Characteristics and Behavioral Outcomes for Youth in Group Care and Family-Based Care

Abstract

This study aimed to answer two questions: (a) Given expected differences in children who are placed in group care compared to those in family-based settings, is it possible to match children on baseline characteristics? (b) Are there differences in behavioral outcomes for youth with episodes in group care versus those in family-based care? Using data from the National Survey of Child and Adolescent Well-Being, the study sample included 1,191 children with episodes in out-of-home care (n = 254 youth with group care episodes; n = 937 youth with episodes in family-based care and no group care). Conditioning variables were identified, which distinguished between the two groups of youth. Using propensity score matching, all youth placed into group care were matched on the propensity score with family-based care youth. Behavioral outcomes at 36 months, as measured by the Child Behavior Checklist, were compared for the matched sample. Of the total 254 youth with group care episodes, 157 could be matched to youth with episodes in family-based care. No significant differences remained between the two groups in the matched sample, and findings revealed no significant differences in longitudinal behavioral outcomes.

Patterns of maltreatment and diagnosis across levels of care in group homes

“…Neglect was most prevalent, followed by physical abuse and sexual abuse, and lower rates of emotional abuse. These findings align with patterns of maltreatment found in previous studies on group homes (Brack et al, 2012; Lee & Thompson, 2009), other residential programs (e.g., James, Zhang, et al, 2012), and youth involved with the child welfare system (Burns et al, 2004). The high prevalence of maltreatment supports the need for trauma-informed assessment and services for youth in residential programs (Briggs et al, 2012).…”

“…In the literature on out-of-home placements, some studies report similar characteristics or needs among youth in more restrictive residential programs, such as group homes, and those in less restrictive community- or family-based settings, such as foster care (Farmer, Mustillo, Burns, & Holden, 2008; James, Roesch, & Zhang, 2012; Lyons, Libman-Mintzer, Kisiel, & Shallcross, 1998). Other investigators indicate that youth served by more restrictive residential programs have greater emotional and behavioral needs than youth receiving less restrictive community- or family-based care (Briggs et al, 2012; Handwerk et al, 1998; Nash, Thompson, & Kim, 2006; Pottick, Warner, & Yoder, 2005).…”

Who Goes Where? Exploring Factors Related to Placement Among Group Homes

“…Following literature in the field (Friman, 2000; Handwerk et al, 2000; James, 2011; Wolf et al, 1995), the current study posited that Teaching Family programs were delivering a promising model of care, and non-Teaching Family programs would be delivering more eclectic and untested models of treatment. Hence, it would be concerning if disadvantaged groups within society were not being served by Teaching Family programs.…”

“…Much of the current literature on group residential care is from one of two types of studies: large national studies of group care (e.g., Aarons et al, 2010; James et al, 2011) or regional programs (e.g., Chamberlain et al, 1996; Hagaman, Trout, Chmelka, Thompson, & Reid, 2010). In both types of studies, the focus has been on factors related to youth characteristics, placement trajectories, and/or outcomes with little attention to the potential variation among/between group residential facilities and, consequently, lack of information about whether the broad category of group residential facilities is serving a common set of youth or whether there are distinct niches and settings that are differentially serving specific subgroups of youth.…”

Does Model Matter? Examining Change Across Time for Youth in Group Homes

“…Furthermore, youth served in group care settings differ on various characteristics, including clinical and trauma histories (e.g., psychiatric diagnoses, substance abuse, maltreatment history), service utilization (e.g., psychotropic medication), and number of placements (Chow, Mettrick, Stephan, & Von Waldner, 2014; Duppong Hurley et al, 2009; Pumariega, Johnson, & Sheridan, 1995; Seifert, Farmer, Wagner, Maultsby, & Burns, 2015). Not surprisingly, current literature comparing group care and other out-of-home placements reveals inconsistent findings on youth outcomes (Chamberlain & Reid, 1998; DeSena et al, 2005; James, Roesch, & Zhang, 2012; McCrae, Lee, Barth, & Rauktis, 2010; for reviews, see Lee, Bright, Svoboda, Fakunmoju, & Barth, 2011; Osei, Corey, & Hernandez Jozefowicz, 2016). However, when studies do not distinguish between types of group care and heterogeneity of youth served, findings related to the effectiveness (or lack thereof) of various group care settings for youth treatment may be obscured and it is difficult to assess generalizability or implications.…”