Organizational Research MCFD and Learning Initiative A Shared Research Agenda

Transcription

1 Organizational MCFD and Learning Initiative A Shared Agenda Final Report of the Shared Agenda Initiative

2 EXECUTIVE SUMMARY The goal of the Shared Agenda Initiative has been to identify the priorities for research in the six service areas of the Ministry of Children and Family Development in order to improve outcomes for children, youth and families in British Columbia. A working group comprised of a representative from the Ministry, the Federation of Community Social Services of BC, the BC Office of the Representative for Children and Youth and the University of British Columbia conducted a wide reaching consultation throughout the province in order to identify the potential areas for research. Over 1,400 community practitioners, academics, young people and ministry staff took part in the process either through involvement in the eight forums and youth consultation held or through an on-line survey. The priorities identified through this process will be used by academics, government employees and community practitioners to generate research collaborations and initiatives that can inform service improvements and policy and program development.

3 TABLE OF CONTENTS Introduction... 1 Process for Developing the Shared Agenda... 3 Framework for the Shared Agenda... 6 Early Years... 7 Children and Youth with Special Needs Child and Youth Mental Health Child Safety, Family, Youth and Children in Care Adoption Youth Justice Conclusion Appendix A Working Group and Staff Support Appendix B SRA Forum Locations and Institutional Hosts Appendix C Participating Organizations... 35

4 INTRODUCTION The Ministry of Children and Family Development (MCFD) is the largest provider and funder of social services for children, youth and families in British Columbia. In collaboration with community service agencies, it delivers a wide array of direct and indirect services across six service lines. The Ministry wants to ensure that its policies, programs, practices and resources are achieving the best possible outcomes for the children, youth and families being served. plays an important role in understanding the past, identifying areas for improvement and informing future direction. supports the development of policies, planning, decision-making and evaluation of the efficiency and effectiveness of program and service delivery. A strong research platform provides a critical part of the professional education infrastructure. MCFD has not had a formalized system for embedding research and learning into policy and practice, though strong ad-hoc relationships exist. This initiative is about building a strong applied research foundation in support of, and aligned to, MCFD s strategic and operational agenda. The Organizational and Learning Initiative has been focusing on the development of a system of research and learning within the following three functional areas: Comprehensive, reliable and contextualized research provides evidence for how to achieve better outcomes for children, youth and families. For post-secondary and research institutions, research is integral to their mandates and research is also an essential component in the development and implementation of effective policies and practices. Child and family serving agencies and practitioners are increasingly looking towards the research literature to inform their work and to help achieve their goals. The key, then, is to ensure the research areas examined are those most in need of examination and that strong collaborative partnerships are created. MCFD, post-secondary and research institutions and the community social service sector all have an interest in using applied research to drive strategy and innovation. Activities include: Creating a Shared Agenda with partners to identify key priority areas and gaps in current research and inform future research. Creating a process to refresh and develop the prioritized Shared Agenda. Developing processes that will increase the rigor and quality of internal research and evaluation. Developing a process to ensure a standard of quality for external research posted or distributed by the ministry. Creating formalized partnerships between the ministry and partners by where appropriate by collaboratively developing MOUs which outlines the purpose and benefits of the partnership for each party. 1

5 Action Learning Sharing research is also not enough to ensure evidence can and will be used in operations, policy and practice. People need tools and approaches that support putting the learning into action. Build an Applied Promising Practices (APP) model into ministry practice. Such a model matches researchers with practitioners/teams who identify an emerging promising practice to determine if the outcomes merit a further scaling up of the practice. Establish Social Innovation and Learning Labs Develop a discussion paper on Aboriginal specific models for action learning. Create a paper on additional Action Learning tools that can move ideas into implementation at a local level. Knowledge Mobilization Identifying the appropriate audience for the knowledge, and tailoring the message and medium to the audience is the focus of knowledge mobilization. Making research available is not enough to support evidenced informed operations, practice and policy. shows that in spite of the fact that using research can have significant benefits and pay-offs in terms of improvements in outcomes, the vast pool of research-based knowledge is largely underused by service providers and practitioners. Develop a virtual research sharing site to provide MCFD and partners platforms to share research and evaluations and tools to facilitate knowledge dissemination and mobilization. Develop a number of key tools and processes for sharing research. 2

