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Exploring the implementation of the Indian Child of Welfare Act of 1978

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Exploring the implementation of the Indian Child of Welfare Act of 1978

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Content Exploring the Implementation of the Indian Child of Welfare Act of 1978
by
Erika Ashley Salinas, M.S.W.
A Dissertation Presented to the
FACULTY OF THE USC GRADUATE SCHOOL
UNIVERSITY OF SOUTHERN CALIFORNIA
In Partial Fulfillment of the
Requirements for the Degree
DOCTOR OF PHILOSOPHY
(SOCIAL WORK)
August 2024
Copyright 2024 Erika Ashley Salinas

ii
Dedication
To all the Native children who were failed by the system:
You are never forgotten.
You are always loved.
We will never give up.
When your heart calls you home, we will be waiting for you with open arms.

iii
Acknowledgments
My academic journey hasn’t been easy, but it has been worth it. My academic success is
attributed to my amazing support system who helped me along the way.
First and foremost, I want to thank my dissertation chair, Dr. Michael Hurlburt. Since I
began the program, you have always supported me. I am truly grateful for your guidance and
support over the years. I am thankful to have been able to work with you and have you as my
mentor/chair as I transition into my professional role. It has been difficult to balance completing
a dissertation and being a mom, but I am grateful for your understanding and patience. I also
appreciate you always finding time to meet with me, even if it is short notice, so that I could stay
on track with completing my dissertation. I could not have done this without your continued
support.
Next, I want to thank Dr. Claradina Soto. As a Native woman, you know the weight of
pursuing a PhD as a Native person. At times, it can feel overwhelming because research is
important to understanding issues impacting Native communities. The research and the data are
important to our people so the weight can feel tremendous. However, you taught me how to
engage and conduct ethical research in Tribal communities. I learned so much working with you
and I would not be the researcher I am today without you. Personally, you have been such a
piece of home for me and always supported me to pursue opportunities to give back to our
community.
I want to thank Dr. Jacquelyn McCroskey. Your love for policy has truly inspired me.
Our time during my tutorial was one of my favorite memories. I loved our conversations about
child welfare policy and policy implementation because you were the only one who shared this
same love. I learned so much from you and for that I am truly grateful.

iv
I want to thank Dr. Ruth Supranovich for being my safe space. Since I met you, you
accepted me and believed in me. No questions asked. You have always supported my research
and made sure to uplift me. You always made sure to check on me, especially in moments when
I needed it the most. I would not have been able to do this without you.
I want to thank Dr. Concepcion Barrio for serving on my qualifying exam committee. I
want to thank Dr. Olivia Lee for your continued support. I want to thank Dr. Lawrence Palinkas
for all he has done for me as my mentor all these years. I want to thank Malinda Sampson for
always supporting us students and making sure that we were on the right track to graduate. I
want to thank all the faculty who volunteered to serve on my mock interview panel as I was best
prepared and was offered the position.
I want to thank the Native American faculty at Sacramento State who showed me the
importance of Native representation in academia: Dr. Annette Reed and Dr. Brian Baker. You
both have always supported my academic endeavors, from the McNair Scholars Program to
pursuing my Master of Social Work program to applying for scholarships and fellowships. You
have always made time to help me with applications, letters of recommendation, and going over
application materials. I feel honored to be able to follow your footsteps and work alongside you
in the Native American Studies program. I hope to be able to make the same impact.
I want to thank my cohort. It is because of you all that I even made it this far. I am
grateful to have experienced this with each and every one of you! I do not know what I would
have done without you all: Dr. Adriane Clomax, Dr. Leslie Schnyder, Dr. Jessenia De Leon, Dr.
Graham DiGuiseppi, and Dr. Jiaming Liang. I truly had the best cohort.
I want to thank my best friend, Dr. Jasmine Grika, for listening to me and reminding me
to keep going. When we graduated with our M.S.W. together, we joked about getting our

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doctorate one day. Fast forward to now, she completed her D.S.W. and I am completing my
Ph.D. We continue to support one another, and I am thankful to have her in my life. She is my
sister and the godmother to my son. I would not be who I am today without her and I feel
grateful to have had her by my side through this journey.
I want to thank my parents for their love and support. You both have sacrificed so much,
and I do not know how I can repay you. You set the example for me and I hope to pass that along
to my son. I would not be here without all that you have done, and continue to do, for me. I love
you both to the moon and back. I hope to have made you proud.
I want to thank my family for always being there for me. You all know how rough this
road has been, but still came together to make sure that I was able to achieve my dreams. From
watching my son to making me to-go plates to visiting with me, I am so appreciative of you all.
I want to thank my partner, Roberto, for all you do for me. I know this road has not been
easy for you, but you continue to support me through it all. I am grateful for all you do for our
little family. I know you believe in me and I believe in you. You are the greatest dad, and we
love you so much.
Most importantly, I want to thank my son. Elíaz, you are the best thing to ever happen to
me. I love you with all of my heart. I could not have completed this without you. During the
toughest moments, I looked at you and was reminded to keep going. I want this dissertation to
serve as a reminder that there are no limits on what you want to accomplish. You can be
whatever you want to be and accomplish whatever you want to accomplish. Do not let anyone
tell you that you can’t do something. If you can dream it, you can achieve it. I love you.
Finally, I want to thank my community and my Tribe, the Comanche Nation, for always
believing in me. I appreciate all that they have done in raising me, instilling important cultural

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values, and looking out for me. I will always prioritize serving my community and ensuring that
the world is a better place for the next seven generations. Ura (thank you)!

vii
Table of Contents
Dedication ...................................................................................................................................... ii
Acknowledgments......................................................................................................................... iii
List of Tables .................................................................................................................................ix
List of Figures .................................................................................................................................x
Abbreviations .................................................................................................................................xi
Chapter 1. Introduction .................................................................................................................. 1
Before the Implementation of the Indian Child Welfare Act of 1978 ……………………1
AI/AN Youth in Foster Care ...............................................................................................3
The Indian Child Welfare Act of 1978 ...............................................................................4
ICWA and California ..........................................................................................................6
ICWA Compliance Barriers ................................................................................................7
Culture as a Protective Factor .............................................................................................9
Implementation Science …................................................................................................10
Consolidated Framework for Implementation Research (CFIR) ………………..11
Expert Recommendations for Implementing Change (ERIC) ……………….….11
The Indian Child Welfare Act of 1978: An Examination Through the Lens of
the Media (Paper 1) .................................................................... ......................................12
A Comparative Case Study: Identifying Facilitators and Barriers to ICWA
Implementation in California Using the Consolidated Framework for
Implementation Research (CFIR) (Paper 2) .....................................................................13
The Indian Child Welfare Act of 1978: Recommendations for Policy
Implementation Strategies in California (Paper 3) ...........................................................14
Goal of the Dissertation ....................................................................................................14
Chapter 2. The Indian Child Welfare Act of 1978: An Examination Through the Lens of
the Media (Paper 1) .......................................................................................................................16
Abstract .............................................................................................................................17
Introduction ...................................................................................................................... 18
Methodology .................................................................................................................... 19

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Data Collection .................................................................................................... 19
Data Analysis ....................................................................................................... 22
Results .............................................................................................................................. 23
Discussion ........................................................................................................................ 28
Limitations and Future Research ..................................................................................... 33
References ........................................................................................................................ 34
Chapter 3. A Comparative Case Study: Identifying Facilitators and Barriers to ICWA
Implementation in California Using the Consolidated Framework for Implementation
Research (CFIR) (Paper 2) ........................................................................................................... 36
Abstract ............................................................................................................................ 37
Introduction ...................................................................................................................... 38
Methodology .................................................................................................................... 42
Participants ........................................................................................................... 42
Data Collection .................................................................................................... 42
Data Analysis ....................................................................................................... 42
Results .............................................................................................................................. 43
Discussion ........................................................................................................................ 53
Limitations and Future Research ..................................................................................... 58
References ........................................................................................................................ 59
Chapter 4. The Indian Child Welfare Act of 1978: Recommendations for Policy
Implementation Strategies in California (Paper 3) ...................................................................... 62
Abstract ............................................................................................................................ 63
Introduction ...................................................................................................................... 64
Methodology .................................................................................................................... 68
Participants ........................................................................................................... 68
Data Collection .................................................................................................... 68
Data Analysis ....................................................................................................... 69
Results .............................................................................................................................. 69
Discussion ........................................................................................................................ 80

ix
Limitations and Future Research ..................................................................................... 86
References ........................................................................................................................ 87
Chapter 5. Conclusion .................................................................................................................. 90
References………………………………………………………………………………………. 94
Appendices ……………………………………………………………………………………. 100
Appendix A: CFIR Domains, Sub-Domains, and Constructs Along With Their
Respective Definitions ……………………………………………………………..…. 101
Appendix B: ERIC Recommendation Strategies (n=73) ……………………………... 106
Appendix C: ERIC Recommendation Strategies Organized By Their
Respective Cluster Along With Mean Importance and Feasibility Ratings …….….… 112

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List of Tables
Table 2.1 Media Themes and Sub-Themes Along with Article Quote Examples ………………23
Table 3.1 CFIR Constructs, Definitions, and Examples………………………………………... 44
Table 4.1 ERIC Implementation Strategy Clusters, Definitions, ICWA Implementation
Strategy Examples, and Participant Response ………………………………..………………... 72
Table 4.2 Participant Recommendation Strategies Listed in Quadrant I Along With Mean
Importance and Feasibility Ratings As Identified By Waltz et al. Study ……………………… 81

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List of Figures
Figure 2.1 Data Collection Process of Articles Chosen For Analysis …………………………..21
Figure 3.1 Map of California Tribal Lands (List of the Federally Recognized Tribes) ……….. 40
Figure 4.1 Map of California Tribal Lands (List of the Federally Recognized Tribes) ……….. 65

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Abbreviations
AIAN American Indian and Alaska Native
BIA Bureau of Indian Affairs
CFIR Consolidated Framework for Implementation Research
CFT Child and Family Team
CWLA Child Welfare League of America
ERIC Expert Recommendations for Implementing Change
ICWA Indian Child Welfare Act
IEP Individualized Education Plan
MOU Memorandum of Understanding
OTA Office of Tribal Affairs
SB Senate Bill

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Abstract
The Indian Child Welfare Act (ICWA) is a federal law designed to protect cultural and
familial ties among American Indian and Alaska Native (AIAN) children and families. This law
also upholds tribal sovereignty by mandating tribal involvement pertaining to placement
preferences of AIAN children. ICWA has been labeled the “golden standard” yet it is not being
implemented appropriately. The barriers to implementation call for a better understanding of
what contributes to the facilitation of implementation. Outside factors, such as media reporting,
plays a role in how policymakers and stakeholders view and implement ICWA. The aim of this
dissertation is to explore the implementation of ICWA. The findings from this dissertation
identifies ways to best improve the implementation of ICWA. These includes forms of media
advocacy, improving stakeholder practice when implementing ICWA, and creating a plan of
action for incorporating recommendation strategies. The implications to social work are
discussed to improve the field and develop practices to best serve AIAN children and families.

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Chapter 1: Introduction
This dissertation is comprised of three studies aimed to explore the implementation of the
Indian Child Welfare Act (ICWA) of 1978. The first study (Paper 1) describes a media analysis
to explore how ICWA has been presented in the media. This is important because media is
consumed by the people who are responsible for implementing ICWA. The second study (Paper
2) presents a comparative case study to understand the barriers and facilitators to the
implementation of ICWA. Participants were asked to provide one case each of a successful and
an unsuccessful implementation of ICWA. These cases were provided by stakeholders (county
social workers, tribal social workers, cultural organizations, state government, and qualified
expert witnesses) who implement ICWA. By identifying barriers and facilitators to implementing
ICWA, we can better improve the way that we approach implementation. Finally, the third study
(Paper 3) used the Expert Recommendations for Implementing Change (ERIC) to systematically
prioritize strategies to improve the implementation of ICWA in California. By doing this, we can
best create a plan of action to improve the implementation of ICWA.
Before the Implementation of the Indian Child Welfare Act of 1978
Four major government policies contributed to the original development of ICWA: the
Civilization Fund, the boarding school system, the outing system, and the Indian Adoption
Project. Each of these policies contributed to the historical trauma faced by AIAN children and
families as well as the cultural genocide and ultimate loss of identity. The effects of these events
are prevalent today.
The National Indian Child Welfare Association (1997) reported that in 1819, the United
States government passed legislation to establish the Civilization Fund, the first federal policy to
directly affect AIAN children. It provided grants to private agencies, primarily churches, to

2
establish programs to “civilize” the Indian. In a report to Congress in 1867, the Commissioner of
Indian Affairs declared that the only successful way to deal with the “Indian problem” was to
separate Indian children completely from their tribes, resulting in complete absence of culture
and identity (Judicial Council of California, 2022). This policy led to the creation of boarding
schools, which were schools designed to assimilate AIAN children.
Throughout the remainder of the 19th century, boarding schools became more
oppressive, eliminating the use of native language and mandating the cutting of the children’s
hair. To AIAN peoples, the cutting of hair is a sign of mourning or shaming. In addition, school
officials gave AIAN children more Christian names, thus the names their parents or family had
given them were eliminated. Furthering the assimilation process, officials banned the practice of
any Native American ceremonies or rituals, declaring that children only learn Christianity. In
1910, bonuses were used to encourage boarding school workers to take leaves of absence and
forcibly gather as many students as possible from surrounding reservations.
Aside from boarding schools, other federal practices encouraged the displacement of
AIAN children from their families and communities. In 1884, the “outing” system placed
numerous AIAN children on farms in the East and Midwest in order for children to learn the
“values of work and the benefits of civilization.”
Throughout the 1950s and ’60s, the adoption of Indian children into non-Indian homes,
primarily within the private sector, was widespread. In 1959, the Child Welfare League of
America (CWLA), which was the standard-setting body for child welfare agencies, in
cooperation with the Bureau of Indian Affairs (BIA), initiated the Indian Adoption Project. In the
first year of this project, 395 Indian children were placed up for adoption with non-Indian
families in eastern metropolitan areas. Later, in 2001, Shay Bilchik, the president and CEO of the

3
CWLA, made a public apology on the League’s behalf. A portion of the apology read “In many
instances, [the children] were deprived of their culture, their language, connections to their
families, their tribe, and in many instances it caused such hurt and sorrow and deprived them of
so much happiness in their lives” (Tribal Successful Transitions for Adult Readiness [STAR],
2009). This apology was recognition of how the CWLA did not act in the best interest of tribes
or children and acknowledged the negative impact that the Indian Adoption Project had on the
lives of these children.
A 1976 study by the Association on American Indian Affairs found that 25% to 35% of
all AIAN children were being placed in out-of-home care (Unger, 1977). Eighty-five percent of
those children were being placed in non-Indian homes or institutions (Unger, 1977). Specifically,
in California, it was found that over 90% of California AIAN children subject to adoption were
placed in non-AIAN homes and that AIAN children were more than eight times as likely as nonIndian children to be placed in adoptive homes. Overall, one of every 124 AIAN children in
California was in a foster care home, compared to a rate of one in 367 for non-AIAN children
(Broadhead et al., 1976). In response to overwhelming evidence from AIAN communities that
the loss of their children meant the destruction of AIAN culture, Congress passed The Indian
Child Welfare Act of 1978.
AI/AN Youth in Foster Care
Today, AIAN children are overrepresented in foster care at a rate 2.7 times greater than
their proportion in the general population (Woods & Summers, 2016). This means that although
AIAN children are just 0.9% of all children in the United States, they are 2.1% of all children
who are placed outside their homes in foster care (Woods & Summers, 2016). These numbers do

4
not account for children who are placed through tribal authorities. It is estimated that one-third to
40% of AIAN children in foster care are placed there by tribal authorities (Earle & Cross, 2001).
The Indian Child Welfare Act of 1978
In 1978, Congress signed The Indian Child Welfare Act (25 U.S.C. §§ 1901-63) into law,
and it is regarded as the most significant piece of federal legislation affecting AIAN (Brown et
al., 2002). Congress prefaced the Act by stating,
There is no resource more vital to the continued existence and integrity of Indian tribes
than their children... [A]n alarmingly high percentage of Indian families are broken up by the
removal, often unwarranted, of their children from them by non-tribal public and private
agencies and that an alarmingly high percentage of such children are placed in non-Indian foster
and adoptive homes and institutions; and that the States have often failed to recognize the
essential tribal relations of Indian people and the cultural and social standards prevailing in
Indian communities and families (Indian Child Welfare Act, 1978).
ICWA is a federal law that is aimed at preserving cultural and familial ties among AIAN
children and families while encouraging respect for tribal authority in decisions concerning the
placement of AIAN children in foster care (Brown et al., 2002). It also limits states’ powers
regarding AIAN children and imposes specific procedural requirements on state courts and state
child welfare agencies in the removal and placement of AIAN children (Brown et al., 2002).
There are several provisions to ICWA, including 1) identification of Indian children by
the state and subsequent notification to the child’s parents and the child’s tribe of their rights to
intervene in state child custody proceedings; 2) the use of tribal courts by way of requests for
transfer of jurisdiction; and 3) procedural requirements for child custody proceedings that remain
in state courts, including tribal intervention, standards of proof, and placement preferences

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(Brown et al., 2002). It is important to note that ICWA applies only to child custody
proceedings: foster care placement, termination of parental rights, pre-adoptive placement, and
adoptive placement (25 U.S.C. § 1920 [1]). Furthermore, ICWA may only apply to an Indian
child, defined under the law as any unmarried person who is under age eighteen and is either a) a
member of an Indian tribe or b) is eligible for membership in an Indian tribe and is the biological
child of a member of an Indian tribe (Sec 1903, 4).
To be removed from their home, ICWA creates the following two-part requirement for
states: 1) proof that active efforts have been made to prevent the breakup of the Indian family
and that these active efforts have proved unsuccessful; and 2) a court finding supported by clear
and convincing evidence that the continued custody of the child by the parent or Indian custodian
is likely to result in serious emotional or physical damage to the child (Brown et al., 2002).
When a child is removed from the home, the law states that preference shall be given to the
child’s placement with one of the following, in descending priority order: 1) a member of the
child’s extended family, as defined in Section 1903 of The Indian Child Welfare Act (25 U.S.C.
Sec. 1901 et seq.); 2) a foster home licensed, approved, or specified by the child’s tribe; 3) An
Indian foster home licensed or approved by an authorized non-Indian licensing authority; or 4)
an institution for children approved by an Indian tribe or operated by an Indian organization
which has a program suitable to meet the Indian child’s needs (25 U.S.C Chapter 21). Once a
state court has determined that a particular child custody proceeding is governed by ICWA, the
court must adhere to multiple requirements in order to comply with the act.
To protect the interests of tribes, ICWA requires states to provide notification to the tribe
at least 10 days in advance of pending involuntary child custody proceedings (25 U.S.C. § 1912

6
[a]). Delivery must be made by registered mail with a return receipt requested to the parent(s)
and/or Indian custodian(s), as well as the child’s tribe (25 U.S.C. § 1912 [a]).
ICWA and California
In 2006, the California Legislature passed Senate Bill (SB) 678, and it was signed into
law by Governor Arnold Schwarzenegger in 2007 (Geary & Radoff, 2007). SB 678 is the
uniform application of The Indian Child Welfare Act in California. Changes in the federal law to
fit California standards allow participation of non-federally recognized tribes, on request and at
the discretion of the judge in the dependency matter. This difference expands the option and
availability of culturally appropriate services to children from non-federally recognized tribes.
SB 678 encourages the courts and counties to work with an Indian child’s family and tribe to
ensure that the child’s emotional, political, and spiritual well-being is promoted by fostering
strong connections with the child’s extended family, culture, ancestral homeland, and tribe
(Geary & Radoff, 2007). Tribal Successful Transitions for Adult Readiness [STAR] (2009)
reported that “Tribal youth who maintain connection to their families and culture demonstrate
better outcomes; that the ‘Tribal’ as identified in the Act itself does not match being ‘Tribal’ in a
historical context; that many ‘Tribes’ are unrecognized yet still function as Tribes, maintain their
own culture, ceremonies, language, traditions, and systems of government” (p. 46).
In regard to the placement preferences outlined in ICWA federal law, SB 678 codified
placement preferences into California state law, indicating that California has an interest in
“protecting the essential tribal relations and best interest of an Indian child by... placing the child,
whenever possible, in a placement that reflects the unique values of the child’s tribal culture and
is best able to assist the child in establishing, developing, and maintaining a political, cultural,

