On the Way Home (OTWH)

About This Program

Target Population: Middle and high school students (12-18) with, or at-risk for, emotional and behavioral disorders transitioning from residential placements back into the home and community school settings and their caregivers

For children/adolescents ages: 12 – 18

For parents/caregivers of children ages: 12 – 18

Program Overview

OTWH is a 12–14 month reunification program developed to address the transition needs of middle and high school youths with, or at-risk of, emotional and behavioral disorders who are reintegrating into the home and community school settings following a stay in residential care. The program modifies and integrates three interventions: Check & Connect, Common Sense Parenting, and homework support to address the educational and family-based transition challenges most common for school-aged youths. Services are provided by a trained OTWH Consultant in the family home, school, and community, and primary objectives are to promote youth home stability and prevent school dropout. On average, families engage in 2 hours of direct service hours per week and consultants carry caseloads of up to 15 families. Training is manualized, service decisions are guided by weekly data analysis, and consultants are supervised in weekly individual and group consultation.

Program Goals

The goals of On the Way Home (OTWH) are:

  • Increase family empowerment and self-efficacy through teaching skills that can aid in the transition back home
  • Engage youth in school and assist in academic success toward high school graduation
  • Improve caregiver-child relationships which assists in creating placement stability in the youth’s home

Logic Model

The program representative did not provide information about a Logic Model for On the Way Home (OTWH).

Essential Components

The essential components of On the Way Home (OTWH) include:

  • OTWH provides reunification support to youths and their families for a period of 12 months after discharge from residential care with the primary goals of maintaining placement and school stability.
  • Supports are provided by a trained OTWH Consultant who works directly with each family for an average of 2 hours per week and maintain caseloads of up to 15 families.
  • OTWH Consultants work with families to provide supports in school drop-out prevention using a modified version of Check & Connect, parent training through Common Sense Parenting, and homework support. All supports are manualized.
  • All services are provided to the family in the youth’s home and community school by a trained OTWH Consultant.
  • When possible, the family begins services up to 8 weeks prior to the youth discharge from residential care. During this initial period, parents are provided with several individualized parenting sessions using Common Sense Parenting. Families also complete a homework checklist to establish rules and routines regarding homework completion, youth information is transferred to the community school, and a school contact person is identified to serve as the home-school liaison. Following the parenting sessions, the OTWH Consultant meets with the family weekly to review any family or educational related challenges or concerns that affect school and placement stability. In cases in which there is no advanced warning of discharge, services begin upon the youth’s return home. OTWH can be used with both planned and unplanned discharges from residential care.

Program Delivery

Child/Adolescent Services

On the Way Home (OTWH) directly provides services to children/adolescents and addresses the following:

  • Youth who are departing residential care with a possible lack of support systems (e.g., family and school) and prosocial skills (e.g., social skills, coping skills, academic skills, etc.) and possible problems controlling emotional and behavioral problems such as internalizing and externalizing disorders, disruptive behavior, maladaptive school and home behaviors, and poor school engagement

Parent/Caregiver Services

On the Way Home (OTWH) directly provides services to parents/caregivers and addresses the following:

  • Parents with children who have or are ready to leave residential treatment that may lack the skills needed to stay calm and address family problems when they occur; parents may also have limited experience navigating school systems
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: School personnel are involved in the youth’s direct services. School liaisons participate in weekly discussions with the youth and OTWH Consultant to review educational engagement and problem-solve when high-risk behaviors occur. OTWH Consultants serve as a liaison between the youth, family, and school to promote family-school partnerships and collaboration.

Recommended Intensity:

Weekly contact with the family and school. On average, OTWH Consultants provide two direct service hours in the home and school environments and an additional hour of indirect services (e.g., completion of paperwork, travel, preparation, scheduling) related to the youth, family, and school reunification needs.

Recommended Duration:

12–14 months

Delivery Settings

This program is typically conducted in a(n):

  • Adoptive Home
  • Birth Family Home
  • Foster / Kinship Care
  • School Setting (Including: Day Care, Day Treatment Programs, etc.)

