A Reorientation to Knowledge Development in Family Preservation Services: A Proposal.

In response to deteriorating conditions for many American children [Children's Defense Fund 1992], to increases in the number of children in out-of-home placement [U. S. House of Representatives Select Committee on Children, Youth, and Families 1990], and to influential critiques of the residual nature of the child welfare system(1) [Kamerman and Kahn 1990; National Commission on Children 1991], federal legislation was passed in August 1993 to strengthen troubled families. Hailed as the most significant reform of federally funded child welfare services since the Adoption Assistance and Child Welfare Act of 1980 [P.L. 9-272], the Omnibus Budget Reconciliation Act of 1993 [P.L. 103-66] will provide one billion dollars to the states, over a five-year period, for early intervention, prevention, and family support services [Binder 1993]. The legislation calls specifically for family preservation services. (2) The bill includes in this designation a range of services, including services to prevent the out-of-home placement of children. Indeed, some advocates lobbied for the family preservation components of the legislation on the basis that such services would reduce the number of children in out-of-home care [Cushman 1993]. In light of the prominence of family preservation and, in particular, of placement prevention programs within the new child welfare legislation, and in light of the likely increase in such programs over the next five years, it is critical at this juncture of service system reform that we consider what is known regarding the replicability, effectiveness, and role of family preservation services, to identify gaps in knowledge, and to consider needed research.This paper focuses on intensive family preservation services (one type of family preservation service), and on the Homebuilders model of intensive family preservation practice, in particular. (3) I chose this approach because the Homebuilders model was designed specifically to prevent the out-of-home placement of children [Kinney et al. 1977]; it has been implemented widely with programs in about half the states [Ooms and Beck 1990]; it has been the subject of considerable research and evaluation efforts over the last 15 years [Rossi 1992; Wells and Biegel 1992]; and because many of the complex issues raised by the evaluation of the Homebuilders model mirror those raised by other family preservation and child welfare services.Defining Intensive Family Preservation ServicesBefore considering the research in this area, it is useful to consider the parameters of intensive family preservation services and of the Homebuilders model. There is considerable agreement as to the definition of intensive family preservation services. For example, the Child Welfare League of America's Standards for Services to Strengthen and Preserve Families [Child Welfare League of America 1989], the new child welfare legislation [P.L. 103-66], and initial efforts to formulate regulations for this legislation [Allen et al. 1993] all define intensive family preservation services as short-term (e.g., services are provided from between four and 12 weeks), intensive (e.g., families are seen, on average, eight to ten hours per week), flexible (e.g., services are available 24 hours per day), and home-based. (4)The Homebuilders model is one of several approaches to intensive family preservation practice (see AuClaire and Schwartz [1986] for a description of a program relying on structural family therapy, and Henggeler et al. [1993] for a description of a program relying on multisystemic therapy). Homebuilders-type programs seek to prevent the unnecessary out-of-home placement of children who could remain at home safely with the provision of services. Services are designed for families with children at risk of imminent placement in out-of-home care. The intent is to resolve the crisis that led to a child's referral for out-of-home placement and to improve family functioning, or at least to return the family to the level of functioning that existed before the referral was made. …