Developing Strong Helping Alliances in Family Reunification

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Developing Strong Helping Alliances in Family ReunificationCary E. Jenson a; Barbara A. Pine b; Robin Spath b; Benjamin Kerman c

a University of Maine, Orono, ME, USA b University of Connecticut School of Social Work, WestHartford, CT, USA c Casey Family Services, New Haven, CT, USA

Online publication date: 01 December 2009

To cite this Article Jenson, Cary E., Pine, Barbara A., Spath, Robin and Kerman, Benjamin(2009) 'Developing StrongHelping Alliances in Family Reunification', Journal of Public Child Welfare, 3: 4, 331 — 353To link to this Article: DOI: 10.1080/15548730903347812URL: http://dx.doi.org/10.1080/15548730903347812

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Journal of Public Child Welfare, Vol. 3:331–353, 2009

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DOI: 10.1080/15548730903347812

Developing Strong Helping Alliancesin Family Reunification

CARY E. JENSONUniversity of Maine, Orono, ME, USA

BARBARA A. PINE and ROBIN SPATHUniversity of Connecticut School of Social Work, West Hartford, CT, USA

BENJAMIN KERMANCasey Family Services, New Haven, CT, USA

The development of positive working relationships with clients has

been a hallmark of the social work profession since its inception.

More recently there has been a resurgence of interest in both

measuring the dimensions of the working relationships and the

processes through which these relationships are formed. This article

reports findings on working relationships from a comprehensive

evaluation of a family reunification program that used multiple

approaches to study these relationships. These overlapping findings

are discussed in the context of program elements that fostered en-

gagement and the maintenance of positive working relationships

between clients and staff.

KEYWORDS therapeutic alliance, alliance, child welfare

Engaging clients in a helping relationship is one of the chief hallmarks ofsocial work practice (Woods & Hollis, 2000). Mary Richmond, one of the

Received: 3/11/08; revised: 1/15/09; accepted: 9/4/09The authors acknowledge and appreciate the essential assistance of Casey Family

Services staff and service participants, as well as the collaboration of staff in the Connecticut

Department of Children and Families and the Maine Department of Health and HumanServices. The evaluation was supported by Annie E. Casey Foundation/Casey Family Services.

Opinions expressed are those of the authors and do not necessarily represent those of the

Annie E. Casey Foundation or Casey Family Services.Address correspondence to Robin Spath, University of Connecticut, School of Social

Work, 1798 Asylum Avenue, West Hartford, CT 06117. E-mail: [email protected]

331

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332 C. E. Jenson et al.

profession’s pioneers, wrote of the essence of the relationship as gainingthe trust and cooperation of clients (Petr, 1988). Engagement, also calledthe therapeutic alliance, has been defined as ‘‘the collaborative and affectivebond between therapist and patient’’ (Martin, Garske, & Davis, 2000, p. 438).Altman (2005) points out that engagement is both product and process.Engagement as product is the beginning work with the client, whereasthe process of engagement is ‘‘a complex and multilevel phenomenon thatinvolves the establishment of a helping relationship between worker andclient so that active work toward change can begin’’ (p. 74).

Yatchmenoff (2005) discusses some of the features of engagement thathave been addressed in the social work literature over time, including suchconstructs as joining, forming a relationship, developing trust, establishinggoals, cooperation and participation, and a client’s willingness and readinessto change. Yet, as she and others point out, there has been little informationabout the processes of engagement, limited attention to the development oftools for measuring it, especially from the client’s perspective, and few em-pirical studies of the helping alliance in social work (Petr, 1988; Yatchmenoff,2005).

Nowhere is the process of engagement and building the helping alliancewith clients more challenging than in child welfare practice, where socialworkers work mainly with involuntary clients, such as parents whose chil-dren have been removed from their care and placed in foster care. Especiallynow with the shortened timelines for reunification under The Adoption and

Safe Families Act (ASFA) (PL 105-89) (Child Welfare League of America,n.d.), timely development of effective working relationships is critical if thegoal of helping parents solve the problems that led to their involvementwith child welfare authorities and ultimately to reunify with their childrenis to be reached. Early engagement improves communication with families,helps to better recognize their strengths, helps in maintaining parent–childbonds through positive, planned visiting, and helps motivate parents to worktoward change (Altman, 2008).

In this article, we examine the helping relationship in family reunifica-tion practice. We discuss select findings from a comprehensive study of amodel reunification program focused on the development of a productiveworking alliance between program staff and parents whose children hadbeen removed by child welfare authorities and placed in foster care. Weused qualitative and quantitative measures in the evaluation as well as in thestudy of worker/client alliance reported here. Qualitative study approachesincluded observation of parent groups, parent–child visits, and team meet-ings; focus groups with parents and staff; comprehensive case reviews; andinterviews with program staff and their collaborators in two partner statechild welfare agencies. To obtain quantitative data on the client/staff allianceand its relationship to program outcomes, the Working Alliance Inventory

(WAI ) (Horvath & Greenberg, 1989) was used.


Alliances in Family Reunification 333

The article begins with a discussion of the helping relationship and areview of selected studies of the helping alliance in social work, and inparticular child welfare practice. Then a brief overview is provided of themodel program and the comprehensive evaluation of which this sub-studywas a part. Measurement of the helping relationship, using both qualita-tive and quantitative approaches is discussed. Finally, sub-study findingsin relation to the model program’s approaches and the development ofpositive working relationships are considered. Throughout the article theterms helping alliance, helping relationship, and working alliance are usedinterchangeably. The model family reunification program is referred to as‘‘the program.’’

THE HELPING ALLIANCE

The helping alliance has consistently been shown to be an important el-ement of helping. For example, Freud long ago pointed out that, besidespositive transference, the patient experiences genuinely fond and warmfeelings for the analyst (as cited in Horvath & Symonds, 1991). Somewhatmore recently, Carl Rogers (1957) argued that a strong relationship betweentherapists and clients was necessary for successful outcomes in therapy. Ac-cording to Rogers, the therapist must demonstrate empathy, congruence, andunconditional positive regard. Perlman (1979) emphasized the supportiveand compassionate aspects of the helping relationship. Others have notedthat the relationship involves such elements as joining, cooperation, andcollaboration; in short it constitutes a partnership in the helping process(Maluccio, Pine, & Tracy, 2002). Hartman (1979) also posits the relationshipas one built on a ‘‘shared project,’’ with both client and helper bringing‘‘a special expertise to the task’’ (p. 264). Germain and Gitterman (1996)further state that positive relationships with clients are those characterizedby openness, authenticity, and caring. Shonfeld-Ringel (2001) emphasizesempathy as an important component of the working alliance in cross-culturalrelationships.

