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In 2021, the Evidence into Practice Special Interest Group was launched with online events. At the 11th European Conference for Social Work Research in Amsterdam in April 2022, the Evidence into Practice Special Interest Group had its inaugural in-person sessions. This short article in the ‘Research, policy and practice exchange’ section of this new journal, European Social Work Research (a collaborative venture involving European Social Work Research Association), has been written to bring the launch of the Evidence into Practice Special Interest Group to a wider audience and to encourage participation. The article gives something of the context for the Evidence into Practice Special Interest Group and a flavour of the presentations at the 2022 European Conference for Social Work Research.

This chapter describes the conceptual and methodological approach that serves as the foundation for the subsequent individual contributions by country. Each succeeding within-country chapter will be organized around a completed matrix that aims to facilitate cross-country comparisons around conceptually meaningful dimensions for residential care. The matrix was developed by the author of this chapter as part of a five-country Erasmus+ project (2018–2021) and further modified for purposes of this book. In this chapter the genesis, development, and use of the matrix will be detailed and its significance for a deeper and focused understanding of residential care discussed. Key variables including residential care system/program features, staff training and personnel, and characteristics of children and youth in residential care will be explored along with data collection issues and challenges.

Revitalizing Residential Care for Children and Youth: Cross-National Trends and Challenges addresses the question of how societies with developed welfare and social service systems assess current needs and future directions in their residential child and youth care sectors. This includes dealing with historical concerns raised about the placement of children and youth in residential care settings, as well as identifying innovative strategies that offer new pathways for the integration of this often-neglected sector of service within the broader area of child welfare. Each of the 16 countries selected for inclusion is examined through a common matrix that provides information about the current policy context, key trends and initiatives, characteristics of children and youth served, preparation of residential care personnel, promising programmatic innovations, and present strengths and challenges. Individual country analyses are supplemented by regional exemplars of innovative residential programs and practice in areas such as family engagement, helping youth with the transition from care to community, promising model programs, and reflections on recent policy reform initiatives. In addition to takeaways from each country, the book’s closing chapter identifies specific implications for policy reform, empirical research, and residential program innovation. What sets this book apart is its systematic cross-national appraisal of residential care for children and youth with an eye toward identifying innovative policies and practices undergirded by research. In so doing, it offers a unique contribution to the international child welfare literature.

This chapter notes the long historical tradition of residential care in Germany and its current expression in a wide variety of settings. Residential care programs mostly consist of small community-based group homes and supported living units with about seven to 10 youths and four or five pedagogical staff. Some homes offer specialized services (e.g., therapeutic residential care, wilderness programs, mother–child homes). The authors note that residential care is guided by general pedagogical principles and concepts, emphasizing learning through a milieu-based and “life-space-oriented” perspective (Lebensweltorientierung), which stresses an individualized, participatory, and relationship-based approach. Parent engagement and youth participation are also noted as important, as are the growing numbers of unaccompanied minors and their impact on the residential care system. The chapter concludes with the matrix used throughout the book, which provides information about the current policy context, key trends and initiatives, characteristics of children and youth served, preparation of residential care personnel, promising programmatic innovations, and present strengths and challenges.

This final chapter synthesizes the main findings from the 16-country cross-national review of residential care for children and youth. Major topics include differing rates of use for residential care, characteristics of children and youth served, contextual elements and policy developments, quality factors in residential care, and education and training strategies. The authors conclude with some general recommendations for future improvement of residential child and youth care, including policy initiatives, research, and promising pathways for innovation. The authors urge a more nuanced and better specified conceptualization of residential care. They make the case for continued and expanded cross-national analysis of residential care provision in future.

Chapter 1 sets the parameters for the editors’ view of “residential care for children and youth” and offers a working definition of the same viewed in the context of legal, administrative, and children’s rights within an organized child welfare system. The editors make clear the rationale for their choice of a range of countries with developed welfare systems, while acknowledging a far more diverse range of residential settings viewed in worldwide context. The contributors to this volume share a commitment to a high-quality, revitalized residential service sector grounded both in research and commonly shared values such as partnership with families and residential practice that is close to the rhythms of diverse and vital community life. This does not mean “one size fits all,” but rather that we can learn much from the often subtle ways in which culture and tradition create the niches within which residential services are formed, sustained, and changed.

