Boys Town In-Home Family Services (BT-IHFS)

About This Program

Target Population: Families with children ages 0-17 at-risk of out-of-home placement

For children/adolescents ages: 0 – 17

For parents/caregivers of children ages: 0 – 17

Program Overview

Boys Town In-Home Family Services (BT-IHFS) is an in-home parent skills-based service for parents/caregivers with children at-risk for involvement in the child welfare system or out-of-home placement. The program includes family engagement, assessment, service planning, parent and life skills training using an adapted version of Common Sense Parenting®, assisting with resources and supports, and case closure planning. BT-IHFS was developed to serve families with high caregiver strain, ineffective parenting strategies, difficulty accessing formal and informal supports, and children with significant emotional and behavioral needs. The BT-IHFS program has a hypothesized theory of change that starts with the provision of individualized, needs-driven services to families with a focus on building strong relationships through quick engagement interactions. The primary method is to provide coaching on parenting skills and connect the family to needed community resources or supports.

Program Goals

The goals of Boys Town In-Home Family Services® (BT-IHFS) are:

  • Achieving family safety, permanency, and well-being
  • Providing a safe home environment, with no immediate threat of danger to a child including no evidence of substantiated or unsubstantiated child maltreatment
  • Keeping the family together in their homes
  • Improving their family relationships and decreasing caregiver strain
  • Promoting healthy well-being and decreasing conduct and/or emotional problems in their children
  • Improving their family functioning that includes physical care of family members and socialization and education of children
  • Developing supports to maintain economic and housing stability

Logic Model

The program representative did not provide information about a Logic Model for Boys Town In-Home Family Services (BT-IHFS).

Essential Components

The essential components of Boys Town In-Home Family Services® (BT-IHFS) include

  • Trained Family Consultants work directly with family members to:
    • Identify existing strengths
    • Build on existing strengths
    • Solve problems that impact the safety, permanency, and well-being of their family
  • Teaching parenting skills by using an adaptation of the Common Sense Parenting® program:
    • Skills include:
      • Encouraging good behavior
      • Preventing problems
      • Correcting misbehavior
      • Setting tolerances
      • Using strategies to stay calm
    • Taught one-on-one by Family Consultants during weekly visits to the home through:
      • Providing skill instruction
      • Providing modeling Providing practice
      • Providing coaching
      • Giving assignments for the parents to complete with their children
  • Teaching family life skills during Family Consultants’ weekly visits to the home:
    • Skills include:
      • Checking on child’s school progress
      • Setting up a budget
      • Creating a family safety plan
    • Taught through:
      • Providing instruction
      • Providing modeling
      • Providing practice
      • Providing coaching
      • Giving assignments related to specific family needs
      • Customizing skills taught to the individual needs of each family
  • Increasing family resources and supports to help meet family needs through caregivers being encouraged to identify and connect with existing:
    • Informal supports including:
      • Friends
      • Family
      • Neighbors
    • Formal supports including:
      • School
      • Church
      • Community
    • Building strong partnerships with families by:
      • Providing individualized services:
        • Focused on parenting and family life skills
        • Specific skills chosen based on the strengths and needs of each family
      • Providing quick engagement interventions given by family consultants in order to:
        • Increase family engagement in services
        • Create momentum for substantial change
      • Promoting self-determination by:
        • Involving families in making their individual service plan
        • Having family share accountability for goal attainment
        • Encouraging self-advocacy and empowerment in families
      • Providing support by family consultants through:
        • Conducting scheduled weekly visits
        • Being available 24/7 to provide support and advice

Program Delivery

Child/Adolescent Services

Boys Town In-Home Family Services (BT-IHFS) directly provides services to children/adolescents and addresses the following:

  • Children and adolescents at high risk of involvement in the child welfare system and/or out-of-home placement due to abuse/neglect, disruptive behaviors, internalizing disorders (e.g., anxiety, depression), and maladaptive home and school behaviors

Parent/Caregiver Services

Boys Town In-Home Family Services (BT-IHFS) directly provides services to parents/caregivers and addresses the following:

  • Parents/caregivers of families that are at high risk of involvement in the child welfare system (e.g., abuse, neglect, dysfunctional family interactions, limited parenting skills, lacking access to community/financial resources or supports); parents of children at risk for out-of-home placement who have disruptive behaviors, internalizing disorders (e.g., anxiety, depression), and maladaptive home and school behaviors
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: Services include all of the members of the family in the home. In addition, supports may be coordinated with family members outside of the home, friends, teachers, etc.

Recommended Intensity:

One to two face-to-face contacts weekly for a total of 2-6 hours

Recommended Duration:

20 weeks (on average)

Delivery Settings

This program is typically conducted in a(n):

  • Adoptive Home
  • Birth Family Home
  • Foster / Kinship Care

Homework

Boys Town In-Home Family Services (BT-IHFS) includes a homework component:

Families can be asked to complete homework assignments related to the parenting skills training, etc.

Languages

Boys Town In-Home Family Services (BT-IHFS) 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:

Family Consultants require personal transportation, cell phone, computer, and secure office work space for maintaining confidential files/program materials.

Manuals and Training

Prerequisite/Minimum Provider Qualifications

Family Consultants are required to have at least a bachelor’s degree in the behavioral sciences or human services-related fields. Requirements can vary by state. For example, some states or contracts require Family Consultants to have a master’s degree. Supervisors typically have prior experience as a Family Consultant.

Manual Information

There is a manual that describes how to deliver this program.

Program Manual(s)

Father Flanagan’s Boys’ Home. (2015). Boys Town In-Home Family Services program manual. Author.

Training Information

There is training available for this program.

Training Contact:
Training Type/Location:

Training for Family Consultants and supervisors is available onsite at Boys Town, Nebraska.

Number of days/hours:

Family Consultant training is five days, with an additional two days of training for supervisors on observing and developing staff, model fidelity, data collection and analysis, leadership, etc.

Relevant Published, Peer-Reviewed Research

Duppong Hurley, K., Griffith, A. K., Casey, K. J., Ingram, S., & Simpson, A. (2011). Behavioral and emotional outcomes of an in-home parent training intervention for young children. Journal of At-Risk Issues, 16(2), 1–7. https://eric.ed.gov/?id=EJ960071

Type of Study: One-group pretest-posttest study
Number of Participants: 107 families

Population:

  • Age — Not specified
  • Race/Ethnicity — Families: 45% Hispanic, 37% African American, 15% Caucasian, and 3% Two or More Races
  • Gender — Children: 85% Male
  • Status — Participants were children referred by local schools in Palm Beach County.

Location/Institution: Palm Beach County, Florida

Summary: (To include basic study design, measures, results, and notable limitations)
This study examined the effects of the Boys Town In-Home Family Program [now called Boys Town In-Home Family Services (BT-IHFS)] on improving child behavior and parenting skills. Measures utilized included the Children Health Services Screen, the Child Behavior Checklist (CBCL), the Behavioral and Emotional Rating Scale-Second Edition (BERS-2), and the North Carolina Family Assessment Scale (NCFAS). Results indicated that preassessments and postassessments of child behavior indicated significant improvements on internalizing and externalizing problem behavior as measured by the CBCL. Significant gains were found on all child, family, and school behavior subscales of the parent version of BERS-2. Service provider ratings of child problems and parental capabilities (as assessed by the NCFAS) also demonstrated significant improvement from intake to discharge. Limitations include the lack of a comparison group; the study was conducted in a single county in Florida, which may affect the generalizability of the results to children in other geographic regions; and lack of follow-up.

Length of postintervention follow-up: None.

Duppong Hurley, K., Griffith, A., Ingram, S., Bolivar, C., & Mason, W. A., & Trout, A. (2012). An approach to examining the proximal and intermediate outcomes of an intensive family preservation program. Journal of Child and Family Studies, 21, 1003–1017. https://doi.org/10.1007/s10826-011-9563-z

Type of Study: One-group pretest-posttest study
Number of Participants: 44 families

Population:

  • Age — Children: 5–16 years (Mean=8.7 years); Adults: Not specified
  • Race/Ethnicity — Children: 50% African American, 27% Caucasian, 21% Hispanic, 2% other; Adults: Not specified
  • Gender — Children: 52% Female and 48% Male; Adults: Not specified
  • Status — Participants were families involved in the child welfare system

Location/Institution: Palm Beach County, Florida

Summary: (To include basic study design, measures, results, and notable limitations)
This study examined the effects of the Boys Town In-Home Family Program (BT-IHFP) [now called Boys Town In-Home Family Services (BT-IHFS)] on parenting skills, family functioning, and child behavior for at-risk families involved with child protective services. Measures utilized included the Parenting Practices Inventory (PPI), the Parenting Stress Index-Short Form (PSI), the Family Assessment Device (FAD), the Behavioral and Emotional Rating Scale-Second Edition (BERS-2), and the North Carolina Family Assessment Scale (NCFAS). Results indicated inspecting intake and discharge data for 44 families, 94% were intact at discharge and significant preintervention-postintervention improvements were found in proximal and intermediate outcomes. Limitations include the lack of comparison group, reliance on self-reported measures, and lack of follow-up.

Length of postintervention follow-up: None.

Parra, G. R., Ross, J. R., Ringle, J. L., Sampson, N., & Thompson, R. W. (2016). An evaluation of Boys Town In-Home Family Services with families referred by child welfare. Journal of Evidence-Informed Social Work, 13(4), 401–411. https://doi.org/10.1080/23761407.2015.1086715

Type of Study: One-group pretest-posttest
Number of Participants: 135 families

Population:

  • Age — Children: 1 month–17 years (Mean=4.54 years); Adults: 17– 63 years (Mean=32.15 years);
  • Race/Ethnicity — Children: 83% White; Adults: 86% White
  • Gender — Children: 60% Male; Adults: Not specified
  • Status — Participants were parents referred by child welfare for issues related to maltreatment.

Location/Institution: Nebraska

Summary: (To include basic study design, measures, results, and notable limitations)
This study evaluated the Boys Town In-Home Family Services (BT-IHFS) model with families referred by child welfare for issues related to maltreatment. Measures utilized included the Addiction Severity Index-Lite, the Strengths and Stressors Questionnaire and the Model Fidelity Assessment Observation form. Results indicate that reduced levels of perceived stressors were found for several domains of functioning with the largest effects observed for family safety, parental capabilities, and environmental factors. Limitations include the lack of comparison group, reliance on self-reported measures, and lack of follow-up.

Length of postintervention follow-up: None.

Stuva, D., Ringle, J. L., Thompson, R. W., Chmelka, B., Juliano, N., & Bohn, K. (2016). In-home family services: Providing lasting results to crisis helpline callers. The American Journal of Family Therapy, 44(5) 245–254. https://doi.org/10.1080/01926187.2016.1223566

Type of Study: One-group pretest-posttest study
Number of Participants: 75 families

Population:

  • Age — Children: 3–21 years (Mean=13 years); Adults: Not specified
  • Race/Ethnicity — Children: 52% White, 14% Two or More Races or Other, and 13% Black or African American; Adults: Not specified
  • Gender — Children: 60% Male; Adults: Not specified
  • Status — Participants were families referred from the Nebraska Family Helpline.

Location/Institution: Nebraska

Summary: (To include basic study design, measures, results, and notable limitations)
This study examined the efficacy of the Boys Town In-Home Family Services (BT-IHFS) program on families referred from a helpline. Measures utilized included the Strengths and Stressors Questionnaire. Results indicate that at-risk families calling the Nebraska Family Helpline for assistance can be referred to and benefit from more intensive in-home family services over and above what is typically offered from a helpline service. Results also indicated that families experienced a significant reduction in stress and were able to remain intact. Follow-up data indicate that outcomes were maintained up to twelve months after case closure. Limitations include the lack of comparison group, reliance on self-reported measures, and lack of follow-up.

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

Patwardhan, I., Duppong Hurley, K., Thompson, R. W., Mason, W. A., & Ringle, J. L. (2017). Child maltreatment as a function of cumulative family risk: Findings from the intensive family preservation program. Child Abuse & Neglect, 70, 92–99. https://doi.org/10.1016/j.chiabu.2017.06.010

Type of Study: Cross-sectional design
Number of Participants: 837 families

Population:

  • Age — Not specified
  • Race/Ethnicity — Not specified
  • Gender — Not specified
  • Status — Participants were families who received BT-IHFS

Location/Institution: 9 Boys Town sites across the United States

Summary: (To include basic study design, measures, results, and notable limitations)
This study examined child maltreatment as a function of cumulative family risk in a sample of at-risk families who were referred to Boys Town In-Home Family Services (BT-IHFS) because of child behavior problems or suspected child abuse and neglect. This study was conducted with intake data from families who received BT-IHFS in 2015. Measures utilized included the Addiction Severity Index-Lite, the Strengths and Stressors Questionnaire, and the Model Fidelity Assessment Observation form. Results indicate that the most prominent family risks comprising the cumulative risk scale in the sample were socio-economic disadvantage (e.g., income, unemployment, housing instability) and parental characteristics (e.g., mental/physical health, parental use of alcohol, domestic violence). Further, the results demonstrated a strong quadratic trend in the relationship between cumulative family risk and child maltreatment, and identified a risk threshold effect at three cumulative family risks after which the child risk for maltreatment increased exponentially. Limitations include the lack of comparison group, reliance on self-reported measures, and lack of follow-up.

Length of postintervention follow-up: None

Duppong Hurley, K., Lambert, M., Patwardhan, I., Ringle, J., Thompson, R., & Farley, J. (2020). Parental report of outcomes from a randomized trial of in-home family services. Journal of Family Psychology 34(1), 79–89. https://doi.org/10.1037/fam0000594

Type of Study: Randomized controlled trial
Number of Participants: 300 (152 treatment/148 control) families

Population:

  • Age — Parents/Guardians: Younger than 31 years to older than 39 years; Children: 5–14 years
  • Race/Ethnicity — Parents/Guardians: 70% White/Caucasian; Children: Not specified
  • Gender — Parents/Guardians: 90% Female; Children: 68.3% Male
  • Status — Participants were high-risk families recruited from a state helpline for families struggling with child emotional or behavioral issues.

Location/Institution: United States

Summary: (To include basic study design, measures, results, and notable limitations)
This study examined the efficacy of the Boys Town In-Home Family Services (BT-IHFS) program for families of high-risk youth. Families were randomly assigned to participate in BT-IHFS (n=152) for 3-4 months and to the services as usual comparison group (n=148). Measures utilized include the Caregiver Strain Questionnaire (CGSQ), the Family Assessment Device (FAD), the Alabama Parenting Questionnaire (APQ), the Parenting Scale (PS), the Family Resource Scale (FRS), and the Strengths and Difficulties Questionnaire (SDQ). Results indicate that four main effects were significant at the .05 per-test alpha level: caregiver strain (CGSQ), parenting (PS), child behavior (SDQ), and money and time subscale of the FRS. However, only caregiver strain was statistically significant after applying a conservative family-wise correction for multiple tests. During the maintenance phase, there were no significant differences between the BT-IHFS and comparison groups, aside from caregiver strain that showed a significant improvement for the comparison condition. Limitations include the reliance on self-reported measures.

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

Additional References

Ingram, S. D., Cash, S. J., Oats, R. G., Simpson, A., & Thompson, R. W. (2015). Development of an evidence-informed in-home family services model for families and children at-risk of abuse and neglect. Child & Family Social Work, 20(2), 139–148. https://doi.org/10.1111/cfs.12061

Thompson, R., & Koley, S. (2014). Engaging families in in-home family intervention. Reclaiming Children and Youth, 23(2), 19–22. https://eric.ed.gov/?id=EJ1038847

Spielberger, J., Scannell, M., & Harden, A. (2010). Characteristics and outcomes of children served by the Boys Town South Florida family centered services program, 2004–2009. Chapin Hall at the University of Chicago.

Contact Information

Susan Lamke
Title: MS
Website: www.boystown.org
Email:
Phone: (531) 355-1477

Date Research Evidence Last Reviewed by CEBC: December 2019

Date Program Content Last Reviewed by Program Staff: November 2020

Date Program Originally Loaded onto CEBC: December 2020