Although the helping relationship has historically been seen as a power-ful tool by social workers (Coady, 1993; Woods & Hollis, 2000), only a limitednumber of studies have examined it in social work practice using empiricalmethods (Petr, 1988), although more recently there has been a revivedinterest in the helping relationship and a call to emphasize it in social workeducation, practice, and research (Coady, 1993; Dore & Alexander, 1996).Moreover, current researchers have documented the role of the helpingrelationship and outcomes (Horvath & Symonds, 1991; Martin et al., 2000;Marziali & Alexander, 1991).

For example, Kokotovic and Tracey (1990) examined the impact ofclient characteristics such as interpersonal relationships, hostility, and level



of adjustment on the helping relationship in a mental health setting andfound that clients with positive characteristics also had strong alliances. Inanother study in a mental health setting, Solomon, Draine, and Delaney(1995) compared two groups of case management teams; they found nodifference in scores between the groups, but a positive relationship betweenstrong alliance scores and quality of life, attitudes toward adherence tomedication, and satisfaction with mental health services. In a study of aprogram aimed at reducing aggression in school-aged children, Letendre,Henry, and Tolan (2003) examined the effect of leader and group factors on794 school-aged children enrolled in a special program to reduce aggressionand increase pro-social behavior. The authors found that alliance and groupleader experience predicted change in aggression but not in pro-social skills.In another study, Smith, Shane, and Jackson (2004) studied 150 self-identifiedproblem gamblers, and found that the helping alliance was a significant factorin successful outcomes.

Studies in child welfare also have examined the impact of the helpingrelationship and outcomes. Most relevant to the current study, Fraser andhis colleagues (Fraser, Walton, Lewis, & Pecora, 1996) linked the buildingof strong and motivating alliances with family members to successful reuni-fication. Similarly, Lee & Ayon, (2004) conducted research among familiesreceiving either court-ordered family preservation services or family main-tenance services and found an association between the development ofhelping relationships in the two types of cases. In particular, they notedstronger relationships in cases receiving family preservation services.

Alexander, Littell, Reynolds, and Girvin (2001) studied 362 families withsubstantiated reports of child abuse or neglect to learn the effect, if any, ofthe helping relationship on service outcomes. They found that the helpingrelationship was associated with lower levels of maternal depression andthat it reduced the likelihood of additional substantiated reports of abuseand neglect at 12 but not 18 months. The consistency of this link betweenrelationship and outcome, despite the range of measures and settings, un-derscores the relevance and validity of this construct.

Some studies have looked at what contributes to a positive helpingrelationship. Altman (2008), in a qualitative study examining the processesof engagement in neighborhood-based child welfare services, found thatparents valued worker communication with them that offered reassurance,affirmation, and was honest and direct. They also said that the workingrelationship was important and positive when workers were empathic, sup-portive and focused on parents’ strengths, and they appreciated workers whokept the case moving forward at an adequate pace. Workers, in contrast,judged the relationship on the extent to which parents accepted responsibil-ity for what had happened and were compliant with case plans and demands.

Another factor apparently contributing to the development of a posi-tive helping relationship, especially in child welfare, is the extent to which



the helper understands and can relate to the client’s cultural values andexperiences. Indeed, in recent years there has been increased attention onculturally competent practice in child welfare, although empirical evidenceabout its role in either relationship-building or outcomes is limited (Cohen,2003; Harris, Skyles, Barrett, & George, 2005; Leung, Cheung, & Stevenson,1994; Maiter, 2004; McPhatter, 1997; Mederos & Woldeguiorguis, 2003; Nybell& Gray, 2004; Pierce & Pierce, 1996; Sandau-Beckler, Salcido, & Ronnau,1993; Smith, 2006; Woodroffe & Spencer, 2003).

Cultural competence has been defined as ‘‘understanding language,attitudes, values, and behaviors of diverse groups’’ (Sherraden & Segal, 1996,p. 498). Culturally competent practice is especially important because ofthe disproportionate numbers of children and families of color involvedin child welfare systems nationally. In 2005, approximately 50% of thosereported to the child welfare system were African American (23.1%), Hispanic(17.4%), American Indian or Alaska Native (1.2%), Asian (0.8%), PacificIslander (0.2%), or multi-racial (2.3%) (U.S. Department of Health and HumanServices, 2007).

Child welfare agencies have worked to improve cultural competencein various ways. One approach has been to provide training to help staffat all levels develop a better understanding of the values, behaviors, andattitudes of diverse groups (Fong & Furturo, 2000; Nybell & Gray, 2004;Pierce & Pierce, 1996; Sherraden & Segal, 1996). Another approach involvesthe provision of services in communities where clients live, and developingpositive and effective working relationships in these diverse communities(Hosley, Gensheimer, & Yang, 2003; Pierce & Pierce, 1996; Woodroffe &Spencer, 2003).

Researchers have also examined the use of ethnic/racial matching ofchild welfare social workers with the clients they serve (Perry & Limb,2004), although the impact this has on the quality of services providedin child welfare is not adequately understood. Finally, researchers havenoted the growing Hispanic population and their over-representation in thechild welfare system in some areas of the country. This creates the needfor language interpretation to be able to assess the families’ situations andcommunicate in a culturally competent manner (Suleiman, 2003; Zambrana& Dorrington, 1998). Although researchers have explored various ways toincrease cultural competence in child welfare practice, there is still much tobe learned about the effectiveness of these approaches and other practicemethods for serving diverse populations.

Finally, the strengths perspective and empowerment practice are seenas important contributors to the development of positive working relation-ships with clients. A strengths perspective assumes that every individual nomatter what the trauma, abuse, or struggles they may have experienced, hasstrengths and resources that they can be helped to garner to meet their ownneeds (Saleeby, 2006). Empowerment practice seeks to put this perspective



into action. Thus, work with families would be characterized by relationshipsof equality and respect, aimed at helping them to support the growth anddevelopment of all family members, while affirming and strengthening theircultural, language, or religious identity, with programs that are flexible andresponsive to individual family needs (Benard, 2006).

The study reported here links cultural competence, the strengths per-spective and empowerment practice, and other attributes of the staff andthe program to the development of positive relationships and program out-comes. Following is an overview of the model reunification program and itsevaluation.

OVERVIEW OF THE MODEL REUNIFICATION

PROGRAM AND EVALUATION

The study of the helping alliance reported here is part of a larger, 5-year re-search project evaluating the implementation and outcomes of a model fam-ily reunification program. A team of four social worker researchers, workingclosely with staff in the program, used quantitative and qualitative methodsto gather both process and outcome data. The evaluation examined childand family outcomes such as reunification, reduced risk factors, children’spermanency and safety, and family stability following reunification. Whilethe full results of the study, which showed that the program achieved anumber of successful outcomes, go beyond the scope of this article and areavailable elsewhere (Pine, Spath, Werrbach, Jenson, & Kerman, 2009), thestudy showed that children in the program were reunified or achieved analternative permanent placement far sooner than children in the comparisongroup. They also experienced fewer moves while in state care.