This article reports on the 18-month formative evaluation of a model project aimed at preparing young adult refugees (YARs) for entry into vocational education training (VET) as an essential step toward the labor market. Qualitative methods were used to gain insight into the perspectives of YARs, program staff, and vocational instructors as well as explore program dynamics. Within a longitudinal research design, 45 qualitative semistructured interviews were conducted with 22 of 27 program participants. Additionally, program staff and vocational instructors were interviewed. Qualitative content analysis guided the analytic process. Outcome data indicated that 83.3% of program completers or 55.6% of the program participants entered a VET within the evaluation period. Triangulated qualitative data revealed relevant program processes and generated hypotheses about factors that facilitate or hinder the difficult transition for YARs. Implications for program development as well as needed structural changes are discussed.

Abstract. In this study the 15-item Evidence-Based Practices Attitude Scale (EBPAS), a measure designed to assess attitudes toward the adoption of EBPs, was collected from administrators of residential care facilities for youth in the United States. As the EBPAS was administered to a different sample for which it was originally developed (i.e., community mental health), we conducted a Confirmatory Factor Analysis (CFA) to investigate if its factor structure was maintained. Results confirm the factor structure of the EBPAS as a valid measure of attitude toward evidence-based practice among youth residential care providers. Limitations and areas of future research are discussed.

In 2015, 35,369 unaccompanied refugee minors (URMs) applied for asylum in Sweden, making it the number one destination country for URMs in Europe. URMs often face multiple social problems and menta...

Changes in the adolescent brain underlie the development of executive functions (EFs) after the onset of puberty; however, adolescents that engage in deliberate self-harm (DSH) have impaired EFs in the areas of inhibition, emotion regulation, shifting, and interpersonal functioning. On the other hand, dialectical behavior therapy (DBT) has been shown to be effective in treating adolescents with DSH. Moreover, the DBT skills of mindfulness, emotion regulation, distress tolerance, interpersonal effectiveness, and “walking the middle path” are suited to treat these adolescents with impaired EFs. This single group pre-post study examined changes in adolescents’ EFs who were enrolled in DBT. Ninety-three adolescents from a 16-week DBT program for DSH were administered the Behavior Rating Inventory of Executive Function-Self Report (BRIEF-SR) at pre-treatment and post-treatment. Adolescents improved from the elevated to non-clinical range on the Emotional Control, Shifting, and Monitor scales in addition to the Global Executive Composite of the BRIEF-SR. Significant effects for funding type on shifting, interpersonal functioning, and overall EF were observed while a significant effect for previous history of psychiatric hospitalizations was observed for emotion regulation. DBT appears to be effective for improving the EFs of adolescents with DSH and for specific subgroups of this population. Knowledge of these adolescents’ profile of EFs will assist clinicians in determining the type and level of intervention with DBT in order to shape positive behaviors during this important period of brain development.

This study aimed to add to the limited empirical knowledge base on evidence-based practice (EBP) and social work in Germany. Using a regional sample of 158 social workers that were recruited throug...

Residential care agencies have been making efforts to provide better quality care through the implementation of evidence-based program models and evidence-based treatments. This paper retraces the developments that led to such efforts. It further aims to answer two questions based on the available conceptual and empirical literature: (1) What is the current status on milieu-based program models that were developed for residential care settings with a therapeutic focus? (2) What is known about the implementation of client- or disorder-specific evidence-based treatments into residential care settings? Findings from this review will be integrated to provide recommendations to residential care providers about the integration of evidence-based treatments into their agencies and to point to the challenges that remain for the field.

Using data from a U.S. survey of residential care providers on the utilization of evidence-based practices (EBPs) in residential care, this study examines outcomes, processes, and barriers related to the implementation of EBPs. Descriptive data on 115 EBPs implemented in 66 residential care agencies were analyzed with regard to multiple domains of implementation outcomes, such as the adoption, appropriateness, fidelity, and sustainability of EBPs. Study results showed that residential care programs are primarily implementing EBPs that target specific client problems and populations and address prevalent problems of trauma and emotional disorders. A low rate of utilization of milieu-based program models, which were specifically designed for residential care, was noted. Child care staff were mostly excluded from the training and delivery of EBPs. Although providers reported that implementation of EBPs yielded desired results, considerable barriers persisted. Fidelity data raised questions about the degree to which agencies are in fact implementing EBPs. Findings from this exploratory study are meant to encourage further inquiry of the conditions necessary in residential care programs to foster openness toward the implementation of EBPs and to achieve sustained success.

