UConn Study Finds Interprofessional Communication May Aid Family Reunification in Child Welfare Cases


Jon Phillips has not forgotten the communication roadblocks he often faced when, as a child welfare caseworker in Colorado, he wanted to schedule a family visit for a child in foster care to assess whether it was safe to return a child home.

“If I wanted them to be able to go home on a weekend, I needed to get the approval of other people involved, specifically the guardian ad litem,” he says, referring to a court-appointed official, often an attorney, who is engaged in a child welfare case to represent the best interests of the child. “I’d also want to talk any therapists that were involved to know if there were any concerns I needed to be aware of before I allowed a visit. And sometimes it was really hard to get information from them.”

If the professionals involved in the case weren’t effectively sharing information with one another, sometimes those family visits just wouldn’t happen, regardless of what the impact of that missed opportunity might be on the child or their caregivers.

“There’s a lot of expectations that we put on families to do certain things, and to follow their case plans,” says Phillips, who is now an assistant professor and researcher with the UConn School of Social Work, “and sometimes I thought that we needed to focus a little more on what the professionals could do to better support families and to help them achieve a positive outcome, whatever that might be.”

The dynamics of interprofessional collaboration in child welfare are a primary focus of Phillips’s research, and according to a study he recently published in the Journal of Public Child Welfare, more frequent communication between caseworkers and the other professionals involved in child welfare cases is associated with an increased likelihood that a child will be reunified with their family in a timely manner.

His study findings highlight the importance of communication between professionals involved in child welfare, while suggesting areas for future study that may help improve outcomes for children and families who enter the child welfare system.

The data analysis showed that, when caseworkers communicated with both the guardian ad litem and the therapist or counselor working with the family, foster children were more likely to be reunified with their families.

“There are a lot of hypotheses as to why interprofessional communication is important in child welfare, but it hasn’t really been studied directly very much,” Phillips says. “You can probably find 100 different definitions of interprofessional collaboration, and probably 30 different ideas of what it means, but in order to promote it and support it, we need to understand what it is.”

In his study, Phillips looked at administrative data from one large, urban child welfare system to assess whether communication between the professionals involved in child welfare cases – including caseworkers, therapists, substance use counselors, and court-appointed guardians ad litem – was significantly associated with timely reunification, defined as reunification within 12 months of the child being placed in foster care. Caseworkers in the system are required to document each communication with the other professionals involved in the case in a centralized database.

The data analysis showed that, when caseworkers communicated with both the guardian ad litem and the therapist or counselor working with the family, foster children were more likely to be reunified with their families.

However, when they communicated with only one of those professionals – just the guardian ad litem or just the therapists and counselors – this probability not only disappeared, but in some cases was associated with a reduced likelihood of timely reunification.

“Frequent interprofessional communication had what we might call an additive effect,” says Phillips. “It suggested that caseworkers really need to be communicating frequently with both professionals in order to facilitate timely reunification, that communicating frequently with just one of those professionals does not necessarily increase the likelihood of timely reunification.”

As part of the study, Phillips also conducted qualitative interviews with some of the caseworkers, guardians ad litem, substance use counselors, and therapists involved in child welfare cases in the country system in order to further explore how interprofessional communication might contribute to timely reunification.

“In the qualitative phase, three themes emerged that suggest why interprofessional communication may facilitate timely reunification,” Phillips says. “One is that, when these professionals are communicating, they’re better able to identify and address any barriers to reunification. Maybe the family needs a bus pass. Maybe the parents aren’t attending their substance use treatment regularly and the professionals need to address that. If you think about it, each professional has one piece of the puzzle they’re seeking to fit, and so only by sharing information are they getting the complete picture of what needs to happen.”

A second theme was that frequent communication helped the team of professional stay on the same page in terms of expectations about what they needed to see happening in order to reunify a child, and a third theme was that, when professionals are communicating, they’re enabled to make decisions in a timely manner. If they’re simply not hearing information, decisions may be delayed.

“One study participant was a guardian ad litem, and they weren’t getting information from the caseworker about how the family had progressed,” Phillips says, “so they weren’t in a position where they could advocate for the child to return home . And they actually said, had I known this, had I had this information, I could have recommended reunification two months earlier. And that really resonated with me personally, just thinking of a kid lingering in foster care for two months for no reason.”

While the study was limited to data from one county, and was dependent on caseworkers recording their own data into the centralized database, the findings, Phillips says, help to fill an existing gap in our understanding of how improving communication between child welfare professionals might positively impact family outcomes.

He hopes that additional research will help develop a better understanding of interprofessional collaboration that can help to guide policymakers and child welfare administrators in developing policies, guidance, and protocols that encourage interprofessional collaboration as a means of improving child and family wellbeing.

“What I’m trying to do with my research is determine if interprofessional collaboration is related to various outcomes in the child welfare system – whether it may be outcomes for families, like timely reunification, or outcomes for professionals,” he says, “and then once I understand that better, shifting to say, OK, we know this is important. How can we promote it? How can we facilitate it? A related goal of my research is to identify the key components of interprofessional collaboration—or what it looks like when professionals collaborate well. We need to understand that more so that we can know what we need to target with our interventions. If you’re going to design a training on interprofessional collaboration, what is it that you should be talking about?”

This study was supported by grant funding from the National Association of Social Workers.

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