Develop and Support Families

KEEP (Keeping Foster and Kin Parents Supported and Trained), Multiple Locations

This is one of 31 program profiles that appears in Support Matters, Lessons from the Field on Services for Adoptive, Foster, and Kinship Care Families (PDF – 2 MB), published March 2015.

Overview        

KEEP is a 16-week training and support program for foster and kinship caregivers. The program has been implemented in Oregon, New York City, Baltimore, and in 12 sites across England.

Population Served

Foster and kinship caregivers of children ages five to 12, particularly children with challenging behaviors.

In New York City, more than 2,000 caregivers have been through the program.

Theory of Change     

If foster and kinship caregivers have information and support, they will be better able to deal with their children’s externalizing behavior problems. Foster and kinship caregivers can become agents of change with the opportunity to change the course of a child’s life.

Provider                                                

The program can be offered by any child welfare organization, with training, implementation support, and consultation provided by the Oregon Social Learning Center.

Role of Public Child Welfare Agency    

Local child welfare agencies refer caregivers to the program.

Key Service Components     

KEEP is a 16-week program, with the following key program elements:

  • Each week a group of seven to 10 foster and kinship caregivers attend a 90-minute meeting and training session run by a facilitator and co-facilitator. During these interactive, participatory sessions, the caregivers learn about effective behavior management methods. A training manual is used, but discussion is adapted based on the specific situations facing the families.
  • Caregivers receive homework assignments to complete between sessions.
  • The facilitator or co-facilitator calls each family weekly to discuss any problems the family is having and to gather data on the child or children’s behaviors during the day.
  • If caregivers are unable to attend group sessions, they may receive a home visit where a facilitator will present the materials to them.
  • Child care is provided during the group time.

Curriculum topics include:

  • Framing the foster or kin parents’ role as that of key agents of change for the children in their care
  • Methods for encouraging child cooperation, using behavioral contingencies and effective limit setting and balancing encouragement and limits
  • Dealing with difficult problem behaviors including covert behaviors
  • Promoting school success
  • Encouraging positive peer relationships
  • Strategies for managing stress brought on by providing foster care

Outreach Efforts    

The agency offering the program is responsible for any outreach to its caregivers.

Staffing    

Each group is run by a trained facilitator and co-facilitator. The primary work is provided by paraprofessionals with bachelor’s degrees and training on the program. Supervisors are master’s level clinicians.

After conducting three 16-week groups with intensive support from the KEEP implementation team, facilitators become KEEP-certified facilitators.

Training Requirements     

To implement the program in new sites, the Oregon Social Learning Center provides up to one year of training and consultation. Initial training takes five days, which is followed by weekly telephone supervision for one year.

In addition, those implementing the model video record sessions to ensure ongoing program fidelity.

Evaluation and Outcomes

Evaluation Design

Over the years, program designers have conducted a number of studies of the program, including a randomized control trial from 1999 to 2005 of more than 700 families in San Diego County. This trial randomly assigned families to either the 16-week program or to the usual casework services. At baseline and after the intervention, child behavior problems were measured using the Parent Daily Report Checklist. The New York City effort is being evaluated by Chapin Hall at the University of Chicago.
 
 Key Findings from the San Diego Trial

  • The trial found higher levels of positive reinforcement and lower levels of children’s behavior problems in the families who were assigned to the KEEP group, compared to those in the control group. The differences were greatest for those children who initially showed more behavior problems at the baseline assessment.
  • Children in the KEEP group were more than twice as likely to have a positive exit from care, meaning either reunification with birth parents or a relative or adoption. Children in the KEEP group also saw fewer placement disruptions than those in the control group.
  • Children whose families participated in KEEP were no more or less likely to have a negative exit (either running away, a placement change, or a more restrictive placement) than those in the control group. For children who had a higher number of placements before the KEEP program, the intervention may have had a positive effect on reducing negative exit types.

The California Evidence-Based Clearinghouse for Child Welfare rated KEEP as having promising research evidence.

Budget     

Costs to start up the program are about $40,000. Operating costs depend on the staff costs of the participating agency and the number of families served.

Funding     

Agencies fund the program in a variety of ways, including using federal Title IV-E funds and IV-E waivers. Some agencies have been able to access family support or preservation funds for the program.

Partnerships Required or Recommended

Agencies must work with Oregon Social Learning Center to implement the KEEP program.

Challenges

KEEP requires child welfare agencies to make a change in the way they operate — to engage families more deeply in the process during the 16-week program. For some agencies, this cultural shift is a challenge.

Background

In the early 1990s, KEEP grew out of multidimensional treatment foster care, a family-based alternative for teens with significant behavioral or mental health challenges. Multidimensional treatment foster care is an evidence-based practice that places children and teens in well-trained and supported foster families. The program developers sought to determine if the training and support features of multidimensional treatment foster care could be used with other foster and kinship families. In 1996, the first KEEP group was created.

Currently, the organization is planning how to take the project to scale in larger ways while maintaining program fidelity.

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