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Interventions to support care placement stability for looked-after children and young people
Evidence review A
NICE Guideline, No. 205
Interventions to support care placement stability in looked-after children and young people
Review question
- 1.1a.
What is the effectiveness of health and social care interventions and approaches to support care placement stability?
- 1.1b.
Are interventions to support placement stability acceptable and accessible to looked-after children and their care providers? What are the barriers to, and facilitators for the effectiveness of interventions to support placement stability?
Introduction
This review will consider interventions to support placement stability in children and young people who are looked after. In March 2018, 75,420 children and young people in England were looked after. Care placements for looked after children and young people may include: foster placement (73%), residential accommodation (including secure units, children’s homes, and semi-independent living arrangements) (11%), placement with birth parents (6%), placement for prospective adoption (3%), another placement in the community (4%), or placement in residential schools or other residential settings (3%). For looked after children and young people only 29% of placements are long term and 50% of long-term teenage placements have been found to break down. Placement break-down is associated with poor outcomes for looked-after children and young people. Interventions that support placement stability in looked-after children could help to improve a wide range of outcomes including educational, relational, and physical, mental, and emotional health and wellbeing.
Local authorities may use interventions to support placements (for example, parent training) in looked after children and young people, however there is uncertainty about which specific interventions work. The (2010) NICE guideline for looked-after children and young people did not include recommendations on specific interventions to support placement stability. A NICE surveillance review found new evidence that indicated recommendations on interventions to support placement stability in looked-after children might be needed.
Summary of protocol
PICO table
Table 1
PICO for review on interventions to support care placement stability in looked-after children and young people.
SPIDER table
Table 2
SPIDER table for review on interventions to support care placement stability in looked-after children and young people.
Methods and process
This evidence review was developed using the methods and process described in Developing NICE guidelines: the manual. For further details of the methods used see Appendix N. Methods specific to this review question are described in this section and in the review protocol in Appendix A.
The search strategies for this review (and across the entire guideline) are detailed in Appendix B.
Declarations of interest were recorded according to NICE’s 2018 conflicts of interest policy.
Effectiveness evidence
Included studies
The search for this review was part of a broader search for the whole guideline. After removing duplicates, a total of 36,866 studies were identified from the search. After screening these references based on their titles and abstracts, 181 studies were obtained and reviewed against the inclusion criteria as described in the review protocol for interventions to support placement stability (Appendix A). Overall, 25 studies, reporting on 21 original studies, were included. 156 references were excluded because they did not meet the eligibility criteria.
The evidence consisted of 13 randomised controlled trials, and 8 qualitative studies. See the table below for a summary of included studies. For the full evidence tables, see Appendix D. The full references of included studies are given in the reference section of this chapter. These articles considered 11 different interventions to support placement stability in school-aged looked-after children.
Excluded studies
See Appendix J for a list of references for excluded studies, with reasons for exclusion.
Summary of included studies
Quantitative Evidence
Table 3
Summary of included quantitative studies.
Qualitative Evidence
Table 4
Summary of included qualitative studies.
See Appendix D for full evidence tables
Summary of the evidence
Quantitative evidence
Evidence from 17 studies (and 13 original RCT studies) considered the effectiveness of interventions to support placement stability in looked-after children and young people.
Table 5
Summary GRADE table (Parent Management Training Oregon (PMTO) vs Care as Usual (CAU)) (Akin 2015/Maaskant 2017).
Table 6
Summary GRADE table (Multi-dimensional Treatment Foster Care for adolescents (MTFC-A) vs CAU) (Bergstrom 2016).
Table 7
Summary GRADE table (Family Group Decision Making (FGDM) vs CAU) (Berzin 2008).
Table 8
Summary GRADE table (Multi-dimensional Treatment Foster Care for preschoolers (MTFC-P) vs CAU) (Fisher 2011).
Table 9
Summary GRADE table (Middle School Success (MSS) vs CAU) (Kim 2011/2013).
Table 10
Summary GRADE table (Family Finding Intervention (FFI) vs CAU) (Landsman 2014/2016).
Table 11
Summary GRADE table (CBT-informed Parent Training Programme (CBT-PTP) vs CAU (Macdonald 2005).
Table 12
Summary GRADE table (Promoting First Relationships (PFR) vs Early Education Support (EES)) (Pasalich 2016/Spieker 2014).
Table 13
Summary GRADE table (KEEP foster parent training (KEEP) vs Training As Usual (TAU)) (Price 2008).
Table 14
Summary GRADE table (Fostering Healthy Futures (FHF) vs CAU) (Taussig 2012).
Table 15
Summary GRADE table (Social Learning Theory-based Training (SLT) vs CAU) (Van Holen 2017).
Table 16
Summary GRADE table (Non-Violent Resistance vs CAU) (Van Holen 2018).
See appendix F for full GRADE tables.
Qualitative evidence
Table 17
Summary CERQual table (Experience of practitioners delivering Parent Management Training Oregon).
Table 18
Summary CERQual table (Experience of foster care youth and conference facilitators undertaking Family Team Conferencing).
Table 19
Summary CERQual table (Experience of carers undertaking Treatment Foster Care).
Table 20
Summary CERQual table (Experience of carers, youth, and practitioners undertaking Multidimensional Treatment Foster Care).
Economic evidence
Included studies
A systematic review was conducted to cover all questions within this guideline update. The study selection diagram is available in Appendix G. The search returned 3,197 publications since 2000. Additionally, 29 publications were identified through reference tracking. After screening titles and abstracts 3 publications were considered for full text inspection but did not meet the inclusion criteria and were excluded from the evidence report. An updated search was conducted in November 2020 to identify any newly published papers. The search returned 584 publications. After screening titles and abstracts five publications were considered for full text inspection but did not meet the inclusion criteria and were excluded from the evidence report. Reasons for exclusion are summarised in Appendix J – Excluded studies.
Economic model
Interventions to support care placement stability (review question 1.1), positive relationships (review question 2.1), and physical, mental, and emotional health and wellbeing of LACYP (review question 3.2) were initially prioritised for economic modelling, as the committee agreed that they were likely to have important downstream consequences on the health-related quality of life of LACYP and utilisation of public sector resources. Additionally, initial evidence mapping in the Economic Plan indicated an overlap in RCT evidence for review questions 1.1, 2.1 and 3.2, hence an overarching model was planned to address all three review questions. However, review question 1.1 was only to be considered for inclusion within the overarching model if sufficient evidence was available to support the efficacy of any intervention in improving placement stability. Two studies with effectiveness evidence for interventions improving placement stability showed a positive effect on outcomes for the intervention, but those effects were noted as potentially less than the MID. Therefore, review question 1.1 could not be included in the planned overarching model. Further details of the planned overarching model and a costing analysis undertaken to support recommendations for review questions 2.1 and 3.2 are provided in the respective evidence reviews.
The committee’s discussion of the evidence
Interpreting the evidence
The outcomes that matter most
The committee considered the presented evidence on placement stability. The committee discussed the problematic follow-up times measured in some of the studies, for example, 6-months and 4-months was considered too short a length of time to adequately assess whether placement breakdown had or would occur. However, one of the significant differences observed was in a study which measured outcomes over a 6-month period (Akin 2015). Though a borderline (MD −0.30 95%CI −0.60 to −0.00) significant effect was observed in favour of the intervention group for this study, the committee expressed concern that observed effects could be due to a “honeymoon effect” whereby there is an initial positive response following the intervention, which drops off over time. Additionally, it was not clear in this study that outcomes and follow up time had been agreed a priori (e.g. no registered protocol was cited). While not unusual in the literature, this leaves open the possibility that results were selected for a certain timepoint that had significant differences between comparison groups.
The committee noted the difference between outcomes that measured the number of care placement moves vs those which measured the number of placement breakdowns (unplanned or for a negative reason such as foster carers being unable to cope). It was considered that, particularly in short-term foster care, placement moves may happen in a manner that is planned and in the best interests of the child, and therefore not a true adverse event.
Otherwise, the outcomes of interest for this question were narrowly defined and all related to changes in care placement situation. It was noted that the majority of outcomes were derived straight from electronic administrative records or social care records which tend to be less subjective, and, depending on record keeping, may have greater accuracy than self-reported or carer-reported outcomes.
It was considered that certain results of interest (outlined in the protocol) had not been reported, for example, absconding. However, one study (Price 2008) included child runaways in its definition of a negative exit from care.
The quality of the evidence
The committee noted that the majority of the evidence presented had not shown a significant impact of the intervention studied upon placement stability outcomes. However, when the wideness of the confidence intervals in several studies was taken into account, this was not necessarily strong evidence of lack of effect. In numerous studies, the number of placement moves or placement breakdowns that had occurred across the follow-up period was less than had been anticipated, and therefore trials were underpowered to detect a significant effect.
