Transcript POIT FHF presentation- 2014-01-16

Fostering Healthy Futures
Kempe Center for the Prevention
and Treatment of Child Abuse and Neglect
Fostering Healthy Futures
Program Design
1) Assessments of Children’s Functioning
2) Therapeutic Skills Groups
3) Mentoring
It Takes a Village
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Denver Department of Human Services
Adams County Social Services Department
Jefferson County Human Services
Arapahoe County Department of Human Services
Broomfield County Health and Human Services
Colorado Department of Human Services
Graduate schools: DU, Newman, CSU, UCD, Metro
School districts and schools
Mental health centers and therapists
Multiple non-profit organizations
Children and families
David Olds
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Sara Culhane
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Ann Petrila
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Daniel Hettleman
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Volunteers
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Kempe Center
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Kempe Foundation
Youth Mentoring Collaborative
Department of Pediatrics, University of Colorado
Developmental Psychobiology Research Group
FHF Core Staff 2002-2013
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Sara Culhane, Ph.D.
Ann Petrila, LCSW
Daniel Hettleman, Ph.D.
Becky Gennerman-Schroeder, LPC
Patrick Nickoletti, PhD
Jill Gjerde, MA
Michel Holien, LCSW
Dana Morgan, LCSW
Robyn Wertheimer, LCSW
Jennifer Koch-Zapfel, MSW
Tracy Rudhe
Dongmei Pan, MA
Liz Goetter, BA
Julie Bemski, BA
Tabitha Webster, BA
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Laura Mann, BA
Melody Combs, Ph.D.
Tali Raviv, PhD
Chris Kelman, LCSW
Leslie Fitzpatrick, LCSW
Orah Fireman, LCSW, M.Ed
Edward Garrido, Ph.D.
Christie Petrenko, PhD.
Leigh Clasby, BA
Michael Knudtson, MA
Wendy Gehring, BA
John Holmberg, Psy.D.
Tara Rhodes, MA
Lindsey Weiler, Ph.D.
Heather Taussig, Ph.D.
FHF Graduate Student
Research Assistants and Group Leaders
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Brendan Close
Erika Joye
Nicole Lariviere
Amy Franke
Mia Kim
Jessi Wheatley
Melani Dawson-Lear
Melanie Rodriguez
Riley Spuhler
Walter Heidenreich
David Roberts
Alexis Karris
Marisa Duran
Patrick Nickoletti
Dena Miller
Thea Wessel
Jennifer Sackett
Amy Percosky
Tisha Bean
Emily Macdonald
Jill Gjerde
Rachel Lund
Ann Chu
Yael Chatav
•Tiffany Conway
• Tracy Rudhe
• Brian Wolff
• Jenn Winkelmann
• Pam Freeman
• Danielle Smith
• Amanda Brown
• Heather Frey
• Vyga Kaufmann
• Neta Bargai
• Julie Bemski
• Jenell Ribble
• Martine Lopez
• Alana Henken
• Kathryn Jargo
• Liz Hooks
• Tara Buckley
• Jordan Pock
• Andrea Reece
• Sara Rosenau
• Natalie Tolejko
• Kristen Simpson
• Shari Watters
• Michelle Brunner
Lindsay Heath
Kristin Nelson
Kate Slivka
Lindsay Smart
Susan Whittle
Elizabeth Goetter
Julie Lyons
Courtney Fiedler
Edyta Biegunajtys
Claire Heppner
Clara Paynter
Kelsey McNeill
• Jenell Ribble
• Dena Miller
• Martine Lopez
• Thea Wessel
• Alana Henken
• Julie Bemski
• Claire Heppner
• Amy Percosky
• Andrea Temple
• Allison Glover
• Sarah Morehouse
• Jennifer DeVault
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Debra Boeldt
Christine Kelley
Denise Onofrey
Jennell Ribble
Alanna Gangemi
Jenny Doft
Jenea Jones
Kristin Allen
Maddie Philley
Rachel Shulman
• Leigh Clasby
• Sarah Perzow
• Emily Rotbart
• Laurel Story
• Mayla Yang
• Tish Wer
• Claire Stephenson
• Allison Glover
• Melissa Toppel
• Jasmine Crane
• Christina Hack
• Olga Leonova
• Leah Chelist
• Katie Lange
• Melena Postolowski
• Kristen Mackiewicz
• Allison Bratsch
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Kristen Vescera
Leah Scandurra
Emily Laux
Caroline Oppenheimer
Tara Rhodes
Leah Harrigan
Cory Reid-Vanas
Erica Ragan
Jessica Schnittka
Shelby Scott
Maria Davidsmeier
Shawna Henry-Lange
Anne Eden
Rachel Stonecipher
Michelle Turner
Liz Healy
Lucia Lapaz
Rachel Levine
Aleja Parsons
Meagan Rohde
Laura Sullivan
FHF Graduate Student Interns
2002-2003
• Melani Dawson-Lear
• Kristine Wilson
• Brenna Ellington
• Lanette Ambers
• Carrie Oliver
2003-2004
• Amy Bruner
• Liz Dinsdale
• Vashawn Banks
• Josh Goldman
• Marisa Duran
• Amber Cross Thomas
• Melanie Rodriguez
• Clover Bone
2004-2005
• Tiffany Conway
• Katie Ferguson
• Katie Melstrom
• Lisa Meyers
• Kendra Sasa
• Carla Scarpone
• Lewis Smirl
• Kelsey Wennesland
• Regina Richards
2005-2006
• Michelle Brunner
• Jocelyn Gray
• Jon Phillips
• Jennifer Stucka
• Christina Haskins
• Tina Francis
• Sarah Kane
• Mark Spehn
• Jennifer Nelsen
2006-2007
• Lorendia Schmidt
• Phoung Phan
• Beth Lipschutz
• Jacquelyn Eisenberg
• Angela Bierle
• Lisa Harrison
• Nicole Henkins
• Erin Hoglund
2007-2008
• Kerrie Earley
• Ashley Moore
• Justine Stewart
• Lauren Goldberg
• Marissa Nasca
• Amber Wolfe
• Jennifer Reynolds
• Krystal Caduff
• Miranda Learmonth
• Molly Jenkins
• Rebekah
Koenigbauer
• Sarah Oakley
• Lauren Timkovich
• Sam Murillo
• Elizabeth Berling
• Kristin Krietemeyer
2008-2009
• Rachel Alpert
• Katherine Belcher
• Taylor Collins
• Renata Heberton
• Alyse Keilson
• Blake Konner
• Emily Lyons
• Melissa Maurer
• Regan Linton
• Nina Modern
• Jennifer Pitcavage
• Meredith Schaffer
• Holly Selepouchin
• Heidi VanEpps
• Katherine Ware
2009-2010
• Lissa Miller
• Jenna Brown
• Jane Simon
• Allison Harris
• Shane Spears
• Jolie Rinebarger
• Diane Bouhall
• Kelly Fries
• Erica Brown
• Shavon Perkins
• Jess Valsechi
• Katie Kaser
• Britta Johnson
• Renea Nilsson
• Laura Merten
• Kyle Steinke
2010-2011
• Mele Cabral
• Jon Florida
• Sibyl Graham
• Beth Hilligoss
• Tighe Kaysar
• Alexandria Lewis
• Sarah Romero
• Stacy Walsh
• Jessica Devore
• Jacquelyn Gabel
• Jeffrey Hatcher
• Ryan Holmes
• Emily Laux
• Megan Lovingier
• Sapphire Rosier
• Cami Wangaard
2011-2012
• Jessica Barry
• Rachel Berns
• Maria Davidsmeier
• Diana Gonzalez
• Brandon Hester
• Nadine Leonard
• Julia McKinnon
• Amy Muetterties
• Heather Price
• Kristen Schmidt
• Rachel Stonecipher
• Ashley Wiggins
2012-2013
• Jessica HenritzeHoye
• Jenna Kelley
•Diane Kleinschnitz
•Linda Ladago
•Rachel Sacco
•Ani Sttele
2013-2014
• Rachel Bennett
• Emily Bruce
• Stephanie Cichocki
• Emily Frank
• Senite Sahezghi
• Ashley Stewart
• Elizabeth Stitzel
• Nancy Vargas
*Over
80,000
hours of
training
provided to
130 interns
Federally-Funded Research
Risk Behaviors in Maltreated Adolescents
National Institute of Mental Health Dissertation Award, 1 R03 MH56781-01, $25,000.
Preventive Interventions for Foster Care Youth
National Institute of Mental Health, 1 K01 MH01972, $590,166.
Intervention Development and Pilot for Foster Care Youth
National Institute of Mental Health, 1 R21 MH067618, $472,500.
Fostering Healthy Futures Efficacy Trial for Preadolescent Youth in Foster Care
National Institute of Mental Health, 1 R01 MH076919, $2,655,734.
Research Supplement to Promote Diversity in Health Related Research
National Institute of Mental Health, 3 R01 MH0876919-02S1, $283,706.