6 PROCESS FOR DEVELOPING THE SHARED RESEARCH AGENDA The goal of the Shared Agenda (SRA) component of the Organizational and Learning Initiative is to facilitate access to applied research and learning for all the involved partners. The research generated by partners will enhance the capacity of MCFD and the sector to better understand the characteristics of the service delivery system. Access to new research will support the development of policies, planning, and decision-making while the strategic and operational agenda will be strengthened and continually informed by relevant research and enabled through ongoing organizational learning. It is not the intention of the SRA to identify every possible research question related to the six service areas of the ministry. Rather, the aim has been to identify questions that are of immediate concern and if answered would fill gaps in knowledge in each of the six service areas of the Ministry. The priorities identified through this process can be used by academics, students, community practitioners and government employees to provide focus to and to generate research collaborations and initiatives that can inform service improvements and policy and program development. Previous research agendas that have been developed in the child and family services arena in other jurisdictions have tended to involve relatively small groups of experts in the area who were asked to identify key knowledge gaps from their perspective. While this process captures the concerns of key players in the field it was thought that it would be more productive for this initiative to broaden the width and depth of the consultation process so as to capture the voices of people throughout the province and across the six service areas. In order to identify the potential areas of research the initiative working and staff group (see Appendix A) conducted a thorough review and consultation process that involved a number of different steps. These included: A review of the research themes identified in selected reports that were prepared by or for the Ministry, such as the aggregate report of case reviews, the aggregate review of Office of the Representative for Children and Youth reports, topic-specific forum reports, and youth engagement reports. A widely distributed online survey which solicited suggestions for research questions in each of the six service areas. The survey was made available from March 8 to April 30, 2012 and received 1,185 responses from across the academic, policy and practice communities. Of those who identified the type of organization with which they were affiliated approximately 55% were from government, 20% were from nongovernment organizations, 6% were from post-secondary institutions, 5% were from community-based Aboriginal agencies, and 3% were from delegated agencies. The rest were from a variety of other organizations. The respondents also came from across the province. Of those who identified where they were from approximately 3

7 32% were from Coast Fraser, 23% from Vancouver Island, 20% from Interior, 15% from North and 9% from the Provincial Office. Approximately 59% were from urban or suburban settings, 29% from rural settings and 12% from First Nations reserves. Eight forums were held across the province to bring together practitioners, MCFD staff and researchers from the child and family service sector to discuss the research needs for policy and practice. These forums were hosted by Vancouver Island University, University of Victoria, University of British Columbia (Okanagan), University of British Columbia (Vancouver), Douglas College, University of the Fraser Valley, University of Northern British Columbia, and Thompson Rivers University (see Appendix B). Collectively, 355 people representing over 150 organizations (See Appendix C) attended the forums. Of these approximately 52% were from community agencies, 29% were from academic and research institutions, 17% were from MCFD and 1% were from other provincial ministries. A discussion was also held with the Choices of Reality (COR) Youth Advisory Council in the Coast Fraser region. Reports summarizing the discussions at each of the eight forums and with the COR Youth group were completed. These reports were distributed to participants for feedback and were then finalized. These reports are posted online. The working group followed a number of steps in order to identify a manageable number of questions from the over 4,000 that were submitted throughout the consultation process. The following highlight the process used to select the research priorities: 1. All of the research questions/comments from the consultation process were entered into a database. 2. Each question/comment was reviewed, and those that were not related to research were eliminated. Those that were comments were forwarded to members of senior management at MCFD for their review. 3. Questions that did not have implications for policy, practice, operations or outcomes were eliminated. 4. The remaining questions were grouped together based on topic for each service line. There was repetition amongst a number of the questions so in such cases the questions were grouped together. 5. The research topics were reviewed against selection criteria that included: Significant to the well being of children and youth (and their families) Relevant to policy, standards, or legislation/regulation 4

8 Feasibility: Achievable given available data, access to resources and participants. Amenable to good research methodology/rigor Scalability or applicability: The results to this research topic would be relevant to multiple communities or to children and youth with similar characteristics Of interest to a broad range of practitioners and other stakeholders. Easily understood by diverse stakeholders Potential to reinforce collaborative practices and community engagement Potential to enhance understanding of cultural practices (e.g. cultural safety, competence, incorporation of Indigenous practices) particularly with services provided to Aboriginal children and families Helps us understand the outcomes and cost-benefits of current practices, i.e. what is working in what situations; what is not. Helps measure success. Addresses the interests and needs in rural practice 6. Staying as close as possible to the language and content provided in the original questions, research questions were developed for each of the remaining research topics and highlighted whether these questions required: (The question hasn t been answered sufficiently in existing research) Literature Reviews (We already know the answer a lot of research is available) Best Practice Review (We can learn through a review of literature and a jurisdictional scan) Data Analysis (We can learn more about the current situation/clients/outcomes through the analysis of existing data) 7. A sub-group of the working group then spent extensive time reviewing the data and resultant questions to ensure that the main research themes were captured accurately and that the selected questions fit the abovementioned criteria. The resulting questions were then sent out to content experts to verify that the category into which the questions fit were reflective of the status of our current knowledge in each of the service areas. The working group then used their feedback was used to inform the final research agenda. 5

