Children and Youth Services Review 33 (2011) 945–954

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Children and Youth Services Review

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The impacts of accessible child protection services on services, jobs, and families

Gary Cameron a, Lirondel Hazineh b, Karen Frensch b, Nancy Freymond c, Michèle Preyde d, Bob Gebotys e,Ian DeGeer c, Trudy Smit Quosai b,⁎a Lyle S. Hallman Chair in Child and Family Welfare, FSW, Wilfrid Laurier University, Canadab Partnerships for Children and Families Project, Wilfrid Laurier University, Waterloo, ON, Canadac Faculty of Social Work, Wilfrid Laurier University, Waterloo, ON, Canadad Family Relations and Applied Nutrition, University of Guelph, Guelph, ON, Canadae Department of Psychology, Wilfrid Laurier University, Waterloo, ON, Canada

⁎ Corresponding author. Tel.: +1 519 884 0710x5236E-mail address: tsmitquosai@wlu.ca (T.S. Quosai).

0190-7409/$ – see front matter © 2011 Elsevier Ltd. Aldoi:10.1016/j.childyouth.2010.12.014

a b s t r a c t

a r t i c l e i n f o

Article history:Received 24 June 2010Received in revised form 21 December 2010Accepted 24 December 2010Available online 14 January 2011

Keywords:Child protectionEmploymentServicesOutcomesCommunitySchool

This multi-faceted study assessed the differences between accessible and central child protection servicedelivery sites in Ontario on: (1) family functioning; (2) front-line child protection service providers'satisfaction with services; (3) parents' satisfaction with services; (4) the services and supports available tofamilies; (5) front-line service job satisfaction; and (6) front-line helping relationships in child welfare. Aquasi-experimental outcome design gathered data from parents at case-opening and approximately10 months later. Semi-structured individual or group qualitative interviews were conducted with parents,front-line service providers, and supervisors/managers. Information also was gathered from agency files.Front-line service providers completed an employment questionnaire. Findings indicated that the accessiblesites were able to foster a greater proportion of cooperative helping relationships with families and to createmore service partnerships. Parents at the accessible sites weremore positive about their service involvementsand more willing to ask for help again in the future. Front-line child protection service providers at bothservice delivery models described positive aspects of their jobs as well as frustrations with the expectations ofthe formal child protection system.

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1 This investigatiofunded by the OntarMore information abwlu.ca/pcfproject.

l rights reserved.

© 2011 Elsevier Ltd. All rights reserved.

1. Introduction

The evolution of “Anglo-American” child protection model has hada number of unintended consequences over the past two decades.Among the best documented of these challenges are the expansion ofthe number of investigations, increased costs and number of childrenin out-of-home care, and continued high turnover among serviceproviders (Cameron, Coady, & Adams, 2007; Differential ResponseSub-Committee of Ontario Children's Aid Society Directors of Service,2004; Freymond & Cameron, 2006; Hetherington & Nurse, 2006;Kufeldt & McKenzie, 2003; Swift & Callahan, 2009; Waldfogel, 1996,1998).

In response to these difficulties, there is a more recent interest indifferential or flexible-response child protection systems (AlbertaChildren's Services, 2003; Differential Response Sub-Committee ofOntario Children's Aid Society Directors of Service, 2004; Schene,2006; Waldfogel, 1998). Related to this interest in more flexible childprotection systems is a desire to increase local communities'capacities to support families and to protect children, and to share

more of the child and family welfare mandate with formal servicepartners (Child Welfare Secretariat, 2005, 2006).

In 2006, the Ontario government launched a multi-facetedTransformation Agenda for child welfare services. Among this Agenda'sobjectives were the development of more cooperative helping relation-ships, reducing the system's reliance on legal authority, creatingpartnerships, and increasing capacity to respond flexibly to families(Child Welfare Secretariat, 2005, 2006).

In the context of this Transformation Agenda, this paper presentsthe results of a study1 comparing the consequences of locating front-line child protection service providers in central and accessible servicedelivery sites. It examined service delivery setting impacts on:(1) helping relationships, (2) services and supports provided tofamilies, (3) client functioning, (4) selected service system indicators(e.g., out-of-home care); and, (5) assessments of front-line childprotection jobs.

Assessments of flexible response models in several Americanstates have found some evidence of more families receiving

n is part of the Transforming Front-Line Practice Project researchio Ministry for Children and Youth (136: A16176-576810: A770).out this program of research and its products is available at www.

946 G. Cameron et al. / Children and Youth Services Review 33 (2011) 945–954

assistance, higher levels of cooperative helping relationships, andgreater family satisfaction. Differential response models have beenfound to not compromise the protection of children (DifferentialResponse Sub-Committee of Ontario Children's Aid Society Directorsof Service, 2004; English, Wingard, Marshall, Orme, & Orme, 2000;Loman & Siegel, 2004a,b; Schene, 2001; Siegel & Loman, 2000;Waldfogel, 1996, 1998).

There is agreement in the literature about the complex challengesof creating productive flexible response systems. Among other things,system effectiveness has been linked to having access to supportiveresources for families, creating partnerships, and services beingaccessible to families (Child Welfare Secretariat, 2005, 2006;Hornberger & Briar-Lawson, 2005; Howell, Palmer, & Mangum,2004; Schene, 2001, 2005, 2006).

While the research available is sparse, there is some evidence ofencouraging results from enriched flexible response demonstrationprojects having greater access to partners in local communities andmore implementation support (Chahine, van Straaten, & Williams,2005; Differential Response Sub-Committee of Ontario Children's AidSociety Directors of Service, 2004; Schene, 2006). In particular, thesedemonstration projects have been linked to creating more servicepartnerships and community involvement in protecting children andsupporting families (Hazineh, Cameron, & Frensch, 2005; Schene,2001; Waldfogel, 1998).

Within flexible response systems, some innovations in the deliveryof child welfare services have emphasized service delivery settingsthat are familiar and comfortable for families served (Children'sBureau, 2010; Taylor, Janzen, Murtha, Powell, & Majstorovic, 2001).Most of the available literature on these innovations is descriptive orprescriptive suggesting why these settings should improve services.For example, Schene (2006) anticipated that community-based childwelfare partnerships would improve access to community resourcesfor families, lower perceived stigma to accessing services, andincrease shared community responsibility for the welfare of childrenand families. Some research has suggested that, when compared totraditional service delivery, clients involved with community-basedchild welfare services find services more accessible and responsivewith fewer transportation challenges and decreased feelings ofstigmatization (Onyskiw, Harrison, Spady, & McConnan, 1999).

