Monthly Archives: February 2014

IFPS and Disproportionality

Racial/ethnic disproportionality in child welfare has been a topic of interest and controversy among child welfare researchers and administrators since data became available that permitted its investigation.

These findings from a Casey study in 2007 [1]highlight the over- and under-representation of ethnic groups in foster care:

Black children are overrepresented in foster care by a ratio of 2:1
Native Americans are overrepresented in foster care by a ratio of 2:1
Whites are underrepresented by a ratio of 0.7:1
Hispanics are underrepresented by a ratio of 0.9:1
Asians are underrepresented in foster care by a ratio of 0.25:1

Disproportionate Need or Discriminatory Practices

Citing Hill (2006) [2], Casey Family Programs states that three national incidence studies revealed no significant differences between the base maltreatment rates of Black and White families.

This lack of differences in base rates suggests that disproportionality in the child welfare system is not due to disproportionate need, but rather to discriminatory practices in society (reports of abuse and neglect) or within the child welfare system (investigations, substantiations, placements, permanency outcomes).

Addressing Disproportionality

In order to determine effective strategies for reducing disproportionality, I undertook a study to examine an effort to address disproportionality with a policy and practice initiative utilizing Intensive Family Preservation Services (IFPS). [3] The study was based on data from the state of North Carolina:

IFPS is available in 70 of the state’s 100 counties, although IFPS is not available in sufficient quantity in any county to respond to all eligible families.

Families eligible for but that did not receive IFPS received traditional public and contract agency services, such as, counseling, skill training, protective supervision, day care, etc.
The study employed a retrospective, population-based design that permitted the selection of all high-risk abuse and neglect cases.
Data were merged from various statewide (NCCANDS, AFCARS) and program-specific (IFPS) databases.
The study included 2,056 high-risk families that received IFPS, and the comparison group included 28,004 high-risk families.
About three-fifths of the treatment population was White, a little more than one-third was Black, and the remainder comprised American Indians, Hispanics, and Asian/Southeast Asian families.
There were no differences on placement rates between Blacks and non-Black minorities, so these groups were combined.
White and non-White racial groups within the IFPS treatment condition were essentially equivalent with the exception of non-Whites having slightly more substantiated prior reports. Theoretically, any increased overall risk associated with this difference would be likely to diminish, rather than enhance the treatment outcome being investigated.
Independent variables: race, risk, IFPS versus non-IFPS
Dependent variable: cumulative risk of placement

The Results

High-risk minority children receiving traditional services were at higher risk of placement than White children, but minority children receiving IFPS were less likely to be placed than White children.
When only minority children were examined, those receiving IFPS were less likely to be placed than those receiving traditional services.

Figure 1—Risk of Placement After CPS Report for Children Receiving Traditional CW Services by Race

Figure 2—Risk of Placement After Referral to IFPS for Children Receiving IFPS by Race

Figure 3—Risk of Placement After CPS Report/Referral to IFPS for Non-White Children

Conclusion

IFPS is associated with a reduction in racial disproportionality of out-of-home placement among high-risk families. Within-race analysis suggests that IFPS may mitigate racial disparity in out-of-home placement existing in the remainder of the child welfare population that receives traditional services.

References

1. Casey Family Programs. (2007). Fact Sheet: Disproportionality in the Child Welfare System: The Disproportionate Representation of Children of Color in Foster Care.

2. Hill, R.B. (2006). Synthesis of Research on Disproportionality in Child Welfare: An Update. Washington, DC: Casey/Center for the Study of Social Policy Alliance for Racial Equity.

3. Kirk, R.S. & Griffith, D.P. (2008). Impact of intensive family preservation services on disproportionality of out-of-home placement of children of color in one state’s child welfare system. Child Welfare, 87 (5), 87–105.

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Posted by Ray Kirk, Researcher
Dr. Kirk’s research on the child welfare system includes assessment tools, IFPS, reunification, and prevention.

Implementing IFPS Nationwide

Part of the excitement of celebrating the 40th Anniversary of IFPS comes from discovering or re-discovering publications that document the history and impact of IFPS.

In this post we review a paper written in 2001 by Frank Farrow, Director of the Center for the Study of Social Policy. Mr. Farrow looked at the first quarter-century of IFPS; the following is a summary of his findings taken from The Shifting Policy Impact of Intensive Family Preservation Services.

In the 1980s, the Edna McConnell Clark Foundation funded 10 programs to determine how to keep families in crisis intact. The Homebuilders® IFPS program stood out based on clarity of service approach, quality training, and quality assurance. The Clark Foundation was convinced that the Homebuilders® program could be replicated nationwide.

