Enhancing the Well-being of Children and Families through Effective Interventions

International Evidence for Practice

Wendy Rose, Colette McAuley, Peter Pecora

• Publisher: Jessica Kingsley Publishers
• Year: 2006
• Print ISBN: 9781843101161
• eBook ISBN: 9781846424779
• Topic: Social Sciences
• Subtopic: Social Work
• Index: Social Sciences

Services for families and children are rightfully the focus of intense scrutiny and debate, and there is a clear need to establish a knowledge of which services work well.

This volume provides a comprehensive overview of research evidence from the UK and USA on the effectiveness of selected child welfare interventions. It addresses the challenges of measuring effectiveness in child welfare and explains the policy context for child welfare service delivery. Leading international contributors summarize the evidence of effectiveness in each core area, and consider the impact on children's development, parenting capacity and the wider community. Critically, the book also draws out the implications of the evidence for policy, practice and service delivery as well as for future research.

This book is essential reading for policy makers, practitioners and commissioners of services in child welfare as well as students and researchers.

PART ONE

Child Welfare in the UK and US

CHAPTER 1

Effectiveness of Child Welfare Interventions

Issues and Challenges

Peter J. Pecora, Colette McAuley and Wendy Rose

Introduction

Child and family services in the United Kingdom, Europe, the United States and many other countries are at an important nexus of development. A foundation of qualitative and quantitative research studies is gradually being established which has produced documentation that certain intervention approaches are supported by research – this is a key part of what is necessary to implement evidence-based practice.In the US, while the emphasis on using evidence-based practice models is originating more with state and county agencies, the US federal government requirement that each state’s services be measured using a common set of performance standards and its modest support for child welfare research are contributing to this shift. The ability of some child welfare interventions to be manualized and formatted for larger-scale replications is resulting in cautious optimism that evidence-based practice approaches may indeed be possible in some areas. (See, for example, the Blue Skies Project at www.aecf.org; Chamberlain 2003; Cohen, Mannarino and Zhitova 2003; Henggeler et al. 1998; Jensen et al. 2005).

In the UK since the 1980s there has been considerable interest in exploring the effectiveness of specialist services for children in need and their families and the impact that processes of service intervention may have on their lives; examples of such services are child protection, residential and foster care, and leaving care. However, UK government policy since 1997 has been increasingly directed at improving the outcomes for all children and minimizing the risk to children of loss of opportunity. This has given added impetus to the interest in effectiveness of interventions. It has broadened the focus from the provision of specialist services for children in need to strengthening the universally provided services of health and education, and targeting those children and families in the population who may be at risk of exclusion, disadvantage and other difficulties. It has been expressed as a strategy to shift the focus ‘from dealing with the consequences of difficulties in children’s lives to preventing things from going wrong in the first place’ (HM Government 2004b, p.2). Knowing what works has acquired more importance as major national programmes are established, because of the implications both for government resource allocation decisions and for the government’s record of policy achievement.

Evidence of Effectiveness of Interventions

A number of relevant reviews of research about children in need and their families already exist – although they are not strictly reviews of programme effectiveness. For example, the UK government has produced reviews of research on child protection (Department of Health 1995a), residential care (Department of Health 1998b), the Children Act 1989 implementation (Department of Health 2001d) and supporting parents (Quinton 2004) among others. There have also been some reviews that have focused on the effectiveness of child welfare interventions. The Barnardo’s What Works series (e.g. Alderson et al. 1996) has been followed by reviews of the effectiveness of family support (Statham 2000) and child protection services (Macdonald 2001). Children and Society has also devoted a special edition to evaluating the effectiveness of community-based initiatives (Lewis and Utting 2001, p.1).

Alongside this, the UK government and research foundations have recently initiated a series of major research studies on outcomes and costs of child welfare interventions. Evidence on the effectiveness of child welfare interventions is accumulating also in North America. Reviews of the evidence on early childhood interventions (Gomby et al. 1995; Guralnick 1997, 1998; Karoly et al. 1998; Reynolds 2004), home-visiting services (Gomby et al. 1999; Olds et al. 2000), family support (Comer and Frazer 1998), child maltreatment (Chaffin and Friedrich 2004; Corcoran 2000), multisystemic family therapy (Littell 2005; Littell, Forsythe and Popa 2004), family foster care (Geen 2004; Pecora and Maluccio 2000), and residential care (Whittaker 2000) among others have recently become available. But many gaps exist and there are many unanswered questions about the dynamics of parent, child and family behaviours and how best to address those that may be harmful.

Challenges in Measuring Effectiveness in the Social Welfare Field of Child and Family Services

While an exhaustive discussion of methodological and other challenges to measuring effectiveness in these programme areas is beyond the scope of this chapter, some of the major challenges are described below, drawing from the research experience of the editors, from issues presented in the chapters and from other sources:

1.Theoretical frameworks that can guide research or the interpretation of the data are sometimes not available. One of the clearest examples of this is how the family-based services field has struggled to articulate a specific logic model of therapeutic change and to make sense of conflicting research findings (e.g., Pecora et al. 1995; Walton, Sandau-Beckler and Mannes 2001).

2.Interventions are developed and show positive results in sheltered environments but then are not ready to be rigorously tested in community settings with a wide range of complexities or barriers. In contrast, a number of projects involving Family Group Conferencing (see www.americanhumane.org), Functional Family Therapy (see www.strengtheningfamilies.org/html/programs_1999/01_FFT.html), Treatment Foster Care (Chamberlain 2003) and Multisystemic Therapy (Henggeler et al. 1998) are attempting to carefully implement large-scale replication projects in a variety of communities.

3.Lowering the costs of evaluation studies by using agency administrative data has been hampered by the limited inclusion of outcome indicators in those information systems and/or modest rates of completion by workers. The data lack reliability if there has been insufficient training to ensure common understanding or validity if too few workers have completed a particular data element.

4.Infrequent use of related agency administrative databases hamper the ability to measure key programme outcomes. For example, in foster care, the employment of young adults who have recently left care is a crucial outcome to track (Goerge et al. 2002); educational achievement is often a key indicator of adult success; and former service recipients who are involved in juvenile justice or receiving public assistance are judged as being less successful.

5.Over reliance on cross-section (‘snapshot’) or exit data instead of longitudinal cohort data. A growing number of authors have provided compelling arguments concerning the dangers of over-relying on cross-sectional or exit data (Courtney, Terao and Bost 2004).

6.Too few studies have been able to collect detailed service usage and programme fidelity data. Consequently, programme fidelity (adherence by staff to the treatment model) is infrequently measured and we are therefore unable to determine if the intervention was actually implemented according to a certain set of standards for type, dosage and quality (e.g., Kirk, Reed-Ashcraft and Pecora 2003).

7.Small sample sizes hamper or prevent the use of multivariate approaches and analyses of key subgrou...

Table of contents

• Cover
• Of Related Interest
• Title
• Copyright
• Contents
• List
• Foreword
• Preface
• PART ONE: Child Welfare in the UK and US
• PART TWO: Evidence on Interventions with Vulnerable Children, Young People and Families
• PART THREE: Evidence on Therapeutic Interventions with Children who have Experienced Abuse or Neglect
• PART FOUR: Evidence on Foster Care, Adoption and Transitions for Children and Young People
• PART FIVE: Innovative Approaches in Schools and Community Programmes
• PART SIX: Summary and Conclusion
• References
• The Contributors
• Subject Index
• Author Index