Homebuilders®

Families with children (birth to 18) at imminent risk of placement into, or needing intensive services to return from, foster care, group or residential treatment, psychiatric hospitals, or juvenile justice facilities

For children/adolescents ages: 0 - 17

For parents/caregivers of children ages: 0 - 17

Homebuilders® is a home- and community-based intensive family preservation services treatment program designed to avoid unnecessary placement of children and youth into foster care, group care, psychiatric hospitals, or juvenile justice facilities. The program model engages families by delivering services in their natural environment, at times when they are most receptive to learning, and by enlisting them as partners in assessment, goal setting, and treatment planning. Reunification cases often require case activities related to reintegrating the child into the home and community. Examples include helping the parent find childcare, enrolling the child in school, refurbishing the child’s bedroom, and helping the child connect with clubs, sports or other community groups. Child neglect referrals often require case activities related to improving the physical condition of the home, improving supervision of children, decreasing parental depression and/or alcohol and substance abuse, and helping families access needed community supports.

Lisa Greenwald
Institute for Family Development

• http://www.institutefamily.org/
• Email: lgreenwald@institutefamily.org
• Phone: (253) 927-1550

The goals of Homebuilders® are:

• Reduce child abuse and neglect
• Reduce family conflict
• Reduce child behavior problems
• Teach families the skills they need to prevent placement or successfully reunify with their children

The essential components of Homebuilders® include:

• Engagement: Use a collaborative and collegial approach to engage and motivate families
• Assessment and Goal Setting: Use client-directed assessment across life domains, ongoing safety assessment and planning, domestic violence assessment, suicide assessment, and crisis planning
• Behavior Change: Use cognitive and behavioral research-based practices and behavioral interventions
• Skills Development: Teach parents and children a wide variety of “life skills” using “teaching interaction” process including practice, feedback, and homework
• Concrete Services: Provide and/or help the family access concrete goods and services that are directly related to achieving the family’s goals, while teaching them to meet these needs on their own
• Community Coordination and Interactions: Coordinate, collaborate, and advocate with state, local, public, and community services and systems affecting the family, while teaching clients to advocate and access support for themselves.
• Immediate Response To Referral: Accept referrals 24 hours a day, 7 days a week; therapist and back- up are available 24-hours a day, 7 days a week
• Service Provided in the Natural Environment: Provide services in the families’ homes and community
• Caseload Size: Carry caseloads of two families at a time on average
• Flexibility and Responsiveness: Tailor services to each family’s needs, strengths, lifestyle, and culture

Child/Adolescent Services

Homebuilders® directly provides services to children and addresses the following:

• Noncompliance, behavioral/emotional problems, aggression/anger, truancy, and running away

Parent/Caregiver Services

Homebuilders® directly provides services to parents/caregivers and addresses the following:

• Family conflict and violence, poor parenting skills, depression, aggression/anger, substance abuse, child abuse, and neglect

Recommended Intensity

Three to five 2-hour sessions contacts per week; an average of 8 to 10 hours per week of face to face contact, with telephone contact between sessions.

Recommended Duration

An average of four to six weeks. Two aftercare ‘booster sessions’ totaling up to five hours are available in the six months following referral.

Delivery Settings

This program is typically conducted in a(n):

• Adoptive Home
• Birth Family Home

Homework

Homework is individually tailored based on family goals; usually includes collecting data, practicing skills, and implementing interventions.

Resources Needed to Run Program

The typical resources for implementing the program are:

• A team of 3-5 therapists, 1 supervisor (carries a partial caseload), and 1 secretary/support staff
• A small amount of staff work/office space, supplies, telephone, copier, etc.
• Pagers and /or cell phones
• Clinical staff use their own vehicles for home visits, mileage is paid for all client and program related travel
• Access to a computer and Internet for client records and data collection

Prerequisite/Minimum Provider Qualifications

• Therapist: Master’s degree in psychology, social work, counseling, or a related field, or Bachelor’s degree in same fields plus two years of experience working with families.
• Supervisor: Master’s degree in psychology, social work, counseling or a related field, or Bachelor’s degree in same fields plus two years of experience providing the program, plus one year supervisory/management experience.

