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Group homes are a frequently used but controversial treatment setting for youth with mental health problems. Within the relatively sparse literature on group homes, there is some evidence that some models of treatment may be associated with more positive outcomes for youth. This article explores this possibility by examining differences across time for youth served in group homes utilizing the Teaching Family Model (TFM) and geographically proximate homes using more eclectic approaches. Data come from a longitudinal quasi-experimental study that included 554 youth. Results suggest that youth showed, on average, significant and rapid improvement during initial months in a group home. Improvement did not differ for TFM and non-TFM homes during this initial period. Post-discharge results, though, show that TFM was associated with continued improvement after discharge and significantly better outcomes by 8 months post-discharge. Results also discuss youth-level factors that may influence outcomes as well as need for additional work to more fully understand processes and practices that are key for maximizing and maintaining youths' positive outcomes during and after group home placements.

Although females represent almost half of all youth involved in residential care in the US, very little is known about this population. In order to examine differences in characteristics of male (n = 308) and female (n = 180) youth departing from residential care, data were collected on 488 youth from a large residential treatment facility in the Midwest. Gender differences were assessed on 16 variables measured at the time of departure across family, education, behavior, and departure domains. Overall, male and female youth departing from residential care were very similar for measures collected at the time of departure. Only three variables (GPA at departure, number of school referrals during the previous 8 weeks, and planned departure) were found to be significantly different between males and females. Implications for future research and the provision of aftercare services are discussed.

Recent work suggests that out-of-home placements continue to be relatively common for youth with mental health problems, even within systems of care. The current work examines rates and predictors of movement back home and stability of reunifications. During the focal period, 1,778 youths experienced out-of-home placements; 61% moved back home, and 22% of those reunited were placed out of home again. Race was related to likelihood of reunification and instability: American Indian youth were least likely to return home, whereas Hispanic youth were at increased risk of unstable reunifications. Older youth and boys were more likely to return home, whereas youth from families with higher incomes were slightly more likely to be placed out of home but also most likely to be stably reunited. Higher (i.e., worse) total "Child Behavior Checklist" score was related to moving back home, whereas decreased strengths and more child-level risk factors predicted instability of reunification. (Contains 4 tables.)

Objective: This article focuses on caseworkers' assessments of risk of maltreatment recurrence among families in contact with social services. Specifically, the article has two primary goals: (1) to examine the association between caseworkers' risk assessments and demographic, child, parent and family-level risk factors; and (2) to examine agreement between caseworkers' risk assessments and any subsequent report, or reports, of maltreatment. Objective: This article focuses on caseworkers' assessments of risk of maltreatment recurrence among families in contact with social services. Specifically, the article has two primary goals: (1) to examine the association between caseworkers' risk assessments and demographic, child, parent and family-level risk factors; and (2) to examine agreement between caseworkers' risk assessments and any subsequent report, or reports, of maltreatment. Results: Analyses indicated that parent-level risk factors and a prior report of maltreatment were most strongly associated with caseworkers' assessments of risk for both physical abuse and neglect cases. A smaller set of factors, which varied by the type of maltreatment, were associated with a subsequent report of maltreatment. Despite some overlap in correlates of risk assessment and subsequent reports, analyses indicated that agreement between caseworkers' assessments of risk and re-reports was low. Conclusions: Findings suggest that although caseworkers' assessments were associated with a limited set of risk factors from the literature, few of these factors also were associated with a recurrent report of maltreatment. Correspondence between caseworkers' assessments of risk and a subsequent report of maltreatment was low, suggesting that considerable work may be needed to improve accuracy and identification of cases most at risk. Practice implications: This study provides information to assist caseworkers, administrators, and policymakers in thinking critically about risk assessment policies and procedures. Although caseworkers' assessments of risk were associated with some of the empirical predictors of recurrent maltreatment, their assessments were only slightly better than guessing. Agreement between caseworkers' risk assessments and actual subsequent reports was better for low-risk cases, but primarily because the majority of cases did not have a subsequent report during the study period. Clearly, considerable improvement in risk assessment is needed so that at-risk families can be better identified and the limited services available can be directed toward those most in need.

This article examines out-of-home placements for youth with mental health problems in community-based systems of care. Longitudinal data come from the national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program. One third of youth residing at home when they enrolled in the system of care were placed out of home during the 2-year follow-up period. As expected, youth who were placed out of home displayed more problems, fewer strengths, and more risk factors than youth who remained at home. However, results suggested few differences between youth placed in foster care and those placed in more restrictive settings. In addition, there was increased placement instability for Hispanic and older youth. Findings suggest that out-of-home placements remain a common component in systems of care. This suggests the immediate need for additional work on effectiveness of these settings for youth within systems of care. (Contains 4 tables.)

The authors consider school violence from a dynamic systems conceptualization of aggression. This perspective suggests that aggression and school violence involve the contributions of both school social dynamics and the developmental histories of youth who are at risk for involvement in antisocial behavior. The authors present the concept of correlated constraints to describe the systematic alignment of developmental factors and their role in behavioral continuity and realignment. Building from this perspective, the authors present a theoretical framework that complements public health models of prevention to guide the establishment of comprehensive programs for preventing aggressive and violent behavior in schools. This framework suggests that three distinct but complementary levels of intervention are required to effectively reduce school violence: (a) universal strategies to address contextual factors, including the social dynamics of aggression and the activities of "conventional" peers that promote interpersonal conflict; (b) selective strategies for supporting the strengths of at-risk youth to prevent the negative reorganization of their developmental systems; and (c) indicated strategies involving coordinated services from multiple providers to reorganize the developmental systems of high-risk youth (i.e., youth with emotional and behavioral disorders).

This study examined preliminary effectiveness of one of the first Project Re-ED (Re-education of Emotionally Disturbed children) residential treatment centers for children. Data were collected at admission, at discharge, and up to 6 months postdischarge. Findings show substantial decreases in problem behaviors and improvements in personal strengths during treatment for children ages 6-12. Despite some deterioration of outcomes in the postdischarge period, improvement compared to baseline continued to be evident at 6 months postdischarge. Multivariate analysis showed that relatively few factors were associated with differential change while in treatment. Younger age, however, was related to more substantial change during treatment and longer length of stay was associated with more positive outcomes by 6 months postdischarge. (Contains 2 figures and 2 tables.)

We examined the factor structure and psychometric properties of the Trusting Relationship Questionnaire, a brief measure of relationship quality between youth and community-based service providers involved in their care. Data on youth residing in Therapeutic Foster Care and in Group Homes (N = 296) were collected. We identified a one-factor solution for the child version of the measure and a two-factor structure for the adult version: child's perception of the relationship and adult's perception of the relationship. Both versions appear to be highly reliable and possess adequate levels of construct, criterion, and discriminative validity. While no statistically significant age differences were noted on the parent version, on the child version, older youth were more likely to report lower relationship scores. Gender differences were found on both versions: Female youth reported higher scores on the child version as did adults reporters of relationships with female youth, but only for the first factor--child's perception of the relationship. Overall, the TRQ appears to capture the quality of the relationship between service providers and youth in their care, thus bridging a gap in assessment measures.

Little is known about what additional services youth receive while they reside in out-of-home treatment settings. However, such information may be crucial for explaining effectiveness and variation in outcomes for youth in such settings. Our research examines patterns of multi-sector service use for youth in two settings--Therapeutic Foster Care and group homes. Data come from in-person interviews with Treatment Foster Parents and Group Home Staff for a NC state-wide sample of youth with psychiatric disorders and aggressive behavior. Findings indicated high rates of service use by youth in both settings. Analyses indicated significant differences in service types used by youth in each setting, yet similar volume of service use between settings. Clinical and demographic factors did not significantly influence types of services received. Differences in service patterns between the two groups indicated that youth in TFC were more likely to receive community-based, individualized services while youth in group homes were more likely to receive more restrictive services.

