KEEP (Keeping Foster and Kin Parents Supported and Trained)

3  — Promising Research Evidence
High
3  — Promising Research Evidence
High
3  — Promising Research Evidence
High

About This Program

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

Program Overview

The objective of KEEP is to give parents effective tools for dealing with their child's externalizing problems, trauma, 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 creating a safe environment, encouraging child cooperation, using behavioral contingencies, strategies for self-regulation, 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. An adaptation of KEEP, for foster and kinship parents of teenagers called KEEP SAFE, has been reviewed by the CEBC and is rated a 2 –Supported by Research Evidence on the CEBC Scientific Rating Scale in the areas of Behavioral Management Programs for Adolescents in Child Welfare and Resource Parent Recruitment and Training Programs. KEEP SAFE has also been rated a 3 –Promising Research Evidence in the area of Placement Stabilization Programs; that entry is accessible here.

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 the child
  • Decrease the child's emotional and behavioral problems
  • Decrease foster/kin parent stress

Logic Model

The program representative did not provide information about a Logic Model for KEEP (Keeping Foster and Kin Parents Supported and Trained).

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.

Program Delivery

Parent/Caregiver Services

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

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

Recommended Intensity:

One 90-minute meeting per week plus one 10-minute telephone call per week for foster/kin parents

Recommended Duration:

16 weeks

Delivery Settings

This program is typically conducted in a(n):

  • Community-based Agency / Organization / Provider
  • Public Child Welfare Agency (Dept. of Social Services, etc.)

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)

Manuals and Training

Prerequisite/Minimum Provider Qualifications

KEEP can be delivered by case workers or 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 consultation from the Oregon consultant. Individuals with a Bachelor's degree and good interpersonal skills are qualified. Supervisors are Master's level clinicians.

Manual Information

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

Training Information

There is training available for this program.

Training Contact:
Training Type/Location:

Year-long training and consultation

Number of days/hours:

Typically 2 years of consultation, including training local trainers so the site can train and coach new staff to sustain the program long term. Initial training takes 5 days. Training to be a local coach/trainer takes an additional 5 days.

Implementation Information

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for KEEP (Keeping Foster and Kin Parents Supported and Trained) as listed below:

Readiness and feasibility questionnaires followed by telephone calls prepare the site to implement KEEP. The pre-implementation planning typically takes 3 months. Please contact the program representative at the bottom of this page for more information.

Formal Support for Implementation

There is formal support available for implementation of KEEP (Keeping Foster and Kin Parents Supported and Trained) as listed below:

Weekly consultation is provided to support group leaders. Monthly reports are provided to track fidelity and progress. Please contact the program representative at the bottom of this page for more information.

Fidelity Measures

There are fidelity measures for KEEP (Keeping Foster and Kin Parents Supported and Trained) as listed below:

The Fidelity Adherence Rating (FAR) is used to code sessions for fidelity to the KEEP model. The FAR a 14-item rating scale that is completed by the Oregon Coach of the Local Coach (depending on what stage the implementation is). Please contact the program representative at the bottom of this page for more information.

Implementation Guides or Manuals

There are implementation guides or manuals for KEEP (Keeping Foster and Kin Parents Supported and Trained) as listed below:

Manuals are used and are available in English, Spanish and Danish.

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. https://doi.org/10.1016/j.childyouth.2012.10.002

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. https://doi.org/10.1016/j.chiabu.2015.09.013

Relevant Published, Peer-Reviewed Research

Child Welfare Outcomes: Permanency and Child/Family Well-Being

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. https://psycnet.apa.org/record/1993-10980-001

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 and 39% Male; Adults: Not specified
  • Status — Participants were foster and kinship parents and their children.

