Toolkits Exploring the Benefits to Team Formation

Why Form a Multidisciplinary Team?

Exploring the Benefits to Team Formation

Multidisciplinary Teams in Minnesota

Over the past four decades, the use of multidisciplinary teams (MDTs) in response to child abuse and maltreatment claims has grown exponentially. When staffed and sustained effectively, MDTs are invaluable resources to county workers and supervisors, as well as to community member agencies and the youth and families most affected. The Minnesota Department of Human Services strongly encourages child welfare agencies to utilize MDTs to assist in decision-making involving “frequency, recency, or severity of child maltreatment concerns.” This is in addition to the statutory mandate for counties to establish an MDT.

Pursuant to Minn. Statute 260E.02, each county “shall establish a multidisciplinary child protection team,” including representatives from multiple disciplines, including: child welfare, law enforcement, healthcare (medical and mental health), tribes, community-based agencies, parent groups, and “other agencies serving children and families.” These MDTs “may provide case consultation[, i.e.,] a case review process in which recommendations are made concerning services to be provided… and for screening reports.”

Benefits to the MDT Approach

While there are numerous reasons to form an MDT, the historical provenance of these teams in the field of child abuse and maltreatment developed over concerns regarding how siloed agencies conducted investigations. This is evidenced in the multiple-year string of high-profile child abuse cases in Jordan, MN, in which dozens of allegations of child sexual abuse (both founded and unfounded) resulted in the arrest of more than 23 adults. One defendant pleaded guilty, one couple was acquitted, and the remaining charges were dropped.  Regardless of how one views these cases, “the simple reality in early June 1984 was that [the prosecutor] was overwhelmed and needed more staffing and support to handle these cases.”

Furthermore, as is demonstrated in this example and other high-profile child sexual abuse cases from this time, past procedures for interviewing children routinely proved unreliable and retraumatized abused children. This includes re-interviewing children multiple times (regularly totaling upwards of dozens); conducting interviews in the presence of abusers; berating children until obtaining desired statements; highly leading and coercive lines of questioning, including specifically introducing key suspects’ names during subsequent interviews; giving children the impression that providing/corroborating newly named suspects would be favorably rewarded; “confronting” children with separate allegations made by peers, pressuring them to conform to others’ allegations; having victim’s therapists lead investigative interviews, conducting joint interviews, and otherwise inextricably linking law enforcement and mental health supports (thus blurring lines between investigations and therapy); and other traumatizing practices of questionable reliability at best. The importance of trauma-informed forensic interviews being conducted by well-trained interviewers outside of a punitive, criminal justice system setting cannot be overstated. ,

In addition to overhauling procedures for forensic interviewing of children, the multidisciplinary team approach developed to ameliorate additional commonplace, harmful investigative practices among law enforcement, prosecution, and child protection. Prior to this approach, investigative practices frequently involved, “intrusive medical procedures, separation from support systems, intimidating courtroom procedures and tactics, and lack of communication and information sharing among investigative agencies,” which resulted in avoidable additional trauma to youth and families.

Though the empirical evidence for improved outcomes through a multidisciplinary response is somewhat limited, that which is available supports the effectiveness of this response. Indeed, there is a growing body of evidence that multidisciplinary teaming results in beneficial outcomes. Outlined below are four evidence-based rationale consistently demonstrated in the literature regarding why forming an MDT is a vital approach.

Maximize Limited Agency Resources

In general, responding effectively to child abuse and maltreatment requires the collaboration and cooperation of many disciplines – it cannot be adequately achieved by one alone. The reality that individual agencies lack “the expertise or resources to handle every aspect of the child abuse investigation” is an important consideration in the establishment of child abuse MDTs. For example, while a child protection worker may be charged with investigating a case, at a minimum they will need to collaborate both with law enforcement for evidence collection on criminal matters, and with the county attorney who can advise on the potential for filing charges. The reality is that affected children and families require intervention and assistance from many fields, including those outside the county structure. As such, multidisciplinary collaboration on the front end helps to “maximize limited resources by bringing together different disciplines to deal with the complex issues” affecting abused children, youth and their families.