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and social relationship with the child’s tribe and tribal community” (California Indian Legal
Services, 2012).
The most significant change made by SB 678 was the new exception to termination of
parental rights. The new exception applied where termination of parental rights would be
detrimental to an Indian child, including but not limited to cases where: 1) termination would
substantially interfere with the child’s connection to his or her tribal community or the child’s
tribal membership rights; or 2) the child’s tribe identifies guardianship, long term foster care
with a fit and willing relative, tribal customary adoption, or another permanent plan (California
Indian Legal Services, 2012). This exception recognizes that the severing of the legal
relationship of a parent and child is not a concept that is culturally recognized by most Indian
tribes, which ultimately reorients social services agencies away from the narrow view that
conventional adoption is always the best placement for the child (California Indian Legal
Services, 2012).
ICWA Compliance Barriers
Currently, there are various barriers when it comes to compliance of ICWA. First, there is
no federal administrative body authorized to oversee the ICWA implementation and compliance
(Lee, 2015). This would help guide the implementation of ICWA. This can be done in various
ways, such as an amendment to ICWA or federal intra-agency coordination to share the
assumption of authority (Lee, 2015). In 2016, the BIA released the 2016 updated guidelines of
how to interpret the regulations (i.e. how to interpret the definition of an Indian child,
determining when ICWA applies, requirements for notice, etc…). These guidelines included
extensive revisions and set forth the BIA’s view on a number of matters that have arisen since
1979, but like the earlier guidelines, they are not federally enforceable (Turner, 2016). With

8
implementation of federal oversight, it would demand for accountability of compliance of
ICWA. However, as of now there is no federal oversight nor is there formal consequence for
non-compliance of child welfare agencies. Only AIAN tribes, communities, families, and
children face these consequences through repeated trauma.
Second, there is no comprehensive and uniform collection of Indian child welfare data to
measure the impact of ICWA (Lee, 2015). With the collection of nationwide ICWA data, this
would make it easier to track how many AIAN are in foster care, their placements, length of
time, and overall compliance. These child welfare agencies will be responsible for reporting the
necessary data to track compliance and will re-enforce their responsibilities when coming into
contact with AIAN children and families who enter the foster care system. Developing a
database could help identify the extent of ICWA problems, assist with full implementation of
ICWA, and promote future policy development for continued improvements (Lee, 2015).
The National Indian Child Welfare Association, which is an advocacy organization for
AIAN children, had addressed the above issues as they are also imperative for Child Welfare
agencies in understanding their role identity, and stated the following:
ICWA is the only major federal child welfare law that does not have oversight assigned
to a specific federal agency and a regular evaluation of implementation, either process or
outcome related. Reports of noncompliance go uninvestigated by any federal agency, no
implementation data is regularly collected and analyzed, and performance improvement
plans are not required for agencies that are out of compliance even when the
noncompliance is documented (Simmons, 2014).
Looking more at how ICWA is written itself, the lack of clear definitions leaves
considerable room for states to vary in interpretation of ICWA expectations. Surprisingly,

9
inconsistencies in interpretation have resulted in the continuation of many of the problems
Congress intended to address by enacting ICWA still persists today (Bureau of Indian Affairs,
2016). This was also stated in Mississippi Band of Choctaw Indians v. Holyfield (1989), where
the Supreme Court determined that the meaning of key ICWA terms and requirements
necessarily raises Federal questions and that conflicting interpretations of the statute lead to
arbitrary outcomes that threatened the rights that ICWA was intended to protect. While some
states have taken the lead in promulgating statutory protections, court rules, and administrative
guidelines to protect Indian status offenders under the Act, many states have left judges,
attorneys, practitioners, and advocates with little or no guidance as to whether the Act applies to
status offenders, nor how it should be interpreted more generally. Such a disconnect reflects a
crucial need for better communication and collaboration between state and tribal service
providers, law enforcement, and court systems (Gonzalez, 2012).
Overall, conflicting State-level statutory interpretation can lead to arbitrary outcomes and
can threaten the rights that the statute was intended to protect (Bureau of Indian Affairs, 2016).
Therefore, the Bureau of Indian Affairs (BIA) determined it be appropriate and necessary to
promulgate additional and updated rules interpreting ICWA and providing uniform standards for
State courts to follow in applying the Federal law (Bureau of Indian Affairs, 2016). The finalized
regulations and guidelines became effective in December 2016, which aimed to encourage
greater uniformity in the application of ICWA measures.
Culture as a Protective Factor
There are no studies that link the effects of enculturation directly on AIAN foster youth.
However, one study found that AIAN adults who were adopted by non-Native parents
demonstrated much higher mental health problems than would be expected in the general AIAN

10
population (Landers, Danes, & Whitehawk, 2015). These adults provided direct qualitative
narratives stating that for them, cultural connection to Native identity is the only way they have
been able to heal from a sense of confusion and lack of coherence in their identity (Landers,
Danes, & Whitehawk, 2015).
Past research has shown that strong cultural ties, known as traditional ways, enhance
one’s resilience to severe life circumstances (Winderowd, et al., 2008). LaFromboise, Hoyt,
Oliver, and Whitbeck (2006) found a positive relationship between higher levels of cultural
involvement and higher levels of resiliency with pro-social behaviors among Native American
adolescents. For example, Native children, adolescents, and young adults involved in their tribal
communities and cultural activities have lower rates of depression, alcohol use, and antisocial
behavior (National Indian Child Welfare Association, 2019). In addition, tribal language,
ceremonies, and traditions are linked to a reduced risk of delinquent behavior for Native
children, adolescents, and young adults (National Indian Child Welfare Association, 2019).
Identification with a specific cultural background and a secure sense of cultural identity is
linked to higher self- esteem, higher educational attainment, and lower rates of mental health
problems and substance abuse in adolescents and adults (National Indian Child Welfare
Association, 2019). Native youth report that being well grounded and connected to their tribal
culture is a major reason they stay and do well in school because it helps them gain a “good selfconcept, a strong sense of direction, and tenacity” (Strand and Peacock, 2003). Cultural identity
and ethnic pride result in greater school success, lower alcohol and drug use, and higher social
functioning in Native children, adolescents, and young adults (National Indian Child Welfare
Association, 2019).

11
Overall, research shows that there are important long-term benefits to being raised with a
distinct cultural identity as a Native person (National Indian Child Welfare Association, 2019).
Implementation Science
This dissertation will explore the implementation of ICWA using implementation
science. Implementation science is defined as “the scientific study of methods and strategies that
facilitate the uptake of evidence-based practice and research into regular use by practitioners and
policymakers” (Eccles & Mittman, 2006). Originally, implementation science was developed for
the field of health sciences, but it has been found to be relevant to other fields, such as education
and public policy. Implementation science becomes useful as we aim to better understand the
barriers and facilitators to implementation of ICWA as well as identify strategies that would best
serve the implementation of ICWA.
Consolidated Framework for Implementation Research (CFIR)
The CFIR is one of the most widely used frameworks to guide assessment of contextual
determinants of implementation (Damschroder et al., 2022). This framework is flexible in
application; therefore, it can apply to the particular context being studied (Rosalind et al., 2017).
Since the CFIR is used to identify and understand the barriers and facilitators to implementation,
this framework was applied to Paper 2. The CFIR consists of five domains: 1) Innovation, 2)
Outer Settings, 3) Inner Setting. 4) Individuals, and 5) Implementation. Within these five
domains, there are 39 constructs. A more detailed list, along with their respective definitions, of
the domains as well as their constructs can be found in Appendix A. This framework is found to
be essential as “examining research (and real-world implementation efforts) through the lens of
the CFIR gives us some indication of how comprehensively strategies address important aspects
of implementation” (Powell et al., 2014).

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Expert Recommendations for Implementing Change (ERIC)
The Expert Recommendations for Implementing Change (ERIC) project aimed to “refine
a published compilation of implementation strategy terms and definitions by systematically
gathering input from a wide range of stakeholders with expertise in implementation science and
clinical practice” (Powell et al., 2015). The researchers did this using a modified Delphi process
to develop a compilation of implementation strategies. From this, 73 discrete strategies were
identified. A full list and their definitions can be found in Appendix B. Later, these 73 strategies
were grouped into 9 clusters: 1) Engage consumers; 2) Use evaluative and iterative strategies; 3)
Change infrastructure; 4) Adapt and tailor to the context; 5) Develop stakeholder
interrelationships; 6) Use financial strategies; 7) Support clinicians; 8) Provide interactive
assistance; and 9) Train and educate stakeholders. This framework was used in Paper 3 to
categorize the implementation recommendations stated by participants. This framework goes
further by using go-zone analysis to place the strategies into four quadrants that identified the
strategies’ importance and feasibility. Waltz et al. (2015) describes the strategies and quadrants
as:
“Strategies in quadrant I fall above the mean for both the importance and the feasibility
ratings. Thus, these strategies are those where there was the highest consensus regarding
their relative high importance and feasibility. Conversely, quadrant III reflects the
strategies where there was consensus regarding their relative low importance and
feasibility. Quadrants II and IV reflect strategies that were relatively high in feasibility or
importance, respectively, but low on the other rating scale.”
Paper 3 uses this framework to systematically approach the next steps of putting the
implementation recommendations to practice.

13
The Indian Child Welfare Act of 1978: An Examination Through the Lens of the Media
(Paper 1)
The first paper in this dissertation aimed to explore how ICWA is presented through the
lens of the media. By conducting a media analysis, we are better informed in what types of
information is being presented to the general public. The consumers of media consist of
policymakers as well as different stakeholders in the implementation of ICWA. Therefore, this
study is important to understanding the potential impact that media has on the implementation of
ICWA. Upon analysis, five broad themes were identified: 1) Justification, 2) Racialization, 3)
Bias and Stereotyping, 4) Tribal Sovereignty, 5) Understanding of ICWA. The results of this
study show that there needs to be a re-framing around the information reported on by the media.
This includes an increase in the reporting on tribal sovereignty (what it is, why it is important,
why it is relevant in the context of ICWA) as well as the understanding of ICWA (what it is,
what it entails, and why it is important to AIAN communities). In addition, there needs to be
conscious reporting on decreasing justification statements, racializing ICWA, and bias and
stereotyping statements. In the context of social work, social workers can engage in media
advocacy to empower AIAN communities and advocate for policy improvements of ICWA.
A Comparative Case Study: Identifying Facilitators and Barriers to ICWA
Implementation in California Using the Consolidated Framework for Implementation
Research (CFIR) (Paper 2
The second paper in this dissertation aimed to examine barriers and facilitators to ICWA
implementation by conducting a comparative case study. After identifying barriers and
facilitators mentioned from the cases provided by study participants, the researchers were able to
use the Consolidated Framework for Implementation Research (CFIR) to systematically

14
categorize them. Upon analysis, barriers and facilitators were found in all 5 domains with 12
constructs: 1) Outer Setting (Partnerships and Connections); 2) Inner Setting (Constructs:
Structural Characteristics: Physical Infrastructure, Structural Characteristics: Work
Infrastructure, Relational Connections, Communications, Access To Knowledge and
Information); 3) Individuals (Constructs: Mid-level leaders, Innovation Deliverers, and Culture:
Human Equality Centeredness); 4) Implementation (Construct: Teaming); and 5) Characteristics
(Constructs: Capability and Motivation).
The Indian Child Welfare Act of 1978: Recommendations for Policy Implementation
Strategies in California (Paper 3)
The third paper in this dissertation aimed to understand opportunities for improved
ICWA implementation strategies. Using the Expert Recommendations for Implementing Change
(ERIC), we were able to systemically categorize strategies for improving ICWA implementation.
The strategies that were located in quadrant I, as identified by the study from Waltz et al. (2015),
were found to be the most important and feasible. Therefore, the discussion section focused on
the following recommendation groups and their respective strategies: 1) Train and Educate
Stakeholders: Conduct Ongoing Training, Provide Ongoing Consultation, Develop Educational
Materials, Make Training Dynamic, Distribute Educational Materials, and Conduct Educational
Meetings; 2) Provide Interactive Assistance: Facilitation; 3) Use Evaluative and Iterative
Strategies: Audit and Provide Feedback, Develop and Implement Tools For Quality Monitoring;
4) Develop Stakeholder Relationships: Identify Champions, Build a Coalition, and Use Advisory
Boards and Workgroups. From these various areas, recommendations for different strategies
were identified.

15
Goal of Dissertation
This dissertation aimed to explore the implementation of ICWA and provide better
insight into how to improve the implementation of ICWA in California. This dissertation can be
used to provide ways to improve implementation with ICWA to provide best outcomes for AIAN
youth. For example, urban AIAN youth who may already feel isolated and disconnected from
their cultural ties may be even more at risk if they enter the foster or adoption systems and there
are no protections to keep them from being further removed from their communities and culture.

16
Chapter 2. The Indian Child Welfare Act of 1978: An Examination Through the Lens of
the Media (Paper 1)
Highlights
• This study utilized a media analysis that examined how the Indian Child Welfare Act
(ICWA) is presented through the lens of the media.
• Themes that arose from the media analysis were: 1) Justification, 2) Racialization, 3)
Bias and Stereotyping, 4) Tribal Sovereignty, 5) Understanding of ICWA.
• Findings show that there needs to be a re-framing of the media reporting on ICWA to
increase discussion around Tribal Sovereignty and Understanding of ICWA while
decreasing justification statements, racializing ICWA, and bias and stereotyping.
• Social workers can engage in media advocacy to empower AIAN communities and
advocate for policy improvements of ICWA.

17
Abstract
Objective: To examine how the Indian Child Welfare Act (ICWA) of 1978 is being discussed
through the lens of the media. Methods: Using the LexisNexis Academic (NexisUni) database,
250 news articles were included for analysis. These news articles belonged to mainstream media
and local news sources. Results: Using thematic analysis, five broad themes were identified: 1)
Justification, 2) Racialization, 3) Bias and Stereotyping, 4) Tribal Sovereignty, 5) Understanding
of ICWA. Discussion: There needs to be a re-framing of the media reporting on ICWA to
increase discussion around Tribal Sovereignty and Understanding of ICWA while decreasing
justification statements, racializing ICWA, and bias and stereotyping. The implication for social
work practice is for social workers to engage in media advocacy to empower AIAN communities
and advocate for policy improvements of ICWA.

18
INTRODUCTION
The media can be a powerful tool in providing information to the general public about
particular issues at a particular time. Media then becomes important to our political landscape as
the general public, and policymakers, consume this information. Therefore, the way that the
news is curated becomes important as it controls the information that we receive and can sway
the way we think about an issue. For American Indians and Alaska Natives (AIAN), AIAN
issues are not widely reported on. Actually, AIANs are nearly invisible when it comes to
mainstream media (First Nations Development Institute, 2018). This invisibility leaves AIAN
communities vulnerable to stereotypes, discrimination, and misperceptions. It is then exacerbated
as media perpetuates these when reporting on AIAN issues.
Currently, there are 574 federally recognized tribes in the United States (Bureau of Indian
Affairs, 2024). These federally recognized tribes are recognized as domestic-dependent nations
and having a government-to-government relationship with the United States. Therefore, tribes
have tribal sovereignty, which refers to the right of AIAN tribes to govern themselves (National
Conference of State Legislatures, 2013). This includes determining membership requirements,
which the Indian Child Welfare Act (ICWA) is based upon. ICWA is a federal law aimed at
preserving cultural and familial ties among Native American children and families while
encouraging respect for tribal authority in decisions concerning the placement of Native
American children in foster care (Brown et al., 2002). However, ICWA is constantly being
challenged in court with the argument that it is a race-based law. This argument is repeatedly
mentioned in the media, which can sway public opinion about this law. This is also prevalent in
cases covered by the mainstream media.

19
Media coverage surrounding ICWA has stemmed from legal cases, such as the
Mississippi Band of Choctaw Indians v. Holyfield, Adoptive Couple v. Baby Girl, and the “Lexi
case.” More recently, ICWA was prevalent in the news for Brackeen v. Haaland, a Supreme
Court case that challenged the constitutionality of the ICWA as well as questioned the validity
and legality of the sovereignty of Tribal nations. The outcome of this case had the potential to
impact the way that policies are interpreted and implemented across Indian country. Ultimately,
the Supreme Court upheld the constitutionality of ICWA. With the threat to dismantle tribal
sovereignty, it becomes important to understand how ICWA is being represented in media to the
general public.
To our knowledge, there has only been one article that looks at media and ICWA in the
context of media reporting on “best interest of a child” for the Baby Veronica case (Sweeney &
Pollack, 2017). Therefore, this study is the first to explore how ICWA is discussed in the news.
This study aims to examine how the Indian Child Welfare Act (ICWA) of 1978 is being
discussed through the lens of the media.
METHODOLOGY
Data Collection
Articles were collected using the LexisNexis Academic (NexisUni) database with the
keywords of “Indian Child Welfare Act.” The dates of the published news articles ranged from
1981-2024 with a total of 6,376 articles. With the wide date range and high number of articles,
the researchers identified the timeline in the news articles search where the number of articles
discussing ICWA suddenly increased. We were then able to separate the news articles into the
following four timeline groups: 1981-1993, 1994-1995, 1996-2014, and 2015-April 11, 2024.
For each grouping, “group duplicates” was turned off to reduce the number of repetitive news

20
articles and the search excluded obituaries to decrease the amount of non-relevant articles. The
final total of articles from January 1, 1981-April 11, 2024 was 6,245 articles.
For each grouping, the “sources” tab was used to identify news media sources to include
in analysis. The researchers aimed to identify mainstream media sources as they reach a wider
audience. In addition, local newspapers were chosen at random to have a diverse sample set.
Once the media sources were chosen, all articles were downloaded and imported into NVivo.
Articles were omitted from analysis if the article only mentioned ICWA in a listing or if it was
not relevant (i.e. book review, honoring a person’s life contributions, etc...).
The first grouping was January 1, 1981 to December 31, 1993. Using the criteria
mentioned above, the total amount was 82 articles. Mainstream media sources were identified,
and the total amount of articles published by those news sources were selected. These
mainstream news sources and number of articles were: Associated Press: 25; NY Times: 7; UPI
(United Press International): 9; The Guardian: 2; The Christian Monitor: 6; and Associated Press
International: 1. The total amount of articles downloaded was 50. After review of the articles,
those that were not relevant were removed. The sample included for analysis was 44 articles.
The second grouping was January 1, 1994 to December 31, 1995. Using the criteria
mentioned above, the total amount was 101 articles. The news media sources and articles
downloaded were: Associated Press:7; Star Tribune: 11; CNN Transcripts: 4; UPI: 1; USA
Today: 2; CBS News Transcripts: 3; The Bismarck Tribune: 15; The Philadelphia Inquirer: 1;
Dayton Daily News: 4; and Salt Lake Tribune: 2. The total amount of articles downloaded was
50. After review of the articles, the sample included for analysis was 46 articles.
The third grouping was January 1, 1996 to December 31, 2014. The total amount of
articles from the initial search was 2,256. The news media sources and articles downloaded were:

21
NY Times: 17; CNN.com: 13; Associated Press: 58; Lincoln Journal Star: 1; and Tampa
Tribune: 5. The total amount of articles downloaded was 94. After review of the articles, the
sample included for analysis was 89 articles.
The fourth grouping was January 1, 2015 to April 11, 2024. The total amount of articles
from the initial search was 3,806. The news media sources and articles downloaded were: NY
Times: 48; Associated Press: 39; USA Today: 6; ABC News Transcripts: 5; Star Tribune: 2. The
total amount of articles downloaded was 100. After review of the articles, the total amount
included for analysis in this grouping was 75 articles.
Overall, this study contained a sample size of 250 articles. This data collection process is
outlined in Figure 1.
Figure 2.1: Data Collection Process of Articles Chosen For Analysis

22
Data Analysis
The news articles were uploaded to NVivo R1 and separated by their respective
groupings. A sample of 6-10 articles were selected in each grouping to have a representative
sample and gain a better understanding of the developing themes. The document analysis
consisted of elements from both content analysis and thematic analysis. Content analysis being
the process of organizing information into categories related to the central questions of the
research (Bowen, 2009) while thematic analysis being the form of pattern recognition within the

23
data, with emerging themes becoming the categories for analysis (Fereday & Muir-Cochrane,
2006). The researcher performed coding and category construction, based on the data’s
characteristics, to uncover themes pertinent to how ICWA is being reported by the media.
RESULTS
Using thematic analysis, five broad themes were identified: 1) Justification, 2)
Racialization, 3) Bias and Stereotyping, 4) Tribal Sovereignty, 5) Understanding of ICWA. Each
of these themes are described in detail below and additional article quote examples are listed in
Table 1.
Table 2.1: The themes and sub-themes along with article quote examples
Theme # of
Articles
Mentioned
(n=250)
Sub-theme # of
Articles
Mentioned
(n=250)
Examples
Justification 81 Cultural
Disconnect
35 “[James] Moore said the
federal Indian Child Welfare
Act does not apply to Kayla
because she had not lived in
an Indian environment since
she was 8 months old.”
Only Family
Argument
56 “Only family they have
known”: “The girl, 6-year-old
Eleanor Armell, has
nightmares over the
possibility of being taken from
the custody of her foster
family, ‘the only parents she
has ever known,’ said her
attorney, Cook County Public
Guardian Patrick Murphy.”
“Since birth”: “The new case
involves a South Carolina
couple who were ordered to
turn over a 27-month-old girl
they had cared for since birth
to her biological father, an

24
Indian, whom the little girl
had never met.”
Racialization 83 “Race-Based” 43 “So far, a federal judge has
agreed with them, ruling that
the act should be struck down
because he believes it is based
on race.”
Blood Quantum 55 “Chief Justice John G.
Roberts Jr., who is the father
of two adopted children,
asked, ‘'Is it one drop of
blood that triggers all these
extraordinary rights?’' He
added that Veronica was
three-256ths Cherokee.”
Bias and
Stereotyping
20 ----- ----- “The American Indian
community is sending
negative smoke signals to
United States couples seeking
to adopt tribal children.”
Tribal
Sovereignty
95 Acknowledgment 57 “’The children are citizens of
the tribe and the tribe is
recognized as a sovereign
entity by the United States
government,’ [Jim Cohen, an
attorney for California Indian
Legal Services] says. ‘The
tribes are allowed to
determine their own
members.’”
Ignorance 48 “Lawyers for the adoptive
and natural parents opposed
the appeal, saying the tribe
has no legal standing to
challenge the adoption
because it was not a party to
the proceeding.”
Understanding
of ICWA
215 Accurate
statements
111 “Native American children,
the act says, should if possible
be placed with a member of
their extended family. Failing
that, they should be placed
with another member of their
tribe. And failing that, they
should be placed with ‘other
Indian families.’”

25
Inaccurate
statements
39 “…the 1978 federal Indian
Child Welfare Act, which
prohibits adoption of native
Americans by non-Indians.”
Intent of the Law 89 “In 1978, Congress passed
the Indian Child Welfare Act
to protect ‘the best interests of
Indian children’ and to
promote the stability of tribes
and Indian families.”
Mentioned with
no definition
51 “The case prompted debate
on Capitol Hill about whether
changes were needed in the
federal law, the 1978 Indian
Child Welfare Act.”
Justification
The first theme of Justification focused on rationales used for why the child is better off
or should stay with the non-Native family. There were two sub-themes that emerged: Cultural
Disconnect and the Only Family argument.
Cultural Disconnect
This sub-theme was assigned to a consistent argument that was repeated throughout the
articles, which was the notion that cultural disconnect was reason enough to not comply with
ICWA. One example of this was:
“The Goldwater Institute, the Arizona-based conservative advocacy group that is
bringing the suit, says those requirements are discriminatory because they apply only to
Indian children, even those who have no connection to their tribes.”
Only Family Argument
The term for this sub-theme was identified by Matthew Fletcher (2020), which is used to
sway supporting placement with the foster or adoptive parents. There were two frequent
arguments that were consistently used to justify why the non-Native family should receive

26
preference over the biological family or Native American families. The first was the use of the
phrase “only family they have known” and “since birth.” An example of this was:
“Matthew D. McGill, who argued the case on behalf of the non-Native families, said his
main concern was for a 5 year-old girl who has been a part of a non-Native family ‘for
nearly her whole life.’”
Racialization
This second theme encompassed every time race was mentioned throughout the articles.
From this theme, two sub-themes were identified: “Race-based” and blood quantum.
“Race-Based”
This sub-theme referred to when an article mentioned ICWA as being “race-based” or
associating ICWA with race. An example of this was:
“At the US Supreme Court this month, the Brackeens argued ICWA should be struck
down as unconstitutional, discriminating, they say, on the basis of race by giving priority
to Native families over white families.”
Blood Quantum
This sub-theme was applied to statements that mentioned any aspect of blood quantum.
This was through the use of words, such as: “full-blooded,” “part,” “ancestry,” or mentioning a
particular fraction of blood quantum when referring to someone being Native American, rather
than referencing enrollment or citizenship. An example of this was:
“Lexi, who is 1/64th Native American, was 17 months old when she was removed from
the custody of her birth parents.”

27
Tribal Sovereignty
This third theme focused on how the media portrays tribal sovereignty in the context of
ICWA. From this theme, two-sub themes were identified: acknowledgement of tribal sovereignty
and ignorance of tribal sovereignty.
Acknowledgment
This sub-theme identified statements that acknowledged, directly or indirectly, tribal
sovereignty. This could be statements using the term “sovereignty” or “sovereign” or discussing
aspects to describe tribal sovereignty without using those terms. One example of a direct
reference to sovereignty is:
“In the United States, there are 574 federally recognized Native American tribes and
each one is a sovereign nation. This recognition is a foundational tenet of federal Indian
law embedded in Article 1, Section 8 of the Constitution, which empowers the federal
government to engage in relations with ‘Indian tribes.’”
Another example, which would be an indirect mention to tribal sovereignty, would be:
“Brown's relationship within the "federally recognized government" of the Cherokee
Nation means Veronica is a member of the tribe and subject to its jurisdiction.”
Ignorance
This sub-theme identified statements that dismissed tribal sovereignty or made statements
with misinformation that disregarded tribal sovereignty. One example of this was:
“The law allows Indian tribes to claim jurisdiction over an Indian or part-Indian child.”
Understanding of ICWA
The fourth theme focused on how the media has relayed information about ICWA and
how that contributes to the public’s understanding of how ICWA operates. There were four sub-

28
themes identified: accurate information, inaccurate information, intent of the law, and ICWA
mentioned with no definition.
Accurate Statements
This sub-theme identified statements that were accurate when discussing ICWA. One
example of this was:
“The law sets standards for removing Indian children from their families, terminating
parental rights and placing them in foster or adoptive homes.”
Inaccurate Statements
This sub-theme identified statements that were not accurate when discussing ICWA. One
example of this was:
“…the 1978 federal Indian Child Welfare Act, which prohibits adoption of native
Americans by non-Indians.”
Intent
This sub-theme identified statements that mentioned the intent or the aim of ICWA. This
provided more context for the reader. One example was:
“In 1978, Congress passed the Indian Child Welfare Act to protect ‘the best interests of
Indian children’ and to promote the stability of tribes and Indian families.”
Mentioned with No Definition
This sub-theme identified where articles mentioned ICWA, but provided no further
context to what it is. By omitting this information, it may sway someone to think in a biased way
about ICWA. One example of this was:
“The Pages said Monday they will keep fighting for changes to the law ‘and the rights of
other children unnecessarily hurt by the Indian Child Welfare Act.’”

29
Bias and Stereotyping
Finally, the last theme focused on statements that presented bias and/or stereotyping. An
example of this was:
“[Chad Brackeen, non-Native foster parent] was thinking of the baby ‘not as an infant
living in a room with a great-aunt but maybe as an adolescent in smaller, confined
homes,’ he said. ‘I don’t know what that looks like — if she needs space, if she needs
privacy. I’m a little bit concerned with the limited financial resources possibly to care for
this child, should an emergency come up.’”
DISCUSSION
This study aimed to explore how ICWA is reported on through a media lens. This media
analysis identified 5 broad themes: 1) Justification, 2) Racialization, 3) Bias and Stereotyping, 4)
Tribal Sovereignty, 5) Understanding of ICWA. We found that there needs to be an increase on
discussion around tribal sovereignty and understanding of ICWA while decreasing justification
statements, racializing ICWA, and bias and stereotyping.
Justification
With the intentional use of justification terms, such as “since birth” and “only family they
have known,” it creates the idea that a non-biological, non-Native family is more suited to raise
an AIAN child. The statements in the media also alluded that by being raised in a non-Native
home there is a cultural disconnect, which is used to justify why the separation is suitable.
However, a cultural disconnect is one of the very things that ICWA aims to protect against.
Through decades of Federal Indian policy that served to separate and assimilate Native American
children and families, the ICWA aims to reverse the consequences of that trauma. In fact,
cultural disconnect is a result of historical trauma (Brave Heart & DeBruyn, 1998). Decades of

30
Federal Indian policy aimed to exterminate as well as assimilate Native American people into
western culture, resulting in a cultural genocide. This brings about loss of identity. ICWA was
designed to address this cultural disconnect by providing a way to protect Native American
children and families from further re-traumatization. Therefore, it would not be unusual if AIAN
children impacted by child welfare were not culturally connected.
Racialization
The term “Indian,” used in ICWA, explicitly defers to the Indian tribes’ definition of
“Indian,” not self-identification, meaning that it does not impose race-based restrictions (Elder,
2018).
This study supports the recommendation put forth by the Native American Journalists
Association (2018) to “Never refer to the blood quantum.” The media analysis showed that there
were references made to blood quantum and ICWA being a “race-based” law. However, race is
not a factor when implementing ICWA as ICWA is only applicable to children who are either
citizens of a federally recognized tribe or eligible for citizenship in a federally recognized tribe.
By referencing blood-quantum or racializing ICWA, it creates a false narrative that ICWA is
race-based. Framing ICWA in this way leaves room for debate because it appears that there is no
legal standing and that the law is discriminatory. However, that is simply not the case because it
is based on the government-to-government relationship that federally recognized tribes have with
the federal government. In addition, focusing on race rather than the political classification of
citizenship neglects the understanding of tribal sovereignty.
Bias and Stereotyping
These statements focused on the idea that AIAN communities are not suitable for AIAN
children. As AIAN communities are invisible in the media (First Nations Development Institute,

31
2018), statements like these become the only exposure that the public gets about AIAN people.
This begins to frame a false preconceived notion in public opinion about how AIAN
communities may not be suitable. However, the research shows that, for AIAN youth, being
connected to their culture, extended family, and community are proven protective factors
(National Indian Child Welfare Association, 2015). Therefore, media outlets should be mindful
when reporting statements of bias and stereotypes. These can also contribute to implicit or
unconscious bias, which is “the attitude or internalized stereotypes that unconsciously affect our
perceptions, actions, and decisions” (Shah & Bohlen, 2023). These can impact policymakers
making decisions around ICWA as well as individuals who implement ICWA through child
welfare agencies and court systems.
Tribal Sovereignty
The matter of tribal sovereignty is highly important when discussing AIAN issues,
especially ICWA. As Kalt & Singer (2004) wrote, “Tribal sovereignty is not just a legal fact; it is
the life-blood of Indian nations.” ICWA only applies to children who are members, or eligible
for membership, of a federally recognized tribe. Therefore, it is based on tribal sovereignty and
political membership. When discussing ICWA, it is imperative that tribal sovereignty is
mentioned. However, tribal sovereignty was only mentioned in 38% of the news articles, which
means that over half of the articles did not mention or discuss tribal sovereignty. Without
addressing tribal sovereignty, it can be difficult for the public to understand the government-togovernment relationship that Tribes have with the United States as well as the legal ramifications
when ICWA is not implemented appropriately. Therefore, the media should make an effort to
include tribal sovereignty in their news articles when reporting on ICWA.
Understanding of ICWA

32
When the media reports on ICWA, it is important to be able to communicate its
importance as well as accurate information regarding the policy. Inaccurate definitions and
information being relayed through the media can cause disruption. It can cause misinformation to
appear as fact and can sway public opinion, such as the idea that this law is “race-based,” that
non-Native family placements aren’t considered, and that it is more difficult to remove AIAN
children from an abusive or neglectful home.
One point of concern is that approximately 1/5 of the articles mentioned ICWA, but
never defined what it meant. Therefore, members of the public reading these news articles are
not provided with understanding or context about what ICWA is. Their opinions about ICWA
are based solely on the additional information being presented, such as if the article writes that
ICWA is race-based. An absence of information can be detrimental when discussing ICWA
because there is already a disconnect between the public and AIAN in the media. This includes
policymakers who are consuming the media and have the power to potentially influence policy
reform. If the media is reporting on ICWA, it is important to be able to accurately define what it
is so that the public has a basic understanding of what the law entails. By having this knowledge,
the public is able to make an informed opinion and see the importance that ICWA has when it
comes to AIAN communities.
Implications for Social Work
For social workers, understanding how the media portrays ICWA is important when it
comes to empowerment and advocacy efforts. This type of advocacy is called media advocacy,
which is defined as “the strategic use of mass media to advance public policy initiatives”
(Wallack, 1994). It also allows for communities that are impacted by these policies to provide
their voice and stories to promote social change. Social workers become important in media

33
advocacy as they can provide resources to the media who may be reporting on ICWA, but who
may not be necessarily well versed in it. Social workers can provide accurate information,
connect media with AIAN organizations or individuals who work with ICWA, and/or AIAN
impacted by ICWA to share their stories. It is apparent that there is a gap between the media and
ICWA; therefore, social workers are able to act as that bridge. By advocating in this way, social
workers are able to uplift AIAN communities and voice, protect tribal sovereignty, and place
ICWA at the forefront for policymakers to recognize and make the effort to strengthen the
policy.
LIMITATIONS AND FUTURE RESEARCH
In conducting this content analysis, there were several limitations. The first limitation is
that this study looked at results from one database: LexisNexis Academic (NexisUni). Therefore,
other news sources may have been left of the analysis. To further this study, it may be beneficial
to analyze social media conversations regarding ICWA. This could be done on various platforms
(Facebook, X, Instagram, TikTok) to explore how the general public is consuming the media and
how it may be shaping their thoughts and opinions on ICWA. This could be done by looking at
the comments under the published news articles on the media outlet’s social media pages and/or
by looking at posts that reference hashtags (#) related to ICWA. Even further, it would also be
beneficial to conduct focus groups around media messaging regarding ICWA to establish how
the public is interpreting the news and how individuals are formulating their opinions on ICWA.
This can provide better insight into how media can improve in its reporting to provide nonbiased, accurate news to the general public.

34
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High Country News. Retrieved from https://www.hcn.org/articles/indigenous-affairsjustice-how-the-only-family-argument-is-used-against-indigenous-families/
Kalt, J. P., & Singer, J. W. (2004). Myths and Realities of Tribal Sovereignty: The Law and
Economics of Indian Self-Rule. IDEAS Working Paper Series from RePEc.
National Conference of State Legislatures (2013). An Issue of Sovereignty. Retrieved from
https://www.ncsl.org/quad-caucus/an-issue-ofsovereignty#:~:text=Tribal%20sovereignty%20refers%20to%20the,to%20regulate%20th
eir%20internal%20affairs.
National Indian Child Welfare Association (2015). Setting the Record Straight: The Indian Child
Welfare Act Fact Sheet. Retrieved fromo https://www.nicwa.org/wpcontent/uploads/2017/04/Setting-the-Record-Straight-ICWA-Fact-Sheet.pdf

35
Shah, H, Bohlen, J. (2023). Implicit Bias. StatPearls [Internet]. Treasure Island (FL): StatPearls
Publishing; 2024 Jan-. Available from:
https://www.ncbi.nlm.nih.gov/books/NBK589697/
Sweeney, K. A., & Pollack, R. L. (2017). Colorblind Individualism, Color Consciousness, and
the Indian Child Welfare Act: Representations of Adoptee Best Interest in Newspaper
Coverage of the Baby Veronica Case. Sociological Quarterly, 58(4), 701–720.
The Native American Journalists Association (2018). Recommendations for Reporting on the
Indian Child Welfare Act. Retrieved from https://najanewsroom.com/resources/
Wallack L. (1994). Media Advocacy: A Strategy For Empowering People and
Communities. Journal of Public Health Policy, 15(4), 420–436.

36
Chapter 3. A Comparative Case Study: Identifying Facilitators and Barriers to ICWA
Implementation in California Using the Consolidated Framework for Implementation
Research (CFIR) (Paper 2)
Highlights
• This qualitative study investigated the barriers and facilitators of ICWA implementation
in California through a comparative case study.
• The Consolidated Framework for Implementation Research (CFIR) was used to
understand barriers and facilitators that impact the implementation of ICWA.
• Implications for social work practice are to take the initiative to overcome identified
barriers and using the National Association of Social Work (NASW) Code of Ethics as a
guide. The values mentioned are competency; dignity and worth of a person; and
importance of human relationships. In addition, there is an emphasis on prioritizing
cultural competency when working with AIAN children and families as well as Tribal
nations for best ICWA implementation outcomes.

37
Abstract
Objective: To identify barriers and facilitators to the implementation of the Indian Child
Welfare Act (ICWA) in California. Methods: With 12 participants, this study was able to collect
12 cases to identify barriers and 12 cases to identify facilitators for a total of 24 cases. These
cases were located across California. Interviews were conducted via Zoom from late February
2024 to early May 2024. Results: Using the Consolidated Framework for Implementation
Research (CFIR), barriers and facilitators were found in all 5 CFIR domains with 12 constructs:
1) Outer Setting (Partnerships and Connections); 2) Inner Setting (Constructs: Structural
Characteristics: Physical Infrastructure, Structural Characteristics: Work Infrastructure,
Relational Connections, Communications, Access To Knowledge and Information); 3)
Individuals (Constructs: Mid-level leaders, Innovation Deliverers, and Culture: Human Equality
Centeredness); 4) Implementation (Construct: Teaming); and 5) Characteristics (Constructs:
Capability and Motivation).
Discussion: By identifying barriers and facilitators, we are better able to determine how to
improve implementation of ICWA. Areas discussed are having ICWA courts and/or ICWA units
or a specialized ICWA worker, improving training, improving communication and collaboration,
utilizing resources such as cultural services and the Office of Tribal Affairs (OTA), and
addressing bias. Finally, implications for social work practice are discussed.

38
INTRODUCTION
Today, American Indian/Alaska Native (AI/AN) children are overrepresented in foster
care at a rate 2.7 times greater than their proportion in the general population (Woods &
Summers, 2016). This means that although AI/AN children account for just 0.9% of all children
in the United States, they represent 2.1% of all children who are placed outside their homes in
foster care (Woods & Summers, 2016). These numbers do not account for the estimated onethird to 40% of children that are placed in foster care by tribal authorities (Earle & Cross, 2001).
Hence, the number of AI/AN children placed in foster care is higher than reported. AI/AN
children are also removed from their homes at 2 to 3 times the rate of their white counterparts
and often are not placed with relatives or other Indian families, even when such placements are
available and appropriate (National Indian Child Welfare Association, n.d.).
The Indian Child Welfare Act (ICWA) is a federal law aimed at preserving cultural and
familial ties among Native American children and families while encouraging respect for tribal
authority in decisions concerning the placement of Native American children in foster care
(Brown et al., 2002). The need for this law became apparent after a 1976 study by the
Association on American Indian Affairs found that 25% to 35% of all Indian children were being
placed in out-of-home care (Unger, 1977). Eighty-five percent of those children were being
placed in non-Indian homes or institutions (Unger, 1977). Specifically, in California, it was
found that over 90% of California Indian children subject to adoption were placed in non-Indian
homes and that Indian children were more than eight times as likely as non-Indian children to be
placed in adoptive homes (Rose, 2008). In a response to the overwhelming evidence from Indian
communities that the loss of their children meant the destruction of Indian culture, Congress
passed ICWA.

39
ICWA has been labeled the “gold standard” in child welfare practice by a coalition of 18
national child advocacy organizations (National Indian Child Welfare Association, 2015). This
law lessens the trauma of removal by promoting placement with family and community while
promoting the best interest of Indian children by keeping them connected to their culture,
extended family, and community, which are proven protective factors (National Indian Child
Welfare Association, 2015). This law also encourages states to develop effective relationships
and procedures with tribes to carefully coordinate the care of AI/AN children and families.
Unfortunately, research has proven that ICWA is not always adhered to with fidelity when foster
care placements involving AI/AN youth are made. However, the reasons for non-compliance
with ICWA are poorly understood.
Barriers to the Implementation of ICWA
Previous studies that identified barriers to ICWA implementation have found that there is
an absence of or limited: specialized positions dedicated towards ICWA and AIAN social
workers (Groves, 1981), available AIAN foster homes (Groves, 1981; Reza, 1989), and technical
support (Groves, 1981; Limb & Brown, 2008). In addition, there is a lack of formal ICWA
training (Wares et al., 1994). Finally, there is limited integration of culture into practice when
working with AIAN populations (Hand, 2006).
In California, one study found that counties had issues with inquiry and sending notice to
Tribes (Moore, 2020). Another study in California found that almost half of county social
workers did not ask AIAN children or families their cultural background (Waddell, 2002).
Without proper inquiry, county social workers are unable to identify who qualifies as an “Indian
child” and ICWA is ignored.

