Decisions on placement and family preservation. Agreement and targeting

Vignettes presented to experts and workers in the child welfare field were used to explore the degree of agreement on decisions to place children in substitute care or to refer them to family preservation services. The design allowed for investigation of the problem of targeting in family preservation programs. Findings indicate considerable inconsistency in decisions among experts and workers, particularly in decisions to refer to family preservation and other in-home services. Contrary to the stated intentions of family preservation services, a majority of the referrals to these programs do not involve children who would have been placed in the absence of these programs.     

Family Functioning as a Measure of Success in Intensive Family Preservation Services

ABSTRACT

An experimental research design was employed in evaluating intensive family preservation services to reunify families after out-of-home placement. There was a significant difference between the treatment group and control group in terms of family reunification, but there were mixed findings with regard to the difference between the two groups on measures of family functioning. Although more treatment parents than control parents felt their families were functioning better, there was no difference between scores for the two groups of parents on normed instruments designed to measure family functioning. The author describes the measures of family functioning employed in the evaluation and discusses the confusing findings along with implications for program evaluation.     

Enhancing the validity of foster care follow-up studies through multiple alumni location strategies

While family-based placement prevention services, family reunification programs, subsidized guardianship, and aggressive adoption programs are reducing the numbers of children spending long periods of time in substitute care, a significant number of America's children will come of age in foster care. Agencies and policymakers should use research and evaluation to assess the effectiveness of foster care in nurturing healthy adults and to explore ways to improve services. Outcome studies that have focused on locating and interviewing young or middle-aged adults emancipated from foster care have been hampered by modest response rates, limiting the field's ability to evaluate the efficacy of foster care programs. This article describes a set of strategies that were used to achieve higher response rates in two recent follow-up studies.     

Foster care placement change: The role of family dynamics and household composition

Sibling co-placement and kinship care have each been shown to protect against the occurrence of placement change for youth in substitute care. However, little is known about the effects of different combinations of sibling placement and relative caregiver status on placement change. Nor does the field fully understand how family dynamics may differ in these households. Utilizing data from the Supporting Siblings in Foster Care study, this paper examines family dynamics across four typologies of living composition, and tests the effects of living composition membership on the odds of experiencing a placement change over an 18-month period of time. Findings suggest that across living composition typologies, children who were placed separately from their siblings in non-relative care were more likely to be older, have more extensive placement histories, and experience more placement changes both prior to and during the study than were children in other living composition groups. Family living composition was found to influence the occurrence of placement change. Specifically, children co-placed in kinship care were least likely to experience movement; however, sibling co-placement in non-relative care was also protective. Results reveal the need to conduct additional research into the experiences of children in different family living arrangements, and tailor case management services and supports to children in substitute care accordingly. Implications and future directions are discussed.     

A preventive services program model for preserving and supporting families over time

Selected findings from a three-year study are reported regarding a prospective sample of 189 families served by the Center for Family Life's preventive services program and the nature and results of the services the families received. The program combines elements of both family preservation and family support services to provide a comprehensive, individualized response to families in need and prevent the unnecessary placement of children in care. Four program elements correspond with those typically identified as characterizing family preservation programs, and three key program elements differentiate the Center's approach from other family preservation programs. These latter characteristics are more typically found in family support programs and address limitations of current family preservation programs as identified in the literature.     

Are services to prevent foster care effective?

The prevention of foster care became an important issue for child welfare services during the 1970s. Two main types of prevention models have emerged: crisis intervention programs intended to prevent imminent placement and intensive service programs designed to avert those crisis situations that precipitate placement. A critical analysis of several project evaluations leads to the conclusion that neither model has been markedly successful. Low nominal project placement rates seem attributable to inability to predict placements and to client selection biases. From a strictly financial perspective, preventive services have been considerably more expensive than regular services, including temporary family foster care. Data from a new demonstration project in New Jersey illustrate various problems in providing and evaluating preventive services to families referred to protective service agencies. Implications of the findings for prevention programs and policies are discussed, and a new direction focused on truly early intervention with children and families is proposed.     

Re-examining child welfare's response to ICWA: Collaborating with community-based agencies to reduce disparities for American Indian/Alaska Native children

Many state and county child protection systems (CPS) are attempting to reduce the documented disproportionality in out of home placement rates for American Indian/Alaska Native children. This article presents a case example of collaboration between Colorado CPS and an urban American Indian family services agency that was intended to impact this disproportionality. The Denver Indian Family Resource Center created and evaluated a family preservation model that includes both direct services to Native families and CPS-level systemic interventions designed to reduce out-of-home placement. Direct services addressed family stressors and caregiver substance abuse and mental health issues, and incorporated Native cultural values. Systemic interventions focused on collaborative partnerships and provided CPS with practical ways to comply with the Indian Child Welfare Act. Agency data showed an increase in the number of children remaining at home or with extended family. Statewide data showed a decrease in the disparity ratio for placement of Native children compared to White children.     

