PATHWAYS TO STRENGTHENING

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• PATHWAYS TO STRENGTHENING
• AND SUPPORTING FAMILIES IN ILLINOIS

Module 3A Assessing Child Safety
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Job Competencies

• Review and discuss skills necessary to protect
  children.
• Define the core concepts of safety and risk
• Discuss how safety and risk relate to and are
  different from each other.
• Differentiate between safety and risk.
• Develop an understanding of the CERAP protocols
  effect on children and families.
• Develop an awareness of the potential effects
  culture may have on our application of the CERAP
  protocol

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Job Competencies (Contd)

• Assess child safety taking into account
• the childs age and developmental status
• exposure to adverse childhood experiences (ACES),
  and
• the protective capacities of the parents

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How many of you drove to training today?

• What are the inherent risks of driving an
  automobile?

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Legislation / Development

• In 1994, Illinois passed Senate Bill 1357 which
  required DCFS to develop a valid and reliable
  child endangerment protocol.
• assists the Department in strengthening its focus
  on protecting endangered children.
• mandated that public and private child welfare
  staff receive training in the Child Endangerment
  Risk Assessment Protocol (CERAP), and to become
  CERAP certified (pass the CERAP exam).

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What knowledge and skills do DR workers need to
assess safety?

• to identify factors that pose concerns about
  immediate safety
• to assess whether the current circumstances
  mitigate for or against these safety factors
• to determine whether children are safe or unsafe
  and
• if they are unsafe, to develop and implement
  interventions in order to control for safety

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But thats not how its done in the field.

• The CERAP training is the officially sanctioned
  way the child endangerment risk assessment
  protocol is to be completed.

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Safety-based Model of Practice

• What have you seen the parent or caregiver do
  to the child
• Refocused as
• What have you seen or what do you know that
  would cause you to believe the child might be in
  imminent danger of significant harm?

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CERAP Effects on Children Families

• Requires that we intervene with families when
  they most need our services (at each milestone in
  a case)
• Increases the safety of our most vulnerable
  children
• Increase and enhances the services that we
  provide
• Offers an extra measure of protection by
  requiring specific supervisory involvement in the
  decision making early on in a case.

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Illinois Statutory Definitions

• Abused Child
• Neglected Child

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Definition of Safety

• A child is considered to be safe when an
  assessment of available information supports the
  belief that a child in a household or in
  custodial care is not in immediate (near future)
  danger of moderate to severe harm.

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A Safety Concern

• The potential harm to the child which could be
• immediate or in the very near future and
• moderate to severe
• If an intervention is not made to control the
  situation.

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Definition of Risk

• The likelihood of any degree of longer-term
  future harm/maltreatment. It does not predict
  when the future harm might occur, but rather the
  likelihood of it happening at all.

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Viewing Safety and Risk Concerns

• Risk Concerns
• Longer Term
• Low to severe
• Decrease/Resolve

• Safety Concerns
• Moderate to severe
• Immediate/Very near future
• Control

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Safety Risk Concerns Similarities

• Prediction of harm
• Describes potentially harmful
• home conditions
• family members-caretaker behavior
• family interactions

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Safety Risk Concerns - Similarities

• Can change quickly
• Can often be controlled by family strengths or
  change in circumstances
• Can be addressed with interventions

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Safety Risk Concerns - Differences

• Safety Concern
• Immediate or near future

• Risk Concern
• Future or in the longer term

Aaron, age 3, has been living with his
grandparents for 6 months while his mother
received in and out-patient substance abuse
treatment program. He was originally reported as
neglected (Inadequate Supervision). She is now
clean and has had no relapses. Aaron is in
daycare. Grandparents state his mother is doing
well, and have returned him to her care.
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Safety Risk Concerns Differences

• Safety Concern
• Moderate to severe

• Risk Concern
• Low to severe

Safety Concern
Risk Concern
No/Low
Moderate
Severe
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A father locks out his 13 year old son, Joseph,
for violating curfew, and says hell do so again
if he continues to come in late. Joseph just
started being defiant. The father also tells the
DR Specialist that he wishes to get into family
counseling before he hurts Joseph because
Josephs teenage angst is starting to increase.

• What are the degree of harm issues in this
  situation?

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Safety Risk Concerns Differences

• Safety Concern
• Needs to be controlled now

• Risk Concern
• Needs to be resolved or reduced in the future

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Mark, age 3, was berated by his father Frank
because he refused to eat his carrots. The
chastisement was so severe the child began to
shake uncontrollably. Frank also berated Marks
mother, Lola, because she let the child play with
his food and didnt make him eat it. Lola says
she tries to stop her husband from berating Mark,
but he is a madman when hes angry and there is
nothing she can do.

• What is the immediate safety issue ?
• What is the long term risk issue?

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Comparing Safety to Risk
Safety Risk
Time Now or very near future Longer term
Degree of Harm Moderate to severe Low to severe
Purpose of Intervention Control Resolve
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What does this mean for you?

• Safety must be assessed quickly, often in one
  visit.
• Risk is assessed over a longer period of time,
  allowing time to gather, assess, and evaluate
  information.

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How Culture Affects the Safety Determination
Process

• Definition
• the totality of a persons learned behaviors.
• based on values, beliefs, and assumptions derived
  from shared experiences, history and geographic
  proximity.
• guides peoples interpretation of life
  experiences and development of coping strategies
  for day-to-day living.

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Impact of Culture

• How does
• Culture affect our work at various points in the
  Safety Determination process?
• Attitudes guide our decision-making?
• Lack of knowledge regarding a certain culture
  affect our safety determinations?
• Culture get defined broadly?

