Purpose: To examine the effects of Treatment Foster Care on youth with serious behavior problems. Method: Included studies are controlled trials with high or medium quality, published between 1990 and September 2017. The control group consists of youth with serious behavior problems in group care, and the follow-up time was at least 12 months. The review also examines ethical and economic aspects. Results: A total of eight controlled studies were included, consisting of 633 young people and 55 effect sizes. All studies examined the same model, Treatment Foster Care Oregon (TFCO). There is moderate certainty of evidence that TFCO reduces the risk of future criminal behavior and the number of days in locked settings. Furthermore, there is low certainty of evidence that TFCO reduces the risk of delinquent peer associations, drug use, and depression. Discussion: TFCO is to be preferred to group care for youth with serious behavior problems. Ethical and economic implications are discussed.
In Swedish child welfare, there are no mandatory guidelines on what interventions to use. Local authorities are able to set their own criteria for implementing or designing interventions. We carried out a survey to identify interventions in use in Children's Social Services and Child and Adolescent Psychiatric Care in Sweden. A total of 102 interventions were stated to have been in use, with between 31 and 45 different interventions for each of the four different child welfare populations. Of the 102 interventions, 56 were designed outside Sweden and later imported. Only 27 interventions were supported with some kind of research evidence. About half of
Purpose: This study investigated the utility of the risk assessment ''Structured Assessment of Violence Risk in Youth'' (SAVRY) within the social services in Stockholm County, Sweden. Method: SAVRY assessments of 56 adolescents were compared to assessments guided by another instrument (Adolescent Drug Abuse Diagnosis [ADAD]; n ¼ 38) and assessments without support of a structured method (n ¼ 38). Results: The results showed that social workers conducting SAVRY assessments documented a significantly larger number of risk and protective factors compared to the other assessments, and these factors predicted, with a few exceptions, reoffending to a larger extent. SAVRY summary risk rating significantly predicted the occurrence of serious violent crimes (area under the curve [AUC] ¼ .80, p < .01) and less serious violence (AUC ¼ .70, p < .05). Conclusions: SAVRY performed at least as well in naturalistic settings as in previous studies conducted in more controlled environments. Furthermore, the SAVRY performed better than the other structured instrument (ADAD).
In social work, practitioners are often faced with situations in which they have to choose an intervention. A fundamental ethical principle of social work practice is to minimize the risk of adverse effects caused by social services. To adhere to this principle, practitioners must be aware of the possible positive and negative effects of potential services. There are hundreds of interventions currently in use in social work. Although there are a growing number of controlled trials on social work interventions, there are only a few interventions based on research that has the highest degree of certainty, making it difficult to know how and in what way these interventions can support a person in need of assistance. This article, based in part on the experience we gained training practitioners working in Swedish social services, presents a tentative model for assessing the best available evidence comparing interventions when scientific evidence is sparse.
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