19.5 Case Consultation

Georgia State Seal

Georgia Division of Family and Children Services
Child Welfare Policy Manual

Chapter:

(19) Case Management

Policy Title:

Case Consultation

Policy Number:

19.5

Previous Policy Number(s):

N/A

Effective Date:

December 2016

Manual Transmittal:

2018-02

Codes/References

Title IV-E of the Social Security Act §§ 431 (a) (1) and (2)
Public Law 96-272 Adoption Assistance and Child Welfare Act of 1980

Requirements

The Division of Family and Children Services (DFCS) will:

  1. Facilitate case consultations[1] for children in foster care as follows:

    1. Within 25 days of a child entering foster care;

    2. Every six months, after the initial entry into foster care, for children ages 0 to 7 years old; and

    3. At the eighth month, after the initial entry into foster care, for children ages 8 and older; and every six months thereafter.

  2. Use the case consultation approach:

    1. When conducting Multi-Disciplinary Team (MDT) meetings.

    2. As a learning tool for developing practice skills as a team, when implementing Georgia’s Practice Model with the Social Services Case Managers (SSCM) and Social Services Supervisor (SSS).

Procedures

Social Services Supervisor

  1. Prepare to facilitate the Case Consultation and provide notification, at least 10 days in advance of the scheduled Case Consultation date, to the:

    1. SSCM (legal and boarding);

    2. Service providers/community partners;

    3. Independent Living Program,

    4. Court Appointed Special Advocate (CASA); and

    5. Other professionals working in partnership with the family and DFCS.

  2. Begin the Case Consultation meeting:

    1. Introduce team members and the process to the team; and

    2. Explain that the role of the group is to learn about the family and to brainstorm possible strategies and interventions to assist the child and family.

  3. Use the Case Consultation Agenda by asking the six agenda questions:

    1. Who is in the family?

      1. Help the team get to know the family by introducing family members with a genogram.

      2. Identify the family developmental stages and tasks (see policy 19.2 Case Management: Family Development Stages and Tasks).

      3. Review the developmental challenges related to the everyday tasks that families face.

    2. What family issues brought this case to the attention of DFCS?
      (Draw a line on the flip chart and bubble the family level and individual level issues)

      1. What are the parenting or caregiving practices related to everyday life tasks that pose a threat to child safety and well-being?

      2. Track the sequence of how the family goes about trying to accomplish these everyday life tasks.

      3. What is working and what is not working.

      These answers will lead to family level issues or concerns. It is important to assess the issues or concerns of safety which will help to identify Family Level Outcomes (FLO).

    3. What are the individual issues?

      1. What self-management issues do caregivers have that serve as barriers to resolve the problems in the family?

      2. What do you know about the individual patterns of behaviors?

      These answers will lead to individual level issues or concerns; once assessed for the level of safety, they will inform the determination of Individual Level Outcomes (ILO).

    4. What are the family’s strengths and skills?

      1. What does the family do well? What is the family proud of? What gives the family a sense of self-worth and satisfaction?

      2. How do these strengths help mitigate the family’s problem?

      3. Identify exceptions to the Family and Individual Level Issues or Concerns.

    5. Do we have a consensus about direction?

      1. Identify the safety issues that would prevent the case from closing.

      2. Identify and discuss the old plan (this is the way that the family was managing the everyday life task which cause safety issues or concerns) that was ineffective and what new plan(s) that will make the situation better.

    6. Do we have action plans in place yet?

      1. Review and discuss the action plans to identify the tasks and to ensure that the tasks are behaviorally focused, S.M.A.RT. (Specific, Measurable, Attainable, Relevant and Time-Limited) and can be documented to notice and celebrate change (see policy 19.14 Case Management: Action Plan).

      2. Is the family and their support network keeping track of their successes?

      This step is only applicable when a case plan and action plan have been developed with the family.

  4. Summarize the activities of the Case Consultation team and ensure that everyone is clear on the expectations and goals going forward.

  5. Ensure that any documents provided at the Case Consultation are reviewed and uploaded into External Documentation in SHINES within 72 hours of the Case Consultation.

Practice Guidance

Solution Based Casework (SBC) posits that child safety and well-being are endangered when families cannot successfully manage the everyday life tasks associated with the stage of the family developmental cycle that family is currently functioning in. In order to create safe environments for children to thrive in, caregivers have to gain insight into how their thinking affects their feelings; which in turn, is manifested in their behaviors. Child welfare staff and community based providers must focus their approach on the family’s strengths, competency and the times when the family was able to successfully meet the developmental needs of the child and family (problem exceptions). This empowers the family to work in partnership with child welfare staff and community based providers to address the challenges faced in their everyday life tasks in order to keep their children safe.