40
Facilitators to the Implementation of ICWA
There have been studies that explored facilitators to implementation of the law of ICWA.
Some of the facilitators identified have been: obtaining feedback from tribes (Limb & Brown,
2008), an ICWA social worker (Waddell, 2002), or the Administration for Children and Families
(Limb & Brown, 2008).
AIAN Population in California
California is home to the nation’s largest AIAN population, with approximately 720,000
AIAN residents (Judicial Council of California, 2021). Currently, there are 109 federally
recognized tribes in California with 78 entities petitioning for recognition (Los Angeles
City/County Native American Indian Commission, n.d.). Overall, there are nearly 100 separate
reservations or Rancherias located in the state of California (Judicial Council of California,
2021). Figure 3.1 shows a map of California along with the federally recognized tribes. This map
does not include the Rincon Band of Luiseño Indians and the La Jolla Band of Luiseño Indians.
Approximately 90% of the AIAN population in California live in cities and urban areas with
only 3% living on tribal lands (Rancherias and reservations) (First 5 Center for Children’s
Policy, 2023). California is home to over 346,000 AIAN children, one of the largest populations
of AIAN children in the United States (First 5 Center for Children’s Policy, 2023).

41
Figure 3.1: Map of California Tribal Lands (Federally Recognized Tribes)
The Consolidated Framework for Implementation Research (CFIR)
The CFIR is one of the most commonly used and among the most highly cited
determinant frameworks in implementation science (Damschroder et al., 2022). The CFIR is the
formative evaluation of identifying barriers and facilitators to successful implementation. In this
framework, there are five major domains that impact implementation: 1) Innovation: The “thing”
being implemented; 2) Outer Settings: The setting in which the Inner Setting exists; 3) Inner
Setting: The setting in which the innovation is implemented; 4) Individuals: The roles and
Cabazon
Torres-Martinez
Ramona
Pala
Table Mountain
Big Sandy
Santa Ynez
Ione Band
Jackson
CC AA LL II FF OO RR NN II AA
Wade
Parcels
Elk
Valley Karuk
Karuk
Fort Bidwell
Quartz Valley
Yurok
XL Ranch
Cedarville
Alturas Hoopa
Big
Lagoon
Lookout Trinidad
Big Bend Likely Roaring Creek
Montgomery Creek
Table Bluff
Rohnerville
Redding Rancheria
Susanville
Blue Lake
Pit River
Greenville Susanville
Round
Valley
Laytonville
Grindstone Berry Creek
Enterprise Mooretown
Coyote
Valley Redwood Valley
Upper Lake
Colusa
Smith
River
Robinson
Big Valley
Guidiville Cortina
Pinoleville
Manchester
Sulphur
Bank Hopland
Rumsey
Middletown
Stewarts
Point Washoe
(Woodfords
Community)
Shingle
Springs
Bridgeport
Benton Paiute
Bishop North Fork Picayune
Big Pine
Cold Springs
Fort Independence
Lone Pine
Santa Rosa
Tule
River
San Manuel Twenty-Nine
Palms Morongo
Agua Caliente Soboba
Cabazon
Augustine Cahuilla
Santa Rosa
Pechanga
Pauma-Yuima Los Coyotes
San Pasqual Santa Ysabel Mesa Grande Inaja-Cosmit
Barona Capitan Grande
Viejas Cuyapaipe Quechan Sycuan Manzanita
La Posta Jamul Indian Village Campo
Tuolumne
Sheep Ranch
Chicken Ranch
Fort
Mojave
Chemehuevi
Paskenta
Chico Rancheria
Dry Creek
Cloverdale
Graton
Lytton
Auburn Rancheria
Timbisha
Homelands
Sherwood
Valley
Me-Wuk
Colorado
River
ALAMEDA
COUNTY
ALPINE
COUNTY AMADOR
BUTTE
CALAVERAS
COUNTY
COLUSA
CONTRA
COSTA
DEL NORTE
COUNTY
EL DORADO
FRESNO
COUNTY
GLENN
HUMBOLDT
COUNTY
IMPERIAL
COUNTY
INYO
COUNTY
KERN
COUNTY
KINGS
COUNTY
LAKE
LASSEN
COUNTY
LOS
ANGELES
COUNTY
MADERA
COUNTY
MARIN
COUNTY
MARIPOSA
COUNTY
MENDOCINO
COUNTY
MERCED
COUNTY
MODOC
COUNTY
MONO
COUNTY
MONTEREY
COUNTY
NAPA
NEVADA
ORANGE
COUNTY
PLACER
PLUMAS
COUNTY
RIVERSIDE
COUNTY
SACRA
MENTO
SAN
BENITO
COUNTY
SAN
BERNARDINO
COUNTY
SAN DIEGO
COUNTY
SAN FRANCISCO COUNTY
SAN
JOAQUIN
COUNTY
SAN LUIS
OBISPO
COUNTY
SAN MATEO
COUNTY
SANTA
BARBARA
COUNTY
SANTA
CLARA
SANTA COUNTY
CRUZ
COUNTY
SHASTA COUNTY
SIERRA
COUNTY
SISKIYOU
COUNTY
SOLANO
COUNTY
SONOMA
STANISLAUS
COUNTY
SUTTER
TEHAMA
COUNTY
TRINITY
COUNTY
TULARE
COUNTY
TUOLUMNE
COUNTY
VENTURA
COUNTY
YOLO
YUBA
0
µ25 50 100 Miles
Tribal Lands
County Boundary
Sources: U.S. Census Bureau (2011),
ESRI (2006), TANA (2006).
AIR1100040_3 16 May 2011
CALIFORNIA TRIBAL LANDS

42
characteristics of individuals; and 5) Implementation: The activities and strategies used to
implement the innovation. Within these domains are 48 constructs that are used to organize these
barriers and facilitators. Overall, the CFIR aims to provide a comprehensive framework for
implementation of research findings into practice (Damschroder et al., 2009).
The Current Study
This qualitative study aimed to identify barriers and facilitators to ICWA implementation
in California through a comparative case study. By using the CFIR, we are able to classify
barriers and facilitators that impact the implementation of ICWA and focus on strategic
solutions.
METHODOLOGY
Participants
Participants in this study were a purposively selected sample (Palinkas et al., 2015).
Eligible participants had to be: 1) be actively working with ICWA and 2) be located in
California. This study was able to recruit 12 participants across California, representing areas of
Northern California, Central California, and Southern California. For a diverse perspective, this
study was able to recruit individuals who implement ICWA, such as county social workers, tribal
ICWA social workers, qualified expert witnesses, state government, and native organizations that
represent tribes. This study was approved by the Institutional Review Board (IRB) of the
University of Southern California and informed consent was obtained from all participants.
Data Collection
The researchers used a semi-structured interview guide to conduct interviews via the
Zoom online platform. For this study, participants were asked to provide ICWA case examples to
identify barriers to the implementation of ICWA as well as ICWA case examples to identify

43
facilitators to the implementation of ICWA. With 12 participants, this study was able to collect
12 cases to identify barriers and 12 cases to identify facilitators for a total of 24 cases. Interviews
were conducted between late February 2024 and early May 2024. These interviews ranged from
approximately 45 minutes to 1.5 hours.
In assessing for barriers to the implementation of ICWA, participants were asked to
provide the researchers with an ICWA case example that they considered to be an unsuccessful
implementation of ICWA. After discussion of the ICWA case example, participants were then
asked “Were there any barriers or challenges encountered to the application of ICWA in this
case? If so, what were they?” and “In your experience, how common are these barriers or
challenges?”
In assessing for facilitators to the implementation of ICWA, participants were asked to
provide the researchers with a case example that they considered to be successful
implementation of ICWA. After discussion of the case example, participants were then asked
“Were there any factors that helped to facilitate the application of ICWA in this case? If so, what
were they?” and “In your experience, how common are these factors?”
Data Analysis
Qualitative interviews were recorded on Zoom and transcribed with Otter.ai for accuracy.
Transcripts were then entered into the qualitative software program NVivo R1 for analysis. This
study used a directed content analysis, which is a structured process, by using the categories of
an existing framework for initial coding categories (Hsieh & Shannon, 2005). The framework
that guided the analysis was the Consolidated Framework for Implementation Research to
identify the barriers and facilitators from the cases. A codebook was developed using the CFIR

44
domains and sub-domains as the themes and subthemes. Then, participant responses were
mapped to these themes and subthemes. All coding was done using NVivo R1.
RESULTS
Using the case examples provided by the participants, the researchers mapped barriers
and facilitators to the CFIR framework. Upon analysis, participants discussed across the 5
domains, 12 constructs that contributed to the barriers and facilitators. The domains, constructs,
their definitions, and example responses discussed by the participants are outlined by Table 3.1.
Table 3.1: CFIR Constructs, Definitions, and Examples.
CFIR Domain Barrier
s
Facilitato
rs
CFIR
Construct
CFIR
Definition
Barrier
Examples
Cases
(n=12
)
Facilitator
Examples
Cases
(n=12
)
Outer Setting 1 5 Partnerships
and
Connections
The Inner
Setting is
networked
with external
entities,
including
referral
networks,
academic
affiliations,
and
professional
organization
networks.
Lack of
services
1 Office of
Tribal Affairs
(OTA);
cultural
services
5
Inner Setting 5 9 Structural
Characteristics
: Physical
Infrastructure
Layout and
configuration
of space and
other
tangible
material
features
support
functional
performance
of the Inner
Setting.
No ICWA
Court
2 Established
ICWA Court
1
Structural
Characteristics
: Work
Infrastructure
Organization
of tasks and
responsibiliti
es within and
between
individuals
and teams,
and general
staffing
levels,
support
functional
Not having
an ICWA
unit;
Turnover
4 ------- 0

45
performance
of the Inner
Setting.
Relational
Connections
There are
high quality
formal and
informal
relationships,
networks,
and teams
within and
across Inner
Setting
boundaries
(e.g.,
structural,
professional) .
No
relationship
between
counties and
Tribes
5 Dual
relationship;
roundtables
4
Communicatio
ns
There are
high quality
formal and
informal
information
sharing
practices
within and
across Inner
Setting
boundaries
(e.g.,
structural,
professional) .
No
communicati
on
4 Effective
communicati
on
7
Access to
Knowledge
and
Information
Guidance
and/or
training is
accessible to
implement
and deliver
the
innovation.
Inadequate
Training
5
0
Individuals
4
7 Mid
-Level
Leaders
Individuals
with a
moderate
level of
authority,
including
leaders
supervised
by a high
-
level leader
and who
supervise
others.
County
supervisors
not
supporting
implementati
on of ICWA
2 Leadership
buy
-in
2
Innovation
Deliverers
Individuals
who are
directly or
indirectly
delivering
the
innovation.
County workers have
an ego
4 County
counsel open
to supporting
social worker
4

46
Culture:
Human
Equality
Centeredness
There are
shared
values,
beliefs, and
norms about
the inherent
equal worth
and value of
all human
beings.
Racist 5 1
Implementati
on
3 9 Teaming Join together,
intentionally
coordinating
and
collaborating
on
interdepende
nt tasks, to
implement
the
innovation.
No
collaboration
6 Effective
collaboration
9
Characteristic
s
3 8 Capability The
individual(s)
has
interpersonal
competence,
knowledge,
and skills to
fulfill Role.
Ignorance of
ICWA
8 Understands
ICWA
7
Motivation The
individual(s)
is committed
to fulfilling
Role.
County social
worker not
committed to
implementing
ICWA
2 Having
AIAN Social
Workers who
are
committed to
implementing
ICWA
4
Outer Setting
Partnerships and Connections
Participants discussed the importance of cultural services for AIAN children and families
impacted by the child welfare system. One participant discussed how there are not many
organizations that offer cultural services in the area so it becomes impacted:
“That's another area, appropriate services. When there's a ‘lack of’ it creates waitlists. It
creates barriers when there's only 1 agency that services. They do a great job and they
service a lot of people. They do a lot.”

47
Other participants highlighted using the Office of Tribal Affairs (OTA) to properly
implement ICWA. One participant stated:
“I utilize my resources. I call the Office of Tribal Affairs, just for kind of checks and
balances. [I tell them] my experience and [compare] with what they have documented as
far as what are the rights of the tribes.”
Inner Setting
Structural Characteristics: Physical Infrastructure
Participants discussed how the absence of an established ICWA court remained a barrier.
One participant stated
“That needs to be part of the barriers: when an ICWA case is not assigned to an ICWA
court. All the other courts are supposed to but don't have the necessary narrowed down
knowledge of the ICWA mandate. They always side wrong because ICWA is not
something that comes to you naturally. You have to really know it.”
By not having an ICWA court, there is a cultural component that is missing. The cultural
component is important for AIAN families navigating a system that they are not familiar with. In
addition, these courts are specialized in handling ICWA cases, which serves as a facilitator to
implementation.
Structural Characteristics: Work Infrastructure
Participants discussed the issue of high case loads and how that impacts implementation
efforts. One participant stated:
“It's just social workers are overworked. We see that, I see that. Every social worker has
the same problem. It's staffing issues and high case loads. So when you see this extra
work, they don't want to put the effort in.”

48
Another issue is high turnover. This creates instability and can become emotionally
taxing on children and families. One participant stated:
“But the county, the way that they set it up, is there is a revolving door of workers.
Especially the first six months of any case, where these people have to relive whatever's
going on, they have to retell their story, and they have to start over with services.
Relational Connections
Participants discussed how having a dual relationship between the county and Tribes is
necessary when implementing ICWA. This goes beyond collaboration by ensuring that the
relationship is nurtured. One participant explained an aspect of this as:
“So dual relationships is really important because you have to do hard work and have
hard conversations, but you still have to maintain respect and you still have to maintain
relationships in a positive way to do hard work.”
One participant discussed how their Tribe and the county worked together to form these
relational connections. The participant stated:
“Those were some of the things that we touched on was how to actually have a
relationship with the tribe, how to build and continue to foster that relationship, to really
try to put aside some of those misnomers and harsh feelings that were there because all
tribes have them with all counties and all counties have them with all tribes.”
Communications
Participants discussed the importance of communication when it comes to implementing
ICWA. By not effectively communicating or not communicating at all, there becomes problems
with implementation. One participant highlighted this:

49
“Yeah, [the county social worker] would invite me to a home visit, but there wasn't any
communication about reaching out to relatives. A child has been in out-of-home
placement and we'd have relatives [for placement], and then we'd lose our placement
because a child has some dysregulated behaviors. She wouldn't communicate with me
that's what she was doing nor communicate to me about what services were in place, the
who, what, where. I'd be invited to the CFT and then I'd be invited to an IEP, which she
wasn't in attendance at. That's so important because that incorporates the academics
along with the behavioral piece, you know, the emotional disturbance piece, and she
wouldn't be there.”
One participant discussed the use of language among county workers and how that can
negatively impact the relationship. For example, one participant stated:
“And it's all it's downright to the point of disrespectful communication. You know, you'll
hear people having conversations like, ‘ why don't we just go by here and powwow about
this?’ Or ‘maybe this person, that's how they have when they're off the reservation,’ and
it's like you sit back and you hear those things. Do you accept it? Do you continue to
hear? Do you just not say anything? I have never been that way my whole life, believe it
or not. I started at a really young age that I wasn't going to stand for that. I've always
spoke up and said, ‘No, you're not going to treat us or talk to the people like that. You’re
going to treat them as human beings.’ I know, this case is a horrific case, but you don't
get to treat them like that.”
Access to Knowledge and Information
Participants discussed cases where county social workers did not have adequate training
to be able to implement ICWA correctly. One participant discussed this:

50
“So, I can't necessarily blame field workers per se, other than lack of training and their
own experience and bias. A lot of times they don't know a lot of the bureaucracy that's
happening, like things that are just going on. So, I think that just goes back to the training
and really understanding the why behind ICWA. I think a lot of people aren't being
trained with the why.”
In addition, there were discussion about judges, attorneys, and even Tribes being trained on
ICWA. These deliverers are essential to the implementation of ICWA.
Culture: Human Equality Centeredness
Participants discussed how there are issues with AIAN children and families not being
treated kindly by child welfare systems. This treatment hinders implementation efforts. One
participant stated:
“Then, in talking to the family, the social worker was very mean to them, like relatives,
the elders, mean to everyone, putting down the parents. In the social worker's, court
reports there was nothing about the parents’ strengths. It literally said, "they're just
making up excuses" and just all these mean things. I was like, this is not a social work
relationship. If you want to be a cop go to probation. Of course, with Native families,
there's the importance of relationship, especially if they're in a system they don't want to
be involved in.”
Individuals
Mid-Level Leaders
The case examples showed how county supervisors play a role in the success or failure to
implementation of ICWA. Leadership support and buy-in becomes essential to implementation.
As a barrier, one participant highlights this through her case:

51
“And I think that what's missing is I've never heard from her supervisor, not one thing.
So that supervisor not being involved, probably not even trained, not being able to tell
her, ‘Hey, look, this is an Indian Child Welfare case, you should not be sitting there
going toe-to-toe with the attorney’ and say, ‘I'm going to follow this case right into the
ICWA courtroom.’”
Another case discusses the impact of having leadership support, which helped to facilitate
success implementation:
“I think just working with the supervisor on that case… And then just come back, circle
back around and have everybody just work together in the best interests of the family and
making sure that we were holding the parents accountable to their case plan.”
Innovation Deliverers
Having supportive individuals that contribute to the implementation of ICWA is
essential. One case highlights the role that county counsel had in supporting the implementation
of ICWA:
“And then, having a county counsel that supported, you know, county counsels are
supposed to support the department's social workers position, but they don't always.
They're not always super supportive. So having a county counsel that trusted the social
worker's recommendations and supported them was helpful.”
Without support, this can have a negative impact on implementation. One participant
highlights how not having support of their supervisor impacts the social worker:
“Yeah, it's important to mention, seeing resistance and adversarial behavior of
the [county] social worker in cases. There's too much of the ‘us versus them.’ And

52
you can call that ignorance, ego, racism, bias positioning, social worker
ignorance…”
Characteristics
The characteristics of the individual is important to implementation. The characteristics
that were most discussed were capability and motivation. Motivation becomes important to the
individual’s willingness to implement ICWA.
In addition, participants discussed the importance of an AIAN social worker in the
implementation of ICWA as it contributes to that individual’s motivation. In a case example, one
participant elaborated on this facilitator by stating:
“The ICWA department can [implement ICWA] better than a county department because
the ICWA department is vested in the community, vested in keeping families together,
vested in making sure that families have resources, tools, tips, strategies that they need in
order to rebuild a relationship in a family… I think Native people doing ICWA jobs is a
real big bonus to being able to work with a family, a native family, you can relate to
those individuals on a different spiritual level than non-Natives can, and you know, really
making sure that ICWA itself has a purpose and a role in the reunification or support of
this family.”
Implementation Process
This domain focuses on the activities and strategies used to implement the innovation.
The construct of “Teaming” was discussed by the majority of participants. This construct was
important to being a facilitator to the implementation of ICWA:
“The tribe was involved from the beginning and they remained involved. All the social
workers were in regular contact with the tribal representative, inviting them to Child and

53
Family Team (CFT) meetings, discussing placement, the case plan, and permanency
options. The Tribe was just regularly consulted and in contact with. They had
interactions with the therapist as much as they wanted, they were involved in the all the
big decisions, and they were in court most of the time. So just from beginning to end, the
tribe was involved. And I think it just made things run smooth, and they were in
agreement to the adoption.”
With half of the participants mentioning this construct, it is apparent that the absence of
or lack of teaming remains a barrier to implementation:
“The county took jurisdiction over this matter and did everything they possibly could to
move to termination of parental rights. Not involving the tribe with case management,
case planning, or visitations. We wouldn't even get notice of court hearings until after
things were done… And so, it has always been an issue for tribes to be able to have an
equal voice, to be able to be an equal partner, with county agencies on CPS cases.
Always, it’s always a fight.”
DISCUSSION
Outer Setting
The Office of Tribal Affairs (OTA) is placed under the California Department of Social
Services and their aim is to improve government-to-government relationships between the state
and California Indian Tribes, Counties and Tribal Governments, as well as working with Native
American stakeholders (Office of Tribal Affairs, 2024). OTA seemed to be a highly favored
resources amongst Tribes during implementation. They are able to advocate for Tribes as well as
provide guidance for the implementation of ICWA. Their role is effective and contributes to the
success of implementation of ICWA.

