Additional Counseling Considerations


Counselors bring with them their own degree of effectiveness with these generic characteristics. They also bring with them their cultural manifestations as well as their unique personal, social and psychological background. These factors interact with the cultural and personal factors brought by the client. The interaction of these two sets of factors must be explored along with other counseling-related considerations for each client who comes for counseling. The effective counselor is one who can adapt the counseling models, theories, or techniques to the unique individual needs of each client. This skill requires that the counselor be able to see the client as both an individual and as a member of a particular cultural group. Multicultural counseling requires the recognition of: (1) the importance of racial/ethnic group membership on the socialization of the client; (2) the importance of and the uniqueness of the individual; (3) the presence of and place of values in the counseling process; and (4) the uniqueness of learning styles, vocational goals, and life purposes of clients, within the context of principles of democratic social justice (Locke, 1986).


The Multicultural Awareness Continuum (Locke, 1986) was designed to illustrate the areas of awareness through which a counselor must go in the process of counseling a culturally different client. The continuum is linear and the process is developmental, best understood as a lifelong process.


Self-awareness. The first level through which counselors must pass is self-awareness. Self-understanding is a necessary condition before one begins the process of understanding others. Both intrapersonal and interpersonal dynamics must be considered as important components in the projection of beliefs, attitudes, opinions, and values. The examination of one's own thoughts and feelings allows the counselor a better understanding of the cultural "baggage" he or she brings to the situation.


Awareness of one's own culture. Counselors bring cultural baggage to the counseling situation; baggage that may cause certain things to be taken for granted or create expectations about behaviors and manners. For example, consider your own name and the meaning associated with it. Ask yourself the cultural significance of your name. Could your name have some historical significance to cultures other than the culture of your origin? There may be some relationship between your name and the order of your birth. There may have been a special ceremony conducted when you were named.
The naming process of a child is but one of the many examples of how cultural influences are evident and varied. Language is specific to one's cultural group whether formal, informal, verbal, or nonverbal. Language determines the cultural networks in which an individual participates and contributes specific values to the culture.


Awareness of racism, sexism, and poverty. Racism, sexism, and poverty are all aspects of a culture that must be understood from the perspective of how one views their effect both upon oneself and upon others. The words themselves are obviously powerful terms and frequently evoke some defensiveness. Even when racism and sexism are denied as a part of one's personal belief system, one must recognize that he/she never-the-less exists as a part of the larger culture. Even when the anguish of poverty is not felt personally, the counselor must come to grips with his or her own beliefs regarding financially less fortunate people.


Exploration of the issues of racism, sexism, and poverty may be facilitated by a "systems" approach. Such an exploration may lead to examination of the differences between individual behaviors and organizational behaviors, or what might be called the difference between personal prejudice and institutional prejudice. The influence of organizational prejudice can be seen in the attitudes and beliefs of the system in which the counselor works. Similarly, the awareness that frequently church memberships exist along racial lines, or that some social organizations restrict their membership to one sex, should help counselors come to grips with the organizational prejudice which they may be supporting solely on the basis of participation in a particular organization.


Awareness of individual differences. One of the greatest pitfalls of the novice counselor is to overgeneralize things learned about a specific culture as therefore applicable to all members of the culture. A single thread of commonality is often presumed to exist as interwoven among the group simply because it is observed in one or a few member(s) of the culture. On the contrary, cultural group membership does not require one to sacrifice individualism or uniqueness. In response to the counselor who feels all clients should be treated as "individuals," I say clients must be treated as both individuals and members of their particular cultural group.


Total belief in individualism fails to take into account the "collective family-community" relationship which exists in many cultural groups. A real danger lies in the possibility that counselors may unwittingly discount cultural influences and subconsciously believe they understand the culturally different when, in fact, they view others from their own culture's point of view. In practice, what is put forth as a belief in individualism can become a disregard for any culturally specific behaviors that influence client behaviors. In sum, counselors must be aware of individual differences and come to believe in the uniqueness of the individual before moving to the level of awareness of other cultures.


Awareness of other cultures. The four previously discussed levels of the continuum provide the background and foundation necessary for counselors to explore the varied dynamics of other cultural groups. Most cross-cultural emphasis is currently placed upon African Americans, Native Americans, Mexican Americans or Hispanics, and Asian Americans. Language is of great significance and uniqueness to each of these cultural groups, rendering standard English less than complete in communication of ideas. It is necessary for counselors to be sensitive to words which are unique to a particular culture as well as body language and other nonverbal behaviors to which cultural significance is attached.
Awareness of diversity. The culture of the United States has often been referred to as a "melting pot." This characterization suggests that people came to the United States from many different countries and blended into one new culture. Thus, old world practices were altered, discarded, or maintained within the context of the new culture. For the most part, many cultural groups did not fully participate in the melting pot process. Thus, many African American, Native American, Mexican American, and Asian American cultural practices were not welcomed as the new culture formed.

Of more recent vintage is the term "salad bowl" which implies that the culture of the United States is capable of retaining aspects from all cultures (the various ingredients). Viewed in this manner, we are seen as capable of living, working, and growing together while maintaining a unique cultural identity. "Rainbow coalition" is another term used in a recent political campaign to represent the same idea. Such concepts reflect what many have come to refer to as a multicultural or pluralistic society, where certain features of each culture are encouraged and appreciated by other cultural groups.

Skills/Techniques. The final level on the continuum is to implement what has been learned about working with culturally different groups and add specific techniques to the repertoire of counseling skills. Before a counselor can effectively work with clients of diverse cultural heritage, he or she must have developed general competence as a counselor. Passage through the awareness continuum constitutes professional growth and will contribute to an increase in overall counseling effectiveness, but goes much further than that. Counselors must be aware of learning theory and how theory relates to the development of psychological-cultural factors. Counselors must understand the relationship between theory and counselors' strategies or practices. Most importantly, counselors must have developed a sense of worth in their own cultures before attaining competence in counseling the culturally different.


Cultural Constraints


People define cultural constructs within the context of their own life histories, growth, and current situations. A working framework for competence in the care of HIV-infected clients must take the following areas of cultural concern into account for each individual:

  • Demographics: race, ethnicity, gender, age, generation
  • Communication: language(s), literacy (reading, speaking, health)
  • Education level: functional as well as actual
  • Economic status of the individual and the environment in which s/he functions
  • Occupation/means of support: work status, current means of income (legal? illegal? borderline?), labor, profession
  • Geography: current residence, community/neighborhood, place of birth, legal status, travel, nationality, etc.
  • Environment and situational context: safety of communities in which the individual spends a significant amount of time; risks related to violence, fear of violence, or coercion; communities of risk (i.e., drug/alcohol use, anonymous sex)
  • Personal relationships: family, friends, partnerships, sex, drugs, etc.
  • Health (physical, emotional, mental): norms, beliefs, practices, preferred providers, taboos; definitions of health, disease/sick role, disability, and care; HIV and other disease diagnoses, treatments, achievements; perceptions (developed over time) of efficacy, value, and disparity/discrimination in relationships with various healthcare systems and providers
  • Gender and sex: gender, gender roles, transitions, sexual orientation, sexual intercourse
  • Community affiliations: religious, political, service, social, etc.
  • Culture-specific definitions: spirituality, art, ethics, value, locus of control, power
  • Individual experiences: development over time that has lead the individual to accept, reject, and/or modify cultural components that were imparted to him/her as a child; life experiences that have expanded, challenged, realigned, or reinforced early cultural influences; individual constellation of factors that make up her/his cultural orientation
  • Culture comfort: has the individual integrated a personal set of cultural influences into his/her life? how do those beliefs and practices intersect with health practices and self-acceptance? can the individual function within larger social systems (family, community, social structures)? is the individual in a state of cognitive dissonance, discord, or discomfort with/between the values of personal, familial, and/or social cultures?

