The 'dirty work" of child welfare

(Originally published February 2022)

During most of the 1970’s and 1980’s, I was a CPS caseworker, then a supervisor in two states (Colorado & Washington).   During that time, I often met strangers or acquaintances at social functions who asked me about my employment.  When I replied,  “CPS caseworker” or “CPS supervisor,” the most frequent response was : “I couldn’t do that job,” or “I don’t understand how anyone could do that job for long.”  I don’t remember anyone asking a follow up question about the work, not once. I didn’t take the lack of curiosity regarding child protection personally. The comment, ”I couldn’t do that job” was not an expression of social disapproval; occasionally the statement reflected admiration, but it was always a conversation stopper. The underlying message was, “I don’t want to know anything more about your work.”  

In past commentaries, I have written about the lack of interest in child welfare caseworkers in TV series and movies - the opposite of unending fascination with every aspect of police work, including the personal lives of police officers. The fascination with police and policing does not reflect an uncritical acceptance of morally questionable police conduct. TV series and movies include police officers who are often violent, venal, racist, alcoholic and/or emotionally troubled as well as courageous, heroic, ethical, skilled at what they do. The morally compromised work of child welfare (see below) does not account for the lack of interest or public support for child welfare professionals, even though this is often a source of unease among child welfare staff and child advocates. Why then the common attitude of “the less I know the better” which is so frequently encountered from persons outside the public agency during discussions of child welfare?

 

The ‘dirty work’ of child welfare

Eyal Press’ book, Dirty Work: Essential Jobs and the Hidden Toll of Inequality in America (2021) is destined to be a sociological classic. In Dirty Work, Press discusses the lives of prison guards who work in units that segregate criminally mentally ill inmates from the general prison population, drone pilots stationed in the U.S. who carry out attacks on targets thousands of miles across the world and workers in slaughterhouses whose job is to kill animals for meat consumption. Press comments that “The familiar, colloquial meaning of “dirty work” is a thankless unpleasant task.”  He continues: “it entails doing something that “good people” – the respectable members of society – see as morally compromised. He writes: “One characteristic common to nearly all forms of  dirty work is that they are hidden, making it easier for “good people” to avoid seeing or thinking about them.” What person who loves meat would choose to spend hours in a slaughterhouse? Better not to know.    

 

Press emphasizes the morally compromised nature of ‘dirty work’ and the risk of experiencing lasting moral injury from doing these jobs. However, Press’ analysis of moral compromise is inadequate.  Police and soldiers may openly engage in morally questionable activities, but this does not lead Americans to avert their gaze from policing or war - quite the opposite. The critical factors are (or seem to be) the characteristics of children and adults, or animals affected by dirty work: vulnerable, helpless, disturbed , unpleasant, difficult, i.e., potential victims of violence or other destructive actions but often not evil or bad.  In child death cases, when events fit into a perpetrator-victim framework the public agency is  often pressured to reveal details.  However, there is usually little or no interest in the conditions in which abused and neglected children live – which are often ugly and unpleasant given the enmeshment of poverty, substance abuse, mental illness and DV.  When maltreated children do not die and are not severely harmed, there is usually little or no interest in child protection.   Knowing more about the lives of maltreated children or foster children would be emotionally uncomfortable and without obvious purpose, especially when public policy tolerates or sustains these conditions and there is not underlying motivation to act.  Better not to know.   

 

The emotionally grueling work of child welfare

 

It is impossible to understand the challenges of child welfare without an appreciation of the emotional difficulties of the work.  A retired caseworker who worked in Washington State for almost three decades sent me the following comments:         

        

“There is so much that is brutal about the work, even with supportive leadership. Telling a child their parent is dead. Sitting with a child in the hospital who is dying (from an illness) and the parents can’t be found. Trying to intervene with traumatized parents whose child

is terribly injured. Going to homes alone, without backup and with very angry people. Testifying with skilled public defenders attacking your character can be debilitating to workers, testifying about terribly impaired parents is also painful. Moving children from one placement to another can be horrible, that has often (required) searingly difficult conversations with children … Moving children from their often-beloved animals. Having to decide when to risk taking a beloved pet when the parent has been evicted and the pet is thrown out on the street. Getting your hands literally dirty to clean a  parent’s home, clean a sick child, move parents from one home to

           another … being the physical support so many parents don’t have.

