Case Consultation

Time: up to 2 hours

Developmental Competencies

SW219-01 Ability to respectfully relate to, engage, and assess parents from a strengths-based “person in environment” perspective, and to develop and implement a case plan based on this assessment

SW205-03 Ability to assess safety throughout the life of a case and evaluate conditions for family reunification

SW208-01 Ability to incorporate specific safety activities and tasks, including formal and informal supports, that control safety threats or substitutes diminished caregiver protective capacities

SW208-04 Ability to integrate permanency planning throughout the life of the case

SW216-01 Ability to identify and describe key signs, symptoms, impacts and manifestations of trauma, disrupted attachment, and childhood adversity in children and adults and to incorporate trauma informed care into case and safety plans.

Course Description

Participants in the Case Consultation with an Alliance Coach training will have the opportunity to present a case, particularly a complex case where child safety, permanency or wellbeing might be improved by structured consideration of what is known and unknown about the child and family. Case consultation is a process that reinforces important case work best practices, and specifically supports accurate identification of child safety threats or of information that’s needed to adequately assess and plan for child safety. Participants will be supported in their development of critical thinking skills about safety assessment, assessment of progress, and determinations about community referrals and other supports in the community.

Materials and Preparation

No specific materials must be brought to the training.

It’s highly recommended that the coach ask which case is expected to brought for consultation so that the coach can review the case in FamLink beforehand. This will give some sense of the policy or practice areas that may be helpful in sorting out how to move forward with the case.

Several documents listed in the resources section are recommended handouts or may be helpful.

You may want chart paper to document ideas generated.

You will need to physically record the information that is shared as part of the Case Consultation, as well as next steps agreed upon. It’s ideal if the room has a white board on which to document this. You can then take a picture of it and send it to the worker, or you can have a participant take notes.

Resources

Recommended Handouts:

  • Tips for Constructing a Genogram (attachment 1)

Safety Framework materials

  • Gathering Information worksheet (helpful when the worker can’t describe the context for maltreatment, including how the particular incident happened within the family – the particular issues present that day or that hour that resulted in ca/n)
  • Safety Threats guide or the Safety Threats Worksheet (helpful when the worker/supervisor are trying to decide whether to keep the case open or close it out, and when looking at safety planning and return home)

Policy Materials

  • If you know the policy or practice arewhere additional information/consultation could improve outcomes for this case, you may want to prepare some materials that address these areas. For instance, if one of the issues impacting the case is a parent’s cognitive disability, you may want to bring the policy on working with Developmentally Delayed parents and any other important resources related to that issue if it appears they might be helpful.

Session Flow

Step / Delivery Method / Time
1 / Review of purpose of Case Consultation and goal for the consultation / Facilitated discussion / 10 minutes
2 / Case Consultation / Facilitated discussion / 40 minutes
4 / Next Steps and Closure / Facilitated discussion / 10 minutes

Pre-Learning/Before Class Preparation

There is nothing required for participants or supervisors prior to attending the training, but it’s helpful if they provide the case information so the coach might be able to read the case prior to the consultation.

The following is highly recommended for the coach prior to the training:

  • Talk with the supervisor about what is challenging or complex related to this case to ensure that Case Consultation is the best way to support the participant’s needs. (Case consultation is not the first choice for issues like determining permanency preferences, or identifying options to support child wellbeing – but can help in sorting these things out when they are part of a complex case where the overall case resolution is tied to multiple areas of concern related to the family or children. Remember the other supports that exist for workers, supervisors and families; including shared planning meetings, CPT’s, FTDM’s, Adoption staffings, consultation with internal and external experts, etc. You may need to refer a case to one of these settings when they are the more appropriate venue.)
  • Ask the supervisor to ensure that the worker is well prepared to discuss the case history.
  • If a case plan exists have the worker bring copies of the case plan and court ordered services, if applicable.