54
Another area is cultural services for AIAN children and families. The barrier arises when
there are no cultural services available or when counties are not referring AIAN families to these
resources (Hand, 2006). Therefore, counties should make an effort to develop relationships with
the cultural organizations in the area. By knowing the cultural organizations in the area and the
services that are available to AIAN children and families, social workers can better serve and
implement ICWA.
Inner Setting
Participants discussed the importance of having ICWA courts as well as particular ICWA
units or an individual who specializes in ICWA cases. These entities provide a cultural
understanding as well as an expertise in the implementation of ICWA. These are necessary when
working with AIAN populations. These can also decrease the case load for other social workers
in the department as the ICWA cases would be filtered to these specialized units or individuals.
Counties should create an action plan to incorporate these pieces into their programs to best
serve AIAN children and families.
Another aspect was creating a relationship with Tribes. To be effective in implementing
ICWA, there needs to be communication and collaboration with Tribes. However, this cannot be
done without a developed relationship. Some methods of doing this include the creation of
roundtables where stakeholders come together to discuss issues happening around ICWA
implementation. This is a space dedicated to individuals who want to improve their
implementation practices and develop relationships with other stakeholders. With that said, there
are individuals who do not attend nor want to. Therefore, these individuals are the ones who need
to develop the relationships the most.

55
Another area that was found to be effective was communication. By having clear and
transparent communication, the team can better serve AIAN children and families. The Bureau
of Indian Affairs (2016) deems it best practice to communicate with the Tribe about what is
happening with the AIAN child throughout the duration of the ICWA case. In addition, effective
communication contributes to collaboration, teamwork, and the overall successful
implementation of ICWA.
Finally, the last discussion point was about inadequate training. There is a clear
consensus that training needs to be improved. Social workers receive one day of ICWA training
as a new hire, but not expected to maintain or update their knowledge throughout the duration of
their employment. The training would best serve as an annual requirement so that ICWA can
stay relevant to social workers and they can be best prepared to implement ICWA as it arises.
Individuals
There needs to be a way to create leadership buy-in from child welfare supervisors. In
child welfare, it has been found that supervisors have the power to build effective teams and
advance frontline practice by creating a supportive environment (Center for the Study of Social
Policy, 2006). By having a supervisor who is dedicated to ensuring that their unit is
implementing ICWA and prioritizing improving implementation of ICWA, this will trickle down
to the social workers. Leadership buy-in is important to the implementation of ICWA.
Implementation
The implementation of ICWA is more successful as stakeholders begin to collaborate
with one another. This was apparent throughout the cases as the more collaboration was seen as a
facilitator while the lack of collaboration created a barrier to implementation. Therefore, there is
a need to strengthen collaboration when implementing ICWA. The collaboration happens

56
amongst various stakeholders. For example, between county social workers and Tribes as well as
between Tribes and the court system (i.e., judges, lawyers). T
Characteristics
The capability of stakeholders to successfully implement ICWA remained both a barrier
and facilitator. As a stakeholder is more capable, the more implementation was successful. On
the other hand, the less capable, the less implementation was successful. Therefore, there needs
to be a push for a way to hold social workers accountable for not completing tasks necessary for
successful implementation. In addition, motivation to implement ICWA needs to be improved.
One way to create motivation is through training so that social workers are able to understand the
importance of ICWA. By learning about the historical trauma faced by AIAN communities, how
ICWA came to be, and how to properly implement it, social workers may be better prepared to
carry out their duties. In addition, motivation efforts can be approved through accountability.
Currently, there are no consequences for not implementing ICWA. Therefore, social workers
may not see the importance or be held accountable for the implementation of ICWA. In addition,
child welfare departments may not make an effort to ensure that implementation of ICWA is
being followed because they are not at risk of losing funding or facing additional consequences.
By improving the capability and motivation, then the implementation of ICWA can improve.
Implications for Social Work
Social work practice is guided by the National Association of Social Work (NASW)
Code of Ethics. These values and their accompanying ethical principles are what drives the field.
By identifying the barriers and facilitators to ICWA, social workers can do their part to address
micro-level barriers. One example is the value of competence, which the NASW describes as
“Social workers continually strive to increase their professional knowledge and skills and to

57
apply them in practice” (National Association of Social Work, 2021). This value would demand
that social workers make an effort to increase their knowledge and skills as it pertains to cultural
competency and implementing ICWA. As a social worker in the child welfare field, it is
important to understand the population one is working with, understand the particular policies
that one’s job requires, and to approach each case with a trauma-informed lens.
Another social work value is the importance of human relationships. NASW describes
this as “Social workers understand that relationships between and among people are an important
vehicle for change. Social workers engage people as partners in the helping process. Social
workers seek to strengthen relationships among people in a purposeful effort to promote, restore,
maintain, and enhance the well-being of individuals, families, social groups, organizations, and
communities” (National Association of Social Work, 2021). Barriers noted in this study involved
the lack of partnership and relational connections between county social workers and Tribes.
Therefore, it is important for social workers to see Tribes as a mutual partner in the
implementation of ICWA. Social workers should make a conscious effort to create and maintain
a working relationship with local tribes in their areas so that there is a better collaborative effort
around ICWA cases.
Finally, one other relevant and important social work value is dignity and worth of the
person. NASW describes this as “Social workers treat each person in a caring and respectful
fashion, mindful of individual differences and cultural and ethnic diversity. Social workers
promote clients’ socially responsible self-determination” (National Association of Social Work,
2021). A portion of the barriers discusses issues of racism. It is important for social workers to
be aware of their explicit and implicit biases when working with vulnerable populations,
especially AIAN populations. Therefore, social workers should make an effort to better

58
understand the culture of Tribes with which they engage. Overall, a social worker must
understand and appreciate diversity among and within AIAN populations; know the history,
culture, and contemporary realities of specific AIAN clients; have good general social work
skills and strong skills in patience, listening, and tolerance of silence; be aware of one’s own
biases and need for wellness; display humility and a willingness to learn; be respectful,
nonjudgmental, and openminded; value social justice and decolonize one’s own thought
processes (Weaver, 1999).
LIMITATIONS AND FUTURE RESEARCH
There were several limitations to this study. The first limitation is there was a small
sample size. The second limitation was that although we had a diverse sample of stakeholders,
we may have only had one viewpoint for that particular stakeholder. Therefore, it is difficult to
generalize the results. Future research would include participants that represented judges or
county counsel, which would provide better insight into the implementation barriers and
facilitators for ICWA in the court system, which is an integral piece to ICWA implementation.

59
References
Brown, E. F., Limb, G. E., Chance, T., Munoz, R. (2002) The Indian Child Welfare Act: An
Examination of State Compliance in Arizona. Seattle WA: Casey Family Programs.
Bureau of Indian Affairs (2016). Guidelines for Implementing the Indian Child Welfare Act.
Retrieved from https://www.bia.gov/sites/default/files/dup/assets/bia/ois/pdf/idc2-
056831.pdf
Center for the Study of Social Policy (2006). Using a Competency Model to Increase Frontline
Supervisor Effectiveness in Child Welfare Agencies. Hired for Good. Retrieved from
https://www.socialserviceworkforce.org/system/files/resource/files/Compentency-ModelSupervisor-Effectiveness-Child%20Welfare.pdf
Damschroder, L. J., Aron, D. C., Keith, R. E., Kirsh, S. R., Alexander, J. A., & Lowery, J. C.
(2009). Fostering implementation of health services research findings into practice: a
consolidated framework for advancing implementation science. Implementation science :
IS, 4, 50.
Damschroder, L. J., Reardon, C. M., Widerquist, M. A. O., & Lowery, J. (2022). The updated
Consolidated Framework for Implementation Research based on user feedback.
Implementation Science : IS, 17(1), 1–75.
Earle, K. A. & Cross, A. (2001). Child Abuse and Neglect Among American Indian/Alaska
Native Children: An Analysis of Existing Data. Seattle, WA: Casey Family Programs.
First 5 Center for Children’s Policy (2023). Support for Native American Infants, Toddlers and
their Families in California. Retrieved from https://first5center.org/assets/files/Supportfor-Native-American-Infants-Toddlers-and-their-Families-in-CA.pdf
Groves, J. (1981). Implementation of the Indian child welfare act of 1978.
Hand, C. A. (2006). An Ojibwe perspective on the welfare of children: Lessons of the past and
visions for the future. Children and Youth Services Review, 28(1), 20–46.
Hsieh, H.-F., & Shannon, S. E. (2005). Three Approaches to Qualitative Content Analysis.
Qualitative Health Research, 15(9), 1277–1288.
Judicial Council of California (2021). California Tribal Communities.
https://www.courts.ca.gov/3066.htm
Limb, G. E., & Brown, E. F. (2008). An Examination of the Indian Child Welfare Act Section of
State Title IV-B Child and Family Services Plans. Child & Adolescent Social Work
Journal, 25(2), 99–110.

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Los Angeles City/County Native American Indian Commission (n.d.). Tribal Governments.
https://lanaic.lacounty.gov/resources/tribal-governments/
Moore, S. (2020). Indian Child Welfare Act of 1978: An Analysis of Policy Implementation.
National Association of Social Workers (NASW). (2021). National Association of Social
Workers Code of Ethics.
https://www.socialworkers.org/About/Ethics/Code-of-Ethics/Code-of-Ethics-English
National Indian Child Welfare Association (n.d.). Top 10 ICWA Myths: Fact Sheet.
https://www.nicwa.org/wp-content/uploads/2017/04/Top-10-ICWA-Myths.pdf
National Indian Child Welfare Association (2015). Setting the Record Straight: The Indian Child
Welfare Act Fact Sheet.
Office of Tribal Affairs (2024). Welcome to the Office of Tribal Affairs. Retrieved from
https://www.cdss.ca.gov/inforesources/tribal-affairs
Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K. (2015).
Purposeful Sampling for Qualitative Data Collection and Analysis in Mixed Method
Implementation Research. Administration and Policy in Mental Health and Mental
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Reza, C. C. (1989). The impact of the Indian child welfare act of 1978 on the reunification of
American Indian families.
Rose, G. (2008). All County Letter No. 08-02. Department of Social Services, State of California
Health and Human Services Agency.
Unger, S. (1977). The Destruction of American Indian families. New York: Association on
American Indian Affairs.
Waddell, L. D. (2002). The Indian child welfare act and American Indian children receiving
child welfare services in Butte county, California.
Wares, D. M., Wedel, K. R., Rosenthal, J. A., & Dobrec, A. (1994). Indian Child Welfare: A
Multicultural Challenge. Journal of Multicultural Social Work, 3(3), 1–16.
Weaver, H. N. (1999). Indigenous People and the Social Work Profession: Defining Culturally
Competent Services. Social Work (New York), 44(3), 217–225.
Woods, S. & Summers, A. (2016). Technical assistance bulletin: Disproportionality rates for
children of color in foster care (Fiscal Year 2014). National Council of Juvenile and
Family Court Judges: Reno, NV.

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Chapter 4. The Indian Child Welfare Act of 1978: Recommendations for Policy
Implementation Strategies in California (Paper 3)
Highlights
• This study aimed to identify recommendations on strategies to improve implementation
of ICWA in California.
• Overall, 23 out of the 73 strategies were mentioned throughout the interviews. Then,
using the study by Waltz et al. (2015) that determined the applicability of the ERIC
recommendation strategies, it was found that 12 strategies were identified as being the
most important and feasible.
• Recommendations discussed improving ICWA training provided to county social
workers as well as including additional stakeholders such as judges and county counsel,
making ICWA training an annual mandate, promoting a trauma-informed care approach,
creating educational materials for stakeholders and AIAN families, improving database
systems, developing ICWA units and ICWA courts, and creating roundtables or ICWA
task force meetings.
• Implications for social work discussed developing and implementing an ICWA
curriculum for students interested in working with children, youth, and families. In
addition, social workers can advocate for ICWA through law and policy as well as
enhance their cultural competency skills when working with AIAN children, families,
and Tribes.

62
Abstract
Objective: This study aimed to identify recommendations on strategies to improve
implementation of ICWA in California. Methods: Qualitative interviews were conducted with
12 participants across California, representing stakeholders. The interviews were conducted
between late February 2024 and early May 2024. Results: Using the Expert Recommendations
for Implementing Change (ERIC), participant recommendations were found in seven of the nine
implementation categories. Overall, 23 out of the 73 strategies were mentioned throughout the
interviews. Then, using the study by Waltz et al. (2015) that determined the applicability of the
ERIC recommendation strategies, it was found that 12 strategies were identified as being the
most important and feasible.
Discussion: Recommendations discussed improving the ICWA training provided to county
social workers as well as including additional stakeholders such as judges and county counsel,
making ICWA training an annual mandate, promoting a trauma-informed care approach, creating
educational materials for stakeholders and AIAN families, improving database systems,
developing ICWA units and ICWA courts, and creating roundtables or ICWA task force
meetings. Implications for social work were also discussed.

63
INTRODUCTION
The Indian Child Welfare Act (ICWA) of 1978 (25 U.S.C. §§ 1901-63) is a federal law
aimed at preserving cultural and familial ties among Native American children and families
while encouraging respect for tribal authority in decisions concerning the placement of Native
American children in foster care (Brown et al., 2002). It also limits states’ powers regarding
Indian children and imposes specific procedural requirements on state courts and state child
welfare agencies in the removal and placement of Indian children (Brown et al., 2002). A need
for this law became apparent after a 1976 study by the Association on American Indian Affairs
(AAIA). The findings reported that 25% to 35% of all Indian children were being placed in outof-home care (Unger, 1977). Of those children being placed in out-of-home care, 85% were
being placed in non-Indian homes or institutions (Unger, 1977).
Today, Native American children are overrepresented in foster care at a rate 2.7 times
greater than their proportion in the general population (Woods & Summers, 2016). This means
that although Native American children are just 0.9% of all children in the United States, they
are 2.1% of all children placed outside their homes in foster care (Woods & Summers, 2016).
These numbers do not account for children who are placed through tribal authorities; it is
estimated that one-third to 40% are placed in foster care by tribal authorities (Earle & Cross,
2001). Hence, the number of Native American children placed in foster care is higher than
reported and it is evident now more than ever that compliance with the ICWA is imperative to
provide the best possible outcomes for AIAN children and families.
ICWA has been labeled the “gold standard” in child welfare practice by a coalition of 18
national child advocacy organizations (National Child Welfare Act, 2015). This law lessens the
trauma of removal by emphasizing placement with family and community while promoting the

64
best interest of Indian children by keeping them connected to their culture, extended family, and
community, which are proven protective factors (National Child Welfare Act, 2015). This law
also encourages states to develop effective relationships and procedures with tribes to carefully
coordinate the care of AIAN children and families, but research has revealed that there seems to
be a disconnect.
AIAN Population in California
California is home to the nation’s largest AIAN population, with approximately 720,000
AIAN residents (Judicial Council of California, 2021). Currently, there are 109 federally
recognized tribes in California with 78 entities petitioning for recognition (Los Angeles
City/County Native American Indian Commission, n.d.). Overall, there are nearly 100 separate
reservations or Rancherias located in the state of California (Judicial Council of California,
2021). Figure 1 shows the map of California along with the federally recognized tribes. This map
does not include the Rincon Band of Luiseño Indians and the La Jolla Band of Luiseño Indians.
Approximately 90% of the AIAN population in California live in cities and urban areas with
only 3% living on tribal lands (Rancherias and reservations) (First 5 Center for Children’s
Policy, 2023).

65
Figure 4.1: Map of California Tribal Lands (List of the Federally Recognized Tribes)
California is home to over 346,000 AIAN children, one of the largest populations of
AIAN children in the United States (First 5 Center for Children’s Policy, 2023).
Implementation of ICWA
Data shows that public child welfare systems often fail to identify Native American
children, fail to provide adequate notice to tribes and families, and/or fail to place Native
American children in culturally appropriate homes (Barnes, Brown & McCarty-Caplan, 2019). In
addition, implementation of ICWA frequently suffers from inadequate training of child welfare
Cabazon
Torres-Martinez
Ramona
Pala
Table Mountain
Big Sandy
Santa Ynez
Ione Band
Jackson
CC AA LL II FF OO RR NN II AA
Wade
Parcels
Elk
Valley Karuk
Karuk
Fort Bidwell
Quartz Valley
Yurok
XL Ranch
Cedarville
Alturas Hoopa
Big
Lagoon
Lookout Trinidad
Big Bend Likely Roaring Creek
Montgomery Creek
Table Bluff
Rohnerville
Redding Rancheria
Susanville
Blue Lake
Pit River
Greenville Susanville
Round
Valley
Laytonville
Grindstone Berry Creek
Enterprise Mooretown
Coyote
Valley Redwood Valley
Upper Lake
Colusa
Smith
River
Robinson
Big Valley
Guidiville Cortina
Pinoleville
Manchester
Sulphur
Bank Hopland
Rumsey
Middletown
Stewarts
Point Washoe
(Woodfords
Community)
Shingle
Springs
Bridgeport
Benton Paiute
Bishop North Fork Picayune
Big Pine
Cold Springs
Fort Independence
Lone Pine
Santa Rosa
Tule
River
San Manuel Twenty-Nine
Palms Morongo
Agua Caliente Soboba
Cabazon
Augustine Cahuilla
Santa Rosa
Pechanga
Pauma-Yuima Los Coyotes
San Pasqual Santa Ysabel Mesa Grande Inaja-Cosmit
Barona Capitan Grande
Viejas Cuyapaipe Quechan Sycuan Manzanita
La Posta Jamul Indian Village Campo
Tuolumne
Sheep Ranch
Chicken Ranch
Fort
Mojave
Chemehuevi
Paskenta
Chico Rancheria
Dry Creek
Cloverdale
Graton
Lytton
Auburn Rancheria
Timbisha
Homelands
Sherwood
Valley
Me-Wuk
Colorado
River
ALAMEDA
COUNTY
ALPINE
COUNTY AMADOR
BUTTE
CALAVERAS
COUNTY
COLUSA
CONTRA
COSTA
DEL NORTE
COUNTY
EL DORADO
FRESNO
COUNTY
GLENN
HUMBOLDT
COUNTY
IMPERIAL
COUNTY
INYO
COUNTY
KERN
COUNTY
KINGS
COUNTY
LAKE
LASSEN
COUNTY
LOS
ANGELES
COUNTY
MADERA
COUNTY
MARIN
COUNTY
MARIPOSA
COUNTY
MENDOCINO
COUNTY
MERCED
COUNTY
MODOC
COUNTY
MONO
COUNTY
MONTEREY
COUNTY
NAPA
NEVADA
ORANGE
COUNTY
PLACER
PLUMAS
COUNTY
RIVERSIDE
COUNTY
SACRA
MENTO
SAN
BENITO
COUNTY
SAN
BERNARDINO
COUNTY
SAN DIEGO
COUNTY
SAN FRANCISCO COUNTY
SAN
JOAQUIN
COUNTY
SAN LUIS
OBISPO
COUNTY
SAN MATEO
COUNTY
SANTA
BARBARA
COUNTY
SANTA
CLARA
SANTA COUNTY
CRUZ
COUNTY
SHASTA COUNTY
SIERRA
COUNTY
SISKIYOU
COUNTY
SOLANO
COUNTY
SONOMA
STANISLAUS
COUNTY
SUTTER
TEHAMA
COUNTY
TRINITY
COUNTY
TULARE
COUNTY
TUOLUMNE
COUNTY
VENTURA
COUNTY
YOLO
YUBA
0
µ25 50 100 Miles
Tribal Lands
County Boundary
Sources: U.S. Census Bureau (2011),
ESRI (2006), TANA (2006).
AIR1100040_3 16 May 2011
CALIFORNIA TRIBAL LANDS

66
personnel, there are misinterpretations of the law, a lack of data collection, and at times willful
ignorance (National Indian Child Welfare Association, 2015).
On a federal policy level, ICWA is the only major federal child welfare law that does not
have oversight assigned to a specific federal agency and does not have a regular evaluation of
implementation related to either process or outcome (Simmons, 2014). There seems to be limited
accountability, few consequences, and lack of urgency in improving the implementation of
ICWA which contributes to the repeated trauma faced by Native American communities. A
policy brief developed by the National Indian Child Welfare Association stated that there is
limited research available on ICWA compliance (2024).
Expert Recommendations for Implementing Change (ERIC) Recommendation Strategies
The ERIC Recommendation Strategies is a compilation of 73 implementation strategies
developed by a panel of implementation science and clinical practice experts. These strategies
were then categorized into 9 content areas: 1) Engage consumers; 2) Use evaluative & iterative
strategies; 3) Change infrastructure; 4) Adapt & tailor to the context; 5) Develop stakeholder
interrelationships; 6) Utilize financial strategies; 7) Support clinicians; 8) Provide interactive
assistance; and 9) Train & educate stakeholders (Waltz et al., 2015). These strategies can be used
to make action-oriented plans and mitigate or overcome anticipated barriers (Powell et al., 2015).
The Current Study
This study aimed to identify recommendations on strategies to improve implementation
of ICWA in California. By using the ERIC Recommendation Strategies, it will help to
strategically identify feasible strategies to decrease the barriers and support the facilitators, as
mentioned in Chapter 3, to implement ICWA.

