Re: Family Pres/Reunif Studies

["Julia H. Littell" <jlittell@xxxxxxxxxxxx>]

Hi Brandon and others,

The most recent, rigorous evaluation in this area is a large, multi-site
study conducted by Westat and the Chapin Hall Center for Children under
contract with the U.S. Dept. of Health and Human services. The study was
conducted in NYC, NJ, KY, TN, and Philadelphia. Ronna Cook (at Westat) and
John Schuerman (Chapin Hall) are Principal Investigators.

Findings for the NYC HomeRebuilder's program (a reunification effort) can
be found at:
http://aspe.os.dhhs.gov/hsp/NYC-HomeRebuilders99/index.htm

Findings for family preservation programs in three sites (NJ, KY, TN) are at:
http://aspe.os.dhhs.gov/hsp/fampres94/index.htm

Findings for the Philadelphia site are in preparation.

A review of previous studies of FPS and reunification programs is available
at:
http://aspe.os.dhhs.gov/hsp/cyp/fplitrev.htm

Controlled studies continue to suggest that substantial reductions in
out-of-home placement and subsequent child maltreatment are not achieved
via intensive in-home services. In fact, under the close scrutiny provided
by these programs, maltreatment reports and placement rates often increase
(slightly). Although it can be argued that the detection of ongoing
maltreatment (or real risks of harm to children) and renewed efforts to
protect children (via placement) are "good" outcomes, it must be remembered
that these are not the outcomes that are typically promised by "family
preservation" and "reunification" programs. 

I have been arguing that in-home services ought drop the "family
preservation/reunification" rhetoric for two reasons 1) there is no
convincing evidence that these programs achieve those goals across the
board and 2) under ASFA, family preservation/reunification are subordinate
to the safety and permanence of children's living situations. In other
words, family preservation/reunification are not sensible goals for *all*
of the families in these programs.

Perhaps most disappointing are the rather consistent findings across
controlled studies in this area that intensive in-home services do not
result in substantial and sustained improvements in caregiver and family
functioning. While the measures of individual and family functioning that
have been used in these studies are not particularly potent, one would hope
to see some improvements in these areas. It is possible that the lack of
consistent aftercare and adequate supportive services for these families
(in mental health, substance abuse, and welfare) makes is quite difficult
to achieve lasting improvements in parent and family functioning via
short-term interventions, no matter how intense.

The intensity and time-limits of these programs may be problematic. As one
public child welfare agency administrator in Philadelphia says, it may not
be reasonable to expect multiproblem families to adjust to the rather
arbitrary timetables imposed on them by these programs. Many aren't ready
for 5-10 hours of contact at the point of referral; nor are they ready to
quit at 3 months. There has been quite a bit of discussion about more
flexible use of in-home services in terms of their intensity and duration.

There has also been some talk about the use of intensive in-home services
for rapid assessment purposes. Elaine Walton has conducted a small study on
this.

Our recent research in Philadelphia looks at caregivers' readiness for
change and the alliance formation (working relationships) between
caregivers and caseworkers in home-based services as moderators of
outcomes. We have some evidence that caregiver readiness and alliance
formation are affected by certain service delivery processes and predict
some outcomes, but these predictions are not consistent across outcome
measures.

Hope that's helpful.
Julia 


At 09:53 AM 3/18/2002 -0700, you wrote:
>Gentlepeople,
>
>A while back there was a thread that I've lost pertaining to the 
>impact of family preservation/reunifcation programs.  In that thread 
>I believe some studies were identified that were more recent than 
>Pecora and the evaluation of Illinois' Family First.  I seemed to 
>remember Julia Littell identifying studies suggesting that while 
>greater preservation/reunification was not always the outcome, other 
>effects occasionally resulted from these programs?  Any help with 
>those references would be appreciated.  Julia?
>
>Thanks in advance.
>bfgreene
>-- 
>Brandon F. Greene, Ph.D.
>Professor, Behavior Analysis & Therapy
>Coordinator, Project 12-Ways
>Southern Illinois University
>Carbondale, IL  62901
>Ph: (618)453-2434
>Fax: (618)453-2450
>EMail: bfgreene@siu.edu
>
>
Julia H. Littell, Ph.D.
Associate Professor
Graduate School of Social Work and Social Research
Bryn Mawr College
300 Airdale Rd.
Bryn Mawr, PA 19010
610/520-2619
FAX 610/520-2655
jlittell@brynmawr.edu