Implementing a Child Mental Health Intervention in Child Welfare Services: Stakeholder Perspectives on Feasibility

Abstract

This pilot study integrated quantitative and qualitative data to examine the feasibility of implementing a modified version of a multiple family group behavioral parent training intervention (The 4Rs and 2Ss for Strengthening Families Program [4Rs and 2Ss]) in child welfare (CW) placement prevention services from the perspectives of participating caregivers ( n = 12) and CW staff ( n = 12; i.e., 6 caseworkers, 4 supervisors, and 2 administrators). Quantitative surveys were administered to caregivers and CW staff followed by semi-structured interviews to examine the feasibility of implementing the modified 4Rs and 2Ss program as well as factors impacting feasibility. Results indicated that quantitative benchmarks for high feasibility were met in all assessed areas (e.g., family recruitment, caseworker fidelity ratings, CW staff feasibility ratings) except for family attendance, which was markedly lower than desired. Factors facilitating feasibility included agency and research support, intervention ease-of-use, perceived benefits to existing CW practice, and logistical support (e.g., food, transportation, child care) promoting attendance. Factors hindering feasibility included conflicts between research-based eligibility criteria and existing client population demographics, research-related processes resulting in delays, CW staff role conflicts, added workload burden, complex family issues, and power differentials inherent to CW services which complicated families’ voluntary participation.

Sustainability of a Child Mental Health Intervention in Child Welfare Services: Case study

“…A previous publication describes the modification process. 18 Between 2015 and 2017, the intervention was delivered in the CW agency to three cohorts of families, with the University providing critical support -both financial (for transportation, childcare, food) and research (fidelity monitoring and supervision).…”

“…By comparison, the attendance rates for the modified 4 Rs and 2 Ss Strengthening Families Program were lower than those reported in this study. 18 This may be attributed to a key adaptation the agency made: moving the intervention beyond agency walls into community settings (library, community center, online). Palinkas and colleagues 37 found that providing incentives for participation was an indicator to sustainment of a service.…”