Correlates of problem recognition and intentions to change among caregivers of abused and neglected children.

OBJECTIVE To identify individual, family, and caseworker characteristics associated with problem recognition (PR) and intentions to change (ITC) in a sample of caregivers who received in-home child welfare services following substantiated reports of child abuse or neglect. METHODS Caregivers were interviewed at 4 weeks, 16 weeks, and 1 year after referral for in-home services. In these interviews, the University of Rhode Island Change Assessment scale assessed PR and ITC in relation to caregiving practices. Additional data were obtained from administrative records and surveys of in-home services caseworkers. We used growth models to identify caregiver, family, and caseworker characteristics associated with initial levels of PR and ITC, and with changes in PR and ITC over time. RESULTS Contrary to expectations, there were no overall increases in PR and ITC during the first 4 months of in-home services. PR and ITC scores fluctuated over time, in relation to some external events, case characteristics, and caseworker characteristics; however, we were able to account for small portions of the variance in PR and ITC. Controlling for social desirability bias and other variables in the analysis, negative life events, lack of network support, and the severity of caregiver depression were associated with greater PR; housing problems were associated with lower PR. Caregiver depression and age were associated with ITC. Caregivers whose children had been removed from their homes showed significant increases in ITC in the first few months of in-home services. The duration of caseworkers' child welfare experience predicted increases in their clients' PR in the first 4 months and more frequent contacts with an experienced caseworker predicted small, but significant increases in ITC over time. CONCLUSIONS PR and ITC are associated with somewhat different case characteristics and may be affected by caseworkers' experience.