9 FRAMEWORK FOR THE SHARED RESEARCH AGENDA The questions in the Shared Agenda are grouped into the six MFCD services areas: Early Years; Children and Youth with Special Needs; Child and Youth Mental Health; Child Safety, Family, Youth and Children in Care; Adoption; and Youth Justice. The questions under each service are organized into a number of theme areas. Finally the questions are grouped into three categories: Data The three categories are not included in each of the theme areas as not all were identified in the selection process. As mentioned, the questions identified in the SRA do not represent everything we need to know in each of the areas. Rather they are a reflection of key areas that are immediate concern to the stakeholders who participated in the development of the SRA. This exercise can be conceptualized as a large Delphi study which can assist researchers from each of the stakeholders group identify and develop specific research agendas and collaborations locally, regionally or provincially. 6

10 EARLY YEARS The objective of the Early Years service line is to ensure that children and families are supported with a strong network of coordinated, family-centred, culturally relevant and responsive early childhood development and child care services. Early childhood development (ECD) programs in BC aim to assist parents, families and service providers in providing the best possible start for children from birth to six years of age. The programs currently serve a broad range of families from a variety of cultural backgrounds based primarily on individuals seeking services. Some programs are focused on the general young family population while others are focused on specific sub-populations: Aboriginal; immigrant; refugee; low income; and those which are geographically and/or socially isolated. Child care programs are utilized and required by parents in a number of different circumstances. While the majority of child care is targeted at working parents, it is also needed by those who are attending school or participating in an employment-related program. In addition, child care supports parents who, due to a medical condition, are unable to care for their children full-time, and plays a supportive role for vulnerable and at-risk families by providing access to opportunities that enrich children s healthy development and improve mothers and fathers parenting skills. Preschool and child care services are also sought by parents to provide their children with rich learning experiences in their early years and positively affect their social, emotional, physical and cognitive development. While child care programs primarily serve families with children aged 0-12, some children with special needs who require extra support and are unable to care for themselves may be served through child care programs up to the age of 18. The questions generated in this service area are: ASSESSMENT AND SCREENING 1. What are effective tools for screening and assessment? How can these tools be developed and implemented to ensure cultural relevance? 2. What should we screen for in preschool children to prevent problems that disrupt social and learning success? 3. Does a universal screening process make a positive difference? If so, what are the best approaches to implementing a universal screening program (how, where, what ages, etc.)? 4. What can be done to enhance early identification? Data 7

11 5. How many children who demonstrate risks/vulnerabilities had undiagnosed issues (audiology, speech, language, medical, behavioural) in their early years? SERVICE AVAILABILITY, ACCESSIBILITY AND WAITLIST MANAGEMENT 1. What are the current challenges in accessing and providing ECD/CC services? 2. How do we address the different ECD/CC needs of on-reserve and off-reserve Aboriginal children and families? 3. What are the needs related to ECD/child care for older caregivers (ex. grandparents raising grandchildren)? 4. What are alternative service delivery models that can be used in rural communities? 5. What are successful approaches used in other jurisdictions/sectors to effectively manage waitlists? 6. What are the impacts of not being able to access ECD/CC services in a timely way? PROGRAM EVALUATION 1. What are the outcomes of play based vs. school readiness focused early years programs? What types of children/families benefit most from these different models? 2. What are the characteristics of children/families that are attending Strong Start programs? How effective is it? How does it compare to other early years programs in terms of child development, school readiness and family development? RECRUITMENT, RETENTION AND SKILL DEVELOPMENT 1. What would the implications be of raising or lowering child/staff ratio in the areas of: staff retention, child outcomes, space availability and access, and affordability? 2. How do the skills of care providers and support given to them influence the efficacy of services? How can this inform education/training and policy? 3. What are promising practices for cultural training of ECEs? 8

12 INTEGRATION AND COLLABORATION 1. What are effective ways for MCFD to work with school districts to achieve shared goals in early years work? What is working well with current efforts and what factors are contributing to this success? 2. What are effective mechanisms for cross-ministry, cross-sector integration? How have other jurisdictions successfully incentivized integration? SERVICE DELIVERY MODELS 1. How does attaching a diagnostic label to a child impact their experience and development? 2. Would the effect and outcomes of ECD services for children change if the focus was on developmental age rather than chronological age in determining access? 3. What are alternative methods by which to determine who should receive and benefit from services beyond diagnostic labeling? 4. What are the societal and economic implications and outcomes associated with universal child care? PARENTAL EDUCATION AND CAPACITY 1. What is the role of parent education to support early identification of developmental concerns? 2. What are effective approaches to enhance parental capacity and reach potential prevention? 3. What is the effect of early parental education on parental capacity? 9

