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Child-Maltreatment-Research-L (CMRL) List Serve

Database of Past CMRL Messages

Welcome to the database of past Child-Maltreatment-Research-L (CMRL) list serve messages. The table below contains all past CMRL messages (text only, no attachments) from Nov. 20, 1996 - December 22, 2017 and is updated quarterly.

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Message ID: 8498
Date: 2010-03-27

Author:Chaffin, Mark J. (HSC)

Subject:RE: Evidence-based treatment models for older foster children

Kristen, re: Triple P I think you could put any good evidence based behavioral parent training program on the list, so long as it is suited to teenagers. The teen version of Triple P or Barkley's Defiant Teen program would probably work out well. Most of these behavioral parent training models share similar content. PMT has been researched more with high-problem teens in foster care, so I picked that one. MST is fundamentally a parenting program in many ways too, although not exclusively, and is obviously well supported for a range of very difficult teens. The problem with all of these better supported parent-mediated service models is that they rapidly loose their applicability as kids get older and the role of parents or caregivers diminishes. So, better get going at 15 and not wait until 17 and independence looms. Most of the best models also require that the foster parent/caregiver has some commitment to the kid and won't give them the boot at the first sign of problems, and that the foster parent is willing to be strongly involved in the service, and is motivated and properly supported to learn and apply the skills. The foster care system needs to expect (if not demand) this level of engagement from foster parents, and provide the supports that make it possible. This is one of the things that makes EBTs different and harder to implement, regardless of the model. They are not the same structure the usual "drop him off in front of the shrinks office for 45 minutes of ad hoc talk therapy, then give him the boot when (not surprisingly) it doesn't work." We have hopefully now passed the tipping point where individual office based talk therapy with no parent involvement is dying off as the dominant service model among teens living with their biological parents. With kids in foster care, we are still stuck there I suspect, although I haven't seen much data on this. Our dilemma in this system may not be about lacking effective models. There are quite a few--which I think is the point of the post. Our dilemma is that ineffective treatments are easy to deliver and consume and fit the setup and service expectations of our current foster care system. This is probably why we keep doing them. Implementing more effective models requires change at multiple levels, and training providers is the least of the work required. In this regard, I think the more difficult and determinative question for foster care systems is not "which model do we pick?" from among the crop of good models, but "what will we have to change about our whole foster care structure in order to implement it?" Mark ________________________________________ From: Kristen Shook Slack [ksslack@wisc.edu] Sent: Friday, March 26, 2010 9:37 AM Subject: Re: Evidence-based treatment models for older foster children Mark and others, I am curious about your perspective on the Triple P-Positive Parenting Program, that is getting so much attention as a promising child maltreatment prevention strategy. My understanding is that it was originally developed as an intervention for parents of children with behavioral problems (I am unsure if there is a target age range specified for this program)--would you include it in this in your list of treatment models to consider? Kristi Slack Chaffin, Mark J. (HSC) wrote: > > The difficulty in thinking this through is that evidence-based > treatment models are usually matched with a dysfunctional behavior > pattern, symptom or diagnosis, not with a type of home or a setting. > Because none of us would want to characterize being in foster care as > a mental disorder, there is really no treatment per se for being a > foster child. But the positive flip side of this is that virtually all > evidence based treatment models that fit older teens in general would > qualify, presuming that they are matched to a particular disorder or > problem in an assessment driven fashion. Given what we know about > older teens and prevalent problem areas, you might wish to consider: > > 1) Multisystemic Therapy (delinquent behavior and/or substance abuse) > > 2) Parent Management Training (behavior problems) > > 3) Trauma Focused Cognitive Behavioral Therapy (ptsd and internalizing > symptoms) > > 4) Dialectical Behavior Therapy (stuff that some might characterize as > “borderline personality”) > > My guess is that these four would probably cover 90% of clinical > mental health problem presentations. I don’t know if you are looking > beyond mental health treatments, and in the direction of things like > life skills training, supported employment, medical homes, family > planning, mentoring, and other concrete supportive services as well. > Certainly mental health issues are far from the only needs, and maybe > not even the dominant need. There also may be more educational > materials oriented around common foster child life themes, > irrespective of mental health status. Hopefully others can comment on > these areas. Curtis McMillen at Washington University in St. Louis > would be a good person to consult on this question. > > Mark Chaffin > > *From:* Noriko Ishibashi Martinez [mailto:noriko@uchicago.edu] > *Sent:* Thursday, March 25, 2010 1:59 PM > *Subject:* Evidence-based treatment models for older foster children > > Hi folks, > > I'm putting together an annotated bibliography, and I am in the > process of searching for published articles on evidence-based > treatment models for older foster children, but I thought I would ask > the listserv if anyone knows of any particularly good models I should > look for specifically. > > Thanks in advance, > > Noriko Ishibashi Martinez, PhD, LCSW > > Adjunct Faculty > > School of Social Service Administration > > University of Chicago > > 969 East 60th Street > > Chicago, IL 60637 > > noriko@uchicago.edu > > > -- Kristen Shook Slack, Ph.D. Associate Professor School of Social Work University of Wisconsin-Madison 1350 University Avenue Madison, WI 53706 ph: 608-263-3671 fx: 608-263-3836

