Evidence Based Practice Child Welfare System Webcast Training September 15, 2005 Presented by California Institute for Mental Health

Research to PracticeEvidence Based Practices2 Main Points Defining evidence-based practices Child welfare outcomes Child welfare specific practices

Research to PracticeEvidence Based Practices3 Evidence-Based Practices “…the integration of the best research evidence with clinical expertise and patient values” Based on the definition used in “Crossing the Quality Chasm: A New Health System for the 21st Century” (2001), by the Institute of Medicine

Research to PracticeEvidence Based Practices4 Levels of Science Effective--achieves outcomes, controlled research (random assignment), with independent replication in usual care settings. Efficacious--achieves outcomes, controlled research (random assignment), independent replication in controlled settings. Not effective--significant evidence of a null, negative, or harmful effect. Promising--some positive research evidence, quasi-experimental, of success and/or expert consensus. Emerging practice--recognizable as a distinct practice with “face” validity or common sense test.

Research to PracticeEvidence Based Practices5 Child Welfare Outcomes Protection from abuse and neglect Children maintained safely at home Families have enhanced capacity to provide for children’s needs Permanency and stability without increasing foster care re-entry

Research to PracticeEvidence Based Practices6 Child Welfare Evidence-Based Practices Multidimensional treatment foster care Early intervention foster care Incredible years Triple P parenting Nurse family partnership Parent-child interaction therapy Functional family therapy Trauma-Focused Cognitive Behavioral Therapy

Research to PracticeEvidence Based Practices7 Multidimentional Treatment Foster Care (MTFC) Effective Teenage youth in or at-risk group home Increases foster parent competencies Decreases in child behavioral problems Increases in parenting competencies Low rate of re-entry into foster care or the juvenile justice system Patti Chamberlain and colleagues from Oregon Social Learning Center

Research to PracticeEvidence Based Practices8 MTFC Interdisciplinary team One child per foster home Intensive foster parent training Foster parent support group and daily calls Behavior point system in the foster home Individual therapy for the youth Behavior skills training for the youth Family therapy for biological family Coordination with school, family and others 24 support to foster parent and biological family

Research to PracticeEvidence Based Practices9 Early Intervention Foster Care Promising--efficacious Preschool age foster children Increases foster parent competencies Strong support for foster parents Decrease in child behavior problems Develops age appropriate child competencies Improves parenting competencies Decreases parental stress and depression Increase in social support Promotes reunification Phil Fisher and colleagues from Oregon Social Learning Center

Research to PracticeEvidence Based Practices10 Early Intervention Foster Care Interdisciplinary team Intensive foster parent training Foster parent support groups Daily support calls 24 support to foster parent and biological family Child focused therapy Behavioral specialist for child in preschool, childcare or home settings Parent training

Research to PracticeEvidence Based Practices11 The Incredible Years Effective Children 2-12 Decreases child behavior problems Increases parenting competencies Decreases maternal stress Strengthens parent-teacher and parent- caregiver relationships Carolyn Webster-Stratton, University of Washington

Research to PracticeEvidence Based Practices12 Incredible Years Facilitated group intervention, practitioners with diverse educational backgrounds Three sets of comprehensive developmentally based curriculums for parents, teachers and children to promote emotional and social competence  Basic parenting (early and school age)  Advanced parenting  Supporting your child’s education  Child social skills  Classroom based  Teacher training Weekly groups (12-14 sessions), 2 hours in length Uses work books, and video-vignettes to illustrate skills

Research to PracticeEvidence Based Practices13 Triple P Parenting Effective Children 0-16 Improves parenting skills Decrease in parental stress and depression Improves coping skills Decrease in child behavior problems Improves partner support Improves parent anger management skills Decreases social isolation Matt Sanders, University of Queensland www1.triplep.net

Research to PracticeEvidence Based Practices14 Triple P Parenting Practitioners with diverse educational backgrounds Parenting program Titrated levels of intervention Detailed support material for parents Five levels of intervention from primary prevention to treatment  Universal Triple P (primary prevention)  Selected Triple P  Primary Care Triple P  Standard Triple P (individual or group)  Enhanced Triple P

Research to PracticeEvidence Based Practices15 Nurse Family Partnership Effective Low-income, high risk first time parents (pregnancy-age 2) Intensive home visitation to promote health and welfare of parents and children Improved pregnancy outcomes Improved child health and well being Increases economic self-sufficiency David Olds and his colleagues, University of Colorado

Research to PracticeEvidence Based Practices16 Nurse Family Partnership Registered nurse Intensive home visitation  Mother’s personal health  Quality of care  Life course outcomes Visitations begin no later than 28 weeks of gestation until age 2 Visits involve mother’s support system

Research to PracticeEvidence Based Practices17 Parent-Child Interaction Therapy Effective Children ages 2-8 years Parent-child guided intervention Decrease child behavior problems Increases parenting competencies Sheila Eyberg and colleagues, University of Florida _traincenter.html _traincenter.html

Research to PracticeEvidence Based Practices18 Parent-Child Interaction Therapy Therapists Clinic with two-way mirror, and “bug in the ear” technology Individual sessions (about 12) Home models being developed Parent-child guided intervention  Relationship  Discipline

Research to PracticeEvidence Based Practices19 Functional Family Therapy Effective Youth ages years Decreases family negativity and hostility Decreases child behavior problems Decreases the need for out of home placement Increases parenting competencies Jim Alexander and colleagues, University of Utah

Research to PracticeEvidence Based Practices20 Functional Family Therapy Practitioners with diverse educational backgrounds Individual family sessions (about 12-14) Standard process with content tailored to individual families Multiple phases  Engagement  Change behavior  Generalization

Research to PracticeEvidence Based Practices21 Trauma-Focused Cognitive Behavioral Therapy Effective Children ages 4-18 years Decreases PTSD symptoms Decreases negative attributes (self-blame) about the traumatic event Decreases externalizing problem behaviors Improves parent-child relationship Decreases parental depression Improves parenting Judith Cohen and Anthony Mannarino, Allegheny General Hospital or

Research to PracticeEvidence Based Practices22 Trauma-Focused Cognitive Behavioral Therapy Therapists (LPHA) Individual sessions (weekly) with the child, parent and joint child-parent (12-16 sessions)  Therapeutic relationship  Psycho-education  Emotional regulation  Stress management  Connecting thoughts, feelings and behaviors  Gradual in vivo exposure  Cognitive and affective processing of trauma experiences  Personal safety and skills training