Parental substance abuse and the development of children in family foster care

To determine the impact of parental substance abuse on children, the cognitive skills and behavior ratings of 268 school-age children placed in family foster care were examined. As a group, the children in family foster care presented with low average cognitive skills and made significant improvement in cognitive functioning during placement. The children with prenatal exposure to drugs scored significantly lower in cognitive skills at the beginning of placement but made significantly more progress than the other children during placement. Behavior ratings by the foster parents and teachers revealed that 29% of the children had scores in the significant range, and the children exposed prenatally to drugs had a higher incidence of behavior problems at school compared to family foster care peers. Recommendations for further study of these factors and for enhancing outcomes for children in care are provided.     

Engaging families in child welfare services: an evidence-based approach to best practice

Successfully engaging clients in the helping process is a critical task for child welfare practitioners. Drop-out and noncompliance rates in child welfare services are high and lead to high rates of removal of children from their families and to eventual termination of parental rights. Although no known interventions guarantee treatment compliance, this review of the empirical literature delineates critical components of engagement in child welfare services. Effective engagement strategies, including service components and caseworker qualities and behaviors, are identified as contributing to the positive case outcomes of treatment compliance, family preservation, and placement prevention. The unique needs of neglectful parents are also examined, with recommendations for practice.     

Intensive Family Preservation Services: The Perceptions of Client Families

This qualitative study seeks to understand the correlation between intensive family preservation services and family functioning in those families who have participated in services. The focus is on the perceptions of client families with respect to the impact of services on family functioning including communication, family dynamics, and parenting skills. The discussion centers on the responses of client families to a narrowly constructed survey instrument designed to capture their perceptions with respect to the services provided by case workers.     

Family systems functioning,family health roles,and utilization of physical health services

The purpose of the study reported here is to determine the relationship between family systems functioning, family health role, and family utilization of health services. The research is based in the Circumplex Model of Marital and Family Systems (Olson, Sprenkle, & Russel, 1979). Family functioning variables include family level of cohesion, family adaptability, and family type, as measured by FACES II. Family health role (i.e., leadership role and acceptance of sick role) and utilization of health services are measured by scales of the investigator-developed Family Health Questionnaire. The sample consists of 140 parents of 70 families, composed of two parents with children under 25 years of age living at home. Analysis reveals significant relationships between the family level of adaptability and acceptance of the sick role, in conjunction with significant gender and gender interaction effects. There are no significant differences between family cohesion levels or family typologies with the health variables.Su An Arnn Phipps is an Assistant Professor at the University of Oklahoma College of Nursing Graduate Program, Tulsa, 700 N. Greenwood, Tulsa, OK 74106. Her research interests include family systems functioning and family physical health, couples' infertility experience, and fathers' role(s) in family health. She received her Ph.D. from Oklahoma State University in Family Relations and Child Development.     

Family preservation: a potential not yet realized

When they received widespread promotion and support beginning in the 1980s, family preservation services seemed to hold much promise for the child welfare field, and for the lives of families and children. Unfortunately, this promise has never been fully realized throughout the United States. This article traces the recent history of family preservation services, examines some of the reasons why efforts to implement family preservation services have been less than completely successful, and proposes a strategy for ensuring that these services reach their potential in the future.     

The influence of family environment on mental health need and service use among vulnerable children

Children in child welfare are especially likely to have unmet mental health needs. The role of family factors in children's use of mental health services was examined in a longitudinal sample of 1075 maltreated or at-risk children. Vulnerable family environment (poor family functioning, low social support, and caregiver psychological distress) is an important predictor of children's mental health needs. It also predicts them not having these needs met.     

Crisis nursery effects on child placement after foster care

The results of a study of the relationship between receiving crisis nursery services and the placement outcomes for young children leaving the child welfare system in Illinois are reported in this paper. The placement outcomes for children leaving foster care whose families received crisis nursery support prior to the children's placement in foster care is compared to the placement outcomes for children whose families received only foster care services. The children in two samples were identified by matching crisis nursery children's data from FY 2006 with children's data in the Illinois Child Abuse and Neglect Tracking System and Children Youth and Services Information System databases. After children served by crisis nursery and foster care services were identified, a comparison group of children with like-characteristics whose families received only foster care services was identified using propensity score matching. The children were followed until their out-of-home placement was terminated or until June 30, 2009. The placement outcomes and the length of stay were compared for the two groups. Using logistical regression analysis the results showed that children whose families received crisis nursery services prior to foster care placement were twice as likely to be reunited with their biological families (birth or extended family members) when compared to children whose families received only foster care services. The difference in the length-of-stay in foster care was not statistically significant when the two groups were compared. This preliminary study using administrative data shows that receiving crisis nursery services may have positive effects on the children's ultimate placement outcome after foster care. Additional research is needed to further explore the relationship between placement outcome and crisis nursery services.     

