Evaluating and Monitoring the Impact of a Crisis Intervention System on a Residential Child Care Facility (original) (raw)
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2006
We describe a comprehensive program to train emergency shelter staff in effective methods for dealing with youth who have behavioral and emotional problems; assess the degree to which staff implemented the treatment approach; measure the impact of the intervention on shelter-wide incidents such as out-of-control behavior, runaways, and violence against other youth; and examine pre-post changes in staff experiences at the shelter via anonymous surveys. Overall, the short-term shelter staff indicated adequate implementation of the intervention. The rate of youth incidents at the shelter significantly declined from pre to post assessment. Direct-care staff ratings of their satisfaction with their proficiency in behavior management and teaching youth skills increased significantly from pre to post implementation. These findings suggest that it is feasible to deliver an effective staff-training program to improve the behavior management and social skills of youth residing in short-term care facilities within the child welfare system.
Prevention science : the official journal of the Society for Prevention Research, 2016
The current study examined the impact of a setting-level intervention on the prevention of aggressive or dangerous behavioral incidents involving youth living in group care environments. Eleven group care agencies implemented Children and Residential Experiences (CARE), a principle-based program that helps agencies use a set of evidence-informed principles to guide programming and enrich the relational dynamics throughout the agency. All agencies served mostly youth referred from child welfare. The 3-year implementation of CARE involved intensive agency-wide training and on-site consultation to agency leaders and managers around supporting and facilitating day-to-day application of the principles in both childcare and staff management arenas. Agencies provided data over 48 months on the monthly frequency of behavioral incidents most related to program objectives. Using multiple baseline interrupted time series analysis to assess program effects, we tested whether trends during the p...
Child Care in Practice, 2005
This study examined the implementation of a model of managing aggressive and harmful behaviour in an adolescent in-patient psychiatric unit. This model, Positive Behaviour Management, replaced a previous model, Control and Restraint, which was considered unsuitable. Both models included the use of physical interventions, and the research into such techniques is considered. The aims of the study were to evaluate the effects of three training courses on staff confidence in managing aggressive behaviour, knowledge about good practice and staff satisfaction with the new model. A multiple baseline design was used to examine change before, during and after the training period, and at one-year follow-up. The study found that staff confidence increased significantly following training but had returned to baseline levels by the time of follow-up. Staff knowledge significantly increased during the study periods but did not appear to be directly linked to the training courses, and was maintained at one-year follow-up. Staff reported significantly higher levels of satisfaction with the new model Steve Killick is with the Harvey Jones Adolescent Unit, a Tier Four CAMH Service covering the geographical area of South Wales. The unit offers a variety of therapeutic approaches including systemic family therapy, cognitive behaviour therapy and psychotherapy within a therapeutic milieu, and works with young people aged between 11 and 18 who are experiencing severe mental health problems, disorders and illness. Prof. David Allen is Consultant Clinical Psychologist & Head of Specialist Services with the Bro Morgannwg NHS Trust, providing specialist services for people with intellectual disabilities comprising a range of intensive community behavioural intervention teams, acute assessment and intervention units, and domestic-scale, community-based long-stay continuing care facilities. Positive behavioural support is the prevailing therapeutic model within the service; the service provides extensive training to external agencies in these approaches and in the safe management of aggressive and other challenging behaviours.
Residential Treatment for Children & Youth
In inpatient and residential youth facilities, staff concerns over actual and potential aggression and conflict frequently affect both the quality of care and staff wellbeing. This study investigated 1) staff perceptions of safety at the residential facilities where they work, and 2) staff experiences with the Basic Training Program in Safety and Security, initiated by the Norwegian Directorate of Children, Youth and Family Affairs (Bufdir), to enhance prevention and management of aggression and conflict. We conducted three focus-group interviews at three different public residential facilities with a total of 18 staff members who work daily with youth. Findings show that staff regard safety as essential and perceive enhanced safety as linked to predictability, stability, team coordination, education and training, organizational support, and trusting and supportive relationships. They also indicate that staff regard the training program as having improved their feelings of safety, enhancing awareness of conflict situations before, during and after they occur, and contributing to more systematic work processes and cooperative and coordinated teamwork. These findings have implications for all facilities providing care and treatment to youth.
