Group Home Placements Research Articles

Predictors of Parent-Child Contact During a Parent’s Incarceration

ABSTRACT Over 2 million people are currently incarcerated – the majority of whom are parents to minor children. The reentry process is often difficult for parents as they navigate reentry challenges such as finding housing and employment while also trying to develop and reestablish relationships with their children. Increased parent-child contact during incarceration is associated with improved incarceration and reentry outcomes for both the parents and their children. Using survey data from 252 parents exiting the prison system, this study uses structural equation modeling to examine predictors of parent-child contact during incarceration. Findings suggest incarcerated parents have higher levels of contact with their children when the parents had less exposure to childhood adversities such as parental incarceration, foster care, and group home placement. Mothers display higher levels of contact with children than fathers; similarly, younger parents display higher levels of contact than older, as do those who had recent contact in the month prior to incarceration compared to those who did not. These findings highlight specific factors and populations for practitioners to target to increase the level of parent-child contact during incarceration.

Mental Health Outcomes of Youth In-Care: Investigating the Effect of General Strain and Self-control Theories

The adverse mental health outcomes of youth in-care have been examined from a number of disciplinary perspectives. A sociological approach emphasizes the importance that environmental and social factors play in the development of mental health problems. What remains unknown is the extent to which general strain theory (GST) and self-control theory can explain the mental health outcomes of youth in-care. The sample consists of 1419 youth taken from the 2016 Ontario Looking After Children (OnLAC) project who are between 16 and 17 years of age. Results indicate that having lower levels of self-control, experiencing multiple placement changes, group home placement, and being female are associated with an increase in psychiatric services and lower positive mental health. The findings highlight the importance of recognizing both the direct and indirect relationship of strain and self-control on mental health outcomes of youth in-care.

The role of intergenerational context in recovery from complex trauma: It's all about attachment

Nicole is wheeled into the emergency room, flanked by four police officers and struggling mightily against the restraints that strap her to the gurney. One officer peels off to explain the situation: Nicole was brought in from her residential mental health treatment program after she became dysregulated with no apparent provocation, striking a male staff member in the face multiple times and attempting to elope. As Nicole settles in the ER, her mood rapidly shifts from angry and frustrated to sad and worried. During her physical examination, the ER staff notices multiple lacerations in various stages of healing scattered around Nicole's body. Nicole points to a specific laceration, noting that this was from her most recent suicide attempt. A few hours after being brought into the ER, Nicole is much calmer, with an almost vacant look in her eyes as she describes her early childhood to the psychiatry team. Without much feeling to her words, she recounts a history of being sexually abused from age 3–6 years old by one of her mother's boyfriends. Nicole describes the despair she felt because of her mother not believing her disclosures or protecting her, and the carousel of foster home, group home, and residential program placements after the Child Protective Services agency in her state removed her from the abusive situation she was living in.

High cost child welfare cases: Child characteristics and child welfare services

The IV-E Waivers and Family First Prevention Services Act prioritize prevention services, including services that reduce out-of-home placements. Placement in out-of-home care is associated with a variety of adverse outcomes as well as high costs to society. Studies that focus on utilization of health services suggest that these costs are not evenly distributed among recipients, and that high utilizers make up a small percentage of individuals who utilize a disproportionate share of resources. The purpose of the paper is to examine child characteristics and child welfare services associated with high welfare costs, defined as the top decile of child welfare costs. Results indicate that older age of child, child sexual abuse and/or neglect, and inability of parent to provide care are associated with high child welfare costs. Parental substance abuse or domestic violence in the household are less common among children with high costs. High cost children are more likely to have serious behavioral problems perhaps reflecting the severity of these problems. Residential treatment and group home placements and services were also associated with having high costs.