13 CHILDREN AND YOUTH WITH SPECIAL NEEDS This service line aims to ensure that children and youth with special needs experience optimal development, health, well-being and achievement through improved access to effective and coordinated services. The term children and youth with special needs (CYSN) refers to those children and youth up to 19 years of age who require significant additional educational, medical/health and social/environmental support beyond that required by children in general to enhance or improve their health, development, learning, quality of life, participation and community inclusion. The focus is on assisting families to care for CYSN at home, and supporting the inclusion of CYSN in their school and community settings. To address stress experienced by parents of children with disabilities, services such as respite care can be used to reduce demands on parents. Also, access to additional family support services, such as parenting and professional supports, is key to the long-term stability of children and youth with special needs. In addition to family support services, intervention services are required to adequately address needs of CYSN along the continuum. The questions generated in this service area are: PREVALENCE OF SPECIAL NEEDS Data 1. What are the factors leading to higher FASD rates in Aboriginal communities? 2. What is the incidence of Acquired Brain Injury in the province? Dual diagnosis? How does this compare with other Canadian jurisdictions? 3. What are the relative levels of special needs in the Aboriginal child population as compared to non-aboriginal? 4. What are the ethno-cultural/socio-cultural backgrounds of children receiving services? Are there any groups being underserved? 5. How many CYSN are children in care and what are their characteristics? 6. What baseline data is available regarding children with certain diagnoses or disabilities? ASSESSMENT APPROACHES AND IMPLICATIONS 10

14 1. What are the outcomes of a diagnosis-based system compared to a needsbased/functioning-level system? 2. What community assessment and intervention models work best for youth with FASD? SERVICE AVAILABILITY, ACCESSIBILITY AND EQUITY 1. What barriers prevent Aboriginal people from accessing CYSN services? 2. How do the needs of FASD clients align with the services available? 3. What approaches will help clients navigate easily through the system? 4. What are promising practices for providing equitable CYSN services in rural and remote communities? EFFECTIVE PRACTICES 1. What practices do Aboriginal families with special needs children and youth feel are working best? 2. What is the cost effectiveness of provision of respite services to families with special needs children? Does it prevent children from coming into care? 3. What child and family outcomes are being achieved with MCFD Autism funding? 4. What interventions are most effective for Aboriginal children with special needs? 5. What is the lifetime impact of FASD on an individual, and how can this inform prevention and early intervention services? 6. Is there one best model for work with children with Autism, or should we support different models? PARENTAL (CAREGIVER) SUPPORT AND CAPACITY 11

15 1. What do parents need at different stages of the developmental continuum to best support a special needs child/youth? 2. What are the promising supports for parents with special needs/mental health issues? 3. How can practitioners best coach parents of diverse cultural backgrounds to support their SN child? What are the best practices for the supporting and monitoring of caregivers of CYSN in providing adequate, well-informed care? EDUCATIONAL AND EMPLOYMENT OUTCOMES 1. How do BC employment success rates for youth with special needs compare with national and international rates? And what programs and services contribute to positive outcomes? Data 2. What are the developmentally key times for integration and specialization based within the educational system? 3. What are effective approaches and strategies for improving educational outcomes for CYSN students? 4. What are educational outcomes for students with special needs, by diagnosis? 5. What are the educational outcomes of CYSN students attending public schools compared to private/independent schools? CULTURAL INFLUENCES 1. How do different cultural beliefs and practices impact outcomes? 2. What do workers need to know about the relationship between culture and special needs to improve practice? 3. What are the most effective ways to design culturally appropriate youth engagement strategies to re-connect with elders and leaders? 4. What are effective approaches to enhance parental capacity and reach potential prevention? 12

16 CHILD AND YOUTH MENTAL HEALTH The objective of this service line is to help children and youth achieve and maintain positive mental health and development through timely access to quality prevention programs, supports and treatment. The ministry delivers services to children and youth from infancy to 19 years of age through community-based Child and Youth Mental Health teams, the Maples Adolescent Treatment Centre and Youth Forensic Psychiatric Services as well as substance-use services for youth involved with the justice system. The ministry s continuum of services includes mental health promotion, prevention, reduction of risk for mental health problems and earlier evidence based interventions to support children and youth with mental disorders. These services can play an important role in improving children s mental health by decreasing the incidence of future problems or reducing their severity. The questions generated in this service area are: SERVICE AVAILABILITY, ACCESSIBILITY, AND TIMELINESS 1. What can be learned from the tele-mental health project? Who has used, how has it been used, what has the experience of participants been, what has changed as a result of access, what outcomes have been achieved? 2. What are the numbers and profiles of children and youth who are referred for services, provided services, or not accepted for services? Are there differences across regions? 3. How does the prevalence of mental health conditions vary across regions and over time and, if there are differences, how can they be explained? 4. What mental health promotion and prevention approaches have a positive impact and reduce need for services; reduce waitlists? 5. What effective approaches have been developed to address barriers to effective referrals and access to timely services? 6. What are effective strategies to reduce the barriers (including stigma associated with mental health concerns) to seeking support, counseling and treatment? PARENTAL MENTAL HEALTH 1. What is the impact upon children of parents with mental illness? 13

