KEEP (Keeping Foster and Kin Parents Supported and Trained)

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. KEEP (Keeping Foster and Kin Parents Supported and Trained) has been rated by the CEBC in the areas of: Placement Stabilization Programs, Resource Parent Recruitment and Training Programs and Kinship Caregiver Support Programs.

Target Population: Caregivers of children 4 to 12 years of age in foster or kinship care placements

For parents/caregivers of children ages: 4 – 12

Brief Description

The objective of KEEP 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.

Program Goals:

The goals of KEEP (Keeping Foster and Kin Parents Supported and Trained) 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 (Keeping Foster and Kin Parents Supported and Trained) 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.

Parent/Caregiver Services

KEEP (Keeping Foster and Kin Parents Supported and Trained) directly provides services to parents/caregivers and addresses the following:

  • Child externalizing problems, trauma, mental health problems and problems in school and with peer group

Delivery Settings

This program is typically conducted in a(n):

  • Community Agency
  • Department of Social Services

Homework

KEEP (Keeping Foster and Kin Parents Supported and Trained) includes a homework component:

Home practice assignments help parents implement behavior management methods discussed and practiced in the groups.

Languages

KEEP (Keeping Foster and Kin Parents Supported and Trained) has materials available in a language other than English:

Spanish

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

KEEP can be delivered by case workers and other staff who are well-trained and supervised weekly. In many child welfare settings, KEEP 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.

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:

Year-long training and consultation

Number of days/hours:

1.5 years of consultation, including training the trainers so the site can train new staff; initial training takes 5 days and then involves weekly telephone consultation for 12 months

Implementation Information

Since KEEP (Keeping Foster and Kin Parents Supported and Trained) 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

The program representative did not provide information about pre-implementation materials.

Formal Support for Implementation

The program representative did not provide information about formal support for implementation of KEEP (Keeping Foster and Kin Parents Supported and Trained).

Fidelity Measures

The program representative did not provide information about fidelity measures of KEEP (Keeping Foster and Kin Parents Supported and Trained).

Implementation Guides or Manuals

The program representative did not provide information about implementation guides or manuals for KEEP (Keeping Foster and Kin Parents Supported and Trained).

Research on How to Implement the Program

Research has been conducted on how to implement KEEP (Keeping Foster and Kin Parents Supported and Trained) 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.

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: Permanency and Child/Family Well-Being

Show relevant research...

Chamberlain, P., Moreland, S., & Reid, K. (1992). Enhanced services and stipends for foster parents: Effects on retention rates and outcomes for children. Child Welfare, 71(5), 387-401.

Type of Study: Randomized controlled trial
Number of Participants: 72 foster families

Population:

  • Age — Children: 4-7 years; Adults: Approximately 40 years
  • Race/Ethnicity — Children: 86% Caucasian, 6% African American, and 4% Hispanic; Adults: Not specified
  • Gender — Children: 61% Female, 39% Male; Adults: Not specified
  • Status — Participants were foster and kinship parents and their children.

Location/Institution: Oregon counties

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study measured the impact on children of a $70-per-month supplement to the foster parent's normal reimbursement and of increased training and support of the foster parents through a training and support program [now called KEEP (Keeping Foster Parents Trained and Supported)] . The effects on foster parent dropout rates were also evaluated. Participants were randomly assigned to an intervention and 2 control conditions. Measure utilized was the Parent Daily Report. The intervention consisted of enhanced training for parents in the form of group sessions, behavior management techniques, and telephone support. Intervention parents also received an additional monthly stipend. One comparison group received the stipend only and the control group received care as usual. Families were assessed at 3 weeks, and at 3, 6, and 9 months. Results indicate that intervention parents reported lower rates of child problem behaviors, had fewer placement disruptions, and fewer foster parents dropped out of providing care. Limitations include small sample size, reliability on self-reported measure, and lack of follow-up.

Length of postintervention follow-up: Not specified.

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(1), 64-75. doi:10.1177/1077559507310612

Type of Study: Randomized controlled trial
Number of Participants: 1,400 (700 parents and 700 children)

Population:

  • Age — Children: 5-12 years; Adults: Mean=47-49 years
  • Race/Ethnicity — • Children: 33% Latino, 22% Caucasian, 22% Mixed ethnic, 21% African American, 1% Asian American, and 1% Native American; Adults: 37% Latino, 27% Caucasian, 25% African American, 6% Mixed ethnic, 3% Asian/Pacific Islander, and 1% Native American
  • Gender — Children: 52% Female and 48% Male; Adults: 94% Female and 6% Male
  • Status — Participants were foster and kinship parents.

