Family preservation reunification programs

A related effort to reunify families who had at least one child placed in foster care was also evaluated, and related issue papers on family preservation, fiscal reform, and cost estimation were produced. Related studies of program implementation and the family support component of the program are available from other offices within the U.

Department of Health and Human Services. These include:. The following reports are available from this evaluation: Final Report of the Evaluation of Family Preservation and Reunification Programs December The Evaluation of Family Preservation and Reunification Programs, conducted between and , studied four local programs providing services intended to improve family functioning and reduce unnecessary foster care placements.

This traditional, experimental-design evaluation examined outcomes of sites that each used the popular HomeBuilders service model which provides intensive services to families over a period of approximately 6 weeks. The report discusses family outcomes approximately one year after program entry. Key findings include: 1 families served experienced a range of problems; 2 participating families received a wider and deeper array of services; 3 foster care placement was not reduced; 4 child safety was maintained; 5 family functioning did not generally improve; 6 all subgroups experienced similar outcomes; 7 families thought their lives had improved.

Estimating Child Welfare Service Costs: Methods Developed for the Evaluation of Family Preservation and Reunification Programs June The Evaluation of Family Preservation and Reunification Programs studied four local programs providing services intended to improve family functioning and reduce unnecessary foster care placements. A cost study was originally planned, but when the evaluation found no significant differences between treatment and control groups on outcome measures of interest, the studys advisory group recommended that the cost study not be implemented.

New York: Columbia University Press. In Kathleen Wells and David E. Beigel eds. Landsman Springfield, IL: Charles C. Landsman, and Wendy Deutelman Family Preservation Services Annual Report Nugent, William R. Olds, David L. Perdiatrics 86 1 : Henderson, R. Chamberlin, and R. Tatlebaum Henderson, Jr. Cambridge: Cambridge University Press. Panel on Research on Child Abuse and Neglect Understanding Child Abuse and Neglect: Summary.

Pearson, Carol L. King Pecora, Peter J. Fraser, Peter J. New York: Aldine de Gruyter. Client outcomes and issues for program design. Reid, William J. Kagan, and Shirley B. Schlosberg Robin, Sandra C. Unpublished doctoral dissertation. University of Minnesota. Rossi, Peter H. Rossi, Peter and Howard Freeman Evaluation: A Systematic Approach, 5 th ed.

Rzepnicki, Tina L. Stein Scannapieco, Maria Schafer, Richard and Sandra D. Schuerman, John R. Rzepnicki, and Julia H.

Littell Littell and Amy Chak Biegel eds. Schwartz, Ira M. Schwartz and Philip AuClaire eds. University of Nebraska Press. Minneapolis: Authors. Harris Siegel, E. Bauman, E. Schaefer, M. Saunders, and D. Ingram Smith, Mary Stein, Theodore J. Stein, T. Gambrill, and K. Wiltse New York: Praeger Publishers. Szykula, Steven A.

Fleischman Taylor, D. Kay and Carole Beauchamp Thieman, A. Fuqua, and K. Linnan Ames, Iowa: Iowa State University. Thieman, Alice A. Dail Van Meter, Mary Jane S. Wald, M. Carlsmith, and P. Leiderman Protecting Abused and Neglected Children. Walton, Elaine Walton, Elaine, Mark W.

Fraser, Robert E. Lewis, Peter J. Pecora, and Wendel K. Walton Wells, Kathleen and David E. Family Preservation Services: Research and Evaluation. Wells, Kathleen and Dale Whittington Wheeler, Charles E. Yuan Sacramento, CA: Walter R. Willems, D.

DeRubeis Willis, Diane J. Wayne Holden, and Mindy Rosenberg eds. New York: John Wiley and Sons. Wilson, Duff. Wulczyn, Fred Yuan, Ying-Ying, Walter R. McDonald, Charles E. McDonald and Associates. Yuan, Ying-Ying T. Struckman-Johnson Publication Date.

