What do we learn from proces-outcome research?

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What do we learn from proces-outcome research?

• Paris, september 23th, 2005
• Bert Van Puyenbroeck - Programme leader IFPS
  Flanders
• Gerrit Loots, phd, Vrije Universiteit Brussel
• Hans Grietens, phd, Katholieke Universiteit Leuven

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IFPS-program

• Intensive Family Preservation Crisishulp aan
  Huis
• Crisis minor is about to be placed out of home
  (residential care foster care ..)
• At home service
• Short term programme, during 4 to 6 weeks
• Family can reach IFPS team or family worker
  24h/day, 7d/ week family worker can also reach
  supervisor at any time
• Intensive 8h/week, 10 meetings/ week at home
• To prevent unnecessary out of home placement

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IFPS in Europe USA

• IFPS programs in USA (Seattle) (Homebuilding)
• Netherlands (Families First)
• U.K.
• Germany ( FAM FIM)
• Luxemburg
• Finland
• Flanders (Crisishulp aan Huis)

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Research items former research

• Whats the target group reached by IFPS?
• What are the results of an IFPS program?
• outcome based research, focused only on an out
  of home placement index

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Basic results international literature

• It seems that
• Comparable results of these homebuilding based
  IFPS programs in the Netherlands, Flanders,
  Seattle in different cultures?
• succesratio of 73 up to 91

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Critical thinking about these research items

• How does that come?
• What is result outcome based, quantitative
  research index of out of home placement?
• OHP isnt necessary negative (safety issue)

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Questions

• What are the procesess behind these results?
• What difference can an IFPS program make for the
  family?
• What is our basic objective?

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Proces-outcome research whats the impact of an
IFPS program

• The research program is based on
• an integration of quantitative and qualitative
  research methods to relate
• outcome data to the intervention processes and
  the experiences of the family members.
• Quantitative research data
• What are the outcomes of an IFPS in Flanders?
• Qualitative research
• What are the processes behind these outcomes?
• What are the changes we are able to introduce in
  the family system?

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Major question

•  does a family has any perspective on how to go
  on as a family, how to raise the children, how to
  stay together in this family, how to keep up? 
• During the intervention, and afterwards?

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Perspective of the parent

• focuses on the impact of Families First Flanders
  on parents experiences of parental stress, their
  relationship and interaction with their
  child/children, and their impressions of the
  strengths and difficulties of the minor.
• Can I bear the stress? Are there a lot of
  stressfactors?
• How is my relationship with my child?
• Where can I find social support?

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Perspective of the minor

• the minors experiences of the parent-child
  interaction and their impressions of their own
  strengths and difficulties.
• Do I feel myself competent as minor in this
  family, at school?
• How is my relationship with my mother, my father?

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Focus of IFPS Flanders

• If we want to make any difference, than
• Competence what do I have in my pocket to keep
  up competence-based model
• Stress how stressful is this situation for me?
• Educational relation hows the relation with my
  child/ my parents
• Social isolation/ support can I relay on a
  supportive system/context?

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Research design

• Within subjects / pretest-posttest-follow up
  design
• All families involved in a crisis intervention
  service (IFPS)
• Minor
• Parent (mother/ father)
• Three moments
• Beginning of the crisisintervention
• At the end
• One month after ending

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Instruments
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Procedure

• Family workers
• 2 Feedback Training moments (before starting/
  after 3 months)
• Referal service
• Standardised letter short introduction to the
  research project
• Family
• Referal service first introduction
• Family worker first questionnaires at the start
  short acknowledgement from both researchers
  at the end after one month
• Closed envelopes back to FW ( send to university
  Brussels)

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Overview questionnaires
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This overview today

• Quantitative data-analysis of the families
  involved in the programme during the first six
  months will be presented and discussed
• SDQ
• NVOS
• OKIV-R

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OKIV-Reducational relationship (parent)
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OKIV-Reducational relationship (parent)
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Conclusion OKIV-R parent

• Parents experience their relationship with minor
  as very problematic
• This does not change/ improve during or after the
  crisintervention

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OKIV-Reducational relationship (minor)
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OKIV-Reducational relationship (minor)
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Conclusion OKIV-R minor

• Minors experience their relationship with their
  parents as very problematic
• This doesnt change/ improve during or after the
  crisisintervention

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SDQStrengths Difficulties Minor (parent)
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SDQStrengths Difficulties Minor (parent)
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Conclusion SDQ parent

• Total difficulties score is problematic range
• This changes significantly during after
  crisisintervention (T3 T1)
• Most important changes
• Emotional symptoms
• Hyperactivity
• And trend
• Conduct problems

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SDQStrengths Difficulties Minor (minor)
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SDQStrengths Difficulties Minor (minor)
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Conclusions SDQ minor

• Total difficulties score is borderline range
• This changes significantly during after
  crisisintervention (T3 T1)
• Most important changes
• Hyperactivity
• Trend
• Conduct problems

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NVOS, part 1 Stress, Opvoedingsbelasting (parent)
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NVOS, part 1 Stress, Opvoedingsbelasting (parent)
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Conclusions NVOS

• IFPS families experience the situation as
  problematic as families where minor is placed in
  residential care (norm group)
• This is target group of IFPS (trying to prevent
  an unnecessary OHP)
• This improves in some domains of the
  educational situation
• Significantly  situation cant go on like
  this  and  Im standing alone  and
   experiencing some fun 
• Trend  I can(not) handle the situation 

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NVOS, part 2ID of situation (parent)
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NVOS, part 2 ID of situation (parent)
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Conclusions NVOS

• ID of the situation changes from  I experience
  quiet a lot of problems  to  sometimes I
  (still) experience problems in education 

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First conclusions

• IFPS reaches the target group trying te prevent
  unnecessary out of home placement of a minor,
  given their is a serious risk of OHP (NVOS)
• During the intervention and afterwards, parents
  and minor experience the situation as less
  perspectiveless/ problematic (SDQ)
• Parents identify the educational situation als
  less demanding (NVOS)

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First conclusions

• But
• Still, IFPS does not make a difference in the
  problematic relationship between parent and child
• Hypothesis IFPS helps to deminish the crisis
  in the situation, while their is still a need for
  further family therapy.
• Hypothesis since family has again more hope,
  perspective on how to go on as a family , theyre
  more willing te accept/ go to further helping
  services.

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Further research

• Reporting 12 months (october 04 september 05)
• also domains of
• Social support
• Their evaluation of the programme
• Qualitative research, based on these first
  quantitative research results
• Hypotheses?
• What helps them to get out of the crisis?
• What didnt help them?

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EUSARF 2007

• Presentation on both quantitative and qualitative
  research programs

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hubert.vanpuyenbroeck_at_vub.ac.be

• Thank you.
• Please contact me for further discussion