67
METHODS
Participants
Participants in this study were a purposively selected sample (Palinkas et al., 2015),
consisting of different stakeholders responsible for ICWA implementation. Eligible participants
had to be: 1) be actively working with ICWA and 2) be located in California. This study was
able to recruit 12 participants across California, representing areas of Northern California,
Central California, and Southern California. For a diverse perspective, this study was able to
recruit individuals who implement ICWA, such as county social workers, tribal ICWA social
workers, qualified expert witnesses, state government, and native organizations that represent
tribes. This study was approved by the Institutional Review Board (IRB) of the University of
Southern California and informed consent was obtained from all participants.
Data Collection
A semi-structured interview guide was used to organize and conduct interviews with
participants via the Zoom online platform. During the qualitative interviews, participants were
also asked about recommendations on how to improve ICWA implementation in California.
Interviews were conducted between late February 2024 and early May 2024. Interview lengths
ranged from approximately 45 minutes to 1.5 hours. The interviews were then transcribed using
Otter.ai.
In Chapter 2, participants were asked to discuss barriers and facilitators to the
implementation of ICWA. This chapter aimed to gather recommendations on how to improve the
barriers and sustain the facilitators. The participants were asked questions, such as “Do you have
any recommendations on how to sustain factors like these mentioned from the case?” and “Do
you have any recommendations on how to overcome the barriers mentioned from the case?” In

68
addition, there was a portion of questions that asked about implementation strategies that they
feel would improve implementation of ICWA.
Data Analysis
This study used a directed content analysis, which is a structured process by using the
categories of an existing framework for initial coding categories (Hsieh & Shannon, 2005). The
framework that guided the analysis was the Expert Recommendations for Implementing Change
(ERIC) Implementation Strategies to categorize responses. The ERIC Implementation Strategies
categories (Waltz et al., 2015) were used as the themes and the strategies were used as the subthemes. A codebook was developed using the themes and subthemes of the ERIC
Implementation Strategies. Then, participant responses were mapped to the themes and
subthemes. All coding was done using NVivo.
RESULTS
Upon analysis, participant recommendations were found in seven of the nine
implementation categories. From most to least mentioned were: 1) Train and Educate
Stakeholders; 2) Provide Interactive Assistance; 3) Support Clinicians; 4) Develop Stakeholder
Interrelationships; 5) Use Evaluative and Iterative Strategies; 6) Change Infrastructure; and 7)
Utilize Financial Strategies. Overall, 23 out of the 73 strategies were mentioned throughout the
interviews. The clusters, strategies, ERIC definitions, specific ICWA implementation examples,
and number of participants who mentioned the above are outlined in Table 4.1.
Train and Educate Stakeholders
This category had recommendations from all 12 of the participants (100%). A majority of
participants discussed the importance of making the ICWA training more dynamic as well as
conducting ongoing training. Participants shared their recommendations on how to improve the

69
training, such as by adding panels, survivors of boarding schools, and inclusion of AIAN voice.
One participant recalls a training that covered various components, which may help to improve
implementation:
“The state contracted with [Tribal STAR] to develop the training and they worked with
elders and got a great training. It's only one day, but it touches upon the history,
disparities, and the history of racism and those types of things. We really try to reach
people at the heart level. And there's even activities like, ‘okay imagine you lost
everything you know and there's no family. When have you felt like this?’ It's a good
process so they can tune into that level of emotion and hope that translates into empathy
when it comes to ICWA implementation.”
In addition, participants felt that the ICWA training for social workers should be done
annually. “I think that in order for things to change there has to be more required training, and
not just a one shot. That ICWA training, like CPR, should be a regular requirement. It should not
be one and done.” In addition, participants felt that it was important to expand the annual
training to include leadership as well as judges, county counsel, and family lawyers. One
participant stated:
“I believe every individual CSW, supervising CSW, commissioner, judge, attorney, both
parent and child attorney should receive ICWA retraining to include various cultural
components annually. I really do believe that the constant repetitive refresher coupled with
knowledge testing at the culmination of each class can help them retain rather than dismiss the
important requirements and necessities.”

70
Another recommendation included creating an ICWA curriculum that would be a
requirement for college graduation in professions that implement ICWA. One participant
recommends:
“Yeah, the Title IV-E. I think it should definitely be acquired as part of the IV-E
[Training Program for the Social Work] master's program, but I think just masters, you
should. It should be offered, at least, for a class. Required for IV-E, but then you could
take it as your elective course, if you want, for masters… At a minimum, it could be a
class required for people getting a law degree. No matter what, it's Federal Indian Law,
you'd have to take the class and its part of the class. But that changes whole requirements
with regulations, but I think it can be done. I think it needs to be a required class for both
professions.”
Other recommendations included consulting with Tribes, providing AIAN families with
materials about the ICWA court process, and having county social workers shadow an ICWA
worker.
Provide Interactive Assistance
This category had recommendations from 9 out of the 12 participants (75%). The strategy
of facilitation discussed county and tribes improving the way that they work together through
communication and collaboration. One example of facilitation was highlighted by a participant
who stated:
“…we know that [compliance] would improve if there was better communication,
coordination, teamwork, collaboration... We know that [compliance] would improve. It
would improve the quality of that child and family's life. It would improve the quality and
effectiveness of services to the family, in which includes the child.”

71
Additionally, participants recommended utilizing the Office of Tribal Affairs, a
centralized technical assistance, to improve implementation.
Support Clinicians
This category had recommendations from 8 out of the 12 participants (67%). Participants
recommended lowering the case load for county social workers to assist with implementation,
having culturally relevant services, and incorporating a reminder for social workers that would
assist in the implementation of ICWA. One participant recommended:
“I want to create a handful of flash cards that guide inquiry and contact and that outline
placement preferences... I think that, you know, the social worker has that on their wallet,
or on their business cards printed, to remind them in the middle of the kid that's bleeding,
or the mother is screaming, or the father with a gun, or whatever the circumstances are.
They need to be able to refocus and go, ‘why am I here, this is why I'm here, this is what I
need to do.’”
Table 4.1. ERIC Implementation Strategy Clusters, Definitions, ICWA Implementation
Strategy Examples, and Participant Response
ERIC
Implementation
Strategy
Grouping
Number of
Participants
Who
Mentioned
Strategies
in These
Groupings
(n=12)
ERIC
Implementation
Strategy
ERIC
Implementation
Strategy
Definition
ICWA
Implementation
Strategy
Recommendation
Examples
Number of
Participants
Who
Mentioned
Implementation
Strategies
(n=12)
Percentage
(%)
Train and
educate
stakeholders
12 Work with
educational
institutions
Encourage
educational
institutions to
train clinicians in
the innovation
Require Bachelor
of Social Work
(BSW) and
Master of Social
Work (MSW)
Students to pass
an ICWA course
3 25%
Require Law
School Students
to pass an ICWA
course

72
Develop
educational
materials
Develop and
format manuals,
toolkits, and other
supporting
materials in ways
that make it easier
for stakeholders
to learn about the
innovation and for
clinicians to learn
how to deliver the
clinical
innovation
Educational
materials to be
disseminated to Tribes and
families about
ICWA process
2 17%
Distribute
educational
materials
Distribute
educational
materials
(including
guidelines,
manuals, and
toolkits) in
person, by mail,
and/or
electronically
Provide Native
American families
educational
materials about
the ICWA court
process
2 17%
Conduct
ongoing training
Plan for and
conduct training
in the clinical
innovation in an
ongoing way
Require
CPS/DCFS
workers to
complete an
annual training
7 58%
Require Juvenile
and Family Court
judges to
complete an
annual training
Require Juvenile
Dependency
lawyers to
complete an
annual training
Make training
dynamic
Vary the
information
delivery methods
to cater to
different learning
styles and work
contexts, and
shape the training
in the innovation
to be interactive
Integrate
personalized
stories (i.e. panel)
9 75%
Integrate a portion
on Historical
Trauma
Conduct
educational
meetings
Hold meetings
targeted toward
different
stakeholder
groups (e.g.,
providers,
administrators,
Educate Native
American families
on ICWA (pre
and/or post
involvement with
the Child Welfare
system)
5 42%

73
other
organizational
stakeholders, and
community,
patient/consumer,
and family
stakeholders) to
teach them about
the clinical
innovation
Judges to be
trained in ICWA
Lawyers to be
trained in ICWA
Provide
Ongoing
Consultation
Provide ongoing
consultation with
one or more
experts in the
strategies used to
support
implementing the
innovation
Counties to
consult with
Tribes
2 17%
Shadow Other
Experts
Provide ways for
key individuals to
directly observe
experienced
people engage
with or use the
targeted practice
change/innovation
County social
worker to shadow
ICWA worker
1 1%
Provide
Interactive
Assistance
9 Centralize
technical
assistance
Develop and use a
centralized
system to deliver
technical
assistance focused
on
implementation
issues
Use of Office of
Tribal Affairs
(OTA)
3 25%
Facilitation A process of
interactive
problem solving
and support that
occurs in a
context of a
recognized need
for improvement
and a supportive
interpersonal
relationshi
p
Communication
and Collaboration
between the
County and Tribes
8 67%
Support
Clinicians
8 Revise
Professional
Roles
Shift and revise
roles among
professionals who
provide care, and
redesign job
characteristics
Reducing
caseload
3 25%
Develop
resource sharing
agreements
Develop
partnerships with
organizations that
have resources
needed to
Organizations that
provide cultural
services
6 50%

74
implement the
innovation
Remind
Clinicians
Develop reminder
systems designed
to help clinicians
to recall
information
and/or prompt
them to use the
clinical
innovation
Cards to place in
work badge to
remind county
worker about
inquiry
2 17%
Develop
stakeholder
interrelationships
7 Build a coalitio
n Recruit and
cultivate
relationships with
partners in the
implementation
effort
Relationship
building between
county and Tribes
5 42%
Reaching out to
Tribes
Use advisory
boards and
workgroups
Create and engage
a formal group of
multiple kinds of
stakeholders to
provide input and
advice on
implementation
efforts and to
elicit
recommendations
for improvements
Create a
roundtable with
County, Tribal,
and organizational
representation
2 17%
Promote
network
weaving
Identify and build
on existing high
-
quality working
relationships and
networks within
and outside the
organization,
organizational
units, teams, etc.
to promote
information
sharing,
collaborative
problem
-solving,
and a shared
vision/goal
related to
implementing the
innovation
Develop a group
for Tribal ICWA
Social Workers
that focuses on
professional and
peer support
2 17%
Identify and
Prepare
Champions
Identify and
prepare
individuals who
dedicate
themselves to
supporting,
marketing, and
driving through
an
Counties to create
ICWA Units (i.e.
American Indian
Unit)
4 33%

75
implementation,
overcoming
indifference or
resistance that the
intervention may
provoke in an
organization
Use Evaluative
and Iterative
Strategies
7 Audit and
provide
feedback
Collect and
summarize
clinical
performance data
over a specified
time period and
give it to
clinicians and
administrators to
monitor, evaluate,
and modify
provider behavior
County to collect
data on their
ICWA cases (i.e.
appeal)
2 17%
Develop and
implement tools
for quality
monitoring
Develop, test, and
introduce into
quality
-
monitoring
systems the right
inpu
t—the
appropriate
language,
protocols,
algorithms,
standards, and
measures (of
processes,
patient/consumer
outcomes, and
implementation
outcomes) that are
often specific to
the innovation
being
implemented
Developing a tool
that helps to go
through the steps
(i.e. inquiry)
5 42%
Change
Infrastructure
6 Mandate change Have leadership
declare the
priority of the
innovation and
their
determination to
have it
implemented
Have CPS or
DCFS Leadership
buy
-in to create a
top
-down
approach
4 33%
Change Physical
Structure and
Equipment
Evaluate current
configurations
and adapt, as
needed, the
physical structure
and/or equipment
(e.g., changing
the layout of a
Developing
ICWA courts
across counties
4 33%

76
room, adding
equipment) to
best
accommodate the
targeted
innovation
Utilize Financial
Strategies
2 Access New
Funding
Access new or
existing money to
facilitate the
implementation
Increase in
funding towards
County ICWA
Units
1 1%
Develop
disincentives
Provide financial
disincentives for
failure to
implement or use
the clinical
innovations
State decreasing
funding to
counties who do
not comply with
ICWA
1 1%
Develop Stakeholder Interrelationships
This category had recommendations from 7 out of the 12 participants (58%). Participants
recommended counties to develop a designated ICWA unit or assign a specialized position for an
individual who only handles ICWA cases as being important to the implementation of ICWA.
One participant stated:
“Yeah, I think every county needs a special skills worker. Or some of them have a Native
American Unit or Indian Unit or ICWA unit. They have different titles. Depending on the
size of the county, I think they should have units, either people in the whole unit are

77
social workers who specialize in all the different parts of the [Child Protective Services]
process or some smaller counties. Maybe it's the person who holds it the whole time. But
either like a unit who is that specialist, but everyone should be trained, but maybe just
have that and maybe smaller counties have like two people who are the point people, who
really are the subject matter experts. Every county needs something like that.”
Even further, some participants even mentioned the importance of having an AIAN social
worker. One participant stated:
“I think Native people doing ICWA jobs is a real big bonus to being able to work with a
family, a native family. You can relate, you can know those individuals on a different type
of spiritual level than non-natives can, and you can really make sure that ICWA itself has
a purpose and a role in the reunification or support of this family.”
Additional recommendations highlighted the importance of networking with others in the
field by utilizing ICWA roundtables as well as having a space for Tribal social workers across
California. One participant states:
“ICWA staff need support and they need to have the opportunity to have their own
groups to be able to manage the stress and the weight of what it is that they carry and
manage on a daily basis. Everything is so confidential. You can't go home and purge
your day. So, there needs to be some mechanism put into place so that workers have
groups… We had a support group that met on a quarterly basis. With being able to have
connections with each other, to just go, ‘oh, my gosh, what would you do here?’ And, you
know, ‘I’m at the point where I'm just going to close my door and leave and not come
back.’ ICWA has laid out a good framework to benefit the family. But if ICWA could
provide some support for staff workers as well, that would be great.”

78
Use Evaluative and Iterative Strategies
This category had recommendations from 7 out of the 12 participants (58%). One
participant highlights the importance of collecting appropriate data pertinent to ICWA cases,
stating:
“So I guess that's another thing, the data is a huge thing because that plays a factor into
policies, laws, procedure, all that stuff. And the data is so wrong. Everyone knows this…
So that's a big piece of like implementation because it factors money, like everything.
Yeah, people making it some big thing, how do we fix it? I'm like it's not hard, but it takes
time.”
Participants recommended creating a database that includes inquiry so that ICWA can be
implemented correctly as well as having a Structured Decision-Making tool. In addition, there
was an emphasis on developing or using culturally appropriate assessments.
Change Infrastructure
This category had recommendations from 6 out of the 12 participants (50%). Participants
recommended implementing an ICWA courtroom. This would be a courtroom designed for
AIAN children and families and would only hear ICWA cases. Also, participants recommended
having leadership buy-in to prioritize the implementation of ICWA. One participant highlighted
this importance:
“I've often thought maybe the higher echelon or the higher administrative bodies should
be educated so that they can see the importance and then they could disseminate all that
information down, you know, instead of going up and trying to go from the worker up.
Maybe from the top downwards too or maybe both ways, going from both angles. I think
it would be important because if your administrative body is not aware or it's not really

79
an important aspect of the day-to-day, then how is it going to be important to the person
like me on the front lines on the day to day?”
Utilize Financial Strategies
A minority of participants (17%) recommended utilizing financial strategies. One
participant recommended developing disincentives to assist with implementation: “Or if [the
county is] working with the tribes they're going to hear that information. Or if the state is really
enforcing things and says, ‘okay county folks, if you if you don't do this, we're not going to give
you this funding’ then the county is going to be like ‘we better follow statute then’ so many of
those things could be helpful.” Another participant mentions funding, stating: “Further, I'm
aware DCFS has allocated funding reasonably to the American Indian unit, to provide active
efforts and other activities to support the children's culture. I believe that's a huge step in the
right decision.”
The other recommendation was to allocate more funding to the ICWA Units, which
would allow for more resources to complete active efforts, networking, and education.
DISCUSSION
This study aimed to identify recommendations on strategies to improve implementation
of ICWA in California. Several of the 23 recommendations suggested by the participants are
consistent with recommendations suggested by previous research.
To prioritize which strategies would be most effective, reference to the study by Waltz et
al. (2015) was used to determine the potential applicability of the strategies. In this study, the
ERIC Implementation Strategies were measured to determine importance and feasibility and
placed into four quadrants. Quadrant I identified strategies found to be the most important and

80
feasible. The recommendation strategies that were provided by the participants and fit into
Quadrant I were identified in Table 4.2.
Table 4.2. Participant Recommendation Strategies Listed in Quadrant I Along With Mean
Importance and Feasibility Ratings As Identified By Waltz et al. Study
ERIC Implementation
Strategy Grouping
ERIC Implementation Strategy Importance Feasibility
Train and Educate
Stakeholders
Conduct Ongoing Training 4.17 3.87
Provide Ongoing Consultation 4.17 3.63
Develop Educational Materials 3.80 4.83
Make Training Dynamic 3.67 4.00
Distribute Educational Materials 3.50 4.77
Conduct Educational Meetings 3.27 4.50
Provide Interactive Assistance Facilitation 4.13 3.77
Use Evaluative and Iterative
Strategies
Audit and Provide Feedback 4.40 4.13
Develop and Implement Tools
For Quality Monitoring
4.37 3.63
Develop Stakeholder
Relationships
Identify Champions 4.20 3.77
Build a Coalition 3.77 3.63
Use Advisory Boards and
Workgroups
3.40 3.87
By identifying the recommendation strategies that are best applicable, by importance and
feasibility, we can begin to prioritize these strategies and begin to move towards improvement of
ICWA implementation.
Train and Educate Stakeholders
Aligning with previous research, incorporating additional training components such as
cultural competence has been found to be beneficial. One longitudinal study found that by doing
this, cultural competence of the caseworker increased as well as their knowledge about ICWA
(Lawrence, 2012). However, this training should be extended to stakeholders who play a role in
implementing ICWA within the court system (i.e. judges and lawyers). By improving the
training component for all stakeholders, it aligns with the research that “for ICWA to be

81
implemented effectively, it is essential that all participants not only have a full understanding and
appreciation of the law and tribal sovereignty, but also understand and appreciate the nature of a
tribe’s relationship to its children and families” (Judicial Council of California, 2020). Rather
than requiring this training once at hire, the requirement should be mandated annually. An annual
training would emphasize the importance of compliance as well as detail the expectations and
requirements necessary for implementation of ICWA.
In addition, it is imperative for the training to include a variety of new approaches, such
as a more personalized component. For example, including AIAN individuals to discuss their
own personal experiences with historical trauma, having local Tribes discuss cultural
importance, case studies, panels, and inviting Tribal ICWA social workers to speak to the county
social workers. By having a Tribal ICWA social worker present, this can assist with relationship
building and begin a process that moves towards better collaboration.
Another theme that continuously came up was historical trauma. Not only should the
training incorporate a historical trauma piece, but also provide a trauma-informed approach when
working with AIAN children and families. AIAN youth experience various forms of trauma at
higher rates than the rest of the U.S. population (National Indian Child Welfare Association,
2014). The child welfare system adds on to that trauma for these AIAN children and families;
therefore, it should be required that social workers in these spaces be trained in trauma-informed
care.
In addition to the training component, there should be a focus on creating a toolkit or
resource for AIAN families to understand the ICWA process. The child welfare system can be
intimidating and overwhelming, especially for the AIAN community. It is a system that
historically was used to harm AIAN communities. Therefore, if AIAN families were able to have

