What the Research Says
Researchers studying the effectiveness of family-preservation programs tend to look first at the percentage of families that are still living together safely a year after the service has ended. States considered successful in that regard--including Maryland--generally report figures in the 80 percent to 90 percent range.
Research data offer evidence that intensive family-preservation programs improve parents' ability to deal with a variety of problems, but the studies don't show conclusively that the approach will reduce out-of-home placements or improve family functioning over the long term.
One well-known study of family-preservation programs in Illinois concluded that children in families that received such services were no more or less likely to be placed outside the home than those in a control group that received traditional child-welfare services. The results, says John Schuerman, the lead author of the study, "Putting Families First: An Experiment in Family Preservation," suggest that some programs may actually be choosing the families that are most likely to succeed.
As the number of children living in extremely troubled homes rises, it is unrealistic to expect that family-preservation services alone can stem placements--especially if there aren't enough programs and workers to go around.~ It's also misleading, advocates stress, to lump everything done in the name of family preservation into one category.
The Illinois study, for example, looked at programs run by many different agencies and using many different approaches. Only one, though, strictly adhered to the Homebuilders model, which is known for its small caseloads and intensive interaction between caseworkers and families.
Family preservation "unfortunately has become a slogan that covers a multitude of situations and sins," notes Marcia Robinson Lowry, the executive director of Children's Rights Inc., a New York-based nonprofit group advocating for child-welfare reforms. "It's a tremendously complicated situation that is becoming grossly oversimplified."
Last spring, family-preservation policies came under fire when three Connecticut children were killed by adults in their households. None of the children's families had been receiving intensive family-preservation services at the time, and two of the families had not received social services of any kind for some time. Still, Gov. John G. Rowland ordered a review of several thousand abuse and neglect cases, and the number of children removed from their parents' care increased. While becoming more vigilant, though, officials say the state is not backing away from family preservation.
"Whenever a child dies, it should be a time of very serious soul-searching about what happened and what went wrong," says Susan Notkin, the director of the program for children at the Edna McConnell Clark Foundation, which provided support for Homebuilders-type programs in several states for many years. But that should not mean discarding the whole concept, she says. "No one's writing the stories about the thousands of children who are kept safely within their own homes rather than being ripped from their parents."
Placement data alone don't tell the full story of how well family-preservation services work. Experts acknowledge, too, that the approach was oversold initially as a way to save money by reducing placements.
"One of the things we've learned is that we should have said much more frequently and clearly that family preservation does not take precedence over child safety," says Michael Weber, the director of a program based at the University of Chicago that is working with the Clark foundation to help reform child-protection systems around the country. Weber also chairs the U.S. Advisory Board on Child Abuse and Neglect, a federal panel that reports to Congress each year on efforts to comply with a 1988 child-abuse prevention law. In its most recent report, the panel laid down some guidelines for determining what types of families and cases are best suited to family-preservation services, while highlighting that child safety should always be the top priority. Proposed regulations for the 1993 federal Family Preservation and Support ACT echo that principle.
Experts agree that the field needs better tools to assess which families are most likely to benefit. The controversy has also spotlighted the need for better training.
"Decisions a worker makes about how can I keep this child safe are often complicated, agonizing decisions," Notkin says. "They need the support and training to allow them to make good decisions."
There's still tension, though, between those who want to promote a tightly controlled model and those who want to frame the issue more broadly so that a wide range of players--including schools--feel they have a stake in it.
"Unless teachers, nurses, law enforcement, and other key service providers are collectively invited to be family-support and prevention activists, how can we build a more coherent community agenda?" asks an article in the Family Preservation Journal.
--Deborah L. Cohen