Some innovations involved partnering with school boards to offerchild welfare services in schools. For example, in a pilot project inOntario, Canada, parents and teachers reported increased under-standing and trust of child welfare services delivered in schoolsettings. Parents, teachers and child welfare service providers allbelieved that these settings contributed to a better understanding ofchildren's behaviors. Students, parents, and teachers felt that theselocations improved accessibility and reduced feelings of fear andstigma in using child welfare services (Taylor et al., 2001).Nonetheless, overall, our review uncovered very little researchabout how either community-based or school-based child welfareservice delivery affects service involvement experiences or outcomesfor children or families.

In Ontario, there have been recent investments to createcommunity hubs in low-income neighborhoods (Ontario Ministry ofFinance, 2009). Child welfare services are involved in some of thesehubs. The recent Roots of Youth Violence report (McMurtry & Curling,2008) recommended creating community-based centers (often inschools) to support children and families. Suggestions about thebenefits of community partnerships are also seen in the literatureabout full-service schools (Dryfoos & Quinn, 2005; Prakash et al.,2010; Quinn, 2005). However, very little of this literature addressesthe challenges or the consequences of locating child welfare serviceswithin these hubs or full-service schools.

One of the ambitions of enriched flexible response as well as theaccessible sites in this study was to create more rewarding workenvironments and, hopefully, to reduce the rate of turn-over among

front-line child protection personnel (Hazineh et al., 2005; Schene,2001). Child welfare services in North America have had to confrontpersistently high levels of turnover among front-line child protectionservice providers (Ellett, 2009; Faller, Grabarek, & Ortega, 2010).Higher turnover rates in child protection agencies have contributed toincreased recruitment costs, difficulties responding to clientele, largercaseloads, reliance on less experienced service providers, and feelingsof discouragement among remaining service providers (Faller et al.,2010; Tham & Meagher, 2009). Equally, for families, high turnoverleads to inconsistencies in service delivery and less satisfaction withservices (Faller et al., 2010). No research that focused on theemployment impacts of enriched child welfare flexible responsesystems or locally accessible child welfare service delivery wasuncovered in our review.

Accessible service providers in this study were located in localschools or neighborhood centers geographically close to theirclientele. None of these schools incorporated community servicehubs; child welfare service providers were the only “out-posted”service providers. Most of the neighborhood center locations in thisstudy involved co-location of child protection and other serviceproviders. Central service providers were located in child welfareagency premises not physically close to most of their clientele.

Both accessible and central service delivery sites were responsiblefor delivering the same mandated services under the public flexibleresponse system created by the Transformation Agenda. However,besides the differences in physical settings, there were differences inservice delivery intentions between accessible and central servicedelivery sites.

One of the additional intentions of the community and schoolservice delivery settings was creating easier access to child protectionservice providers for families. These accessible service deliverysettings also hoped to improve community perceptions of childprotection agencies served and to reduce the stigma and fear ofinvolvement with their services. They hoped to increase families'willingness to ask for help. Accessible programs also placed moreemphasis on collaboration with other community service providersand community associations. Finally, they wanted to create environ-ments that produced more satisfying experiences for both front-lineservice providers and their clientele. Their hope also was that front-line child protection employment would be more sustainable.

2. Methods

This research examined six accessible (3 school and 3 neighbor-hood) and five central child welfare service delivery sites at six childwelfare agencies in Ontario, Canada. More specifically, this multi-faceted research incorporated an assessment of the impacts ofaccessible and central service delivery models on: (1) familyfunctioning and selected child welfare system indicators (e.g., formalcourt applications); (2) front-line child protection service providers'satisfaction with services; (3) parents' satisfaction with services;(4) the services and supports available to families; (5) front-lineservice employment job satisfaction and sustainability; and (6) front-line helping relationships in child welfare. A full description of theprocedures for this multiple method investigation and detaileddescriptions of the individual research sites can be found at www.wlu.ca/pcf (see Cameron, Hazineh, & Frensch, 2010).

2.1. Quasi-experimental design and service experiences research

The accessible sites in this study had been created by participatingagencies for the reasons described previously. At the time of the study,most of the child protection services at these agencies were deliveredthrough centrally-located service teams. The accessible sites wereintended to serve particular geographic areas as were the centralservice delivery sites at these agencies. This precluded the possibility

947G. Cameron et al. / Children and Youth Services Review 33 (2011) 945–954

of assigning families to different service delivery approaches for thisresearch.

Within the general flexible response framework set by Ontario'sTransformation Agenda, all central and accessible sites in this studyfollowed the same regulatory guidelines in responding to calls anddetermining eligibility for service. Each was governed by the sameservice delivery timelines and case documentation procedures. Eachreceived financial resources based upon the same state fundingformula. Front-line child protection caseloads were similar at centraland accessible sites.

However, there were two general areas of difference between theaccessible and central sites in this study. First, within existing workconstraints, the accessible sites were developed with the explicitintention of trying to improve relations with families and communi-ties. Second, accessible service delivery sites were chosen in order tobe geographically close to the children and families that they serviced.Usually the accessible sites were located in communities or schoolswhere the historical demand for child welfare services was high.

There were very few accessible child protection service deliverysites in existence in south-western Ontario at the time of the study.The accessible sites in this study included all available sites. A com-parison central site serving a similar catchment area to the accessibleprogram was selected at each host agency.

Statistical comparisons of participant characteristics at case-opening found only a few significant differences. However, whenthese differences in participant characteristics were controlled forstatistically, all of the statistically significant differences betweencentral and accessible sites reported in this paper remained evident.In addition, the child protection service provider ratings of risk ofmaltreatment at case-opening showed no difference between acces-sible and central sites.

The average age of central-site parents was 34.22 years and35.44 years for accessible-site parents. More than half of all parentswere not currently living with a spouse or partner: 58.4% of central-site parents and 51.9% of accessible-site parents. Approximately 38%of agency based parents and 30% of accessible based parents did notcomplete high school.

A larger proportion of central-site parents had lived in theircurrent home for less than one year at case-opening (50.4% vs. 32.1%)[χ2 (3, n=196)=7.846, p=0.049]. Families at community sitesappeared to have more financial resources than those at agency siteswith a smaller proportion with less than $20,000 annual householdincome (33.4% vs. 45.4%) and a larger proportion with householdincomes greater than $40,000 (38.4% vs. 22.7%) [U=3566.5, Z=−2.005, p=0.045, n=188].