Recovery Act Administrative Supplement Providing Summer Research
Experience for Student and Science Educators
National Institute of Mental Health, 3 R01 MH0876919-03S1, $18,670.
Long-Term Impact of a Positive Youth Development Program on Dating Violence
Outcomes During the Transition to Adulthood
National Institute of Justice, 2013-VA-CX0002, $440,642.
State, University, and Hospital Funding
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Edward Byrne Memorial Justice Assistance Grants
Colorado Division of Criminal Justice, U.S. Department of Justice
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Tony Grampsas Youth Services
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CAPTA Contract
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The Children’s Hospital Research Institute
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Colorado Clinical and Translational Sciences Institute Grants
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State of Colorado
Colorado Department of Human Services
Bridge Funding
University of Colorado
Academic Enrichment Fund
University of Colorado
Kempe Foundation Funding for FHF
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2002
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2004-present
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Daniels Fund ($20,000)
The Janus Foundation ($5,000)
Bonfils Stanton Foundation ($10,000)
PacifiCare ($10,000)
U.S. Bank ($5,000)
Daniels Fund ($50,000)
Pioneer Fund ($1,500,000 endowment for Fostering Healthy Futures)
Bonfils Stanton Foundation ($20,000)
Daniels Fund ($50,000)
Gannett Foundation ($3,000)
First Data/Western Union ($5,000)
Donor Advised Fund, Denver Foundation ($30,000)
Anschutz Family Foundation ($3,333)
Colorado Rockies Charity Fund ($10,000)
Denver Foundation ($15,000)
Daniels Fund ($60,000)
Anschutz Family Foundation ($4,167)
TJX Foundation ($3,000)
Rockies/McCormick Foundation ($20,000)
El Pomar Youth in Community Service - Arvada West High School ($500)
El Pomar Youth in Community Service - Northglenn High School ($1,500)
McGowan Foundation ($15,000)
Daniels Fund ($60,000)
MaggieGeorge Foundation ($16,000)
Kempe Foundation Funding for FHF
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2008
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2011
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2012
2102
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2013
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2013
Xcel Energy Foundation ($5,000)
Rockies/McCormick Foundation ($20,000)
Larrk Foundation ($30,000)
Verdoorn Foundation ($15,000)
Whispering Fox ($5,000)
Daniels Fund ($60,000)
Rockies/McCormick Foundation ($10,000)
Verdoorn Foundation ($11,000)
El Pomar Award of Excellence ($7,500)
Colorado Rapids ($4,000)
IP 5280 ($28,506)
Jay and Rose Phillips Family Foundation ($20,000)
Daniels Fund ($60,000)
Rockies/McCormick Foundation ($10,000)
Rockies/McCormick Foundation ($5,000)
Verdoorn Foundation ($10,000)
Jay and Rose Phillips Family Foundation ($20,000)
Lubert Family Foundation ($7,500)
LARRK Foundation ($35,000)
Daniels Fund ($60,000)
Morgridge Family Foundation ($4,500)
Daniels Fund ($60,000)
Lubert Family Foundation ($5,000)
Verdoorn Foundation ($20,000)
Mile High United Way (30,000)
Inclusion Criteria
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All 9-11-year-old children in any type of out-of-home placement in
participating counties, including those placed in foster homes,
kinship care, group homes, and residential treatment centers
Placed in court-ordered out-of-home care (over prior 12 months) as
result of maltreatment, and were in out-of-home care at the onset
of the intervention
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Cognitive functioning at a level able to comprehend group material
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Did not exclude youth with significant mental health or behavioral
problems (including children with sexual perpetration histories)
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Youth continued to participate in the 9-month program even if they
changed placements or reunified
FOSTERING HEALTHY FUTURES PREVENTIVE INTERVENTION
SHORT-TERM OUTCOMES
Cognitions
Social Functioning
Behavioral Functioning
•Self-Esteem and Efficacy
•Attitudes and Appraisals
•Future Orientation
•Social Support
•Competence & Acceptance
•Peer Associations
•Behavioral Regulation
•Coping Strategies
•Extracurricular Activities
LONG-TERM AND LIFE-COURSE OUTCOMES
Fewer Adverse Life-Course Outcomes
Better Distal Outcomes
•Mental Health
•Problem Behaviors
•Competencies
•Quality of Life
•Arrests and Incarceration
•Pregnancy and STDs
•School Failure and Dropout
•Emergency Mental Health Treatment
•Multiple and Restrictive Placements
•Associated Costs
Fostering Healthy Futures (FHF)
Program Design
1) Evaluations of Children’s Functioning
2) Therapeutic Skills Groups
3) Mentoring
Screening Evaluations
We assess functioning in the following domains:
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Cognitive
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Academic achievement
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Mental health, including trauma symptoms
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Social
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Behavioral
Therapeutic Skills Groups
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30 weeks; manualized program
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8 children per group, equal females and males
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Mental health clinicians and graduate trainees
facilitate
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1 hour group and then dinner with mentors
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Improve skills, process feelings related to the
foster care experience, and reduce stigma
Session Content
Basic Social Skills
Healthy Coping
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Feelings
Perspective Taking
Problem Solving
Healthy Communication
Anger Management
Positive Self-Talk
Dealing with Worry
Active Coping Strategies
Change and Loss
Adolescent Issues
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Mixed Emotions
Abuse and Neglect
Healthy Relationships
Panel Night
Program Ending
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Future Orientation
Career Shadows
Healthy Goodbyes
GRADUATION!
