1. Children without Placement: Facilitating Safe Alternatives
Erica Balderrama, MSW, Dr. Candyce Berger, PhD, MSW, and Virginia Martinez, LCSW
The University of Texas at El Paso
Child Welfare Training Collaborative (CWTC)

2. Nature of the Problem: National Perspective
Nationally, seen an increase from 397,000 (2012) to 415,000 (2014) = 4.5% increase
The declining availability of foster homes has created a crisis in available foster care placements
Possible causes:
Increase in foster children while available foster beds declining
Difficulty recruiting and training potential families
Difficulty of recruiting young generation of foster parents
Retirement of older foster parents (Baby Boomers)
In one state, experienced a drop in the number of foster beds of unrelated foster parents from 22,000 – 9,000
Nature of the Problem: National Perspective

3. Nature of the Problem: Texas
CPS reported an increase in the number of kids without foster placement
Steady decline in the number of approved foster homes
The lack of foster homes resulted in children being placed in alternative locations
Placed in CPS offices
Placed in hotels
178 CPS staff were required to provide 24-hour supervision 7 days a week
CPS staff not sufficiently prepared to provide the level of care or manage behavioral issues
Conservatorship (CVS) personnel qualified but only represented x% of those provided care
Nature of the Problem: Texas

4. Nature of the Problem: Texas
Behavioral and medical challenges surfaced that created concern for compliance and safety:
Runaways
Children with special needs (e.g., autism, mental health diagnoses, and trauma)
Children requiring medications (e.g., psychotropic medications, medical conditions such as asthma and allergies)
Medical appointment schedules
Dietary requirements
Demographics of the CWOP population:
Age range = 4-17 yrs.
Length of stay in alternative setting = 7-10 days
Average occupancy = 9 children
Nature of the Problem: Texas

5. In a Title IV-E Steering Committee (Region 10 CPS and UTEP) meeting the problem of CWOP was identified
A decision was made to provide mandatory training to ALL staff designated to provide supervision for CWOP
Crisis Intervention and De-Escalation chosen as the theoretical underpinning of the training
Contracted with El Paso Child Guidance Center for training: Social worker (LCSW), Psychiatrist, and Licensed Professional Counselor (LPC)
Design of the Project

6. Prior to the training, CPS addressed systemic and some educational issues that created challenges for staff providing CWOP supervision (e.g., communication, creating a medication log, and self-care strategies to decrease burnout)
Outsourcing of Family Based Safety Services (FBSS) decreased available staff
Design of Project

7. As a result of the planning sessions, the following decisions were made:
Title:
“Crisis Intervention & De-Escalation: Working with Children without Placement (CWOP)”
Objectives:
Learn the impact of exposure to trauma in children & adolescents
Learn trauma-informed care principles & how to apply them to working with children & adolescents without placement
Learn methods for working with children & adolescents to prevent escalation
Learn de-escalation techniques in working with children without placement
Design of Project

8. Organization of Training
The training was held in a local CPS office to accommodate all regional staff (214)
Venue accommodated up to 70 with 8 per table
Was provided in 4 half-day sessions within a one week period
Separated into 2-hour blocks:
First 2 hours = LCSW/LPC presented
Last 2 hours = Psychiatrist presented
Training focused on Crisis Intervention & De-Escalation
Interactive (group work)
Video illustrations of case scenarios and discussion
A folder with handouts provided information on:
PowerPoint
Pointers on therapeutic techniques
Policies
Referral links
Organization of Training

9. Training was provided to a total of 209 Department of Family and Protective Services (DFPS) Child Protective Services (CPS) staff out of a total of 214 staff (98%) members
Of those 209, 178 staff (85%) were designated to provide child watch duties
28 staff (16%) management level
150 staff (84%) caseworkers
Implementation:

10. Evaluation Methodology
Each of the 4 half-day sessions were provided with the satisfaction survey from UTEP
An additional satisfaction evaluation was provided by the El Paso Child Guidance Center
An overall satisfaction evaluation report was developed from all 4 sessions from the responses from UTEP’s evaluation
Evaluation Methodology

11. Content of Evaluation Forms:
State mandated satisfaction survey (Likert-Scale responses: Strongly Agree to Strongly Disagree excluding “Neutral”)
UTEP is contracted to provide trainings that will yield at least a 90% satisfaction rating
Divided into 5 categories ranging from 1-6 questions per category
Course Material & Presentation
Trainer
Application of Course Content
Overall Satisfaction
Comments
Content of Evaluation Forms:

12. Evaluation Findings: “Course Material & Presentation”
Overall satisfaction rating of course materials & presentation 98%

13. Evaluation Findings: “Trainer”
Overall satisfaction of trainer = 99%

14. Evaluation Findings: “Application of Course Content”
Overall satisfaction of application of course content = 96%

15. Evaluation Findings: “Overall Satisfaction”
Overall satisfaction rating = 98%

16. Evaluation Findings: “Comments”
Comments by the staff provided feedback that was both positive and negative, suggesting ways in which to better improve the training for the future and suggestions for others who might benefit from attending this training
Examples of Comments:
“This training was very helpful. I learned so much. I will use this material for my next CWOP. Thank you.”
“This should have been a whole day training”
“Great training! The material was very informative although it was based on trauma and I wanted more understanding about CWOP rules & regs. Loved the training”
“I think the training is directed more to children that are acute and in need of hospitalization and not a child who needs basic needs”
Evaluation Findings: “Comments”

17. Evaluation Findings: “Comments”
Comments Continued
“Excellent exercises. I texted my daughter to show her about right/wrong consequences”
“Foster parents should be given the training on de- escalation”
“Should be offered to teachers as well”
“Really enjoyed the training provided. I feel that the training has improved my skills & knowledge of working with children who are under our care”
“We were already aware of what was trained today and practice this. More examples of children in our care de- escalation needed in lieu of Dr.’s patients. His examples of child on CWOP getting up would not work with CWOP kids”
Evaluation Findings: “Comments”

18. The CWOP Training Program is only a band aid to the real crisis
As long as there are children without available foster beds, those providing the temporary supervision need the skills necessary to provide a safe and caring environment for these children
The real challenge is how to expand the number of available foster beds to meet the growth in the number of foster children – suggestions from the literature
Strategies focused on recruitment and retention
Streamlining the approval of kinship foster placements
Improving the relationship between foster parents and CPS staff
Conclusion: