Clinical trial NCT02193126: Trauma Focus Model for Reducing Long-Term Foster Care
Official title: Permanency Innovations Initiative- Trauma Focus Model for Reducing Long-Term Foster Care Project
Study type: INTERVENTIONAL
Overall status: COMPLETED
Phase: NA
Conditions: Foster Care
Keywords: Long term foster care
child abuse and neglect
trauma
Lead sponsor: Westat
Sponsor class: OTHER
Collaborators: name: Children's Bureau - Administration for Children and Families
name: Illinois Department of Children and Family Services.
First posted: 2014-07-17
Enrollment: 462
Sex: ALL
Minimum age (years): 11
Maximum age (years): 16
Standard ages: CHILD
Accepts healthy volunteers: no
Allocation: RANDOMIZED
Intervention model: PARALLEL
Primary purpose: OTHER

Brief summary: 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: 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.

Eligibility criteria: 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.

Primary outcomes:
measure: Time to stable permanence
timeFrame: 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
measure: Placement stability
timeFrame: Measured at initial study enrollment and at the 8, 14, 20, and 26-month mark of enrollment in the study
Secondary outcomes:
measure: Foster parent skills in responding to youth's emotional and behavioral dysregulation
timeFrame: completed by study youth at initial study enrollment and at 6 months after baseline data collection
Other outcomes:
measure: Biological parent ability to regulate their own emotions and behaviors and experience of trauma-related symptoms
timeFrame: completed by biological parents of study youth at initial study enrollment and at 6 months after baseline data collection
measure: Biological parent service completion
timeFrame: Measured at initial study enrollment and at the 8, 14, 20, and 26-month mark of enrollment in the study
measure: Biological parent contact with youth
timeFrame: completed by study youth at initial study enrollment and at 6 months after baseline data collection
measure: Change in Youth trauma-related and mental health symptoms
timeFrame: 1) Measured at initial study enrollment and at the 8, 14, 20, and 26-month mark of enrollment in the study and 2) completed by study youth at initial study enrollment and at 6 months after baseline data collection
measure: Youth capacity to form and maintain relationships.
timeFrame: Measured 1) at initial study enrollment and at the 8, 14, 20, and 26-month mark of enrollment in the study and 2) completed by study youth at initial study enrollment and at 6 months after baseline data collection
measure: Youth capacity to regulate their emotions and behavior
timeFrame: Measured 1) at initial study enrollment and at the 8, 14, 20, and 26-month mark of enrollment in the study and 2) completed by both study youth and their current caregiver at initial study enrollment and at 6 months after baseline data collection
measure: Change in support for biological and foster parents
timeFrame: Measured at initial study enrollment and at 6 months after baseline data collection
measure: Change in Youth traumatic events
timeFrame: Measured at initial study enrollment and at the 8, 14, 20, and 26-month mark of enrollment in the study
measure: Youth emotional permanency
timeFrame: Measured at initial study enrollment and at 6 months after baseline data collection
measure: Frequencies of change in direction of youth permanency
timeFrame: collected at 6, 12, 18, and 24 months
measure: Permanency rates
timeFrame: collected at 6, 12, 18, and 24 months
measure: Timely permanence
timeFrame: collected at 6, 12, 18, and 24 months
measure: Placement stability after legal permanency
timeFrame: collected at 6, 12, 18, and 24 months
measure: Repeat maltreatment following legal permanence
timeFrame: collected at 6, 12, 18, and 24 months
Locations:
Study officials:
affiliation: Westat
name: Andrea Sedlak, PhD.
role: STUDY_DIRECTOR
affiliation: University of North Carolina
name: Mark Testa, PhD.
role: PRINCIPAL_INVESTIGATOR
References: