Smith Richardson Foundation
This study identifies factors associated with client participation in intensive, in-home family preservation services. Our initial focus was on client cooperation, but a review of the literature and preliminary analysis of empirical data convinced us to broaden this focus to consider the diverse ways in which clients participate in treatment.
The clients in our study were involuntary, in that they were referred for family preservation services by a public child welfare agency following substantiated reports of child abuse and neglect. The services were intended as an alternative to removal of a child from the home. The primary caregiver was the main focus of intervention, and thus it is her (occasionally his) participation that is of greatest interest here. We were particularly interested in identifying factors related to active involvement of clients that are considered more "difficult" to engage in child welfare. Thus, we sought predictors of active participation within several subgroups of cases.
The central foci of our inquiry were the characteristics of workers, the intervention, and service delivery environments that relate to variations in treatment participation. We paid particular attention to practice techniques that workers reportedly used since these have been under investigated in previous research.
Our study was based on secondary analysis of data from a large scale evaluation of family preservation programs in Illinois (see Schuerman, Rzepnicki, & Littell, 1994). It also builds on previous work, funded by the Smith Richardson Foundation (Littell, 1997; Littell & Schuerman, in press; Littell, Schuerman, & Chak, 1994).
We conclude that workers ought to hold out hope that clients can change their behavior and some aspects of their circumstances, involve clients in service planning, provide them with material
assistance when needed, match the focus of treatment to clients' needs and goals, and serve as advocates for them. Intensity of contact with clients and the use of feedback and confrontation ought to be driven by concerns about risks to children, clients' readiness for change, and the formation of a helping alliance between the worker and client.
Program administrators should attend to the quality of supervision and support provided to child welfare workers, as these have a direct impact on practitioners and important indirect effects on clients' responses to treatment.
Littell, J. H. and E. Tajima. 1998. "Client Participation in Intensive Family Preservation Programs." Smith Richardson Foundation.