms of abuse, or appropriate interventions.

A concise yet thorough and extremely useful resource may be found at the Children’s Administration website, http://www.dshs.wa.gov/ca/general/index.asp

There are also many clinically-sound trainings, seminars, journals, etc., available on the topic of identification of and intervention in child abuse and neglect.

Keeping in mind the parameters of your role as an FPS therapist, access these resources to increase your knowledge and skill level!

Who is a mandated reporter?Who is a mandated reporter?

RCW 26.44.030 is quite explicit; three subsections detail who is required by law to report suspected child maltreatment.

To summarize these subsections:

(1)(a) Medical providers and other helping professionals;

(1)(b) DOC employees who observe offenders and/or children with whom offenders come in contact;

(1)(c) Any adult who has reasonable cause to believe that a child who resides with them, has suffered severe abuse.

Please refer to the RCW for a comprehensive list of mandated reporters.

FPS providers may actually fall under several covered categories; however, the category of “social service counselor” generally covers most providers.

Must a mandated reporter have Must a mandated reporter have proof of CA/N before making a proof of CA/N before making a

CPS referral?CPS referral?

No, the RCW specifies that one only needs to have reasonable cause to believe that CA/N has occurred.

If you have reason to suspect a child has been maltreated, CPS should be contacted and a referral made.

How quickly must CPS be How quickly must CPS be contacted?contacted?

The RCW specifies that the report must be made at the first opportunity, but in no case longer than 48 hours after becoming aware of the situation.

IMPORTANT: If the referral is related to an FPS-involved family, the therapist must report immediately, and follow up with written notification within 24 hrs.

What constitutes making a What constitutes making a referral to CPS?referral to CPS?

It begins with an intake call, when a referent contacts the designated CPS intake worker, who then gathers as much information as possible.

Be sure to have all available information in front of you, and be prepared to answer detailed questions from the intake worker.

Also, check with your agency for agency-specific protocol around CPS reporting that may be in place, e.g….

• Are you required to contact your immediate supervisor before making a referral?

• Are there specific intra-agency forms to complete? Many agencies require an incident report or other specialized documentation be completed.

Can a CPS referral be made Can a CPS referral be made anonymously?anonymously?

Well………..yes, but don’t do it!!!

• As a mandated reporter, the way to prove you have fulfilled your obligation to report is by giving your name, phone number, and your connection to the child involved to the intake worker when making the referral.

It’s helpful to find out the name of the intake worker to whom you’ve made the report.

Make note of this in your FPS charting notes as further verification you have fulfilled your responsibility as a mandated reporter—and in case questions arise later.

Can non-mandated individuals Can non-mandated individuals make reports to CPS?make reports to CPS?

Absolutely—and if someone shares information with you about their own suspicion a child has been maltreated, you should encourage them to report it directly to CPS intake.

Please note, however, that this does not satisfy YOUR responsibility to report! (unless you make the call with them)

Mandated Reporter TrainingMandated Reporter Training

According to the FPS Contract, all new FPS staff must view the video, “Making a CPS Referral: A Guide for Mandated Reporters,” within 2 weeks of being hired to provide these services.

• The video may be obtained from CA or accessed online at: http://www1.dshs.wa.gov/ca/pubs/pubcats. asp?cat=Multi-Media

After viewing, each employee or subcontractor must sign and date a statement acknowledging his/her duty to report CA/N.

The video must be viewed, and the appropriate statement signed, at least once every three years, according to the contract.

Some final words on Some final words on Mandatory Reporting…Mandatory Reporting…

Making a referral to CPS should never be viewed as a negative action!

Remember, the purpose for mandated reporting and for CPS in general is to ensure the safety and well-being of all children—not coincidentally, the primary focus of Family Preservation.

As FPS therapists and parapros, we pledge to ensure the safety of the child as our top priority.

As mandated reporters, we are given the legal responsibility not for investigating allegations or considering potential repercussions of a CPS referral—but for speaking up any time we have reason to suspect a child may be experiencing abuse or neglect.

• Failure to fulfill your obligation as a mandated reporter may not only jeopardize a child’s safety…

…it could result in the loss of your FPS contract, your job, suspension or revocation of your professional licensure and/or registration, and your inability to obtain future employment in the field of social welfare.

So please, understand and be prepared to fulfill this vital responsibility to the children of your community…

…as well as to your profession, your agency, and yourself.

Differences BetweenDifferences BetweenSafety and RiskSafety and Risk

Safety vs. Risk: Safety vs. Risk: What are we talking about here?What are we talking about here?

• Safety: freedom from danger or injury. The primary focus of FPS is ensuring that children are free from threats to their health or well-being.