Providers. Healthcare providers possess knowledge and skills that were developed in a process of professional education. They have their own language, expectations, and professional cultures.  They also have responsibilities:

  • To develop skills to assess individual client cultures and to work with the client to integrate components of that culture into a care and treatment plan that the client can accept.
  • To be open to learning about the ways of others and willing to see past stereotypes when working with individuals and families.
  • To suspend judgment, especially in the assessment phases of care.
  • To remember that individuals are unique even within groups: some Hispanics do not speak Spanish, some women are not mothers, some Catholics use birth control, and some college-educated people use alternative/traditional healthcare practices.
  • To adopt an attitude of service to the client and the community.
  • To explore, understand, and honor their own cultural definitions and values.
  • To constantly compare personal culture(s) within the context of professional obligations.
  • To deal with any dissonance that occurs between cultures by “honoring and setting aside” or by making personally acceptable changes and developing methods of dealing with larger culture clashes and ethical dilemmas that can occur in cross-cultural settings.
  • To accept responsibility as the power broker in healthcare situations to address healthcare in a holistic manner that includes culture.

Client. The client also has obligations:

  • To share the components of her/his culture that will impact on the ability to seek care, to participate in the process of developing a healthcare plan, and to implement care prescriptions.
  • To seek care from providers who understand his/her culture.
  • To teach providers who are open to these discussions.

Unfortunately, many clients feel that they are in a “one down” position in ANY healthcare setting, especially if they are poor, do not understand healthcare systems, have cultural constraints against disagreeing with authority figures, or already suffer from discrimination by virtue of race, ethnicity, gender, status, or diagnosis (especially HIV, drug use, mental health problems, and STDs).  Because of this, the provider’s responsibility to honor various cultures is imperative.


Overview of Cultural Diversity and Mental Health Services


The U.S. mental health system is not well equipped to meet the needs of racial and ethnic minority populations. Racial and ethnic minority groups are generally considered to be underserved by the mental health services system (Neighbors et al., 1992; Takeuchi & Uehara, 1996; Center for Mental Health Services [CMHS], 1998). A constellation of barriers deters ethnic and racial minority group members from seeking treatment, and if individual members of groups succeed in accessing services, their treatment may be inappropriate to meet their needs.


Awareness of the problem dates back to the 1960s and 1970s, with the rise of the civil rights and community mental health movements (Rogler et al., 1987) and with successive waves of immigration from Central America, the Caribbean, and Asia (Takeuchi & Uehara, 1996). These historical forces spurred greater recognition of the problems that minority groups confront in relation to mental health services.


Research documents that many members of minority groups fear, or feel ill at ease with, the mental health system (Lin et al., 1982; Sussman et al., 1987; Scheffler & Miller, 1991). These groups experience it as the product of white, European culture, shaped by research primarily on white, European populations. They may find only clinicians who represent a white middle-class orientation, with its cultural values and beliefs, as well as its biases, misconceptions, and stereotypes of other cultures.


Research and clinical practice have propelled advocates and mental health professionals to press for “linguistically and culturally competent services” to improve utilization and effectiveness of treatment for different cultures. Culturally competent services incorporate respect for and understanding of, ethnic and racial groups, as well as their histories, traditions, beliefs, and value systems (CMHS, 1998). Without culturally competent services, the failure to serve racial and ethnic minority groups adequately is expected to worsen, given the huge demographic growth in these populations predicted over the next decades (Takeuchi & Uehara, 1996; CMHS, 1998; Snowden, 1999).


This section of the chapter amplifies these major conclusions. It explains the confluence of clinical, cultural, organizational, and financial reasons for minority groups being underserved by the mental health system. The first task, however, is to explain which ethnic and racial groups constitute underserved populations, to describe their changing demographics, and to define the term “culture” and its consequences for the mental health system.


Introduction to Cultural Diversity and Demographics


The Federal government officially designates four major racial or ethnic minority groups in the United States: African American (black), Asian/Pacific Islander, Hispanic American (Latino), and Native American/American Indian/Alaska Native/Native Hawaiian (referred to subsequently as “American Indians”) (CMHS, 1998). There are many other racial or ethnic minorities and considerable diversity within each of the four groupings listed above. The representation of the four officially designated groups in the U.S. population in 1999 is as follows: African Americans constitute the largest group, at 12.8 percent of the U.S. population; followed by Hispanics (11.4 percent), Asian/Pacific Islanders (4.0 percent), and American Indians (0.9 percent) (U.S. Census Bureau, 1999). Hispanic Americans are among the fastest-growing groups. Because their population growth outpaces that of African Americans, they are projected to be the predominant minority group (24.5 percent of the U.S. population) by the year 2050 (CMHS, 1998).


Racial and ethnic populations differ from one another and from the larger society with respect to culture. The term “culture” is used loosely to denote a common heritage and set of beliefs, norms, and values. The cultures with which members of minority racial and ethnic groups identify often are markedly different from industrial societies of the West. The phrase “cultural identity” specifies a reference group—an identifiable social entity with whom a person identifies and to whom he or she looks for standards of behavior (Cooper & Denner, 1998). Of course, within any given group, an individual’s cultural identity may also involve language, country of origin, acculturation, gender, age, class, religious/spiritual beliefs, sexual orientation, and physical disabilities (Lu et al., 1995). Many people have multiple ethnic or cultural identities.


The historical experiences of ethnic and minority groups in the United States are reflected in differences in economic, social, and political status. The most measurable difference relates to income. Many racial and ethnic minority groups have limited financial resources. In 1994, families from these groups were at least three times as likely as white families to have incomes placing them below the Federally established poverty line. The disparity is even greater when considering extreme poverty—family incomes at a level less than half of the poverty threshold—and is also large when considering children and older persons (O’Hare, 1996). Although some Asian Americans are somewhat better off financially than other minority groups, they still are more than one and a half times more likely than whites to live in poverty. Poverty disproportionately affects minority women and their children (Miranda & Green, 1999). The effects of poverty are compounded by differences in total value of accumulated assets, or total wealth (O’Hare et al., 1991).


Lower socioeconomic status—in terms of income, education, and occupation—has been strongly linked to mental illness. It has been known for decades that people in the lowest socioeconomic strata are about two and a half times more likely than those in the highest strata to have a mental disorder (Holzer et al., 1986; Regier et al., 1993b). The reasons for the association between lower socioeconomic status and mental illness are not well understood. It may be that a combination of greater stress in the lives of the poor and greater vulnerability to a variety of stressors leads to some mental disorders, such as depression. Poor women, for example, experience more frequent, threatening, and uncontrollable life events than do members of the population at large (Belle, 1990). It also may be that the impairments associated with mental disorders lead to lower socioeconomic status (McLeod & Kessler, 1990; Dohrenwend, 1992; Regier et al., 1993b).


