Essay Grade

Engaging Families in Child
Welfare Services: Worker Versus
Client Perspectives
Julie Cooper Altman
Part of a larger mixed-method study of engagement in
neighborhood-based child welfare services, the qualitative
data this article reports on highlights the extent to which
parents and workers differ in their views of engagement,
the best ways to foster engagement in services, and the
importance each group places on it as a process. Strategies
designed to improve engagement are offered, including
knowledge that can help workers interact more effectively
with families and in so doing improve permanency for
children.
Julie Cooper Altman PhD, LCSW is Associate Professor, Adelphi University School of
Social Work, Garden City, New York.
0009–4021/2008/030841-61 $3.00 Child Welfare League of America
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R
ecent developments in the field of child welfare in the United
States hasten our need to better understand both the processes and outcomes of family engagement in child welfare
services, especially as it relates to foster care and permanency
planning. The Adoption and Safe Families Act (ASFA, P.L. 105-89)
has shortened the timeline child welfare workers have to work toward family reunification with the families of children who have
been placed in out-of-home care, making the brief opportunity
workers have to engage parents in remediation services all the
more critical. Findings from recent federal Child and Family Service
Reviews indicate that no state currently meets the standards for
family involvement in services. Recent reform efforts in New York
City highlight the importance of engaging families, but through recent study suggest that strategies to enhance these efforts continue
to be needed (New York City Child Welfare Advisory Panel, 2003).
Thought to be vital to successful client change, there is surprisingly little empirical evidence to suggest how, when, or why family engagement occurs or its impact on client outcomes in child
welfare practice (Altman, 2005). There is even a lack of clarity regarding the construct of engagement itself, particularly as it relates
to work with nonvoluntary clients such as those in the child welfare system. The work from which this study comes focused on the
processes and outcomes of family engagement in one neighborhood-based child welfare service center in New York City. Through
an exploratory, sequential mixed-method approach, a better understanding was gained of how best to engage families whose children were in foster care, and if and how engagement was related
to measurable outcomes such as rates of visitation and reunification
(Altman, in press). This study reports on the qualitative, processoriented data from that work, and highlights the extent to which
parents and workers differ in their views of engagement, how best
to engage families in services, and why it is important.
Address reprint requests to Julie Cooper Altman, Adelphi University School of Social Work,
One South Avenue, Garden City, NY 11530. E-mail: altman@adelphi.edu.
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Engagement: Process and Product
Client engagement can be seen as a process or a product, an intra- or
interpersonal effort, worker- or client-driven, both a cause of participation, and its result. From one perspective, engagement is viewed
as an interactional, interpersonal process, beginning when workers
establish communication with a potential client and ending when
there is a preliminary agreement to work together. It can be seen as
the process whereby the social worker creates an environment of
warmth, empathy, and genuineness that enables a client to enter
into a helping relationship and actively work toward change. It can
also be seen as the degree to which a given client is committed to
collaboratively working with a worker toward change.
Disparate definitions and conceptualizations of engagement
complicate efforts to further research it. Prinz and Miller (1996)
define engagement as “the participation necessary to obtain optimal benefits from an intervention” (p. 163). Yatchmenoff (2005)
defines it as “positive involvement in the helping process” (p. 86),
operationalized via five factors: receptivity, expectancy, investment,
mistrust, and a working relationship. Often conceptualized for
research purposes as an outcome, it is measured by rates of client
participation (Littell, Alexander, & Reynolds, 2001; Littell & Tajima,
2000) or attrition (Daro, McCurdy, Falconnier, & Stojanovic, 2003).
Still lacking are the more subjective, contextual, worker- and clientdriven ideas of what engagement is, how it occurs, and its importance in the work they do together.
Evidence for the Importance of Engagement
in Child Welfare
Belief in the need for child welfare workers to successfully engage
clients in the helping process has long been noted (Altman, 2005;
Dawson & Berry, 2002; Pecora, 1989; Rooney, 1992; Yatchmenoff,
2005). Research suggests that parent involvement hastens family
reunification (Jivanjee, 1999; Tam & Ho, 1996), reduces the chance
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of being referred to court (Karski, 1999), and increases the likelihood they are offered needed services (Jones, 1993). Active participation in services reduces the chances parents will lose custody
of children (Atkinson & Butler, 1996); parents more involved and
able to visit their children are more likely to be reunited (Davis,
Landsverk, Newton, & Granger, 1996; Fanshel, 1975; Hess, 1987).