Location/Institution: San Diego, CA

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study uses the same sample as Chamberlain et al. (2008). Parents were randomly assigned to receive 16 weeks of training, supervision, and support or to casework services as usual. The intervention used was KEEP (Keeping Foster Parents Trained and Supported). Child placement exits from foster care were defined as occurring within 200 days of baseline and were based on foster parent report. Positive placement exits were defined as reunion with a parent or relative or adoption. Negative placement exits included another foster placement, more restrictive placement, or running away. Analyses regarding the KEEP intervention found that those in the intervention group were nearly twice as likely to experience a positive placement exit as the control group, but were no more or less likely to experience a negative exit as the control group. However, children with a higher number of placements prior to the beginning of the study were more likely to have negative placement exits if they were in the control group but not if they were in the intervention group, which suggested a mitigating effect. The authors note that 70% of the sample experienced no change in placement during the study period. Limitations include generalization of parenting effects to nonstudy foster children and lack of follow-up.

Length of postintervention follow-up: None.

Chamberlain, P., Price, J., Reid, J. B., & Landsverk, J. (2008). Cascading implementation of a foster and kinship parent intervention. Child Welfare, 87(5), 27-48.

Type of Study: Randomized controlled trial
Number of Participants: 700

Population:

  • Age — 19–81 years (Mean=48.6 years)
  • Race/Ethnicity — 37% Latino, 27% Caucasian, 26% African American, 6% Multiethnic, 3% Asian/Pacific Islander, and 1% Native American
  • Gender — 94% Female and 6% Male
  • Status — Participants were foster/kinship parents in San Diego County.

Location/Institution: San Diego County, CA

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study uses the same sample as Price et al. (2008). This study tests the effectiveness of KEEP (Keeping Foster Parents Trained and Supported) with 700 foster/kinship parents in San Diego County. Child behavioral outcomes were measured using the Parent Daily Report (PDR) checklist. In this study, PDR data were collected from foster and kin parents for three days at baseline and three days at treatment termination. No differences existed between the behavior rates reported by intervention parents and those reported by control parents at baseline. At treatment termination, however, foster/kin parents in the KEEP intervention condition reported significantly fewer child behavior problems than those in the control condition. In addition, these changes in child behavior were found to be mediated by changes in parenting behavior. At the five-month postbaseline interview, foster parents who participated in the KEEP groups showed an increase in the proportion of positive reinforcements relative to discipline parenting practices, and this increase predicted a decrease in child problem behaviors. Children of parents in the KEEP group were also found to have higher rates of reunification with biological or adoptive families and fewer placement disruptions than those in the control condition. Limitations include generalization of parenting effects to nonstudy foster children and lack of follow-up.

Length of postintervention follow-up: None.

DeGarmo, D. S., Chamberlain, P., Leve, L. D., & Price, J. (2009). Foster parent intervention engagement moderating child behavior problems and placement disruption. Research on Social Work Practice, 19(4), 423-433. doi:10.1177/1049731508329407

Type of Study: Randomized controlled trial
Number of Participants: 337

Population:

  • Age — Children: 5-12 years, Adults: Not specified
  • Race/Ethnicity — Children: Not specified; Adults: 33% Latino, 22% Caucasian, 22% mixed ethnicity, 21% African American, 1% Asian American, and 1% Native American
  • Gender — Children: Not specified, Adults: Not specified
  • 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 uses a subset of the same sample as Chamberlain et al. (2008). The primary goal of this study was to conduct a within intervention group analysis to test whether caregiver engagement (e.g., participation, homework completion, openness to ideas, apparent satisfaction) in KEEP (Keeping Foster Parents Trained and Supported) moderates risk factors for foster child outcomes. Measures utilized include the Parent Daily Report Checklist (PDR). Results showed caregiver engagement moderates both the influence that the number of prior placements has on increases in child problem behaviors and the risk of negative placement disruption for Hispanics. Limitations include reporter bias and absence of measures focusing on implementation fidelity, adherence to the weekly session curricula, or specific weekly intervention goal and lack of follow-up.

Length of postintervention follow-up: None.

