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Iowa Department of Human Services

Child Protective Services

“Child Engagement Activities”

Emmalee Bolin

Social Work Practice III

Margarite Reinert

April 22, 2020

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Table of Contents

Introduction……………………………………………………………………...……3

The Need for Change………………………………………………………….……...4

Identifying the Change………………………………………………………….……6

Analyzing the Change Opportunity……………………………………....………….8

Goals and Outcomes…………………………………………………………………9

Designing and Structuring…………………………………………………………...11

Determining Resources………………………………………………………………13

Implementing the Change Process...……………………………………………….…14

Monitoring the Change………………………………………...……………………...15

Evaluating the Change Process……………………………………………...……….16

Reassessing and Stabilizing……………………………………………………...…...16

References…………………………………………………………………………....18
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Introduction

The Iowa Department of Human Services (DHS) vision is to make a positive difference

in the lives of Iowans they serve. The mission for DHS is to help Iowans achieve healthy, safe,

stable, and self-sufficient lives through the programs and services they provide. The four guiding

principles are customer focus, excellence, accountability, and teamwork. DHS has many

programs within the agency: food assistance, childcare assistance, Medicaid, ongoing case

management, adoption, and so much more. A student at Briar Cliff University, Emmalee Bolin,

took a practicum position with the child protection workers and the ongoing caseworkers for

parents involved with DHS. The department is under is called Child and Family Services.

Major social problems that DHS addresses with families are abuse allegations around

neglect, physical, medical, sexual, and psychological. Services and types of intervention that the

workers use include early intervention and prevention services, family-centered child welfare

services, family safety, risk, and permanency (FSRP) services, Parent Partner program, family

foster care services, foster group care services, and transition services to name a few. The goal of

the Iowa DHS is to make sure children are safe from abuse. The goal is to keep children safe and

enhance the engagement of families to increase service delivery. Achieving permanency for

children is another main goal, no matter what that will look like for the child. DHS tries to keep

families together or reunify them as quickly as possible. DHS wants children to have a positive

sense of well-being. The staff is working hard to have training activities related to the effects of

childhood trauma on growth and development.

The student practicum role at DHS was to observe and learn how to engage with families.

Participating in watching how workers interview the parents and children in both child abuse

assessment interviews and ongoing case visits. Taking notes for the workers when they do the
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interviews and typing the narratives. The student works with DHS as a parent partner coordinator

and already knows quite a bit about the process and how the system works. Attending court

hearings with workers identifying what happens in the background. Through these shadowing

experiences, the student discussed with the supervisor about the needed change the agency

wanted to work on.

Currently, the field supervisor, Mary Jo, was wanting to implement child engagement

activities to the social workers. During a caseworker visit, the agenda is on building rapport,

gathering information, reviewing progress towards goals, assessing the effectiveness of services

provided, and what actions need to be taken. The Child and Family Services Review (CFSR) has

10 specific items related to outcomes for in-home cases and 18 items for out-of-home cases that

assure the case has been managed through best practice. The frequency and quality of visits to

parents, children, and substitute caregivers have a substantial impact on achieving 8 of the CFSR

items. It is the caseworker’s responsibility to visit with the child alone every month. This is not

always happening. The activities are meant to engage the child with the caseworker to build

rapport and allow the child to have a voice. Monitoring how the child engagement activities are

being used with the caseworkers will show in the case notes conducted every month.

The Need for Change

“A direct service worker, a planner, a development resource person, a manager, an

administrator, a board member, or community worker. The change agent orchestrates or

coordinates the change process but need not personally carry out all the change efforts” (Fineran,

2012, p. 21).

Social workers are working with families one on one to assess the needs and challenges

they are experiencing. It is the responsibility of the social worker to be able to provide insight
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and information for the need for the change needed in the community and population they are

working with. This is no different from the Iowa DHS. The catalyst of change is to see the needs

of the population DHS works with and come up with ways to improve those outcomes for the

clients. Accountability for the human service organization need to show how the program is

working and how the public-funded dollars are being spent on to help improve client outcomes is

essential. Using the Child and Family Services Review (CFSR) is a good way to look at how the

caseworkers are meeting the current goals and outcomes for families they are working with. The

Carroll office is meeting more criteria than most of the state but there is always room for

improvement and ways to change the current procedure to ensure those reviews are getting better

scores.