Relatively little empirical attention has been paid to understanding how refugees conceptualize depression and how this concept varies between genders. The purpose of this study was to explore beliefs about depression among Afghans residing in San Diego County, California, using cultural consensus analysis. Using the prescribed mixed-method approach, we employed results from in-depth interviews to develop a culturally meaningful questionnaire about depression. Consensus analysis of responses to questionnaire items from 93 Afghans (50 men, 43 women) indicates shared beliefs that associates depression causality with mild traumatic experiences and post-resettlement stressors, symptomatology to include culturally salient idioms of distress, and treatment selections ranging from lay techniques to professional care. Divergence between genders occurred most in the symptoms subdomain, with women associating depression with more somatic items. This study contributes to understanding the etiology of and cultural responses to depression among this population, which is critical to improving culturally sensitive intervention for Afghan refugees.

The psychological effects of war and resulting displacement continue to negatively impact Afghan refugees. The purpose of this study was to investigate factors that are associated with and predict psychological distress symptoms among Afghan refugees. We analyzed data from a diverse sample of 130 Afghan refugees recruited through non-random sampling in the San Diego area. Participants completed self-report questionnaires consisting of a culturally validated measure of psychological distress, the Afghan Symptom Checklist [ASCL] alongside standardized measures of acculturation, social support, and perceived stress. In bivariate analyses, older age, older age at migration, female gender, being widowed, having lower education, being unemployed, unable to comfortably pay monthly bills, lower acculturation and social support, and higher levels of perceived stress were associated with psychological distress. However, only few variables – female gender, being widowed, unable to comfortably pay monthly bills, and perceived stress – remained significant in multivariate analysis. The findings from this study contribute to understanding the social determinants of distress that affect Afghans in exile even after long-term resettlement in the US. These reported outcomes support the need for continued research with Afghans, alongside the implementation of culturally relevant psychosocial interventions that emphasize prevention of post-resettlement stressors immediately upon resettlement.

This study reports on results of a national survey conducted in the United States about the attitudes, perceptions and utilization of evidence-based practices (EBPs) in residential care settings. Seventy-five of 118 member agencies (63.6% response rate) of a voluntary national residential care association responded to a web-administered structured survey, which included the Evidence-Based Practices Attitude Scale (Aarons, 2004). Results show overwhelmingly positive attitudes toward EBPs. Concerns were reported mainly with regard to cost and impeding a client-driven practice approach. The study also showed a high degree of utilization of EBPs with over 88 percent of programs reporting the use of at least one practice they considered to be evidence-based. Altogether 53 different practices were reported although it is unknown at this point whether practices were delivered with fidelity. Behaviorally-based and trauma-focused interventions constituted the most common interventions used by residential care agencies. Practices were subsequently validated against four national clearinghouse sites, indicating that only slightly over half of all reported practices had been evaluated by at least one clearinghouse and rated as having some research evidence for effectiveness. Divergent views about what practices are evidence-based point to the need for continued discussion between the practice and research fields about conceptualizations of evidence.

In many developed countries around the world residential care interventions for children and adolescents have come under increasing scrutiny. Against this background an international summit was organised in England (spring 2016) with experts from 13 countries to reflect on therapeutic residential care (TRC). The following working definition of TRC was leading: "Therapeutic residential care involves the planful use of a purposefully constructed, multi-dimensional living environment designed to enhance or provide treatment, education, socialization, support, and protection to children and youth with identified mental health or behavioural needs in partnership with their families and in collaboration with a full spectrum of community based formal and informal helping resources". The meeting was characterised by exchange of information and evidence, and by preparing an international research agenda. In addition, the outlines of a consensus statement on TRC were discussed. This statement, originally published in English and now reproduced in a Dutch translation, comprises inter alia five basic principles of care that according to the Work Group on Therapeutic Residential Care should be guiding for residential youth care provided at any time.

