Evaluating the Effects of Comprehensive Substance Abuse Intervention on Successful Reunification

Brook, Jody; McDonald, Thomas P.

doi:10.1177/1049731507300148

Cited by 58 publications

(39 citation statements)

References 24 publications

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“…Three records 580,591,611 were excluded because the focused was on parenting stress and parenting outcomes, rather than child-focused outcomes. Seven records 579,582,589,593,597,606,607 were excluded because participants were not recruited or selected on the basis of their maltreatment; instead they were recruited on the basis of problems including depression, PTSD, substance abuse and delinquency. Three records 585,587,603 were excluded because they focused on general services, such as general foster care and child protection service, and did not focus on a therapeutic intervention for maltreatment.…”

Section: Excluded Studiesmentioning

confidence: 99%

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Macdonald

Livingstone

Hanratty

et al. 2016

Health Technol Assess

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BackgroundChild maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems.ObjectivesTo synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment.Study designFor effectiveness, we included any controlled study. Other study designs were considered for economic decision modelling. For acceptability, we included any study that asked participants for their views.ParticipantsChildren and young people up to 24 years 11 months, who had experienced maltreatment before the age of 17 years 11 months.InterventionsAny psychosocial intervention provided in any setting aiming to address the consequences of maltreatment.Main outcome measuresPsychological distress [particularly post-traumatic stress disorder (PTSD), depression and anxiety, and self-harm], behaviour, social functioning, quality of life and acceptability.MethodsYoung Persons and Professional Advisory Groups guided the project, which was conducted in accordance with Cochrane Collaboration and NHS Centre for Reviews and Dissemination guidance. Departures from the published protocol were recorded and explained. Meta-analyses and cost-effectiveness analyses of available data were undertaken where possible.ResultsWe identified 198 effectiveness studies (including 62 randomised trials); six economic evaluations (five using trial data and one decision-analytic model); and 73 studies investigating treatment acceptability. Pooled data on cognitive–behavioural therapy (CBT) for sexual abuse suggested post-treatment reductions in PTSD [standardised mean difference (SMD) –0.44 (95% CI –4.43 to –1.53)], depression [mean difference –2.83 (95% CI –4.53 to –1.13)] and anxiety [SMD –0.23 (95% CI –0.03 to –0.42)]. No differences were observed for post-treatment sexualised behaviour, externalising behaviour, behaviour management skills of parents, or parental support to the child. Findings from attachment-focused interventions suggested improvements in secure attachment [odds ratio 0.14 (95% CI 0.03 to 0.70)] and reductions in disorganised behaviour [SMD 0.23 (95% CI 0.13 to 0.42)], but no differences in avoidant attachment or externalising behaviour. Few studies addressed the role of caregivers, or the impact of the therapist–child relationship. Economic evaluations suffered methodological limitations and provided conflicting results. As a result, decision-analytic modelling was not possible, but cost-effectiveness analysis using effectiveness data from meta-analyses was undertaken for the most promising intervention: CBT for sexual abuse. Analyses of the cost-effectiveness of CBT were limited by the lack of cost data beyond the cost of CBT itself.ConclusionsIt is not possible to draw firm conclusions about which interventions are effective for children with different maltreatment profiles, which are of no benefit or are harmful, and which factors encourage people to seek therapy, accept the offer of therapy and actively engage with therapy. Little is known about the cost-effectiveness of alternative interventions.LimitationsStudies were largely conducted outside the UK. The heterogeneity of outcomes and measures seriously impacted on the ability to conduct meta-analyses.Future workStudies are needed that assess the effectiveness of interventions within a UK context, which address the wider effects of maltreatment, as well as specific clinical outcomes.Study registrationThis study is registered as PROSPERO CRD42013003889.FundingThe National Institute for Health Research Health Technology Assessment programme.