Littell and John R. Schuerman Westat, Inc. We conclude our review with a discussion of directions for further research in this area. Placement Prevention Non-experimental Studies Many early evaluations of programs designed to prevent placement used non-experimental designs in which groups receiving these services were followed without comparing them to other groups or in which nonequivalent comparison groups were used. Overflow Designs Overflow designs, in which a comparison group is composed of cases not served because programs are full, provide information about effects that is somewhat better than single group or non- comparable group designs.

Early Experimental Studies In the studies reviewed so far, rates of placement in the groups provided family preservation services were quite low. Relationships between Service Characteristics and Placement Several studies have examined correlations between service characteristics and placement outcomes.

Summary Although many non-experimental studies have suggested that high percentages of families remain intact after intensive family preservation services, the results of randomized experiments provide more convincing tests of the extent to which "placement prevention rates" can be attributed to the effects of these programs.

Prevention of Subsequent Child Maltreatment The hope in family preservation programs is to prevent the placement of children without subsequent maltreatment. Program Effects on Child and Family Functioning Several studies examined effects of services on measures of family functioning. Cost Family preservation programs have been promoted as a way to save costs on foster care.

Family Reunification In addition to establishing the objective of preventing placements, the Adoption Assistance and Child Welfare Act of called for the reunification of children in foster care with their biological parents whenever possible, within the larger context of efforts to achieve permanent and safe living conditions for children. Results of Controlled Studies We know of only two well-controlled studies of special services designed to reunify children in foster care with their biological families.

Correlates of Reunification and Reentry Several researchers have examined characteristics that are associated with reunification. Summary There is little solid evidence that programs aimed at preventing out-of-home placements or reunifying families with children in foster care have the intended effects. The average length of service for families who entered the program was 56 days.

One provider operated a four week program; the remaining providers offered six to eight week programs. Each agency spent an average of 45 hours providing direct services usually in-home counseling , and 41 hours providing indirect services these figures are based on the families who exited the program in fiscal year Service delivery models varied somewhat among the provider agencies.

OUTCOMES Investigators used three measures of success when analyzing outcome: a comparison of risk level at the beginning of family preservation services with risk level at completion of family preservation services, the number of new substantiated reports of child abuse or neglect that involved families who were receiving family preservation services and at six months post-treatment , and number of out-of-home placements within families who were receiving family preservation services and at six months post-treatment.

Seventy-nine percent of families completed the program; risk status was reduced for 78 percent of families. In addition, almost 83 percent of families who entered and exited the program had no new substantiated reports of child abuse or neglect while receiving family preservation services. Eighty-six percent of the children who entered and exited the program during fiscal year did not experience out-of-home placement while participating in the program, and at six months following program completion.

Age 17 years or younger. These children had an average of 1. Behavioral-cognitive approach. Median length of service, 4 weeks. Crisis resolution, parenting education, child development training, advocacy, communication and negotiation skills, home maintenance skills, concrete services, job readiness training, linkages to other services.

Cost avoidance analyses were performed. An analysis of a small overflow comparison group was to have been completed in A child was considered at-risk of placement if they had been abused or neglected, were severely emotionally disturbed, or had been involved in delinquent behavior. In-home services were provided on a daily or weekly basis and emergency housing funds were available.

Reasons for a family not being intact included child ran away, child moved out of home not placed , child living with relative or guardian court ordered , child in foster home or group home, child in residential treatment, child with Division of Youth Services, child in juvenile justice or child in in-patient psychiatric diversion.

Of the 2, children considered at-risk within the 1, exiting families, 1, returned home, while did not return home. A limited number of qualitative case studies are also presented. One appendix provides instruments used in data collection. Families received services for a six week period. Services provided included in-home family and individual counseling and parent skills training; several programs also provided transportation, food, housekeeping assistance, budgeting assistance, financial counseling, and substance abuse prevention services.

Fifty-nine children were placed out-of-home; 7 children were placed in the mental health system, 6 children were placed in the juvenile justice system, 1 child was placed in a private placement, and 1 child ran-away. At intake, cases were assigned to either Intensive Family Services or traditional family services based on an assessed "risk of placement" level. Cases assigned to Intensive Family Services were assessed as more at risk of placement.

