KEEP SAFE

Scientific Rating:
2

(provisional rating)

Supported by Research Evidence
See scale of 1-5
Child Welfare System Relevance Level:
High

(provisional rating)

See descriptions of 3 levels

Provisional Rating

KEEP SAFE currently has a provisional rating for the 60 days between: October 23, 2017 and December 22, 2017. If you would like to respond to the Scientific Rating, please submit feedback via the Contact Us page.

About This Program

The information in this program outline is provided by the program representative and edited by the CEBC staff. KEEP SAFE has been rated by the CEBC in the areas of: Resource Parent Recruitment and Training Programs and Behavioral Management Programs for Adolescents in Child Welfare.

Target Population: Caregivers of youth 10 to 18 years of age in foster or kinship care placements and the youth themselves

For children/adolescents ages: 10 – 18

For parents/caregivers of children ages: 10 – 18

Brief Description

The objective of KEEP SAFE is to give parents effective tools for dealing with their child's externalizing and other behavioral and emotional problems including trauma and to support them in the implementation of those tools. Curriculum topics include framing the foster/kin parents' role as that of key agents of change with opportunities to alter the life course trajectories of the children placed with them. Foster/kin parents are taught methods for creating a safe environment, encouraging child cooperation, using behavioral contingencies and effective limit setting, and balancing encouragement and limits. There are also sessions on dealing with difficult problem behaviors including covert behaviors, promoting school success, encouraging positive peer relationships, and strategies for managing stress brought on by providing foster care. There is an emphasis on active learning methods; illustrations of primary concepts are presented via role-plays and videotapes. There is also a component of the model that involves having the youth meet weekly with a skills coach. The emphasis is on developing and maintaining positive peer relationships, increasing skills to deal responsibly and safely to avoid drug use and participation in health-risking sexual behavior, and to help these youth problem solve difficulties and stresses in social relationships with adults and at school. KEEP SAFE is also rated in the Placement Stabilization Programs topic area. Please click here to go to that entry.

Program Goals:

The goals of KEEP SAFE are:

  • Decrease placement disruptions from foster care
  • Increase reinforcement from foster parent to child/adolescent
  • Decrease child/adolescent emotional and behavioral problems
  • Decrease foster/kin parent stress

Essential Components

The essential components of KEEP SAFE include:

  • Foster/kinship family attends weekly parent support and training group sessions.
  • Foster/kinship family groups are conducted by a trained facilitator and co-facilitator.
  • Foster/kinship family receives supervision in behavior management methods.
  • Foster/kinship family group sessions are structured so that the curriculum content is integrated into group discussions.
  • Foster/kinship family receives weekly Parent Daily Report Checklist calls by either the facilitator or co-facilitator to trouble shoot problems the foster parent was having in implementing the assignment, and to collect data on the child's problem behaviors during the past day.
  • If foster/kinship family misses a parent-training session, the material from the missed session is delivered during a home visit at a time convenient for the foster parent.
  • Youth are provided with a skills coach to help them practice prosocial skills in the community.

Child/Adolescent Services

KEEP SAFE directly provides services to children/adolescents and addresses the following:

  • Externalizing problems, trauma mental health problems, drug use, high-risk sexual behavior, and problems in school and with peer group

Parent/Caregiver Services

KEEP SAFE directly provides services to parents/caregivers and addresses the following:

  • Caregiver of a child with externalizing problems, trauma, mental health problems, drug use, high-risk sexual behavior, and problems in school and with peer group

Delivery Settings

This program is typically conducted in a(n):

  • Community Agency
  • Department of Social Services
  • Child Welfare Agencies

Homework

KEEP SAFE includes a homework component:

Home practice assignments help parents implement behavior management methods discussed and practiced in the groups. Home practices are also given to youth by their skills coach.