The model program is operated by a large, non-profit child welfareagency in two New England states. Referrals of families experiencing a first-time removal of their children are received from the respective state childwelfare agency. The program works collaboratively with the referring agencyto return the children to their parents’ care within six months, if possible.Other key features of the program include a comprehensive and mutualassessment and service planning process; a program philosophy that seeksout and works with family and parent strengths; culturally competent pro-fessional staff working in teams; intensive family-centered and home-basedservices; regular, frequent and well-planned parent-child visits; goal-directed,individualized services that are both concrete and therapeutic; regular teammeetings that include staff from the model program and the referring stateagency and parents; parents’ groups as an integral part of treatment; andthe program’s expanded view of success that aims to involve parents inplanning for their children even if they are unable to resume full-time carefor them.



The sub study reported here hypothesized that the program’s philos-ophy and approaches would result in strong, positive, and mutual helpingrelationships, or therapeutic alliances between reunification staff and parents.Moreover, these relationships were expected to positively affect outcomes.Following is a discussion of the various methods used throughout the studyto collect data on the therapeutic alliance.

METHODS

Information about philosophy and practice approaches and the developmentof staff–client alliance in the program was gained through triangulation ofdata. In the social sciences, triangulation involves the use of multiple ap-proaches for gathering data to examine a certain phenomenon (Berg, 2004).To gather data on the alliance, a variety of methods, both quantitative andqualitative, were used during the five-year evaluation. Qualitative data onthe alliance were gathered through observation of staff working with clients,as well as interviews and focus groups with parents and staff. In addition,the study used the WAI (Horvath & Greenberg, 1989) to obtain empiricaldata on this relationship between program staff and parents in the program.

Sample Demographics

The study sample consisted of 135 families,1 and the WAI was completed bymothers who were served by the program. At the time of referral, almost 50%of the mothers were age 16 to 24 years (42.8%). The remaining membersof the sample were mothers age 25 to 30 (27.6%); 31 to 35 (18.1%); or36 years or older (11.5%). Most were Caucasian (50.6%), and the next largestracial/ethnic group was Hispanic (32.9%). The rest of the sample includedmothers who were African American (8.8%), bi-racial (4.0%), and individuals(3.6%) of unknown racial/ethnical origin.

In addition, the WAI was completed by the social workers and familysupport workers working with the families in the program, however demo-graphic data was not gathered on the program staff.

Working Alliance Inventory

One definition of a positive helping relationship or alliance is that it is acollaborative endeavor between client and therapist in which they negotiate acontract appropriate to the nature of the client’s presenting problem (Horvath& Symonds, 1991). Horvath and Greenberg (1989) conceptualize this helpingalliance as consisting of three dimensions: 1) Goal: how well the client andtherapist agree on the goals of treatment; 2) Task: how well the two agree onhow to reach the agreed-upon goals; and 3) Bond: the degree of mutual trust



and acceptance the dyad has for each other. The WAI is a 36-item scale, withseven Likert-type responses ranging from ‘‘never’’ to ‘‘always,’’ containingthree sub-scales that measure Task, Goal, and Bond. There are three versionsof the instrument, one each for the therapist, client, and observer.

Among its attributes for use in this study were the reliability of theclient’s version of the instrument (Cronbach’s alpha D .93) and the reliabilityof the therapist’s version (Cronbach’s alpha D .87) (Horvath and Greenberg,1989). The developers of the WAI have also established that the instrumentdemonstrates convergent, concurrent, and predictive validity (Horvath andGreenberg, 1989). Further, it can be used by social workers with eclecticand varying theoretical orientations (Horvath & Greenberg, 1989). Since themodel program under study emphasized goal-directed service planning andintensive work with parents to carry out service plans, measuring agreementon goals and tasks seemed essential.

The evaluation assessed staff members’ (both the social worker andthe family support worker) perspectives of their alliance with the parent, aswell as the parent’s perspective of his/her alliance with the staff. The staffmembers working on each case were contacted by the researchers 6 monthsafter a family entered the program. (Staff members involved in planning thestudy felt that 6 months was an optimal time to measure the alliance withparents.) Each was asked to complete the therapist version of the WAI toassess their relationship with their client. Researchers then contacted theparent in the program by telephone and completed the client version of theWAI. Response rates were high, with completed WAI questionnaires fromsocial workers (n D 79, 96.3%), family support workers2 (n D 77, 100%),and parents (n D 64, 78%).

To score the WAI, each Likert response is assigned a numeric value of 1to 7—with a rating of 1 indicating a low score and a rating of 7 indicating ahigh score (Horvath & Greenberg, 1989). The three sub-scales have 12 itemseach; a mean score, standard deviation and t-test are calculated for theresponses on each sub-scale. This process was followed for each of the threerespondent groups. The findings of these analyses are reported in Tables 1and 2. The next step in the data analysis was to examine the relationshipbetween the WAI scale scores of the parents and the staff, the reunificationoutcome and other key categorical variables.3 One-way analysis of variancestatistics were used, along with Welch and Brown-Forsythe tests, in caseswhere the assumptions of equal variance and sample size were not met(Norusis, 2005).

Observation of Staff and Parents

Research team members conducted observations of both groups and parent–child visits. At one study site, two researchers observed seven sessions of twoon-going parent groups. In addition, researchers observed at both program



TABLE 1 Working Alliance Inventory Mean and Standard Deviation for Staff Assessment ofAlliance with Parent

SCALE**

Staff assessment Task Bond Goalof parent alliance M (SD) M (SD) M (SD) n

Social worker 5.00 (1.02) 5.06 (.914) 4.78 (1.06) 79Family support worker* 5.35 (1.16) 5.78 (.750) 5.31 (1.26) 77

t D 1.44(p < .05)

t D 5.70(p < .05)

t D 2.47(p < .05)

—

Note. *Due to staff attrition, there was not a family support worker assigned when the survey was

conducted, therefore the n is smaller. **The three sub-scales have 12 items each.

sites a total of three parent-child visits. During the observations, they lookedfor markers of the staff–client alliance, such as active parent involvement inoutlining goals and activities and positive parent-staff interactions.

Interviews and Focus Groups

Interviews and focus groups with both the staff and parents also provideddata on the alliance. The research team interviewed parents in the programat 12 months after intake and again at 24 months. The focus of the interviewat 12 months was client satisfaction with the service; at 24 months it wasoutcomes and child well-being. These follow up interviews with parentsprovided information on their relationship with program staff and the extentto which they felt they were helped.

