Noncompletion of Evidence-Based Parent Training: An Empirical Examination Among Families of Children in Foster Care

Child welfare have historically experienced high dropout rates. As evidence-based interventions (EBIs) spread to the child welfare field, treatment noncompletion could interfere with successful outcomes. Using a mixed methods approach, this study investigated the differences between completers and noncompleters, and reasons for treatment noncompletion of an EBI for families of children in foster care. The sample comprised 315 families randomized to receive Parent Management Training, Oregon Model (PMTO). Researchers examined clinicians' discharge notes to explore reasons for noncompletion. Using data collected from a battery of assessments, bivariate logistic regression compared completers and noncompleters on demographics, socioeconomic factors, children's social-emotional functioning, and parents' functioning. About one third of families were noncompleters. Single fathers and parents with lower socioeconomic status were more likely to drop out. By contrast, parents with lower functioning on child behavior and parenting trended toward higher completion rates. Formidable challenges were parental substance abuse and mental illness. Results suggest parent training may require tailoring for specific subgroups and pairing with strategies for enhancing early engagement and reducing treatment barriers. Future research is needed to include parents' views on noncompletion and to more closely examine the influence of specific factors, such as severity of parental mental illness and substance abuse.     

A Test of a Model with Reciprocal Effects Between Religiosity and Various Forms of Delinquency Using 2-Stage Least Squares Regression

ABSTRACT

This was a study of 1,093 adolescents from six different public high schools, where the same integrated theoretical model of control and social learning theories fit the data on alcohol use, heavy alcohol consumption, use of marijuana, criminal behavior, sexual exploration, and suicidal thoughts. It was observed that the model explained significantly more variance in some of these forms of delinquency than in others, indicating only equivocal support for the deviance syndrome argument in the literature. This study also found that religiosity was a significant influence only on criminal behavior, whereas the feedback eifect of delinquency on religiosity was significant for all forms of delinquent behavior studied. The importance of this particular finding was discussed in relation to previous studies, since almost all prior research has used statistics that do not consider reciprocal eifects. In the present study, the reciprocal effects between religiosity and various forms of delinquency were analyzed with two-stage least squares regression.     

‘She was like a mother and a father to me’: searching for the ideal mentor for youth in care

Recent studies of youth in out‐of‐home placements have indicated that a successful mentoring relationship in care is associated with better emotional, educational and behavioural outcomes in adulthood. The goal of this exploratory qualitative study is to describe the profile of a staff member who is able to establish a meaningful relationship with youth in care through the perspectives of 20 young adults aged 21–26 who left care in Israel. Findings revealed that the staff member who formed meaningful relationships with youth was the staff member who was available to the youth and familiar with their personal backgrounds, who was able to see them as positive and trustworthy and to provide guidance and support from a non‐judgmental approach. One of the study's conclusions is that staff members who were able to transform their connection with the youth into mentoring relationships were those who were able to make the youth feel as if they were the staff member's own children, and as a result feel cared for deeply and loved. The discussion addresses the barriers in forming a mentoring relationship with a formal professional and the ways to utilize these mentoring relationship components more effectively within the care system.     

Examining Depression,Anxiety, and Foster Care Placement as Predictors of Substance Use and Sexual Activity in Adolescents

ABSTRACT

This study investigated the impact of anxiety and depression on sexual activity and substance use behaviors in a sample of 56 community- (traditional living arrangements) and foster care-dwelling adolescents aged 12 to 17 years. It was hypothesized that higher levels of anxiety and depression would be related to higher rates of risky sexual activity and substance use. Regression analyses were used to examine impact of the internalizing predictors on the risky behaviors. Results of the sample were presented with group membership emerging as a robust predictor of both sexual activity and substance use. Results suggest that adolescents within out-of-home care are at increased risk for engaging in these behaviors when compared with community-dwelling peers, and they may benefit from specific interventions aimed at decreasing participation. Future research may focus on assessing the effectiveness of interventions for these youth.     

Service Process and Quality in Therapeutic Foster Care: An Exploratory Study of One County System

ABSTRACT

This study assesses the quality of services in the therapeutic foster care programs used by one county in the Midwest. Using a consultative quality assurance review methodology, evaluators examined 67 randomly sampled cases across seven agencies to assess the service quality issues experienced by children. Following interviews with staff, foster parents, and children, and a review of case records, reviewers observed failures in service and in adherence to national program model standards and state regulations. The research indicates the need for consistent monitoring of child-placing agencies and the need for additional research linking service quality with foster care outcomes.     

Recruitment and Retention in a Parenting Intervention: A Case Study with Parents Aging Out of the Child Welfare System

ABSTRACT

Parenting interventions are efficacious in reducing child maltreatment and negative child behaviors, yet the recruitment and retention of parents, especially vulnerable parents, in such interventions can be challenging. Prior research identifies several ways to improve recruitment and retention including laying the foundation for the intervention, fostering relationships with parents, ensuring fit of the intervention with the intended population, and identifying barriers to parents’ participation. This case study presents a process of recruiting and retaining a vulnerable group of parents, specifically parenting youth aging out of the child welfare system. In addition to outlining the strategies used, lessons learned are highlighted. Parents expressed interest in the parenting intervention, experienced significant needs, negotiated great instability in their lives, and valued the social connections facilitated by the group intervention. Despite the research team following best practices and investing significant time and resources, recruitment and retention remained challenging. Implications for future work in this area are presented.     