Languages

KEEP SAFE has materials available in a language other than English:

Swedish

For information on which materials are available in this language, 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:

  • Ability to video tape the group using digital format video
  • Group room
  • Video setup for the group (instructional tapes are used in some sessions)

Minimum Provider Qualifications

The intervention can be delivered by bachelor-level staff who are well-trained and supervised weekly. In many child welfare settings, the intervention is delivered by case workers. All sessions are video recorded and recordings are reviewed prior to the supervision. Paraprofessionals with a Bachelor's degree and good interpersonal skills are qualified. Supervisors are Master's level clinicians. Graduate students or Bachelor’s level staff members deliver the skills coaching sessions.

Education and Training Resources

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

Training Contacts:
Training is obtained:

Year-long training and consultation

Number of days/hours:

Initial training takes 5 days and then involves weekly telephone supervision for 12 months. Skills coach training takes 3 days plus monthly consultation calls for 6 months. In total there are 1.5 to 2 years of consultation, including training the trainers so the site can train new staff.

Implementation Information

Since KEEP SAFE 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 KEEP SAFE as listed below:

Initial “discovery telephone calls are conducted to learn about site needs, priorities, and goals.

There is a readiness questionnaire that is reviewed with all prospective KEEP SAFE programs. This is completed during telephone interviews between the developers and the prospective sites. For more information, please contact Patricia Chamberlain or Rohanna Buchanan at the Oregon Social Learning Center at 541-485-2711.

Formal Support for Implementation

There is formal support available for implementation of KEEP SAFE as listed below:

Agency assigns a group leader to participate in an initial five-day intensive training. The group leader receives additional formal support, including:

  • Weekly written feedback on fidelity and participate in weekly telephone consultation with a KEEP SAFE expert.
  • Group Leaders who complete three 16-week KEEP SAFE groups are eligible to be certified.
  • Certified Group Leaders are eligible to be KEEP SAFE Local Coaches/trainers in their agency/region. Local Coaches participate in an additional 3-day training session and the first training session they lead is “shadowed” by a KEEP SAFE expert.
  • Local Coaches/trainers participate in an additional 5-day training session and the first training session they lead is “shadowed” by a KEEP SAFE expert.
  • Local Coaches are trained to reliably to rate session fidelity.

Fidelity Measures

There are fidelity measures for KEEP SAFE as listed below:

The KEEP Fidelity Adherence Rating System is used. The measure can be obtained from Rohanna Buchanan (email: RohannaB@oslc.org).

Group leaders and agency directors are provided with monthly reports

Implementation Guides or Manuals

There are implementation guides or manuals for KEEP SAFE as listed below:

There is an implementation manual. Information about is available from Rohanna Buchanan (email: RohannaB@oslc.org).

Research on How to Implement the Program

Research has been conducted on how to implement KEEP SAFE as listed below:

Buchanan, R., Chamberlain, P., Price, J. M., & Sprengelmeyer, P. (2013). Examining the equivalence of fidelity over two generations of KEEP implementation: A preliminary analysis. Children and Youth Services Review, 35(1), 188-193. doi:10.1016/j.childyouth.2012.10.002

Chamberlain, P. (2017). Toward creating synergy among policy, procedures, and implementation of evidence-based models in child welfare systems: Two case examples. Clinical Child and Family Psychology Review, 20, 78-86. doi:10.1007/s10567-017-0226-5

Chamberlain, P., Feldman, S. W., Wulczyn, F., Saldana, L., & Forgatch, M. (2016). Implementation and evaluation of linked parenting models in a large urban child welfare system. Child Abuse & Neglect, 53, 27-39. doi:10.1016/j.chiabu.2015.09.013

Relevant Published, Peer-Reviewed Research

This program is rated a "2 - Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The program must have at least one rigorous randomized controlled trial with a sustained effect of at least 6 months. The article(s) below that reports outcomes from an RCT showing a sustained effect of at least 6 months has an asterisk (*) at the beginning of its entry. Please see the Scientific Rating Scale for more information.

Child Welfare Outcome: Child/Family Well-Being

Show relevant research...