Location/Institution: Oregon counties

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to measure the impact on children of a $70-per-month supplement to foster parent's normal reimbursements 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 KEEP (intervention) or one of two control conditions. Measure utilized include the Parent Daily Report. 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 controlled postintervention 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(1), 17–27. https://doi.org/10.1007/s11121-007-0080-7

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

Population:

  • Age — Intervention: Mean=8.88 years; Control: Mean=8.72 years; Parents: Intervention: Mean=49.86 years; Control Mean=47.29 years
  • Race/Ethnicity — Children: 33% Latino, 22% Caucasian, 22% Mixed Ethnic, 21% African American, 1% Asian American, and 1% Native American; Parents: 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; Parents: 94% Female and 6% Male
  • Status — Participants were foster and kinship parents.

Location/Institution: San Diego, California

Summary: (To include basic study design, measures, results, and notable limitations)
The study used the same sample as Price et al. (2008). The purpose of the study was to test the effectiveness of KEEP (Keeping Foster Parents Trained and Supported) with 700 foster/kinship parents in San Diego County. Participants were randomly assigned to KEEP or control (usual caseworker services) condition. Measures utilized include the Parent Daily Report Checklist (PDR). Results indicate that there were 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. Limitations include generalization of parenting effects to nonstudy foster children, reliability on a self-reported measure, and lack of follow-up.

Length of controlled postintervention follow-up: None.

Price, J. M., Chamberlain, P., Landsverk, J., Reid, J. B., Leve, L. D., & Heidemarie, L. (2008). Effects of a foster parent training intervention on placement changes of children in foster care. Child Maltreatment, 13(1), 64–75. https://doi.org/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 basic study design, measures, results, and notable limitations)
The study used the same sample as Chamberlain et al. (2008). The purpose of the study was to examine the impact of a foster parent training and support intervention, Keeping Foster Parents Trained and Supported (KEEP) on placement changes and to determine whether the intervention mitigated placement disruption risks associated with children’s placement histories. Participants were randomly assigned to receive 16 weeks of training, supervision, and support or to casework services as usual. Measures utilized include administrative data from child welfare agency case workers. 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. Results indicate that 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 controlled 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. https://www.jstor.org/stable/48623164

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 basic study design, measures, results, and notable limitations)
The study used the same sample as Price et al. (2008). The purpose of the study was to test the effectiveness of KEEP (Keeping Foster Parents Trained and Supported) with 700 foster/kinship parents in San Diego County. Participants were randomly assigned to KEEP or control (usual caseworker services) condition. Measures utilized include the Parent Daily Report (PDR) checklist. Results indicate that no differences existed between the behavior rates reported by KEEP 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 controlled 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. https://doi.org/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 — Not specified
  • Status — Participants were individuals involved in the child welfare system.

Location/Institution: San Diego County, California

Summary: (To include basic study design, measures, results, and notable limitations)
The study used a subset of the same sample as Chamberlain et al. (2008). The purpose of the 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. Participants were randomly assigned to KEEP or control (usual caseworker services) condition. Measures utilized include the Parent Daily Report Checklist (PDR). Results indicate that 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 controlled 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. https://doi.org/10.1007/s10826-015-0357-6

Type of Study: Pretest–posttest study with a nonequivalent control group (Quasi-experimental)
Number of Participants: 113

Population:

  • Age — Children: 4–12 years; Caregivers: 27–82 years
  • Race/Ethnicity — Children: 43% Black, 38% Caucasian, 13% Other, and 7 Missing; Caregivers: 48% Black/African American, 43% Caucasian, 7% Mixed, and 3% Hispanic
  • Gender — Children: 58% Female and 42% Male; Caregivers: 99% Female
  • Status — Participants were individuals involved in the child welfare system.

Location/Institution: Maryland

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was 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. KEEP participants were referred by their child welfare caseworker, while comparison participants were recruited via mail and a foster parenting newsletter. Measures utilized include the Parent Daily Report Checklist (PDR), Child Behavior Checklist (CBCL), the Discipline and Supervision Measure, and the Parenting Stress Index Short Form (PSI-SF). Results indicate that there were 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 controlled postintervention follow-up: 2 months.

