Intensive Family Preservation Services Research Articles

Reasonable efforts to preserve families? An examination of service utilization and child removal

BackgroundRecent federal policy has solidified the importance of preserving families, yet over 400,000 children enter foster care each year. Although a few studies have found that certain types of services, like intensive family preservation services, may reduce child removals, more research is needed. ObjectiveThis study examined the relationship between family preservation, family support, and basic need service utilization and child removal among families with substantiated cases of maltreatment. MethodsWe conducted a survival analysis using data from the National Child Abuse and Neglect Data System (NCANDS). We took a cohort of families with an investigation and substantiation of maltreatment in FY 2018 and followed them through FY 2019 to identify any that experienced a child removal during the study period. This included a total of n = 558,915 children. ResultsApproximately 15.33% of children experienced a removal during the study period. Case management was the most frequently reported service, followed by transportation services and family preservation services. In the multivariable analysis, family preservation services (HR = 0.95, p < .01), home-based services (HR = 0.98, p < .001), and housing services (HR = 0.87, p < .001) decreased the hazards of child removal. Family support services (HR = 1.36, p < .001), transportation services (HR = 2.30, p < .001), education (HR = 1.13, p < .01), case management (HR = 1.83, p < .001), or daycare (HR = 1.26, p < .001) increased the hazards of child removal. DiscussionFindings from this study suggest that utilization of various services is associated with future child removals. While preservation and home-based services decreased the likelihood of removal, several basic needs services increased the hazards of child removal. This may reflect too little too late with services that may be better applied as primary or secondary preventive efforts. Implications for policy and future rollout of the Families First Prevention Services Act are explored.

Personal, Familial, and Service-Related Predictors of Outcome in Intensive Family Preservation Services Treatment

The use of Intensive Family Preservation services (IFPS) has increased dramatically in recent years, with most states having such programs in place to assist families involved in the child welfare system. While IFPS programs are diverse in their scope, nature, and service provision, most are home-based and employ a highly trained social services professionals. The present study examined the familial, personal, and service characteristics associated with treatment completion and re-referral in IFPS at a community agency. Data were archival (n = 2301) and were provided to the researchers by the agency itself. The present study represents an analysis of treatment-as-usual data, in an effort to determine patterns in service provision and family re-referral. A variety of family factors, such as family structure and the presence of adults in the household, as well as hours and types of services completed, predicted IFPS completion and re-referral. Increased provider-family contact was influential in positive outcomes, including re-referral. These findings suggest that increased provider-family contact is likely to improve the outcomes for families served by IFPS.

A Randomized Controlled Trial of Animal-Assisted Therapy as an Adjunct to Intensive Family Preservation Services.

Families referred by Child Protective Services ( M child age = 6 years ± 4; M parent age = 32 years ± 8.26) were individually randomized to experimental ( n = 14) or control ( n = 14) intervention. Family functioning outcomes were measured using the North Carolina Family Assessment Scale for Reunification. All four targeted family functioning outcomes were significantly increased for participants who received animal-assisted therapy as an adjunct to intensive family preservation services ( n = 14) with medium to large effect sizes. These improvements were sustained in two of the subscales through discharge. No significant differences were measured for the distal clinical outcome of disposition of children at discharge. Findings suggest that adding animal-assisted therapy as an adjunct can improve evidence-based clinical interventions aimed at enhancing the caregiving contexts of children.

Building the Evidence Base for Intensive Family Preservation Services

This article examines the state of intensive family preservation services (IFPS) research. Using studies of IFPS in five states, this article seeks to establish whether IFPS can be regarded as an evidence-based practice, an increasingly important standard for publicly funded services. While reporting rates of repeat child maltreatment, the analysis uses placement rates as the main outcome measure and compares effect sizes using Cohen's arcsine transformation for data reported as proportions. Significant differences in rates of child out-of-home placement and repeat maltreatment were found in some studies, particularly for higher risk families. The findings also underscore the difficulty of identifying which families to serve (targeting), ensuring treatment fidelity, and employing rigorous and appropriate evaluation methods. Overall, additional research is needed to move IFPS from a promising practice to an evidence-based practice.

FAMILY PRESERVATION SERVICES: TYPES OF SERVICES RENDERED BY SOCIAL WORKERS TO AT-RISK FAMILIES

Family preservation services are considered essential in order to avoid the removal of children from their families. In accordance with South African legislation and policy documents, social workers at family welfare organisations must focus on family preservation services in order to prevent children being placed in foster care. Theoretically family preservation services consist of different types of services, namely family support services, family-centred services and intensive family preservation services, or crisis services. In this article the different types of services will be discussed with reference to policy documents. The services delivered by social workers in the context of family preservation are reviewed.

Helping families where parents misuse drugs or alcohol? A mixed methods comparative evaluation of an intensive family preservation service

AbstractOption 2 is an intensive family preservation service for families with serious child protection concerns related to parental misuse of drugs or alcohol. A previous evaluation indicated that it reduced the number of children entering care and, as a result, produced cost savings; however, little data were gathered from families. This study involved interviews with 15 families (46 children) who had received the service, and a comparison group of 12 families (28 children) referred but not provided the service due to no workers being available. Outcomes and experiences were compared, on average, 5.6 years following referral. Findings included a significant reduction in children entering care, and improvements in relation to substance misuse, parental well‐being and family cohesion. There was no difference in emotional and behavioural welfare of children. Qualitative accounts were very positive about the impact of the service, identifying effective engagement of parents and key elements of good practice in supporting families to change. The findings provide additional support for suggesting that high quality, intensive interventions with families affected by parental substance misuse can be effective. Key lessons for current attempts to deal with the increase in children entering care and the English government's ‘troubled families’ initiative are considered.

‘I Just Don't Agree’: A Voice-Oriented Analysis of An IFPS Case of Alleged Child Maltreatment

In contrast to the many outcome studies of Intensive Family Preservation Services (IFPS), little is known about the underlying personal and relational dynamics of family crisis interventions. This article focuses on the core evolving dynamics of the changing self-presentations of a parent involved in an intensive home-based family preservation case of alleged child maltreatment. Three key family intervention sessions were videotaped and transcribed including both verbal and nonverbal behavior. The Listening Guide Method – a theoretically flexible, qualitative, relationally oriented method of in-depth interpretative analysis – served as our guide for this case analysis. In the processes of change toward a jointly constructed meaningful narrative on responsibility and self-care, two key elements emerged as playing a pivotal role: (1) the momentum of a potential referral of children to out-of-home care that precedes the start of an IFPS intervention and (2) the rhizomatic or root-like intertwinement of the voices of both parent and therapist with respect to the rationale for any involvement of society in the family. We argue that discourses on imminent placement in the context of family preservation deserve a genuine and valuable position in the initial discourse of a family therapist when entering a family in the context of crisis intervention. Both in understanding and driving any processes of change, we may need to reconsider our own willingness to step into the blending interplay of discourse and counter-discourse with our clients on the subject of our often drastic intervention. Consequently, we may read this narrative analysis as an invitation to reflect on the conceptualization of ‘client readiness’ in psychotherapy and to shift our thinking on preconditions for therapy from a client's readiness toward a therapist's attentiveness to listen.

The efficacy of family support and family preservation services on reducing child abuse and neglect: what the literature reveals

Globally, child protection services are under-resourced and unable to meet the demands associated with the increasing numbers of families who are being exposed to child abuse and neglect. Family support and family preservation interventions are the methods cited within the literature as those employed by child protection services to address this issue. Intensive family preservation services and cognitive behavioural therapy are discussed as the most effective interventions currently used by child protection services. This article presents a review of the literature on the efficacy of family-centred interventions for child abuse and neglect. Revealed in this review is that such efficacy remains controversial, with literature affirming that the most successful practice is a combination of interventions applied simultaneously. The literature reviewed suggests that more contemporary research around family-centred interventions for child abuse and neglect is required.

