Notes from Wicked Problems: Big Data on Trauma, Solution-Based Casework, and More

It was a big week in Chicago. The Cubs finally broke through and won the World Series, and all of the intractable problems with child welfare were fixed.

Okay, only one of those happened. But the city did play host to the sixth forum held by the Wicked Problems Institute (WP), which featured leaders who are laying the seeds of child welfare reform with more and better data.

A project of the University North Carolina School of Social Work (UNC) and the Children’s Home Society of America (CHSA), Wicked Problems is a running series of forums to identify, and hopefully help solve, the child welfare system’s deepest challenges.

What are those? Here are the eight “grand challenges” agreed upon after WP’s early meetings:

• Reversing the effects of child maltreatment on brain development
• Harnessing the natural motivation of parents and relatives
• Synthesizing research on the impact of foster care
• Sustaining family continuity after legal permanence
• Strengthening the voice of youth and families
• Linking well-being measures to data on safety and permanence
• Attracting private investment and performance-based contracts to improve services
• Preparing the workforce for future challenges

WP has already yielded a more permanent entity: CHSA recently launched the Child Welfare Practice-Based Research Network, with initial funding from UNC, to forge research partnerships with universities around the country.

Youth Services Insider hadn’t been to a Wicked Problems session in awhile, so we popped into Chicago for a few days to hear the scuttlebutt. Some quick notes on what went down:

Knowledge on Toxic Stress: Flying Closer to the Ground

When it was first published, the Adverse Childhood Experiences Survey (ACES) study landed with a metaphorical thud. A decade later, lead researcher Robert Anda retired from the Centers for Disease Control and Prevention and hit the speaking circuit, breathing life into the findings.

Now there is a vibrant discussion about how to incorporate into youth and family services the key lesson from ACES: that those experiences correlate to dangerous health risks in adulthood.

Dr. Bruce Perry, head of the Houston-based Child Trauma Academy, spoke to the group about the emergence of neurosequential therapy as a treatment for child trauma. Click here to read more about it; in a nutshell, the focus is on intense, relationship-based therapy that seeks to rewire the cortex to better handle stressful situations.

The academy is also using an expanding network of other trauma-specializing affiliates around the country to amass a major database that charts brain development and performance against various types and levels of trauma.

ACES is like a 50,000 foot flyover,” Perry said. “This is moving us from 50,000 to 30,000 feet.”

The suggestion, of course, is that the data collection in and of itself will not help address an individual child or parent. But the hope is that this databank can become a vital cog in gauging how successful different strategies, models and programs are.

The Future of Fatality Prevention

Amy Templeman, one of the key staffers on the Commission to Eliminate Child Abuse and Neglect Fatalities, delivered a great overview on the commission’s findings and recommendations, which were divided into proposals for Congress, the executive branch, and states.

She was followed by former Illinois child welfare director Ernie McEwen, now with Casey Family Programs, who

We’re going to tackle this segment in a separate column on Monday. In a nutshell: Attendees expressed a lot of wariness, but also posed some interesting ideas, on moving forward a national fatality prevention agenda.

Wendy’s Whopper of A Grant

Imagine walking around with a winning Powerball lottery ticket in your wallet or pocketbook, knowing you couldn’t redeem it for another month. That’s basically the situation these days for Rita Soronen, CEO of the Dave Thomas Foundation for Adoption (DTFA).

DTFA makes grants to other organizations but also operates Wendy’s Wonderful Kids, which helps fund, recruit and train adoption caseworkers who specialize in finding homes for older and high-needs children.

The program is entrenched in the foundation’s home state of Ohio, and has spread piecemeal throughout the country. But a big influx of money could be on its way that would seek to make Wendy’s Wonderful Kids the rule, not the exception, on finding permanency for the youth least likely to attain it.

Many moons ago, YSI reported that the foundation was in line to get a $200 million, game-changer investment from the Blue Meridian Partners, a weirdly named funding conglomerate spearheaded by the Edna McConnell Clark Foundation. Blue Meridian’s intention was to make four big bets on scaling successful youth-serving programs.

Earlier this year, DTFA and three other organizations – Nurse-Family Partnership, Youth Villages and Zero to Three – received early planning grants to develop plans for scaling their programs.

Soronen told YSI that nothing had been officially signed and agreed to between DTFA and the partners. But in her presentation to the Wicked Problems group, she presented a 12-year plan for major growth of Wendy’s Wonderful Kids and acknowledged that plans for the big bet were already moving forward. The goal is to fully scale up in five states, establishing a proof of concept to export to the next eight largest states on the board.

After that, she said, it’s about ratcheting down the intensity of DTFA’s involvement so that the foundation can eventually move to other issues in the field, for example post-adoption services.

It is similar to the transition being made now by the Annie E. Casey Foundation with its signature juvenile justice venture, the Juvenile Detention Alternatives Initiative (JDAI). The initiative started decades ago as a way to fund and support efforts to reduce the use of pretrial detention facilities.

Casey has now begun to shift attention to eliminating large juvenile prisons, while quietly figuring out how to make the detention component less cumbersome for the foundation. DTFA might find wisdom someday in studying Casey’s JDAI Helpdesk, an online center for many of the tools and resources needed to focus on lowering detention usage.

We will certainly report more on the game plan for widening out Wendy’s Wonderful Kids, if and when it becomes official.

Solution-Based Casework

Dana Christensen of the University of Louisville led a presentation on solution-based casework (SBC), which is essentially the adult equivalent of positive youth development in that it seeks to reframe the mission away from human deficits and toward assets.

Christensen described the traditional process of child welfare casework as noting problems, referring to programs that are supposed to address them, and then monitoring attendance at these programs. This, he said, is why some parents involved in the system spend 24 hours a week complying with court mandates.

SBC is built around three staple services, according to Christensen: Family life cycle theory, cognitive behavioral therapy, and solution-based interviewing.

You can click here for a list of research and evaluation on the SBC model. There is yet to be a randomized control trial (RCT) comparing it side-by-side with a traditional casework approach, but studies so far suggest that the model can help reduce removals, lower re-entry to care, and increase engagement between caseworkers and referral services.

Driving Down Control Trial Costs

Speaking of RCTs: Wicked Problems founder Mark Testa told attendees to keep an eye out for the results of the trial on Safe Families for Children, a faith-based family preservation model that uses host homes to help prevent systemic removal of children from their parents.

You can read about the rise of Safe Families and another faith-based model here, but Testa was more focused on the procedural legacy of the trial. Testa himself got a grant to oversee the RCT, and believes that the venture has helped develop a low-cost model for building in random assignment.

“You often hear [RCT is] too expensive,” Testa said. “This is a project that says, it doesn’t have to be that way.”

It will be a major development for the field if that’s the case. If and when major child welfare finance reform happens in America, one staple will certainly be the pegging of most federal funds to evidence-based services.