In addition, focus groups were conducted with staff at both sites, aswell as with the parents in a group at one of the sites, in order to betterunderstand the group intervention aspect of the model. The research teamprovided the staff with a set of questions in advance of the focus groups.These questions aimed at providing information on group processes, goals,

TABLE 2 Working Alliance Inventory Mean and Standard Deviation for Parent Assessmentof Alliance with Staff

SCALE**

Parent assessment Task Bond Goalof alliance with staff M (SD) M (SD) M (SD) n

Social worker 5.93 (1.26) 5.81 (1.40) 5.85 (1.31) 64Family support worker* 5.88 (1.33) 5.81 (1.35) 5.78 (1.32) 61

t D .293(p < .05)

t D �.298(p < .05)

t D .313(p < .05)

Note. *Due to staff attrition, there was not a family support worker assigned when the survey was

conducted, therefore the n is smaller. **The three sub-scales have 12 items each.



benefits and limitations, as well as the extent of parents’ involvement withother parents both inside and outside of the group setting. In the focus groupwith parents, they were asked five broad, open-ended questions about thestrengths, benefits, and limitations of the group. The research team assessedthe alliance by looking for markers that indicated client involvement inplanning group tasks and goals, as well as descriptions that reflected theclient-staff bond in the group process.

The qualitative data that were collected through observations, inter-views, and focus groups helped to illuminate the quantitative data; thesedata are presented in the following findings and discussion section.

FINDINGS AND DISCUSSION

As noted earlier, engagement with clients includes, among others, suchfeatures as relationship-building, developing trust, and the mutual establish-ment of goals and tasks (Yatchmenoff, 2005). The following findings outlinehow the design of the reunification program was aimed at creating andmaintaining these attributes of the helping alliance, including both programphilosophy and practice.

Quantitative Findings and Discussion

Study results from the WAI indicate that all three groups of respondents gavehigh ratings to the quality of helping relationships. Results of the staff allianceratings reflect the social workers’ and family support workers’ sense that theypromoted strong working alliances with their clients. Solid normative dataare not available for these scales and population, however the ratings may beconsidered to reflect a deeper, stronger, and more positive alliance. Table 1shows results of staff assessments of their working alliances with parents.

While staff in both roles tended to see strong collaboration and alliancewith their clients, family support workers tended to rate the alliances higheron each of the dimensions. This trend was consistent across dimensions,but family support workers and social workers diverged most on the bond

sub-scale, with mean ratings of 5.78 and 5.06, respectively. The smallestdifference was observed on the task sub-scale (M D 5.35 and 5.00). Thedesign of the program is likely to have contributed to these differences.

For example, family support workers may see their alliance as particu-larly strong given their frequent interactions with the parent outside of theoffice, providing hands-on assistance in areas such as housing, basic livingskills, job development, and parenting. During this work together in the com-munity, family support workers enjoy additional structured and unstructuredopportunities for bonding with the parent that the social worker may nothave during their more time-limited and otherwise more formal interactions.



Social workers are not as involved in day-to-day skill building, but insteadprovide weekly therapeutic services, as well as some case managementactivities.

Overall, parents’ ratings reflect very strong alliances with the programstaff, both social workers and family support workers. Table 2 shows theconsistently high mean parent responses, which range between a 5.93 and5.78. Yet while staff ratings favor the alliance between family support workersand parents, there is a slight trend toward parents rating the alliance with thesocial worker higher. Although the divergence is very modest, it is consistentacross each sub-scale.

As predicted, results show the association of a strong alliance and pos-itive permanency outcomes. These positive outcomes included the estab-lishment of a more permanent placement for the child at case closing asevidenced by placement dispositions of reunification, pre-reunification, pre-adoption, and legal guardianship (Pine et al., 2009). While the analysis ofclient scores on the WAI showed no statistically significant relationshipsbetween these and the four permanency outcomes, when the mean scoresof both groups of staff were analyzed together, higher scores on each sub-scale—task, goal, and bond—were significantly related to all four perma-nency outcomes. For example, the analysis showed that reunification ofparents with their children was positively and significantly related to both thesocial workers’ assessment that they and the parent agreed on case goals,and that a positive bond had been formed between them. Social workersrated their alliances as strong with parents who successfully reunified withtheir children in terms of tasks (M D 5.42, F D 11.79, p. < .000), bonds (M D

5.35, F D 6.015, p. < .001), and goals (M D 5.23, F D 11.48, p. < .000).The Family Support Workers also rated their alliances as strong with parentswho successfully reunified with their children in terms of tasks (M D 5.82,F D 8.17, p. < .000), bonds (M D 6.02, F D 8.27, p. < .000), and goals (M D

5.74, F D 6.05, p. < .001). The fact that there is no statistically significantrelationship between parents’ scores and outcomes may be a function oftheir smaller sample size (n D 64).

Staff members expect that efforts to build stronger alliances result ingreater engagement in the various program activities, which will both furtherdeepen the alliance and contribute to better outcomes. As part of the overallevaluation, each case was assessed in terms of parent’s participation inservices offered. Thus, when parents participated in therapeutic services thatwere offered, for example counseling and substance abuse treatment, atleast half of the time these were offered, participation was positively andsignificantly associated with client ratings of a strong alliance in terms of theclient–staff bond.

As noted earlier, alliance strength can vary with participant and servicecharacteristics, including cultural fit and service sensitivity. In fact, familysupport worker WAI mean scores showed differences in the strength of their



TABLE 3 Mean and Standard Deviation of Family Support Worker Assessment of AllianceAcross Parent Race/Ethnicity*

SCALE**

Task Bond Goal

Race/Ethnicity n M SD M SD M SD

Caucasian 35 5.0667 .92417 5.0357 1.06667 5.7071 .62927African American 3 5.6667 .38188 5.7500 .71200 5.8889 .79203Hispanic 21 6.1905 .98536 6.1310 .91385 6.3135 .44167Other 5 5.6667 .85797 5.6667 1.18878 5.9000 .79582F — (3, 60) D 6.500,

p < .001(3, 60) D 4.573,

p < .006(3, 60) D 5.221,

p < .003Welch — (3, 9.112) D 5.447,

p < .020(3, 6.847) D 5.048,

p < .0373, 7.526) D 4.787,

p < .037Brown Forsythe — (3, 22.917) D 9.047,

p < .000(3, 8.379) D 3.241,

p < .079(3, 14.514) D 5.659,

p < .009

Note. *Cases where the race/ethnicity of the parent were unknown were dropped from the analysis.

**The three sub-scales have 12 items each.

alliance with the client across all three sub-scales depending on the race ofthe client as shown in Table 3. The family support workers had the strongestalliance with Hispanic parents. The Tukey post-hoc test confirmed that thisdifference is statistically significant from the mean scores of the alliance withCaucasian parents.

The mean scores for social workers also showed this difference in twosub-scales—task and bond. The Tukey post-hoc test confirmed that thisdifference is statistically significant when comparing the mean scores of theHispanic and Caucasian parents in these two domains. Thus social workersalso formed stronger alliances with their Hispanic clients. Moreover, Hispanicparents had a statistically significant stronger assessment of their alliance withtheir family support worker on both the task and bond sub-scales.

