Team Decision Making (TDM)

About This Program

Target Population: Caseworkers, caregivers of children 0-18 years old involved in child welfare, and their children who are mature/old enough to attend team meetings

For children/adolescents ages: 0 – 18

For parents/caregivers of children ages: 0 – 18

Program Overview

Public child welfare agency workers use Team Decision Making (TDM) meetings with the aim of making the best possible decision regarding out-of-home care, and to engage partners, such as community members and the extended family, in planning. The worker convenes the group whenever their assessment of safety suggests the need to consider out-of-home care, whether or not with court involvement. Initial TDM meetings are held prior to the child leaving home or, in an emergency, prior to the initial court hearing or within its legally required timeframe.

The goal is to reach consensus about a decision regarding out-of-home care that protects the child(ren) while preserving family integrity. The initial TDM seeks to intervene early in a case to prevent a removal or to ensure children are placed with family whenever possible. If out-of-home care is necessary, TDM sets the stage for collaboration among biological parents, foster, or kinship caregivers, and for moving the entire team toward safe reunification.

Program Goals

The goals of Team Decision Making (TDM) are:

  • Increase the likelihood of making informed decisions about the need for out-of-home care for children exposed to safety threats in their homes
  • Strengthen the quality of team discussion
  • Create the likelihood of a stronger long-term safety net for the family and children
  • Reduce unnecessary out-of-home care, whether court-involved or not, while ensuring that children who need out-of-home care to keep them safe are temporarily placed away from home
  • Use consistent, fair and just decision making for all families facing potential separation from their children
  • Ensure the impartial application of assessment tools to each situation
  • Collect specific information from each and every meeting for analysis and self-evaluation

Essential Components

The essential components of Team Decision Making (TDM) include:

  • A TDM meeting, including birth parents and youth, is held for all decisions involving a child leaving home, as well as those involving all changes of placement.
  • The TDM meeting is held before the child’s move occurs, or in cases of imminent risk/emergency moves, by the next working day, and always before the initial court hearing in court-involved cases.
  • Families are encouraged to invite anyone in their informal support system, and public agencies strive to include community members who may have valuable contributions to the discussion.
  • Youth attend the meeting when considered appropriate, given their age and level of maturity.
  • The meeting is led by a skilled, immediately accessible, internal facilitator, using a specific, six-stage model. The facilitator is not a case-carrying social worker or line supervisor and is experienced in child welfare practice.
  • The worker responsible for investigating the allegation of maltreatment, and their supervisor attend the TDM meeting.
  • The meeting is focused on the safety of the child, and making the best, most informed decision about how to protect the child and support the family.
  • Safety threats and mitigating family protective factors are explored, in order to determine whether children can remain safely at home.
  • Consensus is sought for the decision, but if all cannot agree, the worker and supervisor are responsible for making the final recommendation to the court.
  • Information about each meeting, including participants, location, and recommendations, is collected in a timely way and ultimately linked to data on child & family outcomes, in order to ensure continuing evaluation of the TDM process and its effectiveness.

Program Delivery

Child/Adolescent Services

Team Decision Making (TDM) directly provides services to children/adolescents and addresses the following:

  • Being in an unsafe or unstable in-home arrangement, at risk of not being allowed to have input into own living arrangements, at risk of being placed in foster or residential/congregate care

Parent/Caregiver Services

Team Decision Making (TDM) directly provides services to parents/caregivers and addresses the following:

  • Their children are at risk of being removed from their care; at-risk of not being allowed to have input in decisions affecting their children; at-risk of having extended family support not offered or offered incorrectly; at risk of not having in-home support services offered or offered incorrectly
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: A key element of TDM is the engagement and participation of extended family and community partners, as well as providers of services, in the family’s TDM(s). TDM relies on the potential for groups of people (vs. individual casework) to surface creative and collaborative ideas to address concerns and provide support to families facing having their children placed away from home. Family teams with community support can ideally address immediate safety concern, create longer term safety nets for at-risk families, and prevent repeat maltreatment.

Recommended Intensity:

Each initial meeting lasts 1-2 hours. This can be a one-time meeting or repeated.

Recommended Duration:

Meetings are on an “as needed” basis. Families may return for subsequent “live” meetings after the initial meeting if there is a need to consider a change in placement or to plan for reunification or other permanency.

Delivery Settings

This program is typically conducted in a(n):

  • Hospital
  • Community-based Agency / Organization / Provider
  • Public Child Welfare Agency (Dept. of Social Services, etc.)

Homework

This program does not include a homework component.

Languages

Team Decision Making (TDM) has materials available in a language other than English:

Spanish

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

Human resources:

  • Agency staff who serve as non-case-carrying, full-time TDM facilitators
  • TDM meeting schedulers
  • Data analysts to support self-evaluation processes

Facility resources:

  • Meeting room space
  • Informal child care support during TDM meetings

Education and Training

Prerequisite/Minimum Provider Qualifications

TDM facilitators should have the necessary qualifications for a child welfare practitioner, preferably experienced child welfare practitioners with strong communication and leadership skills.

TDM supervisors must be experienced in providing support and supervision to workers.

Education and Training Resources

There is a manual that describes how to implement this program , and there is training available for this program.

Extensive TDM program materials, including education and training resources, are available through The Child Welfare Strategy Group at the Annie E. Casey Foundation and the program contacts listed below.

Training Contact:
  • Heather Meitner
    • National Council on Crime & Delinquency (NCCD)/Children’s Research Center (CRC)

    phone: (608) 203-8670 or (978) 500-6176
Training is obtained:

TDM facilitator training and technical assistance is provided by Annie E. Casey Foundation staff/consultants who travel to child welfare sites anywhere in the U.S outside California.

Advanced topic TDM trainings, including “Managing TDM When DV is Known or Suspected,” “Engaging Youth at the TDM Table,” and others, are provided by Foundation staff/consultants. They are targeted for public system staff and external partners and are usually a half day to two days in length. A link for several examples of the advanced TDM-DV training manuals is provided below and represents a partnership between the Foundation and Futures without Violence: https://www.futureswithoutviolence.org/team-decisionmaking/

In California, the staff from the UC Davis Resource Center for Family-Focused Practice (RCFFP) provides training on-site at UC Davis and also travel to TDM sites to provide technical assistance.

Number of days/hours:

Facilitator pre-service training for TDM is three days in duration.

Basic TDM training for staff, community partners, resource families, and others is generally half a day to a full day and provided or co-trained by Annie E. Casey Foundation staff/consultants. Advanced topic trainings, including “Managing TDM When DV is Known or Suspected,” “Engaging Youth at the TDM Table,” and others, are provided by Foundation staff/consultants. They are targeted for public system staff and external partners and are usually a half day to two days in length.

Implementation Information

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for Team Decision Making (TDM) as listed below:

The Annie E. Casey Foundation’s Child Welfare Strategy Group (CWSG) has developed a range of pre-implementation support materials, such as the TDM Sequencing Checklist to guide implementation planning; the TDM Calculator to predict how many TDM meetings a jurisdiction is likely to hold and how many facilitators will be needed; selection/hiring/training materials for facilitators, schedulers, and data application administrators; and templates for TDM policy and work plan development. These materials can be obtained by contacting Pat Rideout via email: plrideout@gmail.com or phone: 216-288-3833

Formal Support for Implementation

There is formal support available for implementation of Team Decision Making (TDM) as listed below:

The Annie E. Casey Foundation’s Child Welfare Strategy Group (CWSG) provides intensive technical assistance and consultation to sites implementing TDM. CWSG has a team of practice consultants led by Pat Rideout, most of whom are experienced TDM practitioners themselves. CWSG also has a data team which supports TDM practice in its sites.