This paper presents the outcomes of a Dialectical Behavior Treatment (DBT) program, implemented in intensive outpatient care with two groups of adolescents (n = 55 and n = 45), ages 12-18, who engaged in deliberate self-harm (DSH) but had different insurance/funding sources and risk backgrounds. This pre-post study examined variability in clinical functioning and treatment utilization between the two groups and investigated moderating risk factors. Findings support DBT's effectiveness in improving clinical functioning for youth with DSH regardless of insurance type. However, lower rates of treatment completion among youth without private insurance call for extra engagement efforts to retain high-risk youth in DBT.

Using data from a cross-sectional study that examined health risk behaviors among urban intravenous drug-using (IDU) adolescents and young adults, this study investigated risk profiles among a high-risk sample (n = 274). Risk profiles were empirically derived through latent class analysis based on indicators of engagement in health-risking behaviors, experience of abuse and violence as well as individual and family risk factors. The best fitting model was a 3-class model. Class 1 (n = 95) captured participants with the lowest risk across all indicators. Compared to Class 1, Class 2 (n = 128) and Class 3 (n = 51) had elevated rates of engagement in health-risking behaviors as well as individual and family risk factors; however, Class 3 had the highest rate of engagement in sexual risk behavior, and backgrounds of substantial abuse and violence as well as familial psychopathology. Class 2 was the group most socioeconomically disadvantaged, with the highest percentage of participants coming from poor backgrounds, spending the longest time homeless and working the fewest months. Identifying subgroups of IDU has the potential to guide the development of more targeted and effective strategies for prevention and treatment of this high-risk population.

