A pragmatic randomised controlled trial of the fostering changes programme

Moody, Gwenllian; Coulman, Elinor; Brookes‐Howell, Lucy; Cannings‐John, Rebecca; Channon, Sue; Lau, Mark A.; Rees, Alyson; Segrott, Jeremy; Scourfield, Jonathan; Robling, Michael

doi:10.1016/j.chiabu.2020.104646

Cited by 14 publications

(10 citation statements)

References 29 publications

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“…Two thirds of group participants attended sufficient sessions to be included in the analyses. At 12-months follow-up, there were no significant or meaningful mean differences (between intervention and control groups) on carer-reported self-efficacy, child mental health problems (as measured by the SDQ) or placement stability (Moody et al, 2020).…”

Section: Fostering Changesmentioning

confidence: 82%

“…FC is underpinned by social learning, cognitive-behavioural, and attachment theories, and its main therapy components are psychoeducation, behaviour management and relationship-building. FC has been evaluated in two pre-post noncontrolled studies (Pallett, Scott, Blackeby, Yule, and Weissman, 2002;Warman, Pallett, and Scott, 2006) and two RCTs (Briskman et al, 2012;Moody et al, 2020). The first RCT, an efficacy study carried out by the developers, randomly assigned foster carers to the intervention (N = 34) or to waitlist control (N = 29) (Briskman et al, 2012).…”

Section: Fostering Changesmentioning

confidence: 99%

“…Compared with controls, intervention participants' target foster children showed greater pre-post reductions in mean Strengths and Difficulties Questionnaire (SDQ) total problems (d = 0.3), and hyperactivity (d = 0.4) scores; and greater pre-post improvement in mean scores on an attachment relationship measure (d = 0.4) and a caregiver efficacy measure (d = 0.7). The second FC RCT was a Welsh study involving 312 foster carers from 19 sites assigned to the intervention (N = 204) or usual care (N = 108) (Moody et al, 2020). Two thirds of group participants attended sufficient sessions to be included in the analyses.…”

Section: Fostering Changesmentioning

confidence: 99%

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A narrative review of mental and relational health interventions for children in family‐based out‐of‐home care

Tarren‐Sweeney

2021

Journal of Family Therapy

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The present article reviews the evidence base for psychosocial interventions provided to children in family-based out-of-home care that seek to improve children's mental health, felt security, and/or the quality, strength or permanence of their attachment relationships. The review identified very few high-quality treatment trials carried out with this population. The interventions with the strongest demonstrated efficacy are Keeping Foster Parents Trained and Supported (KEEP) and Attachment and Biobehavioral Catchup (ABC). KEEP's effectiveness has also been demonstrated in a community setting. Complex attachment-and trauma-related difficulties manifested by children in care following early maltreatment follow a long-term developmental course and have trait-like durability. Treatment trials should be designed as long-term studies, providing at least several years of post-treatment assessment. K E Y W O R D S foster care, looked after children, mental health interventions, outof-home care, Review, treatment effectiveness | 377 MENTAL HEALTH INTERVENTIONS FOR CHILDREN IN CARE Guidance from organisations that promote evidence-based practiceAside from published clinical reviews, clinicians and mental health services obtain guidance from various organisations and services that evaluate or translate the efficacy and/or effectiveness of Practitioner points: • Very few high-quality intervention trials have been conducted with children and adolescents in out-of-home care and/or their caregivers.• The interventions with the strongest demonstrated efficacy are Keeping Foster Parents Trained and Supported (KEEP) and Attachment and Biobehavioral Catchup (ABC).• Given the enduring nature of complex trauma-and attachment-related problems, treatment trials should include long-term follow-up mental health and relational measures.• The effectiveness of treatments administered directly to adolescents are moderated by caregiver involvement and 'buy-in'. |Michael Tarren-Sweeney mental health interventions 1 , including professional associations, research clearing houses and organisations whose purpose is to identify and disseminate evidence-based practice -such as the UK's National Institute for Health and Clinical Excellence (NICE). A Faculty of Child and Adolescent Psychiatry, Royal Australian and New Zealand College of Psychiatrists (RANZCP) position statement highlights several important assessment and treatment principles, such as the need for assessment and treatment to be developmentally and systemically informed, but otherwise does not refer to specific evidence-based interventions (Royal Australian and New Zealand College of Psychiatrists, 2015). An earlier RANZCP expert report describes the particular mental health and relational needs of children and young people in care -alluding mainly to the absence of an adequate evidence base and the need for further clinical effectiveness studies (Royal Australian and New Zealand College of Psychiatrists, 2008).In 2010, NICE and the UK's Social Care Institute for Excellence (SCIE) pu...

