How can behavioral science be used to promote successful placements?
LESSONS FROM OTHER FIELDS
How can behavioral science be used to promote successful placements?
By Elspeth Kirkman, Senior Director of Health, Education & Communities for the Behavioral Insights Team
In 2017, 270,000 children entered foster care and many tens of thousands more required new placements. The placement process can be complex, given the details of each case, limited placement options, and tight timeframes for permanency, and it’s easy to lose focus on ensuring safe and stable placements for all children, preferably with relatives. All too often, placement decisions are made under pressure in conditions that include an element of risk, and when the emotional stakes may be high. This brief presents recommendations for how behavioral science can help promote placement decisions that are more efficient, effective and stable over time.
Choosing the right placement faster
In the words of an 11-year-old speaking in court, “It’s not fair that we have to put our lives on hold while all of the adults get their act together.” Timely and stable placements are essential for minimizing disruption and trauma, increasing well-being, and decreasing mental health costs that result when a child is removed from their home.1 One of the key insights from behavioral science is that the way in which tasks or choices are presented to us influences how we process them and, as a result, the actions we take. Below are recommendations for how to use this insight to design a more effective placement process.
Free up time to focus on matters of judgment
Overly administrative processes can sap valuable time and lead those using them to focus on the wrong activities. Foster placements are no exception, and a streamlined process can go a long way toward maximizing the time available for staff to find a placement that is right for the child and promoting decisions that are consistent with the system’s values and goals. For example, the state of Arkansas recently started sending text messages to foster parents about specific children in need of placement, so that placement staff no longer needed to make multiple individual calls to a series of potential families. A similar strategy was employed in the UK and, for each message sent, the service received an average of 14 responses. This process gave placement workers a short list of viable options to compare, reduced the burden on families that are typically called first in a crisis, and created opportunities for foster parents who happen to fall farther down the call list. The effects of this intervention were wide ranging: a mother and child placement was made with a foster family who had never expressed interest in such a placement before; a number of unaccompanied migrant minors were placed faster as each search happened concurrently; and one foster family who had never been called on in the old process and was in the process of switching to a private agency reported reversing their decision after the text messaging system gave them a chance to foster through the public agency.
Go with the grain: design environments and practices for the preferred outcome
While the Family First Prevention Services Act will push agencies to reduce dependency on congregate care, new policies and good intentions are not enough to make meaningful change. As one child welfare leader we spoke to remarked, “People talk about the law but it’s about culture change; if it was just a matter of policy change that would have been easy.” In one placement team we interviewed, every staff member was clear on the hierarchy of desirable settings: kinship care, then a foster family, group homes, and residential centers. However, the team was still placing a high volume of children in group homes, despite the availability of local foster families. Further exploration revealed that the design of the work environment likely played a role in this dynamic: the placement team was co-located with the team responsible for managing group home contracts. Since locating placements can be a stressful task, the contracts team would often take action to help their placement co-workers, offering to secure beds at group homes as a temporary fix. Team rapport was high, but the children in the system were not being well-served. Physically separating the teams was necessary to break this dynamic.
This dynamic reflects “ethical fading,”2 a phenomenon whereby the greatest good is overshadowed by some other opportunity to have a positive impact, leading those with good intentions to compromise the ultimate outcome while still feeling they did the right thing. The good news is that intentional design of new processes and practices can go a long way. An audit of how easy it is to take each step on the path to optimal outcomes — and how difficult it is to make worse choices — is an especially effective way to address this. Behavioral science shows clearly that the level of effort associated with taking one action over another can determine which path we choose, even when the consequences of our decisions matter greatly. The barrier of administrative burdens can be greater than we might expect. For example, researchers found that, coupled with in-person assistance, using tax data to automatically complete a substantial portion of the Free Application for Federal Student Aid form for college applicants led to a 25% to 30% increase in high school students from low income backgrounds enrolling in college.3 Similarly, if it turns out the placement process for group homes is simpler than the process for kinship or foster family placements, it follows that more children may end up in congregate care. Adding and removing “friction” so that the process reflects agency priorities for family-based placement settings may be an effective way to drive rapid change.
Use the right comparison
During our interviews with adoption social workers, we heard many descriptions of the processes individual staff go through to give themselves personal assurance that they are making good decisions. A common technique these staff describe is to think about what the perfect family for this child might look like, and use those details as a benchmark during the search process. For example, one social worker described a situation in which “the model family for two children waiting to be adopted is of a German father and Jamaican mother with experience looking after siblings with complex health needs.” Using placement matching processes that focus on unrealistic or irrelevant standards may delay timely decision-making. Counter-balancing this approach by encouraging social workers to use relevant points of comparison — how the prospective family’s interests, dynamics and parenting style stack up when compared to the child’s current arrangement — might help them make a more balanced assessment of whether a particular placement option is appropriate.
Make the arrival into a new home welcoming and personalized
It is not unusual for information about the children being placed to get lost amid the many details of finding them a home. Aside from background on the children, their needs, behavior, and traumas, it is also important to provide information that can help build positive relationships early. For example, in response to data showing that children who share a common interest or trait with their teacher tend to get better grades, researchers designed a simple experiment to see if they could level the playing field. Teachers and students alike were asked to fill out a simple survey that included questions about their favorite ice cream flavor, whether they had siblings, or what sport they liked. Teachers and students were then told what they had in common, forging links that may not have otherwise emerged in the regular classroom environment. This simple intervention resulted in improved outcomes for students whose ethnicity did not match that of their teachers, closing 60% of the achievement gap in the school.4 Similar approaches are being implemented in child welfare: family members in San Diego are asked to help reduce the trauma of removal by filling out an “All About Me” form on behalf of their children so that foster families have a starting point for building a relationship. This process lessens the trauma of removal, and gives a voice to biological parents, acknowledging that they are the experts on their child, even if they aren’t with them at the moment.