In addition to improving investigative practices, MDTs also emerged in response to “the need to coordinate diminishing community resources more efficiently.” As resources and funding for county- and community-based agencies have continued to dwindle, counties with MDTs have managed to do considerably more with less. Fortunately, research indicates that working with a proficient MDT allows for a more effective distribution of limited agency resources. In fact, on a per-case basis, investigations of child abuse and maltreatment without utilizing a true multidisciplinary response (i.e., without staffing an MDT) were 36% more expensive, resulting in upwards of $1,000 in savings per MDT-staffed case. MDT case coordination has also been found to improve communication and information sharing and “reduce fragmentation and duplication of agency services,” further bolstering its cost-effectiveness.

Improve Outcomes for Children/Families

Improvements in outcomes for affected children and families are closely interrelated with the benefits of an MDT approach for county-based agencies. When MDTs include representatives from multiple disciplines, youth and families are more likely to obtain crucial health care services, receive better coordination of forensic interviews that occur in a child-friendly setting, and be considerably more satisfied with the overall investigation process., , As these investigations routinely cause added stress for children and families due to fragmented responses, investigative redundancies resulting in multiple interviews, and duplications of agency services, the MDT approach significantly mitigates these issues.,

The goal of the MDT is not only to promote well-coordinated investigations benefitting from the inclusion of multiple disciplines in order to ensure successful investigations, but also to “minimize additional trauma to the child victim.” Indeed, proficient MDTs have consistently been found to substantially minimize the degree of additional “system-inflicted” trauma and child trauma symptoms experienced by children and families.”, , MDT members also report that operating within the MDT provides them with “much needed feedback about the day-to-day impact their work has on the children and families they serve.”

Taken altogether, the improvements offered by staffing an MDT are consistently recognized to benefit not only partner agencies and their representatives, but service delivery and client outcomes as well.

Improve Criminal Justice & Systems’ Outcomes

While there are gaps which remain in the established research regarding MDT outcomes, syntheses of the existing literature have identified ample evidence of improvements in criminal justice outcomes compared to “practice as usual.”

In addition to maximizing limited agency resources, the MDT approach also results in improvements in criminal justice outcomes, substantiation of child abuse allegations, and other systems-based outcomes. Overall, MDTs are found to have “highly ambitious outcomes;” these include:

Improved outcomes related to child protection and the long-term care of children (“e.g., removal/placement of children in out of home care”).
Higher rates of successful prosecution of physical and sexual child abuse.
Greater success in actions taken by agencies relating to child protection concerns.
Better agency decisions, including more accurate investigations and more appropriate interventions.
Furthermore, child welfare agencies especially stand to benefit from the formation of an MDT. When working independently, child protection professionals are more likely to make “biased or subjective decisions” in abuse and maltreatment determinations. Similarly, child protection workers were found to be “more concerned about ‘overcalling’ abuse and more skeptical of child disclosures than other professionals including law enforcement officials, attorneys, and forensic interviewers.” When working within a team, however, multidisciplinary investigations identified “more substantiated cases of abuse than the traditional CPS model,” and matched with child protection dispositions roughly 80% of the time; further analysis indicated “a non-biased approach to the MDT determination” of child abuse allegations.,

Increase Effectiveness, Expertise, and Job Satisfaction; and Decrease Burnout

Due to a variety of factors, a common reality within youth/family-serving disciplines is that professionals working on child abuse cases are particularly susceptible to burnout and decreased job satisfaction, both of which lead to a decrease in their overall effectiveness. Participation on an MDT, however, has been recognized to significantly reduce these effects. In fact, strong MDTs, and MDTs in which members receive strong support from supervisors, are associated with:

  • Decreased burnout among child abuse professionals.
  • Improved quality of communication across agencies.
  • Augmented psychological safety.
  • Availability of social support from fellow members.
  • Bolstered resilience.
  • Increased social cohesion and attraction to the group.
  • Improved task cohesion.
  • Better trained, more capable professionals.
  • More respect and trust within the larger community.
  • Longer careers and increased professional longevity.

In surveying dozens of members of various MDTs, these benefits were consistently cited by child abuse professionals and are further evidenced in additional research. Investigating child abuse and maltreatment cases is a particularly difficult type of work, and the social support and connectedness that MDT members derive from their shared experiences provides significant advantages over a more siloed approach. These findings demonstrate “evidence of a symbiotic relationship among partner agencies and the MDT;” “MDT members’ participation in the MDT model… is an added (if overlooked) benefit to partner agencies as well.” Members consistently identify relationships built over the lifetime of an MDT as not only being key components of “communication and information sharing” across agencies, but they also regularly cite them as significant facilitators in boosting their job satisfaction and minimizing burnout.