Family Composition

A genogram is an illustration of familial relationships over time. It is valuable for obtaining information about the family, assessing relationship dynamics and behavioral patterns, guiding intervention strategies and assisting families with insight into their familial connections.[2] Genograms also help to identify family strengths and needs throughout generations.

The Case Consultation Team (CCT) must remain conscientious of the need to honor and respect culturally different views, beliefs, attitudes, values and systems in which families raise their children. Differences in parenting styles and practices should not necessarily be viewed from a deficit perspective, but should be assessed in context of the cultural norms of the family. What may be viewed as a deficiency in one culture may be regarded as a strength in another culture.

The CCT should give equal weight to the family’s views on how to solve the problems of the family. The CCT should brainstorm ways to assist families in gaining insight into their beliefs and behavioral practices that place children in unsafe situations. This empowers families to develop new skills that they can maintain once they are no longer actively involved with the child welfare system.

Family Issues

It is important for CCT to identify the developmental stage that the family is currently in and the everyday tasks associated with the stage. All families, whether or not they are involved with the child welfare system, experience common challenges related to everyday life situations involving parenting (e.g. potty training, school attendance, dating, household rules, financial support, health issues and conflict). When these challenges pose a threat to the basic care and safety of children, then the child welfare system must intervene. The CCT uses the Social Services Case Manager (SSCM)'s work of tracking the sequence of events that brought the family to the attention of the child welfare system to gain awareness into what the family has tried that is working and what is not working. This will lead to the identification of Family Level Issues or Concerns. It is important to assess the issues or concerns for safety; which will help to identify Family Level Outcomes (FLO).

In situational domestic violence, the FLO is secondary to the Individual Level Outcome (ILO) because safety must be assured as the primary focus. FLO should not be completed on sexual abuse cases at all because sexually abusive behavior is not normalized as a component of managing the everyday family developmental stages, but is the result of uncontrolled personal behavior that victimizes a child.

Individual Issues

Just as many children in the child welfare system have experienced different kinds of trauma, many birth parents involved with child welfare services have their own histories of childhood and/or adult trauma. Untreated traumatic stress has serious consequences for children, adults, and families. Traumatic events in childhood and adolescence can continue to impact adult life, affecting an adult’s ability to regulate emotions, maintain physical and mental health, engage in relationships, parent effectively, and maintain family stability. Parents’ past or present experiences of trauma can affect their ability to keep their children safe, to work effectively with child welfare staff, and to respond to the requirements of the child welfare system[3].

The CCT Team will assess the behavioral problems or patterns of behavior that the caregivers exhibit which impact the safety or well-being of the child(ren). Assess the identified Individual Level Issues or Concerns based on the safety to the child, in order to identify the Individual Level Outcomes (ILO). How does the adult in the home function in regards to daily life management and protective capacities? Assess the caregiver with the high risk behavior, as well as, any other adults in the home with caregiving responsibilities. Review the assessments/reports of other professionals related to the behaviors of the adults, such as mental health providers, law enforcement, and interviews with relatives or friends.

CASES (criminal activity; anger/control issues; substance abuse; emotional stability; and sexually abusive patterns is the acronym used to categorize the five major problems) that families present with when encountering the child welfare system.

Family Strengths and Skills

Assessing a family’s strengths and skills is a continuous process, conducted jointly with the family, throughout the life of a child welfare case. The CCT should review and discuss the assessment of the family’s strengths and skills that have been completed up to the point of the Case Consultation. Assess the ways in which the strengths and skills can be utilized to safely maintain the child in the family or to safely return the child to the family.

Consensus About Direction

Consensus centers on separating the intentions of the caregiver from the actions of the caregiver by normalizing the developmental challenges of the family and externalizing the problem behavior (while not minimizing it), so that the family and Social Services Case Manager (SSCM) can work together to address the problem behavior without the caregiver focusing on defending himself or herself against the stigma of the behavior.

Reviewing the family history is important; however, it must be assessed in the context of its impact on the current problem. The CCT will need to understand and recognize how the family has attempted to solve their problems in the past as stated in the family’s language or narrative of the problem. Evaluate whether the family’s language adequately assesses the old problematic behaviors and adequately addresses the new desired behaviors.

Forms and Tools

N/A

1. Content for this discussion of case consultation is sourced from the book Solutions-Based Casework by Dana N. Christensen, Jeffrey Todahl, and William C. Barrett.
2. A Picture Is Worth a Thousand Words: Exploring the Use of Genograms in Social Work Practice Natalie D. Pope, Ph.D., LCSW, and Jacquelyn Lee, Ph.D., LCSW The New Social Worker Spring 2015
3. The National Child Traumatic Stress Network 2000