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Section: Excluded Studiesmentioning

confidence: 99%

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Macdonald

Livingstone

Hanratty

et al. 2016

Health Technol Assess

View full text Add to dashboard Cite

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“…However, it also seems likely that parents with more problems would have more difficulty accessing multiple services, and an "everything but the kitchen sink" approach could be problematic. At least one study has found negative associations between receipt of comprehensive intensive services and outcomes of time to reunification and re-entry (Brook & McDonald, 2007).…”

Section: Discussionmentioning

confidence: 99%

“…One study articulated service plan requirements and recommended time allotment for a one intensive reunification program treating substance using clients. Requirements included substance abuse treatment services (9 hours per week), employment services (5 hours per week), case management (5 hours per week), parent training (2 hours per week) and other services (domestic violence counseling, family therapy, trauma counseling) (1-4 hours per week), for a total of 22-26 hours per week of service use (Brook & McDonald, 2007).…”

Section: Case Plan Content and Service Targetingmentioning

confidence: 99%

Parental problems, case plan requirements, and service targeting in child welfare reunification

D'Andrade

Chambers

2012

Children and Youth Services Review

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“…Por otro lado, el alcoholismo está mucho más presente entre las familias lusas, especialmente entre los padres. Este es un dato relevante a la hora de analizar las trayectorias y resultados de la intervención, ya que la literatura científica ha identificado el abuso de sustancias por parte de los padres como uno de los factores claves que afectaría negativamente la posibilidad de que se produzca una reunificación familiar (Brook & McDonald, 2007;Fein, 1993;Harris, 1999;Maluccio & Ainsworth, 2003;Mapp & Steinberg, 2007;Smith, 2003;Terling, 1999;Wade et al, 2010).…”

Section: Discusión Y Conclusionesunclassified

Características y desarrollo del acogimiento familiar en dos países con fuerte tradición de acogimiento residencial: España y Portugal

et al. 2014

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r e S u M e n Los procesos de acogimiento familiar que se producen en cada país dependen de factores históricos y culturales que dan lugar a grandes diferencias internacionales. A pesar de que las comparativas internacionales ofrecen un medio de intercambio de experiencias, lo que permite el aprendizaje mutuo y la transferencia de buenas prácticas, a menudo encontramos enormes barreras para su realización debido, entre otros factores, al limitado acceso a los datos sobre la práctica de la protección infantil. Frente a estas limitaciones, este artículo ofrece una investigación comparativa realizada en España y Portugal, cuyo objetivo ha sido la evaluación del acogimiento familiar en dos países donde la investigación en el ámbito de la protección infantil ha sido tradicionalmente desatendida. Sobre una muestra de 357 casos en España y 289 en Portugal, se realizó un estudio del perfil de características de los niños acogidos, las familias de origen y los acogedores, así como de los procesos de acogida en ambos países. La comparativa reveló importantes diferencias relacionadas con la mayor edad al inicio del acogimiento de los niños en España; el perfil de los acogedores, con edades más avanzadas, un bajo nivel educativo y llevando a cabo acogidas de más de un niño simultá-neamente en Portugal. El estudio comparado nos ha permitido identificar áreas que requieren mayor atención en ambos países, como la renovación generacional del banco de acogedores en Portugal o la necesidad de acelerar los procesos de toma de decisiones para la entrada en acogimiento familiar en España. Se pretende que este artículo sirva de aliento para la recogida de datos y comparación con otros países iberoamericanos.Palabras clave protección infantil; investigación comparativa; acogimiento familiar; medidas de separación familiar a b S t r a c t Fostering processes that occur in each country depend on historical and cultural factors that give rise to large international differences. Despite the fact that international comparisons offer a way of exchanging experiences, allowing mutual learning and transfer of good practice, we often encounter major barriers for its completion due to limited access to data on child protection practice, among other factors. Given these limitations, this article provides a comparative study conducted in Spain and Portugal. The aim

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Evaluating the Effects of Comprehensive Substance Abuse Intervention on Successful Reunification

Cited by 58 publications

References 24 publications

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Parental problems, case plan requirements, and service targeting in child welfare reunification

Características y desarrollo del acogimiento familiar en dos países con fuerte tradición de acogimiento residencial: España y Portugal

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