Outcome-Network.org

An International Database and eJournal for Outcome-Evaluation and Research

Paper

Working with parents of troubled and troublesome young people at risk of care

abstract

Research aims and methodology. Very little research evidence is available on the effectiveness of family support services for adolescents at risk of entry to care. This paper draws on a quasi-experimental study of adolescents at imminent risk of entry to care, which compared outcomes for those receiving specialist, intensive family support services with outcomes for a matched group receiving mainstream social work services. Both service outcomes (placement rates) and individual outcomes (child well-being) were assessed.
The study employed both quantitative and qualitative methods. It surveyed 209 young people and their parents and social workers at the start of the services and followed them up six months later. Outcome measures administered to young people and parents at referral and at follow-up measured children's emotional and behavioural difficulties (SDQ), family functioning (FAD), parental mental health (GHQ), child perceptions of well-being (Cantril's Ladder) and the nature and severity of child difficulties. Change between referral and follow-up was measured through multivariate analysis of quantitati¬ve data. Alongside this, qualitative analysis of interview data from 50 case studies explored how, why and in what circumstances positive outcomes occurred.

Findings. Thresholds for family support services were very high. At referral, the majority (76%) of the young people had emotional and behavioural difficulties above the clinical threshold and most parents also experienced serious personal difficulties, including mental health problems (72%) and domestic violence (43%). Over half of the young people had experienced abuse, neglect or both and one third had been known to social services long-term. Structured interventions, often drawing on social learning theory, were used with both parents and young people. There were marked differences in the duration and intensity of the two services but little difference in the nature of the interventions.
By follow-up, the mean number of reported problems had fallen by 25% and the severity of specific emotional and behavioural difficulties decreased for between one third and one half of the young people. There were particular improvements in emotional and behavioural problems (as measured on the SDQ), the level of child violence within the family, family functioning (on the FAD) and parental mental health (on the GHQ). However, there was no variation in child and family outcomes between the two types of service. In contrast, service outcomes were markedly different for the two groups, as those receiving the specialist service were significantly less likely to enter care.
This paper examines the factors which moderated or mediated outcomes for the young people. While work on child behaviour and parenting skills, and an ecological approach to service provision were all helpful, outcomes were moderated by the degree of child motivation, child hyperactivity and the duration of child and family problems. The successful formation of a therapeutic alliance appeared to be a key mediator of positive outcomes. In relation to service outcomes, variations in local policy and resources appeared to have a greater impact on placement rates than the nature of the interventions.

Recommendations The principal aim of family support services should be to enhance child well-being rather than to prevent placement. In some cases, short-term placement may be a helpful element of family support services. A continuum of services are needed to support families, ranging from low-level services for early intervention to, where needed, intensive services and follow-up support.

Key references
Biehal, N. (2005). Working with Adolescents. Supporting families, preventing breakdown. London: BAAF.
Biehal, N. (2005). Working with adolescents at risk of out of home care: the effectiveness of specialist teams. Children and Youth Services Review, 27(9), 1045-1059.
Biehal, N. (2006). Preventive services for adolescents: exploring the process of change. British Journal of Social Work. Advance Access doi: 10.1093/bjsw/bcl352.

Contacts: Nina Biehal, Social Policy Research Unit, Alcuin College B Block, University of York, YORK YO10 5DD, England. E-mail:nb6@york.ac.uk, Phone 01904 321284, Fax 01904 321281.

© copyright 2024 Outcome-Network.org all rights reserved, in partnership with FondazioneZancan | iaOBERfcs | read the legal notice.