The “very serious” GRADE-rated risk of bias that was determined for the majority of reported outcomes was noted. This was largely because of the imprecision described above; indirectness as a result of studies being from non-UK countries; and study-level quality leading to an increased risk of bias.
The committee considered, as with other review questions, that looked after children in other countries experience care systems that are considerably distinct from the UK’s own. This particularly affects interpretation in studies that compared their intervention group to a “care as usual” group. In countries where the “usual” standard of care is considerably poorer than in the UK this could lead to the appearance of a considerable intervention effect that may not translate in the UK context. Additional areas of indirectness were apparent for a few selected studies which were in populations that may differ to the looked-after children in the UK. For example, certain studies considered youth offenders in the USA. In America, youth offenders may be mandated by a court to group home/residential care or multidimensional treatment foster care, often as a support to reunification with birth parents. It is unclear if this population are legally considered “ward of the state.”
Study level quality was also problematic. Frequent problems with study quality included considerable differences between comparison groups at baseline, lack of clarity about how randomisation was performed, large loss to follow up, lack of clarity regarding how much missing data (or for what reason data was missing), and a lack of clarity regarding a priori approach to analysis or study methods (e.g. use of per protocol or intent to treat approach).
Benefits and harms
The committee considered the interventions presented and their possible benefits/harms. Multidimensional treatment foster care (MTFC) was found to have no meaningful impact for number of placement disruptions over 12 months in pre-schoolers in foster care between the ages of 3 – 6 years (Fisher 2011). Other evidence in MTFC for adolescents could not differentiate an effect for the intervention.
Interventions considering training for caregivers of looked after children were considered, studies investigating Promoting First Relationships, KEEP foster parent training, Middle School Success, CBT-informed foster parent training, Social Learning Theory-based training, were unable to differentiate an effect for placement stability. However, one study that considered Parent Management Training Oregon compared to care as usual, found an improvement in placement instability rate (defined as (number of placements/days in foster care)*365) over 6 months follow up. For the reasons described above (use of “number of placements” and 6-month follow up) the committee did not consider this outcome to be a very convincing one. However, this intervention was discussed for its potential in UK practice. The committee thought that, broadly speaking, any training that provides skills in caregiver’s “therapeutic parenting” is likely to be a good thing in looked after children. However, since Parent Management Training Oregon was an intensive behavioural training intervention for use among children with serious emotional disturbance, they were keen to review the evidence for the usefulness of training programmes in promoting positive relationships before recommending under this review question.
The committee also had further questions about the population in which Parent Management Training Oregon was applied. This study considered participants between the ages of 3 – 16 years, in foster care, with serious emotional disturbance, where the child had a case plan goal of reunification, and caregivers resided in the area. The intervention appeared to be delivered to both foster carers and the birth family. Therefore, was it an intervention with greater relevance for promoting reunification after short-term placement? If so, the committee were also keen to see evidence from review question 5.1 on supporting movement out of care before recommending this intervention.
The committee considered the potential negative effects of training interventions and were concerned that these interventions should be trauma-informed. For example, applying time-outs (often recommended in behavioural management training) can be harmful for children with history of trauma. The committee were concerned that any training offered to caregivers should include emotional support training and not just behaviour management.
Finally, the committee pointed out that while this intervention may reduce the number of placement moves prior to (possible) reunification with birth parents, it was difficult to tell from the outcomes provided if the intervention was successful in preventing placement breakdown following reunification with the birth parents.
Next the committee considered the Fostering Healthy Futures intervention which was found to be significantly associated with a lower odds of negative placement change over 18-months observation period (OR 0.29 95%CI 0.09 to 0.98) among preadolescents in foster care. This was an intervention to improve skills in small groups of looked after children such as emotional recognition, problem solving, anger management, and healthy relationships. In addition, this intervention included a one-to-one mentoring component with graduate students in social work. The committee considered that the intervention was promising however that there were resource implications involved with skills training and mentoring, and that the evidence for this particular intervention was insufficient to merit a recommendation for the entire population under study (preadolescent children in foster care). The committee were not aware of socioemotional skills building interventions currently being used for LACYP in the UK. Instead, the committee suggested such interventions should be considered in response to the needs of the particular child. The committee wanted to revisit relational interventions, such as mentoring, after considering the results from review question 2.1 (interventions to support positive relationships) and review question 3.2 (interventions to support health and wellbeing).
Following the presentation and discussion of evidence, the committee made recommendations that were primarily-consensus based in the response to the lack of clear evidence about interventions and approaches to support care placement stability.
Regarding training, the committee did not wish to make any recommendations about the specific curriculum or methods used in the training provided to caregivers until the other review questions had been completed. However, the committee considered that carers (for example, foster carers) are often unaware of the kinds of interventions that a looked after child placed with them has received or should be practicing. In order to support continuity of care in this regard the committee recommended that carers should be included and informed about the contents and aims of interventions used to support placement stability in looked after children.
The committee also discussed how any training should be delivered. They recognised that, in practice, training - such as behaviour management training - is often delivered reactively, in response to difficulties that a carer is currently experiencing. This threatens placement stability since the carer may feel underprepared and under-supported to continue the placement. Instead, the committee advocated a greater emphasis on forward planning support for carers (prior to placement) based on the recognised and documented needs of the individual child. As well as considering what kinds of training may be necessary, the plan should also identify any other agencies that might need to be involved (for example, mental health) and additionally where the source of funding is likely to come from.
As part of the above process, the committee wanted to suggest some specific aspects of training that should be considered for proactive and planned support. Given the high prevalence of trauma in children in care, the committee suggested that the need for trauma-informed care training should be considered for all caregivers. Examples of the kinds of topics that might be covered in trauma-informed care training include: information about trauma and looking after LACYP with a history of trauma, managing of own emotions, and promoting resilience and self-regulatory skills.
Alongside trauma, the committee considered training for other issues that may commonly affect substitute caregivers and impact placement stability. The committee considered behaviour to be more complex an issue than simply “behaviour management” in LACYP. Rather behaviour may stem from issues relating to disorganised attachment, leading to emotional and social consequences. Caregivers will often need to offer sensitive and responsive care in response to difficult behaviour. For some LACYP, further consolidation may be helpful to support placement stability. For example, coaching, mentoring, or skills training. Therefore, the committee recommended therapeutic parenting training for all carers (encompassing attachment-informed, high support and high nurturing relational care) and further consolidation based on the bespoke needs of the child.
The committee also considered that no evidence had been presented on the use of respite for substitute caregivers. This was felt to be something of vital importance to offer caregivers needed rest and to prevent burnout and subsequent placement breakdown. It was noted that some caregivers may feel that their caregiving duties prevent them from ever going on holiday or travelling. Once again, the committee considered that respite should be offered in a planned and proactive manner, if offered reactively in response to crisis it may already be too late to prevent placement breakdown. In addition, whoever is providing care while the primary caregiver is receiving respite will need to have the skill set required to cope with the individual needs of the child. The committee were also conscious that the term respite may be received very negatively by LACYP (e.g. “my carer needs a break from me”). Therefore, respite care should be framed in as positive a light as possible. The committee encouraged the use of an alternative term (“support care”) for this reason. It is particularly helpful if respite is provided by a person with whom the LACYP is familiar to prevent the feeling that the child or young person is being “sent away”. The committee therefore recommended that planned and proactive (not reactive) respite care be used to support care placements, as part of the care plan, and considering skill set required for the respite carer to meet the child’s needs. Respite should be framed positively for the child and be in their best interest. Where possible, respite should be with a carer who is familiar to the child.
The committee considered that no evidence had been presented about interventions to support placement stability among looked after children and young people in residential care. Therefore, a research recommendation was drafted to encourage further research to fill this gap.
Cost effectiveness and resource use
No economic evidence was identified in relation to this review question, and overall, the committee felt that there was insufficient evidence of effectiveness in relation to costs to recommend any specific interventions for placement stability. However, the committee noted that the interventions captured in the evidence review, especially those taking place in the home, were often intensive and likely to incur substantial costs, but that placement breakdown can also result in high costs to the system. In the short term, placement breakdown leads to increased social care case management work and the need for additional placement arrangements, some of which will be high-cost emergency placements. In addition, placement instability can contribute to further disruption of LACYP’s social and emotional relationships, sense of belonging and educational outcomes, with long-term consequences that were not captured in randomised controlled trials.
The committee discussed that in current practice, behavioural management support is already offered for birth families by family support services in the UK but training for foster carers and other caregivers is more variable and the committee wished to make consensus-based recommendations about how training should be delivered to support placement stability. The committee discussed that in some local authorities, trauma-informed training and therapeutic parenting training for all foster carers is already part of current practice and that it would be desirable to reduce variation in practice across the country. While this is likely to incur additional costs in some areas, the committee felt that the costs would be partially offset by preventing placement breakdown. The committee noted that mandatory training schedules already exist for carers (particularly foster carers) and that the recommended training components could be incorporated into these sessions without the need for extra training capacity or the need to free up more time for carers to be able to participate in training. The committee acknowledged that this may require other areas of the existing training frameworks to be altered or removed, however the recommendations outline the most important elements that should be considered in training schedules for carers and should therefore be prioritised for inclusion over other training areas. Adjustments required to incorporate the recommended areas into existing training frameworks may also incur some administrative costs, but these were thought to be minimal and would be outweighed by the increased benefits achieved from reducing variation in training given to carers. The committee also agreed that there are freely available training resources on trauma-informed care, and that making these accessible and/or integrating them into existing training for carers would not have additional resource implications.
The committee also discussed the importance of support, including respite for carers. These recommendations are about how respite care should be done if it is going to be done (i.e. in a planned manner with better communication and a support carer who the looked after person is familiar with). Therefore, there shouldn’t be a significant additional cost beyond taking a more proactive approach to respite support arrangements.
The committee recognised that there was an additional set of recommendations for carers in the NICE guideline on supporting adult carers, and that these recommendations may be relevant for some carers of older looked-after children.
Research recommendations
What is the effectiveness of interventions to promote placement stability among looked-after children and young people in residential care?
This evidence review supports recommendations 1.3.4 to 1.3.6 and 1.3.8 to 1.3.12 and the research recommendation on placement stability in residential care. Other evidence supporting these recommendations can be found in the evidence review on barriers to, and facilitators for, supporting care placement stability among looked-after children and young people [review B]
References – included studies
- Akin, Becci A, Byers, Kaela D, Lloyd, Margaret H et al. (2015) Joining formative evaluation with translational science to assess an EBI in foster care: Examining social-emotional well-being and placement stability. Children and Youth Services Review 58: 253–264
- Bergström M, Höjman L. Is multidimensional treatment foster care (MTFC) more effective than treatment as usual in a three-year follow-up? Results from MTFC in a Swedish setting. European Journal of Social Work. 2016 Mar 3;19(2):219–35.
- Berzin, Stephanie Cosner, Cohen, Ed, Thomas, Karen et al. (2008) Does family group decision making affect child welfare outcomes? Findings from a randomized control study. Child welfare 87(4): 35–54 [PubMed: 19391466]
- Boel-Studt SM, Landsman MJ. Mixed methods study of the effectiveness of intensive family finding services with youth in congregate care. Journal of Public Child Welfare. 2017 Mar 15;11(2):190–210.
- Fisher, Philip A, Stoolmiller, Mike, Mannering, Anne M et al. (2011) Foster placement disruptions associated with problem behavior: mitigating a threshold effect. Journal of consulting and clinical psychology 79(4): 481–7 [PMC free article: PMC3334279] [PubMed: 21787051]
- Kim HK, Leve LD. Substance use and delinquency among middle school girls in foster care: A three-year follow-up of a randomized controlled trial. Journal of consulting and clinical psychology. 2011 Dec;79(6):740. [PMC free article: PMC3226884] [PubMed: 22004305]
- Kim HK, Pears KC, Leve LD, Chamberlain P, Smith DK. Intervention effects on health-risking sexual behavior among girls in foster care: The role of placement disruption and tobacco and marijuana use. Journal of child & adolescent substance abuse. 2013 Nov 1;22(5):370–87. [PMC free article: PMC3772734] [PubMed: 24043921]
- Landsman MJ, Boel-Studt S, Malone K. Results from a family finding experiment. Children and Youth Services Review. 2014 Jan 1;36:62–9.
- Lynch, Frances L, Dickerson, John F, Saldana, Lisa et al. (2014) Incremental net benefit of early intervention for preschool-aged children with emotional and behavioral problems in foster care. Children and Youth Services Review 36: 213–219 [PMC free article: PMC5663296] [PubMed: 29097828]
- Maaskant, Anne M, van Rooij, Floor B, Overbeek, Geertjan J et al. (2017) Effects of PMTO in foster families with children with behavior problems: A randomized controlled trial. Journal of Child and Family Studies 26(2): 523–539 [PMC free article: PMC5272898] [PubMed: 28190946]
- Macdonald G, Turner W. An experiment in helping foster-carers manage challenging behaviour. British Journal of Social Work. 2005 Aug 15;35(8):1265–82.
- Pasalich, Dave S, Fleming, Charles B, Oxford, Monica L et al. (2016) Can Parenting Intervention Prevent Cascading Effects From Placement Instability to Insecure Attachment to Externalizing Problems in Maltreated Toddlers?. Child maltreatment 21(3): 175–85 [PMC free article: PMC5131711] [PubMed: 27381935]
- Price, Joseph M, Chamberlain, Patricia, Landsverk, John et al. (2008) Effects of a foster parent training intervention on placement changes of children in foster care. Child maltreatment 13(1): 64–75 [PMC free article: PMC2441918] [PubMed: 18174349]
- Spieker, Susan J, Oxford, Monica L, Fleming, Charles B et al. (2014) Permanency outcomes for toddlers in child welfare two years after a randomized trial of a parenting intervention. Children and Youth Services Review 44: 201–206 [PMC free article: PMC4128499] [PubMed: 25125769]
- Taussig HN, Culhane SE, Garrido E, Knudtson MD. RCT of a mentoring and skills group program: Placement and permanency outcomes for foster youth. Pediatrics. 2012 Jul 1;130(1):e33–9. [PMC free article: PMC3382920] [PubMed: 22689870]
- Taussig, Heather N; Culhane, Sara E; Garrido, Edward; Knudtson, Michael D; RCT of a mentoring and skills group program: placement and permanency outcomes for foster youth.; Pediatrics; 2012; vol. 130 (no. 1); e33–9 [PMC free article: PMC3382920] [PubMed: 22689870]
- Van Holen, Frank, Vanschoonlandt, Femke, Vanderfaeillie, Johan et al. (2017) Evaluation of a foster parent intervention for foster children with externalizing problem behaviour. Child & Family Social Work 22(3): 1216–1226
- Van Holen, Frank; Vanderfaeillie, Johan; Omer, Haim; Vanschoonlandt, Femke; Training in nonviolent resistance for foster parents: A randomized controlled trial.; Research on Social Work Practice; 2018; vol. 28 (no. 8); 931–942
- Akin, Becci A; Mariscal, Susana E; Bass, Linda; McArthur, Vickie Burgess; Bhattarai, Jackie; Bruns, Kimberly; Implementation of an evidence-based intervention to reduce long-term foster care: Practitioner perceptions of key challenges and supports.; Children and Youth Services Review; 2014; vol. 46; 285–293
- Augsberger, Astraea; Strategies for engaging foster care youth in permanency planning family team conferences.; Children and Youth Services Review; 2014; vol. 43; 51–57
- Castellanos-Brown, Karen; Lee, Bethany; Transitioning foster youth to less restrictive settings: Perspectives of treatment foster parents.; Families in Society; 2010; vol. 91 (no. 2); 142–148
- Frederico, Margarita; Long, Maureen; McNamara, Patricia; McPherson, Lynne; Rose, Richard; Improving outcomes for children in out-of-home care: The role of therapeutic foster care.; Child & Family Social Work; 2017; vol. 22 (no. 2); 1064–1074
- KIRTON Derek; THOMAS Cliff; A suitable case? Implementing multidimensional treatment foster care in an English local authority; Adoption and Fostering; 2011; vol. 35 (no. 2); 5–17
- McMillen J.C.; Narendorf S.C.; Robinson D.; Havlicek J.; Fedoravicius N.; Bertram J.; McNelly D.; Development and piloting of a treatment foster care program for older youth with psychiatric problems; Child and Adolescent Psychiatry and Mental Health; 2015; vol. 9 (no. 1); 23 [PMC free article: PMC4504401] [PubMed: 26185524]
- Lee, Bethany R; Phillips, Danielle R; Steward, Rochon K; Kerns, Suzanne E. U; Equipping tfc parents as treatment providers: Findings from expert interviews.; Journal of Child and Family Studies; 2020; no-specified
- TULLBERG, Erika; et al; Unpacking “support”: understanding the complex needs of therapeutic foster parents; Children and Youth Services Review; 2019; vol. 105; 104420
Quantitative studies
Qualitative evidence
Cost effectiveness
No cost-effectiveness evidence identified for this review question
Appendices
Appendix A. Review protocols
Review protocol for interventions to support placement stability for looked-after children and young people (PDF, 293K)
Appendix B. Literature search strategies
Effectiveness searches (PDF, 537K)
Cost-effectiveness searches (PDF, 496K)
Appendix C. Evidence study selection
Download PDF (141K)
Appendix E. Forest plots
No forest plots were produced for this review question as meta-analysis was not attempted.
Appendix G. Economic evidence study selection
Download PDF (145K)
Appendix H. Economic evidence tables
No economic evidence was identified for this review question.
Appendix I. Health economic model
No economic modelling was undertaken for this review question.
Appendix J. Excluded studies
Effectiveness studies
| Study | Code [Reason] |
|---|---|
| AKIN Becci A. and et al (2018) Randomized study of PMTO in foster care. Research on Social Work Practice 28(8): 810–826 | - No outcomes of interest under this review question |
| Akin, Becci A, Yan, Yueqi, McDonald, Thomas et al. (2017) Changes in parenting practices during Parent Management Training Oregon model with parents of children in foster care. Children and Youth Services Review 76: 181–191 |
- No outcome of interest reported [Only carer-specific outcomes reported] |
| Armour, Marilyn P and Schwab, James (2005) Reintegrating Children into the System of Substitute Care: Evaluation of the Exceptional Care Pilot Project. Research on Social Work Practice 15(5): 404–417 |
- Non-UK - Uncontrolled before and after study |
| Banerjee, Leena and Castro, Lorraine E (2005) Intensive day treatment for very young traumatized children in residential care. The handbook of training and practice in infant and preschool mental health.: 233–255 | - Intervention description/practice report |
| Barth, Richard P, Greeson, Johanna K P, Guo, Shenyang et al. (2007) Outcomes for youth receiving intensive in-home therapy or residential care: a comparison using propensity scores. The American journal of orthopsychiatry 77(4): 497–505 [PubMed: 18194029] |
- Unclear that population are LACYP [Services to treat behaviourally troubled but not necessarily looked after children. Only a third had maltreatment as a presenting problem. Study compared residential treatment with parent involved and intensive in-home services] |
| BARTLETT Jessica Dym and RUSHOVICH Berenice (2018) Implementation of Trauma Systems Therapy-Foster Care in child welfare. Children and Youth Services Review 91: 30–38 |
- Non-UK - non-randomised controlled study |
| Barto B., Bartlett J.D., Von Ende A. et al. (2018) The impact of a statewide trauma-informed child welfare initiative on children’s permanency and maltreatment outcomes. Child Abuse and Neglect 81: 149–160 [PubMed: 29739000] |
- non-randomised controlled study - non-UK |
| Belanger, Kathleen and Stone, Warren (2008) The social service divide: service availability and accessibility in rural versus urban counties and impact on child welfare outcomes. Child welfare 87(4): 101–24 [PubMed: 19391469] | - No outcome of interest to this review question |
| Benesh, Andrew S and Cui, Ming (2017) Foster parent training programmes for foster youth: A content review. Child & Family Social Work 22(1): 548–559 | - Systematic review considered for relevant references |
| BERGSTROM, Martin and et al (2020) Interventions in foster family care: a systematic review. Research on Social Work Practice 30(1): 3–18 | - Systematic review considered for relevant references |
| BERRY Marianne and et al (2000) Intensive family preservation services: an examination of critical service components. Child and Family Social Work 5(3): 191–203 |
- Unclear that population are LACYP [Families who are served by the Intensive Family Preservation programme who are believed to be at imminent risk of having the child removed from the home.] |
| Biehal, Nina (2005) Working with adolescents at risk of out of home care: The effectiveness of specialist teams. Children and Youth Services Review 27(9): 1045–1059 |
- Unclear that population are LACYP [at risk of out of home placement] |
| Biehal, Nina, Ellison, Sarah, Sinclair, Ian et al. (2011) Intensive fostering: An independent evaluation of MTFC in an English setting. Children and Youth Services Review 33(10): 2043–2049 | - No outcome of interest to this review question |
| Boel-Studt, Shamra Marie (2017) A quasi-experimental study of trauma-informed psychiatric residential treatment for children and adolescents. Research on Social Work Practice 27(3): 273–282 | - No outcome of interest to this review question |
| Brook, Jody and McDonald, Thomas P (2007) Evaluating the effects of comprehensive substance abuse intervention on successful reunification. Research on Social Work Practice 17(6): 664–673 | - No outcome of interest to this review question |
| Brown, Adam D, McCauley, Kelly, Navalta, Carryl P et al. (2013) Trauma Systems Therapy in residential settings: Improving emotion regulation and the social environment of traumatized children and youth in congregate care. Journal of Family Violence 28(7): 693–703 [PMC free article: PMC3782637] [PubMed: 24078769] |
- Non-UK - Uncontrolled before and after study |
| BULLOCK Roger (2016) Can we plan services for children in foster care? Or do we just have to cope with what comes through the door?. Social Work and Society: International Online Journal 14(2) |
- Intervention description/practice report - Case study |
| Chamberlain, Patricia (2003) Antisocial behavior and delinquency in girls. Treating chronic juvenile offenders: Advances made through the Oregon multidimensional treatment foster care model.: 109–127 | - Book |
| Chamberlain, Patricia, Brown, C Hendricks, Saldana, Lisa et al. (2008) Engaging and recruiting counties in an experiment on implementing evidence-based practice in California. Administration and policy in mental health 35(4): 250–60 [PMC free article: PMC2562896] [PubMed: 18302015] |
- No outcome of interest reported [meta-research] |
| Chamberlain, Patricia and Smith, Dana K (2003) Antisocial behavior in children and adolescents: The Oregon Multidimensional Treatment Foster Care model. Evidence-based psychotherapies for children and adolescents.: 282–300 | - Review article but not a systematic review |
| Chamberlain, Patricia and Smith, Dana K (2005) Multidimensional Treatment Foster Care: A Community Solution for Boys and Girls Referred From Juvenile Justice. Psychosocial treatments for child and adolescent disorders: Empirically based strategies for clinical practice., 2nd ed.: 557–573 | - Book |
| CHAN Ko, Ling and et al (2019) The effectiveness of interventions for grandparents raising grandchildren: a meta-analysis. Research on Social Work Practice 29(6): 607–617 | - Systematic review |
| Chinitz, Susan, Guzman, Hazel, Amstutz, Ellen et al. (2017) Improving outcomes for babies and toddlers in child welfare: A model for infant mental health intervention and collaboration. Child abuse & neglect 70: 190–198 [PubMed: 28622589] |
- non-UK - uncontrolled before and after study |
| Chor, Ka Ho Brian, McClelland, Gary M, Weiner, Dana A et al. (2013) Patterns of out-of-home placement decision-making in child welfare. Child abuse & neglect 37(10): 871–82 [PubMed: 23768934] | - No outcome of interest reported |
| Christenson, Brian L and McMurtry, Jerry (2009) A longitudinal evaluation of the preservice training and retention of kinship and nonkinship foster/adoptive families one and a half years after training. Child welfare 88(4): 5–22 [PubMed: 20405775] |
- No outcome of interest reported [Caregiver knowledge test following training] - Non-UK setting |
| Christenson, Brian and McMurtry, Jerry (2007) A comparative evaluation of preservice training of kinship and nonkinship foster/adoptive families. Child welfare 86(2): 125–40 [PubMed: 17533776] |
- No outcome of interest reported [Caregiver knowledge test following training] - Non-UK setting |
| Christiansen, Oivin, Havik, Toril, Anderssen, Norman et al. (2010) Arranging stability for children in long-term out-of-home care. Children and Youth Services Review 32(7): 913–921 |
- non-UK - for consideration under RQ1.2 |
| Clark, Hewitt B, Crosland, Kimberly A, Geller, David et al. (2008) A functional approach to reducing runaway behavior and stabilizing placements for adolescents in foster care. Research on Social Work Practice 18(5): 429–441 |
- non-UK - non-randomised controlled study |
| Cole, Susan A and Hernandez, Pedro M (2011) Crisis nursery effects on child placement after foster care. Children and Youth Services Review 33(8): 1445–1453 | - No outcome of interest reported |
| COOLEY Morgan, E. and et al (2019) A systematic review of foster parent preservice training. Children and Youth Services Review 107: 104552 | - systematic review |
| Critelli, Filomena M (2008) Labor of love: foster mothers, caregiving, and welfare reform. Child welfare 87(4): 5–34 [PubMed: 19391465] |
- Not an intervention of interest [Open ended survey questions regarding foster mother’s views of welfare reform in America.] |
| Cross, Theodore P, Leavey, Joseph, Mosley, Peggy R et al. (2004) Outcomes of specialized foster care in a managed child welfare services network. Child welfare 83(6): 533–64 [PubMed: 15636394] | - No outcome of interest reported |
| D’Andrade, Amy, Frame, Laura, Berrick, Jill Duerr et al. (2006) Concurrent planning in public child welfare agencies: Oxymoron or work in progress?. Children and Youth Services Review 28(1): 78–95 |
- non-UK - for consideration under RQ1.2 |
| Davies, Philippa, Webber, Martin, Briskman, Jacqueline A et al. (2015) Evaluation of a training programme for foster carers in an independent fostering agency. Practice: Social Work in Action 27(1): 35–49 | - No outcome of interest reported |
| Davis, Cynthia W, O’Brien, Kirk, Rogg, Carla S et al. (2013) 24-month update on the impact of roundtables on permanency for youth in foster care. Children and Youth Services Review 35(12): 2128–2134 |
- No outcome of interest reported [prediction of the success of an intervention, plus descriptive outcomes (noncomparative)] |
| DeGarmo, David S, Chamberlain, Patricia, Leve, Leslie D et al. (2009) Foster parent intervention engagement moderating child behavior problems and placement disruption. Research on Social Work Practice 19(4): 423–433 [PMC free article: PMC2804998] [PubMed: 20072708] |
- Not an investigation of an intervention [analysis of factors predicting success of an intervention] |
| Denby, Ramona W (2011) Kinship liaisons: A peer-to-peer approach to supporting kinship caregivers. Children and Youth Services Review 33(2): 217–225 | - No outcome of interest to this review question |
| DeSena, Allen D, Murphy, Robert A, Douglas-Palumberi, Heather et al. (2005) SAFE Homes: is it worth the cost? An evaluation of a group home permanency planning program for children who first enter out-of-home care. Child abuse & neglect 29(6): 627–43 [PubMed: 15979706] |
- non-UK - NRCT |
| Eddy, J. Mark, Whaley, Rachel Bridges, Chamberlain, Patricia et al. (2004) The Prevention of Violent Behavior by Chronic and Serious Male Juvenile Offenders: A 2-Year Follow-up of a Randomized Clinical Trial. Journal of Emotional and Behavioral Disorders 12(1): 2–8 | - No outcome of interest to this review question |
| Edwards, M (2005) Evaluation of the application of the “Incredible Years” programme with foster carers of looked after children in Gwynedd.: 43pp | - controlled trial abstract |
| Farmer, Elizabeth M. Z, Wagner, H. Ryan, Burns, Barbara J et al. (2003) Treatment foster care in a system of care: Sequences and correlates of residential placements. Journal of Child and Family Studies 12(1): 11–25 | - No outcome of interest to this review question |
| Feldman, Leonard H and Fertig, Amanda (2013) Measuring the impact of enhanced kinship navigator services for informal kinship caregivers using an experimental design. Child welfare 92(6): 41–62 [PubMed: 26030980] |
- Unclear that population are LACYP [informal kinship care excluding children with an open case with the child welfare agency] |
| Fisher, Philip A; Burraston, Bert; Pears, Katherine (2005) The early intervention foster care program: permanent placement outcomes from a randomized trial. Child maltreatment 10(1): 61–71 [PubMed: 15611327] |
- No outcome of interest to this review question - to be considered under RQ5.1 |
| Fisher, Philip A and Chamberlain, Patricia (2000) Multidimensional treatment foster care: A program for intensive parenting, family support, and skill building. Journal of Emotional and Behavioral Disorders 8(3): 155–164 | - Review article but not a systematic review |
| Fisher, Philip A and Chamberlain, Patricia (2001) Multidimensional treatment foster care: A program for intensive parenting, family support, and skill building. Making schools safer and violence free: Critical issues, solutions, and recommended practices.: 140–149 | - Duplicate reference |
| Fisher, Philip A, Kim, Hyoun K, Pears, Katherine C et al. (2009) Effects of multidimensional treatment foster care for preschoolers (MTFC-P) on reducing permanent placement failures among children with placement instability. Children and Youth Services Review 31(5): 541–546 [PMC free article: PMC2678807] [PubMed: 19430545] |
- No outcome of interest to this review question - to be considered under RQ5.1 |
| Frederico, Margarita, Long, Maureen, McNamara, Patricia et al. (2017) Improving outcomes for children in out-of-home care: The role of therapeutic foster care. Child & Family Social Work 22(2): 1064–1074 |
-non-UK -Non-randomised controlled trial -to be considered under RQ1.2 |
| Gilbertson, Robyn, Richardson, David, Barber, James et al. (2005) The Special Youth Carer Program: An Innovative Program for At-Risk Adolescents in Foster Care. Child & Youth Care Forum 34(1): 75–89 |
- non-UK - uncontrolled before and after study |
| Greeno, Elizabeth J, Lee, Bethany R, Uretsky, Mathew C et al. (2016) Effects of a foster parent training intervention on child behavior, caregiver stress, and parenting style. Journal of Child and Family Studies 25(6): 1991–2000 |
- non-UK - non-randomised controlled trial |
| Greeno, Elizabeth J, Uretsky, Mathew C, Lee, Bethany R et al. (2016) Replication of the KEEP foster and kinship parent training program for youth with externalizing behaviors. Children and Youth Services Review 61: 75–82 |
- non-UK - uncontrolled before and after study |
| Greenwood, Peter W (2004) Cost-effective violence prevention through targeted family interventions. Annals of the New York Academy of Sciences 1036: 201–14 [PubMed: 15817739] | - Review article but not a systematic review |
| Hahn, Robert A, Lowy, Jessica, Bilukha, Oleg et al. (2004) Therapeutic foster care for the prevention of violence: a report on recommendations of the Task Force on Community Preventive Services. MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports 53(rr10): 1–8 [PubMed: 15229410] | - systematic review checked for relevant citations |
| Hawkins, Catherine A and Bland, Tammy (2002) Program evaluation of the CREST project: empirical support for kinship care as an effective approach to permanency planning. Child welfare 81(2): 271–92 [PubMed: 12014469] |
- Comparator in study does not match that specified in protocol [noncomparative/descriptive data] |
| HERBERT Martin and WOOKEY Jenny (2007) The Child Wise Programme: a course to enhance the self-confidence and behaviour management skills of foster carers with challenging children. Adoption and Fostering 31(4): 27–37 |
- UK study - for consideration under RQ1.2 |
| Hermenau, Katharin, Goessmann, Katharina, Rygaard, Niels Peter et al. (2017) Fostering Child Development by Improving Care Quality: A Systematic Review of the Effectiveness of Structural Interventions and Caregiver Trainings in Institutional Care. Trauma, violence & abuse 18(5): 544–561 [PubMed: 27075337] | - No outcome of interest to this review question |
| Herrman, Helen, Humphreys, Cathy, Halperin, Stephen et al. (2016) A controlled trial of implementing a complex mental health intervention for carers of vulnerable young people living in out-of-home care: the ripple project. BMC psychiatry 16(1): 436 [PMC free article: PMC5142401] [PubMed: 27927174] |
- No outcome of interest reported [feasibility outcomes] |
| Hine, Kathleen M and Moore, Kevin J (2015) Family Care Treatment for dispersed populations of children with behavioral challenges: The design, implementation, and initial outcomes of an evidence-informed treatment. Children and Youth Services Review 58: 179–186 | - No outcome of interest to this review question |
| Holmes, Lisa, Ward, Harriet, McDermid, Samantha et al. (2012) Calculating and comparing the costs of multidimensional treatment foster care in English local authorities. Children and Youth Services Review 34(11): 2141–2146 | - No outcome of interest to this review question |
| Howard, Jeanne A, Smith, Susan Livingston, Zosky, Diane L et al. (2006) A Comparison of Subsidized Guardianship and Child Welfare Adoptive Families Served by the Illinois Adoption and Guardianship Preservation Program. Journal of Social Service Research 32(3): 123–134 |
- Not an intervention of interest [subsidized guardianship vs adoption] |
|
ISRCTN16401432 (2007) Efficacy of a multicomponent support programme for caregivers of disabled persons: a randomised controlled study. Http://www | - Unclear that population are LACYP |
|
ISRCTN19090228 (2017) Confidence in Care Evaluation. Http://www | - trial registration |
|
ISRCTN80786829 (2016) Supporting looked after children and care leavers in decreasing drugs and alcohol. Http://www | - trial registration |
| Izzo, Charles V, Smith, Elliott G, Holden, Martha J et al. (2016) Intervening at the setting level to prevent behavioral incidents in residential child care: Efficacy of the CARE program model. Prevention Science 17(5): 554–564 [PMC free article: PMC4887550] [PubMed: 27138932] |
- non-UK - interrupted time series |
| Jani, Jayshree S (2017) Reunification is not enough: Assessing the needs of unaccompanied migrant youth. Families in Society 98(2): 127–136 | - No outcome of interest to this review question |
| Jayasekara, Rasika (2013) Kinship care for the safety, permanency, and well-being of children removed from the home for maltreatment. Child health and human development yearbook, 2011.: 269–272 | - Not an intervention of interest |
| Johnson, Kristen and Wagner, Dennis (2005) Evaluation of Michigan’s Foster Care Case Management System. Research on Social Work Practice 15(5): 372–380 | - No outcome of interest to this review question |
| Jones, Barry (2008) The price of permanency: Cost-benefit analysis of a psychosocial intervention for children and families. Therapeutic Communities 29(2): 142–159 | - No outcome of interest to this review question |
| Jones, Christopher D, Lowe, Laura A, Risler, Edwin A et al. (2004) The Effectiveness of Wilderness Adventure Therapy Programs for Young People Involved in the Juvenile Justice System. Residential Treatment for Children & Youth 22(2): 53–62 |
- Unclear that population are LACYP [juvenile offenders] |
| Jones, Loring, Landsverk, John, Roberts, Ann et al. (2007) A comparison of two caregiving models in providing continuity of care for youth in residential care. Child & Youth Care Forum 36(23): 99–109 | - No outcome of interest to this review question |
| Jonkman, Caroline S, Schuengel, Carlo, Oosterman, Mirjam et al. (2017) Effects of Multidimensional Treatment Foster Care for Preschoolers (MTFC-P) for young foster children with severe behavioral disturbances. Journal of Child and Family Studies 26(5): 1491–1503 [PMC free article: PMC5387023] [PubMed: 28458502] | - No outcome of interest to this review question |
| Kerr, David C R; Leve, Leslie D; Chamberlain, Patricia (2009) Pregnancy rates among juvenile justice girls in two randomized controlled trials of multidimensional treatment foster care. Journal of consulting and clinical psychology 77(3): 588–93 [PMC free article: PMC2706574] [PubMed: 19485598] | - No outcome of interest to this review question |
| Kim, Jangmin, Trahan, Mark, Bellamy, Jennifer et al. (2019) Advancing the innovation of family meeting models: The role of teamwork and parent engagement in improving permanency. Children and Youth Services Review 100: 147–155 | - No outcome of interest to this review question |
| KIRBY Stuart and MIIDLEHAM Neil (2005) Reducing misery and saving money - how partners can make a difference in reducing the incidence of young runaways. Community Safety Journal 4(4): 10–13 |
- Intervention description/practice report - Unclear that population are LACYP - Data not reported in an extractable format |
| Klein, Sacha, Fries, Lauren, Emmons, Mary M et al. (2017) Early care and education arrangements and young children’s risk of foster placement: Findings from a National Child Welfare Sample. Children and Youth Services Review 83: 168–178 | - No outcome of interest to this review question |
| Koh, Eun, Rolock, Nancy, Cross, Theodore P et al. (2014) What explains instability in foster care? Comparison of a matched sample of children with stable and unstable placements. Children and Youth Services Review 37: 36–45 | - Not an investigation of an intervention |
| Koh, Eun and Testa, Mark F (2011) Children discharged from kin and non-kin foster homes: Do the risks of foster care re-entry differ?. Children and Youth Services Review 33(9): 1497–1505 | - Not an investigation of an intervention |
| Kohli, Ravi K. S (2006) The comfort of strangers: Social work practice with unaccompanied asylum-seeking children and young people in the UK. Child & Family Social Work 11(1): 1–10 |
- No outcome of interest to this review question - to be considered under RQ1.2 |
| Koob, Jeffrey J and Love, Susan M (2010) The implementation of solution-focused therapy to increase foster care placement stability. Children and Youth Services Review 32(10): 1346–1350 |
- non-UK - uncontrolled before and after study |
| Laan N.M.A., Loots G.M.R., Janssen C.G.C. et al. (2001) Foster care for children with mental retardation and challenging behaviour: A follow-up study. British Journal of Developmental Disabilities 47(1): 3–13 |
- Comparator in study does not match that specified in protocol [non-comparative] |
| Landsman, M J, Groza, V, Tyler, M et al. (2001) Outcomes of family-centered residential treatment. Child welfare 80(3): 351–79 [PubMed: 11380046] |
- non-UK - non-randomised controlled trial |
| Landsman, Miriam J, Thompson, Kathy, Barber, Gail et al. (2003) Using Mediation to Achieve Permanency for Children and Families. Families in Society 84(2): 229–239 |
- No outcome of interest reported [descriptive (non-comparative) outcomes reported] |
| Lardner, Mark D (2015) Are restrictiveness of care decisions based on youth level of need? A multilevel model analysis of placement levels using the child and adolescent needs and strengths assessment. Residential Treatment for Children & Youth 32(3): 195–207 |
- No outcome of interest reported [study reports on the relationship between initial need and restrictiveness of placement] |
| LARZELERE Robert E. and et al (2001) Outcomes of residential treatment: a study of the adolescent clients of girls and boys town. Child and Youth Care Forum 30(3): 175–185 |
- Data not reported in an extractable format [no measure of spread reported] |
| Lawson, Kate and Cann, Robert (2019) State of the nation’s foster care: full report.: 42 |
- No outcome of interest to this review question - to be considered under RQ1.2 |
| Lee, Bethany R and Thompson, Ron (2008) Comparing outcomes for youth in treatment foster care and family-style group care. Children and Youth Services Review 30(7): 746–757 [PMC free article: PMC2515489] [PubMed: 19122763] | - No outcome of interest to this review question |
| Lee, Linda J (2011) Adult visitation and permanency for children following residential treatment. Children and Youth Services Review 33(7): 1288–1297 | - Not an investigation of an intervention |
| LEHMAN Constance M.; LIANG Shu; O’DELL KIRSTIN (2005) Impact of flexible funds on placement and permanency outcomes for children in child welfare. Research on Social Work Practice 15(5): 381–388 |
- non-UK - non-randomised controlled trial |
| Leon, Scott C, Saucedo, Deborah J, Jachymiak, Kristin et al. (2016) Keeping it in the family: The impact of a Family Finding intervention on placement, permanency, and well-being outcomes. Children and Youth Services Review 70: 163–170 | - No outcome of interest to this review question |
| Leve, Leslie D; Chamberlain, Patricia; Reid, John B (2005) Intervention outcomes for girls referred from juvenile justice: effects on delinquency. Journal of consulting and clinical psychology 73(6): 1181–5 [PMC free article: PMC1904478] [PubMed: 16392991] | - No outcome of interest to this review question |
| Leve, Leslie D; Fisher, Philip A; Chamberlain, Patricia (2009) Multidimensional treatment foster care as a preventive intervention to promote resiliency among youth in the child welfare system. Journal of personality 77(6): 1869–902 [PMC free article: PMC2787781] [PubMed: 19807861] |
- Review article but not a systematic review - Intervention description/practice report |
| Littlewood, Kerry (2015) Kinship Services Network Program: Five year evaluation of family support and case management for informal kinship families. Children and Youth Services Review 52: 184–191 |
- Unclear that population are LACYP [informal kinship care (not in child welfare system)] |
| Littlewood, K.; Cooper, L.; Pandey, A. (2020) Safety and placement stability for the Children’s Home Network kinship navigator program. Child Abuse and Neglect 106: 104506 [PubMed: 32480103] | - large proportion were informal kinship care and adoption - “The results suggest that CHN-KN kept children safe and out of the formal child welfare system” 62% had no involvement with child welfare services |
| LITZELFELNER Pat (2000) The effectiveness of CASAs in achieving positive outcomes for children. Child Welfare Journal 79(2): 179–193 [PubMed: 10732258] |
- non-UK - non-randomised controlled trial |
| MADDEN Elissa E. and AGUINIGA Donna M. (2013) An evaluation of permanency outcomes of child protection mediation. Journal of Public Child Welfare 7(1): 98–121 | - No outcome of interest to this review question |
| Mapp, Susan C and Steinberg, Cache (2007) Birthfamilies as permanency resources for children in long-term foster care. Child welfare 86(1): 29–51 [PubMed: 17408009] | - Case series |
| McDaniel, Benny, Braiden, Hannah Jane, Onyekwelu, June et al. (2011) Investigating the effectiveness of the incredible years basic parenting programme for foster carers in Northern Ireland. Child Care in Practice 17(1): 55–67 | - No outcome of interest to this review question |
| McKee, Jeanne; Storrs, Jodi; Humphrey, Stewart (2007) Creating a continuum of care for chronically underserved children. Joint Commission journal on quality and patient safety 33(4): 200–4 [PubMed: 17441557] | - |
| Melius, Patience, Swoszowski, Nicole Cain, Siders, Jim et al. (2015) Developing peer led check-in/check-out: A peer-mentoring program for children in residential care. Residential Treatment for Children & Youth 32(1): 58–79 | - No outcome of interest to this review question |
| Mersky, Joshua P, Topitzes, James, Janczewski, Colleen E et al. (2015) Enhancing foster parent training with parent-child interaction therapy: Evidence from a randomized field experiment. Journal of the Society for Social Work and Research 6(4): 591–616 [PMC free article: PMC4788597] [PubMed: 26977251] | - No outcome of interest to this review question |
| Muela, Alexander, Balluerka, Nekane, Amiano, Nora et al. (2017) Animal-assisted psychotherapy for young people with behavioural problems in residential care. Clinical psychology & psychotherapy 24(6): o1485–o1494 [PubMed: 28730756] | - No outcome of interest to this review question |
| Murphy, Kelly, Moore, Kristin Anderson, Redd, Zakia et al. (2017) Trauma-informed child welfare systems and children’s well-being: A longitudinal evaluation of KVC’s bridging the way home initiative. Children and Youth Services Review 75: 23–34 |
- non-UK - interrupted time series |
| Nash, Jordanna and Flynn, Robert J (2009) Foster-parent training and foster-child outcomes: An exploratory cross-sectional analysis. Vulnerable Children and Youth Studies 4(2): 128–134 | - cross-sectional (association) study |
|
NCT00339365 (2006) Promoting Infant Mental Health in Foster Care. Https: | - trial registration |
|
NCT00701194 (2008) Early Intervention Foster Care: a Prevention Trial. Https: | - trial registration |
|
NCT00810056 (2008) Fostering Healthy Futures Efficacy Trial for Preadolescent Youth in Foster Care. Https: | - trial registration |
|
NCT00980512 (2009) Community Implementation of KEEP: fidelity and Generalization of Parenting. Https: | - trial registration |
|
NCT01726361 (2012) Multidimensional Treatment Foster Care for Adolescents. Https: | - trial registration |
|
NCT02220179 (2014) Resilience for Children and Young People in Foster Care and Residential Care in Denmark. Https: | - trial registration |
| No authorship indicated (2008) Review of Effects of a foster care parent training intervention on placement changes of children in foster care. Journal of Developmental and Behavioral Pediatrics 29(4): 328 | - Review article but not a systematic review |
|
NTR4271 (2013) Supporting foster families with a hogh risk on unplanned termination of foster child placements. Http://www | - Trial registration |
|
NTR4282 (2013) Supporting foster families with a high risk on unplanned termination. A Randomized Controlled Trial study (RCT) of Parent Management Training Oregon (PMTO). Http://www | - Trial registration |
| NUGENT William Robert and ELY Gretchen (2010) The effects of aggression replacement training on periodicities in antisocial behavior in a residential facility for adolescents. Journal of the Society for Social Work and Research 1(3): 140–2010 |
- Unclear that population are LACYP [At-risk youth and their families. 55% were in custody of their parent.] |
| Owens-Kane, Sandra (2006) Respite care:outcomes for kinship and non-kinship caregivers. Journal of health & social policy 22(34): 85–99 [PubMed: 17855240] |
- non-UK - uncontrolled before and after study |
| PALLETT Clare and et al (2002) Fostering changes: a cognitive-behavioural approach to help foster carers manage children. Adoption and Fostering 26(1): 39–48 | - No outcome of interest to this review question |
| Pelech, William, Badry, Dorothy, Daoust, Gabrielle et al. (2013) It takes a team: Improving placement stability among children and youth with fetal alcohol spectrum disorder in care in Canada. Children and Youth Services Review 35(1): 120–127 |
- non-UK - mixed methods, non-randomised controlled trial |
| PEMBERTON Camilla (2010) Kent’s foster care scheme makes its point. Community Care 13510: 20–21 |
- non -UK - Mixed methods - Non-randomised controlled trial - to be considered under RQ1.2 |
| PENNELL Joan; EDWARDS Myles; BURFORD Gale (2010) Expedited family group engagement and child permanency. Children and Youth Services Review 32(7): 1012–1019 | - No outcome of interest to this review question |
| Perry, Deborah F, Dunne, M. Clare, McFadden, LaTanya et al. (2008) Reducing the risk for preschool expulsion: Mental health consultation for young children with challenging behaviors. Journal of Child and Family Studies 17(1): 44–54 | - unclear that population are looked after children |
| PIERPONT John H. and McGINTY Kaye (2004) Using family-oriented treatment to improve placement outcomes for children and youth in residential treatment. Journal of Human Behavior in the Social Environment 9(12): 147–163 |
- No outcome of interest reported [descriptive outcomes] - Intervention description/practice report |
| Pithouse, Andrew, Hill-Tout, Jan, Lowe, Kathy et al. (2002) Training foster carers in challenging behaviour: A case study in disappointment?. Child & Family Social Work 7(3): 203–214 | - No outcome of interest to this review question |
| Pratt, Megan E, Lipscomb, Shannon T, Schmitt, Sara A et al. (2015) The effect of head start on parenting outcomes for children living in non-parental care. Journal of Child and Family Studies 24(10): 2944–2956 | - No outcome of interest to this review question |
| Price, Joseph M, Chamberlain, Patricia, Landsverk, John et al. (2009) KEEP foster-parent training intervention: Model description and effectiveness. Child & Family Social Work 14(2): 233–242 |
- Secondary publication of an included study that does not provide any additional relevant information - Intervention description/practice report |
| Price, Joseph M, Roesch, Scott C, Walsh, Natalia Escobar et al. (2012) Effectiveness of the KEEP foster parent intervention during an implementation trial. Children and Youth Services Review 34(12): 2487–2494 [PMC free article: PMC3555514] [PubMed: 23359633] | - No outcome of interest to this review question |
| Price, Joseph M, Roesch, Scott, Walsh, Natalia E et al. (2015) Effects of the KEEP Foster Parent Intervention on Child and Sibling Behavior Problems and Parental Stress During a Randomized Implementation Trial. Prevention science : the official journal of the Society for Prevention Research 16(5): 685–95 [PMC free article: PMC4442755] [PubMed: 25418812] | - No outcome of interest to this review question |
| Pritchett, Rachel, Fitzpatrick, Bridie, Watson, Nicholas et al. (2013) A feasibility randomised controlled trial of the New Orleans intervention for infant mental health: a study protocol. TheScientificWorldJournal 2013: 838042 [PMC free article: PMC3655679] [PubMed: 24023537] | - RCT protocol |
| Randle, Melanie, Ernst, Dominik, Leisch, Friedrich et al. (2017) What makes foster carers think about quitting? Recommendations for improved retention of foster carers. Child & Family Social Work 22(3): 1175–1186 | - No outcome of interest reported |
| Rast, Jim and Rast, Jessica E (2014) Neighbor to family: Supporting sibling groups in foster care. Families in Society 95(2): 83–91 |
- non-UK - Non-randomised controlled trial |
| Redd, Zakia, Malm, Karin, Moore, Kristin et al. (2017) KVC’s Bridging the Way Home: An innovative approach to the application of Trauma Systems Therapy in child welfare. Children and Youth Services Review 76: 170–180 |
- No outcome of interest reported [implementation outcomes] |
| Ringle, Jay L, Thompson, Ronald W, Way, Mona et al. (2015) Reunifying families after an out-of-home residential stay: Evaluation of a blended intervention. Journal of Child and Family Studies 24(7): 2079–2087 | - No outcome of interest reported for this review question |
| Robst, John, Armstrong, Mary, Dollard, Norin et al. (2011) Comparing outcomes for youth served in treatment foster care and treatment group care. Journal of Child and Family Studies 20(5): 696–705 |
- Unclear that population are LACYP [Youth placed in a treatment group care must be diagnosed as having a psychiatric, emotional, or behavioral disorder, be a dependent child, and have serious functional impairment.] - Non-randomised controlled trial - non-UK |
| ROBERTS Rosemarie; GLYNN Georgia; WATERMAN Colin (2016) ‘We know it works but does it last?’ the implementation of the KEEP foster and kinship carer training programme in England. Adoption and Fostering 40(3): 247–263 | - placement stability outcomes reported in this study were non-comparative (study arms were from non-comparable populations) |
| Rock, Stephen, Michelson, Daniel, Thomson, Stacey et al. (2015) Understanding foster placement instability for looked after children: A systematic review and narrative synthesis of quantitative and qualitative evidence. British Journal of Social Work 45(1): 177–203 | - Systematic review checked for relevant citations |
| Sasaki, Ginga and Noro, Fumiyuki (2017) Promoting verbal reports and action plans by staff during monthly meetings in a Japanese residential home. Behavioral Interventions 32(4): 445–452 | - No outcome of interest reported for this review question |
| Schoemaker, Nikita K, Wentholt, Wilma G M, Goemans, Anouk et al. (2019) A meta-analytic review of parenting interventions in foster care and adoption. Development and psychopathology: 1–24 [PubMed: 31366418] | - Systematic review |
| Smith, Carrie Jefferson and Monahan, Deborah J (2006) KinNet:A Demonstration Project for a National Support Network for Kinship Care Providers. Journal of health & social policy 22(34): 215–31 [PubMed: 17855248] |
- Unclear that population are LACYP [mixed population with informal care] - No outcome of interest reported |
| Southerland, Dannia G, Burns, Barbara J, Farmer, Elizabeth M. Z et al. (2014) Family involvement in treatment foster care. Residential Treatment for Children & Youth 31(1): 2–16 [PMC free article: PMC4145528] [PubMed: 25177104] |
- Not an investigation of an intervention [investigation of predictors of family contact] - Not a relevant study design [Although evidence is from an RCT, non-randomised data is presented] |
| SPIEKER Susan J. and et al (2012) Promoting first relationships: randomized trial of a relationship-based intervention for toddlers in child welfare. Child Maltreatment 17(4): 271–286 [PMC free article: PMC3552521] [PubMed: 22949743] | - No outcome of interest reported for this review question |
