Background Materials Useful in Developing a California Integrative Theoretical Framework January 9, 2014 Webinar Led by the members of the Practice Model Design Team in collaboration with Anita P. Barbee, MSSW, Ph.D. Professor and Distinguished University Scholar Kent School of Social Work University of Louisville

Goals of the Presentation To review with you the 6-8 micro theories and 3 macro theories the PM Design Team thought were compelling based on a larger group of theories reviewed by Dr. Barbee this fall. To ask questions and seek input before decisions are made in March

Remember This Summer We took you … From “A” to “A” Academic to Applied Through our primary message, which is… Be clear on what theories, values, and principles you want to guide practice Make sure those theories, values, and principles are fully fleshed out across casework practice, the entire organization, and the system Understand the complexity of implementing a Practice Model and the role that fidelity checking can have in installing and maintaining desired practice Be clear on what the goals for your Practice Model are and what you want to accomplish before you begin the rollout

The Academic lens on Practice Models Theory, research and evidence The Academic lens on Practice Models

What Is a Practice Model? A practice model for casework management in child welfare should be theoretically and values based, as well as capable of being fully integrated into and supported by a child welfare system. The model should clearly articulate and operationalize specific casework skills and practices that child welfare workers must perform through all stages and aspects of child welfare casework in order to optimize the safety, permanency and well being of children who enter, move through and exit the child welfare system. Refresh from webinar Child Welfare Casework Practice Model Definition (Barbee, Christensen, Antle, Wandersman & Cahn, 2011)

Keys to Intervention Success A theoretical underpinning related to orientation towards clients and origins of problems they face. A theory of change focused on how to best assess and intervene to build on strengths and reduce problems A fully articulated set of actions and skills that can be observed for presence and strength System supports Evaluation results, including data benchmarks to monitor the efficacy of the model As discussed in the CALSWEC Webinar in June… 1) Delineates how to think about or conceptualize the practice with the population of focus. The theoretical foundation can respond to four areas: The conceptualization of the problem (e.g., child maltreatment is embedded in the stage of a family’s life development) The change theory that informs how that problem can be remediated (e.g., self efficacy theory) The theory that guides the critical contribution and influence of the relationship alliance or partnership (e.g., solution focused theory) The core practice values that underlie the approach to clients and the problem (e.g. family centered or strengths based). 2) A casework practice model should specify the practice skills that are to be carried out and measured for fidelity and implementation adherence. These include: Core practice skills that guide practice across the life of a case (e.g., engagement, assessment, planning, decision making) so that even when there is no direction about a specific type of encounter, the theory and meta-skills together can guide practice Clearly specified and distinct practice skills for each stage of a child welfare case including intake, investigation, in-home services, placement into and monitoring of progress in out of home care (reunification, foster care recruitment and certification, adoption) This is where incorporating “techniques” particular to different stages of the case can be useful as long as they align with the values and theoretical orientation of the overarching PM Specific skills for dealing with distinct family issues as child sexual abuse, neglect, or domestic violence involvement. 3) The third component involves the ability to create a system infrastructure that supports and reinforces the theoretical orientation and practice skills that are a part of the practice model. This would include: Policy, training, documentation requirements and forms, a SACWIS System (IT) Supervision and worker performance evaluations that align with the casework practice model Quality Assurance (QA) and continuous quality improvement (CQI) processes that align with and evaluate adherence to the casework practice model (measuring fidelity and linking to outcomes). The importance of systems alignment and a list of drivers of systems change has been supported by research in other fields of practice, collected in the NIRN model (Fixsen,et al, 2005) and by research on implementation in child welfare (Cahn, 2010). The fourth component involves development of data points to monitor fidelity to the model and, once fidelity is achieved, to evaluate the impact on outcomes, in this case for children and families in the child welfare system. Process or Implementation Evaluation assessing fidelity to the model is essential before embarking on outcome evaluation Benchmarks important in child welfare would include the federal Child and Family Services Review outcomes of safety, permanency and well-being as well as other intervening or process measures that may be relevant (e.g. employee retention, engagement of community partners, and so on). Wandersman (2009)

What is a Theory? A theory or framework is an organized set of explanatory principles that are susceptible to hypothesis testing. Good theory leads to research to test the theory or debunk the theory and an evidence base to support the theory. Bad theory has either been disproven or is ideologically driven. In Social Work and Child Welfare, we are trying to understand what leads to the problem of child maltreatment, the processes involved in child maltreatment that are predictable and how to practice in such a way as to prevent the problem or process from starting or intervene once the problem has arisen. So there are 4 key pieces to an integrative theoretical framework in any field like child welfare. Problem, Process, Practice and Prevention

Problem, Process, Practice, Prevention: Theories must help staff understand What causes the problem (child maltreatment), including the types of internal vs. external causal attributions staff will make about the causes of child maltreatment What process is going on that is impacting the person and making the situation or problem worse, including past and ongoing oppression and trauma How to engage in optimal practice including the proper orientation to take towards clients and the way to successfully intervene and provide effective treatment How to create efficient and compassionate systems that effectively sustain ongoing treatment and prevent future problems.     Therefore, The integrative theoretical framework of California, or any county or state, needs to be evidence based and trauma informed and pull from theories that address Problem, Process, Practice and Prevention (Evidence Based P Quad or EBPQ).