The quantitative findings from the WAI indicate that during the firstsix months of work together, parents and staff developed strong alliances.Following is a discussion of the qualitative findings in relationship to theformation of strong alliances.

Qualitative Findings and Discussion

The qualitative data gathered through the various methods described earlierpoint to several features of the program that assisted in the development ofstrong therapeutic alliances. These are discussed in detail later. Consistentwith a strengths-oriented, empowerment approach to the research (Canda,2006), we present these and let the parents speak for themselves where theirwords underscore and illuminate our findings.



DESIGN

The program was designed to receive referrals from a partner state agencyin each of the two sites where it operated. Every attempt was made torefer families quickly, within 15 days of a child’s removal from the home.For the most part, these involuntary clients of the child welfare system, allof whom were in crisis over the loss of their children, voluntarily joinedthe model program and were quickly seen by program staff to begin theirwork together. An additional potential contributor to the development ofgood staff/parent relationships in the program was the fact that these werefamilies who had experienced a first time removal of their child or children.Such families may be more willing to engage in a helping relationship thanfamilies long known to the child welfare services system who may have ahistory of adversarial and failed relationships with child welfare authoritiesand other professionals.

FOCUS ON STRENGTHS

A key, stated principle of the reunification program is its focus on strengths(Saleeby, 2006; Benard, 2006). In the initial comprehensive assessment con-ducted with each family at intake, staff members documented these strengthswith parents and included them in the case record. This comprehensiveassessment which enables parents to tell their own stories about life and theevents leading up to involvement with the child welfare authorities, as wellas the focus on strengths, can help overcome feelings of guilt and shame,and anger that may impede the work toward change. Another key programprinciple is the belief that ‘‘with appropriate supports, most families canprovide the love and nurturing environment necessary to raise their children’’(Casey Family Services, 1999, p. 2). These principles guide the work withthe families and the collaboration with the partner agencies.

In a sub-study of the collaboration between the program and its stateagency partners, as part of the comprehensive evaluation (Spath, Werrbach,& Pine, 2008), some respondents from the public agencies noted that some-times during case conferences on individual families, the program’s emphasison family strengths was somewhat at odds with their agency’s emphasis onchild safety, although child safety was stated as paramount in the modelprogram’s guiding principles. On balance, though, respondents said they sawfamilies in a more positive light because of their work on the team with theprogram staff. As others have noted, a strengths approach is ‘‘both an attitudeand a way of working’’ (Zamosky, Sparks, Hatt, & Sharman, 1993, p. 156). Notsurprisingly, parents responded positively to this emphasis on their strengths,as one parent told the researchers: ‘‘In general, (the agency) demonstratedconfidence in my ability to care for my daughter. They always did morethan was expected of them—I always felt their support and encouragement’’(Parent comment after working with the staff 12 months).



A BELIEF IN FAMILIES

Another philosophical underpinning of the program was a strong belief thatbirth families are the best place for most children and that most parentswant what is best for their children (Casey Family Services, 1999, p. 2). Theemphasis on strengths is consonant with the view of parents as resources forthemselves and their families (Pecora, Whittaker, Maluccio, & Barth, 2000). Asone parent commented on her involvement in the program: ‘‘We all workedtogether—(the agency) looked into what I thought would be good for mychild and saw me as the expert’’ (Parent comment after working with thestaff 12 months). It is likely that the high scores on the Bond sub-scale of theWAI are a reflection of the program’s philosophy of focusing on strengthsand believing that families want the best for their children.

COMPREHENSIVE INITIAL ASSESSMENT AND INCLUSIVE SERVICE PLANNING

As noted previously, the initial assessment, conducted as soon as possiblefollowing the family’s referral to the program, included a client’s telling hisor her life story as it pertains to involvement with child welfare author-ities. This personal perception of problems and experiences was seen asan important asset in the future work together. In addition to the strengthsassessment noted above, the program used two sets of clinical tools thatshowed both strengths and needs of families (Pine, Spath, Maguda, Werrbach& Jenson, 2007). Results of the assessment process were openly shared withparticipating parents. Moreover, service goals were mutually determined bystaff and parents and were related to assessment results. Rooney (1992)stresses giving parents who are involuntary clients’ freedom to make choicesabout the services to be engaged in, and planning small steps along theway to the overall goal of these. Both the assessment and the mutuallydetermined service goals were likely contributors to high scores on goaland task agreement in the WAI. Parents who ultimately were reunified withtheir children appeared to have a stronger alliance with staff in terms ofunderstanding goals needed to accomplish the reunification. About mutualityin the assessment and planning process, one parent said: ‘‘I felt like they didthe best they could do for me—I felt like they included my ideas in treatmentplanning’’ (Parent comment after working with the staff 12 months). Anotherparent said: ‘‘They listened to me. They evaluated what I said and thenthey put in their feelings. They asked about my life so they could come upwith treatment goals. They read me and what I was’’ (Parent comment afterworking with the staff 12 months).

DePanfilis (2000) has delineated skills effective in building a workingalliance that include clarifying expectations, authority, and obligations as wellas communicating commitment and acceptance. These skills were reflectedin the work between program staff members and parents. The collaborativeapproach to both assessment and treatment planning helped to build a



foundation of trust and mutual respect—critical first steps in developing astrong and positive alliance. Parents were sent a clear message that theywere key team members in identifying their strengths and determining howthose could be used to address the challenges they faced in caring for theirchildren.

FREQUENT PARENT/CHILD VISITING

As part of the examination of the visiting component of the model program(Pine, Spath, & Jenson, 2005), we observed a number of visits and found staffmembers to be extremely well skilled at coaching, praising, role modelingand making suggestions to which parents seemed very responsive. Oneobserver noted that parents seemed to trust the staff very much despitethe challenges of trying out new behaviors with their children.

The most convincing evidence available in foster care research in theUnited States is the relationship between visiting and outcomes. Visiting iscentral to the achievement of case goals around improved parenting. Regular,planned visits help families to maintain relationships, enhance separatedchildren’s well-being, help parents determine their willingness and abilityto resume full time care of their children, and learn and practice new skillsnecessary for them to do so (Hess & Proch, 1993). The program providedan extensive parent–child visiting component in which visits were plannedand evaluated with parents who were coached throughout visits aroundparticular areas of parenting that needed work. The extent of time staff spentwith parents around visiting and their skillful handling of the coaching roleare other contributors to the development of strong and mutual workingrelationships. About the help she got with her parenting, one mother said:‘‘At visits, the workers gave good ideas on how to talk to the kids and howto listen to them’’ (Parent comment after working with the staff 12 months).Another parent said:

My child seems happy to be with her Mommy. She feels very happyand bonded to me : : : Both children are doing very well : : : We haveplay time together : : : Visits with my other daughter are going well : : :

The last visit was 2 hours, we played video games and made cupcakes.(Parent comment at the interview 24 months after entering the program)

COLLABORATION

Collaboration and teamwork are hallmarks of the program—with parentsand with the state agency partners in the work together with the family. Thisincludes team meetings in which parents are involved, thus reducing thepossibility of splitting the staff from the two agencies. Collaboration also en-hances parents’ feelings of empowerment as they participate in planning andassessing progress. Dore and Alexander (1996) citing Horvath and Luborsky



(1993) note that sharing power enhances the sense of trust and safety inthe relationship, and is thus an important contributor to a positive workingalliance. Having everyone ‘‘at the table’’ also has the potential to decreaseboth the personal and the emotional distance between parents and thosetrying to help them, building parents’ trust in, and comfort level with, theteam. One parent commented on her work with the team: ‘‘They have beenwonderful throughout the case : : : They worked well together with [stateagency partner] : : : The provider meetings were really helpful because theywould get everyone on the same page’’ (Parent comment after working withthe staff 12 months).

