Family Connections (FC)

Scientific Rating:
3
Promising Research Evidence
See scale of 1-5
Child Welfare System Relevance Level:
High
See descriptions of 3 levels

About This Program

The information in this program outline is provided by the program representative and edited by the CEBC staff. Family Connections (FC) has been rated by the CEBC in the areas of: Casework Practice, Interventions for Neglect and Prevention of Child Abuse and Neglect (Secondary) Programs.

Target Population: Families at risk for child maltreatment

For children/adolescents ages: 0 – 17

For parents/caregivers of children ages: 0 – 17

Brief Description

FC is a multifaceted, community-based service program that works with families in their homes and in the context of their neighborhoods to help them meet the basic needs of their children and prevent child maltreatment. Nine practice principles guide FC interventions: ecological developmental framework; community outreach; individualized family assessment and tailored interventions; helping alliance; empowerment principles; strengths-based practice; cultural competence; outcome-driven service plans with SMART goals; and a focus on the competence of the practitioner. Individualized family intervention is geared to increase protective factors, decrease risk factors, and target child safety, well-being, and permanency outcomes.

Program Goals:

The goals of Family Connections (FC) are:

  • Help these families meet the basic needs of their children
  • Reduce the risk of child neglect

Essential Components

The essential components of Family Connections (FC) include:

  • Overview of service delivery for families:
    • Intake and screening
    • Outreach and engagement
    • Emergency assistance/concrete services
    • Comprehensive family assessment including the use of standardized assessment instruments
    • Outcome drive plans with SMART goals
  • Change-focused intervention:
    • Minimum of 1 hour per week of home-based purposeful change-focused intervention
    • Advocacy/service facilitation of community interventions to support families to achieve outcomes and SMART goals
    • Case plan evaluation/progress assessment (at least every 90 days after the initial case plan
    • Case closure
  • FC philosophical principles used in the delivery of services:
    • Community outreach
    • Family assessment
    • Individualized, tailored intervention
    • Helping alliance
    • Empowerment approaches
    • Strengths perspective
    • Cultural competence
    • Developmental appropriateness
    • Outcome-driven service plans
  • FC practitioner activities:
    • Uses, at a minimum, screening criteria that indicate a risk of maltreatment based on the original screening criteria or based on locally determined risk factors of child maltreatment
    • Initiates the therapeutic relationship through face-to-face contact with the family within one business day of acceptance into the FC program
    • Is assigned to work with the qualified family on an ongoing basis
    • Provides at least one hour of face-to-face FC services to families at least once per week for at least three months
    • Provides most FC services in the community, meeting families where they live
    • Uses standardized clinical assessment instruments to guide the identification of risk and protective factors associated with child maltreatment as part of the comprehensive family assessment
    • Provides emergency/concrete services to address initial concrete needs and additional concrete on an ongoing basis as needed
    • Conducts comprehensive family assessments to guide the service delivery process
    • Develops outcome-driven service plans geared to decrease risk and increase protective factors associated with child maltreatment
    • Delivers tailored and direct therapeutic services to help families reduce risks, maximize protective factors, and achieve service outcomes and goals
    • Advocates on behalf of families in the community and facilitates services delivery by other organizations/individuals
  • FC program leadership activities:
    • Implements an assessment of individual and organizational readiness and assessment of organizational culture and climate
    • Tailors the intervention manual with state/local policies and procedures including link to information systems
    • Develops and employs an implementation leadership team
    • Develops and implements an implementation work-plan
    • Forms and utilizes a community advisory committee that incorporates consumer input
    • Implements process for evaluation of client change over time and at case closing
    • Self-evaluation of fidelity and use of results to implement improvement strategies

Child/Adolescent Services

Family Connections (FC) directly provides services to children/adolescents and addresses the following:

  • Externalizing and internalizing behaviors, inconsistent school attendance, antisocial behaviors

Parent/Caregiver Services

Family Connections (FC) directly provides services to parents/caregivers and addresses the following:

  • Poor household conditions, financial stress, inadequate social support, parenting stress and poor parenting attitudes, unsafe caregiver/child interactions, poor family functioning, poor adult functioning (e.g., mental health problems/substance abuse) that impacts parenting, poor family resources

Delivery Settings

This program is typically conducted in a(n):

  • Birth Family Home
  • Community Agency

Homework

This program does not include a homework component.

Languages

Family Connections (FC) has materials available in languages other than English:

Cambodian, Korean, Spanish

For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

  • Trained social worker
  • Office space
  • Computer and printer
  • Transportation for meeting clients in their homes and in other community settings
  • Emergency/concrete needs fund
  • Weekly individual and group supervision

Minimum Provider Qualifications

Master's level worker or Bachelor's level worker supervised by a staff member with a Master's degree or higher

Education and Training Resources

There is a manual that describes how to implement this program, and there is training available for this program.

