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Building healthy relationships to end family violence
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DSW GRAND CHALLENGE FINAL CAPSTONE PAPER 1
Building Healthy Relationships to End Family Violence
Dr. Jennifer Harrington
DSW, MSW, LCSW, LCAS-A
DSW Grand Challenge Final Capstone Paper
Submitted in Partial Fulfillment of the
Requirements for the Degree
Doctor of Social Work
Suzanne Dworack-Peck School of Social Work
University of Southern California
Dr. Renee Smith Maddox
SOWK 722, August 2021
Degree Conferral Date: August 2021
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
2
ACKNOWLEDGEMENTS
First and foremost, I would like to thank my Lord and Savior Jesus Christ who has created
me for such a time as this. My obedience to His voice has brought me thus far and I am grateful
for the precious opportunity to serve His children. I would also like to thank my parents and my
uncle who have always believed in me. I am grateful to my children for understanding me when I
had to miss spending time with them while developing this project. I am obliged to the Georges’
for their unconditional love and support. I would also like to express my appreciation and gratitude
towards my defense chairs, Dr. Smith-Maddox, Dr. Kratz, Dr. James and for their support and
guidance throughout the research process. Finally, I sincerely thank my family and friends for their
loving prayers, support and encouragement that has kept me going all through this research.
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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Table of Contents
Acknowledgements ..................................................................................................................... 3
Area One: Executive Summary .............................................................................................. 6
Build Healthy Relationships to End Violence ............................................................... 6
Innovation Matrix ......................................................................................................... 7
The Exploration Preparation Implementation Sustainment (EPIS) model .................... 8
Family First Prevention Act 2018 ................................................................................... 9
Project Design ................................................................................................................. 10
Area Two: Conceptual Framework ........................................................................................ 10
Grand Challenge ............................................................................................................. 10
Definitions ........................................................................................................................ 11
Area Researched and Current Environmental Context ..................................................... 12
Social Significance & Implications ..................................................................................14
Conceptual Innovation...................................................................................................... 15
The Black Swan Theory ....................................................................................... 16
Child Abuse, Neglect, Fatalities and Black Swan Events ................................... 16
Black Swan Events and Emerging Risks.............................................................. 16
Theory of Change............................................................................................................. 17
Area Three: Problems of Practice and Innovative Solutions ................................................. 20
Innovation: Stride ..............................................................................................................20
Multiple Stakeholder Perspectives: EPIS Barriers and Facilitators...................................20
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
4
Existing Practice and Research......................................................................................... 21
The Logic Model.............................................................................................................. 22
Feasibility of Innovation .................................................................................................. 22
Area Four: Project Structure, Methodology, and Action ...................................................... 22
Prototype .......................................................................................................................... 22
Current Market Analysis .................................................................................................. 25
Implementation Framework: EPIS Model ....................................................................... 27
Exploration ........................................................................................................... 27
Preparation ........................................................................................................... 27
Implementation .................................................................................................... 28
Sustainment ......................................................................................................... 29
Financial plan................................................................................................................... 29
Assessment of Program Impact ....................................................................................... 29
Data Collection and Evaluation Plan................................................................................ 30
Measuring the Impact ...................................................................................................... 30
Stakeholder Influences ..................................................................................................... 32
Marketing Strategy .......................................................................................................... 32
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
5
Ethical Considerations ..................................................................................................... 33
Area Five: Implications, Actions, Conclusions ........................................................ 35
Implications...................................................................................................................... 35
Conclusion........................................................................................................................ 35
References ................................................................................................................................... 37
Appendix A: Infographic ............................................................................................................ 47
Appendix B: Logic Model ........................................................................................................... 48
Appendix C: Current Market Analysis ........................................................................................ 50
Appendix D: Line Item Budget for Stride ................................................................................... 51
Appendix E: Prototype ................................................................................................................ 52
Appendix F: Adverse Childhood Experience Scale .................................................................... 53
Appendix G: Emotional Regulation Skills Questionnaire ........................................................... 56
Appendix H: Parental Self-Efficacy Scale................................................................................... 60
Appendix I: Parent Peer Support Worker Code of Ethics............................................................ 68
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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Area One: Executive Summary
Build Healthy Relationships to End Violence
The Grand Challenge for Social Work - Build Healthy Relationships to End Violence
focuses on the role of positive interaction in fostering resilience to violent experiences, through
safe and supportive people and places (Barth et al., 2020). In 2018, an estimated 670,000 children
were victims of abuse and neglect (Children's Bureau, Administration on Children, Youth and
Families, Administration for Children and Families, and U.S. Department of Health and Human
Services, 2019). Despite the child welfare system’s efforts to keep children safe, the high number
of maltreatment fatalities continues to greatly affect society, with 50 states reporting 1,720
fatalities in 2017 (Child Welfare Information Gateway, 2019). This translates to an average of
nearly five children dying daily on account of abuse or neglect (Children's Bureau, Administration
on Children, Youth and Families, Administration for Children and Families, and U.S. Department
of Health and Human Services, 2019).
The Child Welfare Information Gateway data reflects a high prevalence of children dying
at the hands of their biological parents, and the need for promoting healthy relationships to end
violence. The literature in the field suggests the existence of major controversies regarding
intergenerational transmission of trauma. Thornberry et al. (2012) question the validity of
intergenerational transmission of trauma, but several other authors clearly document its impact.
Hall (2011) reported that mothers with a history of child abuse were 12 times more likely to abuse
or neglect their own children. Ball (2009) reported that 70% of mothers who were abused as
children would transmit the abuse they suffered. In addition, fathers might inflict child abuse
because of their own perception of parenting behaviors, or might encourage mothers to abuse their
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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children (Guterman et al., 2009). One of the major reasons behind child abuse is that most abusers
have previously experienced some type of abuse.
Experiencing child abuse influences an individual’s Adverse Child Experience (ACE)
score, which directly correlates with health outcomes. Dr. Vince Felitti of Kaiser and Dr. Bob
Anda conducted the ACE study at the Center for Disease Control and Prevention (CDC),
concluding that there is a strong association between early adversity and health in later life (Mersky
et al., 2017). Eradicating child abuse and neglect will reduce health care costs, decrease arrests,
lower incarceration rates, and improve family relationships.
Innovation Matrix
Satell (2017) created an innovation matrix and identified four types of innovations for businesses:
sustaining innovation, breakthrough innovation, disruptive innovation, and basic research. In
sustaining innovation, the problem is understood, and the focus is on improving what is already
working. Breakthrough innovation refers to fully understanding the problem, but offering a new
approach to resolve it. Basic research involves utilizing earlier studies and discovering new
phenomena for innovation. Disruptive innovation espouses a shift away from traditional solutions,
focusing on disrupting current innovation structures and systems. Stride utilizes sustaining
innovation, and builds upon best practices such as EBP (Evidence-based Practice) and peer
support. Upon users’ request, Stride provides parent peer support services along with clinical
services, in order to enhance attachment, emotional regulation, and self-efficacy skills. Building
healthier relationships can prevent violence and interrupt intergenerational cycles of violence,
while reducing the potential impact of violence on individuals, families, and communities (Barth
et al., 2020). Based on psychologist Albert Bandura’s social learning theory, Stride is a sustaining
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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innovation that is expected to increase emotional regulation, attachment and self-efficacy skills,
thereby further decreasing the intergenerational transmission of trauma, child abuse, and neglect.
The Exploration Preparation Implementation Sustainment (EPIS) model
Implementation of EBP in the child welfare system has received sparse attention, partially
due to its complex implementation process. The challenges of translating scientific potential into
public health impact have been a barrier to the implementation of EBP. The Exploration
Preparation Implementation Sustainment (EPIS) model is a four-phase implementation model
(Powell et al., 2015), which will be used to facilitate the implementation of Stride.
Stride currently provides contractual services to children and families within the
Mecklenburg County child welfare system. It has developed interorganizational networks to
facilitate referrals, contracting agreements and implementation support. Stride leaders are experts
in the education and implementation of Parent Child Interaction Therapy (PCIT). Stride’s policies
support the mission of the organization and of the child welfare system. Its innovations match the
values of the child welfare system, thus enhancing the innovation-values fit, and thereby increasing
the likelihood of successful implementation. It provides services for families involved in the child
welfare system keeping in mind the goals of safety, permanence, and well-being. Stride’s
implementation of EBP is thus congruent with the child welfare system’s goals, thereby supporting
effective implementation.
Using the EPIS strategy will allow Stride to focus on increasing attachment, emotional
regulation and self-efficacy skills, building community supports, creating alliances, and
motivating service providers to develop social contexts that encourage the use of EBP. EPIS uses
intervention strategies within the inner and outer contexts of each phase. In terms of the inner
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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context, the author included the practitioners and beneficiaries of Stride, who are involved in the
design of organizational processes, which affect the provision of services. In terms of the outer
context, the author made use of alliances with service providers, community stakeholders and
opinion leaders.
Family First Prevention Act of 2018
Socio-political funding and interorganizational networks can influence the implementation
of Stride. The Family First Prevention Act of 2018 is a source of funding that facilitates
implementation of Stride. This act allocates special funding to encourage the use of innovations
which enable keeping the family together and decreasing out-of-home placements for at-risk
children (National Conference of State Legislatures, 2020). It also encourages child welfare
agencies to explore programs providing evidence-based treatment while keeping families together.
Project Design
Stride has a human-centric design which develops solutions by involving beneficiaries,
users, and stakeholders at monthly meetings. It provides parent peer support services for abused
parents and their children. Stride aims to provide evidence-based treatment and peer support to
abused parents, in order to increase attachment, emotional regulation, and self-efficacy skills. It
implements a strength-based approach, identifying strengths in parents, caretakers, and youth. This
runs counter to traditional intervention models which utilize the “blaming and shaming” approach.
Stride prevention services are implemented in the home with the assistance of a Parent Peer
Support Worker (PPSW), and in the office in the presence of clinical staff, and are closely
monitored in accordance with a family’s treatment plan.
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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A PPSW is defined as an individual who engages parents as peers, in order to increase
confidence and self-efficacy skills, by bringing together parents who may share similar
experiences. Goodson (2005) performed a meta-analysis of evaluation data from over 200 parent
peer support programs, and concluded that these programs had the strongest effect if they included
professional staff and used the peer support component. A PPSW receives peer certification
training which teaches them how to engage the parent in a process of non-judgmental support, and
to hold parents accountable when their decisions may negatively affect their children. This process
helps to bolster their parenting confidence, ultimately impacting their self- efficacy skills. Peer
support programs have presented outcomes which address child maltreatment, risk and protective
factors within the child welfare system. These, in turn, have proved to be helpful in reducing child
maltreatment outcomes, such as parental distress, rigidity, and psychological/physical aggression
towards children (Friends, 2008; Pion-Berlin et al., 2011; Polinsky et al., 2010). These outcomes
have also reduced parental involvement and entry/re-entry into the child welfare system, enabled
faster reunification times, and enhanced progress rates for parents with peer support compared to
those without peer support (Cameron, 2002; Rauber, 2009; Goodson 2009 as cited in Horn, J.)
