Child Welfare Decision Making in Context Part 1- Decision Making in Child Welfare: A Comparison of Clinical and Actuarial Models
Scottye Cash
The Ohio State University
Dr. Cash is an Associate Professor of Social Work at The Ohio State University who specializes in child welfare research with a specific emphasis on safety and risk assessment, family assessment, linking services to family needs, family preservation services, managed care and child welfare services, and substance abuse in child welfare families. Dr. Cash was the Principal Investigator on a mixed method evaluation of the state of Ohio’s Comprehensive Assessment and Planning Model—Interim Solution. She has also served as co-Principal Investigator on an Administration on Children and Families grant and as an external consultant with Boys Town helping design the In-Home Family Services program and the Foster Family Services program. Dr. Cash is committed to finding ways to establish partnerships with agencies, supervisors, and front-line staff, with a primary goal of finding ways to bridge the gap between research and practice.
Abstract
Objectives:Decision making in child maltreatment is a critical component of the entire child welfare system. The way in which the system makes decisions about which cases to substantiate and/or open, the level of service... [ view full abstract ]
Objectives:
Decision making in child maltreatment is a critical component of the entire child welfare system. The way in which the system makes decisions about which cases to substantiate and/or open, the level of service intensity for opened cases, and when to place a child in foster care has changed over time. There has been a tension between which type of assessment models are the best, clinical or actuarial, and which items should be included in the model. The current study examined relationships between clinical and actuarial dimensions and caseworker use and supplementary use of actuarial dimensions.
Method:
The study used secondary data (n=2,178 families) from one county in the state of Ohio. Data were collected from May 2005-2007. Two types of risk assessments were analyzed as a part of the study, a clinical and an actuarial model. The clinical model measures risk contributors on the following domains: Child Functioning, Adult Functioning, Family Functioning, and History. The Structured Decision Making model was used for the actuarial assessment. The two primary outcomes were substantiation and services received. Spearman rank-order correlations and logistic regression were used for analysis.
Results:
The clinical and actuarial assessments were highly correlated. Although the actuarial neglect scale was the single best predictor of substantiation and services received when clinical measures were excluded, the caseworkers appeared to rely more on the clinical assessment to make decisions about substantiation. For services received, caseworkers relied more on the actuarial. Although the actuarial alone may not predict case decision, caseworkers appear to supplement their clinical expertise with information from the actuarial domain.
Conclusion:
The dual measurement approach (clinical and actuarial) may be ideal for intensity, however there is still significant complexity in how to ensure the most critical and accurate assessment of families involved in the child welfare system.
Authors
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Scottye Cash
(The Ohio State University)
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Roderick Rose
(University of North Carolina)
Topic Area
Child Protection Systems and Strategies at local, national and international levels
Session
Symposia13 » Session 1-Child Protection Systems (11:00 - Tuesday, 3rd October, Europe 2 Room)
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