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Back to the Future: Measuring the
Effects of Community-Based Practice
Diane DePanfilis, Ph.D. and Esta Glazer, L.C.S.W.-C.
U-MD School of Social Work
Take Charge of Change - Social Work '97-Oct. 4-7, 1997
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Acknowledgements:
• Family Connections is a collaboration between the University of Maryland Schools of Social Work and Medicine.
• Family services are provided by Social Work Community Outreach Services (SWCOS) MSW interns in a faculty field based unit.
• Group services are provided in collaboration with the Positive Parenting Program.
Family Connections is partially supported by the National Center on Child Abuse and Neglect, Grant No. 90CA1580.
Funding:
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Family Connections Goals
• To reach out and provide services to families who may be under stress
• To test the relative effectiveness of 4 alternate intervention strategies
• To measure our results to prevent neglect and enhance child, caregiver, and family functioning
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Why is this important?
• Many families struggle to meet the basic needs of their children
• Our mandated systems get involved too late
• We need to understand more about what models are most successful to reach families early
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Philosophical Principles
• Community outreach
• Family assessment and tailored interventions
• Helping alliance
• Empowerment approaches
• Strengths perspective
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Philosophical Principles
• Cultural sensitivity
• Developmental appropriateness
• Outcome driven service plans
• Emphasis on positive attitudes and qualities of helpers
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Research Design
• Factorial design - random assignment to 1 of 4 home-based intervention groups: (1) 6 months; (2) 12 months; (3) 6 months with parent group; (4) 12 months with parent group.
• Computer assisted assessment protocols: (1) baseline; (2) closure; (3) 6 months follow-up.
• Intern driven assessment and case management system.
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Basic Screening Criteria
The family lives in the West Side Empowerment Zone
There is a child between 6 and 8 years living in the household
There is no known report to CPS for suspected abuse or neglect
The family is willing to participate
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Neglect Risk
Inadequate/delayed health care
Inadequate nutrition
Poor personal hygiene
Inadequate clothing
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Unsafe household conditions
Unsanitary household conditions
Unstable living conditions
Shuttling
Inadequate supervision
Inappropriate substitute caregiver
Neglect Risk
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Drug-exposed newborn
Inadequate nurturance
Isolating
Witnessing violence
Permitting alcohol/drug use
Neglect Risk
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Permitting other maladaptive behavior
Delay in obtaining needed mental health care
Chronic truancy
Unmet special education needs
Neglect Risk
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Caregiver Risk Criteria
Unemployed/ Over-employed
Mental health problem (e.g., depression)
Alcohol or drug problem
Homelessness
Domestic violence
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Child Risk Criteria
Behavior or mental health problem
Physical disability
Developmental disability
More than 3 children in the household
Learning disability
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Baseline Protocol
• Self-administered computer assisted interview
• Asks questions about: child functioning, caregiver childhood history, caregiver functioning, neglectful behaviors or conditions, family functioning, social support, health, alcohol abuse, mental health, social desirability, drug abuse, housing and neighborhood
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Family ConnectionsCase Management System
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Purposes of the Case Management System
• Provide a framework for the intern to learn a practice model.
• Support the field instructor in the management and teaching roles.
• Document and measure the achievement of outcomes.
• Document what services are provided.
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What information will we track?
• Screening criteria• Family needs and strengths• Desired family outcomes• Services that are provided• Level of achievement of outcomes
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Intervention Outcomes
• Family Maintenance and Safety• Family Member Functioning• Family Functioning• Problem Solving• Social Support• Care of Children• Neglect
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Family Maintenance and Safety
• The family demonstrates the ability to meet the basic needs of the family for food, clothing, housing, and health care
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Family Member Functioning
- Caregiver
• The caregiver demonstrates abilities to achieve self sufficiency, cope with daily stresses, manage emotions, and control impulses
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Family Member Functioning
- Children
• The children demonstrate developmental appropriateness in all areas of functioning
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Family Functioning
• The family demonstrates strength in multiple areas such as family-identity, information sharing, coping and resources and uses non-violent methods to resolve family conflict
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Problem Solving
• Family members demonstrate abilities and motivation to accurately identify and solve problems
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Social Support
• The family has access to and effectively uses extended family, friends, and other systems to meet social support functions, i.e., emotional, child related, financial, instrumental, and formal
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Care of Children
• Caregivers demonstrate appropriate attitudes and skill to meet the unique needs of their children
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Self-Report Measures
• Needs based assessment scales – Family Resource Scale– Support Functions Scale– Family Needs Scale
• Social support scales– Family Support Scale– Personal Network Matrix
• Family Functioning Style Scale
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Observational Measures
• Child Well-being Scales• Family Risk Scales
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Measuring Change in a Specific Family
02468
101214161820
1st Qtr 2nd Qtr 3rd Qtr 4th Qtr
IdentitySharingCoping
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Achievement of Outcomes (mean scores)
0
0.5
1
1.5
2
2.5
3
3.5
4
1st Qtr 2nd Qtr 3rd Qtr 4th Qtr
NutritionHygieneHealth Care
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Description of Services Sample Monthly Report
Type of Services % Served
Individual Child 72%
Individual Parent 95%
Family System 86%
Group 50%
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Intensity of Services (Average hours of services)
0
10
20
30
40
50
60
1st Qtr 2nd Qtr 3rd Qtr 4th Qtr
IndividualFamilyGroup
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Need for Flexibility
• We may discover that we want to use different measures over time.
• Interns may discover new things they want to measure over time.
• As technology advances, we may build on the system over time.
Diane DePanfilis, 410-706-3609, (fax) 410-706-6046
EMAIL: [email protected]
FOR MORE INFO...