Cultural identity imparts distinct patterns of beliefs and practices that have implications for the willingness to seek, and the ability to respond to, mental health services. These include coping styles and ties to family and community, discussed below.


Coping Styles


Cultural differences can be reflected in differences in preferred styles of coping with day-to-day problems. Consistent with a cultural emphasis on restraint, certain Asian American groups, for example, encourage a tendency not to dwell on morbid or upsetting thoughts, believing that avoidance of troubling internal events is warranted more than recognition and outward expression (Leong & Lau, 1998). They have little willingness to behave in a fashion that might disrupt social harmony (Uba, 1994). Their emphasis on willpower is similar to the tendency documented among African Americans to minimize the significance of stress and, relatedly, to try to prevail in the face of adversity through increased striving (Broman, 1996).


Culturally rooted traditions of religious beliefs and practices carry important consequences for willingness to seek mental health services. In many traditional societies, mental health problems can be viewed as spiritual concerns and as occasions to renew one’s commitment to a religious or spiritual system of belief and to engage in prescribed religious or spiritual forms of practice. African Americans (Broman, 1996) and a number of ethnic groups (Lu et al., 1995), when faced with personal difficulties, have been shown to seek guidance from religious figures.


Many people of all racial and ethnic backgrounds believe that religion and spirituality favorably impact upon their lives and that well-being, good health, and religious commitment or faith are integrally intertwined (Taylor, 1986; Priest, 1991; Bacote, 1994; Pargament, 1997). Religion and spirituality are deemed important because they can provide comfort, joy, pleasure, and meaning to life as well as be means to deal with death, suffering, pain, injustice, tragedy, and stressful experiences in the life of an individual or family (Pargament, 1997). In the family/community-centered perception of mental illness held by Asians and Hispanics, religious organizations are viewed as an enhancement or substitute when the family is unable to cope or assist with the problem (Acosta et al., 1982; Comas-Diaz, 1989; Cook & Timberlake, 1989; Meadows, 1997).


Culture also imprints mental health by influencing whether and how individuals experience the discomfort associated with mental illness. When conveyed by tradition and sanctioned by cultural norms, characteristic modes of expressing suffering are sometimes called “idioms of distress” (Lu et al., 1995). Idioms of distress often reflect values and themes found in the societies in which they originate.


One of the most common idioms of distress is somatization, the expression of mental distress in terms of physical suffering. Somatization occurs widely and is believed to be especially prevalent among persons from a number of ethnic minority backgrounds (Lu et al., 1995). Epidemiological studies have confirmed that there are relatively high rates of somatization among African Americans (Zhang & Snowden, in press). Indeed, somatization resembles an African American folk disorder identified in ethnographic research and is linked to seeking treatment (Snowden, 1998).


A number of idioms of distress are well recognized as culture-bound syndromes and have been included in an appendix to DSM-IV. Among culture-bound syndromes found among some Latino psychiatric patients is ataque de nervios, a syndrome of “uncontrollable shouting, crying, trembling, and aggression typically triggered by a stressful event involving family. . . ” (Lu et al., 1995, p. 489). A Japanese culture-bound syndrome has appeared in that country’s clinical modification of ICD-10 (WHO International Classification of Diseases, 10th edition, 1993). Taijin kyofusho is an intense fear that one’s body or bodily functions give offense to others. Culture-bound syndromes sometimes reflect comprehensive systems of belief, typically emphasizing a need for a balance between opposing forces (e.g., yin/yang, “hot-cold” theory) or the power of supernatural forces (Cheung & Snowden, 1990). Belief in indigenous disorders and adherence to culturally rooted coping practices are more common among older adults and among persons who are less acculturated. It is not well known how applicable DSM-IV diagnostic criteria are to culturally specific symptom expression and culture-bound syndromes.


Family and Community as Resources


Ties to family and community, especially strong in African, Latino, Asian, and Native American communities, are forged by cultural tradition and by the current and historical need to assist arriving immigrants, to provide a sanctuary against discrimination practiced by the larger society, and to provide a sense of belonging and affirming a centrally held cultural or ethnic identity.


Among Mexican-Americans (del Pinal & Singer, 1997) and Asian Americans (Lee, 1998) relatively high rates of marriage and low rates of divorce, along with a greater tendency to live in extended family households, indicate an orientation toward family. Family solidarity has been invoked to explain relatively low rates among minority groups of placing older people in nursing homes (Short et al., 1994).


The relative economic success of Chinese, Japanese, and Korean Americans has been attributed to family and communal bonds of association (Fukuyama, 1995). Community organizations and networks established in the United States include rotating credit associations based on lineage, surname, or region of origin. These organizations and networks facilitate the startup of small businesses.


Families play an important role in providing support to individuals with mental health problems. A strong sense of family loyalty means that, despite feelings of stigma and shame, families are an early and important source of assistance in efforts to cope, and that minority families may expect to continue to be involved in the treatment of a mentally ill member (Uba, 1994). Among Mexican American families, researchers have found lower levels of expressed emotion and lower levels of relapse (Karno et al., 1987). Other investigators have demonstrated an association between family warmth and a reduced likelihood of relapse (Lopez et al., in press).


Duty to Report Child Abuse


All States, the District of Columbia, the Commonwealth of Puerto Rico, and the U.S. territories of American Samoa, Guam, the Northern Mariana Islands, and the Virgin Islands have statutes identifying mandatory reporters of child maltreatment. A mandatory reporter is a person who is required by law to make a report of child maltreatment under specific circumstances. Approximately 48 States, the District of Columbia, Puerto Rico, and the territories have designated individuals, typically by professional group, who are mandated by law to report child maltreatment. Individuals typically designated as mandatory reporters have frequent contact with children. Such individuals may include:

  • Social workers
  • Marriage Family Therapist
  • Psychologists
  • Interns
  • Counselors
  • School personnel
  • Health care workers
  • Mental health professionals
  • Childcare providers
  • Medical examiners or coroners
  • Law enforcement officers

Some other professions frequently mandated across the States include commercial film or photograph processors (in 11 States and 2 territories), substance abuse counselors (in 13 States), and probation or parole officers (in 13 States). Six States (Alaska, Arizona, Arkansas, Connecticut, Illinois, and South Dakota) include domestic violence workers on the list of mandated reporters. Members of the clergy now are required to report in 25 States.


Reporting by Other Persons


Approximately 18 States and Puerto Rico require all citizens to report suspected abuse or neglect, regardless of profession. In all other States, territories, and the District of Columbia, any person is permitted to report. These voluntary reporters of abuse are often referred to as "permissive reporters."


Standards for Making a Report


The standards used to determine under what circumstances a mandatory reporter should make a report vary from State to State. Typically, a report must be made when the reporter, in his or her official capacity, suspects or has reasons to believe that a child has been abused or neglected. Another standard frequently used is when the reporter has knowledge of, or observes a child being subjected to, conditions that would reasonably result in harm to the child. Permissive reporters follow the same standards when electing to make a report.