Theory of Practice Delineates how to think about or conceptualize the practice with the population of focus. The theoretical foundation can respond to four areas: The conceptualization of the problem (e.g., child maltreatment is embedded in the stage of a family’s life development) The change or intervention theory that informs how that problem can be remediated (e.g., self-efficacy theory) The theory that guides the critical contribution and influence of the relationship alliance or partnership (e.g., solution-focused theory) The core practice values that underlie the approach to clients and the problem (e.g., family-centered or strengths-based) while I think I am on-board when reading Slide 8, I’m not sure how Slide 9 then follows.  I like slide 8 because it makes an application to staff and practice.  Then there’s this leap to slide 9 – maybe it’s me but I can’t quite find the connection or flow from slide 8 to slide 9.  I recognize both Slide 8 and 9 have lists of important things but the two lists seem a little too  discrete and not connected.  If there is a foundation/flow that I have missed, maybe it could be made more obvious.   I think it’s helpful for the audience to have a frame or foundation to really hang the 4 things listed in slide 9 onto, and to understand how the slide 9 list relates to or follows form the list in slide 8. ASK MICHAEL  

Process October-December 2013 Dr. Barbee reviewed all relevant micro level and practice theories that could be relevant to form a child welfare practice model. Dr. Barbee created a chart describing each theory (Table 1 Background of All Theories for CA). She divided the chart into three major types of theories for child welfare practice: Recall that a micro theory focuses on the thoughts, feelings and behaviors of individuals and families and practice theories focus on the interaction between child welfare staff and clients. A child welfare practice model is mostly focused at that level of work and analysis. Later we created a chart to cover relevant macro level theories that guide the work of the organization- the context where the work takes place. Certainly some theories, even micro ones, acknowledge larger macro influences- such as conflict theory- and how those affect daily work with clients.

Three types of micro theories Orienting Theories- These help set the orientation towards clients and work with clients in the child welfare system. Any child welfare casework practice model must choose at least one theory from this cluster to set the tone for all interactions with clients. These include Conflict theories, Humanism, and Social Constructionism and the major therapies that were derived from these theories (e.g. person-centered therapy, strengths-based approach, Solution Focused Therapy). Bio-Developmental Theories- These focus on the developmental nature of children and families. These approaches help determine attributional schemas for maltreatment and interventions. These include attachment theory, family life cycle theory and trauma theory. Intervention Theories- These help set an understanding of the process leading to maltreatment and specify what needs to change in order for maltreatment to end and safety to be ensured. These theories are tied to assessment and treatment such as Behavioral, Cognitive, Systems theories and their derivations such as TF-CBT .                    

Process continued The Practice Model Design Team reviewed the chart in November and chose a subset of theories for more focus. Dr. Barbee created a second summary chart of those theories and showed how they related to existing child welfare practice models. The Practice Model Design Team reviewed this summary chart in December. Dr. Barbee will review a one page version of the summary chart and the organizational theories during today’s webinar (January 9, 2014).

Process continued Practice Model Design Team members will lead discussions at CWDA Regional Committee meetings in January. In February we will have another webinar to prepare for the March 6-7 workshop. Dr. Barbee will align these theories with the values and principles the group generated in July.

Process continued 8. At the March 6-7 meeting we will build on the discussions on the webinars and the regional meetings, and integrate the work on theory into our discussions as we work to come to agreement on the other levels of the Practice Model: - Values and Principles - Practice Components - Practice Elements - Practice Behaviors We will work together to operationalize the values, principles, practice components, practice elements and practice behaviors.

There are two word documents posted We will first turn to and review the first word document (Table 2 Summary Micro Theory Chart and corresponding 1 pager) that focuses on the micro theories. We will then turn to and review the second word document (Table 3 Covering Organizational Theories and corresponding 1 pager) that focuses on the organizational theories that support a practice model.

Questions for Webinar Participants Do these theories appear to undergird good child welfare practice in CA? Do you want more information about any of these theories? Do you have any suggestions on how to present the material most effectively when we all get together to refine the Practice Model in March? Do you have any suggestions for the format of the March meeting?