In California, the UC Davis Resource Center for Family Focused Practice (RCFFP) provides ongoing formal support to sites seeking to implement TDM. Contact the center at resourcecenter@ucde.ucdavis.edu or phone (530) 752-9726 phone

Fidelity Measures

There are fidelity measures for Team Decision Making (TDM) as listed below:

TDM implementation includes the adoption of an automated data application that is provided to TDM sites by the Annie E. Casey Foundation; however, sites may also develop their own data application that allows for the entry and reporting of specific structural measures of fidelity to the TDM model and its key elements. The Foundation’s Child Welfare Strategy Group (CWSG) trains sites on how to use this tool and generate reports from it. Regular observations and debriefing sessions allow for assessment of individual meeting process fidelity. How fidelity is assessed (e.g. self-report checklists, trained observations, video/audio recordings, etc.).

  • Required sharing of TDM data to the Foundation on a monthly or quarterly basis
  • Regular self-evaluation meetings to discuss TDM data and its relationship to the agency’s overall practice improvement efforts
  • Regular observation and debriefing of TDM meetings by supervisors of TDM facilitators and the Foundation’s CWSG consultants

Implementation Guides or Manuals

There are implementation guides or manuals for Team Decision Making (TDM) as listed below:

The Annie E. Casey Foundation’s Child Welfare Strategy Group (CWSG) has developed extensive implementation guidance and support materials. These materials cover staff and partner orientation to TDM, skills training, data and self-evaluation skill development, role-specific coaching and support for staff and partners, development of youth and parent advocacy in TDM, working with juvenile courts to integrate TDM, recruitment and orientation of grassroots community partners as TDM participants, and supporting caregivers as full TDM partners. These materials can be obtained by contacting: Pat Rideout via email: plrideout@gmail.com or phone: 216-288-3833

The UC Davis Resource Center for Family-Focused Practice makes their materials available on-line: https://humanservices.ucdavis.edu/programs/resource-center-family-focused-practice/team-decision-making/facilitators

Implementation Cost

There are no studies of the costs of Team Decision Making (TDM).

Research on How to Implement the Program

Research has been conducted on how to implement Team Decision Making (TDM) as listed below:

Crampton, D. S., Crea, T. M., Abramson-Madden, A., & Usher, C. L. (2008). Challenges of street-level child welfare reform and technology transfer: The case of Team Decisionmaking. Families in Society: The Journal of Contemporary Social Services, 89(4), 512–520. https://doi.org/10.1606/1044-3894.3823

Crea, T. M., Crampton, D. S., Abramson-Madden, A., & Usher, C. L. (2008). Variability in the implementation of Team Decisionmaking (TDM): Scope and compliance with the Family to Family practice model. Children and Youth Services Review, 30(11), 1221–1232. https://doi.org/10.1016/j.childyouth.2008.03.007

Crea, T. M., Usher, C. L., & Wildfire, J. B. (2009). Implementation fidelity of Team Decisionmaking. Children and Youth Services Review, 31,119–124. https://doi.org/10.1016/j.childyouth.2008.06.005

Crea, T. M., & Crampton, D. S. (2011). The context of program implementation and evaluation: A pilot study of interorganizational differences to improve child welfare reform efforts. Children and Youth Services Review, 33(11), 2273–2281. https://doi.org/10.1016/j.childyouth.2011.07.012

Crea, T.M., Crampton, D.S., Knight, N., & Paine-Wells, L. (2011). Organizational factors and the implementation of Family to Family: Contextual elements of systems reform. Child Welfare, 90(2), 143-161.

DeMuro, P., & Rideout, P. (2002). Team Decisionmaking: Involving the family and community in child welfare decisions. The Annie E. Casey Foundation.

Relevant Published, Peer-Reviewed Research

Child Welfare Outcome: Permanency

Crea, T. M., Wildfire, J. B., & Usher, C. L. (2009). The association of team composition and meeting characteristics with foster care placement recommendations. Journal of Social Services Research, 35(4), 297–310. https://doi.org/10.1080/01488370903110803

Type of Study: Three-group pretest-posttest
Number of Participants: 1,344

Population:

  • Age — Not specified
  • Race/Ethnicity — Not specified
  • Gender — Not specified
  • Status — Participants were child welfare employees.