Greater parental involvement in treatment planning results in
fewer subsequent reports of child maltreatment (Littell, 2001).
While interest in the topic of family engagement in child welfare services overall is growing (Daro, McCurdy, & Nelson, 2005;
Dore & Alexander, 1996; Lee & Ayon, 2004; Okamoto, 2001; Petras,
Massat, & Essex, 2002; Shonfeld-Ringel, 2001; Smithgall, 2006;
Yatchmenoff, 2005), few empirically based practices designed to
enhance engagement can be found in the literature (Dawson &
Berry, 2002). Increasingly needed is work that moves beyond seeing engagement as a measurable outcome or factor, to embrace
the underlying complexity of the processes of this important stage
of helping.
The Context of Neighborhood-Based Child Welfare
New York City’s Administration for Children’s Services (ACS)
model of neighborhood-based child welfare services was designed
to meet some of the challenges inherent in mandated work with
clients, emphasizing community service networks, a culturally sensitive, family-centered philosophical orientation, and a reconceptualization of the role of birth- and foster parents as integral collaborators, all of which are thought to enhance conditions that could
facilitate permanency. Despite these improvements, a recent review continues to note that “the most significant challenge facing
(New York City’s Child Welfare) system is to make further, critically needed improvements with regard to permanency,” the heart
of which should be a “re-thinking of the role of parents, around the
primary themes of enhanced respect, engagement and partnership”
(Special Child Welfare Advisory Panel, 2000).
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Strategies designed to improve family engagement practice so
that workers interact more effectively with families, and in so doing improve permanency for children, was seen as critical to moving the city’s child welfare reform agenda forward. So high a priority, a study to see if evidence of reformed family engagement
processes at ACS exists was commissioned in 2003. Increased use
of family team conferences and service plan reviews was noted,
though further work, training and monitoring of the implementation and effects of these efforts were recommended (New York
City Child Welfare Advisory Panel, 2003).
Method
Research Question/Design
Increasing knowledge of how family engagement unfolds in neighborhood-based child welfare practice was the goal of this investigation. The research reported on here comes from a larger, mixedmethod study of the nature and long-term outcomes of family
engagement in neighborhood-based services (Altman, in press). The
question addressed in this portion of the study was studied through
an exploratory, qualitative research design: what is the process of
engagement in neighborhood-based child welfare services as seen
by workers and parents, and how is it seen to be influenced?
For the purposes of this study, engagement was understood as
Yatchmenoff (2005) defined it, conceptualized as a dynamic, complex, and multilevel phenomenon influenced by and comprised of
a number of interwoven factors at the worker, client, agency, and
larger social environment levels. This provided a guiding framework
for the start of the qualitative inquiry, and as a beginning heuristic
for analysis.
Sample
The sample reported on in this study consisted of 16 parent clients
and 9 foster care workers, all currently clients and service providers
of a single neighborhood-based family service center operating under
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the auspices of a large New York City–based child welfare agency.
The agency’s work focused on permanency planning for the families
that were referred to them from ACS, the public child welfare system, subsequent to ACS’s removal of children due to abuse and/or
neglect. Parent participants were a purposive sample, recruited as
suggested by agency administrators for their willingness to share
their experiences and perspectives since their child entered foster
care. Each parent that was asked to participate in the project agreed
to. The entire foster care staff of nine workers from the same center
participated was asked and all agreed to participate. Demographic
characteristics of the sample can be found in Table 1.
Data Collection
Approval for this study was given by the researcher’s University
Institutional Review Board, the child welfare agency’s IRB and both
city and state child welfare authorities. Participants for the study
were recruited upon identification, by sending them a letter explaining the study, and seeking an opportunity to discuss their participation in it. If they acknowledged interest, a member of the research
team either phoned or visited them to discuss their participation.
Once a participant verbally agreed to participate, a time and
place for the initial interview was agreed upon. Interviews were
conducted in locations of the participants’ choosing, usually in their
home or at a private office at the agency site. Informed consent
was solicited in English or Spanish, and the document was read to
all participants.
Interviews were performed by one of two DSW student
research assistants, or the principal investigator, and conducted in
either English or Spanish, as participants chose. Each participant
was interviewed at least once, many twice. The interviews lasted
between one and three hours, were tape-recorded and later transcribed. Field notes taken by each interviewer were also transcribed.
In doing the qualitative interviews, a nondirective approach was
used to resemble purposeful conversations. The interview guide
loosely used covered the following domains of inquiry about
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TABLE 1
Demographics of Sample
VARIABLE PARENT (N ⫽ 16)
WORKER (N ⫽ 9)
N
%
N
%
15
94.0
8
89.0
1
6.0
1
11.0
7
44.0
—
—
Gender
Women
Men
Education
⬍High School
High School
6
37.5
—
—
Some College
2
12.5
—
—
College
1
6
8
89.0
—
—
1
11.0
Graduate Degree
Ethnicity
African American
9
56.0
2
22.0
Latina/o
5
31.0
3
33.0
—–
—
3
33.0
White
2
13.0
1
11.0
Other
—
—
—
—
Parent
16
100
5
55.0
Not a Parent
—
—
4
45.0
Asian American
Parental Status
Age (Mean # years)
Child Welfare Experience
(Mean # months)
37.0
34.0
—
60.0
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engagement: its conceptualization, attributes, differential aspects,
development, meaning, related factors, promotion, and outcomes.
Data Analysis
Members of the research team read all interview transcripts and
field notes independently, then met for joint coding and consensual data analysis (Hill, Thompson, & Williams, 1997). To start, data
were coded and sorted by four system levels (parent, worker, agency,
and larger system), and participant category (parent or worker).
Next, a structure for locating themes within these patterns of data
analysis was applied, known as the Developmental Research
Sequence (DRS; Spradley, 1979).
As per the DRS, a variety of semantic relationships were developed and fitted from coded data in order to produce initial
domains. For example, all codes that fit the semantic relationship
“X is believed to cause good engagement” were one analytic domain.
Taxonomic analysis of each domain was done next. For example,
in the parent participant domain “causes for good engagement,”
and at the worker system level, four subcategories emerged:
“interpersonal skills,” “case-related intervention skills,” “personality,” and “attribute.” Taxonomies of each of these subcategories
were then completed. Next, organized tables of data (matrices)
were developed from these, again according to both system level
and participant category. Themes in the data were then identified
through the comparing and contrasting of taxonomies and matrices,
and writing of analytic memos.
Findings
Worker, Parent, and Interpersonal Level Themes
Communication
Parents cited several dimensions of worker communication that
they felt important to the engagement process: reassurance, affirmation, and their capacity to be honest and direct in what they say
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and how they say it. This parent, like many, would have appreciated more straightforwardness from her worker:
They don’t get to the point. They don’t tell you what you
have to do right at the first meeting. They should just come
straightforward and tell you what’s the outcome, so you
can look forward or ahead to the things that you know is
going to be the outcome of the situation.
The degree to which nearly every parent asked for this honest
and direct approach from their workers spoke volumes about how
infrequently it occurs in actual practice. This parent suggests that
the reason for this may have something to do with workers’ sensitivity to parents’ feelings:
Come out and tell me, don’t beat around the bush just tell
me. You know, don’t sit there and worry about my feelings.
Just tell me. You know I might not like what I hear, you
know, but I’d rather somebody be honest with me.
On the other side, worker after worker shared how difficult it
was to be honest and straightforward with their feelings and interaction with clients:
The difficult part that I have in engaging anyone is when I
feel, when we bring our own personal stuff when we see a
client. I’ve noticed that personally I feel a little afraid of
confrontation, and saying anything negative in a way that
is professional. So sometimes I kind of avoid it . . .
Not only did parents express the need for workers to be empathic and straight in their communication and interaction with
them, they desired honesty and reliability:
Don’t tell me that you’re going to come to my house and
don’t show up. Don’t tell me that you’re going to send me
some mail and don’t send it. Don’t tell me that. That’s the
worse [sic] thing you can do.
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Relationship
Parents felt that dealing with workers who were empathic, reliable, and supportive helped them to engage in services. They believe workers who have good knowledge of their situations and
are on top of case details help them most to engage in change efforts. They believe workers who choose to partner with them and
against ACS—in a kind of parent-centered triangulation—are
more likely to be workers who will help them engage. They see
good outcomes related to collaboratively set goals with them,
who are seen to be “on their side,” and who can help them to see
the reality of their own situations more clearly, but without blame.
