Factors Considered In Frontline Child Welfare Workers’ out-of-Home Placement Decision- Making In the United States: A Scoping Review

Background: The decision to place children outside their home and away from familiar caregivers is one of the most significant actions taken by frontline child welfare workers (FCWWs). While past studies have found poverty to be a primary reason for out-of-home of placement (Rodrigues et al., 2015; Walsh et al., 2018), other studies have identified family-level factors such as abuse, violence, or unsafe home environments as a basis for removal. Certainly, many factors can influence the decision-making process. Despite the fact that understanding factors influencing decision making is essential for promoting improved outcomes such as decision accuracy, early identification of at-risk individuals and safety and developmental outcomes for children and families, much remains unclear about the factors influencing decision-making of frontline child welfare workers. Given the constellation of professional interpretations that appear to shape out-of-home placement decision making, this scoping review synthesized findings from past studies to identify consistent patterns, contradictions, and gaps in the research literature. The primary research question for the scoping review is: What are the factors shaping frontline child welfare workers’ out-of-home placement decisions in the United States?

Methods: Two researchers followed the Preferred Reporting Items for Systematic Reviews and Meta Analysis (PRISMA) guidelines (Page et al., 2021). Studies published between 2016 and 2026 were reviewed. Four databases including APA PsycINFO, Web of Science, Medline, and Social Services Abstracts were utilized to identify relevant articles. The researchers independently used Covidence to screen identified articles. Using the PICO framework, studies involving frontline child welfare workers that examined out-of-home placement decisions in the United States (U.S.) were included. Of 1261 identified articles, nineteen articles were included for full review.

Results: Recurring patterns in factors associated with frontline child welfare workers’ out‑of‑home placement decisions were identified. Across the included studies, findings clustered into five domains influencing placement decision‑making: (1) multi‑factorial assessments of risk extending beyond poverty, (2) policy‑driven placement hierarchies that shape available options, (3) child‑level characteristics and perceived caregiving complexity, (4) the use of categorical risk indicators as decision‑making heuristics, and (5) structural and racialized variation across decision pathways. The results indicate that out‑of‑home placement decisions are characterized by unique circumstances of each case and discretionary judgment of professionals, rather than one uniform risk rule being used across cases.

Implications and Conclusion: This scoping review suggests that frontline child welfare workers’ out-of-home placement decisions are shaped by complex, context-dependent judgements and constrained options rather than standardized or uniformly applied risk thresholds. Placement decisions seem to vary substantially across racialized and other structural contexts. The findings imply that improving fairness, consistency, and stability in placement decisions requires attention beyond individual worker discretion to broader systemic conditions. This may include supporting frontline workers with guidance and resources that address uncertainty and reduce reliance on categorical risk labels, while ensuring that preferred placements such as kinship care are adequately resourced and supported.