Privileged Communications


Mandatory reporting statutes also may specify when a communication is privileged. "Privileged communications" is the statutory recognition of the right to maintain the confidentiality of communications between professionals and their clients or patients. To enable States to provide protection to maltreated children, the reporting laws in most States and territories restrict this privilege for mandated reporters. All but 5 States and Puerto Rico currently address the issue of privilege within their reporting laws, either affirming the privilege or denying it, that is, not allowing privilege to be a reason for failing to report. The physician-patient and husband-wife privileges are most commonly denied by States. The attorney-client privilege is most commonly recognized. The clergy-penitent privilege is also widely recognized, although that privilege is usually limited to confessional communications and, in some States, is denied altogether.


Inclusion of the Reporter's Name in the Report


Most States maintain toll-free telephone numbers for receiving reports of abuse or neglect. Reports may be made anonymously to most of these reporting numbers, but States find it helpful to their investigations to know the identity of reporters. Approximately 16 States, the District of Columbia, American Samoa, Guam, and the Virgin Islands currently require mandatory reporters to provide their names and contact information, either at the time of the initial oral report or as part of the written report. The laws in Connecticut, Delaware, and Washington allow child protection workers to request the name of the reporter. In Wyoming, the reporter does not have to provide his or her identity as part of the written report, but if the person takes and submits photographs or x-rays of the child, his or her name must then be provided.

Disclosure of the Reporter's Identity


All jurisdictions have provisions in statute to maintain the confidentiality of abuse and neglect records. The identity of the reporter is specifically protected from disclosure to the alleged perpetrator in 39 States, the District of Columbia, Puerto Rico, and the territories of American Samoa, Guam, and the Northern Mariana Islands. This protection is maintained even when other information from the report is being disclosed.


Release of the reporter's identity can be allowed in some jurisdictions under specific circumstances or to specific departments or officials. For example, disclosure of the reporter's identity can be ordered by the court when there is a compelling reason to disclose (in California, Mississippi, Oklahoma, Tennessee, and Guam), or upon a finding that the reporter knowingly made a false report (in Alabama, Arkansas, Connecticut, Kentucky, Louisiana, Minnesota, South Dakota, and Vermont). In some jurisdictions (California, Florida, Minnesota, Vermont, the District of Columbia, and Guam), the reporter can waive confidentiality and give consent to the release of his or her name.


Below is a state by state list which includes the following:


Mandated Reporters
Standards for Making a Report
Privileged Communications
Inclusion of the Reporter's Name in the Report
Disclosure of the Reporter's Identity
Reporting by Other Persons


Because laws often change be sure to stay current with the Child Abuse reporting laws in your state.


Philosophy of Child Protective Services


The basic philosophical tenets of CPS include the following:


A safe and permanent home and family is the best place for children to grow up. Every child has a right to adequate care and supervision and to be free from abuse, neglect, and exploitation. It is the responsibility of parents to see that the physical, mental, emotional, educational, and medical needs of their children are adequately met. CPS should intervene only when parents request assistance or fail, by their acts or omissions, to meet their children's basic needs and keep them safe.


Most parents want to be good parents and, when adequately supported, they have the strength and capacity to care for their children and keep them safe. Most children are best cared for in their own family. Therefore, CPS focuses on building family strengths and provides parents with the assistance needed to keep their children safe so that the family may stay together.


Families who need assistance from CPS agencies are diverse in terms of structure, culture, race, religion, economic status, beliefs, values, and lifestyles. CPS agencies and practitioners must be responsive to and respectful of these differences. Further, CPS caseworkers should build on the strengths and protective factors within families and communities. They should advocate for families and help families gain access to the services they need. Often, securing access means helping families overcome barriers rooted in poverty or discrimination, such as readily accessible transportation to services.


CPS agencies are held accountable for achieving outcomes of child safety, permanence, and family well-being. To achieve safety and permanence for children, CPS must engage families in identifying and achieving family-level outcomes that reduce the risk of further maltreatment and ameliorate the effects of maltreatment that has already occurred.


CPS efforts are most likely to succeed when clients are involved and actively participate in the process. Whatever a caseworker's role, he or she must have the ability to develop helping alliances with family members. CPS caseworkers need to work in ways that encourage clients to fully participate in assessment, case planning, and other critical decisions in CPS intervention.


When parents cannot or will not fulfill their responsibilities to protect their children, CPS has the right and obligation to intervene directly on the children's behalf. Both laws and good practice maintain that interventions should be designed to help parents protect their children and should be as unobtrusive as possible. CPS must make reasonable efforts to develop safety plans to keep children with their families whenever possible, although they may refer for juvenile or family court intervention and placement when children cannot be kept safely within their own homes. To read more about the working relationship between CPS and the court system, please refer to the user manual on working with the courts.


When children are placed in out-of-home care because their safety cannot be assured, CPS should develop a permanency plan as soon as possible. In most cases, the preferred permanency plan is to reunify children with their families. All children need continuity in their lives, so if the goal is family reunification, the plan should include frequent visits between children and their families as well as other efforts to sustain the parent-child relationship while children are in foster care. In addition, the CPS agency must immediately work with the family to change the behaviors and conditions that led to the maltreatment and necessitated placement in out-of-home care.


To best protect a child's overall well-being, agencies want to assure that children move to permanency as quickly as possible. Therefore, along with developing plans to support reunification, agencies should develop alternative plans for permanence once a child enters the CPS system. As soon as it has been determined that a child cannot be safely reunited with his or her family, CPS must implement the alternative permanency plan.


Responsibilities of Child Protective Services


According to the National Association of Public Child Welfare Administrators (NAPCWA), the mission of the child protective services (CPS) agency is to:

  • Assess the safety of children;
  • Intervene to protect children from harm;
  • Strengthen the ability of families to protect their children;
  • Provide either a reunification or an alternative, safe family for the child.

CPS is the central agency in each community that receives reports of suspected child abuse and neglect; assesses the risk to and safety of children; and provides or arranges for services to achieve safe, permanent families for children who have been abused or neglected or who are at risk of abuse or neglect. The CPS agency also facilitates community collaborations and engages formal and informal community partners to support families and protect children from abuse and neglect. To fulfill its mission, CPS must provide services, either directly or through other agencies, which are child-centered, family-focused, and culturally responsive to achieve safety, well-being, and permanency for children. When families are unable or unwilling to keep children safe, CPS petitions juvenile or family court on the child's behalf either to recommend strategies to keep children safe at home or to be placed in out-of-home care. This chapter provides an overview of the seven stages of the CPS process, which are described in more detail throughout the manual.


Intake


CPS is responsible for receiving and evaluating reports of suspected child abuse and neglect, determines if the reported information meets the statutory and agency guidelines for child maltreatment, and judges the urgency with which the agency must respond to the report. In addition, CPS educates individuals who report allegations of child abuse or neglect (frequently referred to as "reporters") about State statutes, agency guidelines, and the roles and responsibilities of CPS.


Initial Assessment or Investigation


After receiving a report, CPS conducts an initial assessment or investigation to determine:

  • If child maltreatment occurred;
  • If the child's immediate safety is a concern and, if it is, the interventions that will ensure the child's protection while keeping the child within the family or with family members (e.g., kinship care or subsidized guardianship), if at all possible;
  • If there is a risk of future maltreatment and the level of that risk;
  • If continuing agency services are needed to address any effects of child maltreatment and to reduce the risk of future maltreatment.