none 32 si The International Work Group for Therapeutic Residential Care convened an International Summit on ‘Pathways to Evidence-Based Practice’ at Loughborough University (GBR), Centre for Child and Family Research on 27-29 April, 2016 with generous support from the Sir Halley Stewart Trust and in partnership with The European Scientific Association on Residential and Family Care for Children and Adolescents (NLD) (EUSARF), the International Association for Outcome-Based Evaluation and Research on Family and Children’s Services (ITA) (IAOBER) and the Association of Children’s Residential Centers (USA) and with the additional support of Action for Children (GBR) and the National Implementation Service (NIS) (GBR). Membership includes: Lisa Holmes (Chair), Director, Centre for Child and Family Research, Loughborough University (GBR); James K. Whittaker (Co-Chair), Charles O. Cressey Endowed Professor Emeritus, University of Washington, School of Social Work, Seattle (USA); Jorge Fernandez del Valle, Professor of Psychology and Director, Child and Family Research Group, University of Oviedo (ESP); Frank Ainsworth, Senior Principal Research Fellow (Adjunct), James Cook University, School of Social Work and Human Services, Townsville, Queensland (AUS); Tore Andreassen, Psychologist, The Norwegian Directorate for Children, Youth and Family Affairs (NOR); James P. Anglin, Professor, Faculty of the School of Child and Youth Care, University of Victoria (CAN); Christopher Bellonci, Board-Certified Child/Adolescent and Adult Psychiatrist; Associate Professor, Psychiatry Department, Tufts University School of Medicine, Boston, MA (USA); David Berridge, Professor of Child and Family Welfare, School for Policy Studies, University of Bristol (GBR); Amaia Bravo, Lecturer, Department of Psychology, University of Oviedo (ESP); Cinzia Canali, Senior Researcher, Fondazione Emanuela Zancan, Padova (ITA) and President, International Association of Outcome-Based Evaluation and Research in Family and Children’s Services (IAOBER); Mark Courtney, Professor, School of Social Service Administration, University of Chicago (USA); Laurah Currey, Chief Operating Officer, Pressley Ridge, Pittsburgh, PA (USA) and President, Association for Children’s Residential Centers, (USA); Daniel. L. Daly, Executive Vice President and Director of Youth Care, Father Flanagan’s Boys’ Home, Boys Town, NE (USA); Robbie Gilligan, Professor of Social Work and Social Policy, Trinity College Dublin IRE), Hans Grietens, Professor, Centre for Special Needs Education & Youth Care, University of Groningen (NLD) and President, European Scientific Association on Residential and Family Care for Children and Adolescents (EUSARF); Annemiek T. Harder, Assistant professor, Department of Special Needs Education and Youth Care, University of Groningen (NLD); Martha J. Holden, Senior Extension Associate with the Bronfenbrenner Center for Translational Research and the Principal Investigator and Director of the Residential Child Care Project at Cornell University, Ithaca, NY (USA); Sigrid James, Professor, Department of Social Work & Social Ecology, School of Behavioral Health, Loma Linda University, CA (USA); Andrew Kendrick, Professor of Residential Child Care, School of Social Work and Social Policy at the University of Strathclyde (GBR) and Consultant at the Centre of Excellence for Looked After Children in Scotland (CELCIS) and the Centre for Youth and Criminal Justice (CYCJ) (UK); Erik J. Knorth, Professor, Department of Special Needs Education and Youth Care, University of Groningen (NLD); Mette Lausten, Senior Researcher at SFI - The Danish National Centre for Social Research, Copenhagen (DNK), John S. Lyons, Senior Policy Fellow at Chapin Hall, University of Chicago, IL (USA); Eduardo Martin, Lecturer at the Department of Developmental and Educational Psychology, University of La Laguna, Tenerife (ESP); Samantha McDermid, Research Fellow, Centre for Child and Family Research, Loughborough University (GBR); Patricia McNamara, Senior Fellow (Honorary), Department of Social Work, University of Melbourne (AUS); Laura Palareti, Assistant Professor in Social Psychology, Department of Education Studies, University of Bologna (ITA); Susan Ramsey, Parent and Former Children’s Mental Health Advocate, The Walker School, Needham, MA (USA); Kari M. Sisson, Executive Director, Association of Children’s Residential Centers (USA); Richard W. Small, Walker Executive Director Emeritus, The Walker School, Needham, MA (USA); June Thoburn, Emeritus Professor of Social Work, University of East Anglia (GBR); Ronald Thompson, Senior Director, Boys Town National Research Institute for Child and Family Studies, Boys Town, NE (USA); Anat Zeira, Professor, School of Social Work and Social Welfare, Hebrew University of Jerusalem, and Head of Research and Evaluation at the Haruv Institute (ISR). Our work group wishes to thank CFRC staffer Laura Dale at Loughborough for extraordinary efforts in producing this statement in record time and for her care and assistance with all phases of our Summit activity. Whittaker, James K; Holmes, Lisa; del Valle, Jorge F.; Ainsworth, Frank; Andreassen, Tore; Anglin, James; Bellonci, Christopher; Berridge, David; Bravo, Amaia; Canali, Cinzia; Courtney, Mark; Currey, Laurah; Daly, Daniel; Gilligan, Robbie; Grietens, Hans; Harder, Annemiek; Holden, Martha; James, Sigrid; Kendrick, Andrew; Knorth, Erik; Lausten, Mette; Lyons, John; Martin, Eduardo; Mcdermid, Samantha; Mcnamara, Patricia; Palareti, Laura; Ramsey, Susan; Sisson, Kari; Small, Richard; Thoburn, June; Thompson, Ronald; Zeira, Anat Whittaker, James K; Holmes, Lisa; del Valle, Jorge F.; Ainsworth, Frank; Andreassen, Tore; Anglin, James; Bellonci, Christopher; Berridge, David; Bravo, Amaia; Canali, Cinzia; Courtney, Mark; Currey, Laurah; Daly, Daniel; Gilligan, Robbie; Grietens, Hans; Harder, Annemiek; Holden, Martha; James, Sigrid; Kendrick, Andrew; Knorth, Erik; Lausten, Mette; Lyons, John; Martin, Eduardo; Mcdermid, Samantha; Mcnamara, Patricia; Palareti, Laura; Ramsey, Susan; Sisson, Kari; Small, Richard; Thoburn, June; Thompson, Ronald; Zeira, Anat

This qualitative study explored how Afghan refugees conceptualize frames of mind that may reflect depression in general and as it relates to trauma they experienced. We performed in-depth interviews with 18 Afghans residing in the San Diego area. Views regarding the causes, symptoms, and perceived treatments of depression were gathered through free-listing techniques, and supplemented with narratives relating to pre- and post-resettlement stressors and coping mechanisms. Data were analyzed with standard qualitative content analysis methods. Items endorsed with relation to depression causality included pre-migration war traumas, notably separation from family, and post-migration stressors including status dissonance and cultural conflicts that ranged from linguistic challenges to intergenerational problems. Depressive symptoms were viewed as highly debilitating, and included changes in temperament, altered cognitions, avoidance and dissociative behaviors, and somatic complaints. Relief was sought through family reunification and community support, reliance on prayer, and the academic success of their children in the US. The findings underscore the need for practitioners to take into account situational stressors, cultural aspects of mourning and symptomatology, and existing coping mechanisms in developing interventions that are based on refugees’ articulated needs.