The change identified by the change agent and field supervisor was the implementation

of the child interaction games. Caseworkers are direct service workers who work closely with

clients and can assess the needs of the family. When in contact with children it is important to

build relationships with them just like you do with the parents. The children need to feel

comfortable and willing to share thoughts and concerns with the caseworker. The best way to

build rapport with children is to play games with them. These games will establish to the child

that the caseworker cares about their thoughts and feelings and they want their feedback on how

things are going through the life of the case. When the caseworker writes the contact notes for

the monthly report the narrative will reflect the quality of time spent with the child and how the

safety and goals are being met for this child. The supervisor meets with the caseworkers and they

reflect on how cases are going every week. By doing this they will address if the child interaction

games are being used and how they have helped the caseworker work towards better CFSR

goals.
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The caseworkers will use child interaction games to build rapport with the children so they can

assess the safety and the progress of goals in the life of a case. “Antecedent conditions are those

circumstances existing prior to or at the time of the initial idea-gathering process. Antecedent

conditions may include procedures or methods of “how it has always been done” or has been

happening in the local or global community that may affect aspects of the change process”

(Fineran, 2012 p. 29). Antecedent conditions that were present are the fact that the social work

case manager (SWCM) has always conducted child interactions as best they could. It is

sometimes hard for the SWCM to get alone time with the children when the parent wants to let

the worker know everything that has been going on. Quality child interaction needs to be more of

a priority to get a better picture of how the child is feeling and allow them to feel a part of the

process to get them reunited with their parent and fix the problems in the home.

Identifying the Change

"The primary concern in this phase is the identification of the change process. The

purpose of a change process is to change people, systems, communities, or the behavior and

interaction of the people who constitute the groups, organizations, communities, and systems"

(Fineran, 2012 p. 43).

The change opportunity is to have caseworkers at DHS, both the ongoing SWCM and

child protection worker (CPW), to utilize child interaction games. By using this change it will

enhance the way workers are interacting with children and will result in a better narrative and

will help to identify needs and safety throughout the life of the case. Participants in the change

would be the CPW, SWCM, clients, and the supervisor of the DHS unit. The change agent is the

student and supervisor. Their role is to make sure the workers who are working directly with

clients are utilizing the child interaction games that were given to them as a resource. There was
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no process of obtaining sanctioning. The change is just to the procedure and giving resources to

enhance services already available. The supervisor was already in the process of implementing

this change within the DHS unit.

The boundaries of the change opportunity for the change agent is the local office of

caseworkers. This change is to be made for this office to improve practice outcomes with clients.

This change does not reach out to all offices in Iowa. A child interaction adjustment is simply a

tool for workers to better engage with children. Child interaction is already a requirement for the

CFSR standards, the local Carroll DHS office wants to have improved scores on the CFSR goals.

Not every worker will need to use these child interaction games. Some people already do well at

child engagement. This change is to be used and tested to improve the engagement of

caseworkers who are struggling.

There is no monetary compensation or adjustment that needs to happen with this change.

This change is a procedural way of doing job duties caseworkers already conduct. During the

staff meeting every week the supervisor can check in with the workers as a group to see if they

have been using the tools. Also, the supervisor has an opportunity to speak with the caseworkers

individually in their weekly consultation to see how the tools are working.

“A primary beneficiary, someone who benefits directly,” (Fineran, 2012, p. 45). The

primary beneficiaries of the change are the children/clients. They will feel understood and cared

about in the life of their case if the social worker is building rapport with the client. “Secondary

clients benefit indirectly” (Fineran, 2012, p. 45). Secondary beneficiaries are the workers

themselves. They will feel more fulfilled and connected with the clients if they are able to

establish a good relationship early on. The safety of the clients and the needs can be analyzed

easier when there is a trusting atmosphere that is established. The change is favored by the
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supervisor and potentially the families who have caseworkers. Those opposed would-be workers

who have a routine about client visits. Habits are hard to change and sometimes when a worker is

in a routine it will be hard to implement change well. If the DHS unit is open to trying the child

interaction tools, then this change will be successful. These tools do not need to be used at every

visit and a different tool can be used at different times and for different age groups. The point is

that the workers will use them to help establish that rapport until the client will be able to speak

freely to the worker.

