Isokuorttia, N., Aaltiob, E., Laajasaloc, T., & Barlowd, J. (2020). Effectiveness of child protection practice models: a systematic review. Child Abuse & Neglect, 108, 104632
This manuscript is a systematic review aimed at assessing the effectiveness of child welfare practice models. The research question, “how effective are child protection practice models in improving outcomes for children aged 0−17 years and their parents involved in child protection services?”, was used to guide a systematic search through ten electronic peer-reviewed and grey literature databases. Only studies with control groups were included. The authors’ defined “child protection practice model” as a form of practice designed to change all aspects and stages of child welfare practice. To be included in this review, practice models must have aimed to improve child protection outcomes and have a strong theoretical foundation, an outline for client practice, and picture of child welfare practitioner skills or tools. Some examples of child protection outcomes include child-focused, such as social, emotional, or behavioural functioning, and educational outcomes, or parent-focused, such as mental health, behaviour, and family functioning.
Authors followed PROSPERO (International Prospective Register of Systematic Reviews) to develop their review and used the following inclusion criteria: children between 0-17 years whose parents were involved with child welfare services; child welfare practice (licensed or non-licensed) model; measured child, parent, or family outcome; study included a comparison group; study setting was offered by a public child welfare organization; quantitative methodologies that included before and after measures; peer-reviewed or grey literature; written in English; published between 1990 and March 2019.
Authors’ electronic library database searches resulted in 1360 potential eligible citations. Subsequent to initial screening of manuscript titles and abstracts, 77 manuscripts were fully reviewed for possible inclusion and upon review, a total of five manuscripts, which represent six studies and three practice models, were included in the final systematic review. The three models are: Solution-Based Casework (SBC; four studies included in the review), Reclaiming Social Work (RSW; one study included in the review), and Signs of Safety (SoS; one study included in the review). In each of the five studies included in the review, the control groups were either using child welfare service as usual, a different service to the practice model of interest, or received less training in the practice model of interest.
Results of studies including SBC suggested that “high adherence” to the intervention (vs. “low adherence”) faired significantly better for service users in permanency, well-being, and safety measures. Further, the SBC group experienced significantly fewer re-referrals, higher likelihood of achieving case goals and objectives, fewer legal actions, compared to the control group (non-SBC or low adherence to SBC).
There were no significant differences in the number of children entering care between the RSW and control groups. The study measuring SoS effectiveness showed no significant difference between intervention and control group’ reduction of risk of child maltreatment, family empowerment, or service system empowerment.
The Effective Public Health Practice Project (EPHPP) Quality Assessment Tool for Quantitative Studies is routinely used to assess methodological quality of quantitative studies. The authors utilized the tool in this study and found that the strength of all studies was considered “weak”.
SBC was the most tested model but had some limitations due to vague description of sample selection techniques and case characteristics. RSW had limitations in the form of selection bias, a small sample, and the control seemed to be involved in various training sessions. Similarly, the SoS evaluation was found to have a biased and small sample, and imputation (missing values replaced with substituted values) was used in the analysis.
Results of this systematic review indicate that there is a lack of rigorous evidence endorsing the effectiveness of child protection practice models, specifically the SBC, RSW, and SoS, in terms of positive outcomes for children, youth, and families. While, a larger body of evidence is required to demonstrate the effectiveness of practice models, such evaluations are difficult to implement in a child practice setting. Indeed, the studies included in this review have attempted to move the barometer forward in our understanding of effectiveness. Moreover, the lack of evidence does not indicate that the practice models are not effective, rather, child welfare decision makers should be cautious with their use and implementation.
This systematic review yielded a number of limitations. The small number of studies included in this review does not build a strong picture of effective interventions used in child welfare service settings. Authors note that their strict inclusion and exclusion criteria likely limited their identification of practice models. Please see the original manuscript for a full description of the three practice models and the citations included in the review.