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Keeping Foster and Kin Parents Supported and Trained (KEEP)

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

See descriptions of 3 levels

Brief Description

The information in this program outline is provided by the program representative and edited by the CEBC staff. The Keeping Foster and Kin Parents Supported and Trained (KEEP) program has been rated by the CEBC in the areas of: Placement Stabilization and Resource Parent Recruitment and Training.

  • Types of Maltreatment: Does not target any specific kind of maltreatment
  • Target Population: 4 to 12-year-old children in foster or kinship care placements.

The objective of KEEP (Keeping Foster and Kin Parents Supported and Trained) is to give parents effective tools for dealing with their child's externalizing and other behavioral and emotional problems 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 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.

Essential Components

  • 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.

Child Component

Keeping Foster and Kin Parents Supported and Trained (KEEP) was not designed with a child component.

Parent / Caregiver Component

Keeping Foster and Kin Parents Supported and Trained (KEEP) was designed with a parent/caregiver component that addresses the following presenting problems and symptoms:

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

Group Format

Keeping Foster and Kin Parents Supported and Trained (KEEP) was designed to be conducted in a group setting; but has not been tested for use in a group setting.

Recommended group size:

7-10 foster/kin parents.

Delivery Settings

This program is typically conducted in a(n):

  • Community Agency
  • Departments of Social Service

Homework

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

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

Languages

Keeping Foster and Kin Parents Supported and Trained (KEEP) 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

e intervention can be delivered by paraprofessional 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.

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 supervision for 12 months.

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 range — children 4-7 yrs old; parents about 40 years old
  • Race/Ethnicity — Caucasian (86%); African American (6%); Hispanic (4%)
  • Gender — Not Specified
  • Status — Not Specified

Location / Institution: Oregon counties

Summary: (To include comparison groups, outcomes, measures, notable limitations)
72 foster families from 3 counties in Oregon were randomly assigned to intervention and 2 control conditions. 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. Assessments included the Parent Daily Report (of problem behaviors), dropout rates, a staff impression survey rating parents' skills and personal strengths and stable foster placements versus removal to restricted group care. (18 children were returned to their families, but the decision was not based on factors related to their foster condition.) Intervention parents reported lower rates of child problem behaviors, had fewer placement disruptions, and fewer foster parents dropped out of providing care.

Length of post-intervention follow-up: Not Specified

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.

Type of Study: Control Group
Number of Participants: N= 246

Population:

  • Age range — Children 5-12 years old; adults 19-81 yrs old
  • Race/Ethnicity — Children: Caucasian (25%); African American (19%); Hispanic (31%); Asian and Pacific Islander (
  • Gender — Not Specified
  • Status — Children in the foster care system.

Location / Institution: Oregon and San Diego counties.

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study only used children from the control group (foster care as usual). Children with fewer that 6 problem behaviors per day were less likely to disrupt from care than those with 6 or more and increases in behaviors were related to liner increases in the probability to disrupt. One outcome paper is submitted but not yet in press. A second and third are in preparation; will be submitted by December 2006.

Length of post-intervention follow-up: Not Specified

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.

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

Population:

  • Age range — Parents: Intervention average, 49.86; Control average, 47.29. Children: Intervention average, 8.88; Control average, 8.72
  • Race/Ethnicity — Parents: 25% African American, 3% Asian/Pacific Islander, 27% Caucasian, 37% Latino, 1% Native American, 6% Mixed ethnic Children: 21% African American, 33% Latino, 22% Caucasian, 22% Mixed ethnic, 1% Asian American, 1% Native American.
  • Gender — Not Specified
  • Status — Foster and kinship parents.

Location / Institution: San Diego, California

Summary: (To include comparison groups, outcomes, measures, notable limitations)
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), which is based on Multidimensional Treatment Foster Care (MTFC). Child behavior problems were measure using the Parent Daily Report Checklist (PDR) at baseline and termination (5 months post-baseline). Based on the baseline measure, families were split into high and low risk groups for analysis. High risk children were those with more than six reported behavior problems at baseline. The parent also completed an interview including measures of positive reinforcement and discipline. Results showed higher levels of positive reinforcement and accompanying lower levels of children's behavior problems for the intervention group. Effects were strongest for the high risk group.

Length of post-intervention follow-up: None.

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.

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

Population:

  • Age range — Children 5-12 years
  • Race/Ethnicity — Parents: 25% African American, 3% Asian/Pacific Islander, 27% Caucasian, 37% Latino, 1% Native American, 6% Mixed ethnic Children: 21% African American, 33% Latino, 22% Caucasian, 22% Mixed ethnic, 1% Asian American, 1% Native American.
  • Gender — Not Specified
  • Status — Foster and kinship parents

Location / Institution: San Diego, CA

Summary: (To include comparison groups, outcomes, measures, notable limitations)
(Note: This study uses the same sample as Chamberlain, et al., 2008 above.) 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), which is based on Multidimensional Treatment Foster Care (MTFC). Child exits from foster care were defined as occurring within 200 days of baseline and were based on foster parent report. Positive exits were defined as reunion with a parent or relative or adoption. Negative 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 exit, but were no more or less likely to experience a negative exit. However, children with a higher number of placements prior to the beginning of the study were more likely to have negative placements 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.

Length of post-intervention 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 range — Mean age: 48.6 years (range, 19–81 years)
  • Race/Ethnicity — Latino (37%), Caucasian (27%), African American (26%), multiethnic (6%), Asian/Pacific Islander (3%), and Native American (1%).
  • Gender — Not Specified
  • Status — Foster/kinship parents in San Diego County.

Location / Institution: San Diego County, CA

Summary: (To include comparison groups, outcomes, measures, notable limitations)
Most foster parents in the United States are required to participate in training, yet no empirical support exists for the training’s effectiveness. During the past two decades, high-quality clinical trials have documented that parent management training (PMT) programs produce positive outcomes for children and families in clinical and school settings; yet, these advances have not transferred to foster/kinship parents. This study tests the effectiveness of a PMT-based treatment 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.

Length of post-intervention follow-up: None.

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
Department: Center for Research to Practice
Website: www.keepfostering.org
Email:
Phone: (541) 485-2711
Fax: (541) 485-7087

Date Reviewed: November 2009 (originally reviewed in May 2007)