• Risk: danger; the possibility of suffering harm or loss. Risks are those factors that jeopardize a child’s ability to live in a safe environment.

Safety and risk are essentially different sides of the same coin—both important elements of our work in FPS.

• Safety is what an FPS intervention seeks to promote, enhance, increase.

• Risk is what an FPS intervention seeks to manage, reduce, eliminate.

There is another significant distinction to keep in mind when considering safety and risk…

• Safety focuses on current conditions that may harm or endanger a child now—involves immediate action to protect children from current threats.

• Risk focuses on factors that estimate likelihood of future CA/N—involves planned interventions to decrease risk of harm.

It is critical to identify both risk factors and safety concerns as quickly as possible… • To ensure that there is a plan to keep

children safe despite current safety concerns, and

• To develop planned interventions that will decrease the risk of potential safety concerns (that may not yet have emerged but may be predicted based on identified risk factors).

How are risk factors and How are risk factors and safety concerns identified?safety concerns identified?

Beginning with the CA social worker’s first meeting, and continuing once a family is referred to FPS…

…a variety of areas (such as parenting skills, history of CA/N, etc.) are considered and addressed via observation, interviews, and the application of assessment tools.

Risk factors within and around the family (including environmental factors) are gauged in terms of what part they may play in a family’s ability to ensure their children’s safety….

…safety concerns are identified—i.e., what components of a child’s safety may be jeopardized by the identified risk factors….

…and a search is undertaken for ameliorative measures that may intervene in or even prevent circumstances that could result in harm to a child.

These steps set the stage for risk assessment and safety planning.

Before a case is referred to FPS, the CA social worker will typically have assessed risk factors and developed a safety plan for the family.

The FPS therapist will also be assessing various levels of risk, more formally with the NCFAS/NCFAS-R at the beginning and end of services, and less formally throughout the intervention.

Levels of both risk and safety will fluctuate during the course of an intervention, so ongoing assessment of both is necessary…

…by the FPS therapist, the CA social worker, and any other treaters involved with an FPS family.

Safety PlanningSafety Planning

The Role of Safety Planning The Role of Safety Planning in FPSin FPS

The FPS Client Service Contract addresses the responsibility of the therapist to review the CA Safety Plan, if one has been developed.

If the CA social worker has completed a Safety Plan with a family subsequently referred to FPS,

• A copy of the Safety Plan must be attached to the FPS referral form;

• The FPS therapist must review the CA Safety Plan with the family at the first face-to-face meeting; and

• The therapist must review the Safety Plan with the family at least every 2 weeks.

FPS therapists should be aware, when approaching this task, that despite having signed a CA Safety Plan…

…some parents may not know what a Safety Plan is, or how to comply with it—they may simply remember signing something that kept their child from being removed from the home.

This is, in most cases, not due to any fault on the part of the social worker; it’s more typically related to the stress of being investigated by CPS.

Faced with the fear that their child could be taken away from them, however briefly, parents will generally agree to sign almost anything, without much thought to what’s being signed.

Thus, even when the CA Safety Plan provides a list of safety concerns, action steps to correct these concerns, and a designation of who is responsible for taking the necessary actions…

…the family may not find the CA Safety Plan as helpful as it was designed to be.

Not infrequently, the CA Safety Plan will clearly identify what the family should not do (i.e., “Sam will not hit the children,” “Susan will not leave the children unsupervised,” etc.)…

…but will provide limited guidance in terms of what the family should do that would be considered a more appropriate response to the safety concern(s) in question.

Nevertheless, Safety Plans are valuable tools, and as FPS providers, part of our role is to ensure our clients follow them.

One way to enhance client compliance with the CA Safety Plan is to supplement it with another plan, created cooperatively by the FPS therapist with the help and support of the referred family.

What makes a Safety Plan useful?What makes a Safety Plan useful?

A good safety plan clearly states:

• safety concerns (what we hope to avoid—what presents risks to the child),

• available resources (who could be contacted if threat to safety appears), and

• action plans (what steps should be taken and by whom, to ensure child’s safety).

Sounds simple, right?

Well..….. although developing a safety plan is a fairly simple, straightforward process, there’s one aspect that tends to confound helping professionals in general:

we always want to jump ahead and fix things!

Accordingly, whether it’s the CA social worker or the FPS therapist, we tend to want to create safety plans that are more future- than present-oriented…

…and more PROactive than REactive.

But this is one time you’ll actually be encouraged to think in terms of reaction instead of prevention!

When developing a safety plan, don’t include resources the family might access next month, or the skills you hope to teach them next week.

Consider instead what the family might do if the safety issue they need to avoid confronts them 10 minutes after you leave their home—or at 2:00 in the morning, or on Christmas Eve.

