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Partnering for Success: Factors Impacting Implementation of a Cross-Systems Collaborative model Between Behavioral Health and Child Welfare

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Abstract

Cross-system implementation efforts can support needed mental health (MH) service utilization among children involved in the child welfare (CW) system. The Partnering for Success (PfS) initiative is one such effort that promotes greater collaboration between the CW and MH providers by building capacity within and across each system. Frontline CW providers learn to accurately identify child MH treatment targets, link families to locally-provided evidence-based treatments (EBTs), and monitor treatment progress. Concurrently, local MH providers are trained along with CW workers to utilize Cognitive Behavioral Therapy plus Trauma-Focused CBT (CBT +), a common elements training and consultation approach focusing on typical MH issues for CW-involved children: Anxiety, Depression, Behavioral Problems, and Traumatic Stress. Finally, agency leadership receive support around promoting implementation and sustainment. This paper examines factors identified by participating CW and MH staff which impacted PfS implementation. Twenty-nine frontline, supervisory, and executive CW and MH providers were interviewed via audio-recorded web-based calls in six focus groups and 10 individual interviews. Factors facilitating implementation success included training/consultation, support from supervisors and agency leadership, improved referral processes, high quality relationships and communication between CW and MH frontline staff, PfS tools and resources, opportunities to use PfS, as well as buy-in from providers and families. Implementation barriers included poor communication between CW and MH providers, conflicts over role expectations, workload and turnover challenges, lack of buy-in, as well as provider (e.g., not aligned with CBT +) and client characteristics (e.g., frequent crises).

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Acknowledgement

The authors acknowledge support from the UMSSW's Ruth H. Young Center for Families and Children and the Institute for Innovation and Implementation. We also thank the child welfare and mental health agency leaders, line professionals, providers and their clients who participated in the evaluation. The authors recognize the significant contributions of Rick Barth, Lucy Berliner, John Cosgrove, Shannon Dorsey, Pamela Freeman, Angela Jachelski, Bethany Lee, Marc Mannes, Jon Phillips, Karen Powell, Leslie Rozeff, Rochon Steward, and Jessie Watrous.

Funding

Partnering for Success is a program of the National Center for Evidence-Based Practice in Child Welfare which is supported through grant 90CT7001-01-02 from the U.S. Department of Health and Human Services, Administration for Children Youth and Families, Children’s Bureau. Funding support was also provided by the Children’s Bureau through the State of Maryland’s Title IV-E Waiver Demonstration project. The National Center for Evidence-Based Practice in Child Welfare (NCEBPCW) is operated by the University of Maryland, School of Social Work (UMSSW). The contents of this paper/presentation are solely the responsibility of the NCEBPCW and do not necessarily represent the official views of the Children’s Bureau of the US Department of Health and Human Services.

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  1. Silberman School of Social Work, Hunter College, City University of NewYork, 2180 3rd Avenue, New York, NY, 10035, USA

    Geetha Gopalan

  2. Graduate School of Social Work, University of Denver, Denver, USA

    Suzanne E. U. Kerns

  3. Maryland State Department of Education, Baltimore, USA

    Maria Jose Horen

  4. Mid-Atlantic Behavioral Health, Wilmington, DE, USA

    Jennie Lowe

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  1. Geetha Gopalan
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Correspondence to Geetha Gopalan.

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Gopalan, G., Kerns, S.E.U., Horen, M.J. et al. Partnering for Success: Factors Impacting Implementation of a Cross-Systems Collaborative model Between Behavioral Health and Child Welfare. Adm Policy Ment Health 48, 839–856 (2021). https://doi.org/10.1007/s10488-021-01135-5

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