Together Facing the Challenge

Scientific Rating:
2
Supported by 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. Together Facing the Challenge has been rated by the CEBC in the area of: Resource Parent Recruitment and Training Programs.

Target Population: Treatment foster parents and agency staff

For parents/caregivers of children ages: 3 – 17

Brief Description

Together Facing the Challenge is a training/consultation approach to improving practice in treatment foster care (TFC). The intervention was built from a naturalistic study of “usual care” TFC to determine what practice components were related to improved outcomes for youth. It also incorporates elements from existing evidence-based treatments to fill identified gaps in usual care practice. The resulting model includes training/consultation for TFC supervisors as well as training for treatment foster parents. Together Facing the Challenge is designed as a train-the-trainer approach, so that TFC administrative/supervisory personnel can learn the training and model and train treatment foster parents.

This program will provide training on practical parenting and supervisory skills and techniques.

Program Goals:

The goals of Together Facing the Challenge are:

  • At the end, both therapeutic foster parents and supervisors alike will:
    • Build therapeutic relationships
    • Perform and teach cooperation skills
    • Implement effective parenting techniques (communicate effectively, set expectations, reinforce positive behavior, avoid power struggles, etc.)
    • Prepare youth for their future by teaching independence skills
    • Create a positive home environment through family fun time, taking care of self, family meetings, etc.
  • Improve outcomes for youth served in therapeutic foster care settings

Essential Components

The essential components of Together Facing the Challenge include:

  • Provides comprehensive training for both agency staff and treatment foster care parents in classes of 15-20 participants
  • Builds a therapeutic relationship – recognizes the significance of the therapeutic relationship by exhibiting both verbal and non-verbal behaviors that include:
    • Encouragement
    • Showing a genuine interest
    • Identifying common ground
    • Having a positive attitude
    • Being patient, understanding, consistent, and following through
  • Teaches cooperation – is able to balance use of implementing effective corrective discipline strategies and techniques within the context of a supportive and therapeutic environment
  • Addresses thoughts, feelings, and behavior – demonstrates ability to assist child in recognizing, talking, about, and dealing with difficult thoughts and feelings that emerge; helps the child to understand how their thoughts and feelings can impact their behavior
  • Interrupts the conflict cycle – is able to identify conflicts that take place and demonstrates ability to effectively intervene by de-escalating the situation
  • Utilizes problem solving techniques - demonstrates ability to use a problem solving model to address a specific problem by defining it clearly, generating multiple solutions, and selecting best solution based on outcomes
  • Teaches relevant life skills – demonstrates ability to transform daily living activities into learning opportunities to assist youth in the development of independent living skills
  • Takes care of self – is able to recognize the impact that stress has on their life, the ‘warning signs’ that make them aware of it, and the specific strategies they use to manage their stress level while taking time for self on a regularly scheduled basis

Parent/Caregiver Services

Together Facing the Challenge directly provides services to parents/caregivers and addresses the following:

  • Treatment Foster Parents of a child or children with emotional and behavioral problems
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: The treatment foster care agency and supervisors provide support to the treatment foster parents.

Delivery Settings

This program is typically conducted in a(n):

  • Community Agency
  • Department of Social Services

Homework

Together Facing the Challenge includes a homework component:

Treatment foster parents are given homework assignments at each weekly training session. These are to be completed (with support by treatment foster care supervisors as needed) between sessions.

Languages

Together Facing the Challenge does not have materials available in a language other than English.

Resources Needed to Run Program

The typical resources for implementing the program are:

Equipment needed:

  • Laptop
  • Projector
  • Speakers
  • Flip chart

Although accommodations needed for training are minimal, for optimal learning to take place consideration should be made regarding comfortable chairs set up around small tables or u-shaped seating with tables to enable participants to engage in hands-on activities and role play scenarios.

Minimum Provider Qualifications

Supervisors should have a Master’s degree or a Bachelor’s degree with at least 2 years of experience in the field. Treatment Foster Parent must be adults (aged 21 or over) who passed background checks. No minimum education level is required.