82
a toolkit or resource to defer to in understanding the process it may provide information to
empower that family and better advocate for themselves during the process.
Provide Interactive Assistance
It is imperative that counties and Tribes work together to achieve successful
implementation of ICWA. This relationship is built and sustained by effective communication
and collaboration. In addition, the court system (judges and counsel) needs to be active in their
relationship building, as well. This relationship begins with the education and knowledge
discussed in the previous section about historical trauma and cultural humility. In addition, some
counties have memorandums of understanding (MOU) with Tribes. However, there needs to be
enforcement of the MOU by the counties. By prioritizing relational connections with Tribes, it
has the ability to impact the effectiveness of communication and collaboration efforts when it
comes to the implementation of ICWA.
Use Evaluative and Iterative Strategies
The need for an improved database is necessary for proper implementation of ICWA.
Currently, the Child Welfare Services/Case Management System (CWS/CMS) used by the
California Department of Social Services and California counties does not collect the necessary
data needed to measure compliance with ICWA (ICWA Compliance Task Force, 2017).
Therefore, a database that is inclusive of ICWA requirements can assist county social workers in
their efforts to implement ICWA. For example, a database could prompt a social worker to report
inquiry, notice to Tribes, detail active efforts, and placement preferences. Currently, counties in
California are consistently failing to keep required records, such as documentation of active
efforts to meet the placement preferences, which the Supreme Court deems as ICWA’s “most
important substantive requirement” (ICWA Compliance Task Force, 2017). A database will

83
provide the necessary information to identify issues around ICWA cases and potential policy
development as we move towards improving implementation. This system should be uniform
across California so that it remains standardized when working with Tribes nationwide.
With a system in place that requires the collection of data of ICWA cases, there is
potential for an increase in funding to help ICWA implementation. By allocating funding
towards ICWA implementation then there is potential for an increase in ICWA compliance.
Develop Stakeholder Relationships
It is apparent that there is a need for the development of a designated ICWA unit or a
specialized position for ICWA cases. This would depend on the funding available for the
counties as an ICWA unit may not be feasible for some counties at this time. However, having a
specialized unit or individual trained in ICWA provides expertise when it comes to
implementation. These units provide stability for Tribes as they may be working with the same
social workers on the cases, enforcing the relationships to maintain communication and
collaboration. In addition, there is a cultural understanding as these units or individuals are
continuously working with Tribes and AIAN children and families. Even more effective would
be to hire AIAN social workers to assist in the implementation of ICWA.
Some counties have developed ICWA roundtables or ICWA task forces, where different
stakeholders come together to discuss issues happening around ICWA implementation. For
example, county social workers, county supervisors, Tribal representatives, Tribal ICWA social
workers, judges, counsel, Native organizations, and Qualified Expert Witnesses. These meetings,
depending on county infrastructure, can be held in-person or virtually. However virtually can be
more accessible, given that some Tribes are located in rural areas and may be unable to attend inperson meetings. It may be more sustainable as well as funding would be minimal. With 58

84
counties in California, it may not be feasible to develop 58 roundtables or task force meetings.
These meetings can be developed regionally so that surrounding counties and Tribes can attend.
These meetings promote discussion, resolution, resource sharing, and relationship building
amongst individuals implementing ICWA.
Another discussion surrounded the development of a space solely for Tribal ICWA social
workers. Again, this may be more beneficial if held virtually to promote attendance from Tribal
ICWA social workers across the state. This specific roundtable would be dedicated to sharing
experiences, insights, and provide support amongst one another. It also would promote
empowerment amongst the Tribal ICWA social workers.
Implications for Social Work
Schools of Social Work should prioritize developing and implementing an ICWA
curriculum. This curriculum can be mandated for students in the Title IV-E program, a program
designed for social work students interested in pursuing child welfare. It can also be a required
class for students interested in working with children, youth, and families or offered as an
elective. Courses designed to prepare social work students in both Bachelor of Social Work and
Master of Social Work programs to work with and/or in AIAN communities is limited to
nonexistent. In fact, the Task Force on Native Americans in Social Work Education reported that
coursework that focuses on the Indian Child Welfare Act was lacking (Cross et al., 2007). Their
suggestion was to dedicate a unit (3-hour class session) in one of the social work courses to
discussing ICWA.
Professionally, there are additional ways that social workers can make a difference. For
example, social workers can advocate for ICWA at the federal and state level. In addition, social
workers can advocate for re-structuring in their child welfare department in support for ICWA

85
units, an ICWA specialist, or implementing an ICWA court. Even more so, social workers can be
intentional in becoming trained to provide trauma-informed care. This is important when
working with AIAN communities as historical trauma has deeply impacted these communities.
With that said, social workers can reach out to create meaningful relationships with tribes so that
the relationship becomes collaborative when implementing ICWA. Overall, social workers need
to prioritize cultural competency to advocate and empower the AIAN children and families as
well as the Tribal communities whom they serve.
LIMITATIONS AND FUTURE RESEARCH
There were several limitations to this study. First, this study had a small sample size.
Therefore, the results may not be generalizable. Further research may include developing a small
pilot that incorporates the identified recommendations.

86
References
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Consequence of the Indian Child Welfare Act: American Indian Trust in Public Child
Welfare. Children and Youth Services Review, 98, 221–227.
Cross, S., Brown, E., Day, P., Limb, G., Pellebon, D., Proctor, E., Weaver, H. (2007). Task
Force on Native Americans in Social Work Education Final Report: Status of Native
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First 5 Center for Children’s Policy (2023). Support for Native American Infants, Toddlers and
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Francis, A. M., Hall, W. J., Ansong, D., Lanier, P., Albritton, T. J., & McMillan, A. (2023).
Implementation and effectiveness of the Indian Child Welfare Act: A systematic review.
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Hsieh, H.-F., & Shannon, S. E. (2005). Three Approaches to Qualitative Content Analysis.
Qualitative Health Research, 15(9), 1277–1288.
ICWA Compliance Task Force (2017). Report to the California Attorney General’s Bureau of
Children’s Justice. Retrieved from https://caltribalfamilies.org/wpcontent/uploads/2020/12/ICWAComplianceTaskForceFinalReport2017.pdf
Judicial Council of California (2021). California Tribal Communities.
https://www.courts.ca.gov/3066.htm
Lawrence, C., Zuckerman, M., Smith, B. D., & Liu, J. (2012). Building Cultural Competence in
the Child Welfare Workforce: A Mixed-Methods Analysis. Journal of Public Child
Welfare, 6(2), 225–241.
Los Angeles City/County Native American Indian Commission (n.d.). Tribal Governments.
https://lanaic.lacounty.gov/resources/tribal-governments/
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from https://www.nicwa.org/wpcontent/uploads/2016/11/2014_TraumaInformedCare_FactSheet.pdf
Palinkas, L. A., Horwitz, S. M., Green, C. A., Wisdom, J. P., Duan, N., & Hoagwood, K. (2015).
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Powell, B. J., Waltz, T. J., Chinman, M. J., Damschroder, L. J., Smith, J. L., Matthieu, M. M.,
Proctor, E. K., & Kirchner, J. A. E. (2015). A refined compilation of implementation
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Chapter 5: Conclusion
This dissertation aimed to explore the implementation of ICWA and is the first of its
kind. This dissertation added to the literature by 1) examining how ICWA is presented through
the lens of the media (Paper 1); 2) identifying barriers and facilitators to the implementation of
ICWA in California (Paper 2); and 3) identifying recommendation strategies to improve the
implementation of ICWA in California (Paper 3). These findings and the value that they bring to
the literature are discussed below.
The Indian Child Welfare Act of 1978: An Examination Through the Lens of the Media
(Paper 1)
The first paper presented in this dissertation aimed to explore how ICWA is being
presented in the media. This was done through a media analysis to better understand the specific
information being shared with the public through news articles. This becomes important as the
consumers of media consist of individuals responsible for implementation of ICWA, including
policymakers, social workers, judges, and lawyers. If there is not an accurate and clear depiction
of ICWA then implementation can be negatively affected. The results from this study showed
themes of 1) Justification, 2) Racialization, 3) Bias and Stereotyping, 4) Tribal Sovereignty, 5)
Understanding of ICWA. The results from this study show that media reporting can be improved
to increase discussion around tribal sovereignty as well as understanding ICWA. In addition,
eliminating justification statements, discussion around the racialization of ICWA, and bias and
stereotyping statements would be beneficial. In the context of social work, social workers can
best serve in this capacity by engaging in media advocacy to empower AIAN communities and
advocate for policy improvements of ICWA.

89
A Comparative Case Study: Identifying Facilitators and Barriers to ICWA
Implementation in California Using the Consolidated Framework for Implementation
Research (CFIR) (Paper 2)
The second paper in this dissertation was a comparative case study that aimed to identify
the barriers and facilitators to the implementation of ICWA in California. Home to the nation’s
largest AIAN population, understanding the barriers and facilitators in California becomes vital
in improving ICWA implementation. Using the Expert Recommendations for Implementing
Change (ERIC), participant recommendations were found in seven of the nine implementation
categories. Overall, 23 out of the 73 strategies were mentioned throughout the interviews. Then,
using the study by Waltz et al. (2015) that determined the applicability of the ERIC
recommendation strategies, it was found that 12 strategies were identified as being the most
important and feasible. The recommendations included improving the ICWA training provided
to county social workers as well as including additional stakeholders such as judges and county
counsel, making ICWA training an annual mandate, promoting a trauma-informed care
approach, creating educational materials for stakeholders and AIAN families, improving
database systems, developing ICWA units and ICWA courts, and creating roundtables or ICWA
task force meetings. In addition, the field of social work can work towards developing and
implementing an ICWA curriculum for students interested in working with children, youth, and
families. In addition, social workers can advocate for ICWA through law and policy as well as
enhance their cultural competency skills when working with AIAN children, families, and
Tribes.

90
The Indian Child Welfare Act of 1978: Recommendations for Policy Implementation
Strategies in California (Paper 3)
The third paper in this dissertation identified potentially valuable ICWA implementation
strategies. To systemically categorize the strategies that would best serve as a way to improve
implementation, the Expert Recommendations for Implementing Change (ERIC) framework was
utilized. By using the study by Waltz et al. (2015), which organized the ERIC strategies in
quadrants (Quadrants I to IV) depending on importance and feasibility, we were able to prioritize
the strategy recommendations to focus on strategies located in Quadrant I. Strategies in this
quadrant were found to be most important and feasible to implementation. The strategy groups
and recommendations were found to be: 1) Train and Educate Stakeholders: Conduct Ongoing
Training, Provide Ongoing Consultation, Develop Educational Materials, Make Training
Dynamic, Distribute Educational Materials, and Conduct Educational Meetings; 2) Provide
Interactive Assistance: Facilitation; 3) Use Evaluative and Iterative Strategies: Audit and Provide
Feedback, Develop and Implement Tools For Quality Monitoring; 4) Develop Stakeholder
Relationships: Identify Champions, Build a Coalition, and Use Advisory Boards and
Workgroups. This provided better context in how to integrate these recommendations into the
systems responsible for implementation. This included discussion around improving the ICWA
training provided to county social workers as well as including additional stakeholders such as
judges and county counsel, making the ICWA training an annual mandate, promoting a traumainformed care approach, creating educational materials for stakeholders and AIAN families,
improving the database system, developing ICWA units and ICWA courts, and creating
roundtables or ICWA task force meetings. The implications for social work are that the field
should implement an ICWA curriculum for future professional social workers. This can provide

91
a good foundation as social workers who aim to work in child welfare or with children, youth,
and families are more likely to be responsible for the implementation of ICWA. In addition,
social workers can engage in advocacy efforts on a federal and state level to push for
strengthening of ICWA as well as advocate for better practice in their respective child welfare
departments across counties.
Conclusion
This dissertation examined a diverse range of areas that impact implementation of ICWA.
It looked at the impact of media and how information presented about ICWA has the ability to
impact implementation while also exploring what areas of implementation serve as barriers and
facilitators and how we can use these to develop implementation strategies. This dissertation
contributed to the literature by 1) conducting a media analysis to identify the types of
information being disseminated through news articles, impacting stakeholders responsible for
implementing ICWA; 2) conducting a comparative case study that identified barriers and
implementation to ICWA; and 3) identifying recommendation strategies using CFIR to
systematically identify important and feasible recommendations to improve implementation. The
results from these studies highlight the micro, mezzo, and macro factors that contribute to the
implementation of ICWA and how we can utilize these areas to improve implementation. From
an implementation science viewpoint, this is the first step towards change. This dissertation best
serves as a roadmap to strengthen implementation of ICWA and best serve AIAN children and
families as well as their respective Tribal nations.

92
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Appendices
Appendix A: CFIR Domains, Sub-Domains, and Constructs Along With Their Respective
Definitions
Appendix B: ERIC Recommendation Strategies (n=73)
Appendix C: ERIC Recommendation Strategies Organized By Their Respective Cluster Along
With Mean Importance and Feasibility Ratings

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Appendix A: CFIR Domains, Sub-Domains, and Constructs Along With Their Respective
Definitions
Framework guidance:
The CFIR is intended to be used to collect data from individuals who have power and/or influence over implementation
outcomes. See the CFIR Outcomes Addendum for guidance on identifying these individuals and selecting outcomes [19]
The CFIR must be fully operationalized prior to use in a project:
(1) Define the subject of each domain for the project (see guidance for each domain below)
(2) Replace broad construct language with project-specific language if needed
(3) Add constructs to capture salient themes not included in the updated CFIR
I. Innovation domain
Innovation: The “thing” being implemented [20], e.g., a new clinical treatment, educational program, or city service
Project Innovation: [Document the innovation being implemented, e.g., innovation type, innovation core vs. adaptable
components, using a published reporting guideline [21,22,23,24]. Distinguish the innovation (the “thing” that continues when
implementation is complete) [20, 25] from the implementation process and strategies used to implement the innovation
[26, 27] (activities that end after implementation is complete) [28].]
Construct name Construct definition
The degree to which:
A. Innovation
Source
The group that developed and/or visibly sponsored use of the innovation is reputable, credible,
and/or trustable
B. Innovation
Evidence Base
The innovation has robust evidence supporting its effectiveness
C. Innovation
Relative Advantage
The innovation is better than other available innovations or current practice
D. Innovation
Adaptability
The innovation can be modified, tailored, or refined to fit local context or needs
E. Innovation
Trialability
The innovation can be tested or piloted on a small scale and undone
F. Innovation
Complexity
The innovation is complicated, which may be reflected by its scope and/or the nature and number of
connections and steps
G. Innovation
Design
The innovation is well designed and packaged, including how it is assembled, bundled, and presented
H. Innovation Cost The innovation purchase and operating costs are affordable
II. Outer Setting domain
Outer Setting: The setting in which the Inner Setting exists, e.g., hospital system, school district, state. There may be multiple
Outer Settings and/or multiple levels within the Outer Setting, e.g., community, system, state
Project Outer Setting(s): [Document the actual Outer Setting in the project, e.g., type, location, and the boundary between the
Outer Setting and the Inner Setting.]
Construct name Construct definition
The degree to which:
A. Critical Incidents Large-scale and/or unanticipated events disrupt implementation and/or delivery of the innovation
B. Local Attitudes Sociocultural values (e.g., shared responsibility in helping recipients) and beliefs (e.g., convictions
about the worthiness of recipients) encourage the Outer Setting to support implementation and/or
delivery of the innovation

98
Framework guidance:
The CFIR is intended to be used to collect data from individuals who have power and/or influence over implementation
outcomes. See the CFIR Outcomes Addendum for guidance on identifying these individuals and selecting outcomes [19]
The CFIR must be fully operationalized prior to use in a project:
(1) Define the subject of each domain for the project (see guidance for each domain below)
(2) Replace broad construct language with project-specific language if needed
(3) Add constructs to capture salient themes not included in the updated CFIR
C. Local Conditions Economic, environmental, political, and/or technological conditions enable the Outer Setting to
support implementation and/or delivery of the innovation
D. Partnerships &
Connections
The Inner Setting is networked with external entities, including referral networks, academic
affiliations, and professional organization networks
E. Policies & Laws Legislation, regulations, professional group guidelines and recommendations, or accreditation
standards support implementation and/or delivery of the innovation
F. Financing Funding from external entities (e.g., grants, reimbursement) is available to implement and/or deliver
the innovation
G. External Pressure External pressures drive implementation and/or delivery of the innovation
Use this construct to capture themes related to External Pressures that are not included in the
subconstructs below
1. Societal
Pressure
Mass media campaigns, advocacy groups, or social movements or protests drive implementation
and/or delivery of the innovation
2. Market
Pressure
Competing with and/or imitating peer entities drives implementation and/or delivery of the
innovation
3. Performance
Measurement Pressure
Quality or benchmarking metrics or established service goals drive implementation and/or delivery
of the innovation
III. Inner Setting domain
Inner Setting: The setting in which the innovation is implemented, e.g., hospital, school, city. There may be multiple Inner
Settings and/or multiple levels within the Inner Setting, e.g., unit, classroom, team
Project Inner Setting(s): [Document the actual Inner Setting in the project, e.g., type, location, and the boundary between the
Outer Setting and the Inner Setting.]
Construct name Construct definition
The degree to which:
Note: Constructs A – D exist in the Inner Setting regardless of implementation and/or delivery of the
innovation, i.e., they are persistent general characteristics of the Inner Setting
A. Structural
Characteristics
Infrastructure components support functional performance of the Inner Setting
Use this construct to capture themes related to Structural Characteristics that are not included in the
subconstructs below
1. Physical
Infrastructure
Layout and configuration of space and other tangible material features support functional
performance of the Inner Setting
2. Information
Technology
Infrastructure
Technological systems for tele-communication, electronic documentation, and data storage,
management, reporting, and analysis support functional performance of the Inner Setting
3. Work
Infrastructure
Organization of tasks and responsibilities within and between individuals and teams, and general
staffing levels, support functional performance of the Inner Setting
B. Relational
Connections
There are high quality formal and informal relationships, networks, and teams within and across
Inner Setting boundaries (e.g., structural, professional)

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Framework guidance:
The CFIR is intended to be used to collect data from individuals who have power and/or influence over implementation
outcomes. See the CFIR Outcomes Addendum for guidance on identifying these individuals and selecting outcomes [19]
The CFIR must be fully operationalized prior to use in a project:
(1) Define the subject of each domain for the project (see guidance for each domain below)
(2) Replace broad construct language with project-specific language if needed
(3) Add constructs to capture salient themes not included in the updated CFIR
C. Communications There are high quality formal and informal information sharing practices within and across Inner
Setting boundaries (e.g., structural, professional)
D. Culture There are shared values, beliefs, and norms across the Inner Setting
Use this construct to capture themes related to Culture that are not included in the subconstructs
below
1. Human
Equality-Centeredness
There are shared values, beliefs, and norms about the inherent equal worth and value of all human
beings
2. RecipientCenteredness
There are shared values, beliefs, and norms around caring, supporting, and addressing the needs and
welfare of recipients
3. DelivererCenteredness
There are shared values, beliefs, and norms around caring, supporting, and addressing the needs and
welfare of deliverers
4. LearningCenteredness
There are shared values, beliefs, and norms around psychological safety, continual improvement, and
using data to inform practice
Note: Constructs E – K are specific to the implementation and/or delivery of the innovation
E. Tension for
Change
The current situation is intolerable and needs to change
F. Compatibility The innovation fits with workflows, systems, and processes
G. Relative Priority Implementing and delivering the innovation is important compared to other initiatives
H. Incentive
Systems
Tangible and/or intangible incentives and rewards and/or disincentives and punishments support
implementation and delivery of the innovation
I. Mission
Alignment
Implementing and delivering the innovation is in line with the overarching commitment, purpose, or
goals in the Inner Setting
J. Available
Resources
Resources are available to implement and deliver the innovation
Use this construct to capture themes related to Available Resources that are not included in the
subconstructs below
1. Funding Funding is available to implement and deliver the innovation
2. Space Physical space is available to implement and deliver the innovation
3. Materials &
Equipment
Supplies are available to implement and deliver the innovation
K. Access to
Knowledge &
Information
Guidance and/or training is accessible to implement and deliver the innovation
IV. Individuals domain
Individuals: The roles and characteristics of individuals
Roles subdomain
Project Roles: [Document the roles applicable to the project and their location in the Inner Setting or Outer Setting.]