This study examined the 12-month post-departure outcomes for youth who exited a residential treatment program at differing levels of restrictiveness. Study participants were 120 youth who entered an integrated residential continuum of care at its most restrictive level and then either departed the program at the same level or stepped down and departed at a lower level of restrictiveness. Results indicate that youth who stepped down and exited at the lowest level of restrictiveness were the most likely to be living at home or in a homelike setting and experienced fewer formal post-departure out-of-home placements. However, there were no differences in post-departure rates of substance use, arrests, or being in school or having graduated. These results suggest that youth who were served in the integrated continuum and departed at the lowest level of restrictiveness had more positive outcomes at 12-month post-discharge.

This study aimed to answer two questions: (a) Given expected differences in children who are placed in group care compared to those in family-based settings, is it possible to match children on baseline characteristics? (b) Are there differences in behavioral outcomes for youth with episodes in group care versus those in family-based care? Using data from the National Survey of Child and Adolescent Well-Being, the study sample included 1,191 children with episodes in out-of-home care ( n = 254 youth with group care episodes; n = 937 youth with episodes in family-based care and no group care). Conditioning variables were identified, which distinguished between the two groups of youth. Using propensity score matching, all youth placed into group care were matched on the propensity score with family-based care youth. Behavioral outcomes at 36 months, as measured by the Child Behavior Checklist, were compared for the matched sample. Of the total 254 youth with group care episodes, 157 could be matched to youth with episodes in family-based care. No significant differences remained between the two groups in the matched sample, and findings revealed no significant differences in longitudinal behavioral outcomes.

This study examined risk and determinants of rehospitalization of children and adolescents (n = 186) following a first psychiatric hospitalization. It specifically examined the role of post-discharge services. Data were collected for a 30-month follow-up period through structured telephone interviews with caregivers and case record abstractions. 43% of youth experienced readmissions during the follow-up period. Risk of rehospitalization was highest during the first 30 days following discharge and remained elevated for 3 months. 72% of youth received 284 post-discharge services during the follow-up period, which significantly reduced the risk of rehospitalization. Longer first hospitalizations and a higher risk score at admission increased risk.

Objective There is ongoing debate regarding the impact of youth behavior problems on placement change in child welfare compared to the impact of placement change on behavior problems. Existing studies provide support for both perspectives. The purpose of this study was to prospectively examine the relations of behavior problems and placement change in a nationally representative sample of youths in the National Survey of Child and Adolescent Well-Being. Method The sample consisted of 500 youths in the child welfare system with out-of-home placements over the course of the National Survey of Child and Adolescent Well-Being study. We used a prospective cross-lag design and path analysis to examine reciprocal effects of behavior problems and placement change, testing an overall model and models examining effects of age and gender. Results In the overall model, out of a total of eight path coefficients, behavior problems significantly predicted placement changes for three paths and placement change predicted behavior problems for one path. Internalizing and externalizing behavior problems at baseline predicted placement change between baseline and 18 months. Behavior problems at an older age and externalizing behavior at 18 months appear to confer an increased risk of placement change. Of note, among female subjects, placement changes later in the study predicted subsequent internalizing and externalizing behavior problems. Conclusions In keeping with recommendations from a number of professional bodies, we suggest that initial and ongoing screening for internalizing and externalizing behavior problems be instituted as part of standard practice for youths entering or transitioning in the child welfare system.

This study used data on 2,453 children aged 4–17 from the National Survey of Child and Adolescent Well-Being and 5 analytic methods that adjust for selection factors to estimate the impact of out-of-home placement on children’s cognitive skills and behavior problems. Methods included ordinary least squares (OLS) regressions and residualized change, simple change, difference-in-difference, and fixed effects models. Models were estimated using the full sample and a matched sample generated by propensity scoring. Although results from the unmatched OLS and residualized change models suggested that out-of-home placement is associated with increased child behavior problems, estimates from models that more rigorously adjust for selection bias indicated that placement has little effect on children’s cognitive skills or behavior problems.