| Stacks, A.M., Wong, K., Barron, C. et al. (2020) Permanency and well-being outcomes for maltreated infants: Pilot results from an infant-toddler court team. Child Abuse and Neglect 101: 104332 [PubMed: 31926458] | - Non-UK before and after study |
| STRICKLER, Amy and et al (2019) Examining fostering readiness in treatment parents. Child and Family Social Work 24(2): 183–189 |
- No outcome of interest reported readiness to foster, willingness to foster - Non-UK setting - Non-randomised study - non-comparative study |
| Strolin-Goltzman, Jessica; Kollar, Sharon; Trinkle, Joanne (2010) Listening to the voices of children in foster care: youths speak out about child welfare workforce turnover and selection. Social work 55(1): 47–53 [PubMed: 20069940] |
- No outcome of interest to this review question - to be considered under RQ1.2 |
| Summersett-Ringgold, Faith, Jordan, Neil, Kisiel, Cassandra et al. (2018) Child strengths and placement stability among racial/ethnic minority youth in the child welfare system. Child abuse & neglect 76: 561–572 [PubMed: 28941983] | - No outcome of interest reported [no interventions considered] |
| Sunseri, Paul A (2005) Children Referred to Residential Care: Reducing Multiple Placements, Managing Costs and Improving Treatment Outcomes. Residential Treatment for Children & Youth 22(3): 55–66 |
- non-UK - cohort study |
| Taussig, Heather N, Culhane, Sara E, Garrido, Edward et al. (2012) RCT of a mentoring and skills group program: placement and permanency outcomes for foster youth. Pediatrics 130(1): e33–9 [PMC free article: PMC3382920] [PubMed: 22689870] | - No outcome of interest to this review question |
| Testa, Mark F (2002) Subsidized guardianship: Testing an idea whose time has finally come. Social Work Research 26(3): 145–158 |
- Not an intervention of interest [subsidized guardianship vs adoption] |
| Thornton, Jennifer A, Stevens, Gillian, Grant, Jan et al. (2008) Intrafamilial adolescent sex offenders: Family functioning and treatment. Journal of Family Studies 14(23): 362–375 | - Unclear that population are LACYP |
| UNRAU Yvonne; WELLS Michael; HARTNETT Mary Ann (2004) Removing barriers to service delivery: an outcome evaluation of a ‘remodelled’ foster care programme. Adoption and Fostering 28(2): 20–30 |
- non-UK - non-randomised controlled trial |
| Uretsky, Mathew C and Hoffman, Jill A (2017) Evidence for group-based foster parent training programs in reducing externalizing child behaviors: A systematic review and meta-analysis. Journal of Public Child Welfare 11(45): 464–486 | - No outcome of interest to this review question |
| Waid, Jeffrey, Kothari, Brianne H, Bank, Lew et al. (2016) Foster care placement change: The role of family dynamics and household composition. Children and Youth Services Review 68: 44–50 [PMC free article: PMC5157937] [PubMed: 27990039] | - Not an investigation of an intervention [association study] |
| Waxman, Hersh C, Houston, W Robert, Profilet, Susan M et al. (2009) The long-term effects of the Houston Child Advocates, Inc., program on children and family outcomes. Child welfare 88(6): 23–46 [PubMed: 20695290] |
- non-UK - Non-randomised controlled trials |
| Weiner, Dana A, Leon, Scott C, Stiehl, Michael J et al. (2011) Demographic, clinical, and geographic predictors of placement disruption among foster care youth receiving wraparound services. Journal of Child and Family Studies 20(6): 758–770 | - Not an investigation of an intervention |
| Whitaker, Tia (2011) Administrative case reviews: Improving outcomes for children in out-of-home care. Children and Youth Services Review 33(9): 1683–1708 |
- non-UK - cohort study |
| White, Catherine Roller, Corwin, Tyler, Buher, Anne L et al. (2015) The Multisite Accelerated Permanency Project: Permanency roundtables as a strategy to help older youth in foster care achieve legal permanency. Journal of Social Service Research 41(3): 364–384 | - No outcome of interest to this review question |
| Whitemore, Erin, Ford, Monica, Sack, William H et al. (2003) Effectiveness of Day Treatment with Proctor Care for Young Children: A Four-Year Follow-Up. Journal of Community Psychology 31(5): 459–468 |
- non-UK - uncontrolled before and after study |
| WISE Sarah (2002) An evaluation of a trial of looking after children in the state of Victoria, Australia. Children and Society 17(1): 3–17 |
- Study does not contain a relevant intervention [Describes a system of case planning and review which is already statutory care in the UK. This was a Non-UK based uncontrolled before and after study.] |
| Zeanah, C H, Larrieu, J A, Heller, S S et al. (2001) Evaluation of a preventive intervention for maltreated infants and toddlers in foster care. Journal of the American Academy of Child and Adolescent Psychiatry 40(2): 214–21 [PubMed: 11211370] | - book |
| Ziviani, Jenny, Feeney, Rachel, Cuskelly, Monica et al. (2012) Effectiveness of support services for children and young people with challenging behaviours related to or secondary to disability, who are in out-of-home care: A systematic review. Children and Youth Services Review 34(4): 758–770 | - Systematic review considered for relevant references |
Cost-effectiveness studies
| Study | Reason for exclusion |
|---|---|
| Bennett, C.E.; Wood, J.N.; Scribano, P.V. (2020) Health Care Utilization for Children in Foster Care. Academic Pediatrics 20(3): 341–347 [PubMed: 31622784] |
- Exclude - compared LAC with non-LAC - Exclude - non-relevant outcomes |
| Boyd, K.A.; Balogun, M.O.; Minnis, H.; (2016) Development of a radical foster care intervention in Glasgow, Scotland. Health promotion international 31(3): 665 – 673 [PubMed: 26045403] | - Exclude – costing analysis |
| DIXON, Jo (2011) How the care system could be improved. Community Care 17211: 16–17 | - Exclude - not an economic evaluation |
| Holmes, L.; Ward, H.; McDermid, S. (2012) Calculating and comparing the costs of multidimensional treatment foster care in English local authorities. Children and Youth Services Review 34(11): 2141 – 2146 | - Exclude – costing analysis |
| Huefner, Jonathan C, Ringle, Jay L, Thompson, Ronald W et al. (2018) Economic evaluation of residential length of stay and long-term outcomes. Residential Treatment for Children & Youth 35(3): 192–208 | - Exclude - costs not applicable to the UK perspective |
| LOFHOLM Cecilia, Andree; OLSSON Tina, M.; SUNDELL, Knut (2020) Effectiveness and costs of a therapeutic residential care program for adolescents with a serious behavior problem (MultifunC). Short-term results of a non-randomized controlled trial. Residential Treatment for Children and Youth 37(3): 226–243 | - Exclude - population not specific to LACYP |
| Lovett, Nicholas and Xue, Yuhan (2020) Family First or the Kindness of Strangers? Foster Care Placements and Adult Outcomes. Labour Economics 65(0) | - Exclude - not an economic evaluation |
| Sunseri, P. (2005) Children Referred to Residential Care: Reducing Multiple Placements, Managing Costs and Improving Treatment Outcomes. Residential Treatment for Children & Youth 22(3): 55 – 66 | - Exclude – costing analysis |
Appendix K. Research recommendations – full details
Research recommendation (PDF, 136K)
Appendix L. References
Other references
None
Appendix M. Other appendix
No additional information for this review question.
Final
Evidence reviews underpinning recommendations 1.3.5 to 1.3.7 and 1.3.9 to 1.3.13
These evidence reviews were developed by NICE Guideline Updates Team
Disclaimer: The recommendations in this guideline represent the view of NICE, arrived at after careful consideration of the evidence available. When exercising their judgement, professionals are expected to take this guideline fully into account, alongside the individual needs, preferences and values of their patients or service users. The recommendations in this guideline are not mandatory and the guideline does not override the responsibility of healthcare professionals to make decisions appropriate to the circumstances of the individual patient, in consultation with the patient and/or their carer or guardian.
Local commissioners and/or providers have a responsibility to enable the guideline to be applied when individual health professionals and their patients or service users wish to use it. They should do so in the context of local and national priorities for funding and developing services, and in light of their duties to have due regard to the need to eliminate unlawful discrimination, to advance equality of opportunity and to reduce health inequalities. Nothing in this guideline should be interpreted in a way that would be inconsistent with compliance with those duties.
NICE guidelines cover health and care in England. Decisions on how they apply in other UK countries are made by ministers in the Welsh Government, Scottish Government, and Northern Ireland Executive. All NICE guidance is subject to regular review and may be updated or withdrawn.
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