Concurrent child history and contextual predictors of children's internalizing and externalizing behavior problems in foster care

This study contributes to current research on the behavior problems of children in foster care by analyzing a more comprehensive set of concurrent child history and contextual predictors. Kinship home status and sibling status (i.e., whether the sibling is a biological sibling to the foster child) were evaluated as moderators of significant associations. Data were collected at the baseline of a foster parent training intervention program prior to any intervention services using parent phone interviews (N=310, 51.6% male, M age=7.57years). Two linear hierarchical regressions were used to evaluate each set of predictors' association with behavior problems as well as each individual predictor's contribution. Results indicated that as a set, the contextual variables predicted a significant and unique amount of variability in the child's internalizing and externalizing behavior scores, whereas the child history variables did not. Specifically, the child's placement in a non-kinship home, being in a non-ethnically matched child-parent pair, higher parent stress scores, a greater number of prior group home placements, and higher internalizing behavior scores for the child predicted higher child externalizing scores. Higher parent stress scores, higher focal sibling externalizing behavior scores, and higher externalizing behavior scores for the child predicted higher internalizing scores for the child. The association between focal sibling externalizing behavior scores and child internalizing scores was moderated by kinship home status, such that there was a stronger association between the focal sibling's externalizing score and the child's internalizing score if the child was in a kinship compared to a non-kinship home. Implications for intervention services are discussed, particularly the importance of assessing the child's foster home environment when addressing the child's behavior problems.

A Triage Tool to Assess Unmet Health Needs for Children Entering Foster Care

Children in foster care have high levels of health care needs, many of which are unmet at foster care entry. Health care coordination (HCC) is essential to ensure unmet needs are addressed rapidly. Data is lacking about how best to triage children at foster care entry so limited HCC resources can be allocated most effectively. Therefore, we aimed to: (1) utilize a Triage Tool (TT) at foster care entry to stratify children based on unmet health care needs and (2) determine if the TT is an accurate predictor of health care utilization as indicated by cost during a child’s first few weeks in care. A TT was developed and utilized during the initial foster care health exam (IFCHE) to stratify children based on unmet needs. Medicaid records were reviewed to determine health care utilization and cost during the first 60 days post-IFCHE. Most children (61.6%) had the lowest level of unmet needs (Level 3), 29.5% had a moderate level of unmet needs (Level 2), and 9.9% had the highest level of unmet needs (Level 1). Medicaid claims review revealed that triage level did not correlate to health care utilization or costs during the first 60 days post-IFCHE. Youth placed in a group home incurred significantly higher costs than those placed in foster homes. These results suggest that the TT is useful clinically but does not predict health care utilization and costs during the first weeks in care. Group home placement incurs more cost than foster home placement, independent of triage level assigned.

Changes in the self-rated well-being of people who move from congregated settings to personalized arrangements and group home placements.

A natural experiment contrasted the self-rated well-being of people with intellectual disabilities ( n = 75) and those with enduring mental health problems ( n = 44) after they moved to new accommodation and support options, while others remained in congregated settings or living in the family home. Most support staff also provided well-being ratings. In personalized arrangements, personal well-being was significantly higher than in congregated settings; particularly for people with intellectual disability who had higher support needs compared to people with mental health problems. Moving to a group home also brought some improvement in the well-being ratings of people with intellectual disability but only for those with higher support needs. Such moves seemed to lead to a decline in well-being for those with mental health problems. There were marked discrepancies between ratings given by the person with those of staff. The well-being measure shows promise for use in further comparative and longitudinal studies.

The Role of Placement History and Current Family Environment in Children's Aggression in Foster Care.

Predictors of the physical and relational aggressive behavior of children in foster care were examined (N = 160, 50.9% male, M age = 7.57, SD = 2.39). First, predictors representative of children's placement histories were examined in relation to the children's aggression at T1. Next, predictors representing characteristics of the current family environment were examined in relation to the children's aggression at T2 (four months later). Results revealed that a greater number of prior group home placements and being in a non-kinship home were associated with higher physical aggression at T1. A greater number of prior group home placements, a fewer number of regular home placements, being in a non-kinship home, and prior removal from the home due to neglect were associated with higher relational aggression at T1. The results also revealed that higher foster sibling relational aggression at T1 predicted lower child physical aggression at T2. If foster siblings were biological children of the foster parent, higher levels of a foster sibling's physical aggression at T1 predicted reduced child physical aggression at T2. The opposite pattern was observed if foster siblings were not biological children of the foster parent. Lastly, longer time in the current placement, more children in the home, and the presence of a sibling that was a biological child of the parent predicted higher child relational aggression at T2. These findings provide initial insights into how placement history and current family environment are associated with the physical and relational aggressive behavior of children in foster care.