Training Contact:
Training is obtained:

Onsite at replicating agency, delivered by a FC training and technical assistance team affiliated with the University of Maryland School of Social Work and/or ACTION for Child Protection

Number of days/hours:

Determined individually for each site based on needs. Most replicating programs begin with a 1-day orientation training, then supervisors are trained for 4 days (2 days, Practicum, 2 days), followed by social workers with their supervisors for 5 days (Phase I – 1 day, Practicum, Phase II – 2 days, Practicum, Phase III-2 days). Follow-up technical assistance and coaching is highly recommended usually targeting supervisors to build local capacity.

Implementation Information

Since Family Connections (FC) is rated on the Scientific Rating Scale, information was requested from the program representative on available pre-implementation assessments, implementation tools, and/or fidelity measures.

Show implementation information...

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for Family Connections (FC) as listed below:

Assessments of Individual and organizational readiness and of organizational culture and climate are available.

Formal Support for Implementation

There is formal support available for implementation of Family Connections (FC) as listed below:

Training and technical assistance (including coaching) is provided by a team at the University of Maryland School of Social Work and ACTION for Child Protection.

Fidelity Measures

There are fidelity measures for Family Connections (FC) as listed below:

There are three fidelity instruments available for use: the Fidelity Self-Assessment, the Case Review Instrument, and the Supervisory Fidelity Assessment instrument.

Implementation Guides or Manuals

There are implementation guides or manuals for Family Connections (FC) as listed below:

A Replication Implementation Manual was developed for the 8 federally funded sites. Current replications collaborate with the FC Technical Assistance Team during the installation stage to develop an implementation work plan.

Research on How to Implement the Program

Research has been conducted on how to implement Family Connections (FC) as listed below:

  • Filene, J. H., Brodowski, M. L., & Bell, J. (2014) Using cost analysis to examine variability in replications of an efficacious child neglect prevention program. Journal of Public Child Welfare, 8(4), 375-396. doi:10.1080/15548732.2014.939249

Relevant Published, Peer-Reviewed Research

This program is rated a "3 - Promising Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one study utilizing some form of control (e.g., untreated group, placebo group, matched wait list study) establishing the practice's benefit over the placebo, or found it to be comparable to or better than an appropriate comparison practice. Please see the Scientific Rating Scale for more information.

Child Welfare Outcomes: Safety and Child/Family Well-Being

Show relevant research...

DePanfilis, D., & Dubowitz, H. (2005). Family Connections: A program for preventing child neglect. Child Maltreatment, 10(2), 108-123.

Type of Study: Randomized controlled trial comparing 3 and 9 month versions of the program
Number of Participants: 154 families

Population:

  • Age — Caregivers: 19-72 years, Children: Newborn to 20 years
  • Race/Ethnicity — Caregivers: 87.5% African American, Children: 86.4% African American
  • Gender — Caregivers: 97.8% Female
  • Status — Participants were referred due to concerns about neglect, but not currently involved with Child Protective Services.

Location/Institution: Baltimore

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Families were randomly assigned to receive services through Family Connections (FC) for either 3 or 9 months. The study measured risk factors, protective factors, and two child outcomes: safety and behavior. Risk factors measured were caregiver depressive symptoms, measured by the Center for Epidemiologic Studies-Depression Scale (CES-D); parenting stress, measured by the Parenting Stress Inventory (PSI); and everyday stress, measured by the Everyday Stressors Index. Protective factors included parenting attitudes, measured by the Adult-Adolescent Parenting Inventory; parenting sense of competence, measured by the Parenting Sense of Competence Scale; family functioning, measured by the Self-Report Family Inventory; and social support, measured by the Social Provisions Scale. Child safety was assessed by observation, using three subscales of the Child Well-Being Scales (household furnishing, overcrowding, and sanitation) and by Child Protective Services reports (prior, during and 6 months after intervention.) Finally, child behavior was measured with the Child Behavior Checklist. Results for both groups showed positive changes in protective factors (parenting attitudes, parenting competence, and social support); diminished risk factors (depressive symptoms, parenting stress, life stress); improved safety (physical and psychological care of children); and improved behavior (decreased internalizing and externalizing). There was no advantage seen in the 9-month versus the 3-month intervention with the exception of child behavior. Families served for 9 months demonstrated greater or more sustained reported improvements in child behavior. Limitations noted are the relatively small sample, short follow-up, and a possible self-selection bias of families willing to accept a home-based intervention. Note: This study compared two versions of the same treatment with varying lengths. Although randomization occurred, this study cannot be used to support a rating of 1 or 2, as both groups received the FC intervention.

Length of postintervention follow-up: 6 months.

Girvin, H., DePanfilis, D., & Daining, C. (2007). Predicting program completion among families enrolled in a child neglect prevention intervention. Research on Social Work Practice, 17(6), 674-685.

Type of Study: Randomized controlled trial comparing 3 and 9 month versions of the program
Number of Participants: 136 families

Population:

  • Age — Caregivers: 19-72 years, Children: Newborn-20 years
  • Race/Ethnicity — Caregivers: 87.5% African American, Children: 86.4% African American
  • Gender — Caregivers: 97.8% Female
  • Status — Participants were referred due to concerns about neglect, but not currently involved with Child Protective Services.