Children and Youth Services Review, 2021
Conflict and aggression are well-known concerns in youth inpatient and residential facilities, frequently affecting both the quality of children/youth (hereafter, youth) care and the well-being of staff. Responses, such as restraint and seclusion (R&S), also pose challenges and can threaten the safety of youth and staff. Various educational and training programs have been implemented to improve practice and create safer places to live and work for both youth and staff. This article reviews the research on the results of measures taken in response to conflict and aggression in youth facilities. Because very little on this topic was published before 2015, we searched for both systematic reviews and original studies published between January 2015 and November 2020 in a total of 7 databases. Our aims in this article are to 1) describe and review the literature related to the effects of interventions to prevent and manage aggression and violence in inpatient and residential youth facilities, 2) describe and review the literature on the effects of R&S and experiences of youth and staff, related to youth violence, R&S, and 3) identify potential gaps in knowledge about these issues that future research could narrow or close. The literature search retrieved 4,698 potentially relevant publications. A total of 14 publications-2 reviews and 12 individual case studies-met our inclusion criteria. Most of the 14 studies were conducted in residentialcare and hospital/psychiatric facilities; a small number were conducted in juvenile justice facilities. Our review indicates that interventions that contributed to a reduction in episodes of R&S differed from those that led to a reduction in conflicts and aggression. The review also indicates that both youth and staff have negative experiences of physical restraint. Results also show that further studies are needed of both the effects and experiences of physical restraint and the effectiveness of de-escalation measures in preventing violence and aggression.
Promoting Inclusion Through Evidence-Based Alternatives to Restraint and Seclusion
Research and Practice for Persons with Severe Disabilities
The use of restraint and seclusion in schools has been identified repeatedly as an approach that is overused, misused, and potentially dangerous. In this article, we emphasize the importance of an approach to supporting students with significant problem behavior that focuses on prevention, evidence-based intervention procedures, heightened levels of monitoring, and documented professional development. While the need for the use of restraint in emergency conditions will remain, the overall rate at which restraint and seclusion are used needs to be reduced and the quality of support for students with significant problem behavior needs to improve. An example of one district that is adopting a comprehensive alternative approach is provided.
American Journal of Orthopsychiatry, 2012
Restraint and seclusion (R&S) are high risk, emergency procedures that are used in response to perceived violent, dangerous situations. They have been employed for years in a variety of settings that serve children, such as psychiatric hospitals and residential treatment facilities, but are now being recognized as used in the public schools. The field of education has begun to examine these practices in response to national scrutiny and a Congressional investigation. The fields of mental health and child welfare were similarly scrutinized 10 years ago following national media attention and have advanced R&S practice through the adoption of a prevention framework and core strategies to prevent and reduce use. A review of the evolution of the national R&S movement, the adverse effects of these procedures, and a comprehensive approach to prevent their use with specific core strategies such as leadership, workforce development, and youth and family involvement in order to facilitate organizational culture and practice change are discussed. Proposed guidelines for R&S use in schools and systemic recommendations to promote R&S practice alignment between the child-serving service sectors are also offered.
Behavioral Disorders, 2018
Despite the prevalence of Positive Behavioral Interventions and Supports (PBIS) for addressing student behavior in public schools, little information exists on the extent and consistency of implementation efforts in secure juvenile justice (JJ) schools. Reports of fidelity to core PBIS processes and components are needed to determine the ubiquity of comprehensive efforts and link implementation to outcomes. All 301 JJ schools in the United States were sent a survey and we report on responses from 143 (47.5%) principals. The survey focused on (a) use of multitiered systems of behavior supports; (b) organizational leadership and training; (c) expectations and consequences; (d) behavior response, monitoring, and oversight; and (e) crisis prevention and management. Approximately 84% of respondents identified alignment with a multitiered framework for behavioral supports. However, fewer supports were available to youth with more serious behavioral needs (i.e., at Tiers 2 and 3). Additional results, implications, and recommendations are provided.
Children and Youth Services Review, 2014
Using a computer game as a therapeutic intervention for young people in residential care: Some preliminary findings on use and acceptability Mental illness is extremely common among young people living in residential care. However, many are reluctant to avail of therapeutic treatment. The value of using computer games as therapeutic tools for these young people has received very little attention, despite indications of their potential for promoting engagement in therapeutic work and improving mental health outcomes. This study aimed to fill this research gap through the development, introduction, and preliminary evaluation of a therapeutic intervention in group care settings. This intervention incorporated a commercially available computer game (The SIMS Life Stories™) and emotion regulation skills coaching. Qualified residential social workers were trained to deliver it to young people in three children's homes in Northern Ireland, where therapeutic approaches to social work have recently been introduced. The research was framed as an exploratory case study which aimed to determine its acceptability and potential therapeutic value. Computer-game based interventions appear to have value for use as therapeutic tools in group care settings and deserve further development and empirical investigation to determine their effectiveness in improving mental health outcomes.