The terms "assessment" and "investigation" are used interchangeably in many States and territories, but they are not synonymous. Investigation encompasses the efforts of the CPS agency to determine if abuse or neglect has occurred. Assessment goes beyond this concept to evaluate a child's safety and risk, and to determine whether and what services are needed to ameliorate or prevent child abuse and neglect.


The initial assessment or investigation is not just a fact-finding process; it establishes the tone for all future work that may take place with a particular family. During the initial assessment or investigation, CPS must determine whether child abuse and neglect occurred and can be substantiated and whether to conduct an evaluation to determine the risk of maltreatment occurring in the future. CPS also must establish rapport with family members and engage them in the intervention process.


Family Assessment


Once a determination of child abuse or neglect has been made and the child's immediate safety has been ensured, the next step is to conduct a family assessment. During this step, the caseworker engages family members in a process to understand their strengths and needs. In particular, the caseworker works with the family to:

  • Identify family strengths that can provide a foundation for change;
  • Reduce the risk of maltreatment by identifying and addressing factors that place children at risk;
  • Help children cope with the effects of maltreatment.

Since the impact of child maltreatment depends on the interaction of risk and protective factors, using an ecological developmental framework for this assessment is often appropriate


Case Planning


In order to achieve the desired programmatic outcomes of CPS (i.e., child safety, child permanency, child and family well-being), interventions must be well planned and purposeful. These outcomes are achieved through three types of plans:

  • A safety plan, which is developed whenever it is determined that the child is at risk of imminent harm;
  • A case plan, which follows the family assessment and sets forth goals and outcomes and describes how the family will work toward these outcomes;
  • A concurrent permanency plan, which identifies alternative forms of permanency and addresses both how reunification can be achieved and how legal permanency with a new family might be achieved if reunification efforts fail.

All three plans should be developed collaboratively, when possible, among the CPS caseworker, the family, and community professionals who will provide services to the family.


Service Provision


This is the stage during which the case plan is implemented. It is CPS's role to arrange, provide, and coordinate the delivery of services to children and families. When possible, the services that are selected to help families achieve goals and outcomes should be based on an appropriate match of services to goals and should use best practice principles. When needed services are not readily available or accessible, an interim or alternative plan must be made with families.


Family Progress


Assessment is an ongoing process that begins with the first client contact, continues throughout the life of the case, and should incorporate reports from other service providers. When evaluating family progress, caseworkers focus on:

  • Ensuring the child's safety;
  • Reducing the risk of maltreatment;
  • Addressing successfully any of the effects of maltreatment on the child and family;
  • Achieving the goals and tasks in the case plan;
  • Achieving family-level outcomes.

Case Closure


The process of ending the relationship between the CPS worker and the family involves a mutual review of the progress made throughout the helping relationship. Optimally, cases are closed when families have achieved their goals and the risk of maltreatment has been reduced or eliminated.


Some closings occur because the client discontinues services, and the agency does not have a sufficient basis to refer the situation to juvenile or family court. Other cases are closed, however, when families still need assistance. When this happens, the caseworker should carefully document what risks may still be present so this information is available should the family be referred to the agency at a later time. At the time of closure, workers should involve the family in a discussion about what has changed over time and what goals they may still have. When family needs are still apparent and are outside the scope of the CPS system, every effort should be made to help the family receive services through appropriate community agencies.


Gathering Information from Reporters


The more comprehensive the information provided by the reporter, the more experienced caseworkers are able to determine the appropriateness of the report for CPS intervention; whether the child is safe; and the urgency of the response needed. State and local child protection agencies have guidelines for information-gathering at intake. In general, caseworkers should obtain information on:

  • The contact information for the child and family, which helps to locate the child and family and determine if the child is at immediate risk of harm;
  • The alleged maltreatment, including type, nature, severity, chronicity, and where it occurred;
  • The child, including the child's condition and behavior, which helps in evaluating whether the child is in immediate risk of harm or danger and determining the urgency and type of the response;
  • The parent or caregiver, including their emotional and physical condition, behavior, history, view of the child, child-rearing practices, and relationships outside the family;
  • The family, including family characteristics, dynamics, and supports.

More detailed information that should be collected from the reporter within each of these areas. Although not every reporter will have all the information described, it is important to attempt to gather it to guide the investigation and ensure the appropriate decisions at intake. This may be the only opportunity the agency has to talk with the reporter.
Gathering this detailed information is essential to determine if the child is safe and how quickly contact with the family must be made to assure safety. It also enables caseworkers to identify the victim, the parent or caregiver, and the maltreater (if different from the parent or caregiver), and to determine how to locate them so that the initial assessment or investigation can be conducted. In addition, information from the reporter may identify other possible sources of information about the family and the possibility of past, current, or future abuse or neglect. Finally, it will assist the caseworker responsible for the initial assessment or investigation in planning the approach to the investigation in an accurate and effective manner.


Providing Support to Reporters


Reports of child abuse and neglect are most often initiated by telephone and may come from any number of sources. Each reporter should be given support and encouragement for making the decision to report. In addition, the reporter's fears and concerns should be elicited and addressed. These can range from fear that the family will retaliate to fear of having to testify in court.


It is often very difficult for the reporter to make the call. The telephone call usually comes after much thought has been given to the possible consequences to the child and family. More than likely, the reporter has considered that it would be easier just to do nothing or that the CPS system may not be able to help the family. It may be difficult for a reporter to think that this call will actually help the family rather than hurt it. Simple verbal reassurances or a follow-up letter that expresses the agency's gratitude to the reporter for taking the initiative to call can make the difference in the reporter's future willingness to cooperate.


Intake Information Analysis


Upon receiving a referral, the intake worker or caseworker attempts to gather as much information as possible about each family member; the family as a whole; and the nature, extent, severity, and chronicity of the alleged child maltreatment. Once the initial intake information is collected, the caseworker conducts a check of agency records or, in some States, a central registry to determine any past reports or contact with the family. Then the caseworkers must collect and analyze the information and determine if it meets the following criteria.


Statutory and Agency Guidelines


This determination is made by comparing the data collected to State law regarding the definition of child abuse and neglect and the requirements for State or county response; agency policies interpreting the laws and practice standards; agency or office customs regarding further refinement of definitions; required response times; and practical issues, such as jurisdictional authority or caseload management.

 


Credibility
An essential step in the intake process is determining the consistency and accuracy of the information being reported. In some locations, the intake workers take all reports and the investigator determines the credibility of the report; in other locations, the intake workers determine the credibility of the report. Sometimes caseworkers question the validity of the report suspecting it may be influenced by a contentious divorce, custody battle, or bad neighbor relationships. Regardless of suspicions about the motives of the reporter, if the allegations meet the statutory and agency guidelines, the case must be accepted.


A number of questions will help caseworkers evaluate the credibility of the report:

  • Is the reporter willing to give his or her name, address, and telephone number?
  • What is the reporter's relationship to the victim and family?
  • How well does the reporter know the family?
  • Does the reporter know of previous abuse or neglect? What has led him or her to report now?
  • How does the reporter know about the case?
  • Does the reporter stand to gain anything from reporting?
  • Has the reporter made previous unfounded reports on this family?
  • Is the reporter willing to meet with a caseworker in person if needed?
  • Does the reporter appear to be intoxicated, extremely bitter, angry, or exhibiting behavior that makes the caseworker question his or her competency?
  • Can or will the reporter refer CPS to others who know about the situation?
  • What does the reporter hope will happen as a result of the report?
  • Does the reporter fear reprisal from family?
  • Does the reporter fear self-incrimination? For example, due to substance-abusing behavior or participation in physically abusive behavior.