Intensive family preservation services in Flanders: an outcome study

ABSTRACTSet up as a one‐group pre‐test–post‐test follow‐up design, this study examines the outcomes of intensive family preservation services (IFPS) in Flanders addressing the following research questions: Does IFPS make a significant difference concerning (1) the interaction between parent and child? (2) social support as experienced by the parent? (3) stress and empowerment of the parent? and (4) the strengths and difficulties of the minor? Families seem to indicate that their family situation is more manageable, although still, professional help is needed. Parents feel more resilient about the situation and indicate that they can get along with their child better than before the crisis intervention. Parents still feel uncertain about the future and about their role as a parent. There seems to be no indications that their level and quality of social contacts have changed. Further research is suggested to provide more in‐depth information about the conditions associated with processes of change during an IFPS intervention.

Evaluation of an intensive family preservation service for families affected by parental substance misuse

AbstractParental misuse of drugs or alcohol is recognised to be an issue for a high proportion of families to known social services, and for many children who enter care. However, there is limited research on what is effective in working with such families. This article reports on an evaluation of an Intensive Family Preservation Service (named ‘Option 2’) aimed at families in which parents misuse substances and children are considered at risk of entering care. The study used mixed methods. A quasi‐experimental element compared solely data relating to care entry (e.g. how long children spent in care and its cost) for Option 2 children (n = 279) and a comparison group of referrals not provided with the service (n = 89) on average 3.5 years after referral. It found that about 40 per cent of children in both groups entered care, however Option 2 children took longer to enter, spent less time in care and were more likely to be at home at follow‐up. As a result, Option 2 produced significant cost savings. A small‐scale qualitative element of the study involved interviews with 11 parents and seven children in eight families. The findings suggested that Option 2 was a highly professional and appreciated service. For some families it achieved permanent change. For others, particularly those with complex and long‐standing problems, significant positive changes were not sustained. The implications for services designed to prevent public care, particularly where there are substance misuse issues, are discussed and recommendations for policy and evaluation made. Copyright © 2008 John Wiley &amp; Sons, Ltd.

The Match Between Family Needs and Services for High-Risk Neglecting Families

ABSTRACT Child neglect is characterized by a complexity of family problems and needs. Whether families' needs are actually matched to the appropriate services is a critical area for study, although little empirical work exists. In this study, we examine the match between needs and services for a sample of high-risk neglecting families, using cluster analysis to identify clusters of services and previously identified need clusters. We examine need–service match from two perspectives: 1) how well services are allocated to family need, and 2) how well family needs are covered by available services. Some service clusters are well allocated to corresponding needs, such as intensive drug court and family preservation services to substance-abusing families; however, other service patterns are much less coherent. With regard to how well needs are covered by available services, although approximately one-third of substance-abusing families receive the intensive drug court intervention, another one-third receive the low-service cluster of services. Poor match is particularly evident for the mental health/economic need/domestic violence group, in which more than half are represented in the low-service cluster, and only one-fourth in the high-service/economic/domestic violence service cluster. Attention to need–service matching is an important feature of evidence-based practice from both the perspective of case planning with families and the design of services for subgroups of families. Implications for practice and policy are discussed.

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.

Interventions to prevent or ameliorate child physical abuse and neglect: findings from a systematic review of reviews

The aim of this article is to summarise the available evidence from systematic reviews about the effectiveness of interventions to prevent or treat child physical abuse and neglect. A computerised search was undertaken of major electronic databases up to December 2005 using key search terms. Only systematic reviews were included in which the primary studies evaluated the effectiveness of targeted or indicated interventions for child physical abuse or neglect. A total of 31 systematic reviews were identified and 15 met all the inclusion criteria. They covered a range of interventions/services, including home visiting, parenting programmes, multi‐component interventions, intensive family preservation services, family‐focused casework and multi‐systemic family therapy. There was limited evidence of the effectiveness of services in improving objective measures of abuse and neglect, due in part to methodological issues involved in their measurement, but good evidence of modest benefits in improving a range of outcomes that are associated with physical abuse and neglect, including parental and family functioning and child development. The results also showed some interventions (eg. media‐based and perinatal coaching) to be ineffective with high‐risk families. The evidence provided by these reviews has clear implications for children's services in the UK and other western developed countries.