*Smith, D. K., Leve, L. D., & Chamberlain, P. (2011). Preventing internalizing and externalizing problems in girls in foster care as they enter middle school: Impact of an intervention. Prevention Science, 12(3), 269-277.

Type of Study: Randomized controlled trial
Number of Participants: 100

Population:

  • Age — Children: Mean=11.54 years, Parents: Not specified
  • Race/Ethnicity — Children: 63% European American, 14% Multiracial, 10% Latino, 9% African American, and 4% Native American; Parents: 70% European American, 17% African American, 3% Native American, 4% Latino, 1% Asian, and 5% Multiracial
  • Gender — Children: 100% Female, Parents: 70% Female
  • Status — Participants were involved in the child welfare system.

Location/Institution: Lane or Multnomah County, Oregon

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The current study examined the immediate impact of the Middle School Success intervention (MSS, now called KEEP SAFE [Keeping Foster Parents Trained and Supported]) targeting the prevention of internalizing and externalizing problems for girls in foster care prior to middle school entry. Measures utilized include the Parent Daily Report (PDR). Study participants included girls and their caregivers in state-supported foster homes who were randomly assigned to an intervention condition or to a control condition (foster care services as usual). Results indicate that the MSS girls experienced fewer internalizing and externalizing problems. However, there were no significant changes in prosocial behavior. Limitations include limited generalizability due to gender, the outcomes examined were short-term thus demonstrating only the immediate impact of the intervention, and mechanisms underlying the significant improvements in internalizing and externalizing outcomes for the intervention girls were not examined in the present study.

Length of postintervention follow-up: 6 months.

*Kim, H. K., & Leve, L. D. (2011). Substance use and delinquency among middle school girls in foster care: A three-year follow-up of a randomized controlled trial. Journal of Consulting and Clinical Psychology, 79(6), 740-750. doi:10.1037/a0025949

Type of Study: Randomized controlled trial
Number of Participants: 100

Population:

  • Age — Children: Mean=11.54 years, Parents: Not specified
  • Race/Ethnicity — Children: 63% European American, 14% multiracial, 10% Latino, 9% African American, 4% Native American ; Parents: 70% European American, 17% African American, 3% Native American, 4% Latino, 1% Asian, and 5% multiracial
  • Gender — Children: 100% Female, Parents:70% Female
  • Status — Participants were individuals involved in the child welfare system.

Location/Institution: San Diego County, California

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study is a follow up to Smith et al. (2011). The present study evaluated the efficacy of the Middle School Success intervention (MSS; now called KEEP SAFE [Keeping Foster Parents Trained and Supported]) for reducing substance use and delinquency among girls in foster care. Measures utilized include the Parent Daily Report Checklist (PDR) and the Achenbach System of Empirically Based Assessment (ASEBA). Participants were randomly assigned to either or the control group. Results indicate that girls in MSS showed significantly lower levels of substance use than did girls in the control condition at 36-month postbaseline. The group difference was only marginally significant for delinquency. Further analyses indicated significant indirect effects of MSS through increased prosocial behaviors which led to decreased internalizing and externalizing symptoms and then to lower levels of substance use. The direct effect of MSS on substance use remained significant in the presence of the indirect effects. For delinquency, the intervention had positive effects mainly through increased prosocial skills. Limitations include generalizability due to ethnicity, small sample size, and reliance on self-reported measures.

Length of postintervention follow-up: 32 months.

*Kim, H. K., Pears, K. C., Leve, L. D., Chamberlain, P., & Smith, D. K. (2013). Intervention effects on health-risking sexual behavior among girls in foster care: The role of placement disruption and tobacco and marijuana use. Journal of Child & Adolescent Substance Abuse, 22(5), 370-387.

Type of Study: Randomized controlled trial
Number of Participants: 100

Population:

  • Age — Children: Mean=11.54 years, Parents: Not specified
  • Race/Ethnicity — Children: 63% European American, 14% Multiracial, 10% Latino, 9% African American, and 4% Native American; Parents: 70% European American, 17% African American, 5% Multiracial, 4% Latino, 3% Native American, and 1% Asian
  • Gender — Children: 100% Female, Parents: 70% Female
  • Status — Participants were individuals involved in the child welfare system.

