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Impact of a mentoring and skills group program on mental health outcomes for maltreated children in foster care.

ABSTRACT: To evaluate the efficacy of the Fostering Healthy Futures program in reducing mental health problems and associated problems.Randomized controlled trial.Denver metropolitan area.Children aged 9 to 11 years who were maltreated and placed in foster care.Children in the control group (n=77) received an assessment of their cognitive, educational, and mental health functioning. Children in the intervention group (n=79) received the assessment and participated in a 9-month mentoring and skills group program.Children and caregivers were interviewed at baseline prior to randomization, immediately following the intervention, and 6 months after the intervention. Teachers were interviewed 2 times after baseline. Measures included a multi-informant index of mental health problems, youth-reported symptoms of posttraumatic stress, dissociation, and quality of life, and caregiver- and youth-reported use of mental health services and psychotropic medications.After adjusting for covariates, intent-to-treat analyses demonstrated that the treatment group had fewer mental health problems on a multi-informant factor 6 months after the intervention (mean difference, -0.51; 95% confidence interval, -0.84 to -0.19), reported fewer symptoms of dissociation 6 months after the intervention (mean difference, -3.66; 95% confidence interval, -6.58 to -0.74), and reported better quality of life immediately following the intervention (mean difference, 0.11; 95% confidence interval, 0.03 to 0.19). Fewer youths in the intervention group than in the control group had received recent mental health therapy 6 months after the intervention according to youth report (53% vs 71%, respectively; relative risk=0.75; 95% confidence interval, 0.57 to 0.98).A 9-month mentoring and skills group intervention for children in foster care can be implemented with fidelity and high uptake rates, resulting in improved mental health outcomes. Trial Registration clinicaltrials.gov Identifier: NCT00809315.

SUBMITTER: Taussig HN

PROVIDER: S-EPMC3009469 | biostudies-literature | 2010 Aug

REPOSITORIES: biostudies-literature

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Impact of a mentoring and skills group program on mental health outcomes for maltreated children in foster care.

Taussig Heather N HN Culhane Sara E SE

Archives of pediatrics & adolescent medicine 20100801 8

<h4>Objective</h4>To evaluate the efficacy of the Fostering Healthy Futures program in reducing mental health problems and associated problems.<h4>Design</h4>Randomized controlled trial.<h4>Setting</h4>Denver metropolitan area.<h4>Participants</h4>Children aged 9 to 11 years who were maltreated and placed in foster care.<h4>Intervention</h4>Children in the control group (n=77) received an assessment of their cognitive, educational, and mental health functioning. Children in the intervention grou ...[more]

PMID: 20679165

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Project description:Children in foster care have high rates of adverse childhood experiences and are at risk for mental health problems. These problems can be difficult to ameliorate, creating a need for rigorous intervention research. Previous research suggests that intervening with children in foster care can be challenging for several reasons, including the severity and complexity of their mental health problems, and challenges engaging this often transitory population in mental health services. The goal of this article was to systematically review the intervention research that has been conducted with children in foster care, and to identify future research directions. This review was conducted on mental health interventions for children, ages 0 to 12, in foster care, using ERIC, CINAHL, PsycINFO, PubMed, ProQuest's Dissertation and Theses Database, Social Services Abstracts, and Social Work Abstracts. It was restricted to interventions that are at least "possibly efficacious" (i.e., supported by evidence from at least one randomized controlled trial). Studies were evaluated for risk of bias. Ten interventions were identified, with diverse outcomes, including mental health and physiological. Six interventions were developed for children in foster care. Interventions not developed for children in foster care were typically adapted to the foster context. Most interventions have yet to be rigorously evaluated in community-based settings with children in foster care. Little research has been conducted on child and family engagement within these interventions, and there is a need for more research on moderators of intervention outcomes and subgroups that benefit most from these interventions. In addition, there is not consensus regarding how to adapt interventions to this population. Future research should focus on developing and testing more interventions with this population, rigorously evaluating their effectiveness in community-based settings, determining necessary adaptations, and identifying which interventions work best for whom.

Project description:INTRODUCTION:Children who have experienced abuse and neglect are at increased risk of mental and physical health problems throughout life. This places an enormous burden on individuals, families and society in terms of health services, education, social care and judiciary sectors. Evidence suggests that early intervention can mitigate the negative consequences of child maltreatment, exerting long-term positive effects on the health of maltreated children entering foster care. However, evidence on cost-effectiveness of such complex interventions is limited. This protocol describes the first economic evaluation of its kind in the UK. METHODS AND ANALYSIS:An economic evaluation alongside the Best Services Trial (BeST?) has been prospectively designed to identify, measure and value key resource and outcome impacts arising from the New Orleans intervention model (NIM) (an infant mental health service) compared with case management (CM) (enhanced social work services as usual). A within-trial economic evaluation and long-term model from a National Health Service/Personal Social Service and a broader societal perspective will be undertaken alongside the National Institute for Health Research (NIHR)-Public Health Research Unit (PHRU)-funded randomised multicentre BeST?. BeST? aims to evaluate NIM compared with CM for maltreated children entering foster care in a UK context. Collection of Paediatric Quality of Life Inventory (PedsQL) and the recent mapping of PedsQL to EuroQol-5-Dimensions (EQ-5D) will facilitate the estimation of quality-adjusted life years specific to the infant population for a cost-utility analysis. Other effectiveness outcomes will be incorporated into a cost-effectiveness analysis (CEA) and cost-consequences analysis (CCA). A long-term economic model and multiple economic evaluation frameworks will provide decision-makers with a comprehensive, multiperspective guide regarding cost-effectiveness of NIM. The long-term population health economic model will be developed to synthesise trial data with routine linked data and key government sector parameters informed by literature. Methods guidance for population health economic evaluation will be adopted (lifetime horizon, 1.5% discount rate for costs and benefits, CCA framework, multisector perspective). ETHICS AND DISSEMINATION:Ethics approval was obtained by the West of Scotland Ethics Committee. Results of the main trial and economic evaluation will be submitted for publication in a peer-reviewed journal as well as published in the peer-reviewed NIHR journals library (Public Health Research Programme). TRIAL REGISTRATION NUMBER:NCT02653716; Pre-results.

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Impact of a mentoring and skills group program on mental health outcomes for maltreated children in foster care.

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Impact of a mentoring and skills group program on mental health outcomes for maltreated children in foster care.

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