Classroom Training

Introductions and Purpose of the Consultation

  • Coach will introduce self
  • Participants can introduce themselves and their role
  • Coach or supervisor should review the reason for the case consultation, and the desired, realistic outcome for the case consultation. (This is an opportunity to create consensus about what can/will be accomplished during the hour)
  • The roll of participants who are not the expert on this case may be reviewed by the coach
  • Other participants can help the worker both by identifying connections between the work they have done and safety/case plan issues (places the work has been successful and gaps) and by identifying resources and next steps from their knowledge of resources and things that have worked for other families.
  • The overall role of case consultation may be reviewed by the coach
  • Helps us stay grounded in and focused on the child safety issues (or significant risk factors) that brought the family to our attention or that are keeping the case open
  • Helps us sift through information to identify what is critical to our understanding of child safety and how to help the family keep the child safe (vs. information that’s a distraction)
  • Helps us and the family move forward with a plan that supports their ability to (now or in the future[1]) keep the child safe and adequately meet their needs
  • Identify gaps in information that are impacting our ability to assess child safety or to help the family keep the child safe (now or in the future)
  • Can inform or remind workers and supervisors on a host of best practices that may differ from “business as usual” in that office, so supports/reinforces best practice.

Trainer’s Notes:
It can be intimidating to share your work and thinking about a case. Case consultation is important as a way for all of us in child welfare to challenge ourselves and grow our practice. It might be helpful to note this before you start and to appreciate the willingness of theworker to be vulnerable in this way. This sets the group up to participate respectfully and reminds you and them to notice the positive/good work that’s happened on the case, as well as the needs that remain.

Case Consultation

Handout the Tips for Constructing a Genogram if you feel it will be helpful for the group.

Step 1: Genogram and Developmental Challenges

  • Have the person presenting the case provide information so that the genogram can be constructed. Include the immediate family but also other caregivers for the child, and supports to the family.
  • When information is provided that relates to later stages of the case consultation, mark it down but re-direct the participant back to “who is in the family and who are their supports”
  • Ask the group what challenges are normal and expectable given the constellation/makeup of the family and ages of the children.
  • Ask the person presenting the case about the family’s cultural context including the individual member’s identities. This includes how a person identifies in terms of race AND ethnicity but ALSO in terms of sexual orientation/gender identity, religious or spiritual affiliation, citizenship status and primary language, socioeconomic status, and any other identity that is important from the family’s perspective.
  • Ask how these identities and this overall cultural context may impact the family’s current situation generally, their values and challenges around raising children, and their willingness and expectations re: working with our system.

Trainer’s Notes:
There is a fine line between knowing how the family’s cultural context might impact their experience and stereotyping a family or its members. This family is made up of unique individuals who have their own perspectives about their experiences and their values. However, experiences of oppressionpropagated againstpeople holding certain identities can be quite similar and the participants can be primed to think about how and if oppression is impacting the family’s ability to keep their children safe and well cared for (or impacting the larger community’s reaction to their parenting).
We want to understand and “see” the unique members of this family and their values and also to “see” and understand the existence of systems of oppression that may be impacting the family or informing their reaction to our involvement. We have to be curious about both and be able to see both – and also to be humble and continue to ask the family to tell us how they understand themselves and their experiences.

At the end of step one participants should:

  • Have a good idea of who is in the family and of what might be important to the family.
  • Have a good idea of the greater cultural context in which family members, and the family as a whole, operates.

*If we don’t have all this information, the worker should have a next step(s) to gather more information regarding whatever is missing.

Step 2 & 3: Strengths & Skills, and Safety Threats & Challenges

  • What challenges is the family facing that create a safety threat (or concerns about child safety)? What is happening with the family that’s creating high risk situations for the children?
  • What is the context for these struggles? What has the family tried?
  • Which of these, if any, lead to safety threats for the child(ren)? Significant information should support an understanding of the safety threat – including when and how it operates, how the child is endangered, etc. In complex cases, there are often multiple high risk situations identified but it can be difficult to tease out whether any of these rise to the level of a safety threat. You may have to help the group be patient as all the information can be shared and sorted out. It may be clear that there are important gaps which would help in sorting out child safety once all the information known to CA about the family has been provided.
  • What do we know about how the family views and uses discipline? What do we know about overall parenting practices and level of care provided to each child in the household?
  • Ask for information about the family’s strengths and skills
  • What developmental tasks are being managed appropriately and how?
  • What strengths impact the family’s ability to keep their children safe and well cared for during these times?
  • If the family would like things to go better, this is a strength. Do they have a vision for how that would work or what isn’t working? Insight about the problem is also a strength.

Trainer’s Notes:
You may choose to do strengths or challenges first, but often these are parts of the same conversation so it may be most effective to at least create physical space to document both, if not to actually solicit information about both at the same time.

