The next step: Integrating actuarial risk assessment and clinical judgment into an evidence-based practice framework in CPS case management

Assessment in child welfare involves at least two distinct processes: an assessment of risk (prediction of future harm) and a contextual assessment of child and family functioning used to develop case plans. Both types of assessment are critical decision aids, yet there has been confusion in the field about their respective uses. Actuarial risk assessment instruments clearly have the greatest potential to reliably and accurately estimate the recurrence of child maltreatment. This type of risk assessment, however, does not indicate which clinical factors are most important to address and certainly does not indicate which services are most likely to be effective. The structured decision making (SDM) approach is an example of an effort to integrate predictive and contextual assessment strategies into child welfare practice. Clinical decision makers complete both an actuarial risk assessment and an objective assessment of family strengths and needs. Both assessments incorporate clinical input in their design and completion. Yet this is still not enough. Clinicians must translate information from both forms of assessment into the choice of a set of effective service interventions. The process of evidence-based practice and the establishment of structural supports for this practice model may be the next step in the evolution of child protective services.