The use of intensive family preservation services with adoptive families

ABSTRACTWith the increase in special needs adoption, there is growing concern about the adjustment of these children and families beyond legalization. The purpose of this study was to explore in greater depth the use of intensive family preservation services with adoptive families and the factors related to the family’s ability to stay intact beyond services. Multiple regression analyses were used to determine factors that were predictive of the family’s ability to remain intact at 6 and 12 months post services. Potential predictors of family intactness included child characteristics, family characteristics, previous placement history and service characteristics. Results at 6 months found no significance in the full model; however, the individual factors of ethnic origin of the child, full‐time employment of the primary parent and initial placement reason were significant predictors of family intactness. At 12 months post services, the full model was highly significant, with service characteristics being the greatest predictor of the family’s ability to remain intact.

Are Intensive Family Preservation Services Useful?: A Study in the United Kingdom

Are Intensive Family Preservation Services Useful?: A Study in the United Kingdom

Advances in the Reliability and Validity of the North Carolina Family Assessment Scale

SUMMARY Objective: Psychometric properties of the North Carolina Family Assessment Scale (NCFAS) are examined in relation to placement and prediction of future placement within the context of Intensive Family Preservation Services (IFPS). Method: IFPS workers recorded NCFAS intake and closure ratings for 1,279 families. The categorical rating data and change-scores are analyzed in relation to treatment outcomes and future placements. Results: Domain scores of the NCFAS remain highly reliable. Closure ratings are significantly related to placements and future placements of children, and change-scores are related to placements. Conclusion: The NCFAS is shown to be an instrument that helps practitioners assess areas needing service (i.e., parental capabilities, environment), documents changes, and relates the reported findings to placement and future placement.

Examining the Role of Social Network Intervention as an Integral Component of Community-Based, Family-Focused Practice

Social network intervention aimed at bolstering the informal supports of high risk families is recognized as a common element of community-based, family-focused practice models, such as intensive family preservation services (IFPS), multisystemic therapy (MST), and the wraparound process. The empirical research basis for these practice models is examined, with an eye toward discerning the extent to which network intervention is identified as a critical component of comprehensive service. Results reveal that few studies make clear the degree to which treatment adhered to a focus on natural network enhancement or the development of informal resources. Those that did, suggest that relatively few families received this form of ecologically-oriented intervention. Consequently, this body of practice research offers insufficient evidence of the benefits or limitations associated with network facilitation with multi-need families. Explanations for these findings are explored and directions for future research are recommended.

Working with adolescents at risk of out of home care: The effectiveness of specialist teams

This paper reports findings from a quasi-experimental study of services for young people who appeared to be at risk of placement. It compares outcomes for young people in England referred to specialist support teams, which offered an intensive service with those for a group referred to the mainstream ‘service as usual’ delivered by local area social work teams. The services offered by the specialist teams bear some similarities to intensive family preservation services (IFPS) in the USA, insofar as they offer an intensive, short-term preventive service whose principal aim is the prevention of placement. Many of the young people had serious emotional and behavioural difficulties, and many had lengthy histories of abuse, neglect, or past placement. At follow-up, many young people and families receiving both types of service showed considerable improvement on a variety of measures of child and family functioning, but results were not significantly better for the group served by the intensive service. However, the intensive services group were found to be significantly less likely to enter placement. The paper discusses the merits of considering both individual and service outcomes, and considers the impact of a variety of child and service system factors.

Domestic Violence Resources for Women Receiving Intensive Family Preservation Services

Domestic Violence Resources for Women Receiving Intensive Family Preservation Services

The effectiveness of Families First services: An experimental study

An intensive, short-term, family-based intervention was employed to help families overcome serious problems in child behavior and child management. This service was an adaptation of the Teaching-Family Model of therapeutic group home programming with some elements of child welfare intensive family preservation services. In a controlled, 3-year study, families receiving this service were found to report significant improvement in child behavior, physical care and resources, parental effectiveness, and parent–child relationships, when compared with similar difficulties in families who were referred for the service but not served. Not only were the improvements for treatment families apparent shortly after the conclusion of the service, but these changes were also maintained over a number of months' period, suggesting that the improved skills, behaviors, and relationship changes developed during the intervention may have become solidly implanted in parental and family functioning.