Category Archives: Uncategorized

IFPS as EBP

This month the federal Administration for Children and Families (ACF) announced that Abt Associates will serve as the clearinghouse that establishes the list of evidence-based programs approved for use under the Family First Prevention Services Act. The clearinghouse plays a critical role because federal matching funds of 50% will be available only to programs on the clearinghouse list. The Family First legislation defines three levels of evidence-based programs and each level requires that a comparison group be included in the research studies.

Let’s look at an example of a comparison group using Intensive Family Preservation Services (IFPS) as the program in a large-scale study that was conducted in the state of North Carolina.
The study employed a retrospective design meaning no one had prior knowledge of the study and thus no opportunity to influence the data or case practice that could interfere with the reliability of the findings.

The study included 1,265 children who received IFPS services compared to over 110,000 children who did not receive IFPS but did receive other services. The children receiving IFPS were at higher risk than the comparison group in terms of risk assessment, prior substantiated reports of child abuse/neglect, and prior out-of-home placement.

Despite the high-risk factors of the children receiving IFPS, these children had 20-30% fewer out-of-home placements than the comparison group throughout the entire measurement period.

The study did find that the treatment effect of IFPS may diminish post-treatment and recommended that follow-up services be offered 4 to 6 months post-intervention. Most exemplary IFPS programs now provide booster sessions or step-down services.

The Family First Prevention Services Act is ideally suited for IFPS programs because the children eligible for the Family First services must be at imminent risk of entering out-of-home placement, the same criteria used for IFPS services. It’s too early to know which IFPS programs will meet the criteria to be included in the list that the clearinghouse develops. But IFPS program administrators and contracted providers can anticipate that funders and policy makers will ask whether or not their IFPS program is evidence-based. A good starting point is to refer inquirers to the research literature on IFPS.

The study referenced in this post is available here: http://www.nfpn.org/preservation/effectiveness-study

The author of the study, Ray Kirk, also has a PowerPoint summary of 4 IFPS studies that he presented at the National Child Welfare Evaluation Summit: https://www.acf.hhs.gov/cb/capacity/program-evaluation/summit-2011/session3

Posted by Priscilla Martens
NFPN Executive Director

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A Quick Guide to IFPS

With the arrival of the new fiscal year for the federal government and many state governments, agencies are implementing new programs.  One of the most effective programs is Intensive Family Preservation Services (IFPS).  Here’s a quick guide to IFPS that includes online references and resources.

Intensive Family Preservation Services are concentrated, in-home services designed to prevent placement of children at imminent risk of removal.  For a detailed description of these services, visit http://www.intensivefamilypreservation.org/about/

While IFPS programs may vary to some extent, high-quality programs have these components in common:

  • Immediate response within 24 hours
  • Accessibility of staff 24 hours a day, 7 days a week
  • Small caseloads (2 to 4 families)
  • Intensive interventions (8 to 10 hours per week)
  • Service delivery in the family’s home and community
  • Short-term services (4 to 8 weeks), to be followed by other support services
  • Hard & soft services delivered by the same worker
  • Focused on teaching skills

 

States with exemplary IFPS programs incorporate the IFPS components into their RFPs and standards.  To compare 12 states with exemplary IFPS programs see http://www.nfpn.org/preservation/2014-ifps-survey

After reviewing the exemplary state programs, agencies can move to establishing their own IFPS program. The IFPS ToolKit is a comprehensive guide that covers over a dozen issues addressing implementation:  http://www.nfpn.org/preservation/ifps-toolkit

After implementing an IFPS program, it’s important to assure continuous quality.  Here’s a tool to do that: http://www.nfpn.org/preservation/cqi-ifps-instrument

Also critical to assure quality is an annual program evaluation and Missouri provides an example of a statewide IFPS evaluation: http://www.nfpn.org/preservation/state-resources

There is a substantial body of research on IFPS.  The gold standard for research is a randomized control trial (RCT).  Everyone interested in IFPS should be familiar with the RCT on IFPS conducted in Michigan:   https://www.michigan.gov/mdhhs/0,5885,7-339-73970_61179_8366-21887–,00.html

IFPS is also used for reunification services.  The IFPS ToolKit has a section on this issue and a recommended model of service: http://www.nfpn.org/preservation/ifps-toolkit

Every IFPS program needs a reliable and valid assessment tool to assist with determining needs, setting goals, selecting services, and assuring good outcomes.  The NCFAS assessment tools were specifically designed for use with IFPS. For more information visit http://www.nfpn.org/assessment-tools