Peter Forsythe, Director of the Children’s Program at Clark Foundation, developed three strategies to achieve this goal:

Further development of the Homebuilders® practice model
A coalition of national organizations to support IFPS
Support to states that were committed to implementing the model

The most critical implementation occurred at the state level.

Michigan was one of the first states to implement IFPS and pioneered the use of IFPS with families involved in substance abuse. (Note: Michigan was also the site of a random assignment control group study demonstrating the effectiveness of IFPS in preventing placement.)

Kentucky was the first state to introduce legislation mandating IFPS, with Judge Richard Fitzgerald a key supporter.

Iowa’s IFPS program was established statewide with the help of a key legislator, as was Tennessee’s program.

Missouri had a public-private partnership for IFPS consisting of the child welfare agency, a children’s advocacy group, and the mental health agency.

Taken together, these states generated a groundswell of professional opinion in favor of IFPS.

Meanwhile, on the national front, Congress had passed legislation in 1980 requiring that states make “reasonable efforts” to maintain children in their own homes before removing them for placement in foster homes or residential care.

However, there was no clear definition or funding to implement this provision.

And so the national organizations that supported IFPS went to work to link reasonable efforts to family preservation. National organizations that supported IFPS included:

Child Welfare League of America (CWLA),
Children’s Defense Fund (CDF),
Mental Health Institute of the University of South Florida,
National Conference of State Legislators (NCSL), and
Center for the Study of Social Policy (CSSP).

States that had implemented IFPS provided critical testimony and onsite visits. All of these efforts resulted in passage of the Family Preservation and Support amendments to child welfare law in 1993. For the first time, a federal funding stream was available for IFPS that explicitly recognized the concept and practice of family preservation.

Mr. Farrow concludes by saying that family preservation has changed child welfare practice in ways that can never completely disappear. IFPS created a widespread professional belief that intensive interventions can make a difference to families. That belief lives on today!

To read Mr. Farrow’s paper, visit:
http://bit.ly/1jxO6sU

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Posted by Priscilla Martens, Executive Director, National Family Preservation Network

Parent Education

Parent education is a critical issue for the field of IFPS.

A uniform, nationwide approach to protecting children from abuse and neglect is less than 50 years old. This is helpful to keep in mind when discussing aspects of the child welfare system. The advent of a nationwide public agency system in the mid-1960’s for identification of child abuse and neglect brought with it the need for prevention and treatment.

Preventing and treating child abuse and neglect, or its re-occurrence, often focused on parenting skills, with the intent of remedying skill deficiencies. One of the earliest parenting programs, Parents Anonymous, provided support groups and taught new skills to parents. For decades, parenting classes have been the main intervention—not only offered but generally mandated by courts—for parents involved in child abuse and neglect.

A Child Welfare Information Gateway Issue Brief (2013) defines parent education:

Parent education can be defined as any training, program, or other intervention that helps parents acquire skills to improve their parenting of and communication with their children in order to reduce the risk of child maltreatment and/or reduce children’s disruptive behaviors. Parent education may be delivered individually or in a group in the home, classroom, or other setting; it may be face-to-face or online; and it may include direct instruction, discussion, videos, modeling, or other formats (California Evidence-Based Clearinghouse [CEBC], n.d. & Centers for Disease Control and Prevention [CDC], 2009).

How does the field of IFPS address parent education?

Not surprisingly, the most frequently listed need of parents referred for IFPS is parenting skills. In a multi-state study of IFPS, the NCFAS assessment tool (measures family functioning in the domains of environment, parental capabilities, family interactions, safety, and child well-being), indicated that 71% of parents had mild to serious problems in the domain of parental capabilities, significantly higher than for problems in other domains. Parental capabilities includes measures of supervision and discipline of children, parental use of drugs/alcohol, and parental support of children’s education. Over a third of the parents had moderate or serious problems in these areas.

The study found that IFPS services had the most impact on parental capabilities: at the end of interventions parents showed the highest positive gains on this domain.

What is the secret to achieving these gains?

The Child Welfare Information Gateway Brief lists, among others, the following characteristics for effective parent education programs:

Strength-based Focus
Family-centered Practice
Qualified Staff
Targeted Service Groups
Ecological Approach

That pretty well sums up the characteristics of strong IFPS programs!

