When there are safety concerns for the child that cannot be addressed by implementing a safety plan and there is significant risk of child maltreatment, then the child is removed from the home and placed in out-of-home or substitute care. Substitute care, also known as foster care, can range from placement with a relative (sometimes also known as kinship care), to placement with a foster family, to placement in a group setting or in residential treatment. Residential treatment usually occurs when the needs of a child with severe behavioral or mental health issues cannot be addressed in the other settings. The aim, however, is always to place the child in the least restrictive and most family-like setting.
The caseworker must consider numerous factors as well, including the proximity of the placement to the family. Close proximity helps maintain the continuity of family relationships and connections to the community, facilitates visitation between the child and family, and enables the child to remain in his or her school. If the child is removed with his or her siblings, then the goal is to place the siblings together. If siblings cannot be placed together, then the caseworker must arrange for regular sibling visits unless it is contrary to the safety or well-being of any of the siblings to do so.
In many cases where the child has been removed, there are a variety of issues contributing to the maltreatment, such as serious substance abuse, domestic violence, and mental illness, which require that multiple and intensive services be provided. In addition to the services provided to the parents, the child may also need services, including services to help him or her address the trauma arising from the maltreatment and separation from the family.
The caseworker conducts a comprehensive family assessment with the family to determine the services needed to minimize the risk of maltreatment, address the factors that contributed to this risk, and ensure the child’s safety upon return. The caseworker and family then develop the case plan together.
Once the case plan has been developed, the caseworker provides or arranges for services identified in the plan to help family members achieve the case plan's outcomes, goals, and tasks. Selecting and matching interventions and services is a critical step in the casework process. Child maltreatment is caused by multiple contributing factors, so interventions need to address as many of these factors as possible, including the interpersonal needs (such as mental health and/or substance abuse treatment and parent aide and/or other parent support services), and concrete needs (such as housing and child care) of all family members.
While the agency is working with the family, the caseworker will develop a plan for family visitation. The family visitation plan outlines when and how often visitation occurs and under what set of circumstances. The visitation plan addresses the need to develop or improve the parent-child relationship and any child safety or well-being considerations. Initially, visitation may be very structured and occur in a supervised setting. As the family progresses, visits may occur more often, be of longer duration, and become unsupervised.