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The Flint Study of Multidisciplinary Representation of Children in Child Welfare

Research Design 

From 2014-2016, the QIC-ChildRep studied the effects of a multidisciplinary team (MDT) approach to representing children. The Flint study, implemented by Robbin Pott of Michigan Law School, was a random assignment experimental design, the highest quality social science design, as suggested by our collaborator, the late, too young departed, Andy Zinn. The study provides both a description of the functioning of these teams collaborating to represent children and a rigorous evaluation of outcomes compared to a control group. 

In partnership with Genesee County (Flint, Michigan) Child Advocacy Team (CAT), we provided social workers to assist the child lawyers and randomly assigned cases to be either represented by the attorney/social worker team or by the attorney alone. In this county, all court-involved children are represented by five attorneys in this office. The CAT served as both treatment and control subjects. We used a within-group random assignment as suggested by Andy Zinn so that in the control cases the lawyers represented the child without social work assistance and in the experimental group the same lawyers were assisted by the social workers. There was a strictly enforced prohibition against conversations between the lawyers and social workers about cases that were not in the experimental group. 

From March 17, 2014 to October 30, 2015, 60 percent (243) of CAT cases were randomly assigned to the intervention group and 40% (166) were randomly assigned to the control group. The sample of children included 409 individuals involved in 216 child abuse and neglect petitions. 

Strong Findings -- Supportive of the MDT Model 

  • The MDT resulted in quicker resolution of more cases.
    • MDT cases were more likely to be resolved and therefore dismissed at or prior to adjudication. [Dismissal rate for intervention group was 31% versus 11% for the control group.]
  • The MDT was better at preserving family connections.
    • Children represented by the MDT were more likely to be ever placed with relatives [61% versus 46%]
    • Less likely to be ever placed in non-relative foster care. [46% versus 64%] 
  • Fewer petitions for termination of parental rights.
    • Both mothers and fathers of children served by the MDT had fewer petitions for termination of parental rights filed. [Mothers were 16% versus 30%, Fathers 20% versus 30%]

Analysis

There were challenges coordinating these two professions with quite different approaches to problem-solving and families. It was not always a smooth road. There were several keys to successful collaboration. The lawyers eventually recognized that the social workers brought a set of skills and perspective that the lawyers lacked. They learned to let the social workers have a certain level of professional discretion and autonomy. The social workers sometimes drove the creative process in identifying and responding to family needs. Collaboration and outcome improved where attorneys respected and appreciated the social work skill set. 

The MDT social workers were especially effective in better collaborating with the child welfare agency. The MDT social workers sometimes served as a buffer between the agency and the family. They built alliances and tore down barriers. Sometimes the MDT eased tensions and facilitated parents getting effective services. The MDT social worker was often a more consistent presence than the ever-changing agency workers. 

Social workers' intensive advocacy early in the case often changed the case trajectory. The social workers helped the family access assessments and services. Pott writes: “The MDT social workers employed all the best practices of their trade – they focused on their clients’ needs, identified strengths as well as deficits, provided concrete support, promoted competence, demonstrated respect for the clients, and engaged in a wide variety of problem-solving and advocacy activities.” p. 209. For cases where the petition was authorized with children still in the home, the MDT operated very much like traditional family preservation services. "Supporting the parents was part of and consistent with their role in supporting the child." 

Inadequate protection for client privileges 

The MDT never established a clear process for protecting their clients' confidences and they practiced in a culture that tolerated blurred lines of privilege. Michigan's Rules of Professional Conduct required the MDT social workers to abide by attorney-client privilege for their clients and to have permission before talking with represented parties [1]. The social workers were trained on confidentiality issues and reported being responsible in protecting the child's confidences. However, they were not routinely asking their clients their perspectives on sharing information and they were not explicitly asking permission to talk with the parents. The social workers routinely provided reports to the court and the other parties' attorneys were aware of the contact the social workers were having with the agency workers and parents. The culture in these cases was such that the parents' attorneys did not object to the reports the social workers were giving in court, asked the MDT social workers how their clients were doing, and sometimes complimented them on their achievements on the case, which created a sense of collaboration and implicit permission. 

Conclusion 

[Excerpt from Chapter 12, CHILDREN’S JUSTICE, p.211] 

“The lack of teamwork between social workers and attorneys did not prevent the MDT from resolving some cases more quickly and preserving more family connections. However, ongoing and inadequately addressed poor office climate conditions within the MDT damaged the attorneys' ability to retain the social workers. A study of MDT's in Australia concluded that, "The danger is that tensions will escalate to the point where each profession would prefer not to work with the other… If this were lost, it would be a loss to both the legal profession and clients." [2] To avoid this loss, the legal profession should provide greater exposure to opportunities to collaborate with social workers and work to break down the silos in which each profession tends to work. These opportunities should include trainings or workshops that focus on improving understanding of how each profession contributes to successful outcomes and encourage recognition and appreciation of those contributions. Only through increasing understanding, recognition and appreciation can mutual trust and respect grow. And, as this MDT experience has highlighted, a professionally respectful climate is key to ensuring that the two professions continue to collaborate. 

The Flint MDT study demonstrated that having social work services delivered as part of the child's representation in child welfare proceedings resulted in quicker resolution of some cases and the preservation of more family connections. The MDT's social workers' only objective was to do what was in the best interest of the child and every decision was filtered through that lens. The social workers were able to enter the child's world and better understand his needs and wishes. This meant to the social workers that sometimes to help the child, they needed to help the parent. This thinking is contradictory to the adversarial legal system in which they were operating, which assumes one party's rights are opposed to another's. Reconciling the process of providing quality representation to individuals while maintaining the ability to effectively advocate for the family, when that is what's best, should be key when employing MDTs.” 

A full report on Robbin Pott's MDT Study and more can be found in our book, CHILDREN'S JUSTICE: How to Improve Legal Representation of Children in the Child Welfare System, from ABA Publications.)

[1] MRPC 5.3 (responsibilities regarding nonlawyer assistants) and rule 4.2 (communications with persons represented by counsel)
[2] Walsh, supra note 16, p. 769.