The classic book on IFPS, Keeping Families Together, says that the key is to teach parents how all people, including their children, learn. This involves three ways to facilitate learning:

Direct instruction—presenting information
Modeling—showing how to do something
Contingency management—encouraging learning by rewarding desired behaviors and ignoring or (rarely) punishing behaviors that parents want to discourage

There are also specific curricula that are used in IFPS programs and other models of service. Parent education curricula are now evaluated for effectiveness and assigned ratings ranging from evidence-informed to evidence-based. Twelve curricula are listed in the Child Welfare Information Brief along with seven registries that have rated parent education programs. For details, visit:
https://www.childwelfare.gov/pubs/issue_briefs/parented/

Please share what your IFPS program has found to be effective for parent education.

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Posted by Priscilla Martens, Executive Director
National Family Preservation Network

The Top Priority in IFPS

The highest priority in IFPS is safety—safety for family members, safety for the IFPS therapist and safety for others in the environment.

The following case example shows how the IFPS therapist dealt with a high risk incident. Key elements of the IFPS therapist’s response included:

Critical thinking about risk/danger
De-escalation and contingency management
Feedback to the mother

The Situation

A 16-year-old male client (diagnosed with Pervasive Developmental Disorder) gave the therapist the finger and repeatedly gestured angrily towards her and then towards the door. When she did not immediately leave, the boy made threatening gestures with a plastic baseball bat and a push pin, threatened to “end” the therapist, called her a “whore,” tried to take her bag from her, threw an apple on the floor, threw paper napkins at her, and grabbed the chair that she was sitting on. He also grabbed his mother by the wrist to try to prevent her from re-hanging a corkboard he tore down.

Critical Thinking about Risk/Danger

The boy had a history of making threats when frustrated, but no history of ever harming anyone that the therapist knew of.

Because his threats occurred immediately after he gestured for the therapist to leave, she believed that leaving or retreating in response to his threats might reinforce this problematic behavior. This clinical assessment factored into her decision-making. She was able and prepared to leave if needed and she actively assessed for her own and the clients’ safety.

During the incident, she sat in a chair beside the door so that she could immediately leave if she felt a sincere threat. She made sure that the boy never stood between her and the door except when he removed the corkboard from the wall. Her cell phone was in her back pocket.

She assessed that the items the boy used to threaten the therapist (a hollow plastic baseball bat and a push pin) were unlikely to cause serious injury. She remained far enough away while he held the items that he could not easily make contact with them. He put down each of these items after holding them for a matter of seconds.

She noted that each time the boy came closer than a few feet from the therapist, he soon stepped back. She also noted that the boy’s gestures were increasingly less threatening. When the boy grabbed her chair and her bag she was forced to stand up, but later sat down again in an attempt to project calm control without force.

De-escalation and Contingency Management

The therapist remained calm throughout the incident and repeatedly reflected the boy’s anger. Her reflections and statements included:

She could see he was angry and he seemed to want her to know this.
It seemed he was trying to get the therapist to leave by making threats, but she didn’t really think he wanted to hurt anyone.
He didn’t seem to have the words to express himself when he was angry and this must be frustrating.
Making threats, even when it was successful in frightening people, seemed to be causing problems for him.
She hoped she could help him learn other ways to communicate and to manage his frustration.

When the boy grabbed his mother’s wrists to prevent her from re-hanging the corkboard, the therapist told him clearly that if she thought there was any chance he might hurt anyone, even accidentally, she would call the police, and he let go of his mother immediately.

The boy’s behaviors progressively de-escalated to gestures of anger that were not directed towards others (e.g., throwing an apple on the floor, throwing paper napkins on the floor). He calmed down after approximately 10-15 minutes. When he chose safer expressions of anger she told him she was glad he was making safer decisions.

When the boy’s mood seemed to change from anger to frustration to sadness, she reflected this. When he calmed down she noted how impressed she was that he was able to calm down. She told the boy that she hoped she could help him find new ways to express his anger.

She also told him that she was very glad that he spoke to her, even though he was angry and said some things she didn’t like. She told him she wouldn’t hold a grudge because she knew how hard it can be to be angry and not be able to say so, and that she hoped he would talk with her again.

Feedback to the Mother

The following day the therapist reviewed the incident with the boy’s mother. She explained that because his threats seemed to be intended to make the therapist leave, and because she did not think he would cause injury, she chose not to leave in this instance because she didn’t want him to learn that he could get what he wants by making threats.

While the boy wanted the therapist to go away, he wanted his mom with him. The therapist clarified that if the mom were to leave in response to his threats, this would not be a reward for him. She therefore encouraged the mom to leave promptly if he made threats towards her in the future, as this would both keep her safe and would provide a disincentive for making threats. She also encouraged her to call the police if she ever felt that anyone was in danger in the future.

She told the mom that they would complete a written safety plan the next time they met.

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Posted by Bethany Rice, IFPS Therapist, Institute for Family Development