Berrick et al., 2011 reported that peers bring a treasure of shared experiences, encouragement,
trust, hope, clear communication, availability, emotional support, and help to tackle substance
abuse, thereby increasing self-confidence. Stride is different from traditional peer support models
because it also incorporates clinical evidence-based treatment such as; Cognitive Behavioral
Therapy, Parent Child Interaction Therapy & Trauma Focused Cognitive Behavioral Therapy.
According to previous research, child welfare agencies and families may benefit from using parent
peer support programs, but these should be provided in addition to traditional services (DePanfilis,
1996).
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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Area Two: Conceptual Framework
Grand Challenge
Barth et al., (2020), reported that the primary goal of the grand challenge of Social Work -
Build Healthy Relationships to End Violence, entails increasing the availability of services which
strengthen healthy relationships. Another goal is to prevent or interrupt violence by 10%, and
promote healthy, violence-free relationships, in order to bring about a 10% reduction in
interpersonal violence, including child maltreatment and gender-based violence (GBV), within the
next decade (Barth et al., 2020). This grand challenge is important to social work because child
abuse and neglect is a serious problem in America. Solving this problem will decrease violence
against children, reduce health care costs, lower arrest and incarceration rates, and increase
positive relationships. Child abuse and maltreatment often predicts other forms of violence in the
family and carries harmful consequences. Also, involvement with the child welfare system is often
correlated with many factors including child abuse, substance abuse, mental health, and poverty.
Existing strategies have not supported the healthy development of our families, nor have they
resulted in strong outcomes vis-a-vis the predictability of adulthood success. Children who are in
foster care are more likely to have a mental health diagnosis, use illegal substances, live in poverty,
and transmit their trauma (Chapman et al., 2004). Greater prevalence of child abuse and neglect in
particular communities can result in higher rates of associated negative outcomes, such as physical
health, mental health, behavioral and societal consequences for victims in their childhood and
through adulthood (Krase, 2015). Other researchers (Ball, 2009; Hall, 2011) have argued that child
abuse and maltreatment is transmitted intergenerationally. Abused mothers often develop schemas
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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and scripts based on past experiences which become their reference networks. As a result of these
experiences, they develop empirical and normative expectations leading to maladaptive norms,
and thus the cycle of trauma transmission continues.
Definitions
According to the American Psychological Association (2020), trauma is defined as any
disturbing experience resulting in significant fear, helplessness, dissociation, confusion, or other
disruptive feelings, intense enough to have a long-lasting negative effect on a person’s attitudes,
behavior, and other aspects of functioning. Traumatic events include those caused by human
behavior (e.g., rape, war, industrial accidents) as well as by nature (e.g., earthquakes). Such events
often challenge an individual’s view of the world as a just, safe, and predictable place.
The Federal Child Abuse Prevention and Treatment Act (CAPTA), (42 U.S.C.A. §5106g),
as amended by P.L. 111-320, and the CAPTA Reauthorization Act of 2010 define child abuse and
neglect as, at minimum: “Any recent act or failure to act on the part of a parent or caretaker, which
results in death, serious physical or emotional harm, sexual abuse or exploitation, or an act or
failure to act which presents an imminent risk of serious harm.”
Children's Bureau, Administration on Children, Youth and Families, Administration for
Children and Families, and U.S. Department of Health and Human Services (2019), define “child
fatality” as the death of a child caused by an injury resulting from abuse or neglect, or in which
abuse, or neglect was a contributing factor. Almost three quarters (71.8%) of child fatalities in
2017 involved children younger than three years; children younger than one year accounted for
49.6% of all fatalities; and parents were responsible for 80.1% of child fatalities. (Child Welfare
Information Gateway, 2019). More than one quarter (30.5%) of fatalities were perpetrated by the
mother acting alone, 15.5% were perpetrated by the father acting alone, and 20.2% were
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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perpetrated by the mother and father acting together (The Child Welfare Information Gateway,
2019).
Area Researched and Current Environmental Context
According to attachment theory, parent’s early care-receiving experiences are not directly
linked with their later parenting behavior. However, these experiences shape the parent's current
mental representation of attachment, which influences their behavior during interactions with their
children (Zajac et al. 2019). The results of a study conducted by Zajac et al. (2019) indicated that,
adults who are unable to identify an attachment figure, or to recall their own childhood
experiences, were found to have limited ability to respond effectively to children's emotional cues.
Zajac et al. (2019) argued that parental experiences of abuse and neglect were not related to their
state of mental attachment or their sensitive parenting, but rather to the ability to recall positive
attachment figures in their lives. This partially explains why some abused adults do not transmit
their trauma to their children. Attachment theorists believe that rather than focusing on past
experiences of abuse in order to determine risk factors related to child abuse, one should focus on
what attachment looks like to adults and how this influences their behavior toward their children
(Zajac et al., 2019).
Moss et al. (2011) reported that the quality of the attachment relationship determines the
sensitivity of the caregiver's response to a child's needs. Sensitive caregivers can perceive a child's
emotions and respond appropriately. A caregiver’s insensitivity to a child's emotions has been
linked with disorganized attachments. The results of their study revealed that Parent-Child
Interaction Therapy (PCIT), as a long-term intervention, is effective at improving sensitivity and
enhancing attachments relationships. PCIT focuses on improving the quality of parent and child
relationships and may modify maltreated child scripts and schemata.
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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Despite conflicts in the literature regarding the risk probability of transmitting
maltreatment, research supports the proposition that developing positive attachments and
emotional regulation skills will minimize the potential risk of intergenerational abuse transmission.
Emotional regulation skills have proved to be successful in minimizing the risk of inflicting child
abuse and neglect. According to Beauchaine and Cicchetti (2019), emotional dysregulation is a
pattern of emotional experiences and /or expression which interferes with appropriate goal-
directed behavior. Emotional regulation skills need to be evaluated within cultural contexts and
adults need to be aware of their triggers, behaviors, and alternatives with regard to abuse.
Literature has progressed towards clarifying violence in the family as a malicious problem,
and has identified successful interventions for addressing negative behaviors, in order to eradicate
violence within the family. In 1999, Texas enacted Safe Haven laws which allow parents who do
not want their children below 6 months of age, to leave them in a safe place, without fear of being
prosecuted for neglect or abandonment (Capital Texas, 1999).
De Mause (2011) reported views that abusive parents should be subjected to corporal
punishment, instead of simply being investigated by a Child Protective Services worker. He also
discussed the success rates in European countries, where mothers are given paid leave of three
years for each child, and are provided with free health insurance and free pre-school programs.
Manne et al. (n.d.) documented successful efforts by nations to promote healthy emotional
development among children, such as decreasing social isolation by providing parents with social
networks and services, educating medical staff to focus on psychological needs of mother and
infant at the time of childbirth, increasing maternity and paternity leave with pay provisions, and
creating and expanding community-based childcare for working mothers, in order to increase child
interaction and attachment with a caregiver.
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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Another service available in the four states of Maryland, Michigan, Minnesota, and Texas
is Birth Match. Birth Match is an automated system which notifies child protective services intake
systems, when a child is born to a parent who previously had parental rights terminated. This
allows newborns to receive preventive or protective services if needed. According to Shaw et al.
(2013), it has not been proved that Birth Match results in greater protection of newborns. In
addition to the Birth Match, implementing a data system which transfers across state lines, in order
to monitor risk factors from childbirth to parental involvement in child welfare services, is needed.
In this context, Stride provides PCIT to increase interaction and attachment with caregivers, as
well as PPSW to increase social support and self-efficacy.
Social Significance and Applied Implications
Everyone is impacted by trauma; therefore, developing a deeper understanding of trauma,
discussing it, and integrating awareness will help increase impactful societal change. There are
underlying systemic factors, such as structural racism, which cause discrimination, racial health
disparities, unequal distribution of power and wealth. Intergenerational transmission of trauma is
exacerbated by such collective trauma. For example, poverty creates major challenges to mental
well-being, limits access to resources, increases stress, and reduces attachment, which may
increase neglect and child abuse. Childhood poverty impacts educational performance and the
ability to be economically productive in adulthood. According to Pelton (2015), child abuse and
neglect cannot be viewed outside the context of poverty.
Another cause and compounding circumstance of intergenerational transmission of trauma
is untreated substance abuse or mental illness, on account of culturally incompetent services.
Services rendered to impact societal change should be culturally competent, and include evidence-
based treatment effective at increasing attachment, emotional regulation, and self-efficacy skills.
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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Conceptual Innovation Framework
The Black Swan Theory
Social learning theory challenges the view that people are born innately aggressive, and
advocates that aggressive behaviors are learned. Learned behaviors are contributing factors in the
transmission of child abuse and a known risk factor for child abuse in general. However, there is
limited research regarding the potential for individual contributing factors to result in a child abuse,
neglect, or fatality; therefore, risk factors resulting in child abuse, neglect, or fatalities remain
unknown. This is what Flage and Aven (2015) identified as the “known unknowns,” and emerging
risk in the Black Swan theory. The “known unknowns” in child abuse, neglect, or fatalities
constitute the Black Swan theory’s conceptual framework. In 2007, Nassim Nicholas Taleb
utilized this metaphor for discussing a black swan, which was spotted before the existence of black
swans was known. The existence of white swans was known, but the existence of a black swan
was unknown. Taleb’s Black Swan theory is defined as an event which meets three criteria. First,
it is an improbable event which is considered unlikely to happen. Second, it is extremely impactful.
Finally, humans attempt to produce an explanation for the event after its occurrence, making the
event seem explainable and predictable (Taleb, 2007). The Black Swan theory suggests a logical
structure of connected concepts, offering guidance for preventing child abuse, neglect, or fatalities.
Child Abuse, Neglect, Fatalities and Black Swan Events
Child abuse, neglect and fatalities are often a surprising event for the parents, friends,
relatives, social workers, doctors, law enforcement officers, judges, and the Department of
Children’s Services or any service providers (McCarroll, et al., 2017). For example, child fatality
is a traumatic event for those who experienced it, may have witnessed the situation unfold, or may
have interacted with the deceased child. People commonly attempt to explain and predict the event
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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after its occurrence. Taleb (2007) reported two perspectives for managing Black Swan events, that
is, either by predicting and preventing the event from occurring, or by becoming anti-fragile,
exploring the failure, and making changes. Green (2011) stated that Black Swan events are not
predictable, and one should prepare for handling their psychological impact. However, other
researchers believed that these events could be predicted to a certain extent (Murphy & Conner,
2012; Werther, 2013). Hajikazemi et al. (2016) suggested that Black Swans are managed through
prediction, and by proposing the potential actions to stop them or lessen their consequences if they
can be anticipated.
