Program

Fostering Healthy Futures

Mar 06, 2014

OVERVIEW

The Fostering Healthy Futures program is a preventive intervention for 9-11 year old children who have recently been placed in foster care due to maltreatment.  This program aims to reduce risk and promote well-being through skills groups and mentoring.  Experimental evaluations of this program have found positive impacts on mental health symptoms, trauma symptoms, quality of life, use of therapy, and placement in residential treatment facilities when compared with a treatment-as-usual control group.  This program is particularly successful in positive placement and permanency outcomes for children in non-kinship placements at baseline.

DESCRIPTION OF PROGRAM

Target Population:  Children aged 9-11 who were placed in foster care in the past year due to maltreatment.

The Fostering Healthy Futures (FHF) program is a 9-month preventive intervention for children in foster care.  This program aims to promote well-being by identifying and addressing mental health issues, preventing adolescent risk behaviors, and promoting competence.  This program has two components: group skills training and mentoring.  The skills training occurs weekly for 30 weeks in 1.5 hour sessions with groups of 8 to 10 children.  Topics covered include emotion recognition, perspective taking, problem solving, anger management, cultural identity, change and loss, healthy relationships, peer pressure, abuse prevention, and future orientation.  These groups are led by trained interventionists and follow a manualized curriculum.  Mentoring is provided by graduate students in social work, who meet individually with children for 2-4 hours per week throughout the intervention.  Mentors aim to create a relationship with the child in which they serve as a positive example, to ensure that the child is receiving appropriate services, to help children generalize the skills learned in group, to engage children in a variety of extracurricular activities, and to promote attitudes to foster positive future orientation.

EVALUATION OF PROGRAM

Study 1: Taussig, H. N., & Culhane, S. E. (2010). Impact of a mentoring and skills group program on mental health outcomes for maltreated children in foster care. Archives of Pediatrics and Adolescent Medicine, 164, 739-746. doi:10.1001/archpediatrics.2010.124

Evaluated Population:  The sample consisted of 156 children aged 9 to 11 years, who were they maltreated and placed in foster care in Colorado.  Children were recruited for participation if (1)  had been placed in foster care because of maltreatment in the last year, (2) lived within a 35 minute drive of the skills group site, (3) had lived in their foster home for at least 3 weeks, and (4) were not monolingual Spanish speaking.  The average age of the sample was 10.4 years old.  The sample was 51 percent male, 50 percent Hispanic, 30 percent African American, and 49 percent White (non-exclusive categories).

Approach:  Children were individually randomized to intervention (n=79) or treatment as usual control (n=77) groups.  Outcomes were measured at baseline, post-intervention, and 6 months later.  Caregivers and children reported on outcomes at all three assessments, while teachers reported only at post-intervention and follow-up.  The primary outcomes of interest were mental health problems, trauma symptoms, dissociation symptoms, quality of life, receipt of mental health therapy in the past month, and receipt of medication for mental health problems in the past month.  Secondary outcomes included coping, self-worth, social acceptance, and social support.  At baseline, children in the intervention group were more likely to have higher IQ scores, to have been physically abused, and to have mothers with criminal histories.  Otherwise, the groups were equivalent on all measures at baseline.

Results:  At post-intervention, children in the intervention group reported a significantly higher quality of life than children in the control group.  The intervention also had a marginally significant impact on social support at post-intervention.  All other primary and secondary outcomes were not significantly different between groups at the end of the intervention.

At the 6 month follow-up assessment, children in the intervention group showed significantly fewer mental health symptoms, fewer dissociative symptoms, and less use of therapy in the past month compared with the control group.  The intervention also had a marginally significant impact on trauma symptoms.  All other primary and secondary outcomes were not significantly different between groups at the 6 month follow-up.

Study 2: Taussig, H. N., Culhane, S. E., Garrido, E., & Knudtson, M. D. (2012). RCT of a mentoring and skills group program: Placement and permanency outcomes for foster youth. Pediatrics, 130, e33-39. doi:10.1542/peds.2011-3447

Evaluated Population:  The children evaluated in this study are a sub-set of the sample from Study 1 (above), who had open child welfare cases at the beginning of treatment.  The sample consisted of 110 children aged 9 to 11, who were maltreated and placed in foster care in Colorado.  The average age of the sample was 10.5 years old.  The sample was 52 percent male, 46 percent Hispanic, 35 percent African American, and 54 percent Caucasian (non-exclusive categories).

Approach:  Children were individually randomized to intervention (n=56) or treatment as usual (n=54) groups.  Children and caregivers from both groups completed baseline interviews.  The outcome variables of interest were number of placements, placements in residential treatment centers, and permanency.  These were collected from a statewide administrative database 1 year after the end of the intervention.  At baseline, the groups were equivalent on all measures, except maternal criminal history and moral neglect, both of which were significantly higher in the intervention group.  The authors examined the impacts of this program based on placement type at baseline: kinship placement, or non-kinship placement.

Results:  When controlling for baseline externalizing problems and placement history, children in the intervention group showed significantly fewer placements in residential treatment centers than those in the control group.  No significant impacts were found on number of placement changes or permanency when the analysis included the entire sample.  When examining only the children in non-kinship baseline placements, children in the intervention group showed significantly fewer placement changes, were less likely to be placed in residential treatment centers, and were more likely to have attained permanency when compared with the control group.   This effect was seen both when controlling and when not controlling for baseline characteristics.

SOURCES FOR MORE INFORMATION

References

Taussig, H. N., & Culhane, S. E. (2010). Impact of a mentoring and skills group program on mental health outcomes for maltreated children in foster care. Archives of Pediatrics and Adolescent Medicine, 164, 739-746. doi:10.1001/archpediatrics.2010.124

Taussig, H. N., Culhane, S. E., Garrido, E., & Knudtson, M. D. (2012). RCT of a mentoring and skills group program: Placement and permanency outcomes for foster youth. Pediatrics, 130, e33-39. doi:10.1542/peds.2011-3447

Website: www.fosteringhealthyfutures.org

Contact Information

Heather Taussig, Ph.D.

Associate Professor of Pediatrics and Psychiatry

Kempe Center, University of Colorado School of Medicine

The Gary Pavilion at the Children’s Hospital, Anschutz Medical Campus

13123 E 16th Ave, B-390

Aurora, CO 80045

Email: heather.taussig@childrenscolorado.org

KEYWORDS:  Children (3-11), Males and Females (Co-ed), Community-based, Skills Training, Mentoring, Mental Health Other, Self-Esteem/Self-Concept

Program information last updated on 3/6/14

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