Significantly more accessible-site parents (24.7%) than central-siteparents (13.2%) perceived that their home or building was not safefrom crime (χ2 (1, n=195)=4.277, p=0.039). Almost 26% ofaccessible program parents reported there were not enough safeplaces for children to play in their neighborhoods compared to 14%of central-site parents (χ2 (1, n=195)=4.355, p=0.037). Thesefindings might reflect decisions to place the accessible sites incommunities where child welfare involvement had been high.

Information from agency files included a standard overall riskrating and eligibility spectrum rating. The most frequently occurringoverall risk rating at the point of transfer to ongoing service was“moderate” (46%–49%), followed by “high” (42%–42%) risk ratings forboth accessible and central program clients respectively. In theeligibility spectrum, the most frequently cited as the reason forcontinued agency involvement was “caregiver capacity — 40.7% forthe central sites and 42.4% for the accessible sites. The nature of theproblem needing intervention showed that “caregiver with aproblem” was most frequently cited for central-site parents (30.8%)and accessible-site parents (30.3%). The eligibility spectrum level ofseverity rating was “moderate” for most cases: 74.7% and 72.7% for thecentral sites and the accessible sites respectively.

The study's outcome design included gathering data from parentsat case-opening and approximately 10 months later. In addition,selected system indicators (e.g., out-of-home placements and courtinvolvements) were gathered from family files at the child welfareagency. Semi-structured qualitative interviewswith parents alsowereconducted about their service involvement experiences. Finally, semi-structured individual and group interviews were carried out withchild welfare personnel about their perceptions of service delivery.The data for the outcome and service involvement experienceportions of the study included:

• 261 parents completed a set of standardized outcome measures toassess parent, child, and family functioning at the time their casewas opened to ongoing services.

• 192 parents (74%) completed the same set of measures approxi-mately 10 months later.

• 73 parents participated in a semi-structured qualitative interviewabout their service experiences and satisfaction with services.

• Parents also supplied data about the well being of 488 individualchildren in their families: (1) 147 toddlers (under 4 years old);(2) 137 children (4–7 years old); and (3) 204 youth (8–16 yearsold). Data were available for 76% of these young people for bothcase-opening and follow-up in these analyses.

• 18 focus groups involving approximately 150 front-line childprotection service providers were conducted about their percep-tions of service delivery.

• 17 individual qualitative interviews were completed with childwelfare supervisors and administrators about their perceptions offront-line service delivery.

• In addition about 80% (201) of parents gave permission toresearchers to gather information from their files on selectedsystem indicators including court applications, legal supervisionorders, and child placements.

Parents who received ongoing child protection services fromeither the accessible or central sites during the recruitment year of2007 were invited to participate in the study. All participants gavetheir written informed consent. All parents received $25 for each timethat they participated in the research. Parents could provide consentfor researchers to view their child welfare agency file. All serviceproviders and supervisors/administrators participated based on theirwritten informed consent. These research procedures were approvedby the research ethics review committee at Wilfrid Laurier University.

2.2. Employment research

Approximately 150 front-line child protection service providersvolunteered to take part in 18 semi-structured group qualitativeinterviews about their work environments. Each focus group wascomprised of members of the same service delivery team. These focusgroup interviews occurred at each participating organization's officesand took approximately 2 h.

Focus groups with direct service providers were facilitated byresearchers from the research project and were organized aroundthree main questions: 1) How do you understand your work withchildren and families? 2) What is it like to work as front-line childprotection in your setting? and 3) How do you see the OntarioTransformation Agenda affecting your work? Participants were askedthe same general questions about rewarding and difficult aspects oftheir jobs followed by questions about specific aspects of their job(e.g. workload, sustainability of employment, and supervision andsupport).

Seventeen individual semi-structured qualitative interviews werecompleted with child welfare supervisors and administrators abouttheir perceptions of front-line services and work environments. Theseinterviews covered the same topics in the same fashion as the focus

948 G. Cameron et al. / Children and Youth Services Review 33 (2011) 945–954

groups. The interviews took approximately 1.5 h and were conductedby researchers from the project. Focus groups and individualqualitative interviews were recorded and transcribed.

Front-line child protection service providers (n=115) completeda questionnaire that was sent to all appropriate service providers atthe research sites. Service providers who chose to participate returnedtheir completed surveys through the mail directly to researchers atthe university. All service providers who were sent a survey wereeligible to enter their name into a random draw for a prize consistingof a $100 gift certificate to a spa in their city. The survey tookapproximately 20 min to complete and included demographicquestions, Personal Accomplishment, Emotional Exhaustion, andDepersonalization Scales from the Maslach Burnout Inventory(Maslach, Jackson, & Leiter, 1996), and questions about havinginteresting and challenging work, the time and effort required to dothe job, and intention to leave the job.

One caution in interpreting these findings, that will be discussed inthe Results section, is that the low response rate to the employmentsurvey (55%), and the small number of responses at the accessiblesites in particular (22), suggest caution in interpreting the results ofthis employment survey.

About 90% of the front-line child protection service providers atboth the accessible and central sites were female. Almost 40% in bothsettings were 25 to 30 years old and about 65% were married or in acommon-law relationship. About 60% of central front-line serviceproviders had no children compared to about 70% of accessible siteservice providers but this difference was not statistically significant.About 52% of central site service providers had been in their currentposition less than 24 months compared to about 61% of accessiblesite service providers; however, this difference was not statisticallysignificant.

However, there were some notable differences in the profiles offront-line service providers at the accessible and central sites thatcould have influenced client service involvement experiences inparticular. There were more service providers 40 and 49 years old atthe accessible sites (25%) than at the central sites (7.5%) [U=817.0,Z=−2.15, p=0.03, n=117]. More front-line staff at the accessiblesites (78.3%) than at the central sites (54.8%) had a social work degree[χ2 (1, n=116)=4.197, p=0.04]. In addition, more accessibleservice providers (29.2%) had Master's degree than central siteservice providers (7.5%) [χ2 (2, n=117)=9.017, p=0.01]. Becausethis information came from the employment survey, there was nopossibility of linking it statistically to the data from parent interviewsor files to control for these differences.

2.3. Data analysis

Focus groups and individual qualitative interviews were recordedand transcribed. These transcripts were analysed for differentialpatterns among service delivery models using the NVivo software(Richards, 1999). It was probable that there would be differencesamong the six child welfare agencies participating in the study,independent of accessible and central service delivery approachdifferences. Therefore, in the qualitative analyses, before a patternwas considered to represent a difference between the accessible andcentral sites, two conditions had to be satisfied.

