Trauma Focus Model for Reducing Long-Term Foster Care

Study Overview
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Brief Summary
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The Trauma Focus Model for Reducing Long-Term Foster Care Project with the Illinois Department of Children and Family Services (DCFS) is implementing a trauma-focused intervention, Trauma Affect Regulation: Guide for Education and Therapy (TARGET) to increase permanency rates for a target population of children identified as being most at risk of long-term foster care.

Detailed Description
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The Illinois Department of Children and Family Services (DCFS) is one of six recipients of the Permanency Innovations Initiative Grant. These funds support the statewide implementation of Trauma Affect Regulation: Guide for Education and Therapy (TARGET) in Illinois. TARGET is a manualized, psycho-educational intervention designed to address complex trauma and difficulties with emotional regulation and relational engagement that occur across a wide range of trauma-related difficulties, including trauma-related and behavioral symptoms. The aim of this intervention is to address the key barriers to permanence for the target population. This population includes youth ages 11-16 who are placed in traditional, relative, and specialized foster homes throughout the state of Illinois, have been in foster care for at least 2 years, and are experiencing mental health challenges and/or at least one placement change. The three key barriers to permanency are: (1) children's need to improve emotional regulation and reduce symptom severity, particularly disruptive behaviors; (2) biological parents' skills in regulating their emotions so they are better able to complete services and address the underlying issues related to their involvement in the child welfare system; (3) foster parents and other placement resources skills in understanding and addressing the needs and disruptive behaviors of the children in their care with trauma histories. The local evaluation will examine the effectiveness of the TARGET program in increasing permanency rates for foster youth in the target population. The main hypothesis to be tested is that addressing unstable child affect & behavior secondary to trauma using an intervention that improves both youth modulation skills as well as foster parent capacity to respond appropriately to youth will stabilize placements and improve youth ability to engage with potential permanency resources, thus facilitating progress toward permanence. The evaluation involves randomly assigning eligible foster youth to receive TARGET services or receive services as usual. The evaluators collect proximal and distal outcomes from multiple administrative data sources. Additionally, the evaluation includes the collection of key proximal outcomes through the use of interviews with foster youth, their foster parents and biological parents deemed eligible for participation in the project.

Official Title
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Permanency Innovations Initiative- Trauma Focus Model for Reducing Long-Term Foster Care Project

Conditions
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Foster Care

Intervention / Treatment
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* Other: Trauma Affect Regulation: Guide for Education and Therapy (TARGET)


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: Youth ages 11-16 who are placed in traditional, relative, and specialized foster homes throughout the state of Illinois who, upon reaching the two-year anniversary of entering care, are experiencing mental health symptoms and/or have had at least one placement change. If a youth does not exhibit any mental health symptoms as indicated by the Child and Adolescent Needs and Strength (CANS) tool, they need to have at least 3 placement changes to be eligible for the study. Exclusion Criteria: Youth are ineligible to participate if at the time of eligibility assessment, they are in need of immediate and acute substance abuse treatment, have a Full Scale IQ score below 70, and/or have made recent suicidal threats or plans.

Ages Eligible for Study
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Minimum Age: 11 Years
Maximum Age: 16 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Other
Allocation: Randomized
Intervention Model: Parallel Assignment


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: Treatment<br> | Other: Trauma Affect Regulation: Guide for Education and Therapy (TARGET)<br>* The intervention is called the Trauma Affect Regulation: Guide for Education and Therapy (TARGET). TARGET is a manualized, psycho-educational intervention delivered in 10 - 12 sessions. TARGET is designed to address complex trauma and difficulties with emotional regulation and relational engagement that occur across a wide range of trauma-related difficulties, including trauma-related and behavioral symptoms. The full TARGET model consists of learning 7 essential core skills. These skills are called the FREEDOM steps: Focus, Recognize triggers, Emotion self-check, Evaluate thoughts, Define goals, Options, and Make a contribution.<br>* Other names: TARGET;|
| No Intervention: Comparison<br> | |

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Time to stable permanence | Measured by administrative data from the Adoption and Foster Care Analysis and Reporting System (AFCARS) | Measured from the date of random assignment to the discharge date or to the end of the study period for cases that did not discharge | 
| Placement stability | Measured by administrative data from the Adoption and Foster Care Analysis and Reporting System (AFCARS) | Measured at initial study enrollment and at the 8, 14, 20, and 26-month mark of enrollment in the study | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Foster parent skills in responding to youth's emotional and behavioral dysregulation | Measured by Parenting Practices Chicago Survey (PPCS) (Gorman-Smith et al., 1996) | completed by study youth at initial study enrollment and at 6 months after baseline data collection | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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child abuse and neglect, trauma, Long term foster care