Understanding change among multi-problem families: Learnings from a formative program assessment.

This paper describes the implementation of a long-term voluntary intervention to prevent chronic maltreatment among multi-problem families with histories of child welfare involvement. A small formative evaluation included a limited number of interviews with program participants during the first year of program implementation (n=10), a retrospective case file review (n=17) of closed cases following the first three years of implementation, and notes from ongoing meetings and discussion with program staff. Findings regarding client engagement, long-term interaction between risk and services, and program refinement are discussed. Despite the program's voluntary nature, positive comments from families, and extensive engagement strategies, only about 22% of families remained engaged for the full two-year program. Material hardship was one of the most persistent risk factors from baseline to termination. In many cases, unforeseen negative events occurred that, at least partly, derailed progress. In all cases, progress made was not reflective of a consistent linear process used in the design of most child welfare programs. Implications for program theory and design are discussed.

Parent-Child Interaction Therapy in a Community Setting: Examining Outcomes, Attrition, and Treatment Setting.

OBJECTIVES: The purpose of this study was to evaluate Parent-Child Interaction Therapy (PCIT) deployed in a community setting comparing in-home with the standard office-based intervention. Child behavior, parent stress, parent functioning, and attrition were examined. METHODS: Using a quasi-experimental design, standardized measures at three time points were collected from parent-child dyads (n=120) with thirty-seven families completing treatment. RESULTS: Growth modeling analyses indicate significant improvements in child and parent outcomes in both treatment settings with more rapid improvements in parent outcomes within office-based treatment. Attrition was predicted by income and parent functioning. CONCLUSION: PCIT delivered in the community can produce measureable improvements. In-home PCIT is a feasible option but future research should consider benefits and costs. Treatment completion remains a challenge.