Homework

On the Way Home (OTWH) includes a homework component:

The Common Sense Parenting parent training offered as part of OTWH includes a homework component. Families are asked to complete homework assignments related to the parenting skills taught through the program.

Resources Needed to Run Program

The typical resources for implementing the program are:

Cell phone, vehicle, computer, Parent Training materials, secure space for maintaining confidential files/program materials

Manuals and Training

Prerequisite/Minimum Provider Qualifications

Bachelor’s degree in human services or related field

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:

Training for OTWH consultants and supervisors is available by Boys Town.

Number of days/hours:

Five days (40 hours) of OTWH Consultant training and two days (16 hours) of Supervisor training

Implementation Information

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for On the Way Home (OTWH) as listed below:

Pre-implementation materials include an On the Way Home (OTWH) Organizational Readiness Questionnaire. This instrument aids in determining readiness and fit to implement OTWH. Information gathered includes: Program/Organizational Structure; Staff Development/Retention/Evaluation; Consumer and Employee Safety; Educational Services and Partnerships; and Consumer Satisfaction and Outcomes.

Formal Support for Implementation

There is formal support available for implementation of On the Way Home (OTWH) as listed below:

Formal support includes consultant and supervisor training, web-based consultation, on-site visits, data analysis, and licensing and re-licensing. Web-based consultation includes review of model implementation using a web-based platform (LOOMIS – Linking Organizational Outcomes and Measures to Implementation Science) designed for supervisors and consultants trained in the use of OTWH to facilitate exchange of client-based information and data that helps ensure adherence to the OTWH program fidelity and monitoring of program outcomes.

Fidelity Measures

There are fidelity measures for On the Way Home (OTWH) as listed below:

OTWH has an accompanying Model Fidelity Instrument developed to assess the quality of implementation of the OTWH program. This tool provides a mechanism for organizing a Supervisor’s observations of staff and comparing their performances to an objective standard. The Model Fidelity Instrument is on a Boys Town resource website available to all Boys Town employees. It will also be available to other agencies which are trained to implement the program. The instrument consists of four sections: Parent/Family Support (13 items); School Support (5 items); Homework Support (3 items); and Documentation Review (4 items). Evaluators/supervisors use observation data to score items on a five-point scale (1 – Incorrect, 2 – Below Average, 3 – Average, 4 – Above Average, 5 – Excellent) according to definitions. Language in the definitions is consistent with the OTWH training. Additional training is not required to use the Model Fidelity Instrument. For more information, contact the training contact above.

Implementation Guides or Manuals

There are implementation guides or manuals for On the Way Home (OTWH) as listed below:

During a one-week workshop, OTWH Consultants are provided with an OTWH program manual. The On the Way Home Program Manual consists of 7 chapters (Introduction to On the Way Home, Initiating Agency and Family Partnerships, Family Support, School Support, Homework Support, Data Collection and Review, Completing the Program and appendices which include supplemental documents, checklists, intervention menus, and forms).

As part of the training for the Common Sense Parenting component, OTWH Consultants receive an OTWH Parenting Skills Instructional Guide, an OTWH Parenting Skills Participant Workbook, a Common Sense Parenting text book, and a flash drive with support materials. These materials provide all of the implementation information required for the parent training component. For more information, contact the training contact above.

Research on How to Implement the Program

Research has been conducted on how to implement On the Way Home (OTWH) as listed below:

Trout, A. L., Jansz, C., Epstein, M. H., & Tyler, P. (2013). Evaluating service delivery in aftercare for school-aged youth departing out-of-home care. Journal of Public Child Welfare, 7, 142–153. https://doi.org/10.1080/15548732.2013.770356

Relevant Published, Peer-Reviewed Research

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

Trout, A. L., & Epstein, M. H. (2010). Developing aftercare: Phase I. Consumer feedback. Children and Youth Services Review, 32, 445-451. https://doi.org/10.1016/j.childyouth.2009.10.024

Type of Study: One-group pretest-posttest study
Number of Participants: 31

Population:

  • Age — 14-18 years
  • Race/Ethnicity — Not specified
  • Gender — Not specified
  • Status — Participants were youth who were at risk for a disability, parents, and teachers of youth who had discharged from a residential Treatment Family Home services program.

Location/Institution: Omaha, Nebraska

Summary: (To include basic study design, measures, results, and notable limitations)
This purpose of this study was to begin to identify service needs and wants of youth, parents, and school personnel in regards to the academic achievement of youth with disabilities reintegrating into the home and school communities following a stay in out-of-home care through the On the Way Home program. Measures utilized include National Institute of Mental Health Diagnostic Interview Schedule for Children-IV (DISC-IV) and the Child Behavior Checklist. Results indicate common themes identified include the desire for program flexibility, 24-hour on-call support, and well-trained, supportive staff. Limitations include small sample size, lack of randomization, lack of control group, and lack of follow-up.

Length of postintervention follow-up: None.

Trout, A. L., Tyler, P., Stewart, M., & Epstein, M. E. (2012). On The Way Home: Program description and preliminary findings. Children and Youth Services Review, 34, 1115-1120. https://doi.org/10.1016/j.childyouth.2012.01.046

Type of Study: Randomized controlled trial
Number of Participants: 44

Population:

  • Age — Mean=15.63-15.75 years
  • Race/Ethnicity — 33 Caucasian, 10 African-American, 5 Native American, 1 Hispanic, 1 Asian, and 2 Other
  • Gender — 50% Female
  • Status — Participants were middle and high school level adolescents who were discharged from the Boys Town Continuum.

Location/Institution: large residential program in the Midwest

Summary: (To include basic study design, measures, results, and notable limitations)
This study reports on the effects of the On the Way Home (OTWH) on placement and school stability for youth discharged from the Boys Town Continuum. Parents and youths were randomly assigned to the treatment or control condition. Measures utilized include the OTWH Quarterly Data Evaluation Form. Results indicate over 91% of youths in the OTWH condition and 65% of youths receiving traditional transition services remained in the home or community (e.g., parent's, grandparent's, sibling's home) setting. For youths not receiving OTWH services, the percent of youths returning to care or to a jail setting increased over time, with 20% returning to care/jail in Quarter 2, 25% In Quarter 3, and 35% in Quarter 4. No youths in the OTWH condition returned to care or to jail in Quarters 1, 2, or 3. Youth engagement in the school setting revealed similar patterns over time. For youths in the control condition, 5% were no longer attending by the end of Quarter 1. In Quarter 2, 25% had either stopped attending or were presumably receiving educational services in residential care or jail, and by Quarters 3 and 4, these numbers increased with 35% in Quarter 3 and 50% in Quarter 4 no longer attending school or not attending school in the community setting. No youths in the OTWH condition dropped out or attended school in placements outside of the community setting in Quarters 1, 2, or 3. At the end of Quarter 4, 87.5% of youths receiving OTWH supports and 50% of youths receiving traditional supports had graduated or were still attending school in the community setting. Limitations include findings may not generalize to youth served in other residential placements, small sample size, and lack of follow-up.

Length of postintervention follow-up: None.

Trout, A. L., Lambert, M., Epstein, M., Tyler, P., Stewart, M., Thompson, R. W., & Daly, D. (2013). Comparison of On the Way Home aftercare supports to traditional care following discharge from a residential setting: A pilot randomized controlled trial. Child Welfare, 92, 27-45. https://pubmed.ncbi.nlm.nih.gov/24818429/

Type of Study: Randomized controlled trial
Number of Participants: 82

Population:

  • Age — 14-18 years (Mean=15.74 years)
  • Race/Ethnicity — 60% Caucasian, 14.1% African-American, and 3.5% Hispanic
  • Gender — 53% Male
  • Status — Participants were youth identified with or at risk of a high incidence disability who were discharging from residential care.