First, the pattern had to be substantially more prevalent ininterviews representing a particular service delivery approach. Forexample, only patterns that clearly existed at the accessible sites butnot at the central sites, and vice-versa, are reported as a difference.Patterns that were clearly shared by the central and accessible sitesare also reported. Second, when an accessible and a central site werehosted by the same agency, patterns suggesting differences also hadto be evident at these two sites. These conditions ensured that thepatterns identified were robust and represented central and accessi-ble service delivery sites rather than agency differences. Finally, in

examining qualitative data, care was taken to clarify whether thepatterns were shared across all or some of the sites representingparticular service delivery approaches.

Statistical analyses focused on identifying similarities and statis-tically significant differences among accessible and central servicedelivery sites on a variety of indicators. Descriptive statistics werecomputed for the central and accessible sites. In addition, tests ofsignificant differences between the accessible and central sites wereconducted. Chi Square was used when data were categorical; Mann–Whitney Tests was used for ordinal data. Finally, the statisticalsignificance of change over time on various indicators at both types ofsites was calculated. The Wilcoxon Signed-Rank test was used fornon-parametric repeated measures data.

2.4. Strengths and limitations

A limitation of this study is its focus on a limited number of childwelfare settings in Ontario and the relatively small size of theaccessible programs included in this research. We cannot drawconfident conclusions about system-wide applications of suchapproaches nor about their applicability in very different contexts.

In addition, the quasi-experimental outcome design does notstrongly rule against explanations for the observed differencesother than the investigated central or accessible service deliveryapproaches. For example, differences in front-line child protectionstaffing may have contributed to these differences. On the other hand,the advantages of the accessible service delivery sites were what werepredicted from their service delivery intentions and their physicalsettings. As will be discussed later, it is not clear how other observeddifferences, such as staffing, could have led to the particular con-figurations of outcomes described in this study.

A relatively low return rate for the employment survey suggeststhat these results be interpreted cautiously. In particular, the lowreturn rate combined with small program size made it impossible toconfidently illustrate employment environments at specific researchsites from the survey data.

On the other hand, the robustness of this study's findings wasstrengthened by the strong convergence of perceptions and assess-ments between parents and service providers as well as clearagreements across the different types of data (standard measures,file information, and qualitative interviews) gathered in this research.From our perspective, it is probable that these results paint a credibleportrait of differences that existed at these accessible and centralservice delivery settings. If so, they provide a beginning platform forfuture confirmation of the reasons for such differences and consid-eration of the possibility of building on the advantages identified forthe accessible approaches in this study.

3. Results

3.1. Helping relationships

Service providers at the accessible sites weremore confident abouttheir ability to establish cooperative helping relationships than theircolleagues at the central sites. Service providers at the central sitestalked a good deal more about the barriers to developing productivehelping relationships. For example, in the following excerpt, a serviceprovider at a central office talked about how her setting impededaccess to service providers:

P3: …where we were before, we were in a residential area andthen I think there's something symbolic in a sense that we'removing now away from the residential area, a huge building andit's almost like we are further out of reach of clients and theirconnection with us. You know what I mean? [Central site 1: front-line service provider]

949G. Cameron et al. / Children and Youth Services Review 33 (2011) 945–954

Service providers and managers/supervisors at the accessible sitesoften talked about the benefits of service providers being physicallyclose to families:

P4: ….I know, I'm just thrilled that I have clients whose home Ican walk to and, you know, I think one of the biggest things thatwe can do for our families is to show them, to teach them what isavailable in their community … I can take them around andintroduce them to all the programs, they can leave with a stack ofinformation and choices about, you know, child care programsand parent/child programs … I just feel like I've made a bigdifference in a family's life if I've got them connected here.[Accessible site 1: front-line service provider]

P:… so when I think back that this is somebody who came from avery adversarial relationship with our agency, but over years ofseeing us, getting to know we're real people and getting to knowus, started to realize howwe work and why and what it's about, tothe point where they're seeking us out now and to let us know thesignificant events in their life. [Accessible site 2: supervisor]

Responses to the parent survey showed that, at follow-up, agreater number of accessible site parents perceived that their serviceprovider “knew about what was going on in their families” than atcase-opening. The Wilcoxon Signed-Rank test showed that this was astatistically significant change over time (Z=−2.685, p=0.007).There was little change in central-site parents' assessments of serviceprovider knowledge from case-opening to follow-up. At follow-up, agreater proportion of accessible-program parents (38.6%) believedthat their service provider “definitely” knew how to help their familycompared to 23.6% of central-site parents; the Mann–Whitney Testshowed that this was a statistically significant difference (U=1867.5Z=−1.867, p=0.062, n=137).

At follow-up, 52.6% of accessible-site parents saw their serviceprovider as “definitely knowledgeable” about what was going on intheir homes compared to 32.5% at the central settings (U=1879.5, Z=−1.838, p=0.066, n=137). These positive shifts in parents' assess-ment from case-opening to follow-up suggest a greater capacity at theaccessible sites to foster welcome helping relationships with parents.

3.2. Services and support

Service providers from the accessible sitesweremuchmore likely todescribe formal and informal partnerships that they thought gave themadvantages in getting assistance for their clients. Service providers atmost school sites described offering services in collaboration withschool staff or other service providers. Many of the community siteswere co-located with other formal and informal partners:

..so the way for us to get families what they need is to workcollaboratively and in partnership with other organizations, so wehave working agreements with public health, we have workingagreements with [neighbourhood association], that's where thecommunity development comes in, with the neighbourhoodgroups and the city … And we have partnerships with the schoolboards in a variety of different ways where, y'know, we are active

Table 1Parents' perception of the usefulness of child welfare services and support.

Accessible sites

Were agency staff able to connect your family with a useful ran

All thatI needed

Quite a few thatwere useful

One or two thatwere useful

Nonwa

Case opening (185) 18.7% (14) 32.0% (24) 25.3% (19) 24.Follow up (137) 42.1% (24) 8.8% (5) 28.1% (16) 21.

in providing resources and working with other partners to meetthe needs of kids, so, y'know, it's not unusual for us to contributein-kind resources or some staffing resources or a little bit ofmoney to get a program off the ground and those are jointinitiatives. [Accessible site 2: manager]

Table 1 shows how parents rated the adequacy of the services andsupports that they received though their child welfare involvement.Of the accessible-program parents, at follow-up, 42.1% estimated thatagency staff were able to connect them to “all [the services andsupports] that I needed”; only 21.3% of central setting parents wereequally positive (U=1871.0, Z=−1.854, p=0.064, n=137). On theother hand, approximately 80% of the accessible site parents and 70%of the central site parents reported being connected to at least “one ortwo [services and supports] that were useful”.