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Impact of Culture Contd

• What are some examples of cultural
  misinterpretations in the following areas?
• Verbal threats
• Parenting responsibilities of children
• Living arrangements
• Physical markings and healing practices

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Cultural Competence

• The ability to evaluate behavior that is
  acceptable, although culturally variant from
  ones own standards of behavior, and compare it
  to truly dangerous and unacceptable behavior or
  conditions is the goal of cultural competence
  regarding the identification of safety concerns

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Stages of Cultural Competence in Safety
Determination

1. Engage Families
2. Use the relevant broader social network of the
   family
3. Use culturally relevant services

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Determining Safety Concernsand Risks

• Mini Case Scenarios

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Mini-scenarios Activity

• Each scenario is one of the following
• a safety concern, or
• a risk concern, or
• no concern.
• Identify if there are any
• cultural factors or
• contributing factors.
• Write answers in the margin.

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Mini-scenarios Activity Debriefing

• Jody
• Safety
• Four pre-school age children
• Safety
• Melissa
• Risk
• Carrie and Simon
• Risk
• Jonathan
• - Safety

• Judy
• - Safety
• Carter Family
• - Safety
• Milo Children
• - Risk
• Curtis
• - Safety
• Chris
• - Safety

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Mini-scenarios Activity Debriefing

• Trenise
• - No Concern
• Eduardo
• - Safety
• Ahmad
• - Safety
• Bennett Children
• - Risk

• Joseph
• - Risk
• Kyle
• - Risk

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Steps to Determining Safety

• Step 1 Identify relevant safety factors.
• Step 2 Describe the safety factor you
• checked.
• Step 3 Record family strengths and
• mitigating circumstances.
• Step 4 Make Safety Decision

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Safety Factors

• Factors 1-14 Assessing immediate danger of
  moderate to severe harm due to the identified
  factor.
• When assessing for Safety, consider
• Age developmental status of child
• Mental, medical, developmental status of
  caretaker
• Type, severity, location of injury
• Intent, severity or duration of the behavior
• Factor 15 Provides discretion for identifying
  other safety factors.

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Definition of Paramour

• no legal or biological relationship to all the
  children.

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Definition of Caretaker

• In relation to CERAP, caretaker refers to
  anyone who impacts the childs safety in the home.

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Family Strengths

• Sometimes the best way to identify strengths is
  to directly ask the family.
• What might you ask the families in order to
  elicit their areas of strength?

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A child is beaten by his mothers paramour
resulting in the boys arm being broken. Mother
ensures the childs safety by securing medical
attention, seeking a protection order, leaving
her boyfriend and moving in with her parents.
Furthermore, she advises the boys father of the
situation and requests his assistance in
providing care for their son while she removes
her belongings from the boyfriends residence.

• What are the family strengths that are present?

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Mitigating Circumstances

• While family strengths and mitigating
  circumstances may overlap they are not synonymous
  
• What are some examples of family strengths that
  can help mitigate child safety?

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A DR Specialist and a SSF Worker respond to a
report of two children, ages 7 and 5, who have
been seen on two recent occasions playing in the
park unsupervised. They discover the children
are presently supervised by their sitter, a 15
year old aunt who is visiting during three weeks
of summer vacation. She initially denies leaving
the children unsupervised but later discloses she
let the children play in the park across the
street while watching them from the living room
window. Their mother discloses that she wanted to
save money by having her sister watch the
children while she worked. She is clearly upset
at her sister for leaving the children
unsupervised and identifies other caregivers she
will use to watch the children while she is
working.
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Making the Safety Decision

• If no Safety Factors are marked or Safety
  Factors that are marked as concerns can be
  mitigated, it is SAFE.
• If Safety Factors are marked as concerns and
  cannot be addressed by family strengths or
  mitigating factors, it is UNSAFE.

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What should the DR Specialist and SSF Worker do
if the situation is determined to be unsafe?

• transfer the case to the investigative track it
  is ineligible for the DR Pathway (safety plans
  will not be developed in DR)

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Preparation for CERAP Exam Questions

• Case Scenarios
• General questions about assessing for safety
• Safety Determination Form

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Preparation for CERAP Exam Questions

• Sample Test Questions

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Sample CERAP Exam Activity
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Sample CERAP Exam Debriefing

• Question 1
• Has there been physical abuse or threat?
• Has there been neglect?
• Are there issues with a paramour?
• Is there previous history of abuse/neglect?
• Is the caretakers behavior influencing/causing
  the abuse/neglect?
• Are there any special issues?

• Answers
• no concern
• safety
• no concern
• safety
• no concern
• safety DV

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Sample CERAP Exam Debriefing

• Questions
• 1-Risk, 2-No concern, 3-Risk, 4-No concern,
  5-Risk, 6-Risk
• 1-Safety, 2-No concern, 3-No concern,
  4-Safety, 5-No concern, 6-Safety
• 1-Safety, 2-No concern, 3-No concern,
  4-No concern, 5-Safety, 6-No concern
• 1-Safety, 2-No concern, 3-Safety, 4-Safety,
  5-Safety, 6-No concern

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Sample CERAP Exam Debriefing

• Questions
• 1-No concern, 2-Safety, 3-Safety,
  4-No concern, 5-Safety, 6-Safety
• 1-No concern, 2-No concern, 3-Safety,
  4-No concern, 5-Safety, 6-Safety
• 1-No concern, 2-No concern, 3-No concern,
  4-No concern, 5-Safety, 6-Safety

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SACWIS Safety Assessment Activity

• Complete the Safety Assessment
• for Robin and her children.