Black Swan Events and Emerging Risks
Flage and Aven (2015) discussed the concepts of emerging risk and known unknowns, and
their relation to Black Swan-type events. Furthermore, they defined emerging risk as rare and
largely impactful events, which are difficult to predict beyond the realm of normal expectations.
According to Flage and Aven (2015), known unknowns are an emerging risk, identified as a Black-
Swan risk that can lead to a Black Swan event. For example, a child fatality is a Black Swan risk.
We cannot predict the event, but we can predict its possibility based upon emerging risk. The
current child welfare system is anti-fragile; however, movement toward prompt identification of
early warning signs and risk factors, which indicate a probable future fatality, can help prevent
such deaths. Ignoring warning signs may ultimately lead to a Black Swan event (Flage & Aven,
2015).
Theory of Change
Intervening to minimize emerging risk will decrease the probability of a Black Swan event.
The child welfare system can identify emerging risk factors that may lead to fatality, child abuse,
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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and neglect. When a parent’s behavior creates emerging risk for abuse or neglect and warrants out-
of-home placement, the family can be recommended for prevention services with Stride. Stride
prevention will further support the goal of the Family First Prevention Service Act of 2018,
providing prevention services for children who are candidates for foster care, while keeping
families together. It will also change learned behaviors while increasing self-efficacy, attachment,
and emotional regulation skills. Changing learned abusive behaviors among parents and
implementing new ones by behavior observation and modeling are supported by the social learning
theory. Literature suggests that social learning interventions are effective in changing human
behaviors (McCullough Chavis, 2011). Therefore, utilizing Albert Bandura’s social learning
theory as the theory of change seems most suitable to Stride’s goals.
Parents often mimic abusive behaviors from their childhood (Chamberlain et al., 2019;
Machisa, et al., 2016), which are generally transmitted to their children (Hall, 2011; Mayer and
Thursby 2012). Childhood experiences are observed and later become norms for parenting
behaviors in adulthood. This observation is supported by the social learning theory, which
espouses that behavior is learned and mimicked, based upon one’s environment. Social learning
theory, developed in 1969 by psychologist Albert Bandura and revised in 1973, states that people
learn by watching other people and environment plays a major part in learning behavior. The use
of this theory was cited as one of the most recent approaches to explaining human behavior within
the social context (McCullough Chavis, 2011). McCullough Chavis (2011) described social
learning theory as being rooted in many of the basic concepts of traditional learning—learning that
occurs within a social context—and opined that people can learn new information and behaviors
by observing others. According to McCullough Chavis (2011), the four components of the social
learning theory are: 1) observational learning, 2) reciprocal determinism, 3) self-regulation, and 4)
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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self-efficacy. Observational learning refers to observing the manner in which something is done,
and then mimicking that behavior. Reciprocal determinism states that environments influence
individual learning. Self-regulation entails the ability of the individual to apply what is learned;
while self-efficacy is the belief that when people believe in their ability to change, they are more
willing to learn a new skill and put it into action. Further, Bandura’s social learning theory was
said to have a four-step modeling process: attention, retention, reproduction, and motivation
(McCullough Chavis, 2011). Egeland (1993), as cited in Franklyn (2010), reported that
intergenerational transmission of violence is rooted in the social learning theory. If parents can
observe and mimic appropriate behaviors in a safe environment, it will cultivate confidence and
safety, thereby enhancing parent’s self-regulation and self-efficacy skills.
Given the above context, Stride acts as an agent of change. It is expected that, as part of
the Stride intervention, abused parents will learn how to effectively process their trauma and
implement coping skills in order to increase emotional regulation, attachment, and self- efficacy.
Van Wert et al. (2019) emphasized the importance of addressing the consequences of
maltreatment, as these may mediate the relationship between a history of abuse and neglect and,
later, perpetration of abuse. Under Stride, abused parents learn, observe, and model behaviors
during home visits with Parent Peer Support Workers and during Parent Child Interaction Therapy.
Families are assigned a support system, including a Licensed Clinical Social Worker (LCSW) as
well a Parent Peer Support Worker (PPSW). The LCSW implements the Parent-Child Interaction
Therapy (PCIT) which is an evidence-based treatment for children and families (Beveridge, et al.,
2015). The PPSW is a parent with lived experience within the child welfare system. The PPSWs
may be identified by child welfare workers who have previously worked with them in the client-
worker role. The goal is to provide families with the support of an individual who has shared
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
20
experiences in navigating through the child welfare system, and who may be recognized as an
unintimidating presence for the family receiving services. The PPSW applies Albert Bandura’s
Social Learning Theory, by providing parents with an opportunity to observe, learn and model
positive behaviors in a safe environment, thereby increasing confidence and self-efficacy skills.
The frequency of interactions between parents and the PPSW varies over time. Initially, the PPSW
meets parents for about 4 face-to-face visits per month, and subsequently in a less frequent manner,
at intervals of 2 to 3 months, depending on the needs of the family. The PPSW may also contact
parents via phone or online media, between visits. The use of observational learning and modeling
affects a wide variety of human behaviors, according to the social learning theory approach
(McCullough Chavis, 2011). Stride utilizes this approach, in order to increase self-efficacy skills.
Accordingly, PCIT is implemented to increase attachment and emotional regulation skills.
Research has suggested that increasing attachment, emotional regulation and self-efficacy skills
decreases the risk of transmission of trauma (Beauchaine and Cicchetti, 2019).
Area Three: Problems of Practice and Innovation
Innovation: Stride
The Stride innovation will contribute to the Grand Challenge of Social Workers, that is,
Build Healthy Relationships to End Violence. It is expected to do so, by supporting the goal of
increasing the availability of services which strengthen healthy relationships, and of interrupting
violence by promoting healthy, violence-free relationships thereby reducing child maltreatment.
Abusive parents do not fit into a single economic, social, or psychological pattern, and no single
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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characteristic alone can lead to abuse, including the belief that abused children will abuse their
children. However, in order to provide effective treatment, remedial services should include
working together with abused children and their families, and incorporating the development of
attachment, emotional regulation, and self-efficacy skills.
Multiple Stakeholder Perspectives
The beneficiaries of Stride are abused parents and their children who are at risk of foster
care placement. The users are child welfare social workers who make referrals for families. The
child welfare system utilizes Stride as a service provider, implementing its interventions to
decrease child abuse and foster care placements. In order to provide a successful program for
abused parents, clinical services need to be provided, along with a support person who has lived
experience (Berrick et al., 2011). Service providers who are necessary to promote success and
minimize risk, during and upon completion of the program, include: Child Protective Service
Worker (CPS), Licensed Clinical Workers (LCSW) and Parent Peer Support Worker (PPSW). The
users request someone they can trust, to assist them with navigating through the child welfare
system, while learning how to change behaviors. CPS workers support the PPSW system, because
it provides an additional level of support to parents, thereby enhancing success and decreasing
further CPS reports. LCSWs believe that PPSWs are required due to the limited amount of time
they can offer the family and the need for additional support networks outside of the professional
clinical role. PPSWs offer support in their capacity as individuals with lived experience, helping
others overcome addictions, mental health issues, and involvement with various systems. Stride’s
internal stakeholders also include advisory board members and employees, who influence Stride’s
financial plans and decisions. Advisory board members and employees can provide positive or
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negative feedback about the program. Employees can provide very important information about
how the program should operate, because of their firsthand knowledge and daily interactions with
the target population. This input is crucial to the success of the program, as it can provide critical
information about the effectiveness of the program and determine how funds should be allocated.
External stakeholders include the child welfare system and legislation supporting the Family First
Preventions Act. These influence Stride’s policy, procedures, and financial plans, because this act
determines the target population, criteria for services and their implementation, and how funds can
be allocated.
Existing Practice and Research
The Family First Prevention Act allocates special funding for services which keep children
out of foster care and with their families (National Conference of State Legislatures, 2020). The
Stride solution builds on the existing policy of the Family First Prevention Act, by providing
services to children and families in order to decrease the risk of child abuse and neglect. Stride
also builds upon existing evidence-based practices such as Parent Child Interaction Therapy, and
the utilization of peers to support individuals with mental health problems and substance abuse
issues.
The Logic Model
Stride utilizes PPSW system in order to implement Albert Bandura’s social learning theory
as the theory of change. This supports the beliefs that people learn by watching other people, and
that individuals are more likely to change and adapt behavioural changes in the long run
(McCullough Chavis, 2011). Abused parents are assigned a PPSW, in order to learn and model
appropriate parenting behaviours, along with Parent Child Interaction Therapy (PCIT) services
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provided by a LCSW. Having the support of a PPSW while receiving PCIT, not only increases
attachment and emotional regulation, but also self-efficacy skills (Appendix B). If parents can
observe and model appropriate behaviours in a safe environment which cultivates confidence,
emotional regulation and self-efficacy skills will increase, ultimately decreasing child abuse
(McCullough Chavis, 2011). Outputs are measured by the number of parents enrolled into the
program, and the number of sessions held and attended. Stride utilizes process and outcome
measures, in order to monitor the implementation of activities, fidelity to the innovation and
program effectiveness. Some of the process measures include child protective services treatment
plans, which focus on specific goals identified by the users and beneficiaries. These plans are
reviewed during treatment team meetings to determine the progress and appropriateness of each
goal.
Feasibility of Innovation
The Stride innovation is feasible, because use of Parent Child Interaction Therapy (PCIT)
has proved to reduce rates of maltreatment, and to enhance parenting attitudes, parent–child
interactions, and child mental health (Whitaker & Lutzker, 2009, as cited in Mersky et al., 2013).
In addition, utilizing Albert Bandura’s Social learning theory as the theory of change involves the
assumption that, if we can provide parents with an opportunity to observe, learn and mimic positive
behaviors in a safe environment, then they are more likely to change behaviors and sustain long-
term changes (McCullough Chavis, 2011).