I think it has to do with my ability to be empathic, be understanding, and be very clear to them that I’m not there to,
you know, to point a finger at them and I think that has to
happen not only from the beginning but continuously
throughout the process.
Not all workers are able to do this effectively, as reported by
this parent:
Nobody acknowledges what I’m doing to help myself and
they need to see that. They need to realize the reasons why
I did the things I did and the reasons why I’m doing the
things I’m doing now . . . because if you can’t understand
me, how can you help me? If you don’t know who I am,
how can you help me?
Parents also asked for their strengths to be recognized and
their capacities supported:
To be willing to put you in a small amount of credence in
what the parent says . . . You know, to even be able to sit
back and say “Hey maybe there’s even one thing that this
parent does that’s good.”
The nature of the relationship between helpers and clients in
this work was seen to be unique, unlike any other that most clients
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had encountered before. In Spanish, the term suavidad was used often in describing the ideal relationship between worker and client:
tact coupled with kindness and fairness, the idea that workers were
in control and knew it, but with finesse. This worker attempted to
describe it:
What I want best is to have a good relationship with my
client but then through experience I find out that sometimes it’s best for the client not to be your friend and to
kind of, you know, be angry at you, but . . . but get him to
do the stuff that he has to do or she has to do . . .
Parents reported wanting, even relying on, their workers to
possess this combination of caring and harshness in their interactions, to be kind and respectful, but also firm and unyielding:
So they put it on the table for you . . . it makes you like open
up your eyes. You could lose your children for any little single mistake that you make, understand? We’re trying to help
you here, you know, this is not a joke. This is not a game.
They got hard with me. They said you got to do this, you
go to do that. You get tough love from them. You know and
I like that.
Motivation and Change
Both parents and workers realized that while relationship and
communication were essential to engagement, neither was sufficient. Both reported struggling to move forward with the change
process and discussed motivation as a key component. Occasionally, parents reported that workers seemed to need for them to admit their blame for their children being in foster care before real
work could continue:
I think they [workers] just want, they are so set on making
sure that I understand that I have done something wrong.
And, occasionally, workers reported that that is exactly what
they did try to do, feeling that it is somehow crucial for parents to
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accept responsibility for the situation that brought them to the
process in the first place:
Accepting responsibility for what happened… when you
start off, when you meet with them and they say I know I
hit my child and they were removed and I was very angry
that day and I am so sorry and I understand what I did and
I take full responsibility and here I am and I know I can get
my children, you know… those are the clients from the
beginning… that’s the difference between a client who was
engaged easily [and one who was not].
Workers sometimes reported on different strategies to motivate
parents to engage, some of which may be considered punitive:
You know, I try to push them a little extra to see, you know,
do you really want your kids back, are you really going to
do this, you know it’s for you, your kids.
To be honest, I think the only thing to get her to move or
change would be to put her kids in a really bad foster
home.
Compliance
Parents who fail to demonstrate any sort of compliance with service activities are likely to be labeled “resistant” by workers. This
includes parents who deny responsibility for their situation, deny
substance abuse when it is a problem for them, who are angry and
suspicious of the worker, and who blame others for the situation
they are in. Some workers see compliance as a step in the process
of “true” engagement:
[W]hen the client is compliant, and signs of compliance are
important because you feel that the client is in that state of
being ready for change… so when you start seeing the
signs, they’re coming to the office now more often, they’re
available for your home visits… when that starts to happen
you start to see they’re contemplating the change now
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because they’re letting you in and now when they start
showing you that, they trust you a little bit more . . . that’s
a sign of engagement.
Mutuality of Pace
Critical to the process of engagement, and mentioned by nearly
all parents, is the worker’s ability to keep things moving forward
in a case—to keep the pace up, making sure they are doing what
they need to assure reunification. One parent did not feel this
was mutual:
And we have a finite amount of time for me to get my child
back so I think if it was her child. You know, you want to
know what you’ve got to do and she don’t seem to get the
urgency. She don’t feel the urgency I feel. I need to do this
now. I don’t have time for you to wait for these people to
get back to you. She keep telling me they didn’t get back to
me. What kind of s*** is that? What kind of s*** is that? I
need my baby back and she’s sitting around waiting four
months for a referral . . . put some fire under your a**, you
know what I’m saying?
