Barkan, S., Rankin, L., Skinner, M., Orlando, L., Tajima, E., & Greenley, K. (2024). Strive to enhance supervised family time visits for children in foster care: Outcomes from a pilot study with randomization. Children and Youth Services Review, 160, 107531. https://doi.org/10.1016/j.childyouth.2024.107531.
While there are many children living in out-of-home care, there is a dearth of knowledge about parent - child visits, including their efficacy. This study was conducted in Washington state and assessed the Strive program aimed at promoting hopefulness about multiple outcomes: the child welfare service case, parent depression, engagement in parent - child visits, perception of parent - child visit quality, communication between parent and visit supervisor, and satisfaction with the Strive program. The Strive Supervised Family Time Program is an evidence- and trauma-informed manualized curriculum delivered on a one-to-one basis by a Strive-trained family time supervisor. The curriculum is delivered once a week over a five week period. The sessions aim to promote visits between parent and child through developing parents’ knowledge and skills: 1) Getting started - orient parent to importance of visits, build positive relationship between parent and Strive supervisor; 2) Connect and reassure - prepare parent for children’s feelings and behaviours in visits, create routines for structure, support, and reassurance; 3) Creating safe and healthy visit environments - developmental focus on child safety, practice scanning space and addressing safety hazards; 4) Communication counts - strategies for positive and productive communication with adults and children; and 5) Child-directed play - learn value of and practice steps in parents following child’s lead in play.
In 2017, parents were recruited for this study if they were in the first three months of supervised family visits and were being served by one of three participating child welfare offices in Washington state. Parent-child dyads were randomized and then recruited into the Strive program (treatment) group (n = 72) or the treatment as usual (TAU) group (n = 58). The final sample included 58 intervention dyads and 49 comparison dyads. Primary outcome measures were collected pre- and post-intervention and parallel the five primary outcomes of the program (i.e., engagement with Strive navigator, quality of visits, depression screen, hopefulness about case).
The outcomes of the study were positive. There was a high degree of program completion, 79% for the entire five-week program and 88% for three or more sessions. Engagement in parent-child family time was significantly higher in the Strive group versus the control, illustrating that the program supports positive parent-child interactions. Similarly, the Strive group illustrated significantly higher engagement with their family visit supervisor than the control group. Strive parents also had significantly higher quality parent-child family time visits compared to the control group. The Strive program overall yielded positive results over treatment as usual, which are important, especially in a research area that is so poorly studied. Strive has the potential to make a positive impact on parent-child visits when children have been placed in foster care.
This study utilized rigorous methods to assess the effectiveness of the Strive program. This was a randomized control trial study, illustrating causation between predictor and outcomes. While the study is strong, it has limitations. Time 1 survey was administered after the first session, therefore, there is no true baseline measure of engagement with family visit supervisor. Children placed with kin or kith were not included in the study, therefore, it is not clear whether Strive program would have the same impact when children are placed with a relative or close family friend who subsequently supervises family visits. Authors were unable to account for the impact of race or ethnicity, as the initial referrals received did not include these data. Lastly, parents were surveyed post randomization; ideally, the first data collection point would be pre-randomization.