Thus, the MDT functions as a sort of protective factor in building resiliency among workers. This resilience is largely what affords MDT members the ability to sustain their careers for longer amounts of time, resulting in growing the expertise which serves to benefit the MDT’s abilities and further decrease burnout.

What is more, given that burnout leads to “decreased performance, decreased organizational commitment, and higher rates of turnover,” these findings are “critically important to the organizational climate and effectiveness of partner agencies.” As MDTs also result in markedly better outcomes for children and families, this continuity is a substantial benefit to all involved parties.

Technical Support to Develop Your Team

The Minnesota Children’s Alliance provides facilitation support for teams developing, reviewing, and refining their collaborative response to child abuse investigations. Contact Marcia Milliken for an initial consultation.

Email Marcia »
  1. DHS Bulletin #20-68-06: Revised Minnesota Child Maltreatment Intake, Screening and Response Path Guidelines
  2. Formerly 626.558, this statute was reorganized via Article I, Section II of HF 1732, 1st Engrossment – 91st Legislature (2019-2020)
  3. Minn. Statute § 626.558, Subdivision 1
  4. Minn. DHS Bulletin Corrected #17-68-09C: Sex Trafficked Children and Youth Investigative Protocols
  5. Cheit & Matthews, 2014
  6. ibid
  7. Jacobson, 2001; Kolbo & Strong, 1997; Young & Nelson-Gardell, 2018
  8. ibid
  9. Cross et al., 2007; Faller & Palusci, 2007; Joa & Godlberg Edelson, 2004; Jones, Cross, Walsh, & Simone, 2007; Miller & Rubin, 2009; Smith, Witte, & Fricker-Elhai, 2006; Walsh, Lippert, Cross, Maurice, & Davidson, 2008; Wolfteich & Loggins, 2007; Jackson 2012
  10. Young & Nelson-Gardell, 2018
  11. ibid
  12. Jacobson, 2001
  13. Olson & Johnson, 2016
  14. NCAC, as cited by Olson & Johnson, 2016
  15. Marina, 2008
  16. Hochstadt and Hardwicke, 1985
  17. Cross, Jones, Walsh, Simone, & Kolko, 2007; Faller & Palusci, 2007; Jones, Cross, Walsh, & Simone, 2007; Walsh, Cross, Jones, Simone, & Kolko, 2007
  18. Cross, Finklehor, & Ormrod, 2005; Cross, Walsh, Simone, & Jones, 2003; Faller & Palusci, 2007; and Jones, Cross, Walsh, & Simone, 2005
  19. Herbert & Bromfield, 2017
  20. Cross, Jones, Walsh, Simone, & Kolko, 2007; Henry, 1997; Jackson, 2004; Whitcomb, Goodman, Runyan, & Goak, 1994; Yeaman, 1986; as cited by Brink, F.W., et al. 2015
  21. Hochstadt and Hardwicke, 1985
  22. Chamberlin & Chase, 2017
  23. Olson & Johnson, 2016
  24. Herbert & Bromfield, 2017
  25. Conners-Burrow et al., 2012
  26. Ballard et al., 2017
  27. ibid
  28. Marina, 2008
  29. Elmquist et al., 2015
  30. Herbert & Bromfield, 2016, 2017
  31. Cross, 2001
  32. Herbert & Bromfield, 2017
  33. ibid
  34. Miller & Rubin, 2009
  35. ibid
  36. Olson & Johnson, 2016
  37. Jent et al., 2011
  38. Brink, F. W., et al. 2015
  39. Wolfteich & Loggins, 2007
  40. Brink, F. W., et al. 2015
  41. Ballard et al., 2017
  42. ibid
  43. Ballard et al., 2017; Olson & Johnson, 2016
  44. Ballard et al., 2017; Marina, 2008
  45. Ballard et al., 2017; Young & Nelson-Gardell, 2018
  46. Ballard et al., 2017; Olson & Johnson, 2016
  47. ibid
  48. ibid
  49. Ballard et al., 2017
  50. Young & Nelson-Gardell, 2018
  51. Ballard et al., 2017
  52. ibid