"At the Mercy of our System": Structural and programmatic changes for supporting parents with children in out-of-home care.

System reforms are needed to better support families and prevent child welfare system (CWS) involvement. For parents with children in out-of-home care, it is critical that CWS required programs meet their unique needs and minimize the harm of separation. Yet, few programs have been developed for this population of parents. This study sought to understand important factors to consider when developing responsive programming within the unique parenting context of supervised visitation. Data were collected through semi-structured interviews and focus groups with 107 individuals. Two focus groups included parents with lived expertise whose children were returned to their care after being removed. Interviewees included service providers from state CWS, legal, nursing, and Court Appointed Special Advocate (CASA) programs, child welfare researchers, and racial equity experts. Qualitative thematic analysis involved coding, code grouping, and theme development using ATLAS.ti. Findings indicate the need for broad systems attention to marginalization, separation trauma, and preparing workers for the context of supervised visitation Programs and requirements for parents should attend to self-identified needs, be trauma-informed, and needs-matched. Implications for child welfare programming are addressed, emphasizing community-based programming and family supports aimed at preventing removal, alongside systems-based efforts to minimize harm and meet families' unique needs when separation cannot be avoided.