The Safety Plan tells the family:

“If the situation you wish to avoid (i.e., whatever it is that could threaten your child’s safety and your ability to maintain him/her in the home) should start to happen, this is what you can do to manage/lessen/avoid the potential for harm to the child, with whatever resources are at hand at that time.”

Put more succinctly…

SAFETY PLAN:SAFETY PLAN:

In Case of Crisis,In Case of Crisis,

DO THIS!DO THIS!

The Safety Plan should be concise and to the point (remember, people tend not to think clearly in times of crisis)…

…so limit the number of steps in an action plan, and limit the number of words used to explain each step.

For example:

• If Dad passes out…….. Tim will call 911.

• If parents are fighting… LaKeisha will go to Pat’s house.

• If John gets violent……. Kelly will take the kids next door.

• If Mom is drinking………Terry will call Dad for a ride.

All the great resources, skills, etc. you wish to introduce to the family—they don’t belong in the Safety Plan; save them for the family’s Service Plan.

The Service Plan calls for proactive planning, resource development, skill building, and all those other things you do so well as an FPS therapist!

How to create an effective How to create an effective Safety PlanSafety Plan

First, review the CA Safety Plan with the client—both the therapist and the family should have a copy. [NOTE: Obviously, if no CA Safety Plan was required or completed by the social worker, this step is omitted!]

Ask the following questions (of yourself, or the client):

• Does the CA Safety Plan include each safety concern designated on the FPS referral form?

• Does it provide specific action steps, or does it merely tell the family what not to do?

• Does the family agree with the information on the CA Safety Plan? (great opportunity to hear the client’s “take” on what led to the referral!)

• Is the CA Safety Plan really a safety plan—i.e., does it provide strategies for crisis prevention/intervention—or is it actually a service plan, focusing on developing resources to decrease risk levels in the future?

If either the client or the FPS therapist feels the CA Safety Plan does not provide clear or sufficient direction (i.e., what should be done if a situation arises that jeopardizes child safety)…

…the development of a new or supplemental plan can make a huge difference in the client’s ability (and willingness) to follow the CA Safety Plan.

Once the decision has been Once the decision has been reached to develop a second reached to develop a second

Safety Plan…Safety Plan…

The next step is to begin where the CA Safety Plan left off.

• Make sure that each safety concern noted by the referring social worker is included—in addition to any others that either the therapist or the family might wish to include.

Be prepared for family members to disagree with the social worker’s interpretation of their situation.

• At this point in the intervention (usually the very first meeting), the therapist’s primary task is to ensure children will be safe even before parents are able to learn new skills or connect with new resources—so arguing, or siding with the social worker, will probably not be the best course of action.

Working with the family, create a list of safety issues/ways to address them, that includes the social worker’s concerns yet fits with the family’s perspective.

Help family members brainstorm about available supports—friends, neighbors, extended family, community crisis services, etc.—and action steps that could be taken to ensure child safety.

Even if the Safety Plan developed jointly by the family and the therapist says exactly the same things as the CA Safety Plan…

…families will typically prefer the one they wrote—with no authority figure dictating, “This is what you’ll do or we take your kids” (which is how parents typically interpret the CA Safety Plan).

Although FPS therapists and their clients may prefer the therapist-generated safety plan to the CA Safety Plan…

…the CA Safety Plan continues to play a role in the FPS intervention.

As mentioned earlier, the CA Safety Plan must be reviewed with the family at least every two weeks.

As long as the second safety plan contains all pertinent requirements detailed in the CA plan, you need only review the second safety plan (documenting results and reporting to social worker) to remain in compliance with this contractual specification.

If, however, the therapist-generated plan doesn’t include each item in the CA Safety Plan, it will need to be reviewed separately.

Rather than placing oneself in this position, any proposed changes to the Safety Plan should be discussed with the referring social worker.

Of course, it goes without saying that the referring social worker should receive a copy of the second Safety Plan for approval…

…as well as any other document the FPS therapist creates related to the intervention.

A few last words on Safety PlansA few last words on Safety Plans

• Families often find Safety Plans one of the most helpful things we do.

• Keeping them “short and sweet” makes Safety Plans most useful in times of crisis situations.

• Suggest that families keep copies in easily-accessible places: next to the phone, on the refrigerator, etc.

Remember, the intent of a therapist-client Safety Plan is not to see who can develop the best-written, most comprehensive plan (or whose plan the family likes better)…

…it’s to ensure the family is able to comply with the CA Safety Plan, by having a clear idea of what they can do—even in the midst of crisis—to keep their children safe at all times.

FPS and Enhancing FPS and Enhancing Family and Child SafetyFamily and Child Safety

What can the FPS therapist do What can the FPS therapist do to ensure children are safe?to ensure children are safe?

We’ve already explored some of the most important means of enhancing the safety of the children we serve:

• compliance with mandatory reporting

• ongoing assessment of risk levels and safety concerns

• development and implementation of Safety Plans

But really, a focus on child safety is inherent in every aspect of Family Preservation…

…whether we’re consciously aware of it every minute, or not!

During the course of each intervention, the FPS therapist remains vigilant…

• observing the behavior of family members towards each other

• listening to what is said (and not said)

• assessing environmental factors

• remaining open to any suggestions or signs that child safety is compromised

The NCFAS/NCFAS-R helps to pinpoint specific areas where safety concerns may exist…

…the written Family Assessment highlights and explains these concerns, and…

…the Service Plan develops various means of managing, correcting, or eliminating them.

Throughout the intervention, the FPS therapist helps the family build on their existing strengths by:

• teaching pertinent new skills, including techniques to decrease potential harm to children/increase child safety

• connecting the family to available resources in the community

• strengthening existing connections with extended family, neighbors, etc.

All of these elements work together to one primary purpose:

to ensure that children can safely remain in their own homes, in the care of their own families, without need of intervention from outside sources.

That’s what Family Preservation is all about.

What should the FPS therapist do What should the FPS therapist do if he/she no longer believes a if he/she no longer believes a child is safe in their home?child is safe in their home? As an FPS therapist and a mandated

reporter, the therapist must contact CPS intake immediately, upon becoming aware of the situation.

The referring social worker must also be contacted immediately, and written notification must follow within 24 hrs.

If the FPS therapist has reason to believe the child is in immediate danger…

…the first call should be to the police (911)!

If you feel a child must be removed from a dangerous situation immediately, call the police as soon as it is safe to do so.

• Do what you can to de-escalate the situation.

• Relocate family members to a safer location if appropriate and possible.

• Provide support and reassurance as appropriate.

Utilize all your clinical skills (including any specialized training you may have in crisis intervention, mediation, etc.) to keep the situation safe while you wait for authorities to arrive.

But do not attempt to remove a child from their home, and never feel you must place yourself in unnecessary danger to protect a child.

• FPS therapists do not have the legal authority to take a child from his/her parental custody.

• The decision whether or not a child should be removed from the home is never up to the FPS therapist!

Also remember…

No FPS therapist would ever be expected to place themselves in harm’s way to protect a child (or, for that matter, any family member).

Your safety is important, too!Your safety is important, too!

There are excellent trainings, workshops, books, and so on, which address the topic of therapist safety.

In addition to honing your clinical skills, take advantage of opportunities to increase your preparation for dealing with potentially volatile situations.

It’s always helpful to be prepared for any type of situation you may encounter.

But by and large, even initially-resistive families referred to FPS find our services extremely helpful.

Aggressive behavior targeting FPS therapists is actually quite rare overall.

To summarize, the FPS therapist To summarize, the FPS therapist plays an important part in plays an important part in

enhancing child safety.enhancing child safety.

Therapist responsibilities include the following:

1. Following up on safety concerns indicated in the FPS referral.

The therapist thoroughly explores each safety concern noted by the referring social worker in the Family Assessment and Service Plan, and addresses them on an ongoing basis throughout the intervention.

2. Ensuring family compliance with the CA Safety Plan.

Therapist reviews CA Safety Plan at least every 2 wks, develops a second plan if necessary to clearly provide a list of available supports/action steps for families to take to ensure child safety, and provides weekly safety updates to referring social worker.

3. Providing a thorough Family Assessment to highlight specific safety concerns subsequently addressed in the Service Plan.

Therapist completes the NCFAS/ NCFAS-R and written Family Assessment, and develops a Service Plan with family, focusing on reducing/ eliminating any concerns related to child safety.

4. Observing, listening for, interpreting any suggestions or signs that a child has been/could be potentially harmed.

Therapist remains continually vigilant for any indications that caregivers may not be keeping children safe—assessing verbal and nonverbal communications, observing behaviors, and so on.

5. Teaching families new skills and connecting them to appropriate resources related to decreasing risk of harm and increasing child safety.

Therapist introduces families to skills, techniques, and resources to further reduce risk factors and enhance the family’s ability to keep children safe and healthy.

6. Complying with mandated reporting in the event of suspected child abuse/neglect.

Therapist reports any suspicion of CA/N, as mandated by RCW 26.44; also provides verbal and written notification to referring social worker as per the FPS Client Service Contract.

From start to finish, every aspect of the FPS intervention is geared towards enhancing family and child safety.

Regardless of the specific task at hand, the FPS therapist is ever alert to the health, well-being, and safety of the children in each home we visit.

Safety of the child is the first priority in FPS…

…and the effective therapist focuses every intervention toward that end.