3.3. Parents' general assessments

During the qualitative interviewswith 73 parents, theywere askedto provide an overall assessment about whether their involvementswith child protection services had produced benefits for their families.What was most striking about their responses was that most parentsin both accessible and central settings reported some positive changesfor their families that they attributed to their child protectioninvolvements. The second important pattern in the qualitativeinterviews was that about 10% to 15% more of the parents at theaccessible service delivery sites identified positive changes because oftheir child protection service involvements.

Table 2 shows that out of 179 respondents at follow-up, 25% ofparents at the accessible sites felt that their families had benefiteda great deal from being involved with the child welfare agencycompared to 12% at the central sites. At the accessible sites, 46% ofparents felt that their families had benefited quite a bit or more incontrast with 31% at the central sites. About 76% of parents at theaccessible sites saw at least some benefit for their families from theirchild welfare involvement compared to 54% at the central sites(U=1662.0, Z=−2.607, p=0.009, n=135).

At follow-up, almost half (46%) of parents involved at the centralsites saw no benefit from their involvement and this represented anincrease in the proportion of negative assessments since case-opening. In contrast, at follow-up, 25% of accessible site parents sawno benefit from their child welfare involvement, a 14% drop in theproportion of negative assessments since case-opening.

In addition, a greater proportion of accessible-site parents weremore satisfied overall with child protection services than werecentral-site parents (U=1721.0, Z=−2.526, p=0.012, n=137).About one-third (32%) of accessible-site parents reported that theywere “very satisfied”with their child welfare experience compared toabout 18% of central site parents. While about 39% of central-siteparents were “very unsatisfied” with their involvement, only about19% of accessible site parents were displeased.

The parent assessments also indicated that, at follow-up, moreaccessible-site parents (59.6%) believed that it was “definitely” or“probably necessary” “for the child welfare agency to become involvedwith your family in the first place” than central-site parents (46%).Equally important, once again suggestive of positive service experiences,

Central sites

ge of services and supports?

e thats useful

All thatI needed

Quite a few thatwere useful

One or two thatwere useful

None thatwas useful

0% (18) 17.3% (19) 12.7% (14) 41.8% (46) 28.2% (31)1% (12) 21.3% (17) 20.0% (16) 30.0% (24) 28.7% (23)

Table 2Parents' overall assessments of child welfare services.

Accessible sites Central sites

Overall, to what extent did being involved with the child welfare agency help to make things better for your family?

A great deal Quite a bit A little bit Not at all A great deal Quite a bit A little bit Not at all

Case opening (190) 14.5% (11) 22.4% (17) 25.0% (19) 38.2% (29) 14% (16) 12% (14) 32% (36) 42% (48)Follow up (135) 24.6% (14) 21.1% (12) 29.8% (17) 24.6% (14) 11.5% (9) 19.2% (15) 23.1% (18) 46.2% (36)

Overall, how satisfied are you with your family's experience with the child welfare agency?

Verysatisfied

Mostlysatisfied

Somewhatsatisfied

Not verysatisfied

Verysatisfied

Mostlysatisfied

Somewhatsatisfied

Not verysatisfied

Case opening (192) 21.3% (17) 28.7% (23) 23.8% (19) 26.3% (21) 18.8% (21) 25.9% (29) 25.9% (29) 29.5% (33)Follow up (137) 31.6% (18) 26.3% (15) 22.8% (13) 19.3% (11) 17.5% (14) 23.8% (19) 20.0% (16) 38.8% (31)

950 G. Cameron et al. / Children and Youth Services Review 33 (2011) 945–954

the proportion of accessible-site parents who made this assessmentincreased by 18% from case-opening to follow-up. The proportion ofcentral-site parents making a similar assessment fell by 2%.

It is important to highlight that what is being reflected in theseassessments are parents' opinions about their service involvements—not whether others would reach the same conclusions. However, it isparents' assessments of their experiences that will influence theirwillingness to ask for help again and what they tell their friends to do.In the above ratings, accessible and central site parents madecomparable assessments at case-opening but accessible-site parentswere notably more positive at follow-up. The most likely explanationwould be different service involvement experiences for these twogroups.

3.4. Parent, child, and family functioning

In addition to these general assessments, parents provided morespecific assessments of personal and family functioning at case-opening and, on average, 10 months later. These ratings showed quitemodest positive changes in parent functioning and confidence overthis time period. However, parents also perceived very little change infamily functioning or child well being over the same time. There werefew differences between accessible and central service delivery siteson these indicators.

Parents were experiencing elevated levels on the Perceived StressScale (Cohen & Williamson, 1988) at case-opening. These decreasedfor both groups at follow-up to levels that were comparable to anaverage score of 9.86 for a comparison group of 268 respondentsrecruited from a post-secondary education institution who werepredominantly female with an average age of 29.06 (Herrero &Meneses, 2006).

On the CES-D (Radloff, 1977), used to measure depressivesymptoms in the general population, the average score for bothgroups of parents at case-opening was just below the cutoff for highdepression, with central-site parents scoring 15.81 and accessiblebased parents scoring 15.75 on this measure. At case-opening, 43% ofaccessible program parents and 40% of central-site parents scored ator above 16, considered a high level of depression. Average scores atfollow-up for both groups suggested a reduction in depressivesymptoms over time; however, these changes were not statisticallysignificant. The average scores for accessible and central-site parentsat follow-upwere 14.01 and 14.38 respectively. Approximately 30% ofaccessible-site based parents and 36% of central-site parents had highlevels of depression (16 or above) at follow-up.

Using the WHO Quality of Life Inventory (Hawthorne, Herrman, &Murphy, 2006), parents rated their overall quality of life andsatisfaction with their health at case-opening and follow-up. Basedon the Wilcoxon Signed-Rank test, accessible-program parentsreported significant improvements in their overall quality of lifeover time (Z=−2.148, pb0.05). Central-site parents also reported

improvements in their overall quality of life; however, the changewasnot statistically significant.