Risk level was assessed through the use of a standardized risk assessment form completed by all workers at intake. In-home services were provided by Intensive Family Services staff a worker or aide between 1. On average, 3. Intensive Family Services were provided for approximately 90 days. Of the remaining families who were referred for traditional services, 18 percent were placed within six months or at termination of services six months or less.

Of the 80 cases referred for Intensive Family Services, 7. At 12 month follow-up, 8 percent of the cases referred for traditional services were open in foster care, while 3 percent of the 80 cases referred for Intensive Family Services were open in foster care. The study also discusses findings related to high and low success in family treatment.

Worker surveys provided family data at time of service termination, as therapists filled out anonymous questionnaires for each family served. Families were also surveyed, and the study reports on parent satisfaction measures. The first, Intensive Family Services, began in and is designed to serve families at risk of having a child removed from the home.

The second, called High Impact, began in and is designed to serve families when they first enter the family services system; this program is designed to help prevent the threat of a child's removal from home. On average, monthly caseworker loads were between 8. Of Oregon's 36 counties, 29 were served by these programs. The specific nature of service offered is not clear, although the authors write: "the focus of treatment is on healing relationships between family members rather than attempting to heal what appears to be an emotional or behavioral flaw that intrinsically resides within a 'dysfunctional' family member" p.

OUTCOMES Treatment success is discussed in relation to each of the six types of family systems outlined above; success is reported based on therapist judgement of the success of treatment and the likelihood of the family avoiding placement in the future. Therapist ratings of overall clinical success and overall likelihood of a family remaining intact in the future are also reported.

The authors conclude: "we are satisfied that the empirical data of actual placements Systemic family treatment is successful in improving family life. Families are better able to remain together" p. A qualitative report is also included, based on interviews with a subsample of 39 families. Case problem areas listed include child abuse or neglect, child's behavior, delinquency, chaotic environment and parental dysfunction. Cases were referred by a variety of institutions, including child abuse investigative units, schools, and the courts.

Services provided included face-to-face contact and availability of cash assistance for rent payments, transportation needs and food. Placement was more likely for families who were referred on an emergency basis, who had a history of psychiatric care, who had experienced prior out-of-home placement, or who had children under court jurisdiction. Both the program and control groups received traditional child welfare services including counseling, financial assistance, medical care, family-life education, and day care.

Intensive services were provided to cases in the experimental group over approximately 14 months. Caseloads in the experimental group were usually 10 families per worker and the families in this group received significantly more in-person contacts with workers. Experimental cases received an average of 40 hours of service, compared with 32 hours for control cases. All agency services were available to families in both groups; specific services provided to families were not described Stein OUTCOMES: Placement The experimental group had a higher number of children placed in foster care versus 84 children in the control group ; however, the total number of children in each group was not reported Stein Families in both the experimental and control groups received counseling, homemakers, day-care, and recreational, medical, legal, financial, and family planning services.

The primary difference between groups was the intensity of services provided: over a one year period, families in the experimental group had three times the number of in-person contacts with workers an average of 39 versus 13 and almost 12 times the number of telephone contacts 39 versus 3.

Project staff also had significantly more contact with collateral and provided emergency financial assistance, vocational counseling, and housing assistance to families. They carried caseloads of 11 to 12 families, while the average caseload size for workers in the control group was 18 families. The main difference between these units is that staff in the experimental group were under less time pressure and had more support and direction in decision-making.

Information on caseload sizes and specific services provided to experimental and control families was not available Stein Data on informal placements with relatives and friends and on placements outside the project county were not available. All families received referrals to community mental health, day care, family planning, health care, and homemaker services. Those in the experimental group had access to legal advocacy, group therapy, and emergency financial services and were more likely to be referred for employment services, homemaker or teaching services, housing services, legal aid, and welfare assistance.

Workers in the experimental group carried caseloads of 11 families each; caseload size for the control group was not reported Stein Families in the experimental group received more home visits and had more contact with workers in their offices. Children in the control group were more likely to be placed in restrictive settings such as residential treatment and less likely to be placed with relatives than those who received more intensive services.

While more control group children were returned to their families 7 versus 3 , reunification in the control cases was described as "unplanned and unsuccessful. Paul, Minnesota child protective services department. Families served in the home-based services unit received a combination of counseling and concrete services. Families in the control group received traditional case management services. Caseloads in the experimental unit were half the size of those in the traditional units.