Set clear goals and expectations for the placement
A related observation from foster families concerns the changing nature of their role based on the different needs of different children. This may be related to the child’s goal: a child with a goal of reunification may need help understanding their situation in a way that is different from a child whose goal is adoption. Children may also need different support depending on their temperament or interests. One foster mother told us that she had two children placed with her in succession: the first child was working to achieve high test scores that would get her into college; the second was dealing with chronic depression and could barely get out of bed. Her approach was to work with each child to set individual goals and hold them accountable. The first child’s chosen goals focused on test preparation and homework, while the second child’s included actions such as brushing her teeth each day. Behavioral research shows that these kinds of implementation intentions5 — a form of goal setting — can improve the chances of turning ideas and goals into action and achievement. Formalizing this kind of goal setting process, perhaps through a goal chart for all children in placement, may give foster families a clearer idea of their role, and a clearer sense of whether they are helping a child make progress.
Offer help at the right time, ideally before families ask for it
Offering advice and resources on post-adoption challenges may not be effective if only done at the adoption ceremony. The emotion of the day and the celebratory nature of the moment may mean that they either feel irrelevant or are simply forgotten. We already know that there are moments when disruption is more likely to occur in adoptive placements. Trauma may resurface and impact a child’s behavior after an initial “honeymoon” period, school transitions, or at the advent of puberty.6 Setting up a formal future correspondence plan to communicate just ahead of these milestones may help adoptive families reach out for support sooner. A reminder that help is at hand at the right moment can normalize the experience, reduce feelings of guilt or shame, and provide helpful structure where chaos threatens to take over.
Apart from formal follow-up from the professionals involved in the initial adoption, finding ways to activate the family’s support network around moments of potential disruption may also be powerful. Friends and family can provide practical and emotional support in ways that the state agency cannot. In one study with adult learners, we asked half of the students to nominate two members of their social network to receive weekly messages about their learning journey. Those students whose supporters received messages attended more classes and were 27% more likely to pass their exams at the end of the year.7 Using similar techniques, we might prompt families to reach out to their support networks before a crisis becomes unmanageable.
Keep foster families skilled and motivated
Keeping foster families engaged and building their skill over time is not something that will happen without intentionality. Evidence shows that providing foster families with training and support is an essential component of placement stability.8 Our own observations corroborate these findings and, in the course of our fieldwork, foster families shared their insights on the licensing process. In West Sussex, UK, their feedback helped design a training program for foster parents to address three specific challenges: 1) the need for tools to help handle the stress of the job; 2) the tendency for foster parents to think — despite being licensed for all case types — that they can only take children whose behaviors, needs and case specifics are similar to those they are used to; and 3) the need for more transparency about how placement decisions are made. Using a train-the-trainer model, foster care social workers were taught how to deliver the session content, which addressed building foster parents’ self-care and coping skills and, relatedly, boosting their appetite for taking on a broader variety of children. Fifty foster parents from a pool of around 105 were selected at random to attend the training. After surveying all foster parents, we found that those who attended the training reported significant improvement in engagement compared to those who had not, including their emotional commitment to fostering and their resilience, which is a key predictor of efficacy.9
Even with the best foster families available, the process of placement will always require expert judgment, a cool head under pressure, and a great deal of effort from those who work in the system. Settling in to a new home will also be tough, no matter how well the process is handled. However, small tweaks informed by behavioral science can make a surprising difference, helping those involved in the process to give children the best chance of success.
1 Rubin, D. M., Alessandrini, E. A., Feudtner, C., Mandell, D. S., Localio, A. R., & Hadley, T. (2004). Placement stability and mental health costs for children in foster care. Pediatrics, 113(5), 1336-1341.
2 Tenbrunsel, A. E., & Messick, D. M. (2004). Ethical fading: The role of self-deception in unethical behavior. Social justice research, 17(2), 223-236.
3 Bettinger, E. P., Long, B. T., Oreopoulos, P., & Sanbonmatsu, L. (2012). The role of application assistance and information in college decisions: Results from the H&R Block FAFSA experiment. The Quarterly Journal of Economics, 127(3), 1205-1242.
4 Gehlbach, H., Brinkworth, M. E., King, A. M., Hsu, L. M., McIntyre, J., & Rogers, T. (2016). Creating birds of similar feathers: Leveraging similarity to improve teacher–student relationships and academic achievement. Journal of Educational Psychology, 108(3), 342.
5 Gollwitzer, P. M. (1999). Implementation intentions: Strong effects of simple plans. American psychologist, 54(7), 493.
6 Selwyn, J., Wijedasa, D., & Meakings, S. (2014). Beyond the Adoption Order: Challenges, interventions and adoption disruption. University of Bristol School for Policy Studies Hadley Centre for Adoption and Foster Care Studies, Bristol, UK.
7 Groot, B., Sanders, M., Rogers, T., & Bloomenthal, E. (April 2017). I get by with a little help from my friends: Two field experiments on social support and attendance in further education colleges in the UK. The Behavrioural Insights Team, London, UK.
8 Koh, E., Rolock, N., Cross, T. P., & Eblen-Manning, J. (2014). What explains instability in foster care? Comparison of a matched sample of children with stable and unstable placements. Children and Youth Services Review, 37, 36-45.
9 Smith, B. W., Dalen, J., Wiggins, K., Tooley, E., Christopher, P., & Bernard, J. (2008). The brief resilience scale: assessing the ability to bounce back. International journal of behavioral medicine, 15(3), 194-200.
This article is the third in a four-part series on decision making and behavioral science in child welfare. This series looks at lessons from other fields and considers their relevance at critical steps in the child welfare system.