Parents evaluated their feelings of belonging using the InterpersonalSupport Evaluation List's belonging subscale (Cohen & Hoberman,1983). At case-opening, the average score for central site parents was21.92. This increased to 22.66 at follow-up.While not large, the increaseover time in perceived sense of belonging was statistically significant(Z=−2.053, pb0.05). For accessible site parents, at case-opening, theaverage score on the ISEL-belonging subscale was 22.33. This increasedto an average score of 24.17 at follow-up. Again, while not large, thischange over time approached significance at the 0.05 level (Z=−1.838,p=0.066). Accessible-site parents reported higher levels of perceivedbelonging at follow-up compared to central-site parents (U=1819.00,Z=−2.02, p=0.043, n=137).

Overall, parents' ratings of their parenting and family functioningshowed little change between case-opening and follow-up. At case-opening, the average score on the Parenting Sense of CompetenceScale (Gibaud-Wallston & Wandersman, 1978) was 4.29 for bothgroups of parents. At follow-up, the accessible program parents'average score increased slightly to 4.43, while there was a slightdecrease in the average score for central-site parents at 4.26. Thesechanges were not statistically significant. Parents were asked to use aself-report measure of family burden (Boyle et al., 1987) to indicatehow often, within the last 6 months, their child or children's behaviorhad a negative impact on the family. Overall, there were nostatistically significant patterns of change from case-opening tofollow-up for either accessible or central program parents. Also,there were no statistically significant changes on General FunctioningSubscale of the Family Assessment Device (Byles, Byrne, Boyle, &Offord, 1988) between case-opening and follow-up.

Parents interviewed also provided information for each of theirchildren's daily functioning, behaviors, health and well-being at bothcase-opening and follow-up. The collection and analysis of child andyouth data were organized into three age groups: children under4 years of age, children 4 to 7 years old, and youth age 8 to 16 years. Inthe qualitative interviews, parents did not talk much about changes intheir children's lives as a result of their child welfare involvement. Inthe analyses of the quantitative indicators, the portrait is of no ormodest positive change in children's lives that might be attributed totheir families' child welfare involvement.

In their general assessments parents were more positive about thebenefits of being involved with child welfare services. However, whenasked at case-opening and 10 months later to make specific assess-ments of family functioning, very little change over time was evidentin how parents thought things were going in their homes. The generalassessment may be related to parents' satisfaction with their overallservice experiences. The lack of evidence of notable progress on thechild, parent, and family functioning indicators in this study raisesquestions about reasonable expectations from this general approachto child protective services.

951G. Cameron et al. / Children and Youth Services Review 33 (2011) 945–954

3.5. System indicators

The Children's Aid Society used legal or court action in 12.3% and18.7% of accessible and central files respectively. For those cases inwhich court authority was used, 47% of central files and 38% ofaccessible program files involved the use of a court mandatedsupervision order. Children were placed in out-of-home care in 24%of all files regardless of program type. By the end of the data collectionperiod, 50% of the children placed in out-of-home care at theaccessible sites were returned home and 39% of children placed inout-of-home care at the central sites were returned home. None ofthese differences was statistically significant.

There was a statistically significant difference in the type of out-of-home placement used at the central and accessible sites. Kinshipservice (voluntary placements within extended families) was usedmore often (41% compared to 14% of cases where children wereplaced) in the accessible program model (U=116.5, Z=−2.129,p=0.045, n=39). While this difference was substantial andstatistically significant, and is consistent with the program philosophyof the accessible sites, given the small number of cases having childrenplaced through kinship service (central: 3 and accessible: 7), it shouldbe interpreted with caution.

3.6. Parent's willingness to ask for help

One of the central ambitions of the accessible sites was to createmore constructive relationships with families and communities.Arguably, if they were successful, then parents would be more willingto seek out services when they had difficulties and to advise others todo so as well. Perhaps the most important consequence could be thedevelopment of an improved capacity to keep children safe and toassist parents, in part, because of earlier access to families andpossessing better information about family circumstances. This wouldbe an even more significant benefit if, as is suggested in the servicesand supports portions of this research, these service providers alsohad greater access to professional and community partnershipsresulting in more varied ways to help children and parents.

Table 3 shows that, at case-opening, both accessible- and central-site parent groups were almost equally divided between believingthat they would contact or not contact the child welfare agency in thefuture if they or a friend needed help. At follow-up, a significantlygreater proportion of accessible program parents (65%) said that they“definitely” or “probably” would refer a friend to the child welfareagency for help than central-site parents (39%) (U=1717.5, Z=−2.447, p=0.014, n=136). Similarly, a greater proportion ofaccessible site parents (61%) said that they “definitely” or “probably”would call the child welfare agency for help in the future than central-site parents (41%) (U=1739.0, Z=−2.446, p=0.014, n=137).Among central-site parents, almost 59% said that they “probably” or“definitely” would not call for help if they were to have difficultiesin the future compared to about 39% of accessible site parents. The

Table 3Parents' willingness to ask for help from child welfare services.

Accessible sites

Definitelywould

Probablywould

Probablywould not

Defiwo

If a friend was having problems at home, how likely would you be to suggest that she or he cCase opening (193) 20.3% (16) 29.1% (23) 24.1% (19) 26.Follow up (136) 22.8% (13) 42.1% (24) 12.3% (7) 22.

If your family were to have difficulties in the future, how likely would you be to call the childCase opening (192) 24.1% (19) 31.6% (25) 21.5% (17) 22.Follow up (137) 35.1% (20) 26.3% (15) 14.0% (8) 24.

willingness expressed by central-site parents to ask for help in thefuture decreased somewhat between case-opening and follow-up(Z=−1.743, p=0.081).

3.7. Job sustaining narratives

It is normal for colleagues sharing a work place to elaborate ashared story about what makes their work worthwhile and what ishard to accept. There were some very clear differences in the sharedemployment stories between central and accessible service deliverymodels.

3.7.1. Pride and enduranceThere was a narrative present at the central sites but not at all at

the accessible sites. This narrative reflected a pride in being able to doa very difficult and important job that many others could not do.Related to this were feelings that this difficult work was notunderstood or appreciated by clients and outsiders:

I think, for me, it's a very, very difficult job that I don't think a lotof people could do. I don't know, certainly not every social serviceprovider could do it. … I find it rewarding to do a job that a lot ofpeople couldn't do... I mean, if you're in it for the right reasons, inthe sense of you know, you're a caring individual, and you havethat natural ability to juggle the authority piece with the clinicalpiece and you can do those things and you've lasted more thantwo years, then maybe you have what it takes to do the job.[Central Site 1: front-line service provider]

Central child protection service providers described a more insularor disconnected world of work than their more accessible modelcounterparts. They were more likely to talk about a lack ofcooperation from community service partners. Having frequentsupport of other child welfare service providers in their centralservice team was considered very important to being able to copewith the pressures of their job. This valuation of team also wasconnected to a sentiment that only others facing similar challengescould understand what they were going through. These front-linechild protection service providers also placed high value on havingaccessible support from a supervisor. Having access to both team andsupervisor support was something that central service providersfound more satisfactory than front-line service providers at the moreaccessible sites.