17 Data 2. What are the most effective ways to support families with parental mental illness? 3. What are the indicators of children being at risk with a parent that has a mental illness? 4. How many children and youth with mental health issues also have parents with mental health issues? What are the diagnoses for each? COMMUNITY TRAUMA 1. What is the impact of community trauma on the development of children and youth and their mental health? HOSPITAL PRESENTATION Data 1. What are the profiles/characteristics of children and youth presenting at hospitals with MH concerns? 2. Do the acute care system responses to these children vary depending upon where they present (hospital location, size, etc) and whether there is a child and adolescent psychiatric unit/specialty? 3. How many children and youth receiving acute psychiatric care services also receive CYMH services (cross referral practices?) CHILDREN IN CARE Data 1. Does the availability of access to CYMH services make a difference to placement for children and youth? 2. How many of the children and youth served in CYMH are also involved in child welfare? Do the presenting mental health concerns for children in care vary from the general population of children and youth with mental health concerns? 14

18 SERVICE APPROACHES 1. When is it more effective for services to be provided in child s home, community, therapist s office, etc.? How does location of service impact accessibility, consistency of service and participation, results/outcomes, transitions to other services/supports? 2. What is an effective balance of services and supports within a mental health system, e.g., prevention, consultation, group and individual counseling, treatment? 3. What are the most effective interventions for working with multigenerational trauma? SPECIFIC POPULATIONS 1. What are the unique mental health needs of refugee children and youth? What services are available to them, and how do these services affect outcomes? 2. What are the most effective interventions/services for girls/young women? Are there differences in outcomes for youth receiving gender specific MH services? 3. What are effective approaches to assessment and intervention for children and youth that have complex and co-occurring conditions (e.g. mental health and substance use, special needs)? 4. How do mental health needs and profiles of girls/young women differ from boys/young men? 5. What are effective interventions to support positive outcomes for children under the age of three? 6. What is the impact of client trauma stories on the practitioners (vicarious trauma)? ABORIGINAL AND CULTURAL PRACTICES 1. How can mental health services be more user friendly for people of all cultures? 2. What interventions provide the best outcomes for children and youth of aboriginal heritage? 3. What factors contribute to under-utilization of mental health services in Aboriginal communities? 15

19 4. How can mental health supports be effectively incorporated into existing Aboriginal culture, practice and traditions? 5. Considering the diversity within Aboriginal populations, how might practices reflect this diversity and unique community contexts? How might we work with Aboriginal peoples without defaulting to generalizations? 6. What is the contribution of spirit and spiritual practices/leaders to positive mental health and to addressing mental health issues? 7. What do Aboriginal (or other multicultural groups) think is working and not working regarding: access to services and supports; cultural competency/relevance; treatment or intervention approaches? 8. What practices and approaches are most effective for serving diverse client populations, e.g. immigrants, refugees? EFFECTIVE PRACTICES 1. What do children, youth and families say is helpful about their contact with CYMH services? What variations exist between different groups of clients (e.g., ethnicity, gender, etc)? 2. How is our understanding of effective interventions for diverse populations being integrated into practices? Are we responding to the need for diversity? 3. Who does Dialectical Behaviour Therapy work well with and in what situations is it most effective? When should it not be used? 4. Given the range of trauma informed assessments, care practices and treatment approaches, which are evidence informed and have been researched or evaluated for effectiveness? 16

20 CHILD SAFETY, FAMILY, YOUTH AND CHILDREN IN CARE This service line has two main components: child safety; and family, child and youth support and care services. Child safety services aim to effectively address child and youth safety and well-being reports. Family, Child and Youth Support and Care services aim to ensure that children grow up in safe, stable environments that promote permanency and meet their emotional, cultural and developmental needs. A number of families need extra support to provide safe and nurturing care for their children. Under the Child, Family and Community Service Act, child welfare workers assess every report about a child s need for protection and respond through the Child Protection Response Model with a variety of approaches including: Family Development Response (FDR), Child Protection Investigation Response and Youth Services Response. Family Development Response is the preferred response when the circumstances do not involve severe abuse or neglect and families are able and willing to participate in collaborative assessment and planning. FDR, through building on the family s strengths, focuses on how to keep children safe while the family stays together and works through challenges. Services range from family service supports to supporting requests for kinship care placements, meeting the needs of children and youth in care, and providing permanency. The questions generated in this service area are: CHILD SAFETY ASSESSMENTS AND REPORTING 1. How many families who received a differential response end up having another report made about them following the file being closed and why? 2. When do different professionals consider it is appropriate to make a report? What factors contribute to their determination of the need for reporting? 3. What are the best practices to assess parent s ability to keep their mental health concerns sufficiently under control so they do not negatively impact their ability to meet the needs of their children? 4. What are the most effective tools in a variety of different contexts to assess parental capacity and ability to provide adequate and safe environment (e.g. for Aboriginal parents, immigrant parents, refugee parents, parents with developmental disabilities)? How can the abilities of families to provide safe, nurturing homes be assessed? 5. What key risk factors should be identified for children under three? What should be monitored within the child welfare system? 17