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Area Four: Project Structure, Methodology, and Action Components
Prototype
A journey map is the most appropriate prototype for Stride, because it helps Stride and
other stakeholders to understand the customer’s experiences and feelings at all stages. This map
explains a customer experience with or without a PPSW. A PPSW is a staff member of Stride, but
also a parent with lived experience within the child welfare system. The PPSW may be identified
by child welfare workers who have previously worked with them in the client-worker role, and is
required to complete 40 hours of peer support training certification, and an additional 20 hours
training related to mental health issues and substance abuse. Parent peer supports may also be
referred from the peer support training certification program. Although peer mentors cannot
provide therapeutic treatment to parents, their similarity to the clients, and the fact that they
themselves have successfully navigated the child welfare system, may offer hope that the goal of
positive parenting skills are achievable (Berrick et al., 2011). The PPSW utilizes Albert Bandura’s
Social Learning Theory, by providing parents with an opportunity to observe, learn, and model
positive behaviors in a safe environment, focusing on increasing self-efficacy skills (Appendix I).
Peer mentors are also expected to help parents overcome social isolation, by encouraging them to
develop positive relationships and model active empowerment, as opposed to passive acceptance
(Berrick et al., 2011).
Stride receives referrals from the Child Protective Service (CPS), when a child is at the risk
of out-of-home placement, or in the process of reunification. After a referral is received, families
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are assigned a LCSW to provide PCIT. If a parent also chooses to work with a PPSW, then the
PPSW will help lessen the family’s stress and anxiety, with regard to involvement with CPS. The
PPSW will support the family even as the clinician administers assessments such as: Parental Self-
Efficacy Scale (Appendix H), Emotional Regulation Scale (Appendix G), Adverse Childhood
Experience Scale (Appendix F), Edberg Child Behavior Inventory, Dyadic Parent Child
Interaction Coding system (DPICS), Sutter - Eyberg Student Behavior Inventory, Therapy Attitude
Inventory (TAI), Child Rearing Inventory, and Revised Edition of the School Observation Coding
System (REDSOCS).
After completion of assessments, Stride facilitates a treatment team meeting including
clinician, user, beneficiaries, PPSW and child (if appropriate), in order to develop a treatment plan.
The PPSW assists parents in breaking down goals into smaller and manageable tasks, and provides
continuous assistance in recognizing their progress throughout this process. Next, the parents begin
receiving the initial eight sessions of PCIT with their clinician. During the first four weeks of
PCIT, the PPSW provides a modeling of appropriate parenting behaviors, and acts as a source of
credible communication and feedback to guide the parents. The PPSW helps parents replace their
destructive patterns of low self-efficacy perceptions, which cause maladaptive parenting
behaviors. During the fourth and eighth week of PCIT sessions, the PPSW allows parents to
observe and model a task, and provides guidance about how to do things. The PPSW also helps
parents to develop the internal imagery needed to conceptualize and implement targeted skills or
learning strategies. Upon completion of the initial 8 PCIT sessions, the parents complete mid
assessments (Parental Self-Efficacy Scale, Emotional Regulation Scale) and a review of treatment
plan goals. Again, the PPSW assists the parents in breaking down the goals and in recognizing the
progress they are making, further increasing their confidence. While parents complete PCIT
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sessions 9 to12 with their clinician the PPSW continues to review goals and increase the parents’
self-confidence by validating, reaffirming, and providing feedback. During sessions 13 to16, the
PPSW continues to influence the parents’ self-efficacy by establishing and reinforcing beliefs of
personal competence, which will ultimately become habits of thinking helping parents throughout
their lives. Upon the conclusion of the process, families receive post-assessment measures to assess
the impact of the model and the outcomes of PCIT, and are appreciated for their success. As a
result, abused parents learn how to effectively process their trauma and implement coping skills,
in order to increase attachment, self-efficacy, and emotional regulation. As Bosquet et al., (2018),
observed, interventions reducing child maltreatment risk and stress exposures, and increasing
family social support, may mitigate the deleterious effects of maternal childhood maltreatment
history on the child’s mental health.
Current Market Analysis
A current market analysis of similar programs in the proposed area was conducted, in order
to determine the need for Stride in North Carolina. Pat’s Place Child Advocacy Center is a non-
profit organization located in Charlotte, N.C. Their mission is to protect and heal children, unite
key partners, and engage the community in ending child abuse. The center provides evidence-
based treatment to support in the healing and recovery process after a traumatic event has occurred.
However, they do not provide modeling of appropriate parenting behaviors and treatment to
parents. Florence Criterion Services is a residential treatment facility for young mothers who are
in foster care and their children. They provide services to enhance attachment and coping skills.
However, they do not provide peer support services or services to fathers. Existing programs which
provide case management and home-based therapeutic interventions, such as Family Centered
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Treatment (FCT), integrate evidence-based theoretical models. These models include Eco-
Structural Family Therapy and Emotionally Focused Therapy, which focus on changing the tone
and interaction patterns with family members. FCT has proven success rates with the juvenile
justice population, however, it is unknown if FCT is effective in enhancing attachment, emotional
regulation, and self-efficacy skills. Despite the efforts made in all these programs, there is no
evidence that they have attempted to implement evidence-based practices geared at decreasing the
transmission of abuse. An advantage of Stride is the ability to provide trauma-informed mental
health and peer support to parents, by utilizing evidence-based interventions that have proved to
be successful in honing attachments, self-efficacy, and emotional regulation skills. Research has
suggested that enhancing these skills leads to increased safety, security and self-esteem, and lower
parental frustration and involvement with the child welfare system.
Additionally, there are a few programs which, like Stride, offer opportunities for
innovation: Circle of Parents, Parent Child Interaction Therapy, and Iowa’s Parent Partner
program. Circle of Parents is a national mutual self-help support group model, grounded in parent
leadership and the five protective factors. The support group allows parents to discuss their
challenges and success. Its goals are designed to address emotional sustenance, offer counseling
advice and provide social monitoring and social control. PCIT is an evidence-based behavior
parent training treatment which places emphasis on improving the quality of the parent-child
relationship and changing parent-child interaction patterns, in order to increase emotional
regulation and attachment skills. Iowa’s Parent Partner program matches a parent who is currently
involved with the child welfare system with a parent partner. Its goals are to mentor and help
parents locate and secure community resources. Stride’s innovations include PPSW support and
evidence-based treatment delivered by a LCSW, with the goal of increasing attachment, emotional
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regulation and self-efficacy skills, thereby decreasing trauma transmission. This innovation is the
first of its kind in the proposed area of Charlotte North Carolina. This clinical program varies
significantly from other programs in Charlotte N.C., due to the utilization of both evidence-based
treatment and PPSW.
Implementation Framework: EPIS Barriers and Facilitators
Stride uses the Exploration Preparation Implementation Sustainment (EPIS) model
framework for its implementation strategies. It takes both an inner and outer context approach
towards implementation by using evaluative and interactive strategies. This allows the
enhancement of implementation science, and the ability to provide individuals, community, and
organizations with evidence-based practices. The feasibility of the program has been a central
evaluation question, focusing on issues related to the implementation of PPSW system in addition
to evidence-based treatment. These issues involved overcoming a few barriers, including: (1)
recruiting, hiring, and training of PPSWs; (2) establishing and maintaining community linkages;
(3) implementation of evidence-based treatment to fidelity; (4) balancing treatment versus program
evaluation; and (5) critical decisions.
Exploration
The first phase of the EPIS model is exploration. This phase can influence exploration of
EBP implementation by the child welfare system. A socio-political source of funding in the outer
context of the exploration phase, which facilitates implementation of Stride, is the Family First
Prevention Act of 2018. The Family First Prevention Act allocates special funding to encourage
the use of innovations for decreasing out-of-home placements for at-risk children (National
Conference of State Legislatures, 2020). This act provides an impetus for child welfare agencies
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to begin exploring programs, which provide evidence-based treatment while keeping families
together. Currently, as part of exploration, this author collaborates with professional associations,
systems of care and community-based organizations. A potential implementation barrier for Stride,
in the exploration phase, is the climate and culture of child welfare agencies. These may not have
the time to explore evidence-based practices due to heavy workloads, multiple responsibilities,
and varying levels of education.
Preparation
Stride is currently developing interorganizational networks in preparation for
implementation. It provides information about innovation to other organizations and leaders
partnering with the child welfare system. It educates potential decision makers about the costs and
benefits of its innovation, thereby potentially minimizing ethical concerns with regard to the
utilization of PPSWs. Stride also establishes referral patterns from the child welfare system, in
order to serve families involved with the system.
Implementation
Stride provides contractual services for Mecklenburg County Department of Social
Services and continues to develop interorganizational networks. Its mission and goals are aligned
with those of the Mecklenburg County Department of Social Services, which should support
implementation. Stride has also located an internal organization champion within the child welfare
system, in order to support implementation.
Sustainment
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Reporting outcomes which illustrate the impact of the program on public health is expected
to support the delivery and sustainment of the innovation. Currently, the Family First Prevention
Act 2018 supports the sustainment of Stride, and funds are allocated for ongoing initiatives.
Mecklenburg County child welfare system has adopted a policy supporting evidence-based
programs. Thus, Stride is sustainable, because it is scalable to other areas and its leadership values
the implementation of EBP for fidelity.
Financial Plan
During the pilot program, Stride is proposed to serve 6 families, of which 3 will receive
the innovation, and 3 will receive the traditional treatment (without a PPSW). It will hire part-
time clinical staff and a part-time PPSW. Stride’s strategy for revenue is fee for service, and
accordingly it proposes to submit treatment billing to the individual’s insurance agency. Stride is
expected to receive weekly PCIT services, with a projected revenue of $27,072, for a total of 6
months for 6 families (Appendix D: Line 20). A PPSW will receive $4,320 (Appendix D: Line 7)
and the PCIT clinician will receive $7,200 during the pilot program (Appendix D: Line 6). An
additional $400 will be charged for the peer support certification training (Appendix D: Line 11).
Thus, Stride has a strong budget, due to a surplus amount of $15, 152 with regard to this program.
Assessment of Program Impact
This author proposes to conduct measurements with treatment and non-treatment groups,
in order to determine the impact of interventions, in increasing attachment, self-efficacy and
emotional regulation skills. Emotional regulation will be measured using the Emotional Regulation
Skills Questionnaire Scale (ERSQ) (Appendix G), and self-efficacy will be measured via the
Parental Self-Efficacy Scale (PSES) (Appendix H). Families will also receive Adverse Childhood
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Experience Scale (Appendix G) to measure the number of adverse childhood experiences an parent
has received, along with PCIT assessments, Edberg Child Behavior Inventory, Dyadic Parent
Child Interaction Coding system (DPICS), Sutter- Eyberg Student Behavior Inventory, Therapy
Attitude Inventory (TAI), Child Rearing Inventory, and the Revised Edition of the School
Observation Coding System (REDSOCS). These assessments will be used to measure the fidelity
and the impact of PCIT.