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Section: Fostering Changesmentioning

confidence: 82%

Section: Fostering Changesmentioning

confidence: 99%

Section: Fostering Changesmentioning

confidence: 99%

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A narrative review of mental and relational health interventions for children in family‐based out‐of‐home care

Tarren‐Sweeney

2021

Journal of Family Therapy

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“…According to studies of child welfare samples, youth in FC with conduct disorder, and especially those with comorbid attention-deficit/hyperactivity disorder (38% co-occurrence in the FC group), are more likely to engage in aggressive and delinquent behaviour and/or substance abuse in adulthood [36,37]. Given the high associated personal and societal costs, there is a need for effective and evidence-based programmes to prevent and treat early-onset disruptive behaviour disorder in this vulnerable population [38][39][40]. For example, socio-emotional development, such as prosocial or self-regulation skills, moderates the relationship between out-of-home care and child behavioural outcomes and significantly improve behavioural outcomes [33].…”

Section: Clinical Characteristicsmentioning

confidence: 99%

Psychopathology and mental health service use among youth in foster care admitted to a psychiatric inpatient unit: a 4-year retrospective controlled study

Solerdelcoll

Ilzarbe

Fortea

et al. 2022

Eur Child Adolesc Psychiatry

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Youth in foster care (FC) are at increased risk of poor psychosocial outcomes. The aim of this study was to assess psychopathology and mental health service use among youth living in FC who require psychiatric hospitalisation. All individuals admitted to our Children and Adolescent Inpatient Psychiatry Unit between 2014 and 2017 who were in FC were systematically reviewed. The control group was defined as all youth living with their immediate family and hospitalised in our unit throughout 2016. We identified 89 patients placed in FC and 247 controls. Socio-demographic and clinical data were retrospectively collected from computerised charts. A survival analysis of emergency department visits and readmission to the hospital was conducted. Compared to controls, the FC group presented significantly higher rates of conduct disorder (78.7% vs 14.6%; p < 0.001) and substance use disorder (49.4% vs 27.5%; p < 0.001), mainly cannabis use (34.8% vs 16.6%; p < 0.001); higher rates of comorbidity (96.6% vs 55.9%; p < 0.001) and mean number of comorbid diagnoses (3.3 ± 1.1 vs 2.3 ± 0.5; p < 0.001). The FC group had a higher number of emergency room visits before and after admission than controls. FC youth were also 2.77 times more likely to visit the emergency department after discharge, and in a shorter time period, than controls (p = 0.004). Disruptive behaviours, substance use disorder, and comorbid psychopathology were all more prevalent among FC youth than controls. Specific strategies are needed to optimize community mental health resources and address the increased use of emergency services by these youth before and after hospitalisation.

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“…Furthermore, while several studies reported on the inter-rater reliability of measures of fidelity, few assessed other forms of reliability or validity. It is important to note that several studies evaluating interventions specifically targeted at foster carers, such as the Fostering Changes and Fostering Connections Programmes have highlighted the need for greater accuracy in measuring fidelity for interventions with this population (Moody et al , 2020; Lotty et al , 2020).…”

Section: Introductionmentioning

confidence: 99%

The Reflective Fostering Programme fidelity rating scale: development and inter-rater reliability

Midgley¹,

Cirasola²,

Sprecher³

et al. 2023

JCS

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Purpose The purpose of this study is to describe the development of the 14-item reflective fostering fidelity rating (RFFR), an observational rating system to evaluate model fidelity of group facilitators in the Reflective Fostering Programme (RFP), a mentalisation-based psychoeducation programme to support foster carers. The authors assess usability, dimensionality, inter-rater reliability and discriminative ability of the RFFR. Design/methodology/approach Eighty video clip extracts documenting 20 RFP sessions were independently rated by four raters using the RFFR. The dimensionality of the RFFR was assessed using principal components analysis. Inter-rater agreement was assessed using the intra-class correlation coefficient. Findings The proportion of missing ratings was low at 2.8%. A single principal component summarised over 90% of the variation in ratings for each rater. The inter-rater reliability of individual item ratings was poor-to-moderate, but a summary score had acceptable inter-rater reliability. The authors present evidence that the RFFR can distinguish RFP sessions that differ in treatment fidelity. Originality/value To the best of the authors’ knowledge, this is the first investigation and report of the RFFR’s validity in assessing the programme fidelity of the RFP. The paper concludes that the RFFR is an appropriate rating measure for treatment fidelity of the RFP and useful for the purposes of both quality control and supervision.

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A pragmatic randomised controlled trial of the fostering changes programme

Cited by 14 publications

References 29 publications

A narrative review of mental and relational health interventions for children in family‐based out‐of‐home care

A narrative review of mental and relational health interventions for children in family‐based out‐of‐home care

Psychopathology and mental health service use among youth in foster care admitted to a psychiatric inpatient unit: a 4-year retrospective controlled study

The Reflective Fostering Programme fidelity rating scale: development and inter-rater reliability

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