Kristen, re: Triple P I think you could put any good evidence based behavioral parent training program on the list, so long as it is suited to teenagers. The teen version of Triple P or Barkley's Defiant Teen program would probably work out well. Most of these behavioral parent training models share similar content. PMT has been researched more with high-problem teens in foster care, so I picked that one. MST is fundamentally a parenting program in many ways too, although not exclusively, and is obviously well supported for a range of very difficult teens. The problem with all of these better supported parent-mediated service models is that they rapidly loose their applicability as kids get older and the role of parents or caregivers diminishes. So, better get going at 15 and not wait until 17 and independence looms. Most of the best models also require that the foster parent/caregiver has some commitment to the kid and won't give them the boot at the first sign of problems, and that the foster parent is willing to be strongly involved in the service, and is motivated and properly supported to learn and apply the skills. The foster care system needs to expect (if not demand) this level of engagement from foster parents, and provide the supports that make it possible. This is one of the things that makes EBTs different and harder to implement, regardless of the model. They are not the same structure the usual "drop him off in front of the shrinks office for 45 minutes of ad hoc talk therapy, then give him the boot when (not surprisingly) it doesn't work." We have hopefully now passed the tipping point where individual office based talk therapy with no parent involvement is dying off as the dominant service model among teens living with their biological parents. With kids in foster care, we are still stuck there I suspect, although I haven't seen much data on this. Our dilemma in this system may not be about lacking effective models. There are quite a few--which I think is the point of the post. Our dilemma is that ineffective treatments are easy to deliver and consume and fit the setup and service expectations of our current foster care system. This is probably why we keep doing them. Implementing more effective models requires change at multiple levels, and training providers is the least of the work required. In this regard, I think the more difficult and determinative question for foster care systems is not "which model do we pick?" from among the crop of good models, but "what will we have to change about our whole foster care structure in order to implement it?" Mark ________________________________________ From: Kristen Shook Slack [ksslackwisc.edu] Sent: Friday, March 26, 2010 9:37 AM Subject: Re: Evidence-based treatment models for older foster children Mark and others, I am curious about your perspective on the Triple P-Positive Parenting Program, that is getting so much attention as a promising child maltreatment prevention strategy. My understanding is that it was originally developed as an intervention for parents of children with behavioral problems (I am unsure if there is a target age range specified for this program)--would you include it in this in your list of treatment models to consider? Kristi Slack Chaffin, Mark J. (HSC) wrote: > > The difficulty in thinking this through is that evidence-based > treatment models are usually matched with a dysfunctional behavior > pattern, symptom or diagnosis, not with a type of home or a setting. > Because none of us would want to characterize being in foster care as > a mental disorder, there is really no treatment per se for being a > foster child. But the positive flip side of this is that virtually all > evidence based treatment models that fit older teens in general would > qualify, presuming that they are matched to a particular disorder or > problem in an assessment driven fashion. Given what we know about > older teens and prevalent problem areas, you might wish to consider: > > 1) Multisystemic Therapy (delinquent behavior and/or substance abuse) > > 2) Parent Management Training (behavior problems) > > 3) Trauma Focused Cognitive Behavioral Therapy (ptsd and internalizing > symptoms) > > 4) Dialectical Behavior Therapy (stuff that some might characterize as > “borderline personality”) > > My guess is that these four would probably cover 90% of clinical > mental health problem presentations. I don’t know if you are looking > beyond mental health treatments, and in the direction of things like > life skills training, supported employment, medical homes, family > planning, mentoring, and other concrete supportive services as well. > Certainly mental health issues are far from the only needs, and maybe > not even the dominant need. There also may be more educational > materials oriented around common foster child life themes, > irrespective of mental health status. Hopefully others can comment on > these areas. Curtis McMillen at Washington University in St. Louis > would be a good person to consult on this question. > > Mark Chaffin > > *From:* Noriko Ishibashi Martinez [mailto:norikouchicago.edu] > *Sent:* Thursday, March 25, 2010 1:59 PM > *Subject:* Evidence-based treatment models for older foster children > > Hi folks, > > I'm putting together an annotated bibliography, and I am in the > process of searching for published articles on evidence-based > treatment models for older foster children, but I thought I would ask > the listserv if anyone knows of any particularly good models I should > look for specifically. > > Thanks in advance, > > Noriko Ishibashi Martinez, PhD, LCSW > > Adjunct Faculty > > School of Social Service Administration > > University of Chicago > > 969 East 60th Street > > Chicago, IL 60637 > > norikouchicago.edu > > > -- Kristen Shook Slack, Ph.D. Associate Professor School of Social Work University of Wisconsin-Madison 1350 University Avenue Madison, WI 53706 ph: 608-263-3671 fx: 608-263-3836