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:
  • Maureen Murray, LCSW
    Services Effectiveness Research Program

    phone: (919) 687-4686 x302
Training is obtained:

The initial training typically is conducted at a location set up by the agency making the request for the training. Specific information pertaining to scheduling and materials needed are arranged on a site-by-site basis with a contractual agreement specifying the details of the plan.

Recommendations for training

  • Group size for agency staff training is typically 15-30 participants.
  • Staff training – 2-3 day intensive seminar
Number of days/hours:

The agency staff train-the-trainer workshop is conducted over 3 consecutive days. A typical schedule would be 9-4pm with an hour for lunch and two 15 minute breaks. Follow-up phone consultation begins after the initial training ends and typically occurs once a month for 6 months to one year.

Implementation Information

Since Together Facing the Challenge 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 Together Facing the Challenge as listed below:

There is a tool included in the manual that can be used by organizations to assess their readiness for implementation of Together Facing the Challenge.

Formal Support for Implementation

There is formal support available for implementation of Together Facing the Challenge as listed below:

Follow-up consultation is currently a required element of Together Facing the Challenge. After the 3-day train-the-trainer workshop has been conducted, monthly phone consultation sessions are scheduled for the first year of implementation. Additional consultation can be arranged as needed.

Fidelity Measures

There are fidelity measures for Together Facing the Challenge as listed below:

A fidelity measure is included in the Together Facing the Challenge manual to be used by agency staff to assess caregiver's ability to effectively implement the 16 skill areas incorporated into the curriculum.

Implementation Guides or Manuals

There are implementation guides or manuals for Together Facing the Challenge as listed below:

There is a Together Facing the Challenge manual that is included in the training.

Research on How to Implement the Program

The program representative did not provide information about research conducted on how to implement Together Facing the Challenge.

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

*Farmer, E. M. Z., Burns, B. J., Wagner, H. R., Murray, M., & Southerland, D. G. (2010). Enhancing “usual practice” treatment foster care: Findings from a randomized trial on improving youth outcomes. Psychiatric Services, 6, 555-561.

Type of Study: Randomized controlled trial (randomized at agency level)
Number of Participants: 247 youth and their treatment parents

Population:

  • Age — 2-21 years (Mean=13 years)
  • Race/Ethnicity — 57% African American, 33% White, and 10% Other
  • Gender — 45% Female
  • Status — Participants were youth served by 14 treatment foster care agencies during the 18-month recruitment period.

Location/Institution: Southeastern states in the U.S.A.

Summary: (To include comparison groups, outcomes, measures, notable limitations)
This article reports on the effectiveness of Together Facing the Challenge to enhance treatment foster care (TFC) in usual care agencies. The study was designed to examine whether additional training and consultation to staff and treatment foster parents improved outcomes for youths. Half of the agencies were randomly assigned to the Together Facing the Challenge condition and received study-provided training and consultation. Agencies in the control group continued to provide training and treatment as usual. Measures utilized included the Strengths and Difficulties Questionnaire (SDQ), Parent Daily Report, and the Behavioral and Emotional Rating Scale. Results indicated that compared with youths in the control group, youths in the Together Facing the Challenge group showed improvement on the three focal domains—symptoms, behaviors, and strengths. Effects were significant for all outcomes at six months. Effects for behaviors remained significant by 12 months. Limitations include generalizability limited to youth in treatment foster care settings.

Length of postintervention follow-up: 10.5 months after the end of training.

References

Farmer, E. M. Z., Burns, B. J., & Murray, M. (2009). Enhancing treatment foster care: An approach to improve usual care practice. Report on emotional and behavioral disorders in youth, Report on Emotional and Behavioral Disorders in Youth, 9, 79-84.

Murray, M., Farmer, E. M. Z., Southerland, D. S., & Ballentine, K. (2010). Enhancing and adapting treatment foster care: Lessons learned in trying to change practice. Journal of Child and Family Studies, 19(4), 393-403.

Contact Information

Name: Maureen Murray, LCSW
Agency/Affiliation: Duke University Medical Center
Department: Services Effectiveness Research Program
Email:
Phone: (919) 687-4686 x302
Fax: (919) 687-4737

Date Research Evidence Last Reviewed by CEBC: January 2017

Date Program Content Last Reviewed by Program Staff: May 2014

Date Program Originally Loaded onto CEBC: April 2011