Child Welfare: Connecting Research, Policy, and Practice

25. Risk Assessment in Child Welfare Use and Misuse

25 Risk Assessment in Child Welfare Use and Misuse Jan Christianson-Wood Child welfare workers face difficult decisions in attempting to meet what may be perceived as competing goals: safeguarding children and preserving family unity. The realities of child protection casework place pressure on workers to “get it right”when assessing risk, as there are potentially harmful consequences for children and families when we are wrong. For the child welfare worker faced with a situation of child abuse or neglect by a caregiver, trying to predict what might happen if the child’s situation remains unchanged involves an assessment of risk. Thus, in a general way, risk assessment in child welfare can be described as an activity designed to prevent future harm to the child. The ability to estimate the probability and severity of future harm is useful in such situations. Rycus and Hughes (2003) argue that best practice in these circumstances requires the use of formal risk assessment protocols based on the findings and conclusions of well-designed and implemented research. Shlonsky and Wagner (2005) caution that assessing risk in child welfare practice is similar to predicting the weather; a forecast of rain is not a certainty, but it does suggest when it is a good idea to carry an umbrella! This lack of precision in risk assessment is recognized by Cash (2001), who notes that risk assessment instruments are not a panacea for decision-making in child welfare . Decisions should optimally be made through a combination of both empirical evidence (science) and practice wisdom (art), as one without the other is incomplete. The synergy created by the art and science of risk assessment provides for a more holistic and effective assessment. (p. 825) 369 Controversies surrounding the use of risk assessment continue. At a general level are those that question the fundamental value of risk assessment,and express concerns about how risk assessment instruments narrow the decision-making focus to a limited set of factors defined by experts—a process that reinforces a topdown managerial approach to assessment in a field which cannot be regulated in this fashion (Callahan & Swift, 2006). Concerns are also raised about the predictive validity of risk assessment measures and the extent to which these are substituted for clinical judgement (Schwalbe,2008).In addition,there are controversies surrounding the preferred type or model of risk assessment. This chapter provides a brief examination of the context of risk assessment, and discusses two alternative approaches. It then focuses on the purpose of risk assessment in child protection, including a discussion of the potential for misuse of risk assessment in practice. Implications for research, policy, and practice are identified in the concluding section. The Context Risk assessment in child welfare work can be described“as a process for assessing the likelihood that a given person (usually a parent) will harm a child in the future”(Wald & Woolverton, 1990, p. 486). Risk assessment tools have become a focus of child welfare research and practice due to the difficulty in predicting under what conditions children who already have been abused or neglected will experience further maltreatment. Formal reviews of child welfare organizations , triggered by the deaths of children known to child protection services, typically focus on services delivered by individual workers, judged against practice standards and policies (Kanani, Regehr, & Bernstein, 2002; Reder & Duncan , 1999, 2004; Reder, Duncan, & Gray, 1993). Recommendations have tended to focus on lowering the threshold of risk required to protect children, as well as expanding the legal definitions of maltreatment to include future harm, thus justifying the use of risk assessment procedures to predict the future safety of children (Callahan & Swift, 2006). One consequence has been an increase in referrals for child abuse and neglect (see Chapter 1). Challenged by limited resources, this creates pressure on child welfare organizations to identify and focus service on children at most risk of harm, and to be more accountable for the services they provide and to whom. The methodology of choice has been risk assessment based on scientific knowledge as opposed to assessments based on value judgments. Historically, risk assessment research has focused on the characteristics of parents or parent substitutes, as they were most often involved in specific acts CHRISTIANSON-WOOD 370 of omission or commission (Ammerman & Hersen, 1990; Factor & Wolfe, 1990; Vondra, 1990). The prediction systems that emerged were built on the combined knowledge and opinions of experts regarding outcomes when certain characteristics were combined with particular events. This...