Another parent describes what she sees as a lack of action on
the part of the worker, particularly at visits:
And she’s very nice and she’s, you know, sits and stays
with us and she joins in like a family, you know. . .but that
ain’t helping me get her back, you know, because we never
really talk, we always just watching . . .
These parents believe that the lack of action on their worker’s
part stems not so much from worker incompetence as allegiance to
system rules and a lack of a clarity about the worker’s role vis-àvis the parent:
She’s doing the best she can with what they gave her to
work with . . . You know, she does her job. In that field,
well, she makes her home visits; she makes sure the fire
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extinguisher and everything she does in that part. But as
far as the parent is concern she doesn’t . . . I don’t think
she realizes that I don’t know why I’m here. I don’t
f***ing know . . .
I’m getting upset because she’s not telling me what to do.
She’s sitting there giving out tokens, you know, and hem, I
take the tokens. Don’t get me wrong. I take the tokens. But
I think, I think she supposed to be something more than
that . . . something is not right here. What’s wrong with this
picture?
Agency, Community, and Larger System Level Themes
Systemwide Issues
Other agency factors that workers identified as being significant
to the success of engaging families included making sure the
workers have enough time to do their work, adequate supervision and training, and the presence of support services that can
enhance worker effectiveness and efficiency. Almost all caseworkers mentioned obstacles such as high caseloads, numerous
foster care visits, and having to do overwhelming amounts of paperwork. This role overload led them to struggle to be available
to clients:
Not enough time is spent with the families. I feel like I’m
doing patchwork with them because of too much paperwork, and court dates. It is too much and we don’t get any
support . . . we have to type our own paperwork. Sometimes
it gets too much, we have 12 UCPs in one month, we have to
attend all meetings, court, foster home visits, birthparent visits, school visits, emergency transfers and our progress
notes. It’s not fair. It is frustrating. It’s too much caseload for
one person . . . it’s impossible to help the parents.
Parents shared stories with the research team about the difficulty interfacing with the numerous helping professionals they
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encounter in the process, and not knowing clearly the function
of each. Even for professionals, understanding the complexities
and nuances of a system as big as this one is difficult. For parents, many of whom already mistrust social service systems generally, a positive sense that the system is on their side and helpful is rare:
But him, this, who, that’s who I get on, the case, the ACS
caseworker . . . he’s a mean son of a b****. I can’t stand his
guts and every time, “I don’t even have this case no more.
You know, you just talk to the foster care agency.” That’s his
attitude. “I just go to court.” That’s exactly what he told me.
“I just go to court.” You know, “I done took your daughter,
don’t even bother me no more.” I scream to his case, to his
supervisor, and I was like, listen, [this agency] didn’t come
and snatch my baby out that park, you did.
You know, why did they throw me in the middle of this
mix? So like now I’m the liaison between ACS and [this
agency].
Occasionally, workers reported capitalizing on this interagency
schism in their work with clients, often quite effectively:
I just try to work with them, join a lot with their anger at
the system . . . sometimes they [ACS] just go in there horrendously and it makes it almost easier to side with the
clients because they seem as abusive as the clients do, you
know . . . when people see you somewhat as an ally . . . they
feel they are coming to someone who can help them
through it . . . sometimes in reality ACS helps us with engagement by being so bad.
Workers also discussed the need for ready, available, and effective community-based services as an important carrot in helping engage parents. Parents discussed this as well, as they told of
the many obstacles they encountered in their efforts toward reunification. Many of these had to do with the referrals to services
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various workers made, and whether they were appropriate and
available:
Marriage counseling, hem, anger management, parenting
class. You know, I don’t care, I’ll do it. Whatever I’ve got to
do. I really don’t mind. But tell me. Don’t just tell me the
name of it like I know, anger management. Where can I go
get some anger management? It’s not like I’m shopping for
it at Home Depot, you know what I’m saying? I don’t
know what to do or where to go, to get it from.
Discussion
Nearly all child welfare clients can be considered involuntary or
nonvoluntary clients. They frequently have not asked for nor do
they want services; many do not see the need and/or value of the
service for their families. They come to the attention of child protection through a judgment of their failures as caretakers, with
goals too often selected and imposed on them by the child welfare
system. These clients engage in services, and in effect become
clients, when they decide that it is possible to accept the terms of
the help offered. Efforts to hasten that decision are critical, especially
given the demands of ASFA, and require considerable worker skill
and system support. The findings reported here lead to a number of practice implications, and add to the growing knowledge
base in this area by providing an analysis of the contextual, subjective program experiences of parents and workers in the child welfare system.
