PRE-CONFERENCE WORKSHOP I: IMPLEMENTING PARENT TRAINING AT SCALE IN CHILD WELFARE WITH LINKED POLICY, FISCAL, AND PRACTICE REFORMS

During the past 5 years, there have been significant opportunities to successfully implement a policy and practice agenda to improve social, emotional, physical, and educational outcomes for children and families in child welfare. Under the leadership of the Administration on Children, Youth and Families (ACYF) at the U.S. Department of Health and Human Services, the role of academic research on child welfare practice was elevated as was the importance of child well-being as a primary outcome of concern for child welfare practice. This included the goal of addressing the long-term impact of maltreatment and associated poor outcomes commonly reported in research involving foster youth. Policy initiatives have called for child welfare systems to be proactive in using research to enhance their capacities for making informed policy and program decisions using scientific evidence. This work emphasizes the emergence of a cutting-edge body of scholarship in evidence-based interventions and neuroscience and the potential for innovative contributions to understanding the effects of maltreatment on child development.

An example of a large-scale foster care reform that linked policy, fiscal incentives, and evidence-based interventions will be described. The goal was to achieve a reduction in the following outcomes: a) placement disruptions (lateral moves); b) the number of placement days; length of stay; and c) the number of re-entries in to care.  Achieving 20% reductions in these targets would make the reform effort cost-neutral.  Two evidence-based interventions were chosen by the child welfare system in a large urban city to achieve these targets: KEEP (Keeping foster and kinship parents trained and supported) and PMTO (Parenting Through Change to support and increase skills of biological parents). These interventions were linked in that they are based on the same theory (social learning), used similar intervention components, used an observation-based fidelity monitoring system, and the training and ongoing consultation of case workers and supervisors were coordinated. The start-up time for this system reform was rapid: 5 months from conceptualization, design, agency selection, planning/readiness, and installation of fidelity monitoring system design. This presented numerous challenges for the implementation.

A multiple baseline study designed to detect whether, relative to the past, performance differed from what would have been expected under a business as usual design. Innovative strategies were used for establishing what was likely to happen as a counterfactual against which to compare what did happen. The evaluation methodology and results will be described.