When an Initial Assessment or Investigation Is Warranted


One of the primary decisions in the intake process is whether or not to accept a report for a CPS investigation. This decision is based on the law, agency policy, and information about the characteristics of the case that are likely to indicate, or result in, harm to the child. The appropriateness of this decision depends on the ability of the caseworker to gather critical and accurate information about the family and the alleged maltreatment and to apply law and policy to the information gathered.
States have different criteria and tools for acceptance of the report. Some of the steps caseworkers should take in making this decision include:

  • Referring to State law. The law defines what is considered child maltreatment under State statutes. These definitions are the caseworkers' ultimate source of guidance.
  • Reviewing agency policies. Agency policies include State and local guidelines. They may have additional information regarding definitions and how to respond to different types of reports.
  • Discussing with the supervisor how these guidelines are implemented in the office. Sometimes customs develop among caseworkers or units that may not reflect agency guidelines. This often occurs as a result of many years of practice and improvisation over time. Unfortunately, these adaptations to circumstances may lead caseworkers away from carrying out their mandated responsibilities.

Whether to accept a case for initial assessment or investigation or to refer it to other community agencies depends on the following:

  • If the child appears to be at risk of harm due to circumstances other than direct parental or caregiver maltreatment, are there other agencies that can intervene quickly enough to guard the safety of the child? For example, in cases of partner abuse with the child in the home, the police are often the most appropriate first responders. CPS also may need to be involved if it is determined that there is potential for harm to the child.
  • Problems that may be more appropriately served by other agencies include parental substance abuse, parental or child physical or mental illness, developmental disability, lack of resources to meet basic needs, lack of information about appropriate parenting, lack of sufficient support systems during a crisis, lack of daycare, the child's constant truancy, or severe learning problems that do not endanger the child.
  • The circumstances that could result in imminent danger to the child should be determined, as well as whether a referral to an appropriate agency will ensure service delivery; whether the connection between appropriate services and the family is so tenuous that the child may not receive the needed intervention, thereby requiring protective intervention; or whether an initial report focused on the need for other services is masking other, more serious, dangers to the child.

This decision is based on having accurate and comprehensive information as well as the ability of the worker to assess and use the information to develop a clear picture of the situation and to apply the law and policy to the case. Agency screening tools can be helpful in making this decision.

Immediate Risk


Determining the urgency of the response to the report is essential to the safety assessment. CPS's primary concern should be to establish whether the child is safe, pending a face-to-face contact by the agency or another professional trained in assessing safety. Many States have their own criteria for response times based on the nature of the report. The criteria considered are the level of severity of the incident or the harm to the child, the person responsible for the alleged abuse or neglect, and the family's situation.


Response Time


Once it has been determined that an initial assessment or investigation is warranted, the next step is to determine the safety of the child and how quickly CPS must respond to the case. Many States have their own criteria for response times based on the nature of the maltreatment and the family situation.
The following factors generally are used by CPS agencies to distinguish between reports that require an immediate response, reports requiring a response within 24 hours, and reports that require a CPS response but do not involve immediate or continuing danger of serious harm to the child. CPS should respond immediately when:

  • The child's injury is severe or the alleged maltreatment could have resulted in serious harm—for example, shooting a gun, pushing a child down the stairs, locking a child in a small enclosed space, not providing enough food to eat over an extended period of time, or locking a toddler out of the house without supervision.
  • The child is particularly vulnerable because of age, illness, disability, or proximity to the alleged perpetrator, or the child is a danger to himself or herself, or others.
  • The behavior of the parent or caregiver, including an inability to take care of the child, is known to have caused harm or endangered the child or others. Or the behavior of the parent or caregiver is unpredictable and could result in serious harm to the child.
  • There is no person who is able and willing to act on the child's behalf in the time that is required to keep the child safe long enough for CPS to intervene within normal time frames.
  • The family is likely to flee the area with the child or abandon the child.
  • The report involves child sexual abuse, and the child continues to have contact with the alleged perpetrator.
  • The child has current physical injuries that need to be documented, such as photographing injuries or measuring bruises.

Case Examples


The caseworker must examine the total picture to evaluate if there is a clear opportunity for the child to be seriously harmed if there is no immediate intervention. To determine how quickly the agency must respond to a particular case, caseworkers must consider the factors that individually present a risk to the child, as well as any factors (such as domestic violence or substance abuse) that in combination present an even greater risk to the child. The presence of several factors and one or more combinations of factors requires an immediate response by CPS.


Case Examples
A Case Requiring an Immediate CPS Response:


A single mother who has been diagnosed as having paranoid schizophrenia is having delusions of killing her 6-month-old infant. The mother stopped taking her medication (often required when pregnant) and has been drinking heavily. The community psychiatric nurse who has been visiting the home weekly was told by the mother never to come back.

A Case Requiring a CPS Response Within 24 Hours:
A daycare provider reports a 3½-year-old child because he has bruises and welts on his buttocks. The child provides three different stories of how they occurred, none of which seem plausible. There are no previous reports of maltreatment and the daycare provider who has been caring for this child for 18 months has never seen bruises before. The daycare provider reports that the mother drops off and picks up the son. The child is very active, difficult to manage, and has attempted to hurt other children.

A Case Not Requiring a CPS Response Within 24 Hours:
During the first 3 months of school, the children of a single mother were absent over one-half of the days. When the 7-year-old girl and 10-year-old boy do come to school, they have severe body odor and dirty clothes. The school nurse treated the children for lice and scabies, and the 7-year-old falls asleep in class. The school has contacted the mother, who has not followed through with any of her commitments regarding the children.

Initial Assessment or Investigation Decisions
To make effective decisions during the initial assessment or investigation process, the CPS caseworker must have competent interviewing skills; be able to gather, organize, and analyze information; and arrive at accurate conclusions. Critical decisions that must be made at this stage of the CPS process include the following:

  • Is child maltreatment substantiated as defined by State statute or agency policy?
  • Is the child at risk of maltreatment, and what is the level of risk?
  • Is the child safe and, if not, what type of agency or community response will ensure the child's safety in the least intrusive manner?
  • If the child's safety cannot be assured within the family, what type and level of care does the child need?
  • Does the family have emergency needs that must be met?
  • Should ongoing agency services be offered to the family?

Decision Point One: Substantiating Maltreatment
The substantiation decision depends on the answers to two questions: "Is the harm to the child severe enough to constitute child maltreatment?" and "Is there sufficient evidence to support this being a case of child maltreatment?" Even in those cases lacking evidence, CPS caseworkers should still document information since unsubstantiated reports may eventually show a pattern that can be substantiated. Due to varying State regulations regarding the expungement of records, this may not be possible for all agencies.


