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Dissemination & Implementation Science

(PS5-D81) Divergence in Child and Family Team Meeting Design and Practice: A Qualitative Needs Assessment to Improve Mental Health Outcomes for Children Involved in the Child Welfare System

Friday, November 17, 2023
2:30 PM – 3:30 PM PST
Location: Regency Ballroom, Level 7
Mental health need is high among child welfare-involved children with approximately half of child-welfare involved children and adolescents meeting criteria for at least one current mental disorder. Research demonstrates that including Child Welfare System (CWS) involved parents and caregivers in treatment planning through shared decision-making is vital to child outcomes, with fewer child removals and fewer recurrences, thus resulting in decreased risk of child trauma and mental health concerns. Child and Family Team (CFT) meetings are a family-centered and collaborative services intervention that, when implemented as designed, facilitate the development of individualized, effective Case Plans based on mutual agreement. Yet, neither parents nor caseworkers perceive that Case Plans include joint influence. In fact, most parents feel they have no voice or input. Without mutual agreement, Case Plans that refer children to behavioral health services for identified mental health needs often result in unsuccessful service linkages.  This p</span>oster presents results from a qualitative needs assessment targeting the ongoing implementation of the CFT services intervention within the County of San Diego Child Welfare Services System (SDCWS), a large, publicly funded, CW system, in which CFT meetings are required for each youth within sixty days. The needs assessment will occur over three phases. In phase one, areas of concern regarding current CFT services intervention implementation efforts will be uncovered through five informant interviews and three focus groups with key stakeholders, including CWS leadership, supervisors, and front-line providers, as well as CWS-involved parents/caregivers. The interview and focus group data will be analyzed iteratively using a template organizing style. The recordings will be professionally transcribed, checked for accuracy, and imported into NVivo software. Transcripts will be read to gain familiarity with the content and to identify themes. NVivo will be used for line-by-line coding using an a-priori code list developed from theoretical and conceptual considerations, as well as the initial reading of the transcripts. While the coding scheme will be formed along predetermined categories, it will remain flexible to accommodate new codes. The second phase will document the current status of CFT services intervention implementation efforts regarding the concerns identified in phase one, including identification of mental health services linkage for children. During this phase, a list of any discrepancies between intended and actual CFT meeting processes and outcomes will be compiled. Phase three of the needs assessment aims to facilitate the preparation of an Action Plan to address the needs, such that CFTs may be implemented as designed. By elucidating the discrepancies that may exist between the ideal and actual CFT meeting processes and outcomes, as well as the action steps SDCWS aims to take to enhance CFT services, this project hopes to enhance shared decision-making in CWS such that case plans are developed with mutual influence, with downstream impact of improving mental health service linkage for youth.