While staff in the model program sought to partner with parents, theywere also honest and straightforward with them in bringing up difficultissues. Such was the case with a mother who allowed an abusive partner,whose leaving was a condition of reunification, back into her home. And,although parents in the program must work hard to achieve their goals—attend groups, go to parenting classes, seek employment, participate in drugtreatment, plan regular visits with their children—for the most part theysucceed. For example, 90% of parents in the program participated in allor most of the visits planned. A parent in the program said: ‘‘They are fair,they want you to work hard and achieve your goal. They are very caringpeople. My children bonded with the staff’’ (Parent comment after workingwith the staff 12 months).

SERVICES TO MEET INDIVIDUAL FAMILY NEEDS

In reunification work, a mix of concrete and therapeutic services has beenshown to be effective in achieving outcomes (Fraser et al., 1996). The pro-gram tailored each service plan developed with parents to their family’sneeds, including both concrete services such as helping the parent to findemployment as well as clinical services, such as counseling and parent educa-tion. One parent commented on this individualizing of the work: ‘‘Everybodyneeds different things : : : for some people it takes longer : : : you have togo through all the steps. [Agency] helps everyone go through this process. Ittakes time and you have to be patient’’ (Parent comment after working withthe staff 12 months).

Parent groups were frequently used to supplement one-on-one workwith clients. Staff members lead these groups that are aimed at helpingparents learn new skills, providing social support from other parents (as wellas reality checks), and helping parents to understand better and deal withtheir situation in relation to child welfare authorities. Thus both individualwork and their work together in groups help parents view the staff membersas being helpful in concrete ways, as well as having a genuine presence intheir lives (Tempel, 2003). Commenting on the helpfulness of groups, oneparent said:



The groups helped because of the fact that I was around other peoplethat were going through the same thing as me. It also helped me to bemore patient—When it comes to our kids, we want things fast. (Parentcomment after working with the staff 12 months)

Another parent said:

The parenting groups helped me know how to talk to my kids. I likedthe groups because of the way they talk and explain things so that wecan understand them : : : If we have questions we can ask them there : : :

They open their arms to you like a friend. (Parent comment after workingwith the staff 12 months)

COMPETENT STAFF

Each family was served by a team of three professionals—a specially trainedfamily support worker, an MSW—trained social worker, with specialty train-ing in reunification, and a team leader who provided clinical and managerialsupport to the team. Additionally, a caseworker and supervisor from thepartner agency continued to work closely with the family and the programstaff, constituting a wider team of helpers. The evaluation findings on thehelping alliances these staff members were able to build with parents, and theparents with them, as well as the positive outcomes, show that specializedprofessional training and a wide range of competencies—knowledge, skills,and attitudes—are essential and that these staff members had what it takesto do the work effectively. Of particular importance were interactional skillsthat conveyed empathy, developed trust and fostered communication.

The findings on outcomes for Hispanic children, that they were morelikely than other children in the program to be placed in a permanentfamily (including reunified with their own family), as well as the higherWAI scores with Hispanic families, are strong evidence of the importanceof cultural competence in reunification and other child welfare practice.Their statistically significant stronger assessment of the alliance with staffmembers on the agreement on the tasks domain of the WAI, as well asstronger assessments in the goals and bond domains, may have been due tothe fact that most of the parents who were of Hispanic origin worked witha family support worker of the same race/ethnicity. Therefore, there was agood understanding of the cultural issues arising during their work together,and lessening the possibility of conflict in these areas.

Additionally, program staff members did most of the work in the parent’sown home, including visits where possible. The family’s own home setting isdeemed the most appropriate environment for helping parents and childrenmake the changes that are needed for reunification. This proximity minimizesboth the physical and the psychological distance that can occur in a helping



relationship and increases the helpers’ genuine presence in the clients’ lives(Tempel, 2003).

Results from the qualitative approaches showed that the program wasbeing carried out as intended. For example, the record review indicated thatprogram staff regularly assessed and recorded parent/family strengths andplanned interventions with parents based on these strengths. Mutuality inthe work together was also reflected in the case narratives, as well as inthe observations of group meetings and parent-child visits. Interviews withparents at 12 and 24 months also yielded a positive assessment of the workingrelationship.

IMPLICATIONS FOR PRACTICE AND RESEARCH

It is important for practitioners to be skilled at forming strong workingalliances. Such relationships are likely to make work with involuntary clientsmore successful and satisfying for both social workers and their clients.Practice wisdom and research suggest that involuntary clients are amongthe most challenging to help (Rooney, 1992). Our study suggests that pro-ductive alliances can be formed even with clients whose children havebeen removed by child welfare authorities. Our findings also point theway for further research on building relationships with clients. For exam-ple: what are the characteristics of social workers who consistently formstrong alliances? Is the ability to assess and focus on strengths a criticalskill? If so, how best can this be learned? Moreover, there is currently littleempirical data about the effect of race and ethnicity on the developmentof strong working alliances, and ultimately service outcomes. And, culturalcompetence as a service variable has not been fully explicated. For exam-ple, are language proficiency and an understanding of a client’s race orethnic group values and culture sufficient, or is race/ethnicity matching ofclient and social worker a requisite for success? Finally future research isneeded to better link the development of positive relationships to programoutcomes.

Our findings also suggest a need for routine measurement of rela-tionships in program planning and development. There are a number ofrelatively new measurement tools available for practitioners. This studyused the WAI. Other studies conducted in social work settings have usedthe Helping Relationship Inventory (HRI ) (Young & Poulin, 1998), and aninstrument developed by Yatchmenoff (2005), to measure client engagementin child protective services. The HRI (Young & Poulin, 1998) empha-sizes empathy and collaboration, whereas the Yatchmenoff (2005) scalefocuses on engagement, perceived benefit and investment, and interpersonalrelationships.



