Program Profile: The Pathways Home Foster Care Reunification Intervention

This is a preventive intervention intended to reunite children returning home to their parents after their first stay in foster care. The program is rated No Effects. The preponderance of evidence suggests that the program does not have a statistically significant impact on parent encouragement, problem behaviors or foster care reentry.

A No Effects rating implies that implementing the program is unlikely to result in the intended outcome(s) and may result in a negative outcome(s).

This program's rating is based on evidence that includes at least one high-quality randomized controlled trial.

Program Goals/Target Population

The Pathways Home Foster Care Reunification Intervention (Pathways) is a selective prevention program targeting families whose children were returning home after their first stay in foster care. Children who are removed from their biological parents and placed in foster care face a variety of risks, including substance abuse, educational failure, risky sexual behavior, and delinquency. The Pathways program aimed to prevent reunification failures when children were returned home to their biological parents by supporting parents and making the transition a smooth process for both immediate and continued parenting success. The Pathways program sought to create a safe and nurturing environment for children by providing parents the support they need to meet parenting demands, such as managing the household, managing stress, and staying healthy. Pathways targeted parents who were considered high risk for conduct and substance abuse problems.

Parent substance use, parent criminality, and poor parenting are factors that lead to children entering or reentering foster care. Thus, parent management theories were used as the foundation of the Pathways program (DeGarmo et al. 2013). The program taught parents management strategies and principles that were based on the social interactional and social learning approaches, both of which emphasized positive reinforcement and encouragement of desired prosocial behaviors. Further, the Pathways program looked to other parenting and foster care programs for guidance when developing the program. For example, the Multidimensional Treatment Foster Care (MTFC) program influenced the development of Pathways.  MTFC stresses the importance of the parent of caregiver’s role in providing children consistent supervision, emotional involvement, and support; these factors were also stressed in Pathways (DeGarmo et al. 2013).

Program Components

The Pathways curriculum, which was delivered in two phases, included strategies to enhance parenting skills, encourage cooperation, teach new behaviors, set limits with a child, and keep track of the child’s behavior and activities, as well as strategies  to help the children succeed in the classroom. The curriculum was delivered in individual sessions and was led by a trained family consultant. Phase 1 began before reunification and lasted 16 weeks. The following topics were delivered in the Phase 1 curriculum: getting started, daily schedules, encouragement and cooperation, tracking cooperation/requests and directions, teaching new behaviors, behavior contracts, setting limits, balance between encouragement and discipline, promoting school success, promoting positive peer and sibling relationships, anticipation and preteaching, avoiding power struggles, problem solving, stress and coping (focused on substance use issues), social support, and parenting plans. The sessions consisted of reviewing the previous week’s lesson, role-plays, and homework assignments. Following the end of Phase 1 the parents were given an 8-week break before the start of Phase 2. Phase 2 lasted 8 weeks and included sessions that fine-tuned the skills taught in Phase 1, assessed the parent’s risk of future harm to family, and developed a plan to safeguard against any perceived risks.

Study

DeGarmo and colleagues (2013) used a randomized control trial to evaluate the impact of the Pathways Home Foster Care Reunification Intervention (Pathways) program on reunification. To be eligible for inclusion, families had to live within 25 miles of the research center and have a child who was between the ages of 5 and 12 and was returning home from his or her first placement in foster care to live with one or both biological parents. Children and their families were referred from the child welfare branch of the local government to participate in the study. Families were randomly assigned to the Pathways program (intervention) or services that are typically offered to families involved in the child welfare system (comparison condition).  Of the families eligible, 50 were assigned to the Pathways program and 53 were assigned to the comparison condition. The overall sample included 52 boys and 51 girls, with a median age of 8. The mean age of mothers was approximately 32, the mean age of fathers 37. Fifty-four percent of the families were single-mother homes. Children were identified as 53 percent European American, 35 percent Hispanic, and 9 percent multiracial, and 3 percent Native American. Seventy-four percent of mothers self-identified as European American, 17 Hispanic, 5 percent African-American, and 4 percent multiracial.  Eighty-two percent of fathers self-identified as European-American, 4 percent African-American, 11 percent Hispanic, and 3 percent multiracial. In terms of criminal history, 92 percent of the mothers had a history of drug or alcohol abuse, 55 percent had been arrested, and 47 had a history of family violence (no information regarding criminal history for fathers was provided). Forty-one percent of the children were underperforming in school. There were no baseline differences between groups in terms of sociodemographics or problem behaviors.

Data was gathered through in-person interviews, questionnaires, and record searches during three time periods: baseline, 6-month follow-up, and 12-month follow-up. The following outcomes were analyzed: child behavior problems, encouragement strategies, and foster care reentry. Child behavior problems were measured through the Parent Daily Report Checklist (PDR), which included 40 behavior problem items that were tallied for an index ranging from 0 to 40. Trained interviewers asked parents questions related to the number of times in the past day certain problem behaviors had occurred. Encouragement strategies were collected through the PDR, where parents were asked by a trained interviewer their response to their child’s behavior. Finally, foster care reentry was collected through Child Welfare Services records. To evaluate the overall impact of the outcomes, hierarchical generalized linear modeling was used.

These sources were used in the development of the program profile: