Presentation on theme: "Fostering Healthy Futures Program Design"— Presentation transcript:
1Fostering Healthy Futures Kempe Center for the Prevention and Treatment of Child Abuse and Neglect
2Fostering Healthy Futures Program Design 1) Assessments of Children’s Functioning2) Therapeutic Skills Groups3) Mentoring
3It Takes a Village Denver Department of Human Services Adams County Social Services DepartmentJefferson County Human ServicesArapahoe County Department of Human ServicesBroomfield County Health and Human ServicesColorado Department of Human ServicesGraduate schools: DU, Newman, CSU, UCD, MetroSchool districts and schoolsMental health centers and therapistsMultiple non-profit organizationsChildren and familiesDavid OldsSara CulhaneAnn PetrilaDaniel HettlemanVolunteersKempe CenterKempe FoundationYouth Mentoring CollaborativeDepartment of Pediatrics, University of ColoradoDevelopmental Psychobiology Research GroupSue
7Federally-Funded Research Risk Behaviors in Maltreated AdolescentsNational Institute of Mental Health Dissertation Award, 1 R03 MH , $25,000.Preventive Interventions for Foster Care YouthNational Institute of Mental Health, 1 K01 MH01972, $590,166.Intervention Development and Pilot for Foster Care YouthNational Institute of Mental Health, 1 R21 MH067618, $472,500.Fostering Healthy Futures Efficacy Trial for Preadolescent Youth in Foster CareNational Institute of Mental Health, 1 R01 MH076919, $2,655,734.Research Supplement to Promote Diversity in Health Related ResearchNational Institute of Mental Health, 3 R01 MH S1, $283,706.Recovery Act Administrative Supplement Providing Summer ResearchExperience for Student and Science EducatorsNational Institute of Mental Health, 3 R01 MH S1, $18,670.Long-Term Impact of a Positive Youth Development Program on Dating Violence Outcomes During the Transition to AdulthoodNational Institute of Justice, 2013-VA-CX0002, $440,642.
8State, University, and Hospital Funding Edward Byrne Memorial Justice Assistance GrantsColorado Division of Criminal Justice, U.S. Department of JusticeTony Grampsas Youth ServicesState of ColoradoCAPTA ContractColorado Department of Human ServicesThe Children’s Hospital Research InstituteBridge FundingColorado Clinical and Translational Sciences Institute GrantsUniversity of Colorado`Academic Enrichment Fund
9Kempe Foundation Funding for FHF 2002 Daniels Fund ($20,000)2003 The Janus Foundation ($5,000)2003 Bonfils Stanton Foundation ($10,000)2003 PacifiCare ($10,000)2003 U.S. Bank ($5,000)2004 Daniels Fund ($50,000)2004-present Pioneer Fund ($1,500,000 endowment for Fostering Healthy Futures)2005 Bonfils Stanton Foundation ($20,000)2005 Daniels Fund ($50,000)2006 Gannett Foundation ($3,000)2006 First Data/Western Union ($5,000)2006 Donor Advised Fund, Denver Foundation ($30,000)2006 Anschutz Family Foundation ($3,333)2006 Colorado Rockies Charity Fund ($10,000)2006 Denver Foundation ($15,000)2006 Daniels Fund ($60,000)2007 Anschutz Family Foundation ($4,167)2008 TJX Foundation ($3,000)2008 Rockies/McCormick Foundation ($20,000)2008 El Pomar Youth in Community Service - Arvada West High School ($500)2008 El Pomar Youth in Community Service - Northglenn High School ($1,500)2008 McGowan Foundation ($15,000)Daniels Fund ($60,000)MaggieGeorge Foundation ($16,000)
10Kempe Foundation Funding for FHF 2008 Xcel Energy Foundation ($5,000)2009 Rockies/McCormick Foundation ($20,000)2009 Larrk Foundation ($30,000)2009 Verdoorn Foundation ($15,000)2009 Whispering Fox ($5,000)2009 Daniels Fund ($60,000)2010 Rockies/McCormick Foundation ($10,000)2010 Verdoorn Foundation ($11,000)2010 El Pomar Award of Excellence ($7,500)2010 Colorado Rapids ($4,000)2010 IP 5280 ($28,506)2010 Jay and Rose Phillips Family Foundation ($20,000)2011 Daniels Fund ($60,000)2011 Rockies/McCormick Foundation ($10,000)2012 Rockies/McCormick Foundation ($5,000)2102 Verdoorn Foundation ($10,000)2012 Jay and Rose Phillips Family Foundation ($20,000)2012 Lubert Family Foundation ($7,500)2012 LARRK Foundation ($35,000)2012 Daniels Fund ($60,000)2012 Morgridge Family Foundation ($4,500)2013 Daniels Fund ($60,000)2013 Lubert Family Foundation ($5,000)2013 Verdoorn Foundation ($20,000)2013 Mile High United Way (30,000)
11Inclusion CriteriaAll 9-11-year-old children in any type of out-of-home placement in participating counties, including those placed in foster homes, kinship care, group homes, and residential treatment centersPlaced in court-ordered out-of-home care (over prior 12 months) as result of maltreatment, and were in out-of-home care at the onset of the interventionCognitive functioning at a level able to comprehend group materialDid not exclude youth with significant mental health or behavioral problems (including children with sexual perpetration histories)Youth continued to participate in the 9-month program even if they changed placements or reunified
