(PS9-15) Child and Family Team Perceptions of Team Functioning and Shared Decision-making in Child Welfare to Improve Mental Health Services Linkage

Half of youth within child welfare (CW) services meet the criteria for at least one mental health diagnosis, 1 illustrating high mental health services need for CW-involved children.2,3 Child and family team (CFT) meetings are mandated interventions to identify needs and facilitate service connection. CFT meetings coordinate a variety of support persons and aim to encourage shared decision-making for developing the youth’s service plan.4 Including families in shared decision-making is fundamental to successful service linkage and improving safety, permanency, and physical and mental well-being of youth and families.5 However, CFT meetings are implemented with low fidelity, and parents believe they have little input and voice in the process.6 

This poster presents preliminary findings from a larger mixed-methods trial that aims to improve CFT processes and outcomes by adapting and testing the after-action review (AAR), a simple and effective tool for enhancing team performance to improve youth mental health services linkage.7,8 This poster examines participant perceptions of shared-decision making and team functioning in CFT meetings, as they are fundamental in linking youth to mental health care. Qualitative inquiry (completed) includes informant interviews and focus groups. Quantitative assessment (ongoing) includes post-CFT meeting surveys using Mathieu’s (2020) Team Process Scale9 (TPS) to assess coordination, goal specification, and strategy formulation, and independent observer ratings on a statewide CFT meeting fidelity tool.  

Eight informant interviews and five focus groups (N = 52) were conducted with CW services leadership, CW-involved parents and caregivers, CFT meeting facilitators, service providers, and Protective Social Workers (PSWs). Participants ranged from 25 to 79 years of age (x = 43; SD= 11.3). Participants were predominantly female (86%) and Hispanic (48%), with race being represented as white (41%), Black or African American (8%), Asian (6%), American Indian or Alaska Native (4%), Native Hawaiian or Pacific Islander (2%), and multi-racial (6%).  

Results show variability in participants’ definitions of a successful CFT. Notably, parents centered the importance of family voice – ability to express concerns and authentic listening. Providers defined success as being solution-oriented – parents understand the process and next steps are clearly outlined. PSWs highlighted success as working together – accomplishing goals and agreement on youth well-being. Across interviews and focus groups, participants also expressed some shared definitions of a successful CFT, emphasizing the creation of an action plan and full CFT member attendance. Qualitative findings will be triangulated with TPS and fidelity results. 

Assessing and comparing participant perspectives on team functioning matters if shared decision-making is consistent and intended in CFTs. Qualitative findings highlight inconsistency and limited overlap in perceptions of success, suggesting an overall lack of shared decision-making and perceived teamwork, likely impacting mental health service linkage. Findings will be expanded to include quantitative results. Implications for future research and practice will be presented.