Fostering families' and children's rights to family connections

Recent federal legislation strengthens children's and families' rights to family-centered practice by increasing the responsibility of child welfare agencies to identify and engage extended family members in providing care and support to children placed out of the home. Preliminary results from an experimental study of a federally funded family finding project found greater involvement of family, kin, and informal supports and a higher likelihood of reunification or relative placement compared with standard child welfare services.     

Key factors and characteristics of successful resource parents who care for older youth: A systematic review of research

There is growing recognition that competent, committed resource parents are a critical component to the effective delivery of foster and adoptive services for teens placed in out-of-home-care. This study implemented a systematic review process to identify the personal characteristics, skills and abilities of successful resource families that maximize foster and adoptive parent retention and maximize placement permanency of teens placed in out of home care. Starting with an extensive search of the literature across the last two decades and outreach to locate studies, the authors systematically analyzed research that used permanency and placement stability as the primary dependent variables and personal characteristics/attributes, knowledge, skills and abilities as independent variables. Of the 838 total documents identified, 48 were original research studies that focused on one or more of these variables. Although rigorous and systematic, this research was hampered by differing definitions, samples, measures, and the type of analysis utilized among these studies. Personal characteristics that promoted permanency and placement stability included having a tolerance for rejection, flexible expectations, having a sense of humor, having a belief in a higher power, belief in self-efficacy, having higher education, having sufficient economic resources, having healthy family and marital functioning, having access to support systems, and being motivated to foster/adopt. Knowledge, skills, and abilities resources families acquired that promoted permanency and placement stability included the ability to communicate effectively, maintain attentiveness to the parent/child relationship (i.e. using routines and structure while also offering children a variety of experiences), understand the effects of trauma and teach socio-emotional health, provide culturally competent care, recognize, express and process grief, take care of oneself, valuing and participating in life -long learning, training and education, and valuing a connection to the child's birth family.     

Children in Need in the South of Italy: Features and Distortions in the Deinstitutionalisation of Care

Despite the shift in emphasis from institutional to foster family care, in the south of Italy children in need are mainly looked after by residential services. These are required to provide family‐style care and to place children on a short‐term basis. Using data from research on a 100% sample of day units, residential services and children in care in the Calabria region, this article investigates the functioning of the system of care for vulnerable children at the sub‐national level, describes looked‐after children’s characteristics and life conditions and questions the extent to which a real deinstitutionalisation process has occurred in this area. Finally, some deinstitutionalisation recommendations are given.     

Family Functioning Patterns as Predictors of Engagement: Which Families Participate in Services and Which Ones Do Not?

The present study examines the relationship between specific areas of family functioning and family engagement in prevention services. A sample of 147 families who initiated youth-centered treatment services from a non-profit agency was selected. Statistical analysis was used to test for relationships between family scores on the Family Assessment Measure (version III, General Scale) and family levels of engagement in services. Results of binary logistic regression analysis indicated that individual and family characteristics are associated with family engagement in services. In addition to demographic variables of age and race, family patterns of denial made a significant individual contribution to the evaluated model. Implications for engaging families in prevention services are discussed and suggestions are made for future research.     

The role of crisis in family crisis intervention: Do crisis experience and crisis change matter?

Evaluation studies of crisis intervention have focused on prevention of out-of-home placement of children or family functioning, but largely neglected the aspect of crisis. The present study examined crisis in 183 families receiving Family Crisis Intervention (FCI), addressing crisis characteristics and crisis change. In questionnaires children and parents were asked about their definition and experience of crisis and about their need for help. Results show that all families but one were in crisis at the beginning of the intervention, although the perception and extent of crisis differed among respondents. Crisis decreased from baseline to posttest according to clients and crisis intervention workers, but was not absent after the intervention. Combined with an unexpected pattern of reported family balance in the months before FCI, this result challenges the 4-6 weeks time span assumption of a crisis period. Variations in perception of crisis, clients' need for help, and possible crisis patterns are discussed, addressing theoretical and practical implications for family crisis intervention.