Caseworkers move from 'gotcha' to 'how can we help?' approach

Caseworkers move from 'gotcha' to 'how can we help?' approach
By Leslie Boyd, Staff Writer
April 27, 2004 10:42 p.m.

HAYESVILLE - Linda Sexton first became involved with Child Protective
Services in southern Georgia when she failed to take the youngest of
her three children to the neurologist for his annual visit.

"They came and told me I had to do this and that or they'd yank my
kids," Sexton says. "I knew who was in charge, and it wasn't me."
Sexton, who is divorced, moved to Hayesville last year to be closer to
family, and her CPS file moved with her.

"It was so different here," she says. "The first thing they asked was
what I needed. They said they were here to help, and they did."

Mike Mason, the lone investigative and in-home services caseworker in
Clay County, helped Sexton find a car and then found money to get new
tires so she could get to her job at a local restaurant.

Sexton's case was closed in February, but she says if she needs help
again, she won't wait for a social worker to knock on her door.

"I approach people the way I would want to be approached," Mason says.
"If a child is in danger, I won't hesitate to change my tone and
remove that child, but in the vast majority of cases, there's no need
to be confrontational or dictatorial. In a lot of cases, families feel
like they're in so deep that they can't see a way out, and I can
help."

Sexton's case exemplifies the new way social workers need to approach
families, say child advocates.

Child protective workers are moving away from the old- style
adversarial approach in many cases because that just breeds
resentment, says Jo Ann Lamm, program administrator for the Family
Support and Child Welfare Services Section of the N.C. Department of
Health and Human Services.

"We've been based on a `gotcha' model for too long," she says. "It's
time to ask what we can do to help."

Switching gears

The system in North Carolina is heading in the right direction, say
advocates, but a lot more needs to happen. Basic attitudes about
approach to families and about removing children have to change.

So do public attitudes, which all too often confuse poverty with
neglect, says Richard Wexler, director of the National Coalition for
Child Protection Reform.

"We tell families they have to work to support themselves, then we
deny them adequate, affordable child care," Wexler said. "If we
address issues of poverty, we'll be fixing a lot of neglect issues,
too."

The ideal system would be one in which families are preserved as often
as possible and in which families receive necessary services before
the Department of Social Services needs to step in. It also would look
at family strengths and what's called natural supports in the
community - resources the family can draw on that are outside the
child protective system.

Already, child protection workers are going into homes looking for
things that work in the family instead of just looking at the
weaknesses. People who report suspected abuse or neglect are asked
whether they know of any strengths the family might have.

"Child protection work is a work in progress," says Becky Kessel,
social work program administrator for the Buncombe County Department
of Social Services. "Things change as often as our understanding of
families change. . We as workers in the field need to be open to those
changes."

The system and any fixes to it need to be holistic, say Wexler and
others. Some states, like Alabama and New Jersey, are getting it right
even though it took lawsuits to institute change. In New Jersey, for
example, reform includes the money to provide housing and services for
needy families.

"There are big problems in plenty of places," says Larry Earl Wraight,
director of Fighting on the Front Line for Children, an advocacy group
based in upstate New York. "New Jersey just got the media attention.
The kinds of problems there are rampant in other places, too. There's
a need for change in almost every system."

Incentives for change

Wexler believes states need incentives to make change. Foster care, he
said, is a good example.

"Foster care costs about $15,000 per child per year," Wexler says.
"Intensive family preservation services cost less and are no
compromise to safety."

Yet the federal government continues to fund foster care and not
family preservation.

Wexler said a program proposed by the Bush administration might help
correct that. The proposal would send block grants to the states in
the amount they now receive but can use only for foster care. The
proposed block grants could be used for foster care or family
preservation. The federal government spends about $15,000 a year for
each child in foster care, and North Carolina has about 10,000
children in DSS custody.

Still, not every family belongs together, says Dennis Duckett, whose
grandson, Gabriel, was killed in January 2003. He had called DSS
numerous times, offering to take Gabriel if the department would
remove him from his mother and her boyfriend.

"Some of these people are really good at making you think they're
changing their ways," he says. "They're good at being manipulative -
they know the right answers."

Wexler agrees some families shouldn't be kept together, but many
children who are removed from their parents' homes could be kept at
home with the proper services, he says. It's imperative, he added, to
avoid the trauma to a child that removal causes. In the mind of a
small child, Wexler says, removal is akin to kidnapping. Even older
children who understand why they're being removed are traumatized.

"You can avoid that trauma in a lot of cases," he says. "You have to
have the intensive family preservation services, though. You can't be
half-hearted about it."

Some states are reforming their systems to reduce the number of
children in foster care, Wexler says, but the pace is slow. The states
that report the most success are the ones involving front-line workers
in the reform.

Generally, Wexler says, the numbers of children in DSS custody go down
as reforms are implemented. In Alabama, for example, the number of
children in foster care fell by 22 percent between 1991 and 1995, even
though fewer than half the counties had implemented the reforms.
Meanwhile, the number of children in foster care nationally rose by 12
percent.

"Turnover is reduced as well, as child protective workers are more
able to do what they came into the field to do - work with kids and
families," he says.

Pete Sansbury, an Asheville psychologist who specializes in domestic
abuse and violence issues, says some families also might need
long-term therapy to maintain the gains made in intensive family
preservation and that assessments should be done periodically before
DSS signs off completely on a case.

"The model out there for DSS is that you need families to be trying,"
he says. "But there are families out there who will slip back as soon
as you sign off on them. We have to do a really good job of risk
assessment, and we have to look at long-term interventions with some
of these families if we want to preserve them."

