Medina, A. & Beyebach, M. & García, F. E. (2022). Effectiveness and cost-effectiveness of a solution-focused intervention in child protection services. Children and Youth Services Review, Elsevier, vol. 143(C).
The emergence of child-centered and family-centered interventions in the field of child protection has challenged traditional approaches which often focus on the shortcomings of families and lead to user dissatisfaction and alienation (Buckley et al., 2011), and distrust between workers and users (Arbeiter & Toros, 2017). Solution Focused Brief Therapy (SFBT) is a strengths-based, client-centered intervention which can be adapted for child welfare settings. In solution-focused child protection, the focus is on empowering service users and offering families choice and voice through establishing goals in partnership, eliciting the clients’ ‘preferred futures’, examining exceptions and solutions, and co-creating next steps.
Using a quasi-experimental design, the study set out to evaluate the impact of a solution-focused approach to child protection service provision by comparing the performance of a cohort of child protection workers who received training and supervision in SFBT with that of child protection workers who employed treatment-as-usual in the local child protection service of Tenerife, Spain over a one-year period. Measures included the Solution-Focused Treatment Fidelity Questionnaire (SFTFQ), the Outcome Rating Scale (ORS), and the Child Outcome Rating Scale (CORS). Goal achievement was measured using parent and worker ratings, the ORS was completed by parents and the CORS by the referred child, whereas referral to risk teams, child removal, recidivism, length of intervention, number of sessions, and the number of additional resources provided by other professionals were included in the study as statutory child welfare measures.
Outcomes were notable. Scores obtained at Time 2 indicated positive results for both child protection workers and service users in the experimental group. SFTFQ values almost tripled for the experimental group in comparison to the control group, indicating that child protection workers who received SFBT training and supervision conducted their interventions in a solution-focused manner and shifted their self-report practices to a solution-focused model. These results suggest that an SFBT approach is not only applicable to and useful in child welfare service provision, but also feasible to disseminate amongst staff. Parent and child well-being and goal attainment were significantly higher in the experimental group in comparison to the control group at post-test. In the experimental group, there was also an overall reduction in recidivism, referrals to “risk teams”, child removals, cost and length of intervention, and number of complementary resources provided. Overall, the study findings suggest that child protection teams who are trained and supervised in solution-focused intervention models become better able to assist families without having to resort to removing children from their homes.
Though this was a prospective study carried out in a naturalistic setting with a high participation rate of both workers and service users, almost one third of families dropped out of the study by either discontinuing contact with social services or by not filling out post-study measures. The remaining service users in both groups were equivalent at Time 1 on all dependent variables, other than recidivism rates which were higher in the control group. The sample was ethnically homogenous, so the potential generalizability of the results is unclear. Additionally, there was a lack of follow-up data beyond the 12-month post-test, so the maintenance and sustainability of positive changes in the solution-focused condition is unknown. Notwithstanding these limitations, the study adds to the evidence of the effectiveness of SFBT in child protection settings. Various sources of data (workers, parents, children, statutory child welfare measures) confirmed that the uptake of solution-focused practices had a number of positive effects. The results warrant replication of the study from a longitudinal perspective (with the inclusion of long-term follow-ups) with a heterogenous sample.