Data Collection and Evaluation Plan
The data collection approach is proposed to be both quantitative and qualitative, and will
be administered pre-, mid-, and post-treatment. There will be on-going data collection during a
family’s treatment. The sampling technique used involves non-probability, purposive, and
convenience sampling. Families will be intentionally selected, based on the eligibility criteria for
services. The sample will also be easily accessible to Stride. This author will take informed consent
from the participants and follow ethical procedures with regard to gathering of data. Stride’s long-
term plan is to partner with a local university, in order to obtain a program evaluator.
Measuring Impact
Stride will utilize output and outcome measures, in order to monitor the implementation of
activities, fidelity to the innovation, and program effectiveness. Some of the output measures
include child protective services case plans and person-centered plans, which focus on specific
goals identified by the users and beneficiaries. These plans will be reviewed monthly to determine
the progress and appropriateness of each goal. These outcome measures will be used to determine
whether families are making progress, or if adjustments are needed during the program. Outputs
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will be measured by the number of families engaging in the program, the number of families
successfully completing the program, and the number of PPSW and PCIT sessions completed.
The American Psychological Association (2020) has been used to locate measurements for
evaluating the impact of implementation. Self-efficacy will be measured using the Parental Self-
Efficacy Scale (PSES), which is a rating scale (Appendix H). The purpose of this scale is to
measure how confident a parent feels about his/her ability to display acceptable parenting
behaviours. PSES assesses a parent’s level of confidence in performing parenting behaviours.
Factor analysis, reliability and validity results were reported for the PSES scale (Nicolas et al.,
2020). According to the American Psychological Association (2020), the Emotional Regulation
Skills Questionnaire (ERSQ) is a 5-point Likert scale, which measures nine dimensions of
respondents' emotional regulation skills (Appendix G).
Program effectiveness will be measured based on the levels of increase in attachment,
emotional regulation and self- efficacy skills, and the completion of the child protective service
case plan. Families who complete the Stride program are expected to demonstrate certain levels
of progress. In the short term, families will gain confidence about their ability to parent, regulating
their emotions and developing attachment skills. As part of the intermediate outcome, families will
demonstrate improved ability to regulate emotions, respond appropriately to the behaviors of their
children, and develop self-efficacy skills. The long-term outcome will be measured by parents’
ability to retain gains, as evidenced by zero new substantiated allegations within three years of
completion of the program. The data collection approach will be qualitative and quantitative
assessments administered as pre-, mid-, post- and follow-up assessments.
Stakeholder Influences
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STRIDE’s internal stakeholders include board members and employees who influence
STRIDE’s financial plans. Board members and employees can provide positive or negative inputs
about the program. Employees can provide very important information about how the program
should operate because of their firsthand knowledge and daily interactions with the target
population. This input is crucial to the success of a program as it can provide critical information
about the effectiveness of the program and determine how funds should be allocated. External
stakeholders include the child welfare system and legislation supporting the Family First
Preventions Act. This Act influences STRIDE’s financial plans because it determines the target
population and how funds can be spent.
Marketing Strategy
The goal of our marketing strategy is to increase the involvement of PPSWs. The campaign
will focus on positive aspects of the child welfare system. The message we would like to convey
to parents is to recall the emotional experiences that their family experienced when they were
involved with the child welfare system: the feelings of distrust, fear, misunderstanding, isolation
and feeling unheard. Thus, the campaign will encourage future PPSWs to utilize their voices to
help a family which needs them. According to Boster and Carpenter (2020), persuasive
communication refers to a scenario in which a source transmits a message to an audience through
a channel, with the purpose of changing an attitude. In order to achieve this, we propose to transmit
a message to ordinary people with lived experience, emphasizing the beneficial experiences they
had with a PPSW. We will also advertise the peer support workers’ experiences, and illustrate how
providing support to families in their community has been a supportive, hopeful, and rewarding
process. Furthermore, social media and other internet sources, radio and word-of-mouth will be
utilized as our marketing channels. Launching this campaign will also include involving the child
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welfare system management team in creating more positive and welcoming packages for PPSWs.
As part of this, first, an awareness drive would be launched for creating and increasing optimism
at all levels. Next, we plan to advertise the welcome package through local media, and public
entities such as libraries, supermarkets and child welfare recipients.
Ethical Considerations
The PPSW system follows an empowerment model, which acknowledges the strengths of
people with lived experiences who can serve as valuable resources to parents. Although PPSWs
receive extensive training to enhance their proficiency and their understanding of key ethical issues
and standards, their use poses several key ethical challenges. PPSWs often provide services
requiring skilled judgments related to client privacy and confidentiality, boundaries and dual
relationships, informed consent, paternalism, documentation, and client abandonment. PPSWs
receive weekly supervision to ensure that they are familiar with these ethical challenges, and
understand prevailing standards regarding clients' right to privacy and confidentiality, as well as
the exceptions to these rights.
One of the ethical considerations with regard to PPSWs is privacy and confidentiality.
PPSWs have access to sensitive information about families. But they may not have the same legal
responsibilities as social workers, regarding the careful management of clients' private and
confidential information. Therefore, Stride’s clinical supervisor provides weekly supervision, in
order to increase PPSWs knowledge, understanding and compliance with regard to confidential
information.
Another ethical consideration involves boundaries and dual relationships. PPSWs pose
unique boundary and dual-relationship challenges, because PPSWs who were once recipients of
child welfare services are now service providers. Therefore, it becomes important to establish
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boundaries between the status of a former client and that of a colleague. Another complication
pertains to self-disclosure and the assumption that informal relationships between support workers
and clients can be therapeutically helpful to clients. These informal relationships may include
social activities and conversations resembling crossing of boundaries. These ambiguous
boundaries may be difficult to navigate, particularly when PPSWs are expected to share
confidential information about clients with agency staff members. To ensure that our families give
informed consent, we propose to provide the families with clear descriptions of the role of PPSWs,
including information about professional boundaries and confidentiality.
A potential risk associated with PPSWs is that they might relapse and have difficulty
performing their professional duties. In such cases, PPSWs are treated the same way as employees
who need time off for health-related challenges. If the severity of their struggles interferes with
their ability to sustain employment, they are treated the way any employee with comparable
challenges would be treated. Stride provides PPSWs with options such as a medical leave, job
coaching, and supplemental supervision, as needed.
Area Five: Implications, Actions, Conclusions
Implications
Effective dissemination involves offering solutions to people who can utilize them. This
author has disseminated information by identifying an organizational champion within the child
protective service. The author will continue to build partnerships and provide a wide range of
outputs for beneficiaries, users and stakeholders. The author’s dissemination of information
includes a business and social networking website (http://www.familiesstride.com/), community
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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stakeholder meetings and briefings for agencies. Further, the author has started sharing Stride’s
prototype with relevant practitioners and external stakeholders. Stride’s future steps of action
include partnering with a university or academic unit for the purpose of shared training and for
bringing research skills to the implementation project (Powell et al., 2015). Stride will continue to
work towards overcoming indifference or resistance provoked by its intervention, within the child
welfare system, and towards purposefully re-examining the implementation process (Powell et al.,
2015). Stride will also continue to promote adaptability, by identifying the ways in which the
implementation can be made innovative and tailored to meet client needs, and by determining
which elements must be maintained to preserve fidelity (Powell et al., 2015).
Conclusion
With approximately 5 children dying daily in the United States, some at the hands of their
biological parents, an effective way to intervene is to use the social learning theory to change
learned behaviors. The child welfare system can address the grand challenge of Building Healthy
Relationships to End Violence, by providing evidence-based treatment along with peer support.
Identifying emerging risks and implementing prevention services for children who are candidates
for foster care is essential. Services need to be geared towards teaching new parenting behaviors,
in an environment which fosters and motivates the parent’s self-efficacy and emotional regulation
skills. Parental training and family support programs such as PCIT have reduced rates of
maltreatment, while bettering parenting attitudes, parent-child interactions, and child mental health
(Whitaker & Lutzker, 2009 as cited in Mersky et al., 2013). Adverse childhood experiences impact
mental health, substance abuse, and physical health outcomes, thereby increasing the financial
burden on society. Stride services are cost-effective and can reduce future economic costs resulting
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from untreated trauma. Every individual is impacted by adverse childhood experiences, which are
often transmitted across generations. Building healthy relationships to end violence, by increasing
attachment, emotional regulation and self-efficacy skills, will decrease intergenerational
transmission of violence.
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Appendix A
Infographic
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Appendix B
Logic Model
Appendix B
1
Name: Stride Logic Model
Date: 06/21
Project: Providing Parent Child Interaction Therapy and Parent Peer Support Workers to assist abused parents increasing self-efficacy, emotional regulation,
and attachment skills.
Goal:
• To decrease intergenerational transmission of trauma.
• To decrease number of children placed into foster care.
• To decrease child abuse and neglect cases.
INPUTS ACTIVITIES OUTCOMES Indicators
(Resources to achieve
objective)
What we do Outputs
# of Participants
Initial Outcomes
(Benefits)
Intermediate
Outcomes
Long-term
Outcomes
Outcome Indicators
Observable, measurable
information to track success
Staff
1 License Clinical
Social Worker (LCSW)
1 Parent Peer Support
Worker (PPSW)
1 Clinical Supervisor
Parent Peer Support
Worker (PPSW) will
implement Albert
Bandura’s Social
Learning Theory
Clinician will implement
Parent Child Interaction
Therapy (PCIT)
Completion and review
of assessments and
treatment plan.
General Assessments:
Emotional Regulation
Skills Questionnaire
(ERSQ) scale
PROGRAM
PARTICIPANTS:
(anticipated #’s)
6 families (these
include abused
mothers and fathers
and their children at
risk of foster care)
Learning
Parents will increase
self confidence
Parents gain
knowledge about
attachment and
regulation of
emotions.
Parents gain
knowledge &
understanding of
parenting skills
Children who are at
risk of out of home
placement will safely
Action
PPSW will assist
parents with
increasing confidence
and self -efficacy
skills.
PPSW will allow
parents to observe and
model appropriate
parenting behaviors.
LCSW will teach
parents about
attachment and
emotional regulation.
Child Protective
Service case plans for
families will be
created to achieve
Conditions
Parents will have
increased self-
efficacy, emotional
regulation,
attachment skills as
evidence by
assessments.
Parents will have a
decreased risk of
transmission of
trauma.
Parents will complete
their Child Protective
Service case plan.
Conditions
90% parents will have increased
self-efficacy, as evidenced by
Parents Self-Efficacy Scale.
90% parents will have increased
emotional regulation, as
evidenced by Emotional
Regulation Skills Questionnaire
(ERSQ) scale
90% parents will have increased
attachment skills, as evidenced
by Edberg Child Behavior
Inventory, Dyadic Parent Child
Interaction Coding system
(DPICS)
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Appendix B
2
Parents Self-Efficacy
Scale
Adverse Childhood
Experience scale
PCIT Assessments:
Edberg Child Behavior
Inventory, Dyadic Parent
Child Interaction Coding
system (DPICS)
Sutter- Eyberg Student
Behavior Inventory
Therapy Attitude
Inventory (TAI)
Child Rearing Inventory
Revised Edition of the
School Observation
Coding System
(REDSOCS)
remain with their
families.
safety and
permanency.