A new focus on strengths

Agencies are looking again at optimal caseloads for their workers.
Most accept the standard set several years ago by the Child Welfare
League of America, which is 12 cases for each CPS caseworker. But
caseworkers are asked being asked to do more as the focus moves to
more intensive services for families, not to mention documenting
everything they do.

"I usually spend Friday papering," says Kathy Squires, a CPS
caseworker in Buncombe County. "It's kind of like when I worked in a
hospital. If you don't write it down, it never happened."

Squires, who left the agency in 1999 and came back last year, says
caseloads dropped while she was gone. Buncombe County CPS caseworkers
average about 12 cases each.

But averages can be deceiving, says Wraight. In that average are
people who have one case, trainees with no cases and people who have
20 or more.

Caseloads need to come down to reasonable levels, and states can't be
left to decide what those levels are, Wraight says. There needs to be
a clearly defined standard, and it needs to be law.

"Once you get above 15 to 20 cases per worker, you lose control of the
workload and it becomes a matter of luck as to whether children are
kept safe," he says. "You can't serve a family when caseloads get that
high."

Some advocates recommend as few as eight cases per social worker, so
workers can spend more time with families. In intensive family
preservation services, caseloads should be as low as two to four per
worker, says Ray Kirk, research professor at the School of Social Work
at UNC-Chapel Hill.

"When we talk about intensive family preservation, though, we mean a
formal program of four to six weeks where caseworkers are available
24-7," he says. "It needs to be a formal program, not just a
philosophy."

Sharing pertinent information

Systems also are opening up more for public scrutiny, and child
protection workers are more likely to speak out about the difficulties
of what they do than they have in the past.

"It used to be we just didn't say anything when people criticized us,"
Kessel says. "We still won't talk about specific cases. We can't."

Wexler believes that must change, too. Social services departments
maintain that federal law prohibits the release of records, but state
laws in Maine and New York now allow release of records when a child
dies or when parents challenge the removal of a child.

"Neither state has been penalized by the federal government," Wexler
says.

DSS directors and social work administrators will talk about low pay,
high stress levels and the dangers involved in the job. Andrew Vachss,
author, attorney child advocate and former CPS caseworker, has been
talking about it for years and advising CPS workers to do more of the
same.

"This is the only job I know of where the worker is expected to
protect the victim and rehabilitate the offender, often while they're
living under the same roof," Vachss says. "They go into places cops
wouldn't dare go alone. It's a dangerous job. Someone who beats up a
kid is a violent person, and what you're doing is sure to provoke
them. I just think people should know that."

Child protection workers and advocates are also realizing the
importance of having everyone speak the same language and ask
pertinent questions. They're changing their focus and refining what
they're looking for, says Joel Rosch, senior research scholar for the
Child and Health Policy Initiative at Duke University's Center for
Child and Family Policy. For example, child abuse traditionally has
been tracked by the number of child abuse and neglect reports and the
number that were substantiated.

"But those numbers were intended to be a measure of (CPS workers')
workload," Rosch says. "One of the things that's happening now is that
we're starting to track . measures of emotional health, social skills
and readiness to read, e- coding children who come into the emergency
room, looking at child deaths. . If you want to track child well-being
and child safety, that's what you have to track, not caseworker
workload."

The changes in the system - reducing caseloads, increasing pay, making
the change to a more collaborative system and one that focuses on
keeping families together - will be gradual, Lamm says. It can't come
overnight. But, she adds, it has to come.

Vachss agrees. "We as a society have a vested interest in this. We
have made more progress in the last 30 years than in the previous 300.
But we need to set and adhere to national standards. We need to define
the job of child protection worker and make sure the resources are
there to perform that job up to standard. Why should a child have
better protection in one state than another? I can't see any defense
of that."

Child protection advocates need to vote this issue and no other,
Vachss says.

"Nothing will be done until we show politicians that we can deliver a
big block of votes, just like the National Rifle Association," he
says. "I don't care if the candidate is a fanny-pinching,
cigar-chomping, foul-mouthed sexist. If he'll vote the right way on
this issue, we have to vote for him. It's the only way to make things
happen."

Wraight offers hope too. He was a CPS worker for 29 years in New York
before forming his advocacy group.

"For me, I'm pretty optimistic about the future, and I don't know
why," he says. "But I'm in this fight for the rest of my life. Things
are so bad right now that people can't keep looking the other way, and
that will mean they will begin to demand change. It will happen, I'm
certain of it."

Contact Boyd at 232-2922 or .

How to recognize abuse, neglect

The state of North Carolina defines abuse and neglect as the
following:

Abuse: Causing serious injury to a child by other than accidental
means.

Neglect: Failure to provide for a child's basic physical and emotional
needs.

Possible signs of abuse


Bruises in various stages of healing, burns, welts, patches of missing
hair or broken bones.

Unusual wariness of physical contact, expression of little or no
emotion when hurt, hyperactive and aggressive behavior or shy and
passive.

Unusual knowledge of sex or an unwillingness to be with a certain
person

A return to bed-wetting; nightmares or other sleep disturbances.

A parent who punishes a child harshly in public, refers to the child
as bad or horrible or who seems unconcerned about the child.

Possible signs of neglect

A child who's constantly dirty, who begs or steals food or whose
clothing is not appropriate for the weather.

Missing school frequently; a child who's constantly tired or
distracted.

Out alone late at night or at home alone, even if for a couple hours
because parents are working and can't afford or can't find child care
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