21 Data CLIENT PROFILES 1. What are the profiles of families with multi-generational/intergenerational involvement with child welfare? 2. What are the profiles of immigrant families whose children come into care? 3. What is the prevalence of mental health and/or substance use issues for parents who are in contact with child welfare? 4. Of the children receiving MCFD services, how many had mothers with perinatal depression in the first five years of their life? REMOVAL, TRANSITIONS AND TRAUMA 1. What are the children s and youth s retrospective reflections about what was difficult or helpful, traumatizing or supportive? 2. What is the impact of removal of children from their homes on: the children, their parents, other family members, workers and other service providers? 3. How do we manage transitions in a way that does not further traumatize and harm? What are transition practices that enhance likelihood of success? EFFECTIVE PRACTICES AND OUTCOMES 1. What caseload variables impact child outcomes? 2. What is the experience of young people, workers and families with the court decision making process? 3. What are the ethical dilemmas being experienced by front line practitioners in their work with children, families and other professions? 4. How do we best identify and understand promising practices that are emerging in communities? 5. What are the known effective intervention strategies for long-term neglect? How can we effectively implement these in the work that we do? 18

22 6. What are the best practice approaches to addressing addiction and mental health issues in the context of child protection services? 7. What are the best ways to assist frontline practitioners to address difficult ethical issues, dilemmas and decision-making? 8. What are the best practices for case reviews after fatalities and critical injuries? STAFF RETENTION AND SKILL DEVELOPMENT 1. What are the most effective practices for promoting health and resilience for human service workers who experience frequent exposure to stressful and psychologically challenging circumstances such as violence, threats, child abuse and neglect? 2. What is the nature of the phenomenon of staff turnover (e.g. what is the incidence of turnover, reasons for leaving, are people leaving the field or simply changing jobs)? 3. What are the administrative practices that increase/decrease the rate of worker turnover? 4. What skills, attitudes and knowledge promote the development of child welfare workers (and other disciplines) ability to manage the responsibility of a child protection mandate? 5. How do we best prepare and train urban based professionals about what goes on in rural and remote communities and how to plan for the children and their families in a realistic way? FAMILY, CHILD AND YOUTH SUPPORT FAMILY EXPERIENCES AND NEEDS 1. What are the experiences of fathers involved in the child welfare system? 2. What are the experiences of immigrant children, youth and families involved in the child welfare system? 3. What are the unique needs of children and youth whose parents are/have been incarcerated? What are their life outcomes? 4. Do programs and services that match the specific needs of families at different times of day achieve better outcomes, e.g. early morning, evening, weekends, transition times? 19

23 What keeps us from offering more evening and weekend services when high need families are in greatest need of support? 5. What is the impact on children experiencing significant periods of father absence (e.g. incarceration)? EFFECTIVE PRACTICES AND OUTCOMES 1. What are effective approaches to coaching and peer mentoring for families and foster caregivers? 2. When and how are Special Needs Agreements used? In what circumstances are they working well? 3. How well prepared are MCFD staff to support families affected by parental mental health and/or substance use concerns? 4. What are the best practice approaches to addressing addiction and mental health issues in the context of child protection services? 5. What are the best practices for reaching out to immigrant and Aboriginal kids living in disenfranchised communities and families to prevent gang involvement? 6. What do we know about trauma informed treatment and services for parents of young children? 7. What are the best practices of supporting children and youth whose parents are/have been incarcerated? 8. What practices are most effective at supporting vulnerable immigrant families to support transition and reduce likelihood of child welfare intervention? ORGANIZATIONAL CULTURE AND SKILL DEVELOPMENT 1. What personal, educational or continuing educational factors contribute to the development of CW (and other) workers proficiency in developing strong working alliances with families? 2. What organizational factors contribute to the development of child welfare workers proficiency in developing strong working alliances with all families? 20

