Close to half of all children who remain at home with their permanent caregivers following a child welfare investigation (i.e., not placed into foster care) manifest high rates of mental health need, yet few engage or remain in mental health treatment (Burns et al., 2004;Lau &Weisz, 2003).This is particularly concerning as children from these child welfare involved families (CWIFs) manifest disproportionately high rates of behavioral difficulties (ACF, 2005;Burns et al., 2004). Lack of available child mental health service providers in inner-city communities (Asen, 2002) creates even greater obstacles to accessing treatment. The Multiple Family Group (MFG) service delivery model to reduce childhood disruptive behavior disorders (DBDs;Franco et al., 2008;Gopalan &Franco, 2009;McKay, et al., 1995;1999;2002;Stone, McKay, &Stoops, 1996) is currently being tested in an NIMH-funded effectiveness study. This model may be beneficial for CWIFs as an innovative, engaging mental health intervention that addresses inner-city service capacity limitations. Although preliminary data indicate that CWIFs manifest high engagement rates in MFGs, CWIFs have substantial needs (e.g., parental depression) which may exceed the MFG model's current capacities. As a result, the MFG model may require adaptation for CWIFs. Consequently, the goals of the proposed fellowship include (1) increasing the applicant's theoretical knowledge and methodological expertise in child mental health service and intervention science;(2) increasing theoretical knowledge in services for CWIFs and family-based treatment of childhood DBDs;and (3) preparing the applicant to develop and pilot a family-based mental health intervention for CWIFs to reduce childhood DBDs.
The specific aims of the current application are met through two studies examining CWIF caregiver responses to the MFG model and identifying where modifications, if any, may be necessary. Using qualitative methods, Study #1 will identify CWIF caregiver perceptions of factors that influence service delivery (i.e., engagement, program helpfulness, relevance, and ability to stimulate motivation to make family- level changes), and recommendations for improvement. Study #2 involves quantitative, secondary data analyses to assess if CWIF status moderates the MFG treatment effect over time regarding (1) engagement and process characteristics of service delivery (i.e., relationship with service provider, relationships between MFG members, parental and youth motivation to address treatment goals, perceived barriers to treatment), (2) family-level outcomes and parent characteristics (i.e., parenting skills, family communication, within family support, and parent/child interaction, parent stress, parent depression, parent coping), and (3) youth-level outcomes (i.e., externalizing behavioral difficulties and functional capacities). Those outcomes where the MFG treatment effect is attenuated can be targeted for further revision when adapting the MFG model. Both studies will provide preliminary data used to develop and pilot a family-based mental health intervention to reduce child DBD's for CWIFs. Thus, mental health treatment may be improved for a diverse and vulnerable population.

Public Health Relevance

The current application proposes two studies which examine how families with child welfare services contact (i.e., open child welfare case without foster care placement, prior child welfare services contact) respond to the Multiple Family Group (MFG) service delivery model to reduce childhood disruptive behavior disorders (DBDs;Franco et al., 2008;Gopalan &Franco, 2009;McKay, et al., 1995;1999;2002;Stone, McKay, &Stoops, 1996) regarding engagement, service delivery characteristics, as well as family- and youth-level outcomes. Qualitative and quantitative techniques will be utilized to identify where modifications, if any, may be necessary in order to adapt the MFG intervention for these child welfare involved families (CWIFs). Given that CWIFs often do not engage or remain in child mental health services (Burns et al., 2004;Lau &Weisz, 2003) despite high rates of child behavioral difficulties (ACF, 2005;Burns et al., 2004), developing an effective, engaging, and innovative mental health service will help children from CWIFs access and benefit from needed treatment.

Agency
National Institute of Health (NIH)
Institute
National Institute of Mental Health (NIMH)
Type
Postdoctoral Individual National Research Service Award (F32)
Project #
5F32MH090614-02
Application #
8063664
Study Section
Special Emphasis Panel (ZRG1-F16-B (20))
Program Officer
Otey, Emeline M
Project Start
2010-04-01
Project End
2011-09-02
Budget Start
2011-04-01
Budget End
2011-09-02
Support Year
2
Fiscal Year
2011
Total Cost
$22,434
Indirect Cost
Name
Icahn School of Medicine at Mount Sinai
Department
Psychiatry
Type
Schools of Medicine
DUNS #
078861598
City
New York
State
NY
Country
United States
Zip Code
10029
Gopalan, Geetha; Fuss, Ashley; Wisdom, Jennifer P (2015) Multiple Family Groups for Child Behavior Difficulties Retention Among Child Welfare-Involved Caregivers. Res Soc Work Pract 25:564-577
Small, Latoya; Jackson, Jerrold; Gopalan, Geetha et al. (2015) Meeting the complex needs of urban youth and their families through the 4Rs 2Ss Family Strengthening Program: The ""real world"" meets evidence-informed care. Res Soc Work Pract 25:433-45
Gopalan, Geetha; Small, Latoya; Fuss, Ashley et al. (2015) Multiple Family Groups to reduce child disruptive behavior difficulties: moderating effects of child welfare status on child outcomes. Child Abuse Negl 46:207-19
Gopalan, Geetha; Franco, Lydia M; Dean-Assael, Kara et al. (2014) Statewide implementation of the 4 Rs and 2 Ss for strengthening families. J Evid Based Soc Work 11:84-96
Gopalan, Geetha; Acri, Mary; Lalayants, Marina et al. (2014) Child Welfare Involved Caregiver Perceptions of Family Support in Child Mental Health Treatment. J Family Strengths 14:1-25
Gopalan, Geetha; Alicea, Stacey; Conover, Kelly et al. (2013) Project Step-Up: Feasibility of a Comprehensive School Based Prevention Program. J Early Adolesc 33:131-154
Rodriguez, James; Hoagwood, Kimberly Eaton; Gopalan, Geetha et al. (2012) Engagement in Trauma-Specific CBT for Youth Post-9/11. J Emot Behav Disord 20:
Alicea, Stacey; Pardo, Gisselle; Conover, Kelly et al. (2012) Step-Up: Promoting Youth Mental Health and Development in Inner-City High Schools. Clin Soc Work J 40:175-186
Gopalan, Geetha; Bannon, William; Dean-Assael, Kara et al. (2011) Multiple family groups: an engaging intervention for child welfare-involved families. Child Welfare 90:135-56
McKay, Mary McKernan; Gopalan, Geetha; Franco, Lydia et al. (2011) A Collaboratively Designed Child Mental Health Service Model: Multiple Family Groups for Urban Children with Conduct Difficulties. Res Soc Work Pract 21:664-674

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