Cases in all units remained open for approximately 10 to 12 months. Cases were identified as more or less difficult by workers, based on numbers of prior abuse reports and types of family problems. Cases within each difficulty group were randomly assigned to program or control services. The program was conducted in the child protective service unit of Cascade County Social Services in Oregon.

No data were provided on the type, duration, or intensity of services received by families. Of the 50 families referred to the project, 26 received FamiliesFirst services as well as other county services. The remaining 24 families did not receive home-based services because of insufficient space in the program; these families received regular county child protective services.

Target children in the in-home services group were somewhat older than those in the comparison group average of 8. They provided family therapy, help in practical matters of living, and liaison work with schools and other community services.

Children who were the focus of intervention were placed more often than their siblings. An overflow comparison group of 12 families was available for the Pius group; one of these 12 families was lost to follow-up. Apparently, all children who were placed were still in placement at the end of the one-year follow-up period.

Cases that were approved for placement were recorded on a log. When an opening in the home-based service program occurred, the log was consulted and the most recent case was referred. If there were no cases available, the next eligible case was referred. Cases not referred to the home-based service were referred for placement services. A random sample of cases, equal in number to those in the home-based service group, was selected from the placement services group as the comparison group.

It is not clear why comparisons were not done with the entire placement services group. Workers carried caseloads of two families.

Referrals were reviewed by a local screening body; screening criteria included "risk of placement. The mean age of "target" children was 13 years. Services provided by private agencies involved a median of 31 hours of face-to-face contact between families and workers over a median of 6 weeks of service. In the first week of services, families received a mean of 13 hours of direct contact with workers.

The median number of total hours of contact including telephone and collateral contacts per family was 48 mean of There were significant differences across sites in duration of services. No information was provided on caseload size. Referring agencies were responsible for determining the kinds of services that were provided to families in the control group. Families in the control group typically received "traditional community services," including less intensive counseling services, referrals to other community resources, youth advocacy services, monitoring by the state child welfare agency, family court interventions, and out-of-home placement.

Services received by control group families were thought to be much less intensive than those in family preservation programs, but, unfortunately, there was no systematic data collection on the nature and amounts of services provided to families in the control group. It was suggested that the services provided to control cases were similar to the kinds of follow-up services received by families in the experimental group after FPS termination. Other Outcomes examined included changes in perceived social support, goal attainment, and client satisfaction.

There were some differences between experimental and control groups in the amount of change in these measures favoring the experimental group but these were quite limited. The families had an average of 2. On average, the duration between referral and the initiation of services was 7 days.

Services lasted an average of 7 weeks. Families received an average of 32 hours of direct contact with workers. In addition, workers spent an average of 17 hours per case on "collateral services" and 10 hours per case on travel. Services consisted of assessment, case planning, individual and family counseling, crisis intervention, parenting skills training, and service coordination. Concrete services e. In most cases, services were provided by licensed therapists, although some projects used co-therapists or case aides.

No data on services provided to the control group. There were no substantial differences in lengths of time in placement or costs of placement. Children in the control group were more likely to be placed with relatives.

Child and Family Functioning Pre- and post-tests were conducted with the experimental group only. A 12 month follow-up was conducted with families. The average age of the oldest child at risk of placement was Families in the Utah program received an average of 23 hours of in-person contact with workers; those in the Washington program received 21 hours of in-person contact.

Caseloads ranged from 4 to 6 families in Utah, while therapists in Washington carried caseloads of two to three families each Pecora, Fraser, and Haapala OUTCOMES: Placement Service failure was defined as placement of a child outside the home for two weeks or more in a non-relative setting during the provision of family preservation services or within 12 months following intake.

Runaways were also counted as failures Pecora, Fraser, and Haapala Over a three month service period, families in the in-home services group received significantly more contact with workers than comparison cases average of 9.

Families in both groups reported that they did not have significant problems in family functioning at case opening and did not see significant change in these areas at case closing. However, families in the in-home services group reported more improvements in living conditions and financial conditions at one year after termination, compared to controls. Parents in the program group also reported more improvements in their children's behavior between referral and the case closing, although there were no differences between groups one year after services had ended.