24 CARE SERVICES TRANSITIONS AND TRAUMA 1. Do youth leaving care experience better outcomes when the mandate of service provision is extended to include youth years of age? 2. When children come into care, what are the practices that mitigate the risk of further traumatizing them? 3. What are good practices that facilitate effective transitions between: placements; service types; workers and offices? 4. How can we more effectively assess and treat children and youth who have experienced trauma? What specific therapeutic interventions are available for children and youth who have experienced trauma, abuse and/or neglect? 5. What are the best practices for preparing staff to help young people make successful transitions? EFFECTIVE PRACTICES 1. Are there differences in the needs and challenges of foster caregivers in rural communities as compared to urban and suburban communities? 2. How can we increase the high school completion and college completion rates for youth in care and youth in contact with the MCFD? 3. What are the best practices for developing and maintaining a network of specialization and treatment care to ensure/facilitate access to needed services, in an efficient and effective way especially in rural areas? 4. Which treatment foster care models are most effective and in what contexts/situations? 5. What are the best practices for medical, mental health and educational professionals working with children in care to better plan for placement transitions? 6. How can we shorten the length of time moving children into a permanent situation while respecting the rights of the biological family? 7. What are the best practices for sustaining family and community connections when there is a separation of siblings and/or geographic separation from community and family? 21

25 8. What are the best practices for supporting foster caregivers in rural communities? 9. What are the barriers to achieving a permanency mindset, and facilitating concurrent planning? What systemic factors affect permanency planning? What factors serve to actualize permanency? 10. What are the most effective practices for engaging fathers to become more involved in the lives of children and youth in care? OUTCOMES Data 1. How many young people in care define themselves as GLBT? How are the experiences of these young people similar or different than other young people in care? Are the outcomes for these young people similar to or different than other young people in care? 2. What is the long-term impact of having been a child in care? 3. What practices reduce or contribute to the risk of placement breakdown in the opinion of young people and staff? 4. How do young people measure success for themselves when they are in care? What is their view of their future? 5. Which children and youth do well and which do not benefit from the following programs: EFP program, treatment foster care, foster care, group care, residential treatment, specialized parent care? 6. What is the prevalence of peer to peer abuse (physical, sexual, emotional) within different in care settings? Where are kids most likely to be safe? 7. How do we differentiate outcomes due to being in care from those that are due to the life experiences that brought the children into care in the first place? 8. What are the practices and decisions that were made that influenced the course of care for the ten most expensive young people currently in care? 9. What are the characteristics of placement breakdowns in different age groups? 10. Have outcomes for youth in care improved from the implementation of Youth Agreements and Agreement with Young Adults? ABORIGINAL PRACTICES AND OUTCOMES 1. Are there different outcomes for Aboriginal children served by delegated agencies as compared to government agencies and non-delegated/non-aboriginal agencies? What are the significant variables and factors? 22

26 2. What are the characteristics of Aboriginal youth that have successfully transitioned out of care into adulthood? What factors and life experiences contributed to successful transition? How many are connected to family and cultural community? How significant is connection to family and cultural community? 3. What interventions are most effective in breaking the intergenerational cycle of Aboriginal children in care? OVERARCHING QUESTIONS FOR CHILD SAFETY, FAMILY, YOUTH AND CHILDREN IN CARE ABORIGINAL PRACTICE 1. How does the incorporation of Aboriginal consumer and stakeholder voice influence the delivery and effectiveness of services and the development of policy? 2. What policies and practices are positively influencing services to Aboriginal people and communities? What policies and practices are not positive and effective? 3. What are the barriers to actualization of indigenization of child welfare services and how does indigenization get actualized? 4. What are the best practices for ensuring that clinical services for Aboriginal children incorporate frameworks that work with Aboriginal ontologies and epistemologies? COLLABORATION AND INTEGRATION 1. What are the indicators we could use to effectively measure the impacts and outcomes related to collaborative, strengths-based practice? 2. What are the barriers to inter-professional and inter-systems collaboration? How can these barriers be overcome? 3. How does professional practice shift as a result of transprofessional training? 4. What impacts has the implementation of a clinical supervisory model and coaching approach had on service outcomes and workplace health? 5. What factors in an organization contribute to the provision of child welfare services in a dignified, supportive and effective manner? 23

27 ADOPTION This service line aims to ensure that children in permanent care with a plan for adoption will be provided services and supports to facilitate timely adoption placements. Children require a stable and continuous relationship with a nurturing person to maximize physical, social, emotional and intellectual development. If this relationship is not possible with the birth family or other extended family members, then permanency while in care is the next step. Adoption is one option within the permanency planning process. The questions generated in this service area are: ADOPTION TIMEFRAMES AND OUTCOMES 1. What is the average length of time and range between a child/youth coming into care and final adoption placement by age, child s needs, and circumstances? 2. What is the impact of adoption timeframes on longer-term outcomes for children and youth? 3. What is the impact of the length of time a child or youth has been in care (or in and out of care) on the likelihood and outcomes of an adoption placement? 4. What are the barriers to efficient and timely adoption? How would removal of these barriers impact outcomes? Data 5. What is the optimal timeframe for moving a child into a continuing custody order and toward adoption after apprehension? 6. What timeframes for permanency are in place in other jurisdictions? 7. What is the average length of time and range between when a person applies to adopt and when a placement is made by age and characteristics of child being adopted? How does the timeframe for adoption impact the prospective adoptive family? 8. How many people that have expressed interest in adopting do not complete the home study process? What are the reasons for not completing the process? 9. What is the optimal timeframe for moving a child into a continuing custody order and toward adoption after apprehension? 24