Location/Institution: Baltimore

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: This study uses a subset of families from DePanfilis & Dubowitz, 2005. Caregivers and families were randomly assigned to groups, which would receive either 3 or 9 months of Family Connections (FC). Variables used as potential predictors for program completion included previous Child Protective Services contact, history of drug use, depressive symptoms (as measured by the Center for Epidemiologic Studies-Depression Scale (CES-D), everyday stressors (as measured by the Everyday Stressors Index), and worker/client relationship (as measured by the Helping Relationship Inventory.) Finally, the Parent Outcome interview was used to assess caregivers’ satisfaction with the worker. Results of analyses showed that more families in the 3-month condition completed services. Those who completed also had significantly more children and reported a better alliance with their worker. Depressive symptoms also correlated with higher completion rates. Limitations include that research has not yet been done to show a link between completion rates and outcomes, and that the moderate overall attrition rate resulted in a reduced usable sample for the study (from 154 to 135 families with data at all 3 follow-up interviews). Note: This study compared two versions of the same treatment with varying lengths. Although randomization occurred, this study cannot be used to support a rating of 1 or 2, as both groups received the FC intervention.

Length of postintervention follow-up: 6 months.

DePanfilis, D., Dubowitz, H., & Kunz, J. (2008). Assessing the cost-effectiveness of Family Connections. Child Abuse & Neglect, 32, 335-351.

Type of Study: Randomized controlled trial comparing 3 and 9 month versions of the program
Number of Participants: 154 families

Population:

  • Age — Caregivers: 19-72 years, Children: Newborn to 20 years
  • Race/Ethnicity — Caregivers: 87.5% African American; Children: 86.4% African American
  • Gender — Caregivers: 97.8% Female
  • Status — Participants were referred due to concerns about neglect, but not currently involved with Child Protective Services.

Location/Institution: Baltimore

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Note: This study uses the same sample as DePanfilis & Dubowitz, 2005. This study assessed the cost-effectiveness of two alternate forms of Family Connections (FC), in relation to changes in risk and protective factors and improvements in child safety and behavioral outcomes. Families were randomly assigned to receive services through FC for either 3 or 9 months. The study measured risk factors, protective factors, and two child outcomes: safety and behavior. Risk factors measured were caregiver depressive symptoms, measured by the Center for Epidemiologic Studies-Depression Scale (CES-D); parenting stress, measured by the Parenting Stress Inventory (PSI); and everyday stress, measured by the Everyday Stressors Index. Protective factors included parenting attitudes, measured by the Adult-Adolescent Parenting Inventory; parenting sense of competence, measured by the Parenting Sense of Competence Scale; family functioning, measured by the Self-Report Family Inventory; and social support, measured by the Social Provisions Scale. Child safety was assessed by observation, using three subscales of the Child Well-Being Scales (household furnishing, overcrowding, and sanitation) and by CPS reports (prior, during and 6 months after intervention). The 3-month intervention was more cost effective than the 9-month intervention in relation to positive changes in risk and protective factors and child safety. However, cost-effectiveness analysis indicated that the 9-month intervention was more cost effective (CE ratio = $276) than the 3-month intervention (CE ratio = $337) in relation to improved unit changes in the child’s behavior between baseline and 6 months after service closure. Limitations include that this is a single-site study, and that the intervention was delivered by carefully supervised interns, which may not reflect real world settings. Note: This study compared two versions of the same treatment with varying lengths. Although randomization occurred, this study cannot be used to support a rating of 1 or 2, as both groups received the FC intervention.

Length of postintervention follow-up: 6 months.

References

Collins, K. S., Strieder, F., DePanfilis, D., Tabor, M., Freeman, P., Linde, L., & Greenberg, P. (2011). Trauma Adapted Family Connections (TA-FC): Reducing developmental and complex trauma symptomatology to prevent child abuse and neglect. Child Welfare, 90, 29-47

Filene, J. H., Brodowski, M. L., & Bell, J. (2014). Using cost analysis to examine variability in replications of an efficacious child neglect prevention program. Journal of Public Child Welfare, 8(4), 375-396. doi: 10.1080/15548732.2014.939249

Lindsey, M. A., Hayward, R. A., & DePanfilis, D. (2010). Gender differences in behavioral outcomes among children at risk of neglect: Findings from a family-focused prevention intervention. Research on Social Work Practice, 20(6), 572-581.

Contact Information

Name: Diane DePanfilis, PhD, MSW
Title: Professor
Agency/Affiliation: Hunter College
Department: Silberman School of Social Work
Website: www.family.umaryland.edu/fc-replication
Email:
Phone: (917) 435-2296

Date Research Evidence Last Reviewed by CEBC: June 2017

Date Program Content Last Reviewed by Program Staff: July 2015

Date Program Originally Loaded onto CEBC: May 2008