There were strong expressions of commitment to the importanceof their child welfare jobs at several central sites. Another commontheme was that the work “is not boring.” Quite a few central serviceproviders expressed appreciation for the challenges and diversity intheir everyday work When they were able to do so, many serviceproviders appreciated being able to establish good helping relation-ships with children and parents and for being part of facilitatingpositive changes in families.

Central sites

nitelyuld not

Definitelywould

Probablywould

Probablywould not

Definitelywould not

ontact the child welfare agency for help?6% (21) 14% (16) 35.1% (40) 21.1% (24) 29.8% (34)8% (13) 13.9% (11) 25.3% (20) 26.6% (21) 34.2% (27)

welfare agency for help?8% (18) 17.7% (20) 31.9% (36) 22.1% (25) 28.3% (32)6% (14) 16.3% (13) 25.0% (20) 23.8% (19) 35% (28)

952 G. Cameron et al. / Children and Youth Services Review 33 (2011) 945–954

3.7.2. Belief and integrationThere was an enthusiasm among front-line service providers and

their supervisors about school- and neighbor-based service deliverythat was not evident in the central employment narrative:

I think it's enhanced me as a person too because I've met suchwonderful people in the community, whether it's partnerships orcommunitymembers. And um, they all bring something to the table,they all bring something to us so it's been a… I'm just really quitethrilled to be part of the community. I love thatwhole aspect so that'sreally rewarding. [School Site 3: front-line service provider]

Compared to central service providers, accessible front-line serviceproviders provided a relatively broader conception of their everydayservice involvements. They talked about protection and preventionresponsibilities with little focus on the tensions between theseundertakings. They talked appreciatively of “doing more than childprotection.”

Because they were often dispersed across different school orcommunity settings, a common lament among accessible-site serviceproviders was not having quick access to a colleague for support whenmaking decisions. In addition, this accessibility contributed to theirsense of working in “fish bowl environments.” Service providersdescribed frequent interruptions by clients to their everyday workroutines and feeling the need to respond constructively in theseinteractions. Overall, most service providers interviewed enjoyed andbelieved in the merit of their accessible service models, but the pricewas some unique employment frustrations as well:

But for me like, I could be in the office trying to do recordings andthey see my car outside so that means, okay we're here, we'reknocking on the door, (name) I need to talk to you about this, this,this, this, and it could be something, it could have waited untiltomorrow at our appointment, but they just… come right there.It's a good and it's a bad. [School Site 1: front-line serviceprovider]

3.8. Job constraining narrative

Despite the presence of contrasting job sustaining employmentnarratives at the central and accessible service delivery sites, anothernarrative about the impacts of the formal child protection system ontheir jobs was shared across all research sites. This narrative wasnoteworthy not only for its pervasiveness but also for its strongemotions expressed. The central theme of this formal systememployment narrative was that the expectations from the formalchild protection system were very excessive:

P1: … how many nights are we lugging our computers home totry to complete some of the work and even if you don't completeit that night you still bring it home because… You can't get it outof your head! You feel guilty. We feel guilt. … You're tired at theend of the day you have the intention to do the work but you'rejust exhausted. [School Site 1: front-line service provider]

P2: I take … one three week block [of vacation] in October, but toget ready for that is just, you're insane, I now need that threeweeks and that's when I'll have my anxiety attacks, my panicattacks, I'll get sick - I always get sick on vacation because it's likemy body is like, staying well, staying well - ok, I'm on vacationwhoosh. ... And then two days before you come back, sleeplessnights again thinking, ‘what's going to hit me when I come back,what's it going to be?’ [Central Site 1: front-line service providers]

One of the largest demands on these front-line service providers'time was completing the formal documentation requirements of their

job. At all sites, front-line service providers talked about spending 50%to 70% of their time on documentation:

P3: Paperwork is crazy; frustration, you're never ahead of thegame and when you get ahead of the game— two weeks ago I wasdoing my happy dance because I had no tasks overdue, got threeinvestigations in a 24 period, an apprehension in that period aswell, next thing I know I'm drowning in paperwork, don't knowwhere to start and that's frustrating. [Central Site 5: front-lineservice provider]

Service providers believed that compliance with the accountabilityrequirements of their work outweighed any other priorities in theirjobs. They stated that this reflected a self-protection emphasis for theMinistry and child welfare agencies. Also, being compliant with thesedocumentation requirements and service timelines was a way forservice providers to protect themselves.

Two harmful consequences of the above profile were identified byfront-line child protection service providers. First, many of the serviceproviders at these research sites stated that it was very hard andperhaps impossible to do good work with children or their parentsunder these conditions. The second perceived negative consequencewas that front-line service providers leave their jobs. The impressionfrom these narratives was that central front-line child protectionservice providers simply wear down and leave their jobs. Despiteproviding a more enthusiastic local employment narrative, in thewords of one respondent, neighborhood and school site front-linechild protection service providers “speak well (of the program) andleave.”

3.9. Confirmation from employment survey

There was confirming evidence from the employment survey offront-line child protection service providers for the patterns identifiedin the qualitative service provider interviews. However, as mentioned,the relatively low return rate for this survey suggests that theseresults be interpreted cautiously. To compensate, we compared the2008 survey results with results from similar surveys in the sameagencies of accessible site front-line child protection service providersin 2004 (Frensch, Cameron, & Hazineh, 2005) and central site front-line child protection service providers in 2001 (Partnerships forChildren and Families Project, 2003).

With the ongoing workload pressures described by central- andaccessible-programmodel service providers, it would be reasonable toexpect that many would show signs of moderate or high employment“burnout”. One manifestation of burnout would be greater difficultyfeeling empathy for service clientele. The Depersonalization Scale ofthe Maslach Burnout Inventory (MBI) (Maslach & Jackson, 1986)measures an unfeeling and impersonal response towards recipients ofone's service (scale range: 0–24). Between 54% and 75% of front-linechild protection service providers scored in the medium and highrange of this measure of depersonalization. In all four samples, at leastone-third of direct service providers scored in the high range fordepersonalization (11 or higher). There were no clear differencesbetween accessible model and central service providers on this scalenor any evidence that service provider depersonalization haddecreased between 2001 and 2008.