Workers who provided home-based services reported that the families had significant problems in all areas of family functioning at case opening and made significant improvements in four of six domains at case closing.

The families were followed through March Families were referred to the program by state child protective services workers on the basis of substantiated reports of child abuse or neglect. The average caseload for workers in the Family First placement prevention program was 5 families compared to an average of 50 cases for public child welfare workers who provided services to families in the control group. Family preservation services generally began within 24 hours of referral and were provided in families' homes.

Cases in the Family First program received more intensive services than controls a median of Services provided to cases in the program included crisis intervention, parent education, transportation, advocacy, and referrals for material aid, substance abuse treatment, and medical care.

Half of the Family First cases left the program within days. Interviews with a subsample of clients in the experiment support the conclusion that Family First cases received much more extensive help than cases in the control group.

Increases in the risk of placement for children in the Family First group were statistically significant in the two experimental sites in the Chicago area there were no sites in which the program produced a significant reduction in placement rates ; however, differences between experimental and control groups disappeared once variations in case characteristics were taken into account.

Family First was related to a significant increase in placements among households headed by single adults; the program had no significant effect on the risk of placement for 15 other subgroups.

There were no significant differences between groups in the duration or types of placements. Child Maltreatment Children in the Family First group were somewhat more likely to be identified as victims of subsequent maltreatment than children in the control group; although statistically significant, the difference between groups was small.

Child and Family Functioning Measures of child and family functioning in eight domains were obtained through interviews with a subsample of parents in three of the six sites. There were no relationships between the duration of Family First services, amounts of contact with caseworkers or parent aides in the first 90 days of services, or the number of concrete services provided and the likelihood of placement or subsequent maltreatment.

The program group included children families and there were children 64 families in the control group. Workers carried caseloads of The duration of services averaged 8. Children's ages ranged from one to 17 years mean age of They had a mean of 2. The mean duration of the most recent placement was 8 months. Primary caregivers were 35 years old on average and they had a mean of 12 years of education.

Caseworkers carried caseloads of no more than six families at a time mean of 5. The program provided concrete services financial assistance, transportation, clothing, food, and household repairs and training in communication skills, parenting skills, and anger management. OUTCOMES: Reunification At the end of the day treatment period 93 percent 53 of 57 children in the treatment group had been returned to their homes, compared with 28 percent 15 of 53 control children--a significant difference Walton et al.

Six months after termination 70 percent 40 of the children in the program group and 42 percent 22 of those in the control group remained at home. Differences between the groups were statistically significant at each point in time. Other Children in the treatment group spent significantly more time days at home during the study period than those in the control group.

Boyd, P. Meezan, William. Personal communication. November 5, Descriptive report on families with children who received Family Preservation Services covering fiscal year Services were provided by nine private agencies in contract with the state. Investigators used three measures of success when analyzing outcome: a comparison of risk level at the beginning of family preservation services with risk level at completion of family preservation services, the number of new substantiated reports of child abuse or neglect that involved families who were receiving family preservation services and at six months post-treatment , and number of out-of-home placements within families who were receiving family preservation services and at six months post-treatment.

Descriptive report on 2, families referred for family preservation services Tennessee Home Ties , 2, were accepted for services, from October to June Cases in which placement was thought to be imminent. Services provided by 28 community service agencies. Descriptive report on 2, referrals for family preservation services 1, accepted for services covering fiscal year Of the 1, families that exited the program during fiscal year , were intact and were not intact.

Already a foster caregiver? Collaborative Partnerships Programs. Family Preservation and Reunification Services Under the Family Preservation and Reunification program VACFSS coordinates a number of culturally-informed programs and services to support families, including in-home supports and strengthening group programs.

Our groups. It also provides support to their children to increase social and emotional functioning. The group is facilitated by Indigenous Elders and incorporates cultural awareness and teachings. The group is facilitated by respected Indigenous Elders who provide positive mentorship.

It is culturally informed and provides supportive workshops to women with high-risk pregnancies. In-home support programs.