The majority of families in the child welfare system are involved in substance misuse.  NFPN has a video training to assist working with these families: http://www.nfpn.org/videos/substance-abuse-and-in-home-services

 

Posted by Priscilla Martens

NFPN Executive Director

Kinship Care–Best Practice

The increase in kinship care in recent years means that those who provide services to kin caregivers will need training and other support. The Child Welfare Information Gateway Bulletin, “Working with Kinship Caregivers” (June, 2018), provides a good starting place: https://www.childwelfare.gov/pubPDFs/kinship.pdf.

Federal law requires agencies to consider placement with kin when a child is removed from the home. About 2.6 million children in the U.S. are in some form of kinship care. Kinship care ranges from an informal arrangement between the parent and the relative to a formal placement by a child welfare agency that has legal custody of the child. Kinship foster homes may be either unlicensed or licensed. If licensed, the relative must meet foster home licensing and training standards and is paid the same as a nonrelative foster home.

Kinship care has the following benefits:
• Ongoing connections with a child’s birth family, extended family, siblings, and community—bonds that are essential to well-being
• Preservation of cultural identity (Generations United, 2016)
• Higher likelihood siblings will remain together
• Greater placement stability than for children in other out-of-home care arrangements

In order to help kinship caregivers make good decisions regarding the child, kin workers need to provide information about licensing options, the court process and the kin’s role, and resources. An assessment opens the door to determine the strengths and needs of the kin caregiver. It’s especially critical to explore family dynamics in terms of the kin caregiver’s relationship with the child’s parent and how to resolve safety and compliance issues. A family-centered practice approach to working with kin empowers them and gives them ownership of their issues.

Model programs for kin placements have these features in common:
• Presumption that placement of the child will be with kin
• Immediate and diligent search for family members
• Licensing waivers for kin homes for nonsafety issues
• Connection of kin to any needed services (frequently requested are financial assistance, day care, behavioral intervention, crisis management)
• Referral to support groups

The Annie E. Casey Foundation, in cooperation with Joseph Trumbley, has developed a five-part video training series to build skills specific to working with kin families. It’s available here: https://www.aecf.org/blog/engaging-kinship-caregivers-with-joseph-crumbley/

Helping kin understand the impact of their caregiving in terms of health, stress, and emotional stability is essential. Here is a list of resources addressing those issues: https://www.childwelfare.gov/topics/outofhome/kinship/resourcesforcaregivers/impact/

Here are details on an upcoming training on kinship care offered by CWLA: https://netforum.avectra.com/eweb/DynamicPage.aspx?Site=CWLA&WebCode=EventDetail&evt_key=67b14325-ac1d-46d8-a2fb-d0c79f7ca7aa.

Posted by Priscilla Martens
NFPN Executive Director

Safe Babies Court Teams

Based on the most recent federal report on children in foster care, half of children entering foster care are age 5 and under and 39% are three and under.

The following information (in quotes) is from the ZERO TO THREE Website on Safe Babies Court Teams and additional information is available at: https://www.zerotothree.org/resources/services/safe-babies-court-teams.

“ZERO TO THREE created the Safe Babies Court Teams Project, rooted in developmental science, which aims to:
1. increase awareness among those who work with maltreated infants and toddlers about the negative impact of abuse and neglect on very young children; and,
2. change local systems to improve outcomes and prevent future court involvement in the lives of very young children.

Safe Babies Court Teams are changing the trajectory for infants and toddlers in foster care. Families are embraced by a team and given targeted and timely services. The adults feel valued as individuals and as parents while they learn how to support the healthy development of their children. Results show that their children are reaching permanency three times faster than infants and toddlers in the general foster care population. Almost two-thirds of them find permanent homes with members of their families while only one-third of infants and toddlers in the general population exit foster care to family members.

Through community-wide collaboration led by the judges who oversee child maltreatment cases, children 0-3 and their families are receiving focused attention that recognizes individual strengths and challenges. Interventions are offered to meet the specific needs of each child and parent. Unlike typical foster care cases where formal hearings occur every 3 to 6 months, these families and the teams of professionals hold hearings and/or family team meetings at least once a month.”

