What are some examples of evidence-informed practices to keep children safe and promote permanency?
The field of child welfare has come a long way in developing and adopting evidence-based practices. Although more research is still needed, there is a growing list of existing evidence-based or evidence-informed practices to meet many child and family needs throughout the life of a case.
Even before a case begins, prevention programs can be effective in reducing the need for further system intervention. Effective prevention of child abuse and neglect requires both primary and secondary prevention approaches: primary prevention programs, often called “universal” prevention programs,1 are directed at the general population, with the goal of preventing child abuse and neglect from occurring in the first place.
Examples of evidence-informed primary prevention approaches include:
- Nurse-Family Partnership (NFP)
- Safe Environment for Every Kid (SEEK)
- Triple P – Positive Parenting Program
- Parent-Child Assistance Program
Secondary prevention2 includes programs focused on individuals or families who are at high risk for maltreating their children, and may include parent education and training, respite care, and home visiting programs. Many of these can also be considered early intervention programs. Examples of evidence-informed secondary prevention approaches include:
- Family Connections
- Functional Family Therapy (FFT) & FFT-CW
- The Incredible Years (IY)
- Parent-Child Interaction Therapy (PCIT)
- Project Connect
Behavioral management programs can also be an instrumental part of both prevention and permanency interventions: on the front end, they can prevent the need for a youth to be placed in out-of-home care due to his/her behaviors; and on the back end, they can help stabilize youth behaviors, which has been tied to improved permanency outcomes. Two behavioral management programs that are well-supported by research evidence include Multidimensional Family Therapy and Multisystemic Therapy.
Some prevention interventions can also serve to support and stabilize foster placements, such as Project KEEP, or to address reunification, especially through home visiting, as they allow families to receive services in their natural environment and provide another layer of safety supports as children transition back into their families. Sobriety Treatment and Recovery Teams (START) is one promising intervention that combines home visiting with substance abuse treatment. Homebuilders® is another in-home service that has been rated by the California Evidence-Based Clearinghouse as “supported by research evidence” in the areas of both family stabilization and reunification.
Another promising intervention in the area of reunification is the Safe Babies Court Team (SBCT), which is a collaboration between the child welfare agency, the courts, and ZERO TO THREE. At least one study3 found that children involved in the SBCT were more likely to be reunified, and that they achieved permanency more quickly, regardless of the type of permanency achieved.
Finally, Homebuilders® and other promising family strengthening programs can be used to address adoption disruption and dissolution, and support the post-permanency needs of children in foster care.
Implementation: The experience of New York City Administration for Children’s Services
The above selection of evidence-informed interventions reflect a snapshot of some of the interventions available to child welfare agencies and courts. However, these interventions must be matched with the right populations in order to achieve the desired and intended outcomes. The key to successfully incorporating evidence-based practices into child welfare practice is to start with an understanding of the needs — both at the systems level and the individual child or family level — and then build a menu of available interventions to address them. In 2011, the New York City Administration for Children’s Services (ACS), in partnership with Casey Family Programs, introduced 11 evidence-based and evidence-informed practice models into its continuum of preventive services. This initiative is the largest and most diverse continuum of evidence-based and evidence-informed preventive programs in any child welfare jurisdiction in the country.
By 2015, almost 5,000 families were served annually through an evidence-based model (EBM), representing one in every four families served by the ACS preventive system. Key considerations, interventions used, and lessons learned are provided in this recent report, Implementing Evidence-Based Child Welfare: The New York City Experience.
Intervention compilations and databases: selected resources
The use of evidence-based practices is gaining momentum within child welfare, but it can be challenging to determine which interventions are the right fit for a particular need. Research compilations as well as resource clearinghouses or databases can be useful tools to help identify which interventions have an evidence base and how rigorous the existing evidence is, which populations they are intended to serve, and the needs they address.
For example, in 2017, Casey Family Programs collaborated with Upbring on the development of Evidence-Based and Promising Interventions for Preventing Child Fatalities and Severe Child Injuries Related to Child Maltreatment.
In addition, below are several databases for locating evidence-informed strategies to support and strengthen children and families:
California Evidence-based Clearinghouse for Child Welfare, Topic Areas (2017)
Administrative procedure: Programs reviewed by the CEBC are organized into the following topic areas:
- Anger Management, Domestic Violence, and Substance Abuse
- Behavior Management, including Parent Training
- Core Child Welfare Services, including Placement and Reunification
- Engagement and Parent Partnering Programs
- Mental Health
- Prevention and Early Intervention
- Support Services for Youth in the Child Welfare System
California Evidence-based Clearinghouse for Child Welfare, Guide to Comparing Clearinghouses for Evidence-Based Programs (2017)
Administrative procedure: This chart provided by the CEBC provides a list of 11 different clearinghouses for evidence-based programs that are relevant to child welfare, including links, descriptions, and each site’s method for rating programs.
National Quality Improvement Center for Adoption and Guardianship Support and Preservation (QIC-AG), Intervention and program Catalog (2017)
Administrative procedure: This tool is designed to identify evidence-based or evidence-informed programs and promising practices that can be used to address adoption disruption and dissolution, and support the post-permanency needs of children in foster care. It contains over 100 programs and interventions that are or could be adapted to work with children transitioning to adoption or guardianship as well as children and families who have obtained permanence through adoption or guardianship.
Washington State Institute For Public Policy, Updated Inventory of Evidence-Based, Research-Based, and Promising Practices: For Prevention and Intervention Services for Children and Juveniles in the Child Welfare, Juvenile Justice, and Mental Health Systems (2017)
Administrative procedure: This report provides an updated inventory of evidence-based, research-based, and promising practices for children and youth involved with child welfare, juvenile justice, and mental health systems.
1 See http://www.cebc4cw.org/topic/prevention-of-child-abuse-and-neglect-primary-programs/
2 See http://www.cebc4cw.org/topic/prevention-of-child-abuse-and-neglect-secondary/
3 McCombs-Thornton, K. L., & Foster, E. M. (2012). The effect of the ZERO TO THREE Court Teams initiative on types of exits from the foster care system — A competing risks analysis. Children and Youth Services Review, 34,169-178.