Data that is helpful to identify is the narratives the caseworkers write each month. The

detailed account of conversations addressing safety and looking at progress through the case is

the main source of data that CFSR uses when assessing the practices of the caseworker. The

better score CFSR gives to a case the more likely that family is in the child welfare system. It is

essential for service delivery to the clients to be on point to help the families be successful. With

the child interaction in place, the scores for the CFSR will begin to improve.

Analyzing the Change Opportunity

"The analysis phase examines why the change opportunity exists and to define its aspects

and implications. The analysis provides the information available needed for the change process

design and implementation" (Fineran, 2012, p. 49).

Improving outcomes through caseworker visits among parents and children is the best

practice method. Statistics have shown that caseworker visits with children, parents, and

caregivers are a method of best practice that provides positive outcomes in all cases. The Child

and Family Services Review (CFSR) has items related to outcomes for cases with both children

in the home and children out of the home. When these items are met it assures that the case was

handled with best practice. The frequency and quality of visits with children, parents, and
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caregivers have a significant impact on 8 CFSR items. This impact of visits results in 80% of

best practice in-home case and 45% of best practice in out of home cases. The quality of visits is

clearly impactful to the outcomes of all cases involved with DHS.

Completing monthly visits with all the family members involved in a case is part of the

caseworker's tasks. But transitioning into doing quality visits is a part of good practice in social

work. Quality visits should follow the CFSR best practice criteria. Iowa Child and Family

Services Plan (CFSP) is a policy assigned by Congress to every state. It requires that states

submit to the federal Children's Bureau a child welfare strategic plan for five years. The CFSP

describes Iowa's goals and objectives to help strengthen the child welfare system. The outcomes

of safety, permanency, and well-being for the children and families being served are of the

utmost importance. Annual progress and service reports detailing activities planned for next year

can be found on the Iowa DHS website. (2020, DHS)

Support for quality visits with children comes from the federal government and the state

government. The CFSR reports are tracking the progress of improving practice in the state of

Iowa every year and reporting to the federal government. The goals are all to help the outcomes

for children. Through the data, there is proof that the quality of child visits has room to grow.

They have made significant progress already in the five years, but the goal has not been achieved

yet. Therefore the child interaction tools are very important to aid the caseworkers in improving

the goal of permanency.

Goals and Outcomes

"Setting goals give direction to the planned change process and providing outcomes

prepares for measuring progress. A clear direction in which the change is to move is critical for

the ultimate success of the change process. The development of goals, objectives, and outcomes
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provides the clarity the change agent system needs to continue the change process” (Fineran,

2012, p. 59).

The mission statement for the Iowa Department of Human Services is to help Iowans

achieve healthy, safe, stable, and self-sufficient lives through the programs and services they

provide. (2020, DHS) The program's purpose statement for Iowa Child and Family Services is

"Child welfare and juvenile justice services are interventions for children, youth, and families,

designed to improve safety, permanency, and well-being." (2020, DHS)

The targeted population to be served by the planned change of using child interaction

tools are the children in the family unit being served. The intended outcome of the activity of

utilizing the tools to better interact with the children will increase the case outcomes and better

meet the CFSR standards. The measurement of the outcome will be reflected in the CFSR grades

and will show in the narratives of the monthly case notes. Critical success factors will show

better outcomes for families. The result of the change process will be that the local DHS unit is

meeting and exceeding the CFSR standards through better child interaction visitations. This will

show in the annual state report to the federal government entities.

Goal 1: To identify the child interaction game tool kit within the on-going social work case

manager (SWCM) unit of the Iowa Department of Human Services.

Objective 1: To design an action plan for child interaction to distribution to SWCM’s by

May 5, 2020.

Objective 2: Test theory of playing games with children to get their input about safety

and permanency in the case planning process.