At the core of this difficult work lies a worker’s capacity to
engage those clients who feel least like developing a working relationship, and an agency’s ability to develop conditions that promote
that capacity. Research shows engaging and retaining clients in services, and its related outcomes, may be less predicted by the legal
status of the client than by the process of interaction between the
client, worker, agency and community (Altman, 2003; McCurdy &
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Daro, 2001; Rooney, 1992). Dawson and Berry (2002) agree and report that worker and agency behaviors appear to be most significant in engaging families in child welfare services. Highlighted in
all this work is the primacy of client–worker relationships (Chapman, Gibbons, Barth, & McCrae, 2003; Lee & Ayon, 2004; Ribner &
Knei-Paz, 2002; Zell, 2006).
Most remarkable in this study is the degree to which clients
are asking for that which the workers seem most unwilling or unable to provide in setting the stage for engagement to take place.
While parents were asking for assertive, honest, clear, and urgent
messages about what they should be doing to ensure their children’s return, workers reported a hesitancy to provide such. Parent requests for caring but firm relationships with their workers
were too often thwarted by the steep costs workers charged in
developing them: confession of responsibility and compliance.
Strategies for motivating client involvement in services had less
to do with responding to the client’s readiness to change and
more likely involved coercive or punitive measures. Clients’
recognition of the need for a deliberate, planned, and urgent progression of activities leading toward reunification were overshadowed by unrelated agency demands on workers, and the
privileging of services to children and foster parents over services to parents.
Supporting and encouraging workers’ capacities to meet the
needs of clients in the engagement process as they have been articulated here should be the primary goal of child welfare agencies.
Systemwide interventions are needed to reduce the role overload
reported in this study, enhance the supervision now well-recognized as a major factor in child welfare worker retention (Strand &
Badger, 2005; Strolin, McCarthy, & Caringi, 2007), and promote the
coordination, clarification and realistic expectations of an all-toofragmented system of care.
Progress has been made in all these areas, with models of treatment with mandated clients being developed that, in part, respond
to some of the concerns raised in this study (DeJong & Berg, 2001).
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Development of community strategies designed to improve the
outcomes of vulnerable children before they become known to formal child welfare systems, through strengthening their families
and neighborhoods, are also encouraging. Engagement and retention strategies as disparate as using strengths-based marketing
and identifying key social spaces have been suggested (Annie E.
Casey Foundation, 2004).
Change is difficult. For clients not asking for services in a cooperative arrangement, it can be an antagonistic experience. Many
child welfare clients perceive themselves as being forced to see
workers against their will, believe that the system is not just or fair,
see the agency and its workers as unwanted intrusions into their
lives, and view the remedies recommended to them as meaningless or harmful. The research presented here suggests some truth
to all of these contentions. Perhaps a different model of social
work practice with these kind of clients is needed, one that is more
direct and expeditious, and that sees the parent of the child in
placement as the primary client.
While neighborhood-based services’ emphasis on responsive,
collaborative, and flexible service delivery are encouraging, we await
larger system changes that support and privilege these principles,
while working to understand what can be done at the agency level
to make engagement in services a more viable and comfortable
experience for client families. The findings from this study reinforce
some of the ways in which that can be attained. One worker’s definition of engagement sums up an ideal all child welfare services
might realistically aspire to:
I think the engagement is really achieved when you
really start seeing that client generally opening up to you
and wanting to see you and letting you know, you know,
I’m here because I like to come here. I’m here because I
like to talk to you… when the client is able to say that,
that’s wonderful… that’s really what I would call
engagement.
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References
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Altman, J. C. (2005). Engagement in children, youth, and family services: Current research
and best practices. In G. Mallon & P. Hess (Eds.), Child welfare for the twenty-first century:
A handbook of practices, policies and programs (pp. 72–86). New York: Columbia.
Altman, J. C. (in press). A study of engagement in neighborhood-based child welfare services. Research on Social Work Practice.
Annie E. Casey Foundation. (2004). Residents engaged in strengthening families and neighborhoods. Baltimore: Author.
Atkinson, L., & Butler, S. (1996). Court-ordered assessment: Impact of maternal noncompliance in child maltreatment cases