Domestic Minor Sex Trafficking Patients: A Retrospective Analysis of Medical Presentation

Study ObjectiveTo describe the clinical characteristics of patients referred for domestic minor sex trafficking (DMST) to improve identification and intervention. DesignRetrospective cohort study. SettingThe Lawrence A. Aubin, Sr Child Protection Center at Hasbro Children's Hospital where patients are evaluated by child abuse pediatricians in outpatient, emergency department, and inpatient settings. ParticipantsA total of 41 patients younger than the age of 18 years referred for the evaluation of DMST involvement between August 1, 2013 and March 30, 2015. Interventions and Main Outcome MeasuresWe collected demographic, social-environmental, medical, and psychiatric variables from the medical records of patients referred for evaluation who have self-disclosed, been reported with evidence, and/or have histories that place them at high risk for DMST involvement. ResultsChildren had frequent contact with medical providers, with 81% seen in the year before referral for DMST. Childhood maltreatment and family dysfunction were identified (sexual abuse, 21/37 or 57%; parental substance abuse, 22/37 or 60%) in the 41 patients. Children had medical problems (eg, sexually transmitted infection, 13/41 or 32%), psychiatric needs (eg, acute suicidality, 8/41 or 20%; at least 1 previous psychiatric admission, 19/41 or 46%), and substance use (36/41 or 88%). Although 26/41 (63%) had runaway and 17/41 (42%) lived in a group home placement, 28/41 (68%) currently lived at home and 29/41 (71%) presented with a parent/guardian or relative. ConclusionChildren referred for DMST present frequently to physicians and have complex medical and psychiatric needs. Medical providers' increased awareness of this health issue would inform victim identification and intervention.

Does Model Matter? Examining Change Across Time for Youth in Group Homes.

Group homes are a frequently used but controversial treatment setting for youth with mental health problems. Within the relatively sparse literature on group homes, there is some evidence that some models of treatment may be associated with more positive outcomes for youth. This article explores this possibility by examining differences across time for youth served in group homes utilizing the Teaching Family Model (TFM) and geographically proximate homes using more eclectic approaches. Data come from a longitudinal quasi-experimental study that included 554 youth. Results suggest that youth showed, on average, significant and rapid improvement during initial months in a group home. Improvement did not differ for TFM and non-TFM homes during this initial period. Post-discharge results, though, show that TFM was associated with continued improvement after discharge and significantly better outcomes by 8 months post-discharge. Results also discuss youth-level factors that may influence outcomes as well as need for additional work to more fully understand processes and practices that are key for maximizing and maintaining youths' positive outcomes during and after group home placements.

“When You First Get There, You Wear Red”: Youth Perceptions of Point and Level Systems in Group Home Care

Child welfare involved youth are frequently referred to group home care. One common intervention utilized in group home care is behavior management systems. This intervention is operationalized as points, token economies, and level systems. Grounded in social learning and behavioral theories, the objective is to reinforce-pro-social behaviors and to provide mild negative consequences for undesirable behaviors. However, little is known about how child-welfare involved youth perceive these kinds of interventions and whether they believe them to be effective. Focus groups were conducted with 40 young adults known to independent living services and formerly in group home placement. The qualitative findings reveal that while youth felt structure was needed, how it was operationalized in group homes was restrictive, non-normative, and non-individualized. Implications for social work practice and further research using an attachment perspective are discussed.

Three-year change in the wellbeing of orphaned and separated children in institutional and family-based care settings in five low- and middle-income countries.