The Safe Babies Court Teams are rated as “Promising” Evidence-Based Practice by the California Clearinghouse. A research study found low maltreatment recurrence, stable placements, high contacts with parents (daily or several times a week), and high delivery of needed services. There is also a federally funded Quality Improvement Center that assists with Safe Babies Court Team that supports implementation and knowledge-building.

Click the following links for more information:

Program description/outcomes report: https://www.zerotothree.org/resources/528-the-safe-babies-court-team-approach-championing-children-encouraging-parents-engaging-communities
Safe Babies Court Teams Evaluation: https://www.zerotothree.org/resources/2181-safe-babies-court-team-trauma-informed-care-that-s-changing-lives
California Evidence-Based Clearinghouse—Promising Research http://www.cebc4cw.org/program/safe-babies-court-teams-project/detailed
Quality Improvement Center for Research-Based Infant-Toddler Court Teams: http://www.qicct.org/

Posted by Priscilla Martens, NFPN Executive Director

Steps for Building Community Fatherhood Programs

A new report reveals that states spend very little money on father involvement. Most of the funding comes from the federal level through Responsible Fatherhood grants (39 organizations in 19 states), child support initiatives, and TANF funds (.5% of total TANF dollars). The paucity of funding for father involvement is a huge barrier to integrating and sustaining fatherhood programs.

There are some strategies to increase funding for father involvement and you can read them in the full report available at http://www.frpn.org/asset/frpn-research-brief-state-approaches-including-fathers-in-programs-and-policies-dealing.

Given the current lack of funding for father involvement at the federal and state levels, it makes more sense to focus on the community level. Here are some steps for implementing low- cost father involvement programs in your community:
1. Get everyone together. Convene a Fatherhood Summit Meeting by inviting participants in organizations and parenting groups that are already active in your community. Head Start has emphasized father involvement for years and is thus one of the best places to find fathers to participate. Ask a local newspaper, radio, or TV station to sponsor this Summit and be sure to invite elected officials.
2. Form a Fatherhood Advisory Council from the emerging leaders of the Fatherhood Summit. Include representatives from as many community groups as possible such as early childhood programs, K–12 schools, colleges/universities, businesses, service organizations, churches, health care programs, and father support groups. Seek funding from these organizations and also from businesses targeted to males such as sports, home repair, and building trades.
3. Begin programs where the most vulnerable families are found and at the earliest stages of fatherhood. Hospitals are a great starting place. Inquire if the local hospital(s) would be willing to provide the Purple Crying program, Conscious Fathering or another program for expectant fathers, and referrals to father support groups.
4. Start several father support groups and be sure to include moms to the greatest extent possible. Also include fathers who are good role models. Use male/female pairs to lead the groups. Seek funding from local foundations, businesses, fraternal, and service organizations. Budget $1,500-$3,000 per group for curricula, incentives, and refreshments. Collaborate with local social services agencies to provide case management services for vulnerable fathers and their families.
5. Train community service providers and child welfare workers on father involvement. It’s critical that all those who work with fathers receive training. This training will reduce the “us vs. them” mentality and results in workers becoming advocates for father involvement programs. Seek funding from the organizations that will participate in the training, perhaps supplemented by local businesses. Plan for an initial training cost of $2,000–$3,000. Curricula to train workers are available here: http://www.nfpn.org/father-involvement/basic-training-package
6. Providing events at schools linked to popular local sports will attract fathers to attend. Start a Watch D.O.G.S. program in elementary schools. Schools may be able to provide funding for these events through their Title 1 programs. Budget $500 per event and another $500 to establish the Watch D.O.G.S. program. Information available at http://dadsofgreatstudents.com/index.php/default/
7. Plan to evaluate every program offered. One simple no-cost method is to provide feedback forms to fathers who participate by asking them what knowledge they gained, a rating for the overall event, program, etc. and what they liked best and least about it. You cannot build support for father-involvement programs or sustainability without evaluation. Programs must demonstrate effectiveness in order to attract any source of funding and feedback from participants is a no-cost way to begin.
8. Work with local colleges and universities to develop father involvement curricula for students and for ongoing education in the community. Everyone who works with fathers should have the opportunity to receive training on father involvement both before and after earning a degree. Colleges and universities can also assist with program evaluation.
9. Always view father involvement as a shared community responsibility. The more that the responsibility and tasks are shared, the more progress and longer lasting results will be seen.

