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: 8138316
• 负责人: Moira Szilagyi
• 金额: $ 43.87万
• 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 2013-05-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8138316
• 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）：寄养的儿童和青少年是一个高风险的特殊需要人群，由于童年时期的多重创伤，他们的发育、行为和心理健康问题的发生率极高。虽然已经发现孤立的循证干预措施可以改善对心理健康问题的综合评估和治疗，提高养父母和亲生父母的养育技能，并加强关键的探视过程，但没有一个社区将这些单独的干预措施转化为全面、协调和可持续的方案。“健康未来”的目标就是实施这样一个示范项目。具体目标：具体目标是：1)为照顾寄养人口的卫生专业人员制定和实施一项培训计划，以使用有效的评估，并指导育儿技能和探视；2)实施对家庭需求/优势和儿童发展/心理健康问题的有效评估；3)对亲生父母及其子女实施有前景的辅导探视模式，包括对极高风险家庭的心理健康干预；4)对寄养儿童实施基于证据的心理健康治疗，包括以创伤为重点的认知行为治疗（所有年龄段）和人际心理治疗（青少年）；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（包括为专业人员提供工具包的国家网站）传播和传播调查结果。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个三年过程的每个阶段。我们将培训探视专家、儿童福利个案工作者和行政人员，以及心理健康和儿科专业人员如何使用安全的网络系统进行跨学科交流。进入寄养的儿童及其父母将接受评估，这些评估将通过这个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，专业人员将对家庭进行分类，按适当程度进行探视（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项目（不可思议的岁月）的原则指导父母。专业人员将定期重新评估儿童和家庭的情况，并利用重新评估将家庭重新分配到干预措施中。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：我们有超过20年的本地和全国寄养经验，丰富的合作历史，和一个接受社区。