.
Interaction Coding system
(DPICS)
80% of parents will successfully
complete their Child Protective
Service (CPS) case plan as
evidence by CPS case closure.
Assumptions
• Parent Peer Support Workers will be effective at implementing Albert Bandura’s
Social Learning Theory
• Parents with a history of trauma want to learn how to parent effectively
• Families want to stay together
External Factors
• The Family First Prevention Act of 2018
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Appendix C
Current Market Analysis
Appendix C: Current Market Analysis
Program Name Servicing
mothers &
fathers
Increasing
attachment and
emotional
regulation skills
Identifying
maladaptive
parenting
behaviors and
practicing new
skills
Utilization of
peer support
increasing self-
efficacy skills
Pat ’s Place Child
Advocacy
Center
Iowa ’s Parent
Partner
Program
Circle of Parents
Family Centered
Treatment
Florence
Criterion
Services
Stride
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Appendix D
Line Item Budget for Stride
Appendix D
Budget
Administration Expenses Cost Units 6 months
PT Licensed Clinical Social Worker 50 pr hr 144 7,200
PT Parent Peer Support Worker 20 pr hr 216 4,320
Operating Expenses
Peer Certification Training 400 1 400
Total 11,920
Revenue
Fee for Services Cost Units 6 months
Parent Child Interaction Therapy 188 144 27,072
Total 27,072
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Appendix E
Prototype
Clinician contacts family
& asks if they would like a
PPSW?
Treatment Assessments
Child Rearing Inventory
Therapy Attitude Inventory (TAI)
Sutter-Eyeburg Behavior Inventory
Eyeburg Child Behavior Inventory
Dyadic Parent Child Interaction Coding
System (DPICS)
Revised edition of the social observation
coding system (REDSOCS)
Supported
Mid Assessments
TTM
Encouraged
PPSW Using Albert Bandura Social Learning Theory
Service
Innovation
Feelings
Traditional Treatment
Clinician
PCIT Completion &
Post Assessments
Parent Peer Support Worker (PPSW)
Assist parents in developing belief in one ’s
capabilities by modeling and providing
guidance through weekly/biweekly home
visits & daily phone calls.
Overwhelmed
Begin PCIT
PCIT 4-8 sessions
Uncertain
Parent-Child Attachment
PCIT 8-12 sessions
Parent-Child Attachment,
Sessions 1-4
PCIT 12-16 sessions
Isolated
Bio: Matthew (36) M
A former foster care youth with a history of
trauma. Matthew J r. is at risk of out of home
placement, due to allegations of neglect and
physical abuse.
General Assessments For Model
Parent Self Efficacy Scale
Emotional Regulation Scale
Adverse Childhood Experience Scale
Stride's Customer J ourney Map
Pre-assessments
NO
Referral received from
CPS
YES
Hopeful
Resistant
TTM
Empowered
Self-efficacy
,
Emotional Regulation
Emotional Regulation
TTM - Treatment Team Meeting
PPSW - Parent Peer Support Worker
CPS - Child Protective Service Worker
PCIT - Parent Child Interaction Therapy
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Appendix F
Adverse Childhood Experience Scale
Adverse Childhood Experience (ACE) Questionnaire
Name: __________________________________________ Date: _____________________
This Questionnaire will be asking you some questions about events that happened during your
childhood; specifically the first 18 years of your life. The information you provide by answering these
questions will allow us to better understand problems that may have occurred early in your life and
allow us to explore how those problems may be impacting the challenges you are experiencing today.
This can be very helpful in the success of your treatment.
While you were growing up, during your first 18 years of life:
1. Did a parent or other adult in the household often:
Swear at you, insult you, put you down, or humiliate you?
Or
Act in a way that made you afraid that you might be physically hurt?
Yes No If Yes, enter 1 _____
2. Did a parent or other adult in the household often:
Push, grab, slap, or throw something at you?
Or
Ever hit you so hard that you had marks or were injured?
Yes No If Yes, enter 1 _____
3. Did an adult or person at least 5 years older than you ever:
Touch or fondle you or have you touch their body in a sexual way?
Or
Attempt or actually have oral, anal, or vaginal intercourse with you?
Yes No If Yes, enter 1 _____
4. Did you often feel that:
No one in your family loved you or thought you were important or special?
Or
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Adverse Childhood Experience (ACE) Questionnaire
2
Your family didn ’t look out for each other, feel close to each other, or support each other?
Yes No If Yes, enter 1 _____
5. Did you often feel that:
You didn ’t have enough to eat, had to wear dirty clothes, and had no one to protect you?
Or
Your parents were too drunk or high to take care of you or take you to the doctor if you needed
it?
Yes No If Yes, enter 1 _____
6. Were your parents ever separated or divorced?
Yes No If Yes, enter 1 _____
7. Were any of your parents or other adult caregivers:
Often pushed, grabbed, slapped, or had something thrown at them?
Or
Sometimes or often kicked, bitten, hit with a fist, or hit with something hard?
Or
Ever repeatedly hit over at least a few minutes or threatened with a gun or knife?
Yes No If Yes, enter 1 _____
8. Did you live with anyone who was a problem drinker or alcoholic, or who used street drugs?
Yes No If Yes, enter 1 _____
9. Was a household member depressed or mentally ill, or did a household member attempt
suicide?
Yes No If Yes, enter 1 _____
10. Did a household member go to prison?
Yes No If Yes, enter 1 _____
ACE SCORE (Total “Yes ” Answers): _______
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Appendix G
Emotional Regulation Skills Questionnaire
Emotion Regulation Skills Questionnaire (Mirabile, 2014)
Listed below are a number of statements which parents, caregivers, and teachers use to describe how children
respond to different feelings and situations. Please read each statement and respond as honestly as you can. There
are no right or wrong answers. Circle the number to show how often your child uses each strategy.
Never Rarely Sometimes Often Almost Always
0 1 2 3 4
Think about when your child gets ANGRY (for example, when s/he wants something but can’t have it, when s/he
has to wait for something s/he wants), and please rate how often your child does the following behaviors when s/he
gets ANGRY.
1. S/he calms him/herself by talking through the problem (e.g., “I’m a big boy;” “I just have to wait
a little longer”).
0 1 2 3 4
2. S/he tries to get the object s/he can’t have. 0 1 2 3 4
3. S/he asks questions about the forbidden object or why s/he cannot have it (e.g., “When do I get
my present?”, “When can I have the candy?”, “Why can’t I have the cookie?”)
0 1 2 3 4
4. S/he watches or stares at the forbidden object (e.g., a candy or toy). 0 1 2 3 4
5. S/he expresses his/her anger by crying, yelling, or screaming. 0 1 2 3 4
6. S/he shows his/her anger by banging, kicking, throwing things, or hitting things or people. 0 1 2 3 4
7. S/he ignores his/her anger and talks to me about something else. 0 1 2 3 4
8. S/he ignores whatever is making him/her angry and finds a toy to play with, sings, dances, runs
around, or finds something else to do.
0 1 2 3 4
9. S/he comforts him/herself by thumb sucking, playing with his/her hair, looking at or playing with
parts of his/her body or clothes (e.g., fingers, buttons, zippers), or uses a teddy or blanket.
0 1 2 3 4
10. S/he comes to me for comfort (e.g., reaches up to me, asks me for a hug, climbs into my lap,
wants to be held).
0 1 2 3 4
11. S/he asks me for help in fixing the problem (e.g., getting another child to share). 0 1 2 3 4
12. S/he asks, threatens, or does run away from what is making him/her angry, leaves the room, or
looks away from it.
0 1 2 3 4
13. S/he tries to hold his/her anger inside and/or does not want to show how s/he feels. 0 1 2 3 4
Think about when your child gets SAD (for example, when s/he wants something but can’t have it, when s/he has to
wait for something s/he wants), and please rate how often your child does the following behaviors when s/he gets
SAD.
14. S/he calms him/herself by talking through the problem (e.g., “I’m a big girl;” “I can find my lost
toy”).
0 1 2 3 4
15. S/he tries to get the object s/he can’t have anyway. 0 1 2 3 4
16. S/he asks questions about the object s/he can’t have or why s/he cannot have it (e.g., “When do I
get my present?”, “When can I have the candy?”, “Why can’t I have the cookie?”)
0 1 2 3 4
17. S/he watches or stares at the object s/he can’t have (e.g., a candy or toy). 0 1 2 3 4
18. S/he shows his/her sadness by crying or pouting. 0 1 2 3 4
19. S/he shows his/her sadness by banging, kicking, throwing things, or hitting things or people. 0 1 2 3 4
20. S/he ignores his/her sadness and talks to me about something else. 0 1 2 3 4
21. S/he ignores his/her sadness and finds a toy to play with, sings, dances, runs around, or finds
something else to do.
0 1 2 3 4
22. S/he comforts him/herself by thumb sucking, playing with his/her hair, looking at or playing with
parts of his/her body or clothes (e.g., fingers, buttons, zippers), or uses a teddy or blanket.
0 1 2 3 4
23. S/he comes to me for comfort (e.g., reaches up to me, asks me for a hug, climbs into my lap,
wants to be held).
0 1 2 3 4
24. S/he asks me for help in fixing the problem (e.g., fixing a broken toy, getting another ice cream
cone).
0 1 2 3 4
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25. S/he asks, threatens, or does run away from what is making him/her sad, leaves the room, or
looks away from it.
0 1 2 3 4
26. S/he tries to hold his/her sadness inside and/or does not want to show how s/he feels. 0 1 2 3 4
Think about when your child gets AFRAID or SCARED (for example, when s/he is watching a scary movie, meets
an unfamiliar person or animal) and please rate how often your child does the following behaviors when s/he gets
AFRAID or SCARED.
27. S/he calms him/herself by talking through the problem (e.g., “I’m a big boy;” “This is just
pretend”).
0 1 2 3 4
28. S/he tries to face the situation and deal with it. 0 1 2 3 4
29. S/he asks questions about the event or object (e.g., “Will it hurt me?” or “Is this pretend or make-
believe?” or “It’s just TV/a movie, right?”)
0 1 2 3 4
30. S/he watches or stares at what makes him/her afraid. 0 1 2 3 4
31. S/he shows his/her fear by crying, yelling, or screaming. 0 1 2 3 4
32. S/he shows his/her fear by banging, kicking, throwing things, or hitting things or people. 0 1 2 3 4
33. S/he ignores whatever makes him/her afraid and talks to me about something else. 0 1 2 3 4
34. S/he ignores whatever makes him/her afraid and finds a toy to play with, sings, dances,
runs around, or finds something else to do.