Anatomy and Puberty
Dealing with Peer Pressure
Resisting Drug/Alcohol Use
Healthy Dating Relationships
Mentoring
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Graduate students spend 3-4 hours per week of individual
time with each child they mentor
They work on child’s lifebook, engage in extracurricular
activities, help find other adult role models, shadow adults
in professions of interest, work on homework, take them
to libraries, recreational activities, etc.
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Focus on engaging them in their communities and
teaching them advocacy skills
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Mentors interface with other adults in child’s life
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Role of mentor - create a web of support for children,
improve social skills, and provide staunch advocacy
Lifebooks
Panel Night
Cultural Presentations
Cultural Engagement
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All project materials translated into Spanish
Multicultural stories in group; materials visually and
linguisitically sensitive
Mentor training in multicultural issues, personal
exploration of culture, community exploration project
Children and mentors do cultural presentations
Embrace and explore differences; engage in culturallymeaningful activities
Career Shadows
Mental Health Outcomes
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Lower Mental Health Composite Score
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Fewer Trauma Symptoms
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Fewer Symptoms of Dissociation
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Less Anxiety
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Less Current Mental Health Treatment
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Fewer Psychotropic Medications (trend)
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Greater Perceived Social Support
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Higher Quality of Life
Placement and Permanency Outcomes
WHOLE SAMPLE
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71% less likely to be placed in residential treatment
Threefold increase in adoption for children with TPR (8%
vs. 26%; non-significant)
FOSTER CARE SAMPLE
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44% fewer placement changes (findings strongest for
those with high baseline behavior problems)
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5 times more likely to have achieved permanency
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Twice as likely to have reunified with their biological parents
Key Features of FHF
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Homegrown Program
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590 youth involved
230 youth received the 9-month program
New grant to follow 250 youth into young adulthood
High Rates of Program Engagement
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92% recruitment rate for voluntary program
92% retention rate
Over 90% follow-up at each post-intervention timepoint
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Similar Level of Evidence with other Evidence-Based
Programs (e.g. TF-CBT, PCIT)
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Reduces both mental health problems and negative
permanency outcomes
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Received recognition
In the
Colorado Practice Model
Best Practice Compendium!
Colorado’s Title IV-E Waiver Application
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Innovative practice
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Piloting teen program
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Advancing knowledge
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Increases permanency
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Trauma-informed child
assessments
Consistent with Colorado
Practice Model
Integration of behavioral
health and child welfare
Addresses mental health needs
of children in foster care
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Reduces use of congregate
care
Reduces psychotropic
medication use
Increases positive outcomes
for children
Culturally-sensitive, destigmatizing and acceptable
Dissemination Phase
Widespread Inquiries
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Replication
Adaptation
Implementation Plan
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Community-Based Agencies Implement
Rural Adaptation
CAPTA Funding to Provide Training
Challenges to Implementation
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Funding
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Prevention Program; No diagnoses
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CORE funding when cases close
Grants end
Opportunities with Waiver or PA3?
First-Year Implementation
Aurora Mental Health Center
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2 groups; 16 children
Adams, Denver, Arapahoe and Douglas Counties
Using Core Service Dollars
$5,600 for 9 month program (for 5 hours of programming/week)
First-Quarter Progress
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Developed training materials and training schedule
All 16 children continuing participation, despite placement changes
Anonymous program evaluations with children:
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FHF is helpful for learning how to deal with feelings (87% - “A Lot”)
I like how we get a chance to know other kids who are in out-of-home care (93% - “A Lot”)
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I am glad I chose to do FHF this year (93% - “A Lot”)
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Phone calls with caregivers:
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Reflect high satisfaction with program
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Report behavioral and academic changes