Outcome: caseworkers will understand the importance of using child interaction tools during

client visits.
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Goal 2: To seek willing caseworkers to follow through with child interaction tools.

Objective 1: to analyze progress and identify adjustments to the child interaction tools.

Objective 2: to report to other caseworkers the strengths and weaknesses of tools

utilized.

Objective 3: to write monthly narratives that reflect child interaction tools used by June

1, 2020.

Outcome: caseworker will demonstrate the results of case notes used with child interaction tools

and the previous case notes when the tools were not used.

Goal 3: To assess how the clients react to the tools being used at visits.

Objective 1: to observe the child's reaction and feelings when using tools to better

interact with them.

Objective 2: ask the child if they enjoyed games in the tool kit.

Objective 3: to report to the supervisor about successful interaction times and discuss

obstacles to use tools with children.

Outcome: The child will report and express if they enjoy working with the caseworker when

using the tools.

Once the goals had been set the student intern observed a few of the caseworkers

beginning to start utilizing the child interaction tools.

Designing and Structuring

The point of the design phase is to “define the purpose and nature of the change intended,

specify overall responsibilities, and to create a delivery system” (Fineran, 2012, p. 67). In the

structuring phase, it is important to "define specific jobs, responsibilities, positions, and their

relationship to one another" (Fineran, 2012, p. 67).

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The purpose and nature of the intended change are to utilize child interaction tools to

improve child visitation results as shown by the CFSR results. The details of the change were

identified by DHS unit supervisor Mary Jo Rehm. “The policy approach deals with changes in

guidelines, establishing principles, writing a new job description, developing or changing

policies for the agency, organization, and community systems. The program approach involves

change regarding an existing or developing a new service program” (Fineran, 2012 p. 68). This

was a planned project that she was already intending on implementing in the unit she oversees.

Time alone with children allows the voice of the child to be heard. They can voice concerns and

talk about their safety and well-being. Rapport needs to be established with children in the first

few months of the case being open. The case notes should reflect the efforts being made by the

caseworker to meet alone and build up that rapport with the child until they are comfortable

enough to meet alone willingly with the caseworker. The purpose of meeting with the child alone

is to gather information from the child's perspective. Case notes will clearly reflect information

that came from the child and the effort of asking age-appropriate engaging and probing

questions. The child interaction tools will aid the caseworker in getting this information more

easily.

The individual caseworkers are responsible for the delivery of the child interaction tools to the

children. They will be able to address the case plan and goals better by engaging the children in

the activities and seeking their age-appropriate input. All the caseworkers in the local Carroll

DHS unit are on the planning committee. It is their job to hold each other responsible for using

child interaction tools throughout the life of the case. The workers can discuss best practices in

using the tools with different age groups and what struggles they have when a child is not

responding to the tool in an intended way.

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The program implementation of the child interaction tool is just that, a tool to use if the

caseworker is struggling to build rapport with a child and not able to get their feedback. Once the

relationship between the caseworker and the child is established this should open the

communication line between the two of them. The peer mentorship is always the best way to

improve practice among the office. Once a caseworker observes the success of a coworker with

the child interaction tool, they will be more likely to try the tools to some capacity. The use of

the tool needs to be an ongoing discussion at unit meetings, individual meetings, and weekly

staff meetings to make sure the tools are being utilized in the practice setting.

Determining Resources

Resources needed to start the change process is the child interaction tool book. DHS supervisor

Mary Jo has already gotten these booklets made and handed out. There is only the cost of

printing the booklet itself. The rest of the change process does not have any costs associated with

it. The person to implement the change is the supervisor and the people on the front lines with

clients using the child interaction tools are the CPW's and SWCM's. No additional person is

needed in the office to carry out this change process. Estimation for the one-time child

interaction booklet printed was $100. The caseworkers would copy the pages they want to use

for child interaction on a case by case basis. This money comes from the budget already

established for office copying and printing.