0 1 2 3 4
35. S/he comforts him/herself by thumb sucking, playing with his/her hair, looking at or playing with
parts of his/her body or clothes (e.g., fingers, buttons, zippers), or uses a teddy or blanket.
0 1 2 3 4
36. S/he comes to me for comfort (e.g., reaches up to me, asks me for a hug, climbs into my lap,
wants to be held).
0 1 2 3 4
37. S/he asks me for help in fixing the problem (e.g., asking to turn off a scary movie, put away a
scary toy, leave a scary place).
0 1 2 3 4
38. S/he asks, threatens, or does run away from what makes him/her afraid, leaves the room, or looks
away from it.
0 1 2 3 4
39. S/he tries to hold his/her fear inside and/or does not want to show how s/he feels. 0 1 2 3 4
Think about when your child gets very HAPPY or EXCITED (for example, when s/he is at a birthday party or is
playing with a best friend) and needs to calm down because s/he is TOO EXCITED and please rate how often your
child does the following behaviors when s/he is TOO HAPPY or EXCITED.
40. S/he calms him/herself down by talking to him/herself (e.g., “I need to slow down”). 0 1 2 3 4
41. S/he puts away or stops playing with whatever is making him/her too excited. 0 1 2 3 4
42. S/he asks questions like “Why do I have to calm down?” 0 1 2 3 4
43. S/he keeps watching or playing with whatever is making him/her excited. 0 1 2 3 4
44. S/he shows his/her excitement by screaming, shouting, or running around. 0 1 2 3 4
45. S/he shows his/her excitement by banging, kicking, throwing things, or hitting things or people. 0 1 2 3 4
46. S/he is able to ignore whatever makes him/her too excited and can talk to me about something
else instead.
0 1 2 3 4
47. S/he ignores whatever makes him/her too excited and finds a different toy to play with, or finds
something else to do.
0 1 2 3 4
48. S/he calms down by thumb sucking, playing with his/her hair, looking at or playing with parts of
his/her body or clothes (e.g., fingers, buttons, zippers), or uses a teddy or blanket.
0 1 2 3 4
49. S/he comes to me for comfort or to help calm down (e.g., reaches up to me, asks me for a hug,
climbs into my lap, wants to be held).
0 1 2 3 4
50. S/he asks me for help calming down (e.g., asking you to put away a fun toy). 0 1 2 3 4
51. S/he asks, threatens, or does run away from whatever is making him/her too excited, leaves the
room, or looks away from it.
0 1 2 3 4
52. S/he tries to hold his/her excitement inside and/or tries not to show how s/he feels. 0 1 2 3 4
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SUBSCALES
Adaptive regulatory strategies:
Self-directed Speech/Symbolic Self-Soothing (SD). These items reflect the degree to which a child responds to
intense emotion by talking to him/herself.
Scoring: Mean of: 1, 14, 27, 40.
Constructive/Instrumental Coping (IC). These items reflect the degree to which a child responds to intense
emotion by attempting to address/change/fix the emotion elicitor.
Scoring: Mean of: 2, 15, 28, 41.
Information Gathering (IG). These items reflect the degree to which a child responds to intense emotion by
gathering information/asking questions about the emotion elicitor.
Scoring: Mean of: 3, 16, 29, 42.
Self Comforting/Soothing (SC). These items reflect the degree to which a child responds to intense emotion by
engaging in self-comforting/stimulatory behaviors.
Scoring: Mean of: 9, 22, 35, 48.
Comfort Seeking (CS). These items reflect the degree to which a child responds to intense emotion by soliciting the
comforting/soothing of a caregiver.
Scoring: Mean of: 10, 23, 36, 49.
Support Seeking (SS). These items reflect the degree to which a child responds to intense emotion by soliciting the
help/assistance of a caregiver.
Scoring: Mean of: 11, 24, 37, 50.
Verbal/Other-oriented Distraction (VD). These items reflect the degree to which a child responds to intense
emotion by talking to a caregiver about an unrelated topic.
Scoring: Mean of: 7, 20, 33, 46.
Self/Object Oriented Distraction (OD). These items reflect the degree to which a child responds to intense
emotion by engaging in an alternate activity unrelated to the stressor.
Scoring: Mean of: 8, 21, 34, 47.
Maladaptive regulatory strategies:
Focus on Distressing Object/Situation (OF). These items reflect the degree to which a child responds to intense
emotion by only focusing their attention on the emotion elicitor.
Scoring: Mean of: 4, 17, 30, 43.
Venting (VN). These items reflect the degree to which a child responds to intense emotion by expressing that
emotion verbally or physically.
Scoring: Mean of: 5, 18, 31, 44.
Aggression (AG). These items reflect the degree to which a child responds to intense emotion by physically
attacking the stressor or an(other) object or individual.
Scoring: Mean of: 6, 19, 32, 45.
Avoidance (AV). These items reflect the degree to which a child responds to intense emotion by attempting to or
actually removing themselves from the situation or removing the stressor from their attention.
Scoring: Mean of: 12, 25, 38, 51.
Suppression (SU). These items reflect the degree to which a child responds to intense emotion by attempting to
minimize their external display of the emotion.
Scoring: Mean of: 13, 26, 39, 52.
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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Composite scales:
Adaptive Emotion Regulation – calculated as mean of SD, IC, IG, SC, CS, SS, VD, OD
( α = .87 in Mirabile & Thompson, 2011; α = .62 in Mirabile, 2014)
Maladaptive Emotion Regulation – calculated as mean of OF, VN, AG, AV, SU
( α = .85 in Mirabile & Thompson, 2011; α = .61 in Mirabile, 2014)
Mirabile, S. P. (2014). Parents’ inconsistent emotion socialization and children’s socioemotional
adjustment. Journal of Applied Developmental Psychology, 35, 392-400. doi:
10.1016/j.appdev.2014.06.003
Mirabile, S. P., & Thompson, B. N. (March, 2011). Skills-based Assessment of Emotion Regulation in
Early Childhood: Description and validation of a novel measure. Poster presented at the 2011 Biennial
Meeting of the Society for Research in Child Development, Montreal, Canada.
Address correspondence to:
Scott Mirabile, Psychology Department,
St. Mary ’s College of Maryland
47645 College Drive
St. Mary ’s City, MD 20686
spmirabile@smcm.edu
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
60
Appendix H
Parental Self-Efficacy Scale
1
PARENTAL SELF-EFFICACY SCALE
This questionnaire is designed to help us gain a better understanding of the kinds of things that
make it difficult for parents to influence their children’s school activities. Please indicate your
opinion about each of the statements below by circling the appropriate number. Your answers will
be kept strictly confidential and you will not be identified.
EFFICACY TO INFLUENCE SCHOOL-RELATED PERFORMANCE
How much can you do to make your children see school as valuable?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to help children to do their homework?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to help your children to work hard at their school work?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to get your children to stay out of trouble in school?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to discourage your children from skipping school?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to help your children get good grades in school?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to teach your children to enjoy school?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
61
2
How much can you do to show your children that working hard at school influences later successes?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
EFFICACY TO INFLUENCE LEISURE-TIME ACTIVITIES
How much can you do to get your children into activities outside of school (for example, music, art,
dance, lessons, sports activities)?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to help your children keep physically fit?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you involve yourself with your children in their leisure activities?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
EFFICACY IN SETTING LIMITS, MONITORING ACTIVITIES AND INFLUENCING PEER AFFILIATIONS
How much can you do to keep track of what your children are doing when they are outside the
home?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to prevent your children from getting in with the wrong crowd of friends?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to get your children to associate with friends who are good for them?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to get your children to do things you want at home?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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3
How much can you do to manage when your children go out and they have to be in?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to instill your values in your children?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to spend time with your children and their friends?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to work with other parents in the neighborhood at keeping it safe for your
children?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to keep your children from going to dangerous areas and playgrounds?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
EFFICACY TO EXERCISE CONTROL OVER HIGH-RISK BEHAVIORS
How much can you do to prevent your children from doing things you do not want them to do
outside the home?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to prevent your children from becoming involved in drugs or alcohol?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to prevent your children from becoming involved in premature sexual
activity?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
63
4
How much could you do if you found your children were using drugs or alcohol?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much could you do to stop your children if you found that they were sexually active?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
EFFICACY TO INFLUENCE THE SCHOOL SYSTEM
How much can you do to influence what teachers expect your children to be able to do in
schoolwork?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to influence what is taught in your children’s school?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to make your children’s school a better place for children to learn?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to influence the social activities in your children’s school?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to get parents involved in the activities of your children’s school?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to influence the books that are used in your children’s school?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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5
How much can you do to make your children’s school a friendly and caring place?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to make parents feel welcome in your children’s school?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to influence what is taught to your children?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to influence what your children do after school?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
EFFICACY TO ENLIST COMMUNITY RESOURCES FOR SCHOOL DEVELOPMENT
How much can you do to get neighborhood groups involved in working with schools?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to get churches involved in working with schools?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to get businesses involved in working with schools?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to get boy scouts/girl scouts involved in working with schools?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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6
How much can you do to get the YMCA/YWCA involved in working with schools?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to get a Private Industry Council involved in working with schools?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to get advocacy groups such as the Urban League,. NAACP, or Anti-
Defamation League involved in working with schools?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to get local colleges and universities involved in working with schools?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to get local health clinics and hospitals involved in working with schools?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to get public funds for specific programs in the schools?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
EFFICACY TO INFLUENCE SCHOOL RESOURCES
How much can you do to help your children’s school get the educational materials and equipment it
needs?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How much can you do to influence the size of the classes in your children’s school?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
66
7
EFFICACY TO CONTROL DISTRESSING RUMINATION
How well can you stop yourself from worrying about things?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How well can you take your mind off upsetting experiences?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How well can you keep yourself from being upset by everyday problems?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How well can you keep your mind on the things you are doing after you have had an upsetting
experience?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
RESILIENCY OF SELF-EFFICACY
How well can you keep tough problems from getting you down?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How well can you bounce back after you tried your best and failed?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How well can you get yourself to keep trying when things are going really badly?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How well can you keep up your spirits when you suffer hardships?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
67
8
How well can you get rid of self-doubts after you have had tough setbacks?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How well can you keep from being easily rattled?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
How well can you overcome discouragement when nothing you try seems to work?
