Tips for Making Home Visits in Child Welfare
By: Natalie D. Pope, PhD, LCSW, and Jennifer B. Hadden, MSW
When first starting out, making a home visit to see a client can be an intimidating and even frightening experience for social workers. Yet, in many areas of practice, the majority of client contact is “in the field,” which typically means seeing a client someplace other than your office. Certainly for social workers practicing in the field of public child welfare (e.g., child protective services, family preservation, foster care, adoption), visiting clients in their home is the norm, rather than the exception.
Many benefits exist to seeing clients in their homes, particularly when working in child welfare. First, as social workers, we give special attention to our clients’ environment and how this affects their functioning and well-being. Observing clients’ living situations (conditions of the home, safety concerns, status of neighborhood and community, and so forth) can provide valuable and relevant information for assessment and case planning. Second, working with clients in their homes enables the social worker to “meet the clients where they are” and to potentially reduce the power differential inherent in work with mandated clients. Third, interventions delivered in the home, rather than in an office, might be easier for clients to implement, since the home is where problems often occur. Finally, service barriers such as limited transportation and scheduling conflicts can be avoided with home-based services (Collins, Jordan, & Coleman, 2010).
Despite the benefits of seeing clients in their homes, there are some inherent challenges and things to keep in mind when interviewing parents and children in their home.
Building Rapport to Get in the Door
Upon first contact with a client, social workers are often met with some barriers. The worker’s ability to gain entry into the home is often indicative of resistance to or compliance with intervention. Here are some suggestions for a first meeting in a client’s home:
1. Knock with authority, but not in a threatening way. It should be audible, but not deafening. Sometimes you must knock a few times before the client will answer. Try to refrain from “peeking” in windows, unless you are concerned for the potential safety of children in the home after repeatedly unanswered knocks.
2. Introduce yourself using your first and last name, and agency representation. You may need to repeat your first name a few times to allow the client to identify you not only as an agency representative, but also a person. When possible, smile. You might say something like, “Our agency received a call from someone concerned about your children. I would like to discuss that concern with you.”
3. Prior to asking to be invited into a client’s home, it is sometimes necessary to allow the client to process the idea of agency intervention. You may have to ask more than once.
4. Once in the home, ask the client’s permission to be seated and follow his or her instruction on where to sit. You may ask to move at some point during the visit, once rapport has been established.
5. Observe obvious rules in the home (shoes by the door or feet off the furniture, for example). You might explain to clients that you are a guest and ask them to advise you if you are breaking any of the house rules.
Physical Conditions
When interviewing a client in an office setting, the social worker has some control over the environment. This is not the case when seeing clients at home. Ideal physical conditions for an interview include comfortable seating and room temperature, freedom from distraction, ample space to move around, and a sanitary location (Hepworth, Rooney, Rooney, Strom-Gottfried, & Larsen, 2010). Some tips for making your surroundings as conducive as possible include:
1. If you have a great deal of paperwork to process with the client, it may be beneficial to be seated at a dining table during a portion of your visit.
2. Politely ask the client to turn off the television or radio so both of you can concentrate on the interview.
3. When visiting a home with young children, take a bag with coloring books and crayons, puzzles, and small toys. These items can be purchased cheaply but are invaluable to keeping young children occupied. You might even consider carrying animal crackers and juice boxes to help pacify cranky kids.
Ethical Considerations
Several ethical quandaries can occur when your primary contact with clients happens outside an office, especially issues related to blurred boundaries, accepting gifts, and confidentiality.
1. Blurred boundaries: There is a certain level of intimacy present when interviewing a client in his or her home rather than in an office. For instance, you might drop by during dinner time or be present during a heated argument between a teenage daughter and her father. It can be tempting to loosen the professional boundaries in what is often an unstructured work environment. It is the social worker’s responsibility to stay focused on issues directly related to child well-being and ensure the home visits are professional, rather than social (Collins, Jordan, & Coleman, 2010; Snyder & McCollum, 1999).
2. Accepting gifts: Clients might also offer you food and drink when visiting their homes. According to Frederic Reamer (2003), an expert on social work ethics, “boundary crossings are not inherently unethical” but are only “harmful when the dual relationship has negative consequences for the social worker’s client” (p. 121). As always, social workers should use professional discretion and appropriate supervision when faced with boundary issues. You must also be sensitive to cultural norms and client motivation when faced with accepting gifts such as food and drink in a client’s home, or small tokens of appreciation from clients.
3. Confidentiality: Most agencies require their employees to be issued an identification badge. For safety reasons, badges help to distinguish employees from clients in the building, as well as identify social workers to their clients. It is important to be aware, however, that a badge might threaten client confidentiality if it draws attention to you and alerts neighbors and community members that you are from a social service agency. A second possible breech of confidentiality “can occur when the client’s extended family members, neighbors, and friends are present during home visits or when visits take place in community settings such as a park or fast-food restaurant” (Allen & Tracy, 2008, p.136). You might want to take the client’s lead to see if he or she introduces you to the family or ask your client’s permission before telling the friend or family member how you know them.
Safety Concerns
Make sure someone else knows the specific address where you are going. We suggest posting a whiteboard in your office with a list of places you will be visiting each day. Your agency may require that you utilize a digital sign in/out method. Since other clients will likely be in the building, you should record the neighborhood or street where you will be, rather than writing down the client name on a whiteboard. Sometimes, upon your first visit, it is advisable to drive by the actual address to assess the surroundings, thus helping you choose the safest and most accessible place to park a vehicle. Additionally, this “drive by” will provide an opportunity to determine if there are hazards such as unrestrained animals, blocked entrances (and exits), and loiterers.
When possible, review agency and criminal history of your client prior to your visit. When in question, consult with your supervisor regarding the accompaniment of law enforcement on your visit.
Always be aware of potential entrances and exits to the home. It is appropriate to ask the client the names of those who enter the home during your visit. Maintain a working cell phone or radio in your pocket or within your reach, and always be prepared to remove yourself from emotionally charged situations as needed. When possible, sit in a location where you can observe the door. It is also appropriate to ask the client to restrain pets during your visit.
Organization and Time Management
Child welfare social workers usually spend a lot of time in their cars, traveling from one client’s house to another, to one of the local elementary schools, to juvenile court, and maybe back to the office before seeing another client on the way home from work. There are several things we suggest, to be as efficient as possible with your time:
1. Arrange your schedule so that you are able to visit with clients who live near each other or on the same side of town. Take into consideration factors such as school release times and work schedules of your clients. If it does not compromise safety of the family members, leave your business card and contact information when you have visited a home with no one there.
2. Carry a folder or binder organized with the forms you are likely to need in the field. Working with families experiencing abuse or neglect, we often utilize referrals to the local food bank, Medicaid, and financial assistance applications, releases of information for communication with other providers, safety plans, and a list of community resources.
3. Ensure that you have a number for the local law enforcement dispatcher readily available on your phone.
4. Sometimes it is helpful to contact the client prior to your visit to ensure contact. When this is not possible, it is advisable to attempt your visit at different times during the day.
5. When possible, take anecdotal notes during the visit to enable you to later record items pertinent to your visit. It can be beneficial to tell the client that you’d like to write a few things down to ensure that you are able to reflect upon them later.
Terminating the Visit
Prior to dismissing yourself from the visit, be sure to summarize the content of the information that you have shared with and gathered from your client. Identify any “to do” items that will be completed by you and the client. Provide the client an opportunity to discuss anything further that he or she feels is important. When possible, advise clients of what your next steps will be. Make sure clients have your contact information for follow-up, as they most likely will have questions after you have left their home.
Social workers practicing in public child welfare have to get used to an often unstructured work setting, seeing clients in their homes and communities. Yet by attending to the unique challenges inherent in making home visits, social workers can be effective in providing hands-on and immediate assistance to vulnerable children and their families.
References
Allen, S.F., & Tracy, E.M. (2008). Developing student knowledge and skills for home-based social work practice. Journal of Social Work Education, 44 (1), 125-143.
Collins, D., Jordan, C., & Coleman, H. (2010). An introduction to family social work (3rd ed.). Pacific Grove, CA: Brooks/Cole Publishing.
Hepworth, D., Rooney, R., Rooney, G. D., Strom-Gottfried, K., & Larsen, J. (2010). Direct social work practice: Theory and skills (8th ed.). Pacific Grove, CA: Brooks/Cole Publishing.
Reamer, F. G. (2003). Boundary issues in social work: Managing dual relationships. Social Work, 48 (1), 121-133.
Snyder, W., & McCollum, E. (1999). Their home is their castle: Learning to do in-home family therapy. Family Processes, 38( 2), 229-244.
Natalie D. Pope, Ph.D., LCSW, is an assistant professor in the social work department at Ohio University in Athens, OH. Jennifer B. Hadden, MSW, is a Ph.D. student at the University of Georgia with more than 15 years of child welfare experience.