BackgroundWith more than 2 million children living in group homes, or “institutions”, worldwide, the extent to which institution-based caregiving negatively affects development and wellbeing is a central question for international policymakers.MethodsA two-stage random sampling methodology identified community representative samples of 1,357 institution-dwelling orphaned and separated children (OSC) and 1,480 family-dwelling OSC aged 6–12 from 5 low and middle income countries. Data were collected from children and their primary caregivers. Survey-analytic techniques and linear mixed effects models describe child wellbeing collected at baseline and at 36 months, including physical and emotional health, growth, cognitive development and memory, and the variation in outcomes between children, care settings, and study sites.FindingsAt 36-month follow-up, institution-dwelling OSC had statistically significantly higher height-for-age Z-scores and better caregiver-reported physical health; family-dwelling OSC had fewer caregiver-reported emotional difficulties. There were no statistically significant differences between the two groups on other measures. At both baseline and follow-up, the magnitude of the differences between the institution- and family-dwelling groups was small. Relatively little variation in outcomes was attributable to differences between sites (11–27% of total variation) or care settings within sites (8–14%), with most variation attributable to differences between children within settings (60–75%). The percent of variation in outcomes attributable to the care setting type, institution- versus family-based care, ranged from 0–4% at baseline, 0–3% at 36-month follow-up, and 0–4% for changes between baseline and 36 months.InterpretationThese findings contradict the hypothesis that group home placement universally adversely affects child wellbeing. Without substantial improvements in and support for family settings, the removal of institutions, broadly defined, would not significantly improve child wellbeing and could worsen outcomes of children who are moved from a setting where they are doing relatively well to a more deprived setting.

First-Time Violent Juvenile Offenders: Probation, Placement, and Recidivism

Rising costs, inefficient systems, and high recidivism rates have recently challenged the social and economic value of secure confinement for juvenile offenders; however, current empirical evidence is inconclusive concerning the value of placing violent youth offenders in secure settings to deter them from future involvement in crime. Using propensity score matching and survival analysis, this study examined the risk of recidivism for first-time violent juvenile offenders assigned to one of three judicial dispositions in Los Angeles County: in-home probation, group-home placement, or probation camp (a secure setting). Approximately half (48%) of first-time violent offenders experienced a subsequent arrest, and the risk of re-offending varied by disposition. Compared with in-home probation, the likelihood of recidivism was 2.12 times greater for youths assigned to probation camps and 1.28 times greater for youths assigned to group homes. African American adolescents, Hispanic adolescents, and adolescents with an open child welfare case were also at an increased risk of recidivism. The findings from this study indicate that in-home probation is a more sensible and effective approach to interrupting criminal trajectories of first-time violent offenders as compared with out-of-home placements. Implications for research, system collaboration, and the training of social work professionals are discussed.

The Viking Homes Saga: Group Home Placements for Juveniles

Juvenile Courts, particularly in Ontario, have always assumed that they had the authority to commit delinquent children into the care and custody of private, corporate-operated group homes. However, a recent ruling of the Supreme Court of Ontario, upheld by the Ontario Court of Appeal, had put an end to this idea when placements with Viking Homes were held to be beyond the powers of a Juvenile Court. This paper examines the value of the group home programme to juvenile delinquents and analyzes two judgments in great detail to show that their reasoning is not entirely free of doubt.

Youth in Group Home Care: Youth Characteristics and Predictors of Later Functioning

This paper presents the findings of an exploratory research study of foster care youth residing in group homes in a mid-Atlantic state in the USA. The aims of the present study were to (1) describe youth characteristics, (2) explore whether baseline functioning differed by gender or ethnicity, (3) explore predictors of cross-time differences in psychosocial functioning, and (4) explore predictors of later functioning, specifically age, gender, and length of stay. Psychosocial functioning at two time points (i.e., T1 = admission into group home; T2 = current or discharge) in 180 charts from 29 randomly selected group homes were reviewed. Youth were on average 14.86 years of age, predominantly male (71%; n = 128), and predominantly African American (79%). Findings suggest that group home placement may benefit some youth but not others, particularly girls and younger children with lower initial level of need. Findings underscore the potential complexity of intervention impact in the context of unique youth, family, and environment factors.

