Cabarrus County Department of Human Services: Program Development

Statement of Need

Each year Cabarrus County Department of Human Services receives numerous reports of child abuse and neglect, or dependency. In 2014, there was a total of 2,493 reports received with neglect as the primary concern (“Cabarrus County North Carolina Preliminary Annual Budget,” 2016). Of those reports, there are now 100 children who have entered into the CCDHS foster care system. With eighty percent of children in foster care having mental health issues, one must take into consideration that some mental health concerns are genetic. Nationally about twenty-three percent of children in foster care receive mental health services (U.S. Department of Health and Human Services, 2003). The majority of children who are in foster care have experienced some form of trauma resulting in a need for therapeutic treatment. Therapeutic services are designed generally to help reduce issues such as stress, depression, and anxiety, in addition to, helping clients be more self-sufficient with decision making and coping.

In particular, it is necessary to meet specific needs of children related to emotional, physical, and social conditions. Cabarrus County Department of Human Services is in need of onsite therapeutic services for the children who have experienced trauma as well as services for their families in foster care (“North Carolina Division of Social Services,” 2015). The target population is in need of adequate and timely foster care that will help them to cope with their health problems. The Fostering Connections to Success and Increasing Adoptions Act of 2008 requires all states to increase their oversight of the health and mental health of foster children (National Conference of State Legislatures, n.d.). This requires the agency to identify the trauma-related needs of the children and their families in foster care. Having an onsite therapist would be beneficial to foster care services, so that families and children would not have multiple places to visit to receive treatment. The addition of services is a way for the child welfare division to improve the family-centered process and communication with clients.

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Empirical Evidence

The Children’s Bureau of 2015 conducted a review of the statistics of children in foster care and reported that approximately 415,129 children were in foster care, as of September 30, 2014. Children who are in foster care have been exposed to a variety of traumatic events, which results in about 80 % of the children in foster care having significant mental health issues (Dore, 2005). With 80 % of children in foster care having mental health issues, one must take into consideration that some mental health concerns are genetic. Nationally about twenty-three percent of children in foster care receive mental health services (U.S. Department of Health and Human Services, 2001). CCDHS Foster Care Services served over 100 children and their families in 2016. All children who are brought into CCDHS Foster Care Services are screened for trauma exposure and subsequently referred for trauma-informed comprehensive clinical assessment (TICCA), if needed.

Organizational Context

The Department of Human Services of Cabarrus County aims at improving the overall quality of life in the given area uncovering both children and adults. Namely, Child Support Services focuses on children’s issues and helps with location, child support order, etc. Establishing an on-site psychotherapy program within the Cabarrus County Department of Human Services is ideal because of the population served who have been affected by past and present traumatic life experiences. There is a need for the service and CCDHS can target and provide to all traumatized youth in foster care and their families Trauma-Focused Cognitive Behavioral Therapy (TF-CBT). This program fits into Cabarrus County Department of Human Services mission, which is strive to improve the quality of life in the community for all citizens. By implementing this program, it will allow the Cabarrus County Human Services foster care youth and their families’ convenient access to assess any mental health concerns that may be prevalent.

Without an onsite therapist or counselor, CCDHS is definitely missing a key component to providing and improving the mental health of the children in foster care, their families, and citizens served. By increasing accessibility to mental health care at CCDHS, it would allow the children and their families the opportunity to stay involved and active in the needed mental health treatment (Vulin-Reynold, Stephans, Lever, & Weist, 2008).

Goals & Objectives

  1. Improve mental health of trauma-exposed children in Cabarrus County Department of Human Services.
    1. Begin identifying children exposed to trauma within 30 days of entering care.
    2. Begin providing psychotherapy and psychoeducation services to at least 75 percent of trauma-exposed children at CCDHS by January 2018.
    3. Improve screening and identification of children impacted by traumatic stress by 75percent within three months.
  1. Decrease depression and anxiety in traumatized youth in foster care by 50% after 15 weeks of ongoing psychotherapy.
    1. Provide individual therapy 1 hour weekly for traumatized youth in foster care for 15 weeks.
    2. Teach coping skills to participants to reduce trauma reactions by 50 %.
    3. Evaluate program effectiveness by surveying participants at the end of 15 weeks.
  1. Reduce the rate of children returning to care by providing psychotherapy to the parents and caregivers.
    1. Conduct weekly one hour parent and child sessions to identify stressors.
    2. Enhance emotional support for all caregivers/parents by 100 %.
    3. Assess child’s need for longer-term treatment by 100 %.

Logic Model

Program Planning Section
Inputs Throughputs / Activities Outputs Objectives/Outcomes
Cognitive Behavioral Therapy counseling
(CBT).Public state agents
Counselors
State mental health agents
Child advocatesThe social workerPersonnel
Provide psychotherapy and psychoeducation for identified clientsfoster care clients.

Provide individual therapy 1 hour weekly for traumatized youth in foster care for 15 weeks.

Foster Care SW refer children to LCSW for Trauma Focused Assessment.

Licensed Clinical Social Worker Assessments teaching coping skills using CBT model.

Conduct weekly 1 hour parent and child sessions to identify stressors.

Reduced rate of children returning to care – by 50 %

Identification of the number of children exposed to trauma within 30 days of entering care.

Enhanced emotional support for all caregivers and parents.

Decrease in depression and anxiety in traumatized youth in foster care by 50% after 15 weeks of ongoing psychotherapy.

Teach coping skills to participants to reduce trauma reactions by 50%

Evaluate program effectiveness by surveying participants at the end of 15 weeks

References

Cabarrus County North Carolina Preliminary Annual Budget (2016). Web.

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Dore, M. (2005). Child and adolescent mental health. In G. Mallon and P. Hess (eds.), Child Welfare for the Twenty-first Century: A Handbook of Practices, Policies and Programs. (148-172) New York, NY: Columbia University Press.

National Conference of State Legislatures. (n.d). NCSL Child welfare policy update: State response to the

Fostering Connections to Success Act of 2008 health oversight and coordination plan provision. Web.

North Carolina Division of Social Services. (2015). Web.

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Vulin-Reynolds, M., Stephans, S. H., Lever, N., &Weist, M. (2008). Foster care and school mental health. Baltimore, MD: Center for School Mental Health, Department of Psychiatry, University of Maryland School of Medicine. Web.

U.S. Department of Health and Human Services, Administration for Children, Youth and Families (2001). National Survey of Child and Adolescent Well-Being: One Year in Foster Care Report. Washington, D.C. Web.

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