1. What do we learn from proces- outcome research? Paris, september 23th, 2005 Bert Van Puyenbroeck - Programme leader IFPS Flanders Gerrit Loots, phd, Vrije Universiteit Brussel Hans Grietens, phd, Katholieke Universiteit Leuven

2. IFPS-program Intensive Family Preservation: Crisishulp aan Huis Crisis = minor is about to be placed out of home (residential care; foster care;..) At home service Short term programme, during 4 to 6 weeks Family can reach IFPS team or family worker 24h/day, 7d/ week ; family worker can also reach supervisor at any time Intensive: 8h/week, 10 meetings/ week at home To prevent unnecessary out of home placement

3. IFPS in Europe & USA IFPS programs in USA (Seattle) (Homebuilding) Netherlands (Families First) U.K. Germany ( FAM; FIM) Luxemburg Finland Flanders (Crisishulp aan Huis)

4. Research items former research 1.What’s the target group reached by IFPS? 2.What are the results of an IFPS program? = outcome based research, focused only on an ‘out of home placement index’

5. Basic results international literature It seems that: –Comparable results of these ‘homebuilding based IFPS programs’ in the Netherlands, Flanders, Seattle = in different cultures? ‘succesratio’ of 73% up to 91%

6. Critical thinking about these research items How does that come? What is ‘result’: outcome based, quantitative research: index of out of home placement? OHP isn’t necessary negative (safety issue)

7. Questions What are the procesess behind these results? What difference can an IFPS program make for the family? What is our basic objective?

8. Proces-outcome research: what’s the impact of an IFPS program The research program is based on –an integration of quantitative and qualitative research methods to relate: outcome data to the intervention processes and the experiences of the family members. –Quantitative research data What are the outcomes of an IFPS in Flanders? –Qualitative research What are the processes behind these outcomes? What are the changes we are able to introduce in the family system?

9. Major question « does a family has any perspective on how to go on as a family, how to raise the children, how to stay together in this family, how to keep up? » During the intervention, and afterwards?

10. Perspective of the parent focuses on the impact of Families First Flanders on parents’ experiences of parental stress, their relationship and interaction with their child/children, and their impressions of the strengths and difficulties of the minor. –Can I bear the stress? Are there a lot of stressfactors? –How is my relationship with my child? –Where can I find social support?

11. Perspective of the minor the minors’ experiences of the parent-child interaction and their impressions of their own strengths and difficulties. –Do I feel myself competent as minor in this family, at school? –How is my relationship with my mother, my father?

12. Focus of IFPS Flanders If we want to make any difference, than: –Competence: what do I have in my pocket to keep up = competence-based model –Stress: how stressful is this situation for me? –Educational relation: how’s the relation with my child/ my parents –Social isolation/ support: can I relay on a supportive system/context?

13. Research design Within subjects / pretest-posttest-follow up design: All families involved in a crisis intervention service (IFPS): –Minor –Parent (mother/ father) Three moments –Beginning of the crisisintervention –At the end –One month after ending

14. Instruments CompetenceStrenghts and Difficulties Questionnaire (SDQ) StressNijmeegse Vragenlijst Opvoedingssituatie (NVOS) Educational RelationshipOuder-Kind Interactievragenlijst (OKIV-R) Social SupportNijmeegse Ouderlijke Stressindex (NOSI)

15. Procedure Family workers –2 Feedback & Training moments (before starting/ after 3 months) Referal service –Standardised letter: short introduction to the research project Family –Referal service: first introduction –Family worker: first questionnaires at the start & short acknowledgement from both researchers – at the end – after one month –Closed envelopes back to FW (+ send to university Brussels)

16. Overview: questionnaires InformantStartEndFollow up ParentSDQ OKIV-R NVOS NOSI SDQ OKIV-R NVOS NOSI SDQ OKIV-R NVOS NOSI Feedback Quest MinorSDQ OKIV-R mother OKIV-R father SDQ OKIV-R mother OKIV-R father SDQ OKIV-R mother OKIV-R father Feedback Quest

17. This overview today Quantitative data-analysis of the families involved in the programme during the first six months will be presented and discussed: –SDQ –NVOS –OKIV-R

18. OKIV-R educational relationship (parent)

20. Conclusion OKIV-R parent Parents experience their relationship with minor as very problematic This does not change/ improve during or after the crisintervention

21. OKIV-R educational relationship (minor)

23. Conclusion OKIV-R minor Minors experience their relationship with their parents as very problematic This doesn’t change/ improve during or after the crisisintervention

24. SDQ Strengths & Difficulties Minor (parent)

26. Conclusion SDQ parent Total difficulties score is: problematic range This changes significantly during & after crisisintervention (T3 – T1) Most important changes –Emotional symptoms –Hyperactivity And trend: –Conduct problems

27. SDQ Strengths & Difficulties Minor (minor)

29. Conclusions SDQ minor Total difficulties score is: borderline range This changes significantly during & after crisisintervention (T3 – T1) Most important changes –Hyperactivity Trend: –Conduct problems

30. NVOS, part 1 Stress, Opvoedingsbelasting (parent)

32. Conclusions NVOS IFPS families experience the situation as problematic as families where minor is placed in residential care (norm group) This is: target group of IFPS (trying to prevent an unnecessary OHP) This improves in some ‘domains’ of the educational situation –Significantly: « situation can’t go on like this » and « I’m standing alone » and « experiencing some fun » –Trend: « I can(not) handle the situation »

33. NVOS, part 2 ID of situation (parent)

35. Conclusions NVOS ID of the situation changes from « I experience quiet a lot of problems » to « sometimes I (still) experience problems in education »

36. First conclusions IFPS reaches the target group: trying te prevent unnecessary out of home placement of a minor, given their is a serious risk of OHP (NVOS) During the intervention and afterwards, parents and minor experience the situation as less perspectiveless/ problematic (SDQ) Parents identify the educational situation als less ‘demanding’ (NVOS)

37. First conclusions But: –Still, IFPS does not make a difference in the problematic relationship between parent and child –Hypothesis: IFPS helps to deminish the ‘crisis’ in the situation, while their is still a need for further family therapy. –Hypothesis: since family has again more ‘hope’, perspective on how to go on as a family, they’re more willing te accept/ go to further helping services.

38. Further research Reporting 12 months (october ’04 – september ’05) also: domains of –Social support –Their evaluation of the programme Qualitative research, based on these first quantitative research results –Hypotheses? –What helps them to get out of the crisis? –What didn’t help them?

39. EUSARF 2007 Presentation on both quantitative and qualitative research programs

40. hubert.vanpuyenbroeck@vub.ac.be Thank you. Please contact me for further discussion