Toward Client-Centered Service: Asking Clients for Their Views of TANF,Food Stamps,Child Care,and Medicaid Services

ABSTRACT

This article presents the results of a randomized study that asked Division of Family and Children Services' (DFCS) clients throughout the state of Georgia to rate their satisfaction with Temporary Assistance to Needy Families (TANF), food stamps, child care services, and Medicaid services, as well as their perspectives of the customer service they received through their county DFCS offices. Telephone interviews were conducted with 2,408 clients. Overall client satisfaction percentages are: TANF, 80%; food stamps, 88%; child care, 92%; and Medicaid, 94%. Satisfaction indices were also created from the data collected. Client suggestions for improvement are presented as well as practice and educational implications.     

Courts,care proceedings and outcomes uncertainty: The challenges of achieving and assessing “good outcomes” for children after child protection proceedings

The professed aim of any social welfare or legal intervention in family life is often to bring about “better outcomes for the children.” But there is considerable ambiguity about “outcomes,” and the term is far too often used in far too simplistic a way. This paper draws on empirical research into the outcomes of care proceedings for a randomly selected sample of 616 children in England and Wales, about half starting proceedings in 2009–2010 and the others in 2014–2015. The paper considers the challenges of achieving and assessing “good outcomes” for the children. Outcomes are complex and fluid for all children, whatever the court order. One has to assess the progress of the children in the light of their individual needs and in the context of “normal” child development, and in terms of the legal provisions and policy expectations. A core paradox is that some of the most uncertain outcomes are for children who remain with or return to their parents; yet law and policy require that first consideration is given to this option. Greater transparency about the uncertainty of outcomes is a necessary step towards better understanding the risks and potential benefits of care proceedings.     

The effects of autonomy support and psychological capital on readiness for independent living through personal growth initiative among youth in out‐of‐home care

This study explored the effects of the factors on independent living readiness among youth under out‐of‐home care. Specifically, this study focused on the effects of caregivers' autonomy support and psychological capital on independent living readiness through personal growth initiative. A total of 215 youth who were expected to be discharged from caring institution within three years were gathered for the survey, and the final sample was 194 after excluding incomplete responses. Structural equation modeling with Mplus (version 7) was used to test research model and hypotheses in the study. Results showed that the research model was appropriated with several fit indices satisfied and that all the hypotheses were supported. Also, direct and indirect effects of independent variables were fully supported. However, the indirect effect of psychological capital was marginally significant. The results implicate that both caregiver's autonomy support and psychological capital are important for increasing personal growth initiative and that personal growth initiative served as a motivation to facilitating the readiness for independent living among children under institutional care.     

Stability and change – a 7‐ to 8‐year follow‐up study of mental health problems in Norwegian children in long‐term out‐of‐home care

The aim of the study was to explore stability and change in mental health problems in Norwegian children aged 6–12 years old (n = 70) in long‐term out‐of‐home care. The children's mental health problems were assessed shortly after the placement and 7–8 years later by the caregivers and the teachers on the Revised Rutter Scales. Information on pre‐placement and placement factors were collected from the child welfare workers. At a group level the children's mental health problems had improved significantly over time according to the teachers' reports. According to the caregivers' reports, however, the children's problems were high and stable across time. Analyses aimed at detecting individual changes revealed a great variability in development according to both informants, indicating that treating the placed children as a homogenous group could be misleading. Several pre‐placement and placement variables were associated with the change in the children's mental health problems from the time of placement to the follow‐up time according to both informants' reports. However, all the predictors were accounted for by the strong effect of the children's problem scores when entering care.     

The complexities of cultural support planning for Indigenous children in and leaving out‐of‐home care: the views of service providers in Victoria,Australia

Indigenous children and young people are over‐represented at all stages of the Australian child protection system. Policy and legislative initiatives exist in the state of Victoria, Australia aiming to support the connection between Indigenous children and young people in state care and their culture and community. This exploratory research involved focus group consultations with seven child and family welfare agencies to investigate the impacts, barriers, benefits and limitations of cultural support planning for Indigenous young people in, and leaving care in, Victoria. Findings indicated that cultural planning was of value when it could be completed. However, various shortcomings of current systems were identified including limited resourcing of Aboriginal Community Controlled Organisations to generate plans and provide direct and secondary consultation services to implement plans, difficulty gathering information for plans and some Indigenous young people expressing disinterest in connecting to their culture and community. Complexities in the relationships between the Indigenous and non‐Indigenous agencies that aimed to support Indigenous young people in care were also acknowledged. Participants identified a number of strategies to improve outcomes, such as facilitating better relationships between agencies, promoting opportunities for ongoing cultural training for staff in mainstream agencies and improving the resourcing of Aboriginal Community Controlled Organisations to deliver planning and to support cultural connections.     

Big Business in a Thin Market: Understanding the Privatization of Residential Care for Children and Youth in Sweden

This article analyzes the transformation of Swedish residential care for children from a regionally coordinated, public social service system into a thin, but highly profitable, national spot market in which large corporations have a growing presence. Marketization and privatization are theorized as complex processes, through which the institutional structure and logics of this small, but significant, social policy field changed profoundly. Using official documents, register data, media reports and existing research, three consecutive phases in the development of the children's home market are identified since the early 1980s. Change was driven on one hand by policies inspired by New Public Management, which shifted public authority horizontally to the private sector, and vertically to local authorities (funding) and to the state (regulation). On the other hand were the responses of local authorities and private actors to the changing incentives that policy shifts entailed. During the first two phases, both the proportion and size of for‐profit providers increased, and the model of family‐like care was replaced by a professional model. Cutting across the trend of privatization in the third phase was establishment of a parallel system of homes for unaccompanied refugee children – mostly in public ownership. Similarities with privatization in the English system of children's care homes are noted. By showing how the Swedish market for residential care has been created by policy and by actors’ responses to those reforms, the article provides a foundation for thinking through how the predictable, significant and well‐documented problems of such care markets might be addressed.