We examined Treatment Foster Care (TFC) in residential trajectories for youth with psychiatric disorders and aggressive behavior. We analyzed residential placements of a statewide sample of youth during the 12 months preceding and following admission to TFC. Prior to TFC, the majority of youth were residing in more restrictive settings (group homes or residential treatment). Two-thirds of youth remained in TFC throughout the follow-up year. Of those who left, nearly half returned home, and slightly fewer were discharged to group homes. By the end of the 12-month follow-up period, rates of group home use were similar to those seen in the pre-TFC period. Movement out of TFC during the year was associated with being older at placement and with increased problem behavior (particularly externalizing behaviors). TFC serves as a step-down placement for a substantial number of youth. However, this is not the only way it is used, and models based on short-term transitioning or reunification with families may not be widely implemented or relevant in practice. Additional research is needed to understand current functions of TFC in residential trajectories and to maximize its utility in systems of care.

Examined points of entry into mental health service system for children and adolescents and patterns of movement through five service sectors (specialty mental health services, education, general medicine, juvenile justice, child welfare). Education sector plays central role as point of entry. Interagency collaboration among education, specialty mental health services, and general medicine is critical to ensuring youths receive appropriate services. (Contains 24 references and 3 tables.) (Author)

This study examined conformity to the Program Standards for Treatment Foster Care among 42 statewide programs. Findings suggest fair to good overall conformity, with considerable variation among programs. A discussion of methodological and substantive considerations for future research and evaluation using this approach is included. (Contains references.) (Author/PB)

Summarizes research on the role of social relations in the development of aggressive and disruptive behavior. Concludes that social growth of such youth is highly complex and that school-based interventions should focus not only on the behavior of the student, but also on socio-cognitive processes and social contextual factors that support aggressive and disruptive behavior. (Author/DB)

Exploration, in three elementary classes, of the social affiliations of students who were either academically gifted or had learning or emotional/behavioral difficulties found students formed distinct peer clusters around shared characteristics, particular social characteristics were associated with students' level of centrality in the classroom, and students with exceptionalities were well integrated into the classroom's social structure. (Author/DB)

Abstract: This manuscript describes the development and psychometric testing of an instrument to assess implementation fidelity of Together Facing the Challenge (TFTC), an evidence‐based approach to treatment foster care (TFC). The development of TFTC utilized a hybrid approach by bringing together components from evidence‐based interventions with data on “what works” in usual care treatment foster care to create an intervention designed to provide enhanced treatment across a wide range of treatment foster care programs. The resulting training/consultation model has shown positive results on practice and youth outcomes in a randomized trial. The TFTC‐FIT was developed during this randomized trial to be used as both a research measure and a quality improvement tool by provider agencies. Findings show that the measure is psychometrically sound and significantly distinguishes agencies trained in TFTC from those that are not. Discussion highlights the potential for such a measure, both in treatment foster care and in other home‐/community‐based interventions and settings for youth. [ABSTRACT FROM AUTHOR]

Group homes are a frequently used but controversial treatment setting for youth with mental health problems. Within the relatively sparse literature on group homes, there is some evidence that some models of treatment may be associated with more positive outcomes for youth. This article explores this possibility by examining differences across time for youth served in group homes utilizing the Teaching Family Model (TFM) and geographically proximate homes using more eclectic approaches. Data come from a longitudinal quasi-experimental study that included 554 youth. Results suggest that youth showed, on average, significant and rapid improvement during initial months in a group home. Improvement did not differ for TFM and non-TFM homes during this initial period. Post-discharge results, though, show that TFM was associated with continued improvement after discharge and significantly better outcomes by 8 months post-discharge. Results also discuss youth-level factors that may influence outcomes as well as need for additional work to more fully understand processes and practices that are key for maximizing and maintaining youths’ positive outcomes during and after group home placements. [ABSTRACT FROM AUTHOR]

Despite their widespread use as a placement option for youth with mental health problems, there is relatively little research on group homes for youth. Available data highlight concerns with practices and treatment within group homes and mixed results on youth-level outcomes. However, existing research appears to collapse a wide range of group residential settings into a single amorphous category. This article explores potential variations among group homes to examine whether different programs are systematically serving different types of youth. It examines, in particular, placement in homes using the teaching family model (TFM) versus homes that do not. Findings suggest that demographics are not significantly associated with TFM placement. However, custody status, types of mental health problems, and use of psychotropic medications are. Homes appear to be serving distinct niches within a geographic area. Implications for future research and policy/practice are discussed. [ABSTRACT FROM AUTHOR]