INTRODUCTION: The burden of child maltreatment is substantial, highlighting the importance of identifying effective prevention programs in reducing occurrence and costs. The SafeCare® model was developed as a home-based service for high-risk parents in child protective services for child maltreatment. Although limited, studies that evaluate interventions for child maltreatment through a public health strategy can be achieved through administrative data and have a positive impact on population level reduction of abuse and neglect. AIM: This current secondary analysis examines the effect of the statewide implementation of SafeCare compared to services as usual on the likelihood of out-of-home placement. The research question is “are there differences in out-of-home placement among families referred to SafeCare compared to families who received services as usual?” METHOD: The original study was a cluster-randomized research design was implemented to evaluate SafeCare verses services as usual at the agency/region level including two urban and four rural child protective services administrative regions of Oklahoma. The secondary analysis sample included 2,175 families, prioritizing the primary caregiver for intervention. The Cox proportional-hazards regression model was used to estimate the relative risk for an out-of-home placement and participants were categorized according to intervention type group. RESULTS: By the end of the 2.9-year follow-up, there were 283 first time occurrences of out-of-home placement. Families randomized to receive services as usual had no effect compared to families receiving SafeCare on the likelihood of out-of-home placement after adjusting for baseline family covariates. DISCUSSION: These findings suggest that many chronic cases in the child welfare system may show limited change with services and may suggest a different service approach for reducing recidivism in out-of-home placement outcomes. Although limited, evaluating interventions for child maltreatment by using administrative data can be achieved through administrative data and have a positive impact on establishing effective prevention programs in reducing occurrence of abuse and neglect on a population level.

Syftet med denna undersökning har varit att se vad förvaltningsrätten grundar sina avslag gällande avslutad LVU vård på när det avser bristande omsorg. Intresset uppkom genom den samhälleliga diskussionen kring LVU där jag uppfattat att det finns två läger – Säkrare kontroller vid en hemflytt, och att barn blir placerade enligt LVU på allt för lättvindiga grunder. Anledningen till att det blev just den bristande omsorgsförmågan som ska ligga till grund för placeringen, var att bristande omsorg kan ha olika kännetecken och därför även vara mer diffust att utreda.   För att ta reda på hur rätten resonerar har jag gjort en tematisk analys av förvaltningsrättsdomar som mitt empiriska material. Efter att jag kodat mitt material blev det snabbt tydligt att det fanns främst två orsaker till att rätten avslog vårdnadshavarnas önskan om avslutad vård. Det ena var att de förhållanden som föranlett vården inte hade förändrats, det andra var att föräldrarna saknade insikt.  I min analys valde jag att använda mig av anknytningsteorin samt ett socialkonstruktionistiskt perspektiv. Utifrån dessa teoretiska ramar kunde jag se att anknytning till barnet var något rätten fäste stor vikt vid. Vidare kunde jag identifiera att rätten resonerade olika och la tonvikten på olika aspekter beroende på om det var en mamma, pappa eller båda som ville att vården skulle avslutas.  Den här undersökningen är relevant för socialt arbete då det kan bidra till en ökad förståelse för vad rätten lägger vikt på vid en bedömning av om vård är nödvändig eller inte. Detta skulle kunna underlätta för socialtjänsten att upprätta en handlingsplan till vårdnadshavarna, för att på ett effektivt sätt hjälpa dem att få hem sina barn igen.  Trots att de nordiska länderna till stor del har ett liknande tillvägagångssätt när det kommer till barnavårdsutredningar, finns även en del skillnader som skulle kunna ha stor betydelse för individen. Detta har fått mig att reflektera kring huruvida Sveriges system är det mest rättssäkra eller inte. / The purpose of this research has been to see on what the administrative court bases its refusals regarding the terminated out-of-home placements when kids have been maltreated by their guardian or guardians. The interest was triggered by the wider societal discussion about out-of-home placements, from which I was able to identify two predominant groups. One group believed a more thorough investigation was required prior to end placements, and the other believed that social service placed children in out-of-home care on too easy grounds. The reason I decided to focus my study on children that has been maltreated by their guardians is that it could include a verity of characteristics and could therefore be difficult to investigate.  To find out how the court reasons, I have done a thematic study with administrative court judgments as my empirical material. After I´d coded the material, it quickly became obvious that there were mainly two reasons why the court rejected the guardians' wish for terminated care. The first was that the conditions had not changed enough and the other reason was that the parents were lacking insight.  In my analysis, I chose to use the attachment theory and a social constructionist perspective. Based on these theoretical frameworks, I could see that connection to the child was something the court put great importance in. Furthermore, I could identify that the court reasoned differently on some aspects depending on whether it was the mother, father or both who wanted the care to be terminated. This study is relevant for social work since it can contribute to an increased understanding of what the court finds important in assessing whether care is necessary or not. This could make it easier for the social services to come up with an action plan for the guardians, in order to effectively help them get their children home again. Despite the fact that the Nordic countries largely have a similar approach when it comes to child care investigations, there are also some differences that could be of great importance to the individual. This has made me reflect on whether or not Sweden's system is the most legally secure. And if there are aspects we could learn and maybe take after from our neighbours.

Il lavoro di tesi ha come oggetto di studio gli interventi di collocamento etero-familiare dei minori, in affidamento familiare e in comunità educativa, realizzati dai Servizi sociali in Emilia-Romagna, nel periodo 2008-2012. Sono stati analizzati i dati provenienti dal sistema informativo regionale, relativi ad 8.438 minori. Il lavoro si compone di tre parti: la prima è un’analisi descrittiva delle caratteristiche dei minori del campione e dei diversi interventi effettuati. Nella seconda parte, assumendo la prospettiva della family reunification, si intende osservare l’effettivo percorso dei minori, in termini di miglioramento o di peggioramento delle condizioni di partenza, al di là del rientro in famiglia. Allo scopo sono state create delle tipologie di esito e delle tipologie di processo, attraverso cui definire ciascun percorso. E’ stata quindi effettuata l’analisi descrittiva degli esiti e dei processi presenti all’interno campione. Nell’ultima parte del lavoro, è stata effettuata un’analisi statistica, volta ad individuare correlazioni significative tra le tre variabili rappresentate dalle tipologie di collocamento, dagli esiti e dai processi e le caratteristiche dei minori, le problematiche prevalenti dei minori e le problematiche prevalenti dei nuclei familiari. Le stime effettuate attraverso tabelle a doppia entrata sono state corrette tramite modelli di regressione di probabilità lineare. / The aim of the study is to examine out-of-home placements for children in Child Protection System, both in foster and in residential care, in Emilia-Romagna, in the period 2008-2012. Data are collected by the regional information system and the sample includes 8,438 children. The work consists of three parts: the first is a descriptive analysis of the characteristics of the children and of the different interventions. In the second part, taking the perspective of family reunification, we intend to observe the actual path of the child, in terms of improvement or deterioration of conditions departure, beyond the return to the family. Some types of outcomes and some types of processes have been individuated. It was then performed the descriptive analysis of the outcomes and processes present in the sample. In the last part of the work, it was carried out a statistical analysis in order to identify significant correlations between the three variables represented by the types of placements, the outcomes and the processes and characteristics of the children, the prevalent problems of children and the problems prevailing household. Estimates made through double entry table have been corrected by linear regression models of probability.