28 CULTURE, AND ADOPTIONS IN AN ABORIGINAL CONTEXT 1. What are the numbers and profiles of Aboriginal children and youth who are adopted and what are the characteristics of the homes (families) that they are adopted into? 2. What alternatives to legal adoption are being developed and used in indigenous communities that support the aim of permanency in a culturally-sensitive way? 3. How are different cultural and community world views considered within the adoption process and does this have an impact on the long term success of adoption? 4. What are the long-term effects of adoption of Aboriginal children by non-aboriginal parents? What factors contribute to or distract from long term success of the placement? 5. Are there differences in adoption outcomes between Aboriginal and non-aboriginal children? What variables appear to make a difference in outcomes? 6. What are current barriers to, and effective approaches for, matching children within their ethno-cultural community? 7. Are there indigenous-appropriate processes for: evaluation for potential adoptive families, preparation for adoption, post adoption support and training? 8. How are the challenges of adoption of Aboriginal children being addressed with bands, urban Aboriginal organizations and Métis communities, including capacity and availability of adoptive families, access to specialized resources and care for children with complex needs? 9. How and when is custom adoption used? How many custom adoptions have been arranged in BC? What are the characteristics of these arrangements? 10. Are there indigenous-appropriate processes for: evaluation for potential adoptive families, preparation for adoption, post adoption support and training? 11. What is understood about effective practices and approaches that balance the long-term interests of a child for permanence and the cultural concerns and interests within Aboriginal communities? 12. How are other jurisdictions implementing custom adoptions and what can be learned from their experiences? What has worked well? 13. When looking at current cultural barriers within adoption, how can MCFD implement effective changes that best provide a culturally safe adoptive system? ADOPTION FACTORS, BREAKDOWNS AND OUTCOMES 25

29 1. What are the differences in processes, matching, continuity of care and outcomes between Aboriginal adoptions undertaken in delegated agencies and ministry-lead adoptions of Aboriginal children and youth? What can be learned from differential practices to enhance positive outcomes? 2. Are there different outcomes for children adopted through MCFD or licensed agency adoptions adoption? What factors appear to be related to differential outcomes? 3. What are the key indicators of attachment that would contribute to positive outcomes in adoption? 4. How many kinship adoption placements are made in homes that meet home study requirements, or do not meet the requirements? Are the outcomes/success of the placement different in homes meeting requirements compared to homes not meeting requirements? Data 5. What are the key indicators of attachment that would contribute to positive outcomes in adoption? 6. How can healthy attachment to adoptive parents be supported in practice, especially for children with disrupted attachment experiences? What is helpful for adoptive parents to understand, know, and develop skills regarding attachment and trauma? 7. What is known about the long-term outcomes for late adoption, and what are the best predictors of long-term success? 8. What are the outcomes for children placed in kinship adoptive placements vs. adoption placements with parents not previously known to the child; in permanent extended family homes vs. adoption; in long-term foster care homes vs. adoption? PROMISING PRACTICES 1. What can be learned from adoptive families and adopted children about their experience with the adoptive process and post- adoption? 2. What are the adoptive child/youths and families experiences of post adoption supports? 3. What are the best practices in assessment and assignment of young people to group home vs. long-term foster care vs. adoption? How can each support permanency for the child? 4. What supports offered to families in kinship situations serve to support/aid long-term stability? 26

30 Data 5. What are best practices for facilitating a mutually respectful and safe relationship between biological and adoptive families? What structural supports or guidance enhance success for openness? 6. What are the best practices with the biological family, adoptive family and the child when open adoptions are arranged for older children and youth? 7. Are there healthy group home alternatives to adoption for children not ready for adoption or for whom adoption is not in their interest? 8. Does the provision of post adoption supports increase the success of the adoption? How do outcomes compare in jurisdictions with and without post adoption supports? 9. How many adoptive families with special needs children access post adoption supports? What supports are requested/needed and how do they align with the supports provided? RECRUITMENT, ASSESSMENT AND SCREENING 1. How can families be recruited/encouraged to adopt youth? What are promising recruitment practices for families interested in older adoptions? 2. What are the best practices in timely screening of prospective adoptive parents? PERMANENCY 1. What are promising practices for integrating a focus on permanency within the early planning for children entering into care? 2. What are the connections between age of adoption and developmental outcomes? What implications does this information have for court processes and timeframes established in policy, standards and procedures? PREPARATIONS AND TRANSITIONS 1. What education training or support is most effective in preparing adoptive parents and reducing the likelihood of adoption breakdown? 2. How effective is adoptions training in BC (e.g., models such as adoptions online training and follow up with families)? 27