Upon completion of the initial assessment, the caseworker must determine the disposition of the report based on State laws, agency guidelines, and the information gathered. CPS agencies use different terms for this decision—substantiated, confirmed, unsubstantiated, founded, or unfounded. To guide caseworker judgment in making the substantiation decision, each State has developed policies that outline what constitutes credible evidence that abuse or neglect has occurred. Most States have a two-tiered system: substantiated-unsubstantiated or founded-unfounded. Some States have a three-tiered system of substantiated, indicated, or unsubstantiated. The indicated classification means the caseworker has some evidence that maltreatment occurred, but not enough to substantiate the case.
At this point in the decision-making process, caseworkers should ask themselves:

  • Have I obtained enough information from the children, family, and collateral contacts to adequately reach a determination about the alleged abuse or neglect?
  • Is my decision on substantiation based upon a clear understanding of State laws and agency policies?
  • Have I assessed the need for other agency or community services when CPS intervention is not warranted?

The following sections discuss substantiation decisions for different types of maltreatment—child neglect, physical abuse, sexual abuse, and psychological maltreatment.


Determining Child Neglect


Determining child neglect is based on the answers to two questions: "Do the conditions or circumstances indicate that a child's basic needs are unmet?" and "What harm or threat of harm may have resulted? Answering these questions requires sufficient information to assess the degree to which omissions in care have resulted in significant harm or significant risk of harm. Unlike the other forms of maltreatment, this determination may not be reached by looking at one incident; the decision often requires looking at patterns of care over time. The analysis should focus on examining how the child's basic needs are met and identifying situations that may indicate specific omissions in care that have resulted in harm or the risk of harm to the child.


Affirmative answers to the following questions may indicate that a child's physical and medical needs are unmet:

  • Have the parents or caregivers failed to provide the child with needed care for a physical injury, acute illness, physical disability, or chronic condition?
  • Have the parents or caregivers failed to provide the child with regular and ample meals that meet basic nutritional requirements, or have the parents or caregivers failed to provide the necessary rehabilitative diet to the child with particular health problems?
  • Have the parents or caregivers failed to attend to the cleanliness of the child's hair, skin, teeth, and clothes? It is difficult to determine the difference between marginal hygiene and neglect. Caseworkers should consider the chronicity, extent, and nature of the condition, as well as the impact on the child.
  • Does the child have inappropriate clothing for the weather and conditions? Caseworkers must consider the nature and extent of the conditions and the potential consequences to the child.
  • Does the home have obvious hazardous physical conditions? For example, homes with exposed wiring or easily accessible toxic substances.
  • Does the home have obvious hazardous unsanitary conditions? For example, homes with feces- or trash-covered flooring or furniture.
  • Does the child experience unstable living conditions? For example, frequent changes of residence or evictions due to the caretaker's mental illness, substance abuse, or extreme poverty?
  • Do the parents or caregivers fail to arrange for a safe substitute caregiver for the child?
  • Have the parents or caregivers abandoned the child without arranging for reasonable care and supervision? For example, have caregivers left children without information regarding their whereabouts?

While State statutes vary, most CPS professionals agree that children under the age of 8 who are left alone are being neglected. It is also agreed that children older than 12 are able to spend 1 to 2 hours alone each day. In determining whether neglect has occurred, the following issues should be considered, particularly when children are between the ages of 8 and 12:

  • The child's physical condition and mental abilities, coping capacity, maturity, competence, knowledge regarding how to respond to an emergency, and feelings about being alone.
  • Type and degree of indirect adult supervision. For example, is there an adult who is checking in on the child?
  • The length of time and frequency with which the child is left alone. Is the child being left alone all day, every day? Is he or she left alone all night?
  • The safety of the child's environment. For example, the safety of the neighborhood, access to a telephone, and safety of the home.

Determining Physical Abuse


In determining whether physical abuse occurred, the key questions to answer are "Could the injury to the child have occurred in a nonabusive manner?" and "Does the explanation given plausibly explain the physical findings?" The caseworker must gather information separately from the child, the parents, and other possible witnesses regarding the injuries. The following questions may help determine if abuse occurred:

  • Does the explanation fit the injury? For example, the explanation of a baby falling out of a crib is not consistent with the child having a spiral fracture. It is important to know the child's age and developmental capabilities to assess the plausibility of some explanations. It is also crucial to receive input from medical personnel and exams.
  • Is an explanation offered? Some caregivers may not offer an explanation, possibly due to denial or an attempt to hide abuse.
  • Is there a delay in obtaining medical care? Abusive caregivers may not immediately seek medical care for the child when it is clearly needed, possibly to deny the seriousness of the child's condition, to try to cover up the abuse, or in hope that the injury will heal on its own.

Caseworkers must also examine the nature of the injury, such as bruises or burns in the shape of an implement, e.g., a welt in the shape of a belt buckle or a cigarette burn.


Determining Sexual Abuse


In addition to the factors mentioned in determining physical abuse, the caseworker should ask the following questions to determine whether sexual abuse has occurred:

  • Who has reported that the child alleges sexual abuse? For example, caseworkers should be alert to separated or divorced parents making allegations against each other.
  • What are the qualifications of the professional reporting the physical findings? For example, if the health care providers do not routinely examine the genitalia of young children, they may mistake normal conditions for abuse or vice versa.
  • What did the child say? Did the child describe the sexual abuse in terms that are consistent with their developmental level? Can the child give details regarding the time and place of the incident?
  • When did the child make a statement or begin demonstrating behaviors suspicious of sexual abuse and symptoms causing concern? Was the child's statement spontaneous? Has the child been exposed to adult sexual acts?
  • Where does the child say the abuse took place? Is it possible for it to have occurred in that setting? Is it possible that the child is describing genital touching that is not sexual in nature? For example, bathing the child.

Determining Psychological Maltreatment


Psychological maltreatment has been given relatively little serious attention in research and practice until recently. There are many reasons for this, including problems with inadequate definitions, failure to establish cause-and-effect relationships, and the difficulty of clarifying the cumulative impact of psychological maltreatment. In order to determine if psychological maltreatment or emotional abuse occurred, caseworkers must have information on the caregiver's behavior over time and the child's behavior and condition. Caseworkers must determine whether there is a chronic behavioral pattern of psychological maltreatment, such as caregivers who place expectations on the child that are unrealistic for the child's developmental level, threaten to abandon the child, or direct continually critical and derogatory comments toward the child. There also must be indicators in the child's behavior suggestive of psychological maltreatment; however, the child's behavior alone is often insufficient to substantiate a case. Caseworkers must determine whether the child has suffered emotional abuse. The following questions may help determine if psychological maltreatment has occurred:

  • Is there an inability to learn not explained by intellectual, sensory, or health factors?
  • Is there an inability to build or maintain satisfactory interpersonal relationships with peers or adults?
  • Are there developmentally inappropriate behaviors or feelings in normal circumstances?
  • Is there a general pervasive mode of unhappiness, depression, or suicidal feelings?
  • Are there physical symptoms or fears associated with personal or school functioning, such as bedwetting or a marked lack of interest in school activities?

Demonstrating a causal connection between the caregiver's behavior and the child's behavior is often difficult to substantiate. This minimally necessitates that the caseworker observe caregiver-child interaction on several occasions, as well as be informed from other sources' observations (e.g., school personnel, relatives, and neighbors).

