Program

Family-Centered Intensive Case Management

Feb 22, 2012

OVERVIEW

Family-Centered
Intensive Case Management (FCICM) aims to support families caring for a child
with serious emotional disturbance using a team in-home approach. The goal is
to keep the child at home and in school and to provide the family with
individualized resources that make this possible. A experimental efficacy
evaluation of the services demonstrates that, with treatment, children show
significant progress in their functioning and symptom reduction compared with
children in an out-of-home foster family intervention.

DESCRIPTION OF PROGRAM

Family-Centered
Intensive Case Management (FCICM) is based on the Child and Adolescent Service
System Program values and on an understanding of the support needs of families
with children with serious emotional disturbance. It aims to support families
caring for a child with serious emotional disturbance using a team in-home
approach. A case-manager and parent advocate, who is a parent of a child who
has or has had serious emotional disturbance, provide regular in-home services.
The team works with a maximum of eight families at a time and is available 24
hours per day, seven days per week. In addition to the team, each 8-family
cluster has two respite families available to provide planned and emergency
out-of-home respite care if needed. The respite families receive training,
supervision, and support from a therapeutic foster family. The goal is to keep
the child at home and in school and to provide the family with resources that
make this possible. The program aims to improve family adaptability and cohesion
and decrease problem behaviors and symptoms.

FCICM provides
behavior management training for the natural parents, using an adaptation of the
Parent Skills Training program. The team also has a strong advocacy function on
the family and local system levels. Parent support groups and one-on-one
support from parent advocates is also included. A service plan is developed
based on a comprehensive assessment taken at intake. Flexible service dollars
of approximately $2,000 are available to the team to purchase individualized
services for the child and family.

Target population:
Children with serious emotional disturbance
and their families

EVALUATION(S) OF PROGRAM

Evans, M.E.,
Armstrong, M.I., Kuppinger, A.D. (1996). Family-centered intensive case
management: A step toward understanding individualized care. Journal of Child
and Family Studies, 5(1), 55-65.

Evaluated
population: 
The total evaluated population was 42 children ages 5-12 (mean
9.1 years) from three rural counties in New York State in this efficacy study.
Eighty-three percent were white and non-Hispanic. Of the participants, 91
percent were boys, 83 percent were in the custody of their parents or relatives,
and 57 percent were enrolled in special education programs. All participants
had serious emotional distress and were referred for Family-Based Treatment by
an interagency committee.

Approach:
Participants and their families were referred by an interagency committee and
randomly assigned, after consenting, to the following conditions: 15 to
out-of-home Family-Based Treatment (FBT; the control group) and 27 to in-home
Family-Centered Intensive Case Management (FCICM). Family-Based Treatment
involved specialist training and support of five treatment foster families with
a child with serious emotional disturbance and one respite family. The ultimate
goal of the Family-Based Treatment was to reunite the child with his/her family
when possible. All children and families were administered assessments at
admission to the program, in six-month intervals, and at a six-month follow-up
after discharge. Parents and case managers completed assessments on the
following outcomes: symptoms, problem behaviors, behavior, moods, emotions, role
performance, thinking, family adaptability and cohesion. Baseline differences
controlled for included significantly higher levels of behavior and thinking
impairment in FCICM participants.

Results:
Participants in the FCICM group showed a significant decrease in number of
symptoms from baseline, at six months, and at one year. Behavior problems did
not change significantly for either group during their first year in
enrollment. Children in FCICM showed significant improvement in behavior,
moods, and emotions and role performance at one year. Those in Family-Based
Treatment did not show significant improvements in behavior, moods, emotions,
role performance, or thinking. Family adaptability and cohesion scores were not
significantly different between treatment groups or across time.

SOURCES FOR MORE INFORMATION

References

Evans, M.E.,
Armstrong, M.I., Kuppinger, A.D. (1996). Family-centered intensive case
management: A step toward understanding individualized care. Journal of Child
and Family Studies, 5(1), 55-65.

KEYWORDS:
Children (3-11), Adolescents (12-17), Males and Females, Rural, Home-Based,
emotional disturbance, parent or family component, parent training/education,
case management, depression/mood disorders, conduct/disruptive disorders

Program
information last updated 2/22/12.

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