Intensive Family Preservation Services to prevent out-of-home placement of children: A systematic review and meta-analysis

Bezeczky, Zoe; El-Banna, Asmaa; Petrou, Stavros; Kemp, Alison; Scourfield, Jonathan; Forrester, Donald J.; Nurmatov, Ulugbek

doi:10.1016/j.chiabu.2020.104394

Cited by 23 publications

(12 citation statements)

References 36 publications

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“…Interventions such as this-that focus on a two-generational approach (a parent and the child)-and on drawing together or improving elements within a child's daily life or ecology of influence-have also been shown to be effective in other selective prevention programs such as in child welfare with multi-stressed families (44,(89)(90)(91). Core to positive outcomes in research in this area, however, rely on program fidelity and implementation support strategies to that ensure program elements are delivered as intended (92,93).…”

Section: Discussionmentioning

confidence: 99%

Development of an Evidence-Informed and Codesigned Model of Support for Children of Parents With a Mental Illness— “It Takes a Village” Approach

et al. 2022

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Providing support to parents and their children to help address the cycle of intergenerational impacts of mental illness and reduce the negative consequences for children is a key focus of selective prevention approaches in public mental health. However, a key issue for children of parents with a mental illness is the lack of access to early intervention and prevention support when needed. They are not easily identifiable (until presenting with significant mental health issues of their own) and not easily accessing the necessary support that address the complex interplay of parental mental illness within families. There are significant barriers to the early identification of these children, particularly for mental health care. Furthermore, there is a lack of collaborative care that might enhance identification as well as offer services and support for these families. The “It takes a Village” project seeks to improve mental health outcomes for children through the co-development, implementation and evaluation of an approach to collaborative practice concerned with the identification of families where a parent has a mental illness, and establishing a service model to promote child-focused support networks in Austria. Here we describe the development of service delivery approach for the “It takes a Village” project that aims to improve identification and support of these children within enhancements of the existing service systems and informal supports. The paper describes the use of codesign and other implementation strategies, applied to a research setting, with the aim of impacting the sustainability of workforce reform to achieve lasting social impact. Results highlight the steps involved in translating evidence-based components, local practice wisdom and lived experience into the “It takes a Village” practice model for Tyrol, Austria. We highlight through this paper how regional context-specific solutions are essential in the redesign of care models that meet the complex needs of children of parents with a mental illness. Service system and policy formation with local and experienced stakeholders are also vital to ensure the solutions are implementation-ready, particularly when introducing new practice models that rely on organizational change and new ways of practice with vulnerable families. This also creates a solid foundation for the evaluation of the “It take a Village” approach for children of parents with a mental illness in Austria.

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Section: Discussionmentioning

confidence: 99%

Development of an Evidence-Informed and Codesigned Model of Support for Children of Parents With a Mental Illness— “It Takes a Village” Approach

et al. 2022

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“…Some have been addressed through the same programme of work (e.g. systematic reviews of the impact on children being in care of intensive family preservation services and shared decisionmaking meetings (Bezeczky et al, 2020;Nurmatov et al, 2020)). A further question that could be addressed in a future systematic review is, as one of the main intervention types for trying to reduce the need for care, 'Are parental skill building programmes effective at reducing care entry/improving reunification?'…”

Section: Discussionmentioning

confidence: 99%

A scoping review of system-level mechanisms to prevent children being in out-of-home care

Stabler

Evans

Scourfield

et al. 2021

The British Journal of Social Work

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Identifying which approaches can effectively reduce the need for out-of-home care for children is critically important. Despite the proliferation of different interventions and approaches globally, evidence summaries on this topic are limited. This study is a scoping review using a realist framework to explore what research evidence exists about reducing the number of children and young people in care. Searches of databases and websites were used to identify studies evaluating intervention effect on at least one of the following outcomes: reduction in initial entry to care; increase in family reunification post care. Data extracted from papers included type of study, outcome, type and level of intervention, effect, mechanism and moderator, implementation issues and economic (EMMIE) considerations. Data were coded by: primary outcome; level of intervention (community, policy, organisation, family or child); and type of evidence, using the realist EMMIE framework. This is the first example of a scoping review on any topic using this framework. Evaluated interventions were grouped and analysed according to system-level mechanism. We present the spread of evidence across system-level mechanisms and an overview of how each system-level mechanism might reduce the number of children in care. Implications and gaps are identified.

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“…Intensive family preservation and reunification services are designed to keep children safe in the care of their parents and prevent child removal or subsequent placement into out-of-home care (OOHC; alternative accommodation when children cannot live at home safely [ 1 ]). They are effective in preventing children from entering OOHC 24 months post program engagement [ 2 , 3 , 4 ]. The effect of these programs is moderated by the sex and age of the child, parent age, the number of children and risk factors in the family, and practitioner caseload; greater effects (i.e., less OOHC placements) have been observed among families with boys and older parental age, whereas families with older and a greater number of children, single-parents, and higher caseloads were associated with reduced effects (i.e., more OOHC placements [ 5 ]).…”

Section: Introductionmentioning

confidence: 99%

“…In order to determine the effectiveness of the program, outcomes including parental knowledge, parenting skills, and capability; child development, adolescent behaviour and education attendance; connection to and use of family services; and protection from child abuse and neglect, were chosen in consultation with key stakeholders. These outcomes are associated with healthy, resilient and thriving children, and the work of family preservation and reunification programs [ 2 , 5 ]. Familial complexity, OOHC experience, and trauma, are risk factors for child abuse and neglect, which is under measured in current preservation programs [ 7 ].…”

Section: Introductionmentioning

confidence: 99%

MacKillop Family Services’ Family Preservation and Reunification Response for Vulnerable Families—Protocol for an Effectiveness-Implementation Study

Morris

Savaglio

Halfpenny

et al. 2021

IJERPH

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International evidence supports the effect of intensive family preservation and reunification services in preventing children’s placement in out-of-home care (OOHC). Evidence within Australia is scarce. This protocol paper describes a hybrid effectiveness-implementation evaluation of the Victorian Family Preservation and Reunification (FPR) Response implemented by MacKillop Family Services. Participants include families engaged in the program and staff involved in program delivery. A pre-post study design will be used to assess the effectiveness of the FPR in improving family outcomes from intake to closure, including: (i) parenting knowledge, skills, and capability; (ii) family safety and home environment; (iii) child development, adolescent behaviour, education attendance and attachment; (iv) connection to services; and (v) prevention of children from entering or re-entering OOHC. Interviews and focus groups will be conducted with staff to evaluate the program’s fidelity, reach, feasibility, acceptability, and enablers and barriers to implementation. Quantitative data will be analysed using descriptive statistics and a series of paired-samples t-tests and F tests to examine changes in outcomes over time; thematic analysis will be used for qualitative data. If the FPR can yield significant improvements in families’ outcomes, this would provide strong support for its scale-up across Australia, to better support vulnerable families.

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Intensive Family Preservation Services to prevent out-of-home placement of children: A systematic review and meta-analysis

Abstract: A systematic review and meta-analysis If you'd like this publication in an alternative format such as Braille,

Cited by 23 publications

References 36 publications

Development of an Evidence-Informed and Codesigned Model of Support for Children of Parents With a Mental Illness— “It Takes a Village” Approach

Development of an Evidence-Informed and Codesigned Model of Support for Children of Parents With a Mental Illness— “It Takes a Village” Approach

A scoping review of system-level mechanisms to prevent children being in out-of-home care

MacKillop Family Services’ Family Preservation and Reunification Response for Vulnerable Families—Protocol for an Effectiveness-Implementation Study

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