Location/Institution: Denver, CO; Anchorage, AK; Wake County, NC

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study examines the extent to which Team Decision Making (TDM) can influence placement recommendations for children currently in foster care. Measures utilized include administrative data from the child welfare system. Results demonstrated that caregiver attendance significantly reduces the likelihood that a child will be recommended to change placements, specifically, to less restrictive and more restrictive placements. Limitations include the fact that the outcome variable is a TDM placement recommendation but not an actual placement experience, reliance on administrative data that do not include contextual information to assist in interpreting findings, and lack of follow-up.

Length of postintervention follow-up: None.

Crea, T. M., Usher, C. L., & Wildfire, J. B. (2009). Implementation fidelity of Team Decisionmaking. Children and Youth Services Review, 31,119–124. https://doi.org/10.1016/j.childyouth.2008.06.005

Type of Study: Three-group pretest-posttest
Number of Participants: 6,019 (families)

Population:

  • Age — Not specified
  • Race/Ethnicity — Not specified
  • Gender — Not specified
  • Status — Participants were child welfare employees.

Location/Institution: Denver, CO; Cleveland, OH; Anchorage, AK

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This purpose of this study is to measure indicators of the implementation of Team Decisionmaking (TDM) [now called Team Decision Making (TDM)]. Measures utilized include the Survey of Organizational Excellence (SOE) and administrative data from the child welfare system. Results demonstrated that a high percentage of meetings are attended simultaneously by parents and friends, parents and relatives, or parents, relatives and friends. Limitations include reliance on administrative data that do not include contextual information to assist in interpreting findings and lack of follow-up.

Length of postintervention follow-up: None.

Crea, T. M., & Crampton, D. S. (2011). The context of program implementation and evaluation: A pilot study of interorganizational differences to improve child welfare reform efforts. Children and Youth Services Review, 33(11), 2273–2281. https://doi.org/10.1016/j.childyouth.2011.07.012

Type of Study: Two-group pretest-posttest
Number of Participants: 410

Population:

  • Age — 29-50+ years
  • Race/Ethnicity — 37.4% Anglo-American/White, 17.9% African-American/Black, 11% Hispanic/Mexican-American, 5.2% Asian- American/Native American, 4.3% Multiracial/Other, and 24.2% Missing
  • Gender — 70% Female and 30% Male
  • Status — Participants were child welfare caseworkers and supervisors.

Location/Institution: Fresno, California and Louisville, Kentucky

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This paper reports on the evaluation of Family to Family (F2F) which included Team Decisionmaking (TDM) [now called Team Decision Making (TDM)]. Measures utilized include the Survey of Organizational Excellence (SOE) and administrative data from the child welfare system. Results indicate administrative data pertaining to TDM support the differences in perceptions of F2F implementation from the survey. Specifically, staff in Fresno reported that their agency had higher TDM fidelity and attendance data confirmed that this is correct. In addition, the widely varying patterns of children served on a monthly basis between the agencies provide evidence that these contextual factors may be related to perceptions of organizational excellence. It is unclear from these data, however, whether organizational factors influence indicators such as the numbers of children in out-of-home care. Respondents in Louisville indicated higher levels of organizational excellence; yet, Fresno respondents tended to rate implementation of F2F higher. Based on administrative data, a higher percentage of TDM meetings were attended by key stakeholders in Fresno, an important indicator of implementation fidelity. Limitations include participant responses to survey items may be subject to recall bias, as is the case with any administrative data; these data are of unknown validity and reliability and thus should be interpreted with caution; survey items pertaining to F2F were created by researchers and experts in the field, but were not vetted ahead of time with staff in Fresno; and lack of follow-up.

Length of postintervention follow-up: None.

Crea, T. M., Crampton, D. S., Knight, N., & Paine-Wells, L. (2011). Organizational factors and the implementation of Family to Family: Contextual elements of systems reform. Child Welfare, 90(2), 143–161.