Children in the child welfare system have entitlements to health insurance coverage—critical because of their considerable physical and mental health needs—based largely on their placement status. This study conducted path and transitions analyses on data from the National Survey of Child and Adolescent Well-Being (3,801 children followed-up for 3 years) to examine the interplay between placement changes and insurance stability. Children maintained in-home at Wave 1 had significantly lower odds of being insured (OR = 0.7); children transitioning from out-of-home placement to in-home care had significantly lower odds of maintaining insurance coverage (OR = 0.6). Child welfare workers working with children maintained in-home and those being reunified should safeguard the children's insurance status. Policy makers should consider extension of categorical eligibility to all children presenting to child welfare agencies in order to assure access to needed services for these vulnerable children.

There have been conflicting reports regarding the applicability of Trauma Injury Severity Score (TRISS) methodology to evaluate trauma care in a developing country setting. The objective of this study was to apply TRISS methodology to evaluate trauma care in the public hospitals of a Caribbean developing country. A prospective, observational study was conducted in the three major general hospitals in Trinidad. Major trauma patients were included. Demographic data, waiting time in the Emergency Department, and nature of injury (blunt or penetrating) were noted. Revised Trauma Score, Injury Severity Score, and Glasgow Coma Scale were applied to all patients on admission. Hospital outcomes were noted. Predicted outcomes were calculated for adult patients using TRISS methodology. M, Z statistics and receiver operating characteristic (ROC) curve analysis were done. There were 326 trauma patients studied, of whom 279 adults were evaluated by the TRISS methodology. Men were more frequently involved in trauma than women; there was more blunt trauma than penetrating trauma. The M statistic was 0.98 and the overall Z statistic was 5.81. The ROC curve analysis showed TRISS to be a fair discriminator in the study case-mix with an area under the curve of 0.82 (95% confidence interval 0.69-0.96). There is a considerable disparity between predicted and observed outcomes when trauma patients are evaluated by the TRISS methodology in a developing country setting.

This study examines the relative risk of first entry into restrictive care settings (RCSs) such as group homes, residential treatment, or inpatient psychiatric care for a cohort of children (N = 570) in out-of-home care, and determines reasons and determinants related to the risk of entering such settings. Findings indicate the cumulative hazard of entering restrictive settings is highest during the first 2 to 3 months following entry into care. Behavior-related placement disruptions, behavior problems, and older age are the primary determinants of this finding. Although the majority of children entered an RCS for behavior-related reasons, close to one third entered an RCS because of reasons unrelated to behavior. Implications for service delivery to children in out-of-home care are discussed.

Children identified as having emotional and behavioral disorders (EBD) may have different out-of-home care placements than their peers without EBD.This study compared the factors influencing placement movements for 362 children with EBD and 363 children without EBD, using clinical Child Behavior Checklist (CBCL) scores at baseline data collection of the National Survey of Child and Adolescent Well-Being. The analyses explored potential case characteristics influencing the number of placements for children with a clinical CBCL score at baseline data collection. Poisson regression models were used to explain the number of placements experienced during the first 36 months of placement. Overall, children with a clinical-level CBCL score were 2.5 times as likely to experience four or more placements as their nonclinical peers. Findings indicated that the presence of depression and not residing with siblings predicted movement among children with EBD. Among children without EBD, only older age was strongly associated with placement moves. Although the direction of effects is equivocal, these results call for greater attention to children's experience of out-of-home placement and the lack of homogeneity among children who are placed outside their homes.

The current review examines conceptual and methodological issues related to the use of dialectical behavior therapy for adolescents (DBT-A) in treating youth who engage in deliberate self-harm. A comprehensive review of the literature identified six studies appropriate for the review. Results indicated several inconsistencies and limitations across studies including the mixing of various forms of self-harm; variations in diagnostic inclusion/exclusion criteria, insufficient use of standardized self-harm outcome measures, variable lengths and intensity of provided treatment, and inadequate attention paid to DBT adherence. Each of these areas is reviewed along with a discussion of ways to improve the quality of future research.