Development of a Safety Plan

The safety plan and the case plan have two different purposes. The interventions in the safety plan are designed to control the risk factors posing a safety threat to the child. Interventions in the case plan, however, are designed to facilitate change in the underlying conditions or contributing factors resulting in maltreatment. To control the risk factors directly affecting child safety, the safety interventions must:

  • Have a direct and immediate impact on one or more of the risk factors;
  • Be accessible and available in time and place;
  • Be in place for the duration of the threat of harm;
  • Fill the gaps in caregiver protective factors.

In identifying safety interventions and developing a safety plan, CPS caseworkers are required to make reasonable efforts to preserve or reunify families. Child safety is the most important consideration in these efforts. ASFA also states that when certain factors are present (e.g., abandonment, torture, chronic abuse, some forms of sexual abuse, killing of another person or the child's sibling, or termination of parental rights for another child), they constitute enough threat to a child's safety that reasonable efforts are not required to prevent placement or to reunify the family. The sequence of least intrusive to most intrusive safety interventions include:

  • In-home services, perhaps combined with partial out-of-home services (e.g., daycare services);
  • Removal of abusive caregiver;
  • Relative or kinship care;
  • Out-of-home-placement.

When possible, the safety assessment should be conducted jointly with the family; it may not, however, be safe to include the perpetrator. The safety plan also should be negotiated with the family. This accomplishes the following:

  • Caseworker and caregiver can assess the feasibility of the caregiver following the safety plan.
  • Caseworker can be assured that the caregiver understands the consequences of his or her choices.
  • Caregiver is provided with a sense of control over what happens.
  • Caregiver is able to salvage a sense of dignity.

Decision Point Four: Determining Emergency Needs
Child maltreatment is often not an isolated problem; many families referred to CPS experience multiple and complex problems, often at crisis levels. Due to any number of these problems that may be identified during the initial assessment or investigation, the CPS caseworker is often in the position of determining whether a family has emergency needs and of arranging for emergency services for the child and family. Examples of emergency services can include:

  • Medical attention
  • Food, clothing, and shelter
  • Mental health care
  • Crisis counseling

Decision Point Five: Offering Services


The decision that a caseworker makes at the end of the initial assessment or investigation is whether a family should be offered ongoing child protective services or other agency services. Who is offered services and on what basis that decision is made depend on the guidelines and availability of services that vary from State to State and sometimes county to county. In some cases, the decision is made based on whether a report is substantiated. In other instances, the decision to offer services is based on the level of perceived risk of maltreatment in the future since substantiation alone is not the best predictor of future maltreatment.

Noninvestigative or Alternative Responses

Traditionally CPS agencies are required to respond to all reports of child maltreatment with a standard investigation that is narrowly focused on determining whether a specific incident of abuse actually occurred. States are attempting to enhance CPS practice and build community partnerships in responding to cases of child maltreatment. One changing area of CPS practice is greater flexibility in responding to allegations of abuse and neglect. A "dual track" or "multi-track" response permits CPS agencies to respond differentially to children's needs for safety, the degree of risk present, and the family's need for support or services. Typically, in cases where abuse and neglect are serious or serious criminal offenses against children have occurred, an investigation will commence. An investigation focuses on evidence gathering and will include a referral to law enforcement. In less serious cases of child maltreatment where the family may benefit from services, an assessment will be conducted. In these cases, the facts regarding what happened will be obtained, but the intervention will emphasize a comprehensive assessment of family strengths and needs. The assessment is designed to be a process where parents or caregivers are partners with the CPS agency, and that partnership begins with the very first contact. States that have implemented the "dual track" approach have shown that a majority of cases now coming to CPS can be safely handled through an approach that emphasizes service delivery and voluntary family participation in addition to the fact finding of usual CPS investigations. CPS can switch a family to the investigative track at any point if new evidence is uncovered to indicate that the case is appropriate for investigation rather than assessment.

Initial Assessment or Investigation Process

To make accurate decisions during the initial assessment or investigation, caseworkers must:

  • Employ a protocol for interviewing the identified child, the siblings, all of the adults in the home, and the alleged maltreating parent or caregiver;
  • Observe the child, the siblings, and the parent or caregiver's interaction among family members, as well as the home, the neighborhood, and the general climate of the environment;
  • Gather information from any other sources who may have information about the alleged maltreatment or the risk to and safety of the children;
  • Analyze the information gathered in order to make necessary decisions.

Using Interview Protocols


The initial assessment or investigation of alleged maltreatment of children requires that CPS respond in an orderly, structured manner to gather sufficient information to determine if maltreatment took place and to assess the risk to and safety of the child. Employing a structured interview protocol ensures that all family members are involved and that information-gathering is thorough; increases staff control over the process; improves the capacity of CPS staff to collaborate with other disciplines; and increases staff confidence in the initial assessment or investigation conclusions. If at all possible, family members should be interviewed separately in the following order:

  • Identified child
  • Any siblings or other children in the home
  • Alleged perpetrator
  • All other adults in the home separately
  • Family as a whole

Depending on the circumstances of the report, it must be determined whether it is in the child's best interest for the CPS worker to initiate an unannounced visit to interview the parent or to contact the parent to schedule an interview. If the child is out of the home at the time (e.g., the child is at school), the process should begin with an introduction to the parent(s) to explain the purposes of the initial assessment or investigation and, if required by law, request permission to interview all family members individually, beginning with the identified child. It is important to remember that the safety of the child is of paramount importance in every case. If there is concern that talking with the parents first or obtaining their permission to interview the child places the child at risk of imminent harm, then the CPS caseworker should proceed in a manner that assures the child's safety. All family members should be interviewed alone to establish rapport and a climate of trust and openness with the caseworker, which is designed to increase the accuracy of the information gathered. A benefit noted across professional boundaries regarding the use of individual interviewing protocols is that it enables the caseworker to utilize information gathered from one interview to assist in the next interview.


Planning the Interview Process


Based on the information gathered at intake, each initial assessment or investigation should be planned with consideration given to:

  • Where the interviews will take place;
  • When the interviews will be conducted;
  • How many interviews will likely be needed;
  • How long each interview will likely last;
  • Whether other agencies should be notified to participate in the interviews.

Interviewing the Sources


During the initial assessment or investigation process, caseworkers should conduct interviews with the following individuals:

  • Identified child victim. The purpose of the initial interview with the identified child is to gather information regarding the alleged maltreatment and any risk of future maltreatment, and to assess the child's immediate safety. Because CPS's purpose is beyond just finding out what happened with respect to any allegations of maltreatment, the interview with the child addresses the strengths, risks, and needs regarding the child, his or her parents, and his or her family.
  • Siblings. Following the interview with the identified child, the next step in the protocol is to interview siblings. The purpose of these interviews is to determine if siblings have experienced maltreatment, to assess the siblings' level of vulnerability, to gather corroborating information about the nature and extent of any maltreatment of the identified child, and to gather further information about the family that may assist in assessing risk to the identified child and any siblings.
  • All of the nonoffending adults in the home. The primary purpose of these interviews is to find out what adults know about the alleged maltreatment, to gather information related to the risk of maltreatment and the safety of the child, to gather information regarding family strengths or protective factors, and to determine the adults' capacity to protect the child, if indicated.
  • Alleged maltreating parent or caregiver. The purpose of this interview is to evaluate the alleged maltreating caregiver's reaction to allegations of maltreatment as well as to the child and his or her condition, and to gather further information about this person and the family in relation to the risk to and safety of the child.