Manual Information

There is not a manual that describes how to deliver this program.

Training Information

There is training available for this program.

Training Contact

Training Type/Location:

Workshop training is provided onsite or at headquarters in Federal Way, WA. Program implementation and quality assurance is provided by telephone and on site.

Number of days/hours:

Recommended for clinical staff: 5 days initial training; 8 days of intermediate/advanced training; and 7 additional days of training for supervisors. Program implementation and quality assurance process involves quarterly 2-3 day site visits, 12 hours of records reviews, and 6-8 hours per month phone consultation.

Pre-Implementation Materials

There are no pre-implementation materials to measure organizational or provider readiness for Homebuilders®.

Formal Support for Implementation

The Institute for Family Development has a comprehensive site development implementation process for both providers and funders/public agencies that includes initial consultation and technical assistance on start-up  (e.g., needs, readiness, funding/costs/rate setting, staffing, training and implementation plans, etc.). They also provide initial and ongoing consultation with the providers agencies, which includes staff hiring, policy alignment, targeting of clients, collaboration with referents, clinical and programmatic team and individual consultation. All Homebuilders staff participate in over 100 hours of initial and ongoing training workshops and webinars over their first two years and fidelity data and reviews, which include onsite visits, are conducted 1-2 times a year as part of the implementation and fidelity process. Each team is assigned a Homebuilders Consultant, who provides initial and ongoing consultation and technical assistance remotely and in person during site visits. The consultant is available 24/7 for emergency consultation. Providers are required to use the Homebuilders web-based client documentation and data system and can also produce data and other reports. A variety of tools and activities including onsite (live) home visit observations are used to assess, enhance, support and achieve program fidelity.

Fidelity Measures

The Homebuilders model involves 20 Standards and a variety of fidelity measures and indicators that include quantitative and qualitative measures.  Quantitative measures are built into the web-based client documentation system. Other measures are assessed during weekly team consultation, through record reviews and through in person observations of home visits. For copies of the Homebuilders model standards and fidelity measures, email info@institutefamily.org

Established Psychometrics

There are no established psychometrics for Homebuilders®.

Fidelity Measures Required

Fidelity measures are required to be used as part of program implementation.

Implementation Guides or Manuals

A variety of training manuals and program tools are provided. The manuals are not available publicly and are provided as part of our implementation and training activities. The Homebuilders Standards and Fidelity Measures are available publicly by emailing info@institutefamily.org.

Implementation Cost

The Washington State Institute for Public Policy conducts meta-analyses (https://www.wsipp.wa.gov/BenefitCost/Program/665) and cost effectiveness studies (https://www.wsipp.wa.gov/BenefitCost/Program/78) of Homebuilders.

Research on How to Implement the Program

Research has not been conducted on how to implement Homebuilders®.

Child Welfare Outcome: Permanency

“What is included in the Relevant Published, Peer-Reviewed Research section?”

• Wood, S., Barton, K., & Schroeder, C. (1988). In-home treatment of abusive families: Cost and placement at one year. Psychotherapy: Theory, Research, Practice, Training, 25(3), 409–414. https://doi.org/10.1037/h0085362

  Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental)

  Number of participants: 59 children in 26 families

  Population:

  • Age — Families First Group: Mean=8.9 years; Comparison Group: Mean=5.4 years
  • Race/Ethnicity — 72% White, 15% Black, 9% Asian, and 4% Hispanic
  • Gender — Not specified
  • Status —

    Participants were families at risk of having a child placed out-of-home, who were referred to the Families First program.

