Healthy Futures for Children in Foster Care: Translating Evidence into Practice

寄养儿童的健康未来：将证据转化为实践

• 批准号: 7925598
• 负责人: Moira Szilagyi
• 金额: $ 44.95万
• 依托单位: MONROE COUNTY PUBLIC HEALTH DEPARTMENT
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-09-01 至 2012-08-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7925598
• 关键词: Healthy; Futures; Children; Foster; Care

DESCRIPTION (provided by applicant): Children and adolescents in foster care are a high-risk special needs population with an extremely high rate of developmental, behavioral, and mental health problems attributable to multiple childhood traumas. Although isolated evidence-based interventions have been found to improve comprehensive assessment and treatment of mental health problems, to improve parenting skills of foster and birth parents, and to enhance the critical visitation process, no community has translated these individual interventions into a comprehensive, coordinated, and sustainable program. The goal of Healthy Futures is to implement such a model program. Specific Aims: The specific aims are to 1) Develop and implement a training program for health professionals who care for the foster care population on using validated assessments, and on coaching parenting skills and visitation; 2) Implement validated assessments of family needs/strengths and child development/mental health problems; 3) Implement a promising coached visitation model for birth parents and their children, including a mental health intervention for extremely high risk families; 4) Implement evidence-based mental health treatments for Children in Foster Care, including Trauma-Focused Cognitive Behavioral Therapy (all ages) and Inter-Personal Psychotherapy (adolescents); 5) Implement evidence-based parenting programs for foster and birth parents; and, 6) Disseminate and diffuse findings via child welfare, public health, and professional organizations (including on a national website with toolkits for professionals). Methods: We will convene an oversight group to plan each stage of the integration, while a local agency will assess and measure each stage of this three-year process. We will train Visitation Specialists, child welfare caseworkers and administrators, and mental health and pediatric professionals on the use of a secure web- based system that will be used for inter-disciplinary communication. Children entering foster care and their parents will receive assessments that will be scored, analyzed and shared through this secure web-based system (COMET). Based on these assessments, professionals will triage families into an appropriate level of visitation (coached or supervised), mental health intervention (child parent psychotherapy) and/or parent skills training. We will also train professionals on coaching parents using the principles of a specific evidence-based parenting skills program (Incredible Years). Professionals will periodically re-assess how children and families are faring and use re-assessments to re-assign families to interventions. We will also increase the access to mental health care for children in foster care by offering on-site evidence-based mental health services. Organization: We have more than 20 years of experience locally and nationally in foster care, a rich history of collaboration, and a receptive community. PUBLIC HEALTH RELEVANCE: Children in foster care are known to have extremely poor long-term mental health outcomes, rooted in multiple adverse childhood experiences that include maltreatment, impaired parenting, exposure to domestic violence, and ongoing separation and loss. Sixty percent of children return to their parent, so that addressing parent and child emotional and behavioral health problems, building on a family's assets, and healing the parent- child relationship are crucial to preventing future maltreatment and improving long-term mental health outcomes. Through Healthy Futures, we will improve the training of professionals and integrate evidence-based parenting skills training, coached visitation and mental health interventions into the care of children in foster care and their families.

描述（由申请人提供）：寄养儿童和青少年是一个高风险的特殊需要人口与发展，行为和心理健康问题的极高的利率归因于多种童年创伤。虽然孤立的证据为基础的干预措施已被发现，以改善综合评估和治疗的心理健康问题，提高养育技能的养父母和亲生父母，并加强关键的探视过程中，没有社区已经转化为一个全面的，协调的，和可持续的计划，这些个人的干预措施。健康未来的目标是实施这样一个示范方案。具体目标：具体目标是：（1）为照料寄养人口的保健专业人员制定和实施一项培训方案，内容涉及使用经验证的评估，以及指导父母养育子女的技能和探视;（2）对家庭需求/力量和儿童发展/心理健康问题进行经验证的评估; 3）为亲生父母及其子女实施一种有前途的指导探视模式，包括对极高风险家庭的心理健康干预; 4）为寄养儿童实施循证心理健康治疗，包括以创伤为重点的认知行为疗法（所有年龄）和人际心理治疗（5）为养父母和亲生父母实施循证育儿方案; 6）通过儿童福利、公共卫生和专业组织（包括在一个为专业人员提供工具包的国家网站上）传播和传播调查结果。研究方法：我们将召集一个监督小组来规划整合的每个阶段，而一个地方机构将评估和衡量这一三年进程的每个阶段。我们将培训访问专家，儿童福利个案工作者和管理人员，心理健康和儿科专业人员使用安全的基于网络的系统，将用于跨学科的沟通。进入寄养家庭的儿童及其父母将接受评估，这些评估将通过这一安全的基于网络的系统（COMET）进行评分、分析和分享。根据这些评估，专业人员将把家庭分类到适当水平的探视（指导或监督），心理健康干预（儿童父母心理治疗）和/或父母技能培训。我们还将培训专业人员，使用特定的循证育儿技能计划（Incredible Years）的原则来指导父母。专业人员将定期重新评估儿童和家庭的状况，并利用重新评估重新分配家庭进行干预。我们还将通过提供现场循证精神卫生服务，增加寄养儿童获得精神卫生保健的机会。组织机构：我们有超过20年的本地和全国寄养经验，丰富的合作历史，以及一个乐于接受的社区。 公共卫生关系：众所周知，寄养儿童的长期心理健康状况极差，其根源在于多种不良的童年经历，包括虐待、父母教养受损、遭受家庭暴力以及持续的分离和损失。60%的儿童回到父母身边，因此，解决父母和儿童的情绪和行为健康问题，建立家庭资产，并治愈亲子关系，对于防止未来的虐待和改善长期心理健康结果至关重要。通过健康未来，我们将改善专业人员的培训，并将循证育儿技能培训、指导探视和心理健康干预纳入寄养儿童及其家庭的护理中。