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Fostering Healthy Futures Kempe Center for the Prevention and Treatment of Child Abuse and Neglect.

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Presentation on theme: "Fostering Healthy Futures Kempe Center for the Prevention and Treatment of Child Abuse and Neglect."— Presentation transcript:

1 Fostering Healthy Futures Kempe Center for the Prevention and Treatment of Child Abuse and Neglect

2 Fostering Healthy Futures Program Design 1) Assessments of Children’s Functioning 2) Therapeutic Skills Groups 3) Mentoring

3 It Takes a Village David Olds David Olds Sara Culhane Sara Culhane Ann Petrila Ann Petrila Daniel Hettleman Daniel Hettleman Volunteers Volunteers Kempe Center Kempe Center Kempe Foundation Kempe Foundation Youth Mentoring Collaborative Youth Mentoring Collaborative Department of Pediatrics, University of Colorado Department of Pediatrics, University of Colorado Developmental Psychobiology Research Group Developmental Psychobiology Research Group Denver Department of Human Services Denver Department of Human Services Adams County Social Services Department Adams County Social Services Department Jefferson County Human Services Jefferson County Human Services Arapahoe County Department of Human Services Arapahoe County Department of Human Services Broomfield County Health and Human Services Broomfield County Health and Human Services Colorado Department of Human Services Colorado Department of Human Services Graduate schools: DU, Newman, CSU, UCD, Metro Graduate schools: DU, Newman, CSU, UCD, Metro School districts and schools School districts and schools Mental health centers and therapists Mental health centers and therapists Multiple non-profit organizations Multiple non-profit organizations Children and families Children and families

4 FHF Core Staff Sara Culhane, Ph.D. Sara Culhane, Ph.D. Ann Petrila, LCSW Ann Petrila, LCSW Daniel Hettleman, Ph.D. Daniel Hettleman, Ph.D. Becky Gennerman-Schroeder, LPC Becky Gennerman-Schroeder, LPC Patrick Nickoletti, PhD Patrick Nickoletti, PhD Jill Gjerde, MA Jill Gjerde, MA Michel Holien, LCSW Michel Holien, LCSW Dana Morgan, LCSW Dana Morgan, LCSW Robyn Wertheimer, LCSW Robyn Wertheimer, LCSW Jennifer Koch-Zapfel, MSW Jennifer Koch-Zapfel, MSW Tracy Rudhe Tracy Rudhe Dongmei Pan, MA Dongmei Pan, MA Liz Goetter, BA Liz Goetter, BA Julie Bemski, BA Julie Bemski, BA Tabitha Webster, BA Tabitha Webster, BA Laura Mann, BA Laura Mann, BA Melody Combs, Ph.D. Melody Combs, Ph.D. Tali Raviv, PhD Tali Raviv, PhD Chris Kelman, LCSW Chris Kelman, LCSW Leslie Fitzpatrick, LCSW Leslie Fitzpatrick, LCSW Orah Fireman, LCSW, M.Ed Orah Fireman, LCSW, M.Ed Edward Garrido, Ph.D. Edward Garrido, Ph.D. Christie Petrenko, PhD. Christie Petrenko, PhD. Leigh Clasby, BA Leigh Clasby, BA Michael Knudtson, MA Michael Knudtson, MA Wendy Gehring, BA Wendy Gehring, BA John Holmberg, Psy.D. John Holmberg, Psy.D. Tara Rhodes, MA Tara Rhodes, MA Lindsey Weiler, Ph.D. Lindsey Weiler, Ph.D. Heather Taussig, Ph.D. Heather Taussig, Ph.D.