Relatively little empirical attention has been paid to understanding how refugees conceptualize depression and how this concept varies between genders. The purpose of this study was to explore beliefs about depression among Afghans residing in San Diego County, California, using cultural consensus analysis. Using the prescribed mixed-method approach, we employed results from in-depth interviews to develop a culturally meaningful questionnaire about depression. Consensus analysis of responses to questionnaire items from 93 Afghans (50 men, 43 women) indicates shared beliefs that associates depression causality with mild traumatic experiences and post-resettlement stressors, symptomatology to include culturally salient idioms of distress, and treatment selections ranging from lay techniques to professional care. Divergence between genders occurred most in the symptoms subdomain, with women associating depression with more somatic items. This study contributes to understanding the etiology of and cultural responses to depression among this population, which is critical to improving culturally sensitive intervention for Afghan refugees.

Using longitudinal data from the National Survey on Child and Adolescent Well-Being (NSCAW), this study investigates entry into intensive or restrictive settings during a 36-month study period. Specifically, this analysis examines entry into treatment foster care, group homes, residential treatment, and inpatient psychiatric care for youth placed into out-of-home care ( n = 981). It aims to determine at what point in their first out-of-home episodes and for what reasons youth entered such settings. As NSCAW used a national probability sampling design,this analysis provides national estimates about entry into intensive or restrictive settings for youth in out-of-home care. Twenty-five percent of youth ( n = 280) experienced an intensive or restrictive setting during their first out-of-home care episode; 70% were in either group homes (33.2%) or residential treatment settings (37.0%).About half of the youth with such placements (48.9%) were placed into intensive or restrictive settings as a first placement during their first out-of-home episode.

Child welfare service agencies provide parent training as part of their legally mandated responsibility to provide services to assist families to keep their children at home or to achieve reunification. The use of parent-training programs for families in the child welfare system has undergone relatively little examination. Mental health, special education, and juvenile justice have been identifying evidence-based approaches that have demonstrated effectiveness with children and families with conduct disorders and other behavioral problems, although few of these interventions have been tested with child welfare services clientele. This article brings together evidence about the most promising programs from other child service sectors with information about the current parent training approaches in child welfare and generates a range of proposals about next steps to enhance the capacity of parent training and fulfill the high expectations set in law and practice.

This study examines the reasons for placement changes in foster care and analyzes determinates of the rate of behavior‐related placement change. Findings indicate that 20 percent of all changes are behavior related. Older age, externalizing behaviors, and emotional abuse increase the hazard of behavior‐related changes. The risk is lower when the child spends more days in kinship care. Having numerous system‐ or policy‐related moves does not increase risk of behavior‐related changes. Risk is highest during the 100 days after entry into care, suggesting that factors contributing to behavior‐related placement change might be present when a child enters care.

The present study examines retrospectively the placement patterns of a cohort of 430 children between the ages of 1–16 who entered out-of-home care in San Diego County between May 1990 and October 1991, and were still in placement after 18 months. It investigates movement through out-of-home care across different placement settings for children who spent an equal amount of time in out-of-home care. Using an inductive methodology, patterns of movement are classified along two main dimensions: The timing and duration of the longest placement and movement along degree of restrictiveness. This paper describes the development of the pattern criteria. It further presents findings of subsequent polychotomous logistic regression analysis, which identifies significant non-clinical and clinical predictors of these patterns.

This study examines 625 Caucasian adoptive parents’ preferences for certain characteristics in adoptive children in order to assist child‐welfare professionals in achieving greater levels of permanency for available foster children. Findings indicate that when willing to adopt a foster child parents generally prefer Caucasian, young, and non–special needs children. However, parents also appear to be willing to adopt foster children who are of color, older, or who have special needs. An underutilized pool of prospective adopters therefore may exist for foster children with a range of characteristics.

Treatment foster care (TFC) is a promising alternative intervention for children and adolescents at risk for placement in residential care settings. An examination of the processes and outcomes of TFC is complicated and leads to the conclusions that: (a) TFC is delivered with such variability that conclusions about its effectiveness are difficult to draw; (b) many variables in the child's ecology that potentially confound the effects of the intervention remain unexamined; and (c) service impacts have been defined narrowly. This article synthesizes the state of knowledge in these three domains and discusses how an ecosystemic framework can advance and refine knowledge building in this field of practice.