Price , J. M., Roesch, S., Walsh, N. E., & Landsverk, J. (2015). Effects of the KEEP foster parent intervention on child and sibling behavior problems and parental stress during a randomized implementation trial. Prevention Science, 16(5), 685–695. https://doi.org/10.1007/s11121-014-0532-9

Type of Study: Randomized controlled trial
Number of Participants: 335

Population:

  • Age — Children: Mean=7.32–7.84 years; Caregivers: Mean=45.10–45.75 years
  • Race/Ethnicity — Children: 49% Hispanic, 18% African American, 17% Mixed, 15% Caucasian, and 1% Native American; Caregivers: 41% Hispanic, 36% Caucasian, 17% African American, 3% Asian/Pacific Islander, 3% Native American, and 2% Mixed
  • Gender — Children: 52% Male and 48% Female; Caregivers: 93% Female and 7% Male
  • Status — Participants were individuals involved in the child welfare system.

Location/Institution: San Diego County, California

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to (a) examine the effectiveness of KEEP (Keeping Foster Parents Trained and Supported) in reducing child behavior problems, as delivered by a community agency; (b) determine if the effects of KEEP generalize to more than one child in the same home; and (c) examine the effectiveness of KEEP in reducing parental stress associated with child behavior problems. Participants were randomly assigned to either KEEP or the control group. Measures utilized include the Parent Daily Report Checklist (PDR). Results indicate that KEEP was effective in reducing child behavior problems when delivered by a community agency. These results expanded prior research on KEEP, revealing that KEEP was effective in reducing the behavior problems of more than one child in the same household and in reducing parental stress levels associated with the behavioral issues of the focal child. Limitations include reliance on parental observation, unequal ethnic distribution of African Americans in the KEEP group, in several instances, the follow-up assessments were conducted on a different child from the one who was assessed at baseline, and lack of follow-up.

Length of controlled postintervention follow-up: None.

Price, J. M., Roesch, S., & Burce, C. M. (2019). The effects of the KEEP foster parent training intervention on child externalizing and internalizing problems. Developmental Child Welfare, 1(1), 5–21. https://doi.org/10.1177/2516103218812092

Type of Study: Randomized controlled trial
Number of Participants: 310 child-parent pairs

Population:

  • Age — Children: 5–12 years; KEEP: Mean=7.82 years; Control: Mean=7.30 years; Parents: Not specified
  • Race/Ethnicity — Children: Not specified; Parents: KEEP: 41% Hispanic, 32% Caucasian, 24% African American, 2% Mixed Ethnicity, and 1% Native American; Control: 41% Caucasian, 41% Hispanic, 10% African American, 4% Native American, and 1% Mixed Ethnicity
  • Gender — Children: 52% Male; Parents: Not specified
  • Status — Participants were foster and kinship families in the child welfare system.

Location/Institution: San Diego, CA

Summary: (To include basic study design, measures, results, and notable limitations)
The study used the same sample as Price et al. (2015). The purpose of the study was to examine the effectiveness of the KEEP (Keeping Foster Parents Trained and Supported) intervention at reducing behavior problems among children in foster care. Participants were randomly assigned to either the KEEP intervention or usual services. Measures utilized include the Child Behavior Checklist (CBCL). Results indicate that the KEEP intervention was effective at reducing the proportion of children in the borderline group for rule-breaking between baseline and follow-up. The intervention was also effective at reducing internalizing problems, as indicated by reductions in internalizing raw scores and the proportion of children in the borderline group over the course of the intervention. Limitations include the lack of blinding to condition in the study, sole reliance in parent report, and attrition.

Length of controlled postintervention follow-up: None.

Additional 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. https://doi.org/10.1007/s11121-007-0080-7

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. https://doi.org/10.1016/j.chiabu.2005.11.004

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. https://doi.org/10.1177/10775595073106

Contact Information

Rohanna Buchanan, PhD
Agency/Affiliation: OSLC Developments, Inc. (ODI)
Website: keepforfamilies.org
Email:
Phone: (541) 485-2711

Date Research Evidence Last Reviewed by CEBC: January 2023

Date Program Content Last Reviewed by Program Staff: May 2024

Date Program Originally Loaded onto CEBC: May 2007