The Emotional Exhaustion Scale of the MBI assesses feelings ofbeing emotionally overextended and exhausted by one's work (scalerange: 0–54). Only about 25% of front-line service providers in all foursamples scored in the low range on this measure of emotionalexhaustion. On average, over 40% scored in the high range (28 orhigher) on this scale. Once again, there were no clear differencesbetween central- or accessible-model service providers on thismeasure of emotional exhaustion. Equally important, there is noevidence here that levels of emotional exhaustion have declined for

953G. Cameron et al. / Children and Youth Services Review 33 (2011) 945–954

child protection service providers between 2001 and 2008. Takentogether these depersonalization and emotional exhaustion patternssupport the themes from the previous job-constraining employmentnarrative about the challenges of sustaining their front-line childprotection employment.

The survey results in Table 4 confirm that most front-line serviceproviders in all four samples felt that they did not have enough time todo the work that they were expected to complete. These results alsoshow that many front-line child protection service providers think afair bit about leaving their jobs. Once again, there were no cleardifferences between service providers at the accessible and centralsites or evidence of change since 2001 on these indicators.

In the employment narratives, central- and accessible-site serviceproviders also talked a good deal about the rewards of front-line childprotection employment at their sites. The employment survey resultsshowed that 75% or more of front-line service providers derived amoderate or high sense of personal accomplishment from their work.Over 40% of front-line child protection service providers scored in thehigh range (37 or higher) on the Maslach Burnout Inventory —

Personal Accomplishment [scale range: 0–48]. Front-line childprotection work at all sites found their jobs interesting andchallenging. Table 4 confirms that most front-line child protectionservice providers in all four survey samples agreed that their workwas “not boring”.

4. Conclusions

One of the central messages from this research is that programintentionsmatter verymuch. All of the research sites in this studyhad astheir highest priority keeping children safe and there was no indicationat all that this priority was compromised by any of the service deliverystrategies investigated. However, the sites emphasizing the creation ofmore cooperative helping relationships with families made substantialprogress on this intention. Those sites designed to facilitate morecollaborations with professional partners had more success in doingso. The two accessible sites that focused on supporting communitydevelopment and creating partnerships with community associationsfostered such collaborations.

Besides service delivery intentions, the accessible sites alsodiffered in their physical locations with all of the accessible sitesbeing geographically much closer to the children and families served.Our findings suggest several service delivery consequences ofgeographic accessibility. Service delivery settings were more familiarand less intimidating for children and parents. Drop-ins and informaldiscussions with clients were common in accessible settings and rarein central settings. Also, service providers described a greater capacityto become familiar what was happening with children and families bybeing regularly present in schools and communities. In addition, theywere likely to be known to more children and parents in schools andcommunities, even those who were not clients of the agency. Finally,locations within schools or local neighborhoods seem to have

Table 4Employee perceptions of workload, interest, and intent to leave (percent of the sample in i

2008 central sample(N=93)

I have enough time to get the job done– not at all or not very true

76.1% (70)

I am not asked to do excessive amounts of work– not at all or not very true

68.8% (64)

I think about leaving this organization– above midpoint of scale of 1=never and 7=all the time

33.3% (31)

The work is interesting– somewhat or very true

96.8% (90)

The problems I am expected to solve are challenging enough– somewhat or very true

98.9% (92)

facilitated working relationships with local service providers andcommunity associations. This was particularly true when childprotection service providers were co-located with other servicesand community associations.

From our perspective, both modified service delivery intentionsand geographic accessibility make different but equally importantcontributions to the advantages found for the accessible sites in thisresearch. If similar intentions to foster good helping relationships andsimilar staffing profiles existed at a central location, it might bereasonable to expect improved client satisfaction with serviceinvolvement, but there would be less reason to expect more casualencounters with clients, better information about their everydayliving realities, and more cooperation with other service providersand community associations. On the other hand, an accessible settingcoupled with an exclusive emphasis on closer monitoring of familiesalso would be unlikely to achieve many of the benefits described inthis study.

A concern not emphasized in this paper was the lack of positivechange from case-opening to follow-up on most child and familyfunctioning indicators from the perspective of accessible and centralsite parents. Whether or not these child welfare interventions werekeeping children safer, there is no evidence in this study that theywere fostering significant improvements in their well-being or dailyliving environments. To do so, in our opinion, service delivery wouldhave to incorporate the parameters of promising programs fordisadvantaged children and families (Cameron & Vanderwoerd,1997; Prilleltensky, Nelson, & Peirson, 2001). This also would requirea major re-thinking about the purposes and procedures of child (andfamily) welfare in North America (Freymond & Cameron, 2006).

There was a duality in how front-line child protection serviceproviders in this research experienced their employment. This splitreflected the difference in how they felt about their local servicedelivery settings and how they saw the formal child welfare systemexpectations shaping their everyday employment realities. Reflectingthis duality, two important child welfare service delivery systemimplications stem from these findings — one opening possibilities forpositive innovations and the other questioning such possibilities.

It was clear that there is nothing “written in stone” about howchild protection services are understood. What we have come toaccept as proper and inevitable in child protective service delivery isin fact a choice. The suggestion from this research is that, if we wantmore cooperative relationships with service partners, communitypartners and clientele, it can be done. The implication also is that wedo not have to compromise the safety of children to make progress inthese areas. The evidence is that both the service philosophy guidingour efforts and the physical settings for delivering child protectiveservices potentially matter a lot.

Yet service providers in this research described a force pulling inan opposing direction and it may have been the dominant influenceover their employment experience. There were underlying currents ofcentral bureaucratic control, risk aversion and system self protection

ndicated response range).

2008 accessible sample(N=24)

2004 accessible sample(N=21)

2001 central sample(N=237)

73.9% (17) 82.1% (23) 69.1% (163)

60.9% (14) 64.3% (18) 64.3% (151)

41.7% (10) 32.1% (9) 54.0% (86)

100% (23) 100% (28) 98.3% (232)

100% (23) 100% (28) 96.6% (227)

954 G. Cameron et al. / Children and Youth Services Review 33 (2011) 945–954

substantially shaping work across all of these research sites. Thesuggestion was that these forces were powerful enough to reshapeany efforts at reform. There is a need to examine the nature andconsequences of the formal centralized bureaucratic organization ofchild protection services. This is a much more daunting undertakingthan proposing specific changes to service delivery strategies. To gofurther, we have to look to other less costly ways to manage risks tothe system and to create space for much more of service providers'time and creative energy to be invested into helping children andfamilies.

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