  Location/Institution: Northern California

  Summary:

  The purpose of the study was to report on a child abuse prevention project designed to keep abused children safely at home. Participants were assigned to either the Families First home-based service program [now called Homebuilders®] or to usual services. Measures utilized include administrative data from the Department of Children and Family Services (DCFS) regarding financial aid, ethnicity, sex of referred children, or reason for referral. Results indicate that 74% of the Families First children remained at home compared to 45% of the comparison group. Placement costs were also significantly lower for the in-home services group. Limitations include lack of randomization of participants, interview bias, and lack of generalizability due to ethnicity.

  Length of controlled postintervention follow-up: 1 year.

• Fraser, M. W., Walton, E., Lewis, R. E., Pecora, P. J., & Walton, W. K. (1996). An experiment in family reunification: Correlates of outcomes at one-year follow-up. Children and Youth Services Review, 18(4–5), 335–361. https://doi.org/10.1016/0190-7409(96)00009-6

  Type of Study: Randomized controlled trial

  Number of participants: 110

  Population:

  • Age — 1–17 years (Mean=10.8 years)
  • Race/Ethnicity — 83% White
  • Gender — 58% Female
  • Status —

    Participants were children in foster care.

  Location/Institution: Utah

  Summary:

  The purpose of the study was to describe findings from an evaluation of a program developed to reunify foster children with their biological parents. Participants were randomly assigned to receive an experimental family reunification intervention [now called Homebuilders®] or to a routine services control group. Measures utilized include administrative data from the Department of Children and Family Services (DCFS). Results indicate that significantly more children in the treatment group returned to their families within the 90-day treatment program than did control group children. Treatment group children also returned in a shorter amount of time than did control children. Children who went through the treatment program spent more time in their own home than did control group children during the 6-month and 12-month follow-up periods. At one-year postintervention follow-up, 70% of children who were in the program remained home as compared to 47% of children in the control group. Limitations include lack of generalizability due to ethnicity and also limited to participants in foster care system.

  Length of controlled postintervention follow-up: 1 year.

• Walton, E. (1998). In-home family-focused reunification: A six-year follow-up of a successful experiment. Social Work Research, 22(4), 205–214. https://doi.org/10.1093/swr/22.4.205

  Type of Study: Randomized controlled trial

  Number of participants: 120 children

  Population:

  • Age — 6.4–23.9 years at 6-year follow-up
  • Race/Ethnicity — 83% White
  • Gender — Not specified
  • Status —

    Participants were children and young adults currently or formerly in foster care.

  Location/Institution: Utah

  Summary:

  The study used the same sample as Fraser et al. (1996), with the addition of 10 young adults who turned 18 during the intervention in that study. The purpose of the study was to report the placement and welfare service histories for children included in the original trial. Participants were randomly assigned to the intervention group [now called Homebuilders®] or to a routine services control group. Measures utilized include administrative data from Department of Children and Family Services (DCFS) on total days of public agency involvement during the 6 years, total number of referrals to the DCFS, public agency involvement after DCFS case closure and reason for discontinuing services. Results indicate that groups did not differ on days of DCFS involvement and number of referrals. Groups were also equal in the extent to which they received extensive involvement with services, defined as placement in a foster home, corrections facility, or facility of the Department of Mental Retardation. Experimental families received more services overall, which authors attribute as possibly being a result of the interventions focus on networking families with services. Finally, a greater number of intervention families were classified as having discontinued services due to the family situation being stabilized. Limitations include lack of generalizability due to ethnicity and also limited to former and current participants in the foster care system.

  Length of controlled postintervention follow-up: Approximately 5.75 years.

• Kinney, J. M., Haapala, D. A., & Booth, C. (2004). Keeping families together: The Homebuilder® Model. New Brunswick, New Jersey. Aldine Transaction.

• Wood, S., Baron, K., & Schroeder, C. (1988). In-home treatment of abusive families: Cost and placement at one year. Psychotherapy, 25(3), 409-414.