100
Framework guidance:
The CFIR is intended to be used to collect data from individuals who have power and/or influence over implementation
outcomes. See the CFIR Outcomes Addendum for guidance on identifying these individuals and selecting outcomes [19]
The CFIR must be fully operationalized prior to use in a project:
(1) Define the subject of each domain for the project (see guidance for each domain below)
(2) Replace broad construct language with project-specific language if needed
(3) Add constructs to capture salient themes not included in the updated CFIR
Construct name Construct definition
A. High-level
Leaders
Individuals with a high level of authority, including key decision-makers, executive leaders, or
directors
B. Mid-level
Leaders
Individuals with a moderate level of authority, including leaders supervised by a high-level leader
and who supervise others
C. Opinion Leaders Individuals with informal influence on the attitudes and behaviors of others
D. Implementation
Facilitators
Individuals with subject matter expertise who assist, coach, or support implementation
E. Implementation
Leads
Individuals who lead efforts to implement the innovation
F. Implementation
Team Members
Individuals who collaborate with and support the Implementation Leads to implement the innovation,
ideally including Innovation Deliverers and Recipients
G. Other
Implementation
Support
Individuals who support the Implementation Leads and/or Implementation Team Members to
implement the innovation
H. Innovation
Deliverers
Individuals who are directly or indirectly delivering the innovation
I. Innovation
Recipients
Individuals who are directly or indirectly receiving the innovation
Characteristics subdomain
Project Characteristics: [Document the characteristics applicable to the roles in the project based on the COM-B system [29]
or role-specific theories.]
Construct name Construct definition:
The degree to which:
A. Need The individual(s) has deficits related to survival, well-being, or personal fulfillment, which will be
addressed by implementation and/or delivery of the innovation
B. Capability The individual(s) has interpersonal competence, knowledge, and skills to fulfill Role
C. Opportunity The individual(s) has availability, scope, and power to fulfill Role
D. Motivation The individual(s) is committed to fulfilling Role
V. Implementation Process domain
Implementation Process: The activities and strategies used to implement the innovation
Project Implementation Process: [Document the implementation process framework [8] and/or activities and strategies
[26, 27] being used to implement the innovation. Distinguish the implementation process used to implement the innovation
(activities that end after implementation is complete) from the innovation (the “thing” that continues when implementation is
complete) [20, 25, 28].
Construct name Construct definition:
The degree to which individuals:

101
Framework guidance:
The CFIR is intended to be used to collect data from individuals who have power and/or influence over implementation
outcomes. See the CFIR Outcomes Addendum for guidance on identifying these individuals and selecting outcomes [19]
The CFIR must be fully operationalized prior to use in a project:
(1) Define the subject of each domain for the project (see guidance for each domain below)
(2) Replace broad construct language with project-specific language if needed
(3) Add constructs to capture salient themes not included in the updated CFIR
A. Teaming Join together, intentionally coordinating and collaborating on interdependent tasks, to implement the
innovation
B. Assessing Needs Collect information about priorities, preferences, and needs of people
Use this construct to capture themes related to Assessing Needs that are not included in the
subconstructs below
1. Innovation
Deliverers
Collect information about the priorities, preferences, and needs of deliverers to guide implementation
and delivery of the innovation
2. Innovation
Recipients
Collect information about the priorities, preferences, and needs of recipients to guide implementation
and delivery of the innovation
C. Assessing
Context
Collect information to identify and appraise barriers and facilitators to implementation and delivery
of the innovation
D. Planning Identify roles and responsibilities, outline specific steps and milestones, and define goals and
measures for implementation success in advance
E. Tailoring
Strategies
Choose and operationalize implementation strategies to address barriers, leverage facilitators, and fit
context
F. Engaging Attract and encourage participation in implementation and/or the innovation
Use this construct to capture themes related to Engaging that are not included in the subconstructs
below
1. Innovation
Deliverers
Attract and encourage deliverers to serve on the implementation team and/or to deliver the
innovation
2. Innovation
Recipients
Attract and encourage recipients to serve on the implementation team and/or participate in the
innovation
G. Doing Implement in small steps, tests, or cycles of change to trial and cumulatively optimize delivery of the
innovation
H. Reflecting &
Evaluating
Collect and discuss quantitative and qualitative information about the success of
implementation and/or the innovation
Use this construct to capture themes related to Reflecting & Evaluating that are not included in the
subconstructs below
1.
Implementation
Collect and discuss quantitative and qualitative information about the success of implementation
2. Innovation Collect and discuss quantitative and qualitative information about the success of the innovation
I. Adapting Modify the innovation and/or the Inner Setting for optimal fit and integration into work processes

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Appendix B. ERIC Recommendation Strategies (n=73)
Strategy Definitions
Access new
funding
Access new or existing money to facilitate the implementation
Alter
incentive/allowance
structures
Work to incentivize the adoption and implementation of the clinical
innovation
Alter
patient/consumer
fees
Create fee structures where patients/consumers pay less for preferred
treatments (the clinical innovation) and more for less-preferred
treatments
Assess for
readiness and
identify barriers
and facilitators
Assess various aspects of an organization to determine its degree of
readiness to implement, barriers that may impede implementation, and
strengths that can be used in the implementation effort
Audit and provide
feedback
Collect and summarize clinical performance data over a specified time
period and give it to clinicians and administrators to monitor, evaluate,
and modify provider behavior
Build a coalition Recruit and cultivate relationships with partners in the implementation
effort
Capture and share
local knowledge
Capture local knowledge from implementation sites on how
implementers and clinicians made something work in their setting and
then share it with other sites
Centralize technical
assistance
Develop and use a centralized system to deliver technical assistance
focused on implementation issues
Change
accreditation or
membership
requirements
Strive to alter accreditation standards so that they require or encourage
use of the clinical innovation. Work to alter membership organization
requirements so that those who want to affiliate with the organization are
encouraged or required to use the clinical innovation
Change liability
laws
Participate in liability reform efforts that make clinicians more willing to
deliver the clinical innovation
Change physical
structure and
equipment
Evaluate current configurations and adapt, as needed, the physical
structure and/or equipment (e.g., changing the layout of a room, adding
equipment) to best accommodate the targeted innovation
Change record
systems
Change records systems to allow better assessment of implementation or
clinical outcomes

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Strategy Definitions
Change service
sites
Change the location of clinical service sites to increase access
Conduct cyclical
small tests of
change
Implement changes in a cyclical fashion using small tests of change
before taking changes system-wide. Tests of change benefit from
systematic measurement, and results of the tests of change are studied for
insights on how to do better. This process continues serially over time,
and refinement is added with each cycle
Conduct
educational
meetings
Hold meetings targeted toward different stakeholder groups (e.g.,
providers, administrators, other organizational stakeholders, and
community, patient/consumer, and family stakeholders) to teach them
about the clinical innovation
Conduct
educational
outreach visits
Have a trained person meet with providers in their practice settings to
educate providers about the clinical innovation with the intent of
changing the provider’s practice
Conduct local
consensus
discussions
Include local providers and other stakeholders in discussions that address
whether the chosen problem is important and whether the clinical
innovation to address it is appropriate
Conduct local
needs assessment
Collect and analyze data related to the need for the innovation
Conduct ongoing
training
Plan for and conduct training in the clinical innovation in an ongoing
way
Create a learning
collaborative
Facilitate the formation of groups of providers or provider organizations
and foster a collaborative learning environment to improve
implementation of the clinical innovation
Create new clinical
teams
Change who serves on the clinical team, adding different disciplines and
different skills to make it more likely that the clinical innovation is
delivered (or is more successfully delivered)
Create or change
credentialing
and/or licensure
standards
Create an organization that certifies clinicians in the innovation or
encourage an existing organization to do so. Change governmental
professional certification or licensure requirements to include delivering
the innovation. Work to alter continuing education requirements to shape
professional practice toward the innovation
Develop a formal
implementation
blueprint
Develop a formal implementation blueprint that includes all goals and
strategies. The blueprint should include the following: 1) aim/purpose of
the implementation; 2) scope of the change (e.g., what organizational
units are affected); 3) timeframe and milestones; and 4) appropriate

104
Strategy Definitions
performance/progress measures. Use and update this plan to guide the
implementation effort over time
Develop academic
partnerships
Partner with a university or academic unit for the purposes of shared
training and bringing research skills to an implementation project
Develop an
implementation
glossary
Develop and distribute a list of terms describing the innovation,
implementation, and stakeholders in the organizational change
Develop and
implement tools for
quality monitoring
Develop, test, and introduce into quality-monitoring systems the right
input—the appropriate language, protocols, algorithms, standards, and
measures (of processes, patient/consumer outcomes, and implementation
outcomes) that are often specific to the innovation being implemented
Develop and
organize quality
monitoring systems
Develop and organize systems and procedures that monitor clinical
processes and/or outcomes for the purpose of quality assurance and
improvement
Develop
disincentives
Provide financial disincentives for failure to implement or use the
clinical innovations
Develop
educational
materials
Develop and format manuals, toolkits, and other supporting materials in
ways that make it easier for stakeholders to learn about the innovation
and for clinicians to learn how to deliver the clinical innovation
Develop resource
sharing agreements
Develop partnerships with organizations that have resources needed to
implement the innovation
Distribute
educational
materials
Distribute educational materials (including guidelines, manuals, and
toolkits) in person, by mail, and/or electronically
Facilitate relay of
clinical data to
providers
Provide as close to real-time data as possible about key measures of
process/outcomes using integrated modes/channels of communication in
a way that promotes use of the targeted innovation
Facilitation A process of interactive problem solving and support that occurs in a
context of a recognized need for improvement and a supportive
interpersonal relationship
Fund and contract
for the clinical
innovation
Governments and other payers of services issue requests for proposals to
deliver the innovation, use contracting processes to motivate providers to
deliver the clinical innovation, and develop new funding formulas that
make it more likely that providers will deliver the innovation
Identify and
prepare champions
Identify and prepare individuals who dedicate themselves to supporting,
marketing, and driving through an implementation, overcoming

105
Strategy Definitions
indifference or resistance that the intervention may provoke in an
organization
Identify early
adopters
Identify early adopters at the local site to learn from their experiences
with the practice innovation
Increase demand Attempt to influence the market for the clinical innovation to increase
competition intensity and to increase the maturity of the market for the
clinical innovation
Inform local
opinion leaders
Inform providers identified by colleagues as opinion leaders or
“educationally influential” about the clinical innovation in the hopes that
they will influence colleagues to adopt it
Intervene with
patients/consumers
to enhance uptake
and adherence
Develop strategies with patients to encourage and problem solve around
adherence
Involve executive
boards
Involve existing governing structures (e.g., boards of directors, medical
staff boards of governance) in the implementation effort, including the
review of data on implementation processes
Involve
patients/consumers
and family
members
Engage or include patients/consumers and families in the implementation
effort
Make billing easier Make it easier to bill for the clinical innovation
Make training
dynamic
Vary the information delivery methods to cater to different learning
styles and work contexts, and shape the training in the innovation to be
interactive
Mandate change Have leadership declare the priority of the innovation and their
determination to have it implemented
Model and simulate
change
Model or simulate the change that will be implemented prior to
implementation
Obtain and use
patients/consumers
and family
feedback
Develop strategies to increase patient/consumer and family feedback on
the implementation effort
Obtain formal
commitments
Obtain written commitments from key partners that state what they will
do to implement the innovation

106
Strategy Definitions
Organize clinician
implementation
team meetings
Develop and support teams of clinicians who are implementing the
innovation and give them protected time to reflect on the implementation
effort, share lessons learned, and support one another’s learning
Place innovation on
fee for service
lists/formularies
Work to place the clinical innovation on lists of actions for which
providers can be reimbursed (e.g., a drug is placed on a formulary, a
procedure is now reimbursable)
Prepare
patients/consumers
to be active
participants
Prepare patients/consumers to be active in their care, to ask questions,
and specifically to inquire about care guidelines, the evidence behind
clinical decisions, or about available evidence-supported treatments
Promote
adaptability
Identify the ways a clinical innovation can be tailored to meet local
needs and clarify which elements of the innovation must be maintained
to preserve fidelity
Promote network
weaving
Identify and build on existing high-quality working relationships and
networks within and outside the organization, organizational units,
teams, etc. to promote information sharing, collaborative problemsolving, and a shared vision/goal related to implementing the innovation
Provide clinical
supervision
Provide clinicians with ongoing supervision focusing on the innovation.
Provide training for clinical supervisors who will supervise clinicians
who provide the innovation
Provide local
technical assistance
Develop and use a system to deliver technical assistance focused on
implementation issues using local personnel
Provide ongoing
consultation
Provide ongoing consultation with one or more experts in the strategies
used to support implementing the innovation
Purposely
reexamine the
implementation
Monitor progress and adjust clinical practices and implementation
strategies to continuously improve the quality of care
Recruit, designate,
and train for
leadership
Recruit, designate, and train leaders for the change effort
Remind clinicians Develop reminder systems designed to help clinicians to recall
information and/or prompt them to use the clinical innovation
Revise professional
roles
Shift and revise roles among professionals who provide care, and
redesign job characteristics
Shadow other
experts
Provide ways for key individuals to directly observe experienced people
engage with or use the targeted practice change/innovation

107
Strategy Definitions
Stage
implementation
scale up
Phase implementation efforts by starting with small pilots or
demonstration projects and gradually move to a system wide rollout
Start a
dissemination
organization
Identify or start a separate organization that is responsible for
disseminating the clinical innovation. It could be a for-profit or nonprofit organization
Tailor strategies Tailor the implementation strategies to address barriers and leverage
facilitators that were identified through earlier data collection
Use advisory
boards and
workgroups
Create and engage a formal group of multiple kinds of stakeholders to
provide input and advice on implementation efforts and to elicit
recommendations for improvements
Use an
implementation
advisor
Seek guidance from experts in implementation
Use capitated
payments
Pay providers or care systems a set amount per patient/consumer for
delivering clinical care
Use data experts Involve, hire, and/or consult experts to inform management on the use of
data generated by implementation efforts
Use data
warehousing
techniques
Integrate clinical records across facilities and organizations to facilitate
implementation across systems
Use mass media Use media to reach large numbers of people to spread the word about the
clinical innovation
Use other payment
schemes
Introduce payment approaches (in a catch-all category)
Use train-thetrainer strategies
Train designated clinicians or organizations to train others in the clinical
innovation
Visit other sites Visit sites where a similar implementation effort has been considered
successful
Work with
educational
institutions
Encourage educational institutions to train clinicians in the innovation

108
Appendix C. ERIC Recommendation Strategies Organized By Their Respective Cluster
Along With Mean Importance and Feasibility Ratings
Importance Feasibility Go-zone
quadrant
Use evaluative and iterative strategies 4.19 4.01 –
4 Assess for readiness and identify barriers and facilitators 4.60 4.57 I
5 Audit and provide feedback 4.40 4.13 I
56 Purposefully reexamine the implementation 4.40 4.03 I
26 Develop and implement tools for quality monitoring 4.37 3.63 I
27 Develop and organize quality monitoring systems 4.33 3.37 I
23 Develop a formal implementation blueprint 4.30 4.47 I
18 Conduct local need assessment 4.27 4.33 I
61 Stage implementation scale up 3.97 3.77 I
46 Obtain and use patients/consumers and family feedback 3.67 3.80 I
14 Conduct cyclical small tests of change 3.63 4.03 I
Provide interactive assistance 3.67 3.29 –
33 Facilitation 4.13 3.77 I
54 Provide local technical assistance 3.97 3.20 IV
53 Provide clinical supervision 3.83 3.10 IV
8 Centralize technical assistance 2.73 3.10 III
Adapt and tailor to context 3.59 3.30 –
63 Tailor strategies 4.37 4.00 I
51 Promote adaptability 3.90 3.57 I
67 Use data experts 3.23 3.13 III
68 Use data warehousing techniques 2.87 2.50 III
Develop stakeholder interrelationships 3.47 3.64 –
35 Identify and prepare champions 4.20 3.77 I
48 Organize clinician implementation team meetings 3.97 3.53 I
57 Recruit, designate, and train for leadership 3.93 3.20 IV
38 Inform local opinion leaders 3.90 4.03 I
6 Build a coalition 3.77 3.63 I

109
Importance Feasibility Go-zone
quadrant
47 Obtain formal commitments 3.77 3.17 IV
36 Identify early adopters 3.70 3.70 I
17 Conduct local consensus discussions 3.63 4.07 I
7 Capture and share local knowledge 3.63 3.87 I
64 Use advisory boards and workgroups 3.40 3.87 I
65 Use an implementation advisor 3.30 3.70 I
45 Model and simulate change 3.30 3.20 II
72 Visit other sites 3.17 3.73 II
40 Involve executive boards 2.97 3.63 II
25 Develop an implementation glossary 2.87 4.57 II
24 Develop academic partnerships 2.83 3.40 II
52 Promote network weaving 2.70 2.77 III
Train and educate stakeholders 3.43 3.93 –
19 Conduct ongoing training 4.17 3.87 I
55 Provide ongoing consultation 4.17 3.63 I
29 Develop educational materials 3.80 4.83 I
43 Make training dynamic 3.67 4.00 I
31 Distribute educational materials 3.50 4.77 I
71 Use train-the-trainer strategies 3.33 3.50 I
15 Conduct educational meetings 3.27 4.50 I
16 Conduct educational outreach visits 3.10 4.07 II
20 Create a learning collaborative 3.10 3.43 II
60 Shadow other experts 2.87 3.37 II
73 Work with educational institutions 2.73 3.30 II
Support clinicians 3.23 3.06 –
32 Facilitate relay of clinical data to providers 4.17 3.43 I
58 Remind clinicians 3.23 3.77 II
30 Develop resource sharing agreements 3.07 3.13 III

110
Importance Feasibility Go-zone
quadrant
59 Revise professional roles 3.00 2.30 III
21 Create new clinical teams 2.67 2.67 III
Engage consumers 3.25 2.95 –
41 Involve patients/consumers and family members 3.87 3.63 I
39 Intervene with patients/consumers to enhance uptake and
adherence
3.50 3.07 IV
50 Prepare patients/consumers to be active participants 3.40 3.03 IV
37 Increase demand 3.30 2.33 II
69 Use mass media 2.17 2.70 III
Utilize financial strategies 2.86 2.09 –
34 Fund and contract for the clinical innovation 3.67 2.43 IV
1 Access new funding 3.57 2.40 IV
49 Place innovation on fee for service lists/formularies 3.40 2.10 IV
2 Alter incentive/allowance structures 3.17 2.23 III
42 Make billing easier 2.93 1.77 III
3 Alter patient/consumer fees 2.60 2.03 III
70 Use other payment schemes 2.30 1.87 III
28 Develop disincentives 2.17 2.13 III
66 Use capitated payments 1.97 1.80 III
Change infrastructure 2.40 2.01 –
44 Mandate change 3.23 2.63 III
12 Change record systems 2.83 2.23 III
11 Change physical structure and equipment 2.60 2.27 III
22 Create or change credentialing and/or licensure standards 2.23 1.47 III
13 Change service sites 2.20 2.20 III
9 Change accreditation or membership requirements 2.17 1.80 III
62 Start a dissemination organization 2.03 2.13 III
10 Change liability laws 1.87 1.33 III

Abstract (if available)

Abstract The Indian Child Welfare Act (ICWA) is a federal law designed to protect cultural and familial ties among American Indian and Alaska Native (AIAN) children and families. This law also upholds tribal sovereignty by mandating tribal involvement pertaining to placement preferences of AIAN children. ICWA has been labeled the “golden standard” yet it is not being implemented appropriately. The barriers to implementation call for a better understanding of what contributes to the facilitation of implementation. Outside factors, such as media reporting, plays a role in how policymakers and stakeholders view and implement ICWA. The aim of this dissertation is to explore the implementation of ICWA. The findings from this dissertation identifies ways to best improve the implementation of ICWA. These includes forms of media advocacy, improving stakeholder practice when implementing ICWA, and creating a plan of action for incorporating recommendation strategies. The implications to social work are discussed to improve the field and develop practices to best serve AIAN children and families.

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Asset Metadata

Creator Salinas, Erika Ashley (author)

Core Title Exploring the implementation of the Indian Child of Welfare Act of 1978

School Suzanne Dworak-Peck School of Social Work

Degree Doctor of Philosophy

Degree Program Social Work

Degree Conferral Date 2024-08

Publication Date 07/26/2024

Defense Date 06/19/2024

Publisher Los Angeles, California (original), University of Southern California (original), University of Southern California. Libraries (digital)

Tag American Indian and Alaska Native,Child welfare,implementation,Media,Native American,OAI-PMH Harvest,the Indian Child Welfare Act of 1978

Format theses (aat)

Language English

Contributor Electronically uploaded by the author (provenance)

Advisor Hurlburt, Michael (committee chair), McCroskey, Jacquelyn (committee member), Soto, Claradina (committee member)

Creator Email easalina@usc.edu

Permanent Link (DOI) https://doi.org/10.25549/usctheses-oUC113998H4U

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