Pressley Ridge Performs First Study of Its Kind to Assess How Child Welfare and Behavioral Healthcare Services Build Trust with Youth and Families

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In 2017, Pressley Ridge’s Social Research and Innovation Center (SRIC) with the support of the Robert Wood Johnson Foundation began analyzing trusting relationships between providers and clients through a series of research studies. The initial results identify the five essential skills that youth and family workers use to develop and maintain trust with those they serve.

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Child welfare and behavioral healthcare services are inherently relationship-based fields, and perhaps the most critical challenge that service providers face is developing healthy relationships with the people they serve. A sense of mutual trust between providers and youth/families may be the most significant component of a strong working relationship. Providers who can establish trust often provide higher quality care and may achieve more desirable service outcomes than those who struggle to develop mutual trust. However, engaging difficult or traditionally hard-to-reach youth/families is one of the most pressing challenges in the field of child welfare, as many individuals in care report a lack of trust between themselves and their service providers.

In one study, the researchers asked a diverse group of service providers from various states and services (residential treatment, special education, community-based, outpatient, foster care, etc.) to identify how they build trust with youth and families.

Researchers used group concept mapping – an approach that uses advanced statistics to analyze comments –to tabulate responses and categorize them into five overarching themes. Within each theme is a menu of practical skills, attitudes, and techniques that provers use to develop trust. These themes constitute a core model for building trust with youth and families usable by anyone, anywhere, anytime.

The study is the first of its kind to assess how staff from across the service array actively build trust. Previously, many believed that the ability to create trust is an innate ability, something that is difficult to teach. Results from this study suggest that providers can learn how to build trust, and that program managers and supervisors can support staff to create healthier relationships built upon trust.

“This study identifies practical and important skills that staff use to build trusting relationships with youth. By building these skills with our staff, we will better position them to engage and partner with our youth and families,” said Michael Valenti, Senior Research Coordinator, Organizational Performance.

“Our organization has a long and distinguished history of measuring the impact on the people we serve, and the working alliance is such an important piece of knowing how well we connect with people to ensure we are having a positive impact on our communities, kids, and families,” stated Susanne Cole, President and CEO

The project also included an official field test of Pressley Ridge’s Alliance Building: Learning to Engage (ABLE), a new model for developing and tracking supportive relationships, or “working alliances.” ABLE combines working alliance theory with practical feedback tools that reinforce that our relationships (with individuals, groups, teams, etc.) are at the center of everything we do. ABLE was developed specifically to increase communication and collaboration across a wide variety of people, services, and systems.

Pressley Ridge is currently sharing the results with staff and examining how the ABLE intervention might support trust-building efforts. The organization will continue to explore how employees create and maintain trust with youth and families. For more information about this work, please contact Michael Valenti, Senior Research Coordinator (

About Pressley Ridge
Pressley Ridge provides individuals and families with hope and support through life’s challenges. Each year, 10,000 children and families are strengthened through community-based mental health services, foster care and adoption, specialized education and supportive services for transition-age youth. Our more than 70 programs all share a common goal of establishing stable, healthy families and life-long connections that result in a successful, happy life. Pressley Ridge was founded in 1832 and remains headquartered in Pittsburgh, Pennsylvania. A legacy of successful outcomes has allowed the organization to expand services to communities in Central Pennsylvania, Ohio, West Virginia, Maryland, Virginia and Delaware.

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Michael Valenti
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