STUDY LIMITATIONS

The reader must be cautious about attempting to generalize from thesefindings. For example, it is unlikely that participants in the model pro-gram consisted of a representative sample of families involved with thechild welfare system. Staff members from the local child protective servicedepartment referred families to the model program if it was the first timechildren had been removed from their caregiver’s home. Therefore, it ispossible that parents in the model program were easier to work with thanother clients of protective services who may have lost custody of theirchildren several times. Second, not every family that received services fromthe model program consented to participate in the evaluation; thus, theremay have been a difference between participants and non-participants. An-other possible limitation to study results relates to clients’ completion of theWAI. Although researchers assured confidentiality and explained that theirresponses would in no way affect the outcome of their case, the clients mayhave responded with this in mind. Therefore, the effects of social desirabilitymust be considered as a limitation with respect to all data collection fromclients regarding relationship. Still another limitation is that not all consentingparticipants completed the WAI or could be reached for follow-up interviewsat 12 months. Those not contacted may have had less positive assessmentsof staff and the program or poorer outcomes for their families, or both.

CONCLUSION

As Coady (1993) has noted, ‘‘[S]ocial work was once the leading voice inadvocating the importance of relationship skills to direct practice’’ (p. 291).Increasingly in the profession attention is once again focusing on the inter-personal skills that engage others in the work at hand in forming relation-ships, establishing goals, and developing trust and mutuality. These skillsare needed as much in direct practice as in practice with larger systems ofcommunities and organizations. The findings of this study, when consideredcollectively, support these professional perspectives about social work andthe importance of human relationships.

NOTES

1. Of the 135 families in the study sample, some had already been in the program for 6 ormore months at the time the WAI was implemented, or they did not consent to participate

in the study during intake, or their case was closed by the 6 months after intake WAI

assessment date. Therefore the WAI was not administered for these 53 cases. An analysiswas conducted on key demographic variables comparing families that did and did not

complete the WAI; no statistically significant differences were found.



2. A family support worker was not assigned to work with the family at the time of the

assessment, due to staff attrition, and therefore there is no WAI data on the alliance with

the family support worker for these families.3. Key categorical variables were determined based on the results of an event history analysis,

which examined what variables were associated with exiting care. The variables selected

for this analysis were based on previous research in this area and preliminary bivariate anal-yses and included: female caregiver age, child age, number of children removed from the

home, number of caregivers in the home at time of removal, race, child’s gender, single fe-

male caretaker, reason for removal, and received services from the family reunification pro-gram. In this multivariate model, race was found to be a statistically significant factor in ex-

iting care, and therefore was subsequently used in the bivariate analysis of the WAI scores.

REFERENCES

Alexander, L. B., Littell, J. H., Reynolds, R., & Girvin, W. (2001). The alliance in home-

based services in child welfare: Reliability and prediction. Paper presented at the14th Annual Research Conference Proceedings, A System of Care for Children’sMental Health: Expanding the Research Base, Tampa, FL.

Altman, J. C. (2005). Engagement in children, youth, and family services: Currentresearch and promising approaches. In G. P. Mallon and P. M. Hess (Eds.), Child

welfare for the 21st century: A handbook of practices, policies, and programs

(pp. 72–86). New York: Columbia University Press.Altman, J. C. (2008). Engaging families in child welfare services: Worker versus client

perspectives. Child Welfare, 87, 41–61.Benard, B. (2006). Using strengths-based practice to tap resilience in families. In

D. Saleeby (Ed.), The strengths perspective in social work practice (4th ed.)(pp. 197–220). New York: Pearson.

Berg, B. L. (2004). Qualitative research methods for the social sciences (5th ed.).Boston, MA: Allyn and Bacon.

Canda, E. R. (2006). The significance of spirituality for resilient response to chronicillness: A quantitative study of adults with cystic fibrosis. In D. Saleeby (Ed.),The strengths perspective in social work practice (4th ed.) (pp. 61–76). NewYork: Pearson.

Casey Family Services (1999). Family Reunification Program [internal planning doc-ument]. Shelton, CT: author.

Child Welfare League of America (n.d.). Summary of the Adoption and Safe Families

Act of 1997. Retrieved April 3, 2004, from http://www.cwla.org/advocacy/asfapl105-89summary.htm

Coady, N. F. (1993). The worker–client relationship revisited. Families in Society,

74, 291–300.Cohen, E. P. (2003). Framework for culturally competent decision making in child

welfare. Child Welfare, 82, 143–155.DePanfilis, D. (2000). How do I develop a helping alliance with the family? In H.

Dubowitz and D. DePanfilis, (Eds.). Handbook for child protection practice

(pp. 36–43). Thousand Oaks, CA: Sage Publications, Inc.



Dore, M. M., & Alexander, L. B. (1996). Preserving families at risk of child abuseand neglect: The role of the helping alliance. Child Abuse & Neglect, 20, 349–361.

Fong, R. & Furturo, S. (Eds.). (2000). Culturally competent practice: Skills, interven-

tions, and evaluations. Needham Heights, MA: Allyn & Bacon.Fraser, M. W., Walton, E., Lewis, R. E., & Pecora, P. J. (1996). An experiment in

family reunification: Correlates of outcomes at one-year follow-up. Children

and Youth Services Review, 18, 335–361.Germain, C. B. & Gitterman, A. (1996). The life model of social work practice:

Advances in theory and practice (2nd ed.). New York: Columbia UniversityPress.

Harris, M. S., Skyles, A., Barrett, K. H., & George, W. H. (2005). Working with AfricanAmerican children and families in the child welfare system. In Race, culture,

psychology, and law (pp. 91–103). Thousand Oaks, CA: Sage Publications, Inc.Hartman, A. (1979). The extended family as a resource for change: Ecological ap-

proach to family-centered practice. In C. B. Germain (Ed.), Social work practice:

People and environments (pp. 239–265). New York: Columbia University Press.Hess, P. M., & Proch, K. (1993). Visiting: The heart of reunification. In B. A. Pine, R.

Warsh & A. N. Maluccio (Eds.), Together again: Family reunification in foster

care (pp. 119–139). Washington, DC: Child Welfare League of America.Horvath, A. O., & Greenberg, L. S. (1989). Development and validation of the

Working Alliance Inventory. Journal of Counseling Psychology, 36, 223–233.Horvath, A. O., & Luborsky, L. (1993). The role of the therapeutic alliance in psy-

chotherapy. Journal of Consulting and Clinical Psychology, 61, 561–573.Horvath, A. O. & Symonds, B. D. (1991). Relation between working alliance and

outcome in psychotherapy: A meta-analysis. Journal of Counseling Psychology,

38, 139–149.Hosley, C. A., Gensheimer, L., & Yang, M. (2003). Building effective working rela-

tionships across culturally and ethnically diverse communities. Child Welfare,82, 157–168.

Kokotovic, A. M. & Tracey, T. J. (1990). Working alliance in the early phase ofcounseling. Journal of Counseling Psychology, 37, 16–21.