Posted by Priscilla Martens, NFPN Executive Director

10 Things I Learned at the Opioid Conference

The National Family Preservation Network (NFPN) helped coordinate a conference on opioids on May 3. Here are 10 things that I learned about opioids:
1. Opioids are depressants which slow the heart rate and breathing and thus overdoses can quickly cause death. Combining opioids with other drugs exponentially increases the risk of overdose and death.
2. The most frequently obtained source of illegal opioids is from a family member’s or friend’s prescription. Anxiety or depression are some of the main reasons for substance use.
3. Addiction is a chronic disease of the brain. Like any chronic illness, such as diabetes, addiction is difficult to treat. It takes time for the brain to recover and resume production of natural chemicals.
4. Detoxification is not sufficient. It is not treatment. The absence of drugs does not equal recovery.
5. 90% of opioid users require medication-assisted treatment. These medications help the brain to regain normal functioning.
6. Behavior therapies enhance the effectiveness of medications and help people stay in treatment longer. Behavior therapies engage people in treatment, modify their attitudes and behaviors related to drug use, and increase their life skills.
7. Addicts can be helped to overcome addiction, even if they don’t want help!
The outcomes for voluntary and involuntary treatment are similar.
8. Relapse is not a failure. It’s part of recovery. One exemplary drug court does not sanction participants for relapse. Rather, treatment is increased. The court does impose jail time for not showing up…so everyone shows up!
9. Children of substance-using parents are more likely to be abused and neglected, and more likely to be placed in foster care. Interventions include comprehensive assessment, safety plan, and increasing parental protective capacity.
10. Get as much training as possible on opioids. For a comprehensive overview of opioids, visit https://emedicine.medscape.com/article/287790-overview.

Here are additional resources:

NFPN offers a video training on substance use. Pricing starts at $275.

NFPN has trainers (board members) with expertise in helping address the effects of opioid use on families: parenting capacity and skills, motivational interviewing, trauma treatment, and depression. Contact NFPN for more information and rates.

For all questions and for information about resources and training, please contact Priscilla Martens, NFPN Executive Director, director@nfpn.org, phone 888-498-9047.

Posted by Priscilla Martens, NFPN Executive Director

Reunification Models

Reunifying families is receiving more attention with the opioid epidemic demonstrating that there are not and never will be enough foster homes. Another incentive is Evidence-Based Practice which requires that programs demonstrate effectiveness in order to receive federal and state dollars.

So reunification, neglected for too long, is now moving to the forefront. A number of states are implementing or reviving reunification programs. Michigan is one of the states that has prioritized reunification. Here is the Michigan model in a nutshell:
• Team leader (therapist) and family worker meet with the family 4 hours a week (8 hours during the first two weeks of services)
• The team is available 24/7
• Caseload is 6 for family worker and 12 for the team leader
• Services include solution-focused therapy and skill-based intervention
• Standard length of service is 4 months with possible extension up to 6 months
• The program costs $6700 per family while foster care averages $30,000 per child
• 85% of families in the program successfully reunify

The Michigan Family Reunification Program is listed on the California Evidence-Based Clearinghouse for Child Welfare but has not yet been rated.

To read a feature article on the program visit http://tucson.com/hard-work-of-reunification-often-entails-rehab-intensive-home-services/article_867a9156-2940-11e8-8744-83e4530d40cd.html

The most pressing social problem at this time is the opioid epidemic. One very promising model to helping families is drug treatment courts. These courts focus on families’ substance use and child welfare issues and seek to improve treatment and reunification outcomes. Children whose families participate in family drug courts spend less time in foster care and are more likely to reunify with their families (Lloyd, 2015).

For a case study of a successful family treatment court for substance abuse visit http://www.cffutures.org/files/PFR_Robeson_Standard_Final2.pdf

Several states are implementing new models of reunification including Nebraska and Mississippi. A demonstration program in Missouri is being tested in one county. All of these programs have in common that service delivery is provided by a team, not an individual worker.

The team approach provides a specialist who focuses on therapeutic treatment while the other team member(s) focuses primarily on skill building. Some of the advantages to this approach may include optimal division of labor within limited resources, built-in support and consultation with each team member having first-hand knowledge of the family, and capacity to serve more families.

While these programs look promising, there is no definitive research that has established their effectiveness. The National Family Preservation Network (NFPN) would welcome an opportunity to partner with a team-approach reunification program to study its effectiveness.

If your agency is interested in a partnership for a reunification study, please email director@nfpn.org or call 888-498-9047.

Posted by Priscilla Martens, NFPN Executive Director