At the end of steps 2/3 you should have a clear understanding of any safety threats that exist, as well as how the family’s challenges (safety threats or not) typically occur within family life. You should also have some ideas as to what this family does well and is motivated by.

*If there isn’t sufficient information about the challenges – particularly those that are or may be safety threats – gathering this information is a critical next step for the worker. You may want to write it with a #1 before it.

*It’s fairly common for the context for the maltreatment to not be sufficiently understood. When the ca/n happens, what is going on for the individuals in the family that allow it to occur (vs other times when it doesn’t). You may want to ask the group to brainstorm how the worker might get this information from the family. Also, there may be times where the ca/n is ongoing. In that case it may be useful to ask when things are better (as with chronic neglect) or it may be important to acknowledge that things are at baseline abusive (as with ongoing sexual abuse where there’s no protective parent).

*If the worker can’t articulate family strengths – particularly protective capacities specific to the individual and the situation (vs. generalized strengths “they have housing”) - that may be an indication that the worker hasn’t taken the time to gather these. This is critical in getting a realistic view of the family and in motivating the family to join the change process. For the vast majority of our families, it is true that parents want to be safe and effective, and that there are times when things go well (or at least better.)

Step 4: Individual behaviors that are causing problems

  • Ask about what individual behaviors or conditions are impacting the caregiver’s abilities to parent safely (or as well as they would like).
  • You may already understand these from the discussions of family strengths and concerns, and child safety threats or high risk situations.
  • Workers often want to list all the concerns or risk factors associated with each caregiver. You may want to allow this, and then get specific about which of these issues actually impact their ability to participate safely in family life. For instance, if a dad was diagnosed with PTSD 6 years ago but the ways in which it impacts him don’t relate to his care for the children, then it might be a concern but it shouldn’t berelated to a safety threat, and we should consider whether our case plan/court ordered services need to address it.
  • This is an area where many biases pop up. Be particularly interested in the connection between the condition/behavior and the safety threat. This is how we end up with long lists of services for family members to complete that don’t actually improve the safety of children.

Step 5: Child’s functioning and vulnerability

  • Ask about each child residing in the household and their specific strengths and vulnerabilities. You may already understand these from the discussions of family strengths and concerns, and child safety threats or high risk situations.
  • How has each child in the household been impacted by ca/n or the ongoing risk so far? How are they likely to be impacted in the near future?
  • Are there needs not related to a safety threat but related to ongoing wellbeing that are important to consider for any of the children in this household?

At the end of this step there should be a clear connection between the individual behaviors and capacities of each caregiver and the safety threat or high risk situations (for our families where risk keeps the case open) which impact children in the adult’s care/in the household. There is also likely to be a list of things which we need to know more about and maybe some steps about where/how to gather this information or seek further consultation.

Step 6: (if applicable) Safety Planning

  • It may be apparent that there is an active safety threat that the caseworker has not identified – OR – that there is not sufficient information to conclude that the child is safe. This includes consideration of whether the child(ren) is/are currently safe during any visitation with parents/siblings.
  • If it appears a safety plan is needed, brainstorm what resources might be available to address the safety threat. Who can assist? Who is reliable and protective? What might be done?
  • Safety planning should be done with the family and with the safety plan participants directly. We should not give the worker a safety plan to deliver to the family. The family and the safety plan participants have to agree to whatever safety plan is developed. Ensure that the caseworker understands that the brainstorming is meant to offer ideas of what resources exist that might keep the child(ren) safe, but that if a plan cannot be agreed to with people who seem to be acting in good faith, and who are really willing to participate, then we need to take other steps to protect the child(ren).

Step 6: (if applicable) Case Plans

  • Review the case plans and court ordered services, if applicable.
  • Are the case plans appropriate given how and when the safety threats were occurring? Do they relate specifically to the child safety threats or significant risk factors?
  • Are the services or supports evidence based? Do they reflect best practice?
  • Is the case plan appropriately specific and measurable? How will we know when the child is safe to return home with a safety plan in place?
  • Are their services or supports needed for each child? If so, do those in place reflect best practice? Will the family be able to continue to offer the child these supports when returned home/when permanency is achieved?
  • Review progress made by the family, including feedback from service providers, others in the family’s life, and the family itself
  • While the case consultation may bring to light areas that need to be addressed on the case plan, it’s best practice to co-create plans with the family, not in contexts where the family is not present.

Step 7: Next steps and specific problem solving