Location/Institution: large residential program in the Midwest

Summary: (To include basic study design, measures, results, and notable limitations)
This study compares the On the Way Home (OTWH) aftercare program to traditional aftercare supports on placement and school stability for youth with or at-risk of disabilities who were discharging from residential care. Participants were randomly assigned to either OTWH or a control condition at program enrollment. Measures utilized include quarterly collection of youth placement and school stability. Results indicate that one-year after discharge, negative event occurrence (i.e., returning to care or discontinuing enrollment in the community school) was three to over five times less likely for OTWH youth compared to youth in the control condition. Limitations include findings may not generalize to youth served in other residential placements, small sample size, and lack of follow-up.

Length of postintervention follow-up: None.

Trout, A. L., Lambert, M. C., Thompson, R., Duppong Hurley, K., & Tyler, P. (2020). On the Way Home: Promoting caregiver empowerment, self-efficacy, and adolescent stability during family reunification following placements in residential care. Residential Treatment for Children & Youth, 37(4), 269–292. https://doi.org/10.1080/0886571X.2019.1681047

Type of Study: Randomized controlled trial
Number of Participants: 187 child-caregiver dyads

Population:

  • Age — Caregiver: M=44.56 years; Youth: Mean=15.45 years
  • Race/Ethnicity — Caregiver: 69% White and 6.4% Latino/a; Youth: 61% White and 12.8% Latino/a
  • Gender — Caregiver: 73.3% Female ; Youth: 58.3% Male
  • Status — Participants were youths departing residential group care settings.

Location/Institution: Not specified

Summary: (To include basic study design, measures, results, and notable limitations)
This study compares the outcomes of youth and caregivers in On the Way Home (OTWH) to traditional aftercare supports following discharge from therapeutic residential care (TRC). Participants were randomly assigned to either OTWH or a control condition at program enrollment. Measures utilized include the Family Empowerment Scale (FES), the Caregiver Self-efficacy Scale (CSES), and the School & Home Placement Change Questionnaire (SHPQ). Results indicate at posttest no significant differences were found between groups on indicators of placement stability and school involvement, however, significant differences were found between groups on several indicators of caregiver empowerment and self-efficacy, with caregivers in OTWH reporting greater levels of self-efficacy and empowerment across the domains of family and community. At follow-up, moderate to large differences were found between groups on indicators of placement stability and school involvement, with odds ratios indicating youths in OTWH were 2 and 3 times more likely to be engaged in school and living in the community, respectively. Limitations include findings may not generalize to youth served in other residential placements, pretest measurements of the outcome variables were not collected, high attrition, small sample size, and lack of follow-up.

Length of postintervention follow-up: 9 months.

Additional References

Trout, A. L., Jansz, C., Epstein, M. H., & Tyler, P. (2013). Evaluating service delivery in aftercare for school-aged youth departing out-of-home care. Journal of Public Child Welfare, 7, 142–153. https://www.tandfonline.com/doi/abs/10.1080/15548732.2013.779356

Trout, A. L., Lambert, M., Epstein, M., Tyler, P., Stewart, M., Thompson, R. W., & Daly, D. (2013). Comparison of On the Way Home aftercare supports to usual care following discharge from a residential setting: An exploratory pilot randomized controlled trial. Child Welfare, 92, 27-45. https://pubmed.ncbi.nlm.nih.gov/24818429/

Trout, A. L., Tyler, P., Stewart, M., & Epstein, M. E. (2012). On The Way Home: Program description and preliminary outcomes. Children and Youth Services Review, 34, 1115-1120. https://doi.org/10.1016/j.childyouth.2012.01.046

Contact Information

Alexandra Trout, PhD
Agency/Affiliation: University of Nebraska Lincoln; Co-Director Academy of Child and Family Well-Being
Website: cehs.unl.edu/acfw/way-home
Email:
Phone: (402) 472-3803

Date Research Evidence Last Reviewed by CEBC: September 2019

Date Program Content Last Reviewed by Program Staff: July 2020

Date Program Originally Loaded onto CEBC: May 2018