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Summary: This is a preventive intervention intended to reunite children returning home to their parents after their first stay in foster care. The program sought to prevent reunification failures when children were returned home to their biological parents by supporting parents and by making the transition a smooth process for both immediate and continued parenting success. The program is rated Promising for improving encouragement strategies. (Review the full program description).
| Title | Rating | Details | Outcome Category | Study(ies) |
|---|---|---|---|---|
| Encouragement strategies |
Promising | One Study |
Families who participated in the Pathways Home intervention demonstrated greater improvements in encouragement-based parenting strategies compared with control group families who did not receive the intervention. This difference was statistically significant. |
Family functioning; Parenting skills | DeGarmo, David S., John B. Reid, Becky A. Fetrow, Philip A. Fisher, and Karla D. Antoine. 2013. “Preventing Child Behavior Problems and Substance Use: The Pathways Home Foster Care Reunification Intervention.” Journal of Child and Adolescent Substance Abuse 22(5):388–406. See evaluation methods. |
Program Goals/Target Population
The Pathways Home Foster Care Reunification Intervention (Pathways) is a selective prevention program targeting families whose children were returning home after their first stay in foster care. The Pathways program aimed to prevent reunification failures when children were returned home to their biological parents by supporting parents and making the transition a smooth process for both immediate and continued parenting success. Pathways targeted parents who were considered high risk for conduct and substance abuse problems. Additionally, children who are removed from their biological parents and placed in foster care face a variety of risks, including substance abuse, educational failure, risky sexual behavior, and delinquency. In an effort to prevent reunification failures, the Pathways program sought to create a safe and nurturing environment for children by providing parents the support they need to meet parenting demands, such as managing the household, managing stress, and staying healthy.
Program Theory
Parent substance use, parent criminality, and poor parenting are factors that lead to children entering or reentering foster care. Thus, parent management theories were used as the foundation of the Pathways program (DeGarmo et al. 2013). The program taught parents management strategies and principles that were based on the social interactional and social learning approaches, both of which emphasized positive reinforcement and encouragement of desired prosocial behaviors. Further, the Pathways program looked to other parenting and foster care programs for guidance when developing the program. For example, the Multidimensional Treatment Foster Care (MTFC) program influenced the development of Pathways. MTFC stresses the importance of the parent of caregiver’s role in providing children consistent supervision, emotional involvement, and support; these factors were also stressed in Pathways (DeGarmo et al. 2013).
Program Components
The Pathways curriculum, which was delivered in two phases, included strategies to enhance parenting skills, encourage cooperation, teach new behaviors, set limits with a child, and keep track of the child’s behavior and activities, as well as strategies to help the children succeed in the classroom. The curriculum was delivered in individual sessions and was led by a trained family consultant. Phase 1 began before reunification and lasted 16 weeks. The following topics were delivered in the Phase 1 curriculum: getting starting, daily schedules, encouragement and cooperation, tracking cooperation/requests and directions, teaching new behaviors, behavior contracts, setting limits, balance between encouragement and discipline, promoting school success, promoting positive peer and sibling relationships, anticipation and preteaching, avoiding power struggles, problem solving, stress and coping (focused on substance use issues), social support, and parenting plans. The sessions consisted of reviewing the previous week’s lesson, role-plays, and homework assignments. Following the end of Phase 1 the parents were given an 8-week break before the start of Phase 2. Phase 2 lasted 8 weeks and included sessions that fine-tuned the skills taught in Phase 1, assessed the parent’s risk of future harm to family, and developed a plan to safeguard against any perceived risks.
Study Title: Preventing Child Behavior Problems and Substance Use: The Pathways Home Foster Care Reunification Intervention (which is associated with outcome Encouragement strategies)
DeGarmo and colleagues (2013) used a randomized control trial to evaluate the impact of the Pathways Home Foster Care Reunification Intervention (Pathways) program on reunification. To be eligible for inclusion, families had to live within 25 miles of the research center and have a child who was between the ages of 5 and 12 and was returning home from his or her first placement in foster care to live with one or both biological parents. Children and their families were referred from the child welfare branch of the local government to participate in the study. Families were randomly assigned to the Pathways program (intervention) or services that are typically offered to families involved in the child welfare system (comparison condition). Of the families eligible, 50 were assigned to the Pathways program and 53 were assigned to the comparison condition. The overall sample included 52 boys and 51 girls, with a median age of 8. The mean age of mothers was approximately 32, the mean age of fathers 37. Fifty-four percent of the families were single-mother homes. Children were identified as 53 percent European American, 35 percent Hispanic, and 9 percent multiracial, and 3 percent Native American. Seventy-four percent of mothers self-identified as European American, 17 Hispanic, 5 percent African-American, and 4 percent multiracial. Eighty-two percent of fathers self-identified as European-American, 4 percent African-American, 11 percent Hispanic, and 3 percent multiracial. In terms of criminal history, 92 percent of the mothers had a history of drug or alcohol abuse, 55 percent had been arrested, and 47 had a history of family violence (no information regarding criminal history for fathers was provided). Forty-one percent of the children were underperforming in school. There were no baseline differences between groups in terms of sociodemographics or problem behaviors.
Data was gathered through in-person interviews, questionnaires, and record searches during three time periods: baseline, 6-month follow-up, and 12-month follow-up. The following outcomes were analyzed: child behavior problems, encouragement strategies, and foster care reentry. Child behavior problems were measured through the Parent Daily Report Checklist (PDR), which included 40 behavior problem items that were tallied for an index ranging from 0 to 40. Trained interviewers asked parents questions related to the number of times in the past day certain problem behaviors had occurred. Encouragement strategies were collected through the PDR, where parents were asked by a trained interviewer their response to their child’s behavior. Finally, foster care reentry was collected through Child Welfare Services records. To evaluate the overall impact of the outcomes, hierarchical generalized linear modeling was used.
Citation: DeGarmo, David S., John B. Reid, Becky A. Fetrow, Philip A. Fisher, and Karla D. Antoine. 2013. “Preventing Child Behavior Problems and Substance Use: The Pathways Home Foster Care Reunification Intervention.” Journal of Child and Adolescent Substance Abuse 22(5):388–406.
The following outcomes were considered in the scored study or studies, but CrimeSolutions Study Reviewers determined the evidence was insufficient for a rating to be assigned:
- Child behavior problems
- Foster care reentry (after 1 year)
Following are CrimeSolutions-rated programs that are related to this program:
This is an in-home, family preservation service and reunification program for families with children returning from or at risk for out-of-home placement. The program is rated Effective. The treatment group had a statistically significant greater number of reunifications and reduced rates of out-of-home placement, compared with the control group. However, there were no significant differences between groups in successful reunification (i.e., whether the children returned to foster care).
The program is a multicomponent family skills training program that targets substance-abusing families. The program is rated Promising. There were overall mixed results across three studies. One study found no significant effects on measures of child problem behavior, risk/protective factors, and family factors. However, one study found significant impacts on children’s problem behavior, and another study found significant impacts on time to reunification for child welfare-involved families.
This program was originally rated Ineffective. It has been re-reviewed based on the change in the program rating instrument. Under the new instrument, CrimeSolutions ow now rates individual program outcomes and no longer assigns an overall rating.
Rating Process
Program Status
This program is Not Active.