 Buying school supplies when a child has been moved, or returned, and there is no time to go through formal channels. Buying diapers, food, etc. for parents who are trying but ran out of money before end of the month you from doing what matters.  Still, I’m grateful. I was able to work when that hard work had some respect. “

 

I can add to these comments with my own experiences and those of people

I worked with in child welfare offices:

 

  • Driving 90 miles an hour to a psychiatric hospital 40 minutes away with a suicidal adolescent being restrained from throwing himself out of the back seat by a residential program manager, after local law enforcement refused to help.

  • Interviewing a 250-pound father who had beaten up his teenage son in the father’s home during evening hours without backup and becoming aware that this powerful man was about to assault me. I knew enough to stop talking, remain calm and avoid eye contact while the father decided whether to attack me.

  • Being  threatened and having one’s family threatened by an angry parent or parent’s violent partner; this is a nearly universal     experience among child welfare caseworkers.

  • I worked with caseworkers who were confronted by parents with handguns or rifles, and one of my friends struggled with a parent for a gun that discharged during the physical altercation.

  • Transporting a grief-stricken inconsolable child from parental visits to a foster home on multiple occasions, an experience that convinced  me that foster care placement was doing this child far more harm than good. 

  • Observing a dead infant with  inflicted bruises and lacerations from head to toe on an emergency room examination table, and then having to argue with a law enforcement office regarding the need to place the child’s sibling.  

     

Any child welfare veteran could add to my list with examples of emotionally difficult experiences which they may never have shared with family or friends outside the agency. I rarely mentioned frightening or disturbing events that occurred at work to family or friends outside the office.  To do so would have been to create worry and anxiety for no purpose.

I spoke freely with co-workers who had similar experiences, while saying little or nothing to others outside the agency, who (for the most part) weren’t  curious and never asked about the work. Other professionals were understandably interested in child welfare decision making, not in the experiences of caseworkers.

 

It has become important for caseworkers and supervisors to speak openly about their experiences in a social milieu in which advocates, child welfare leaders and scholars consistently engage in negative stereotyping of child welfare caseworkers, often without having worked in child welfare for decades, or interacted recently with caseworkers and/or supervisors, or even gone to the trouble to read about the subject.  Yet some critics are supremely confident regarding their negative accounts of child welfare at the line level. Why study a subject when you have an ideological critique at the ready?    

 

Moral injury in child welfare

 

Any profession that confers the authority to help or harm vulnerable people  on a daily basis both reveals and shapes moral character.  Abuse of power occurs to some extent in every social institution, and when leaders of these institutions ignore, deny, or condone abuse of power the institution is morally injured as well,  e.g., the Catholic church’s response to child sex abuse by priests.  Moral injury may be reflected by guilt,  shame or self- loathing, but is even more evident when perpetrators feel no shame despite having committed heinous actions. In the latter instance, moral character has already been seriously damaged or destroyed,  however a person defends injurious behavior. 

The psychiatrist, Jonathan Shay, refers to “the anguish (of combat veterans) that resulted from “perpetrating, failing to prevent, or bearing witness to acts that transgress dearly held moral beliefs.”  Most experienced child welfare staff at all levels understand that they work in a flawed system that sometimes does harm and little good to children and parents.  Some staff have a deep repugnance regarding practices such as involuntary child removal or termination of parental rights,  while others have ethical reservations about the entire child welfare system.  Years before the appearance of the upEnd movement I heard child welfare consultants who had been top child welfare managers opine that vulnerable children and families in their state would be better off if the state’s child welfare system was demolished!

 

When I worked in child welfare I was deeply upset by the anti-therapeutic characteristics of foster care for behaviorally troubled youth, e.g., multiple placements, misuse of psychotropic medications, bullying of weaker youth by stronger youth in poorly managed residential care institutions, exclusion of  parents from treatment plans.

 

I lack first-hand knowledge of the emotional reactions of caseworkers in Washington and other states to supervising hotel placements or office placements or moving children in 24-hour placements from home to home; or driving youth to facilities in distant communities in the middle of the night only to have the youth refuse to get out of the car. These responsibilities must be deeply unsettling (and threatening) to many caseworkers.  Hopefully caseworkers occasionally ask themselves the question regarding hotel or office placements : “If this is child protection, what is child maltreatment?”