Type of Study: Three-group pretest-posttest
Number of Participants: 181

Population:

  • Age — 29-50+ years
  • Race/Ethnicity — 51% White, 29% African American, and 20% No Response
  • Gender — 67% Female and 33% Male
  • Status — Participants were child welfare employees.

Location/Institution: Jefferson County Department of Community-Based Services (DCBS) in Louisville, Kentucky

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This paper reports on the evaluation of Family to Family (F2F) which included Team Decisionmaking (TDM) [now called Team Decision Making (TDM)]. Measures utilized include the Survey of Organizational Excellence (SOE) and administrative data from the child welfare system. Results demonstrated that child welfare managers can effectively use data to improve program implementation across multiple levels of the organization. Results from the SOE showed that on most indicators, supervisors rated indicators of organizational effectiveness more highly than frontline workers; workers did not rate any indicators more highly than supervisors. Results also indicated respondents in adoptions and recruitment and certification (R&C) rated the highest on effectiveness indicators, while those in intake and investigation tended to rate the lowest. Limitations include participant responses to survey items may be subject to recall bias, small sample size, and lack of follow-up.

Length of postintervention follow-up: None.

Crampton, D. S., Usher, C. L., Wildfire, J. B., Webster, D., & Cuccaro- Alamin, S. (2011). Does community and family engagement enhance permanency for children in foster care? Findings from an evaluation of the Family-to-Family Initiative. Child Welfare, 90(4), 61–77.

Type of Study: Three-group pretest-posttest with comparison group
Number of Participants: 44,216

Population:

  • Age — Not specified
  • Race/Ethnicity — Not specified
  • Gender — Not specified
  • Status — Participants were child welfare employees.

Location/Institution: Arizona, California, Colorado, Kentucky, North Carolina, and Ohio

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This article describes results from a national evaluation of Family to Family (F2F), which uses Team Decision-Making (TDM). Based on characteristics measured at the removal meeting closest to the date a child entered placement, the index is categorized into three groups: (1) children who did not have a TDM meeting (serving as a comparison group); (2) children with meetings in which one to four key elements were noted; and (3) children with meetings in which five to eight key elements were noted. Measures utilized include administrative data from the child welfare system. Results indicated that for the subsample of children who had a removal meeting, the risk ratios concerning parental presence and the number of other key elements is significant for all races. When the outcome is either reunification or exit to a relative, children of all races whose parents attend the initial removal meeting are more likely to achieve permanency within a year than children whose parents do not attend. The children with the greatest likelihood of reunification or exit to relative are those whose parents attend a TDM meeting in which one to four key elements are present. White and black children with the greatest likelihood of exit to a relative within one year were those whose TDM meeting was characterized by the presence of five to seven key elements. Additionally, black children whose parents attended the removal TDM meeting were almost twice as likely to exit to reunification within one year compared to black children whose parents did not attend the meeting. Limitations include nonrandomization of participants, children and families for whom a TDM meeting was held were those most easily served and, therefore, not representative of the population being served, and children for whom no TDM meeting was held are assumed not to have been affected by the initiative.

Length of postintervention follow-up: None.

Additional References

Annie E. Casey Foundation. (2014). Team Decision Making: Engaging families in placement decisions. Retrieved from https://www.aecf.org/resources/team-decision-making/

Usher, C. L., Wildfire, J. B., Webster, D., & Crampton, D. S. (2010). An evaluation of the anchor-site phase of Family to Family. Retrieved from the Indiana University-Purdue University Indianapolis/University Library’s website: https://folio.iupui.edu/bitstream/handle/10244/829/anchoreval.pdf?sequence=1

Wildfire, J., Rideout, P., & Crampton, D. (2010). Transforming child welfare, one Team Decisionmaking meeting at a time. Protecting Children, 25(2), 40-50.

Contact Information

Heather Meitner
Agency/Affiliation: NCCD/CRC
Website: www.nccd.org
Email:
Phone: (608) 203-8670

Date Research Evidence Last Reviewed by CEBC: July 2019

Date Program Content Last Reviewed by Program Staff: February 2020

Date Program Originally Loaded onto CEBC: February 2020