Recommendations for the Diagnosis and Management of Prader-Willi Syndrome

The objective of the study was to provide recommendations for the diagnosis and management of Prader-Willi syndrome throughout the life span to guide clinical practice. An open international multidisciplinary expert meeting was held in October 2006 in Toulouse, France, with 37 invited speakers and session chairs (see Acknowledgments) and 85 additional registered participants. The meeting was supported by an unrestricted educational grant from Pfizer. Invited participants with particular expertise reviewed the published evidence base for their specialist topic and unpublished data from personal experience, previous national and international PWS conferences, and PWS Association clinical advisory groups. Sessions covered epidemiology, psychiatric, and behavioral disorders; breathing and sleep abnormalities; genetics; endocrinology; and management in infancy, childhood, transition, and adulthood. This included group meetings including open discussion after each session. The guidelines were written by the Scientific Committee (authors), using the conclusions provided by the sessions chairs and summary provided by each speaker, including incorporation of changes suggested after review by selected meeting participants (see Acknowledgments). The diagnosis and management of this complex disorder requires a multidisciplinary approach with particular emphasis on the importance of early diagnosis using accredited genetic testing, use and monitoring of GH therapy from early childhood, control of the food environment and regular exercise, appropriate management of transition, consideration of group home placement in adulthood, and distinction of behavioral problems from psychiatric illness.

Juvenile delinquency in child welfare: Investigating group home effects

Group homes fall into the broad category of residential care, a category that also includes half-way homes, campus based homes, emergency shelters, self-contained settings, and staff secured setting. In general, residential care services represent an option of last resort. In the current study we use administrative records from a large urban county and propensity score matching to investigate the relationship between group home placements in child welfare and the risk of delinquency ( n = 8226). The results indicate that the relative risk of delinquency is approximately two and one half times greater for adolescents with at least one group home placement as compared with youth in foster care settings. This finding raises serious questions about the use of group homes for victims of physical abuse and neglect.

Manhood Seekers Camp: A Proposal for a Culturally-Centered Camp Intervention

ABSTRACT This article addresses the need for therapeutic camps to support the disportionate number of African-American children in out of home foster care and group home placements. A brief review of literature on camp interventions and their failure to adequately address the influence of ethnicity and culture is provided. A pilot of a small culturally centered therapeutic camp intervention for African-American boys in foster care is reviewed and the impressions of the African-American male facilitators are described and discussed. Although limited sample size prohibited statistical analysis, results suggest the need to further evaluate innovative culturally-centered interventions that are designed to target traditional values and factors that influence positive African-American male development.

Race–gender Differences in Risk and Protective Factors among Youth in Residential Group Homes

Analysis reported here examined youth in residential group home placements in order to better understand how sexual behaviors, drug use, and environmental experiences differ by race and gender subgroups. Data were collected from 336 youth aged 14–21 residing in one of 41 group homes in Maryland. Chi square and logistic regression analyses were done to determine differences on study variables among the race-gender groupings. Results demonstrate not only significant health concerns overall but notable differences were also found between race-gender subgroups. Findings suggest that found race-gender subgroup differences might be informative for tailoring programming for youth of residential group home settings.

A Group Approach to Fostering Self-Cohesion and Developmental Progression in Female Adolescent Group Home Residents

In this project, the applicability of David Wexler's (1991a,b) multi-model Program for Innovative Self Management (PRISM) to adolescent girls in group home placement was explored. The model is based on self-psychological and developmental theory. Originally developed for use in adolescent inpatient settings, PRISM utilizes cognitive-behavioral and relaxation techniques to equip the acting out adolescents with skills to better manage a wide array of emotions and behaviors. A modified version of PRISM was conducted in a group psychotherapeutic format with eighteen residents of two group homes, ages 14 to 18. The study reflected that the participants embraced the model and applied the skills with encouraging results. Recommendations for future research in this area are presented.