1 2 3 4 5 6 7 8 9
Nothing Very Little Some Influence Quite a Bit A Great Deal
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
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Appendix I
Parent Peer Support Worker Code of Ethics
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
69
NC CERTIFIED PEER SUPPORT SPECIALIST PROGRAM
CERTIFICATION APPLICATION FORM
Approved for use in the Peer Support Specialist Credentialing Program
NC Division of MH/DD/SAS and NC Division of Medical Assistance Updated
6/8/2018 5
NCCPSS VALUES AND CODE OF ETHICS
The North Carolina Certified Peer Support Specialist Code of Ethics was developed by a
workgroup consisting of North Carolina Certified Peer Support Specialists, Supervisors, and other
stakeholders over a three-day meeting held in Chapel Hill, North Carolina. This code outlines
uniform standards and expectations to North Carolina Certified Peer Support Specialists in the
workplace. These ethical standards are intended to offer clear boundaries in the workplace for
Peer Support Specialists.
Disclaimer:
The North Carolina Certified Peer Support Certification indicates the person retaining this
certificate has successfully completed the requirements established by the North Carolina Division
of Mental Health, Developmental Disabilities and Substance Abuse Services. These requirements
may be located on the NC CPSS website for further review. Any violation of this code of ethics
should be submitted in writing to the NC Certified Peer Support Specialist Program and shall be
governed by policies and procedures established within the hiring entity.
VALUES
• People have the right to be treated with dignity and have their individual human rights
respected.
• Self-directed recovery does happen, with or without professional help.
• Sharing our recovery experiences fosters mutual relationships, reduces isolation, Inspires
hope, and strengthens the ongoing recovery process.
• Individuals have the right to live the full and meaningful lives they envision for themselves.
• People have the right to make their own choices about their treatment even if others think their
decisions are wrong
• Peer Support values the importance of community building and natural supports (family,
church, NA, AA, friends, etc.).
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
70
NC CERTIFIED PEER SUPPORT SPECIALIST PROGRAM
CERTIFICATION APPLICATION FORM
Approved for use in the Peer Support Specialist Credentialing Program
NC Division of MH/DD/SAS and NC Division of Medical Assistance
Updated 6/8/2018
6
CODE OF ETHICS
Attention to self-recovery is critical to the performance of duties as a Peer Support
Specialist(s) (PSS). When changes in recovery occur, the Peer Support Specialist will take
personal responsibility to seek support.
PSS are honest in their interactions; keeping it simple, keeping it real.
PSS relationships are mutual learning experiences.
PSS have a responsibility to support people to use their own voices to advocate for the
principles of human dignity, self- determination, and empowerment.
PSS honor commitments made to peers. PSS strive to always explore and ask open ended
questions rather than making assumptions. PSS explore alternatives and options with peers
rather than giving advice.
PSS support people to make their own choices, honoring self-determination. The PSS does not
put his/her agenda ahead of the peer ’s agenda.
PSS negotiate within the relationship with peers in order to facilitate peer choice and shared
power.
PSS avoid power struggles and favoritism.
PSS will not exploit, devalue, manipulate, abuse, neglect, or ignore a peer.
PSS and peers will not loan or borrow anything from each other; especially not money.
PSS will not establish romantic relationships with peers and will refrain from intimate or sexual
activity with peers.
PSS avoid dual relationships; when they are unavoidable, appropriate boundaries are
established within the relationship with the support of the supervisor.
PSS will not violate a peer's confidentiality except when required by law.
PSS does not accept or give gifts, if allowed by the agency, must be clearly related to the
peer's recovery process.
PSS do not take peers to their homes; any exception to this must have written agency
approval.
PSS do not hire peers to work for them if they are currently receiving services from their
DSW GRAND CHALLENGE FINAL CAPSTONE PAPER
71
NC CERTIFIED PEER SUPPORT SPECIALIST PROGRAM
CERTIFICATION APPLICATION FORM
Approved for use in the Peer Support Specialist Credentialing Program
NC Division of MH/DD/SAS and NC Division of Medical Assistance
Updated 6/8/2018
7
agency.
PSS's documentation in the agency record is person-centered, strength-based and done with
the peer whenever possible.
PSS take responsibility for their own professional development and are proactive about
expanding their knowledge and honing their skills with continuing education and training.
PSS have a responsibility to educate themselves about available community resources and to
establish helpful contacts in the community.
PSS do not make medical diagnoses.
I affirm that:
1. I have reviewed the ethical guidelines.
2. I have not violated any of the ethical codes.
Name: ___________________________________________________________________________
Signature: ____________________________________ Date: _______________________
Abstract (if available)
Abstract
The Grand Challenge for Social WorkㅡBuild Healthy Relationships to End Violence focuses on the role of positive interaction in fostering resilience to violent experiences, through safe and supportive people and places (Barth et al., 2020). In 2018, an estimated 670,000 children were victims of abuse and neglect (Children's Bureau, Administration on Children, Youth and Families, Administration for Children and Families, and U.S. Department of Health and Human Services, 2019). Despite the child welfare system’s efforts to keep children safe, the high number of maltreatment fatalities continues to greatly affect society, with 50 states reporting 1,720 fatalities in 2017 (Child Welfare Information Gateway, 2019). This translates to an average of nearly five children dying daily on account of abuse or neglect (Children's Bureau, Administration on Children, Youth and Families, Administration for Children and Families, and U.S. Department of Health and Human Services, 2019). ❧ The Child Welfare Information Gateway data reflects a high prevalence of children dying at the hands of their biological parents, and the need for promoting healthy relationships to end violence. The literature in the field suggests the existence of major controversies regarding intergenerational transmission of trauma. Thornberry et al. (2012) question the validity of intergenerational transmission of trauma, but several other authors clearly document its impact. Hall (2011) reported that mothers with a history of child abuse were 12 times more likely to abuse or neglect their own children. Ball (2009) reported that 70% of mothers who were abused as children would transmit the abuse they suffered. In addition, fathers might inflict child abuse because of their own perception of parenting behaviors, or might encourage mothers to abuse their children (Guterman et al., 2009). One of the major reasons behind child abuse is that most abusers have previously experienced some type of abuse. ❧ Experiencing child abuse influences an individual’s Adverse Child Experience (ACE) score, which directly correlates with health outcomes. Dr. Vince Felitti of Kaiser and Dr. Bob Anda conducted the ACE study at the Center for Disease Control and Prevention (CDC), concluding that there is a strong association between early adversity and health in later life (Mersky et al., 2017). Eradicating child abuse and neglect will reduce health care costs, decrease arrests, lower incarceration rates, and improve family relationships. ❧ Satell (2017) created an innovation matrix and identified four types of innovations for businesses: sustaining innovation, breakthrough innovation, disruptive innovation, and basic research. In sustaining innovation, the problem is understood, and the focus is on improving what is already working. Breakthrough innovation refers to fully understanding the problem, but offering a new approach to resolve it. Basic research involves utilizing earlier studies and discovering new phenomena for innovation. Disruptive innovation espouses a shift away from traditional solutions, focusing on disrupting current innovation structures and systems. Stride utilizes sustaining innovation, and builds upon best practices such as EBP (Evidence-based Practice) and peer support. Upon users’ request, Stride provides parent peer support services along with clinical services, in order to enhance attachment, emotional regulation, and self-efficacy skills. Building healthier relationships can prevent violence and interrupt intergenerational cycles of violence, while reducing the potential impact of violence on individuals, families, and communities (Barth et al., 2020). Based on psychologist Albert Bandura’s social learning theory, Stride is a sustaining innovation that is expected to increase emotional regulation, attachment and self-efficacy skills, thereby further decreasing the intergenerational transmission of trauma, child abuse, and neglect. ❧ Stride has a human-centric design which develops solutions by involving beneficiaries, users, and stakeholders at monthly meetings. It provides parent peer support services for abused parents and their children. Stride aims to provide evidence-based treatment and peer support to abused parents, in order to increase attachment, emotional regulation, and self-efficacy skills. It implements a strength-based approach, identifying strengths in parents, caretakers, and youth. This runs counter to traditional intervention models which utilize the “blaming and shaming” approach. Stride prevention services are implemented in the home with the assistance of a Parent Peer Support Worker (PPSW), and in the office in the presence of clinical staff, and are closely monitored in accordance with a family’s treatment plan. ❧ A PPSW is defined as an individual who engages parents as peers, in order to increase confidence and self-efficacy skills, by bringing together parents who may share similar experiences. Goodson (2005) performed a meta-analysis of evaluation data from over 200 parent peer support programs, and concluded that these programs had the strongest effect if they included professional staff and used the peer support component. A PPSW receives peer certification training which teaches them how to engage the parent in a process of non-judgmental support, and to hold parents accountable when their decisions may negatively affect their children. This process helps to bolster their parenting confidence, ultimately impacting their self-efficacy skills. Peer support programs have presented outcomes which address child maltreatment, risk and protective factors within the child welfare system. These, in turn, have proved to be helpful in reducing child maltreatment outcomes, such as parental distress, rigidity, and psychological/physical aggression towards children (Friends, 2008; Pion-Berlin et al., 2011; Polinsky et al., 2010). These outcomes have also reduced parental involvement and entry/re-entry into the child welfare system, enabled faster reunification times, and enhanced progress rates for parents with peer support compared to those without peer support (Cameron, 2002; Rauber, 2009; Goodson 2009 as cited in Horn, J.) Berrick et al., 2011 reported that peers bring a treasure of shared experiences, encouragement, trust, hope, clear communication, availability, emotional support, and help to tackle substance abuse, thereby increasing self-confidence. Stride is different from traditional peer support models because it also incorporates clinical evidence-based treatment. According to previous research, child welfare agencies and families may benefit from using parent peer support programs, but these should be provided in addition to traditional services (DePanfilis, 1996).
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Asset Metadata
Creator
Harrington, Jennifer Yvette
(author)
Core Title
Building healthy relationships to end family violence
School
Suzanne Dworak-Peck School of Social Work
Degree
Doctor of Social Work
Degree Program
Social Work
Degree Conferral Date
2021-08
Publication Date
08/28/2021
Defense Date
08/10/2021
Publisher
University of Southern California
(original),
University of Southern California. Libraries
(digital)
Tag
Build Healthy Relationships to End Violence,Child abuse,neglect,OAI-PMH Harvest,trauma
Format
application/pdf
(imt)
Language
English
Contributor
Electronically uploaded by the author
(provenance)
Advisor
Smith-Maddox, Renee (
committee chair
), James, Jane (
committee member
), Wiley, June (
committee member
)
Creator Email
Jenniferyharrington@gmail.com,Jyharrin@usc.edu
Permanent Link (DOI)
https://doi.org/10.25549/usctheses-oUC15905095
Unique identifier
UC15905095
Legacy Identifier
etd-Harrington-10045
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Capstone project
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Harrington, Jennifer Yvette
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Tags
Build Healthy Relationships to End Violence
neglect
trauma