Expenses DHS child and family Services Project

Internet and phone $10,000,000 $0
Personnel $90,000,000 $0
Copying and printing $10,000,000 $100
Supplies $28,389,223 $0
Rent $20,000,000 $0
Total $158,389,223 $100

Implementing the Change Process

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This phase is all about the action that is to take place when the change is implemented

within the agency. “It is quite simply a description of how the change will happen. This phase

restates much of what has been described already in the previous phases and details how the

change will be implemented” (Fineran, 2012, p. 77).

The change was identified by DHS supervisor Mary Jo. She had spent time on the CFSR

committee and holds her caseworkers to high standards, wanting them to meet as much of the

CFSR standards as possible. It is also expected at the unit that quality visits are a priority.

Workers still struggle to meet those expectations on a consistent basis therefor the supervisor

thought of creating the child interaction tool kit. This is a booklet put together as a resource for

caseworkers to utilize during monthly visits with children. There are instructions to most games,

and you get an idea of which age group the games can be played with.

DHS supervisor handed out the resources at the monthly unity meeting in March. Some of the

caseworkers were able to start using the tools before the COVID-19 lockdown. Due to the state's

policy with social distancing and video interactions with the children and parents right now the

change process is on hold till face to face interaction can be conducted again. The start date we

can estimate to be June 1, 2020. This is contingent on the opening of the state.

The change will be managed and initiated when face to face contact with clients conclude. The

supervisor will have an item on her agenda to ask about how those child interaction tools are

working with the visits. Due to the changes throughout the semester, the change agent will not be

able to monitor and witness the change implemented to see the results. This change will be a part

of weekly consultation with caseworkers and supervisors.

Monitoring the Change

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“The monitoring phase can begin early in the change process. Monitoring means

checking to make sure the change process is being accomplished in the manner and direction as

indicated in the planning and design phases” (Fineran, 2012, p.79).

The monitoring of the change will be conducted by the DHS supervisor. A simple way to

make sure the monitoring is being done is to have a sign-in sheet and to document how many

child engagement activities were done in the last week. Monitoring and reporting how many

activities were done each week will be able to track the progression of the change. The goal is to

get caseworkers used to using these tools, so they are in a habit of utilizing them to build rapport

with the children they work with. Accountability is important to look at when making the

change. Reporting the activities and what the results of those interactions were will prepare the

caseworker to remember to use the tools. An example of the monitoring tool is shown below.

Weekly check-in
Date Signature # child engagement
activities done last week

Evaluating the Change Process

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"The purpose of the evaluation is to develop information that will lead to effective and

efficient interventions. Evaluation is the process of making judgments. Evaluation is making a

value judgment about the worth of the project" (Fineran, 2012, p. 81).

When evaluating the change process of child engagement activities, the supervisor will

be able to identify the quality of the visits with children when the activities are used. Not only is

the process being monitored weekly it will also reflect in the monthly case notes. This change

will reflect in higher CFSR percentage scores. The caseworkers will develop tools necessary for

building rapport with children and help better their practice delivery in the field. The case notes

will reflect the CFSR reviewers how the workers are engaging with the children resulting in

improved scores. Over time it is expected that CFSR scores will increase coming from the local

Carroll DHS office.

Reassessing and Stabilizing

“Time of transferring responsibility duties. The change agent will bring closure to the

episode of change. The formal system of external help constructed specifically to carry out the

change episode is withdrawn” (Finearn, 2012, p. 85).

After the change agent leaves DHS the change will continue. The supervisor will follow

up with monitoring and evaluating the change as it continues to be implemented. This change is

part of a procedure for the local office. If any adjustments will need to be made to this change in

the future the supervisor will be the person to adjust the change of using child interaction tools.

The only remaining part of the change process is the face to face contacts needed to keep the

momentum going. When caseworkers can see clients in person again the change process will

proceed. The change process will need to be addressed again and reminding the workers how and

why this procedure is being put into place. Through information collected with CFSR scores and
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improvement of case notes the DHS supervisor will be able to plan according to the feedback

from those tools.

References
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Fineran, Sr., Sister. (2012). Macro social work change process handbook.

Child and Family Services Plan and Review. (2020). Retrieved from

https://dhs.iowa.gov/reports/child-and-family-services-review

Mission and Vision. (2020). Retrieved from https://dhs.iowa.gov/about/mission-vision