12FOSTERING HEALTHY FUTURES PREVENTIVE INTERVENTION SHORT-TERM OUTCOMESCognitionsSelf-Esteem and EfficacyAttitudes and AppraisalsFuture OrientationSocial FunctioningSocial SupportCompetence & AcceptancePeer AssociationsBehavioral FunctioningBehavioral RegulationCoping StrategiesExtracurricular ActivitiesLONG-TERM AND LIFE-COURSE OUTCOMESFewer Adverse Life-Course OutcomesArrests and IncarcerationPregnancy and STDsSchool Failure and DropoutEmergency Mental Health TreatmentMultiple and Restrictive PlacementsAssociated CostsBetter Distal OutcomesMental HealthProblem BehaviorsCompetenciesQuality of Life
13Fostering Healthy Futures (FHF) Program Design 1) Evaluations of Children’s Functioning2) Therapeutic Skills Groups3) Mentoring
14Screening Evaluations We assess functioning in the following domains:CognitiveAcademic achievementMental health, including trauma symptomsSocialBehavioral
15Therapeutic Skills Groups 30 weeks; manualized program8 children per group, equal females and malesMental health clinicians and graduate trainees facilitate1 hour group and then dinner with mentorsImprove skills, process feelings related to the foster care experience, and reduce stigma
16Session Content Basic Social Skills Healthy Coping Change and Loss FeelingsPerspective TakingProblem SolvingHealthy CommunicationHealthy CopingAnger ManagementPositive Self-TalkDealing with WorryActive Coping StrategiesChange and LossMixed EmotionsAbuse and NeglectHealthy RelationshipsPanel NightAdolescent IssuesAnatomy and PubertyDealing with Peer PressureResisting Drug/Alcohol UseHealthy Dating RelationshipsProgram EndingFuture OrientationCareer ShadowsHealthy GoodbyesGRADUATION!
17MentoringGraduate students spend 3-4 hours per week of individual time with each child they mentorThey work on child’s lifebook, engage in extracurricular activities, help find other adult role models, shadow adults in professions of interest, work on homework, take them to libraries, recreational activities, etc.Focus on engaging them in their communities and teaching them advocacy skillsMentors interface with other adults in child’s lifeRole of mentor - create a web of support for children, improve social skills, and provide staunch advocacy
24Cultural Engagement All project materials translated into Spanish Multicultural stories in group; materials visually and linguisitically sensitiveMentor training in multicultural issues, personal exploration of culture, community exploration projectChildren and mentors do cultural presentationsEmbrace and explore differences; engage in culturally-meaningful activities
26Mental Health Outcomes Lower Mental Health Composite ScoreFewer Trauma SymptomsFewer Symptoms of DissociationLess AnxietyLess Current Mental Health TreatmentFewer Psychotropic Medications (trend)Greater Perceived Social SupportHigher Quality of Life
27Placement and Permanency Outcomes WHOLE SAMPLE71% less likely to be placed in residential treatmentThreefold increase in adoption for children with TPR (8% vs. 26%; non-significant)FOSTER CARE SAMPLE44% fewer placement changes (findings strongest for those with high baseline behavior problems)5 times more likely to have achieved permanencyTwice as likely to have reunified with their biological parents
28Key Features of FHF Homegrown Program High Rates of Program Engagement 590 youth involved230 youth received the 9-month programNew grant to follow 250 youth into young adulthoodHigh Rates of Program Engagement92% recruitment rate for voluntary program92% retention rateOver 90% follow-up at each post-intervention timepointSimilar Level of Evidence with other Evidence-Based Programs (e.g. TF-CBT, PCIT)Reduces both mental health problems and negative permanency outcomesReceived recognition
33Colorado Practice Model Best Practice Compendium! In theColorado Practice ModelBest Practice Compendium!
34Colorado’s Title IV-E Waiver Application Innovative practiceAdvancing knowledgeTrauma-informed child assessmentsConsistent with Colorado Practice ModelIntegration of behavioral health and child welfareAddresses mental health needs of children in foster carePiloting teen programIncreases permanencyReduces use of congregate careReduces psychotropic medication useIncreases positive outcomes for childrenCulturally-sensitive, de-stigmatizing and acceptable
35Dissemination Phase Widespread Inquiries Implementation Plan ReplicationAdaptationImplementation PlanCommunity-Based Agencies ImplementRural AdaptationCAPTA Funding to Provide TrainingChallenges to ImplementationFundingPrevention Program; No diagnosesCORE funding when cases closeGrants endOpportunities with Waiver or PA3?
36First-Year Implementation Aurora Mental Health Center2 groups; 16 childrenAdams, Denver, Arapahoe and Douglas CountiesUsing Core Service Dollars$5,600 for 9 month program (for 5 hours of programming/week)First-Quarter ProgressDeveloped training materials and training scheduleAll 16 children continuing participation, despite placement changesAnonymous program evaluations with children:FHF is helpful for learning how to deal with feelings (87% - “A Lot”)I like how we get a chance to know other kids who are in out-of-home care (93% - “A Lot”)I am glad I chose to do FHF this year (93% - “A Lot”)Phone calls with caregivers:Reflect high satisfaction with programReport behavioral and academic changes