Location/Institution: Lane or Multnomah County, Oregon

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study is a follow up to Smith et al. (2011). The purpose of the present study examined the effects of the Middle School Success intervention (MSS, now called KEEP SAFE [Keeping Foster Parents Trained and Supported]), on their health-risking sexual behavior of girls involved in foster care. Measures utilized included assessment of tobacco and marijuana use and health-risking sexual behaviors, placement change, and pubertal status. Results indicate that girls in MSS showed significantly lower levels of health-risking sexual behavior than did girls in the control condition. Limitations include small sample size, generalizability due to ethnicity and gender, and reliance on self-reported measures.

Length of postintervention follow-up: 32 months.

Roberts, R., Glynn, G., & Waterman, C. (2016). ‘We know it works but does it last?’ The implementation of the KEEP foster and kinship carer training programme in England. Adoption & Fostering, 40(3), 247-263.

Type of Study: Pretest-posttest without control group
Number of Participants: 1,798 (892 carers; 906 children)

Population:

  • Age — Adults: 19-78 years; Children: 3-17 years
  • Race/Ethnicity — Adults: 86% White British/White Other, 8% Black British/Black Other, 2% Asian British/Asian Other, 2% Mixed/Other, 2% Not Known; Children: 78% White British/White Other, 7% Black British/Black Other, 3% Asian British/Asian Other, 7% Other; 9% Not Known
  • Gender — Adults: 86% Female and 14% Male; Children: 54% Male and 46% Female
  • Status — Participants were individuals involved with the child welfare services (CWS).

Location/Institution: England

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The purpose of this study was to determine the efficacy of the KEEP Safe Program. Individuals were assigned to either: KEEP Standard (5-12 years), KEEP Safe (12-19 years) or KEEP 3-6. Measures utilized include the Parent Daily Report (PDR), the Strengths and Difficulties Questionnaire (SDQ), and the Parenting Scale (PS). Results show that the PDR scores for number of problematic behaviors and carer stress are lower for the KEEP Safe adolescents group. Data on the reasons for unplanned moves or disruptions were unknown for a quarter of the KEEP Safe group. In addition, longer-term outcome data for 6- and 12-month postgroup follow-up for KEEP Safe (for carers of children aged 5–12 years) show that significant improvements in behavioral difficulties, foster carer stress, and parenting discipline style are all maintained. Prior to the intervention, 57% (n=70) of the KEEP Safe adolescents were reported to have seven or more behaviors per day on average. This was reduced to 23% (n=28) postintervention as a large proportion moved from the increased-risk to the low-risk category. Limitations include lack of randomization, lack of control group, and missing data.

Length of postintervention follow-up: 6 and 12 months.

References

Chamberlain, P., Price, J., Leve, L. D., Laurent, H., Landsverk, J. A., & Reid, J. B. (2008). Prevention of behavior problems for children in foster care: Outcomes and mediation effects. Prevention Science, 9, 17-27.

Chamberlain, P., Price, J. M., Reid, J. B., Landsverk, J., Fisher, P.A., & Stoolmiller, M. (2006). Who disrupts from placement in foster and kinship care? Child Abuse and Neglect, 30, 409-424.

Price, J. M., Chamberlain, P., Landsverk, J., Reid, J., Leve, L., & Heidemarie, L. (2008). Effects of a foster parent training intervention on placement changes of children in foster care. Child Maltreatment, 13,64-75.

Contact Information

Name: Patricia Chamberlain, PhD
Agency/Affiliation: Oregon Social Learning Center
Department: Center for Research to Practice
Website: www.keepfostering.org
Email:
Phone: (541) 485-2711
Fax: (541) 485-7087

Date Research Evidence Last Reviewed by CEBC: April 2017

Date Program Content Last Reviewed by Program Staff: October 2017

Date Program Originally Loaded onto CEBC: October 2017