Lee, C. D. & Ayon, C. (2004). Is the client-worker relationship associated with betteroutcomes in mandated child abuse cases? Research on Social Work Practice,

14, 351–357.Letendre, J., Henry, D., & Tolan, P. H. (2003). Leader and therapeutic influences on

pro-social skill building in school-based groups to prevent aggression. Research

on Social Work Practice, 13, 569–587.Leung, P., Cheung, K. M., & Stevenson, K. M. (1994). A strengths approach to

ethnically sensitive practice for child protective service workers. Child Welfare,73, 707–721.

Maiter, S. (2004). Considering context and culture in child protection services to eth-nically diverse families: An example from research with parents from the IndianSubcontinent (South Asians). Journal of Social Work Research and Evaluation,

5, 63–80.Maluccio, A. N., Pine, B. A., & Tracy, E. M. (2002). Social work practice with families

and children. New York: Columbia University Press.



Martin, D. J., Garske, J. P., & Davis, M. K. (2000). Relation of the therapeutic alliance

with outcome and other variables: A meta-analytic review. Journal of Consulting

and Clinical Psychology, 68, 438–450.

Marziali, E. & Alexander, L. (1991). The power of the therapeutic relationship.

American Journal of Orthopsychiatry, 61, 383–391.

McPhatter, A. R. (1997). Cultural competence in child welfare: What is it? How do

we achieve it? What happens without it? Child Welfare, 76, 255–278.

Mederos, F. & Woldeguiorguis, I. (2003). Beyond cultural competence: What child

protection managers need to know and do. Child Welfare, 82, 125–142.

Norusis, M. J. (2005). SPSS 14.0 Advanced Statistical Procedures Companion. Upper

Saddle River, NJ: Prentice Hall, Inc.

Nybell, L. M. & Gray, S. S. (2004). Race, place, space: Meanings of cultural compe-

tence in three child welfare agencies. Journal of Social Work, 49, 17–26.

Pecora, P., Whittaker, J., Maluccio, A. N., & Barth, R. (2000). The child welfare

challenge: Policy, practice and research. New York: Aldine de Gruyter.

Perlman, H. H. (1979). Relationship: The heart of helping people. Chicago: University

of Chicago Press.

Perry, R. & Limb, G. E. (2004). Ethnic/racial matching of clients and social workers

in public child welfare. Children and Youth Services Review, 26, 965–979.

Petr, C. G. (1988). The worker–client relationship: A general systems perspective.

Social Casework, 69, 620–626.

Pierce, R. L. & Pierce, L. H. (1996). Moving toward cultural competence in the child

welfare system. Children and Youth Services Review, 18, 713–731.

Pine, B. A., Spath, R., Maguda, A., Werrbach, G. & Jenson, C. (2007). Final Report

of the Evaluation of the Casey Family Services Family Reunification Program.

West Hartford, CT: University of Connecticut School of Social Work.

Pine, B. A., Spath, R., Werrbach, G., Jenson, C., & Kerman, B. (2009). A better path

to permanency for children in out-of-home care. Children and Youth Services

Review, 31, 1135–1143.

Pine, B. A., Spath, R. & Jenson, C. (2005). Report on the Use of Parent–Child Visiting

in the Casey Family Services Family Reunification Program. West Hartford, CT:

University of Connecticut School of Social Work.

Rogers, C. R. (1957). The necessary and sufficient conditions of therapeutic person-ality change. Journal of Consulting Psychology, 21, 95–103.

Rooney, R. (1992). Strategies for Work with Involuntary Clients. New York: Columbia

University Press.

Saleeby, D. (2006). Introduction. In D. Saleeby (Ed.), The strengths perspective in

social work practice (4th Ed.) (pp. 1–24). New York: Pearson.

Sandau-Beckler, P. A., Salcido, R., & Ronnau, J. (1993). Culturally competent family

preservation services: An approach for first-generation Hispanic families in an

international border community. Family Journal, 1, 313–323.

Sherraden, M. S. & Segal, U. A. (1996). Multicultural issues in child welfare. Children

and Youth Services Review, 18, 497–504.

Shonfeld-Ringel, S. (2001). A re-conceptualization of the working alliance in cross-

cultural practice with non-Western clients: Integrating relational perspectives

and multicultural theories. Clinical Social Work Journal, 29, 53–63.



Smith, N. (2006). Review of culturally competent public child welfare practice. Social

Work Education, 25, 114–115.

Smith, S., Shane, T., & Jackson, A. (2004). An exploration of the therapeutic rela-

tionship and counseling outcomes in a problem gambling counseling service.

Journal of Social Work Practice, 18, 99–112.

Solomon, P., Draine, J., & Delaney, M. A. (1995). The working alliance and consumer

case management. Journal of Mental Health Administration, 22, 126–134.

Spath, R., Werrbach, G., & Pine, B. A. (2008). Sharing the baton, not passing it:

Collaboration between public and private child welfare agencies to reunify

families. Journal of Community Practice, 16, 481–507.

Suleiman, L. P. (2003). Beyond cultural competence: Language access and Latino

civil rights. Child Welfare, 82, 185–200.

Tempel, L. R. (2003). The establishment of a working alliance with low-income

single mothers who have engaged in physically aggressive behaviors toward

their children referred for counseling: Clinical social workers’ perspectives about

factors impacting on the process. Dissertation Abstracts International, 64(3),

1081A, (UMI No. 3084170).

United States Department of Health and Human Services (2007). Child Maltreatment

2005. Washington, DC: Government Printing Office.

Woodroffe, A. & Spencer, M. (2003). Culturally and ethnically diverse communities:

Building blocks for working relationships. Child Welfare, 82, 169–183.

Woods, M. E., & Hollis, F. (2000). Casework: A psychosocial therapy. New York:

McGraw-Hill.

Yatchmenoff, D. K. (2005). Measuring client engagement from the client’s per-

spective in non-voluntary child protective services. Research on Social Work

Practice, 15, 84–96.

Young, T. M. & Poulin, J. E. (1998). The Helping Relationship Inventory: A clinical

appraisal. Families in Society, 79, 123–133.

Zambrana, R. E. & Dorrington, C. (1998). Economic and social vulnerability of Latino

children and families by subgroup: Implications for child welfare. Child Welfare,

77, 5–27.

Zamosky, J., Sparks, J., Hatt, R., & Sharman, J. (1993). Believing in families. In B. A.

Pine, R. Warsh & A. N. Maluccio (Eds.), Together again: Family reunification in

foster care (pp. 155–175). Washington, DC: Child Welfare League of America,

Inc.

CONTRIBUTORS

Cary E. Jenson, PhD, is Associate Professor at the University of Maine.

Barbara A. Pine, PhD, is Professor Emerita at the University of Connecticut.

Robin Spath, PhD, is Assistant Professor at the University of Connecticut.

Benjamin Kerman, PhD, is Director of Research at Casey Family Services.


Developing Strong Helping Alliances in Family Reunification

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