5 FHF Graduate Student Tiffany Conway Tracy Rudhe Brian Wolff Jenn Winkelmann Pam Freeman Danielle Smith Amanda Brown Heather Frey Vyga Kaufmann Neta Bargai Julie Bemski Jenell Ribble Martine Lopez Alana Henken Kathryn Jargo Liz Hooks Tara Buckley Jordan Pock Andrea Reece Sara Rosenau Natalie Tolejko Kristen Simpson Shari Watters Michelle Brunner Research Assistants and Group Leaders Lindsay Heath Kristin Nelson Kate Slivka Lindsay Smart Susan Whittle Elizabeth Goetter Julie Lyons Courtney Fiedler Edyta Biegunajtys Claire Heppner Clara Paynter Kelsey McNeill Jenell Ribble Dena Miller Martine Lopez Thea Wessel Alana Henken Julie Bemski Claire Heppner Amy Percosky Andrea Temple Allison Glover Sarah Morehouse Jennifer DeVault Brendan Close Erika Joye Nicole Lariviere Amy Franke Mia Kim Jessi Wheatley Melani Dawson-Lear Melanie Rodriguez Riley Spuhler Walter Heidenreich David Roberts Alexis Karris Marisa Duran Patrick Nickoletti Dena Miller Thea Wessel Jennifer Sackett Amy Percosky Tisha Bean Emily Macdonald Jill Gjerde Rachel Lund Ann Chu Yael Chatav Debra Boeldt Christine Kelley Denise Onofrey Jennell Ribble Alanna Gangemi Jenny Doft Jenea Jones Kristin Allen Maddie Philley Rachel Shulman Leigh Clasby Sarah Perzow Emily Rotbart Laurel Story Mayla Yang Tish Wer Claire Stephenson Allison Glover Melissa Toppel Jasmine Crane Christina Hack Olga Leonova Leah Chelist Katie Lange Melena Postolowski Kristen Mackiewicz Allison Bratsch Kristen Vescera Leah Scandurra Emily Laux Caroline Oppenheimer Tara Rhodes Leah Harrigan Cory Reid-Vanas Erica Ragan Jessica Schnittka Shelby Scott Maria Davidsmeier Shawna Henry-Lange Anne Eden Rachel Stonecipher Michelle Turner Liz Healy Lucia Lapaz Rachel Levine Aleja Parsons Meagan Rohde Laura Sullivan

6 FHF Graduate Student Interns Melani Dawson-Lear Kristine Wilson Brenna Ellington Lanette Ambers Carrie Oliver Amy Bruner Liz Dinsdale Vashawn Banks Josh Goldman Marisa Duran Amber Cross Thomas Melanie Rodriguez Clover Bone Tiffany Conway Katie Ferguson Katie Melstrom Lisa Meyers Kendra Sasa Carla Scarpone Lewis Smirl Kelsey Wennesland Regina Richards Michelle Brunner Jocelyn Gray Jon Phillips Jennifer Stucka Christina Haskins Tina Francis Sarah Kane Mark Spehn Jennifer Nelsen *Over 80,000 hours of training provided to 130 interns Lorendia Schmidt Phoung Phan Beth Lipschutz Jacquelyn Eisenberg Angela Bierle Lisa Harrison Nicole Henkins Erin Hoglund Kerrie Earley Ashley Moore Justine Stewart Lauren Goldberg Marissa Nasca Amber Wolfe Jennifer Reynolds Krystal Caduff Miranda Learmonth Molly Jenkins Rebekah Koenigbauer Sarah Oakley Lauren Timkovich Sam Murillo Elizabeth Berling Kristin Krietemeyer Rachel Alpert Katherine Belcher Taylor Collins Renata Heberton Alyse Keilson Blake Konner Emily Lyons Melissa Maurer Regan Linton Nina Modern Jennifer Pitcavage Meredith Schaffer Holly Selepouchin Heidi VanEpps Katherine Ware Mele Cabral Jon Florida Sibyl Graham Beth Hilligoss Tighe Kaysar Alexandria Lewis Sarah Romero Stacy Walsh Jessica Devore Jacquelyn Gabel Jeffrey Hatcher Ryan Holmes Emily Laux Megan Lovingier Sapphire Rosier Cami Wangaard Jessica Barry Rachel Berns Maria Davidsmeier Diana Gonzalez Brandon Hester Nadine Leonard Julia McKinnon Amy Muetterties Heather Price Kristen Schmidt Rachel Stonecipher Ashley Wiggins Lissa Miller Jenna Brown Jane Simon Allison Harris Shane Spears Jolie Rinebarger Diane Bouhall Kelly Fries Erica Brown Shavon Perkins Jess Valsechi Katie Kaser Britta Johnson Renea Nilsson Laura Merten Kyle Steinke Jessica Henritze- Hoye Jenna Kelley Diane Kleinschnitz Linda Ladago Rachel Sacco Ani Sttele Rachel Bennett Emily Bruce Stephanie Cichocki Emily Frank Senite Sahezghi Ashley Stewart Elizabeth Stitzel Nancy Vargas

7 Federally-Funded Research Risk Behaviors in Maltreated Adolescents National Institute of Mental Health Dissertation Award, 1 R03 MH , $25,000. Preventive Interventions for Foster Care Youth National Institute of Mental Health, 1 K01 MH01972, $590,166. Intervention Development and Pilot for Foster Care Youth National Institute of Mental Health, 1 R21 MH067618, $472,500. Fostering Healthy Futures Efficacy Trial for Preadolescent Youth in Foster Care National Institute of Mental Health, 1 R01 MH076919, $2,655,734. Research Supplement to Promote Diversity in Health Related Research National Institute of Mental Health, 3 R01 MH S1, $283,706. Recovery Act Administrative Supplement Providing Summer Research Experience for Student and Science Educators National 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 Adulthood National Institute of Justice, 2013-VA-CX0002, $440,642.

8 State, University, and Hospital Funding Edward Byrne Memorial Justice Assistance Grants Colorado Division of Criminal Justice, U.S. Department of Justice Tony Grampsas Youth Services State of Colorado CAPTA Contract Colorado Department of Human Services The Children’s Hospital Research Institute Bridge Funding Colorado Clinical and Translational Sciences Institute Grants University of Colorado ` Academic Enrichment Fund University of Colorado

9 Kempe Foundation Funding for FHF 2002Daniels Fund ($20,000) 2002Daniels Fund ($20,000) 2003The Janus Foundation ($5,000) 2003The Janus Foundation ($5,000) 2003Bonfils Stanton Foundation ($10,000) 2003Bonfils Stanton Foundation ($10,000) 2003PacifiCare ($10,000) 2003PacifiCare ($10,000) 2003U.S. Bank ($5,000) 2003U.S. Bank ($5,000) 2004Daniels Fund ($50,000) 2004Daniels Fund ($50,000) 2004-presentPioneer Fund ($1,500,000 endowment for Fostering Healthy Futures) 2004-presentPioneer Fund ($1,500,000 endowment for Fostering Healthy Futures) 2005Bonfils Stanton Foundation ($20,000) 2005Bonfils Stanton Foundation ($20,000) 2005Daniels Fund ($50,000) 2005Daniels Fund ($50,000) 2006Gannett Foundation ($3,000) 2006Gannett Foundation ($3,000) 2006First Data/Western Union ($5,000) 2006First Data/Western Union ($5,000) 2006Donor Advised Fund, Denver Foundation ($30,000) 2006Donor Advised Fund, Denver Foundation ($30,000) 2006Anschutz Family Foundation ($3,333) 2006Anschutz Family Foundation ($3,333) 2006Colorado Rockies Charity Fund ($10,000) 2006Colorado Rockies Charity Fund ($10,000) 2006Denver Foundation ($15,000) 2006Denver Foundation ($15,000) 2006Daniels Fund ($60,000) 2006Daniels Fund ($60,000) 2007Anschutz Family Foundation ($4,167) 2007Anschutz Family Foundation ($4,167) 2008TJX Foundation ($3,000) 2008TJX Foundation ($3,000) 2008Rockies/McCormick Foundation ($20,000) 2008Rockies/McCormick Foundation ($20,000) 2008El Pomar Youth in Community Service - Arvada West High School ($500) 2008El Pomar Youth in Community Service - Arvada West High School ($500) 2008El Pomar Youth in Community Service - Northglenn High School ($1,500) 2008El Pomar Youth in Community Service - Northglenn High School ($1,500) 2008McGowan Foundation ($15,000) 2008McGowan Foundation ($15,000) 2008 Daniels Fund ($60,000) 2008 Daniels Fund ($60,000) 2008 MaggieGeorge Foundation ($16,000) 2008 MaggieGeorge Foundation ($16,000)

10 Kempe Foundation Funding for FHF 2008Xcel Energy Foundation ($5,000) 2008Xcel Energy Foundation ($5,000) 2009Rockies/McCormick Foundation ($20,000) 2009Rockies/McCormick Foundation ($20,000) 2009Larrk Foundation ($30,000) 2009Larrk Foundation ($30,000) 2009Verdoorn Foundation ($15,000) 2009Verdoorn Foundation ($15,000) 2009Whispering Fox ($5,000) 2009Whispering Fox ($5,000) 2009Daniels Fund ($60,000) 2009Daniels Fund ($60,000) 2010Rockies/McCormick Foundation ($10,000) 2010Rockies/McCormick Foundation ($10,000) 2010Verdoorn Foundation ($11,000) 2010Verdoorn Foundation ($11,000) 2010El Pomar Award of Excellence ($7,500) 2010El Pomar Award of Excellence ($7,500) 2010Colorado Rapids ($4,000) 2010Colorado Rapids ($4,000) 2010IP 5280 ($28,506) 2010IP 5280 ($28,506) 2010Jay and Rose Phillips Family Foundation ($20,000) 2010Jay and Rose Phillips Family Foundation ($20,000) 2011Daniels Fund ($60,000) 2011Daniels Fund ($60,000) 2011Rockies/McCormick Foundation ($10,000) 2011Rockies/McCormick Foundation ($10,000) 2012Rockies/McCormick Foundation ($5,000) 2012Rockies/McCormick Foundation ($5,000) 2102Verdoorn Foundation ($10,000) 2102Verdoorn Foundation ($10,000) 2012Jay and Rose Phillips Family Foundation ($20,000) 2012Jay and Rose Phillips Family Foundation ($20,000) 2012Lubert Family Foundation ($7,500) 2012Lubert Family Foundation ($7,500) 2012LARRK Foundation ($35,000) 2012LARRK Foundation ($35,000) 2012Daniels Fund ($60,000) 2012Daniels Fund ($60,000) 2012Morgridge Family Foundation ($4,500) 2012Morgridge Family Foundation ($4,500) 2013Daniels Fund ($60,000) 2013Daniels Fund ($60,000) 2013 Lubert Family Foundation ($5,000) 2013 Lubert Family Foundation ($5,000) 2013Verdoorn Foundation ($20,000) 2013Verdoorn Foundation ($20,000) 2013Mile High United Way (30,000) 2013Mile High United Way (30,000)

11 Inclusion Criteria All 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 centers Placed 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 intervention Cognitive functioning at a level able to comprehend group material Did 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

12 FOSTERING HEALTHY FUTURES PREVENTIVE INTERVENTION Better Distal Outcomes Mental Health Problem Behaviors Competencies Quality of Life LONG-TERM AND LIFE-COURSE OUTCOMES Fewer Adverse Life-Course Outcomes Arrests and Incarceration Pregnancy and STDs School Failure and Dropout Emergency Mental Health Treatment Multiple and Restrictive Placements Associated Costs SHORT-TERM OUTCOMES Cognitions Self-Esteem and Efficacy Attitudes and Appraisals Future Orientation Social Functioning Social Support Competence & Acceptance Peer Associations Behavioral Functioning Behavioral Regulation Coping Strategies Extracurricular Activities

13 Fostering Healthy Futures (FHF) Program Design 1) Evaluations of Children’s Functioning 2) Therapeutic Skills Groups 3) Mentoring

14 Screening Evaluations We assess functioning in the following domains: Cognitive Cognitive Academic achievement Academic achievement Mental health, including trauma symptoms Mental health, including trauma symptoms Social Social Behavioral Behavioral

15 Therapeutic Skills Groups 30 weeks; manualized program 30 weeks; manualized program 8 children per group, equal females and males 8 children per group, equal females and males Mental health clinicians and graduate trainees facilitate Mental health clinicians and graduate trainees facilitate 1 hour group and then dinner with mentors 1 hour group and then dinner with mentors Improve skills, process feelings related to the foster care experience, and reduce stigma Improve skills, process feelings related to the foster care experience, and reduce stigma

16 Session Content Basic Social Skills Feelings Perspective Taking Problem Solving Healthy Communication Healthy Coping Anger Management Positive Self-Talk Dealing with Worry Active Coping Strategies Change and Loss Mixed Emotions Abuse and Neglect Healthy Relationships Panel Night Adolescent Issues Anatomy and Puberty Dealing with Peer Pressure Resisting Drug/Alcohol Use Healthy Dating Relationships Program Ending Future Orientation Career Shadows Healthy Goodbyes GRADUATION!

17 Mentoring Graduate students spend 3-4 hours per week of individual time with each child they mentor Graduate students spend 3-4 hours per week of individual time with each child they mentor They 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. They 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 skills Focus on engaging them in their communities and teaching them advocacy skills Mentors interface with other adults in child’s life Mentors interface with other adults in child’s life Role of mentor - create a web of support for children, improve social skills, and provide staunch advocacy Role of mentor - create a web of support for children, improve social skills, and provide staunch advocacy

18 Lifebooks

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20 Panel Night

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23 Cultural Presentations

24 Cultural Engagement All project materials translated into Spanish All project materials translated into Spanish Multicultural stories in group; materials visually and linguisitically sensitive Multicultural stories in group; materials visually and linguisitically sensitive Mentor training in multicultural issues, personal exploration of culture, community exploration project Mentor training in multicultural issues, personal exploration of culture, community exploration project Children and mentors do cultural presentations Children and mentors do cultural presentations Embrace and explore differences; engage in culturally- meaningful activities Embrace and explore differences; engage in culturally- meaningful activities

25 Career Shadows

26 Mental Health Outcomes Lower Mental Health Composite Score Lower Mental Health Composite Score Fewer Trauma Symptoms Fewer Trauma Symptoms Fewer Symptoms of Dissociation Fewer Symptoms of Dissociation Less Anxiety Less Anxiety Less Current Mental Health Treatment Less Current Mental Health Treatment Fewer Psychotropic Medications (trend) Fewer Psychotropic Medications (trend) Greater Perceived Social Support Greater Perceived Social Support Higher Quality of Life Higher Quality of Life

27 Placement and Permanency Outcomes WHOLE SAMPLE 71% less likely to be placed in residential treatment 71% less likely to be placed in residential treatment Threefold increase in adoption for children with TPR (8% vs. 26%; non-significant) Threefold increase in adoption for children with TPR (8% vs. 26%; non-significant) FOSTER CARE SAMPLE 44% fewer placement changes (findings strongest for those with high baseline behavior problems) 44% fewer placement changes (findings strongest for those with high baseline behavior problems) 5 times more likely to have achieved permanency 5 times more likely to have achieved permanency Twice as likely to have reunified with their biological parents Twice as likely to have reunified with their biological parents

28 Key Features of FHF Homegrown Program Homegrown Program 590 youth involved 590 youth involved 230 youth received the 9-month program 230 youth received the 9-month program New grant to follow 250 youth into young adulthood New grant to follow 250 youth into young adulthood High Rates of Program Engagement High Rates of Program Engagement 92% recruitment rate for voluntary program 92% recruitment rate for voluntary program 92% retention rate 92% retention rate Over 90% follow-up at each post-intervention timepoint Over 90% follow-up at each post-intervention timepoint Similar Level of Evidence with other Evidence-Based Programs (e.g. TF-CBT, PCIT) Similar Level of Evidence with other Evidence-Based Programs (e.g. TF-CBT, PCIT) Reduces both mental health problems and negative permanency outcomes Reduces both mental health problems and negative permanency outcomes Received recognition Received recognition

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33 In the Colorado Practice Model Best Practice Compendium!

34 Colorado’s Title IV-E Waiver Application Innovative practice Innovative practice Advancing knowledge Advancing knowledge Trauma-informed child assessments Trauma-informed child assessments Consistent with Colorado Practice Model Consistent with Colorado Practice Model Integration of behavioral health and child welfare Integration of behavioral health and child welfare Addresses mental health needs of children in foster care Addresses mental health needs of children in foster care Piloting teen program Piloting teen program Increases permanency Increases permanency Reduces use of congregate care Reduces use of congregate care Reduces psychotropic medication use Reduces psychotropic medication use Increases positive outcomes for children Increases positive outcomes for children Culturally-sensitive, de- stigmatizing and acceptable Culturally-sensitive, de- stigmatizing and acceptable

35 Dissemination Phase Widespread Inquiries Replication Replication Adaptation Adaptation Implementation Plan Community-Based Agencies Implement Community-Based Agencies Implement Rural Adaptation Rural Adaptation CAPTA Funding to Provide Training CAPTA Funding to Provide Training Challenges to Implementation Funding Funding Prevention Program; No diagnoses Prevention Program; No diagnoses CORE funding when cases close CORE funding when cases close Grants end Grants end Opportunities with Waiver or PA3? Opportunities with Waiver or PA3?

36 First-Year Implementation Aurora Mental Health Center 2 groups; 16 children 2 groups; 16 children Adams, Denver, Arapahoe and Douglas Counties Adams, Denver, Arapahoe and Douglas Counties Using Core Service Dollars Using Core Service Dollars $5,600 for 9 month program (for 5 hours of programming/week) $5,600 for 9 month program (for 5 hours of programming/week) First-Quarter Progress Developed training materials and training schedule Developed training materials and training schedule All 16 children continuing participation, despite placement changes All 16 children continuing participation, despite placement changes Anonymous program evaluations with children: Anonymous program evaluations with children: FHF is helpful for learning how to deal with feelings (87% - “A Lot”) 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 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”) I am glad I chose to do FHF this year (93% - “A Lot”) Phone calls with caregivers: Phone calls with caregivers: Reflect high satisfaction with program Reflect high satisfaction with program Report behavioral and academic changes Report behavioral and academic changes


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