 

Why do good people work for morally flawed child welfare systems? One answer is that caseworkers and supervisors have the daily opportunity to help children and parents in ways large and small. I worked in units and  offices that had a commitment to helping low-income families (both children and parents) and who worked collaboratively and effectively with other community agencies to help troubled families. The same child welfare consultants I mentioned above were, without exception, proud of their work in child welfare agencies. Outstanding child welfare staff I worked with  routinely:

  • Provided funds for concrete services, including rent, food,  payment of utility bills, clothes, glasses, dental care, bus passes, etc. even when the public agency had no funding category for these services, by asking churches, philanthropists, social clubs for assistance. In the 1990’s, Washington State’s child welfare system began to provide a few million dollars per year for poverty related services. 

  • Provided funding for weekly child-care, as many hours per week as parents were willing to accept.

  • Provided transportation to parents as needed, including in the evening from treatment program to home, without compensation

  • Persistently worked to engage parents in drug/alcohol, mental health and DV services

  • Developed support services to foster parents to maintain placements of behaviorally troubled children

  • Made sound decisions re out-of-home care of children, decisions that saved lives, and often used voluntary service plans rather than court actions for brief placements.  

  • Lobbied policymakers and top managers to provide urgently needed resources and did so despite threat of punitive action from top child welfare mangers and DSHS managers.

 

I cannot remember the last time I read a positive news story about a child welfare caseworker or office, but I regularly encounter moralistic attacks on child welfare staff by persons distant from the front line, many of whom were never caseworkers faced with overwhelming workload pressures, limited resources and tough challenges posed by children and parents with chronically relapsing conditions, not to mention bureaucratic mismanagement.   

 

Persistent attacks on child welfare (and implicitly on child welfare staff ) by  some child advocates and scholars have stigmatized and devalued child welfare caseworkers, and in doing so, increased the difficulty of recruiting and retaining talented young caseworkers. Why should young people with multiple opportunities enter a profession viewed as “dirty work,” i.e.,  someone must do these things, but the less said about the workers and the work the better, except when a movie script , news story or law review article needs a villain?

 

Communalizing ‘dirty work’

 

Press asserts that “the most effective way to help overcome moral injury is to communalize it.” Child welfare systems are the creation of public policy; child welfare staff did not create them. Child protection systems in the U.S. conduct investigations of more than a third of all children by age 18, and more than one half of black children, because they were designed as investigative systems first, with provision of family support services (if any) as an afterthought. Racial disproportionality of black and Native American children is associated with rates of extreme poverty which are 3-4 times higher than for white children; and is present at intake before CPS investigators go out on cases.  Child welfare is overused as a service delivery system for vulnerable families because public health departments and other human service systems are underfunded.  Behaviorally troubled foster youth must often sleep in hotels and offices because policymakers have deliberately undermined residential care programs by paying inadequate rates; and because policymakers refuse to even discuss professional foster care.  Low-income parents in crisis may become embroiled in dependency actions for no good reason because federal policy discourages use of voluntary placement agreements. Everyone of these injurious policies has had widespread public support among  the advocates who are now criticizing them. Press writes: “… a core feature of dirty work is that it has a tacit mandate from “good people” who refrain from asking too many questions about it because its results do not ultimately displease them.”

 

It is not true that all U.S. child welfare systems are the same, or that child welfare staff are all culpable to the same degree for morally questionable ‘dirty work’, however that is described. It is true, however, that policymakers and the public who elected them share responsibility for practices and conditions that injure children and parents, and lead to moral injury among child welfare staff.  Press describes a communal exercise he observed at a VA hospital in Philadelphia: veterans spoke publicly about their moral transgressions. ‘Then audience members spoke, delivering a message all dirty workers deserved to hear. “We sent you into harm’s way,” they  chanted in unison. “We put you into situations where atrocities were possible. We share responsibility with you for all that you have seen; for all that you have done, for all that you have failed to do.”   ©

 

References

 

Press, E., Dirty Work: Essential Jobs and The Hidden Toll of Inequality in America, (2021), Farrar, Straus & Giroux, New York City.

 

Litz, B. et al, “Moral Injury and Moral Repair in War Veterans,” (2009) Clinical Psychology Review, 29, no. 8.

 

Shay, J., Odysseus in America: Combat Trauma and the Trials of Homecoming (2002), Scribner, New York City.

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