Greeno, E. J., Lee, B. R., Uretsky, M. C., Moore, J. E., Barth, R. P., & Shaw, T. V. (2015). Effects of a foster parent training intervention on child behavior, caregiver stress, and parenting style. Journal of Child and Family Studies, 25(6), 1991-2000. doi:10.1007/s10826-015-0357-6

Type of Study: Pretest-posttest with comparison group
Number of Participants: 113

Population:

  • Age — Children: 4-12 years, Caregivers: 27-82 years
  • Race/Ethnicity — Children: 43% Black, 38% Caucasian, 12.5% Other, and 6.5 Missing; Caregivers: 47.5% Black/African American, 43% 3% Hispanic and 6.5% Mixed
  • Gender — Children: 42% Male and 58% Female, Caregivers: 99% Female
  • Status — Participants were individuals involved in the child welfare system.

Location/Institution: Maryland

Summary: (To include comparison groups, outcomes, measures, notable limitations)
The purposes of this study were to evaluate child behavior change, changes in caregiver parenting style, and permanency and placement stability at baseline and then after the KEEP (Keeping Foster Parents Trained and Supported) intervention. Measure utilized was the Parent Daily Report Checklist (PDR), Child Behavior Checklist (CBCL), the Discipline and Supervision Measure, and the Parenting Stress Index Short Form (PSI-SF). KEEP participants were referred by their child welfare caseworker, while comparison participants were recruited via mail and a foster parenting newsletter. Results indicated that significant decreases in child behavior problems for participants in KEEP interventions as compared to the comparison group. Additionally, the KEEP group displayed a significant reduction in PDR scores with a display of five fewer problem behaviors reported from baseline to posttest, while the comparison group did not demonstrate any significant change. The decrease of externalizing behaviors for the KEEP group, as measured by the PDR, was not associated with decreased parental stress (as measured by the PSI-SF) and there was not a significant relationship for the KEEP group at posttest for stress and child behavior. There was no change in the discipline and supervision ratio for either the KEEP group or the comparison group and there was no impact of the KEEP training on permanency outcomes for foster and kinship children. In addition, for KEEP parents, placement stability significantly increased between baseline and postintervention when compared to the comparison group. Limitations include nonrandomization of participants, small sample size, and significant differences between the two groups at baseline.

Length of postintervention follow-up: 2 months.

Greeno, E. J., Uretsky, M. C., Lee, B. R., Moore, J. E., Barth, R. P., & Shaw, T. V. (2016). Replication of the KEEP foster and kinship parent training program for youth with externalizing behaviors. Children and Youth Services Review, 61, 75-82. doi:10.1016/j.childyouth.2015.12.003

Type of Study: One group pretest-posttest study
Number of Participants: 65

Population:

  • Age — Children: 4-12 years, Caregivers: 27-72 years
  • Race/Ethnicity — Children: 48% Black, 32% Caucasian, 17% Other, and 3% Missing; Caregivers: 51% Black/African American, 32% Caucasian 3% Hispanic, and 14% Multiracial
  • Gender — Children: 51% Male, Caregivers: 99% Female
  • Status — Participants were individuals involved in the child welfare system.

Location/Institution: Maryland

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study utilizes the intervention sample from Greeno et al. (2015). The purpose of this study is to evaluate a replication of the KEEP (Keeping Foster Parents Trained and Supported) foster and kinship parent training program. Measure utilized was the Parent Daily Report Checklist (PDR), the Child Behavior Check List (CBCL), the Discipline and Supervision Measure, and the Parenting Stress Index Short Form (PSI-SF). The foster and kinship parents who participated in the KEEP group reported the number of problem behaviors on the PDR at baseline was 8 and that decreased to 3 behaviors reported by posttest and there was a significant difference in CBCL severity level scores with all severity levels decreasing from baseline to posttest. Additionally, placement stability significantly improved between baseline and posttraining. Limitations include the lack of control group, small sample size, and length of follow-up.

Length of postintervention follow-up: 2 months.

References

Show references...

Chamberlain, P., Moreland, S., & Reid, K. (1992). Enhanced services and stipends for foster parents: Effects on retention rates and outcomes for children. Child Welfare, 71(5):387-401.

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
Website: www.oslc.org/projects/keep
Email:
Phone: (541) 485-2711
Fax: (541) 485-7087

Date Research Evidence Last Reviewed by CEBC: April 2016

Date Program Content Last Reviewed by Program Staff: January 2017

Date Program Originally Loaded onto CEBC: May 2007