Post on 15-May-2023
TRANSlT lONlNG FROM CORRECTIONAL CONFINEMENT
The design and implementation of F d v Foster Care Services for
hi& risk delinquents JAMES W. DAVIS,ACSW, PETER J. PECORA, PH.D.,
CHARLEY JOYCE,ACSW, LOWELL FLEMMER,ACSW, BCD, JAMES EDMONDSON, MA, JOYCE
GERHARDT, BSW, KENT HENDERSON,ACSW, GLEN PADDOCK, PH.D.,
NICOLE S. LE PROHN, PH.D., TROY ARMSTRONG, PH.D.
Introdwtion Within the juvenile justice system are many young- sters ready for release from secure facilities but unable to return to their birth fami- lies. A substantial number of these youth would clearly benefit from a family-based placement instead of being moved into other kinds of congregate settings or being left to fend for themselves in an ill-prepared independent living situation. But experts widely acknowledge that
Breiling, 1989; Meadow- croft & Trout, 1990; C h a m b e r l a i n , 1 9 9 4 ) . Another impeding factor is the inherent difficulty in establishing the necessary inter-agency collaborative working relationships to address the challenges encountered i n serving these multi-problem, multi- need youth in family-based settings.
Along with concerns about successful collabora- tion and appropriate pro- gramming is the urgent
these specialized family-based placement programs must be carefully designed to address the treatment and supervision needs of such youth, who have been designated as severely delinquent and have reached the deep end of the youth cor- rectional system (Armstrong, 199 1). Traditional foster care simply does not work well with this population (Hawkins &
problem of increasing numbers. The need to provide suit- able residential placement for paroled youth occurs at a time when the rates of youth confinement are escalating nation- wide. An expansion of placement options structured as treat- ment-oriented, family-based residential settings is certainly needed as increasing numbers of delinquent youth are being
Please see writer biographies at end of article on page 34
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committed to secure correctional facilities for varying lengths of stay. An ominous statistic facing professionals responsible for community reintegration is that within the total population of juvenile offenders annually entering secure confinement, approximately 60,000 will require some form of out-of-home placement at the point of release (Children in Custody, 1993). The need is evident, the pro- gram development challenge is understood, but solutions to date have been scant.
Finally, and perhaps most important from a juvenile justice system perspective, is the ongoing concern over high rates of recidivism that plague youth placed in group living settings following their release from confinement. Without pointing fingers concerning the causes of this problem, it is evident that efforts to normalize the lives of high risk juve- nile offenders upon reentry into the community are doomed to fail unless the intervention plan includes a well designed treatment regimen and a high degree of structured supervi- sion. And the nature of the living arrangement and what occurs therapeutically within it is a major determinant of success or failure for these youth. Outcome findings from formal evaluations comparing family-based with group home placements are almost nonexistent. A recent study by Oregon Social Learning Center researchers compares out- comes with delinquent populations placed in these two resi- dential options. Findings indicate far better results for youth in therapeutic foster care across a number of measures including self-reported criminal activity, subsequent time in confinement, school attendance, academic advancement, and runaway behavior (Chamberlain & Moore, n.d.). These data about differential effectiveness point to an emerging confirmation of a widespread suspicion about the positive influence of more personalized and individualized living arrangements for serious juvenile offenders.
In light of these kinds of circumstances and the strong sense to experiment further with foster care modalities tar- geting delinquent youth, an innovative program has been developed and tested in Bismarck, North Dakota, over the past several years to provide specialized family foster care for a small population of adjudicated youth. The targeted population are youngsters who have been committed to the Division of Juvenile Services in that state and require transi- tioning from secure confinement into out-of-home place- ment. This article will describe both the theoretical and
practical considerations involved in designing this program, and will explore the challenges faced in its implementation. In large part, discussion of this process of program develop- ment will illustrate the importance of careful and sequential planning, strong commitment from all involved agencies, and the criticality of administrative tenacity.
THE SPECIALIZED FAMILY CARE PROGRAM
The Casey Family Program (Casey), with headquarters in Seattle, Washington, was established to provide planned, long-term family foster care for youth who have no parents or whose parents are unable or unwilling to care for them. While Casey has always served a small number of delin- quent youth, it has long recognized that these youth tend to have needs requiring special care and supervision. Such care and supervision have been difficult to provide in Casey’s regular foster care program. Consistent with one of Casey’s purposes (to provide long-term family foster care to youth involved in delinquent acts), staff members and a small group of consultants have developed a specialized program for a particular subset of these youth. This effort has been named The Casey Family Program Specialized Family Care (SFC) Program. The overall goal is to help remediate the youths delinquent behavior by providing sustained, high quality living arrangements and individualized services through a collaborative, inter-agency approach.
The Casey Family Program, the North Dakota Division of Juvenile Services (DJS), and the state Department of Human Services (DHS) have been keenly aware of the fact that a substantial number of adjudicated youth located in child care facilities throughout the state would benefit, upon release into the community, from placement in a particular kind of less restrictive setting; namely, specialized foster care homes. Some of the current placements (group homes and residential treatment facilities tilled with other delin- quent youth) available to DJS appear to perpetuate the sub- culture of delinquency, and thus do not contribute to breaking the cycle of illegal or otherwise unacceptable behavior. Furthermore, delinquent youth placed in these res- idential care facilities frequently experience multiple place- ments in the community, none of which appear to eliminate the pattern of delinquent behavior. Despite the juvenile jus- tice systems interventions, these youth chronically reoffend.
Consequently, these three agencies made the joint deci-
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sion to develop the SFC Program because they shared the belief that a number of confined high risk youth would have a better chance for normalization if they experienced the transition into long-term family foster care. Casey strongly believes that an adjudication of delinquency arising from serious behavioral problems does not preclude many of these youth from successfully adjusting to family foster homes. The procedural key is that these youth be properly identified and then matched to family foster homes where parents have been appropriately trained and supported. Also critical for success is the use of structured supervision pro- vided by a collaborative team of Casey and DJS workers.
PROGRAM GOALS AND OBJECTIVES
The SFC Programs purpose is to provide family-based treatment and supportive supervision that promotes proso- cia1 behaviors and skills in youth with chronic histories of delinquency. The ultimate goal of The Casey Family Program is to assist young people, through planned long- term family foster care, to grow up to lead productive adult lives. Since youth served by SFC have embarked on life courses that could predictably put them in conflict with the law, the goals of SFC have been developed expressly to pre- vent these individuals from becoming adult criminals. These goals are: 1. To reduce youth recidivism. 2. 3. To increase youth socialfinctioning. 4. 5.
To improve youth emotional health and behavior.
To maximize youth educational development. To help youth learn employment skills, maximize their peformance in the workplace, and achieve a high level of retention in employment. To help youth develop superior independent living skills.
6.
Because sustaining adjudicated delinquent youth in family foster care is a complex undertaking difficult to accomplish alone, Casey has adopted a strong stance that the SFC Program must be a collaborative effort. The com- bined involvement and collective resources of the three agencies appear to be critical to reintegrate these youth into the community and to maintain them in the selected family foster home over a long period. [Note 11 Casey, DJS. and DHS have attempted to combine several promising supervi-
sion and treatment modalities into one integrated program. To establish such a collaborative relationship. Operations Guidelines were developed that specify the following allo- cation of tasks, activities and responsibilities for all three agencies in the programming mix:
Roles and responsibilities Type of delinquent youth to be targeted for services Type of family foster homes that will care for these delinquent youth Training necessary for foster parents and staff to operate SFC Blend of supervision and services necessary to maxi- mize the potential success of the youth in SFC
PROFILE OFYOUTH REFERREDTO SFC PROGRAM
Other than the common need for out-of-home place- ment, the most prominent characteristic of adjudicated youth entering the SFC Program from the North Dakota Youth Correctional Center (NDYCC) is their history of repeated contact and increasingly deeper involvement with the juvenile justice system. With respect to crime-related characteristics, this population possesses a common history of being habitual property offenders. This profile is roughly identical for both males and females at this facility, although approximately 10 to 15 percent of the males were com- mitted to DJS for crimes against persons, most notably assault and sex offenses. The majority of NDYCC residents have been previously adjudicated delinquent and placed on probation before the juvenile court committed them to DJS. They have also experienced multiple out-of-home place- ments.
The population of youth at NDYCC screened for pos- sible participation in the SFC Program have a mean age of 15.5 years. A few are as young as 13 years old. On any given day, the NDYCC population includes approximately 65 male and 10 female residents. Females are slightly younger averaging 15.2 years, and males are slightly older averaging 15.8 years. Slightly more than half the females are Caucasian (54 percent) and 46 percent are Native American. For males 57 percent are Caucasian, 34 percent are Native American and 9 percent are either Hispanic or Black. Native American youth are heavily overrepresented in the NDYCC population in comparison to their percentage of the state’s overall adolescent population.
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Most NDYCC youngsters come from broken homes with only one parent. There is usually a history of chaotic living conditions and high levels of family dysfunction including substance abuse, domestic violence, neglect, and criminality among the, residents in these settings. In many instances, the youth are living with other extended family members such as grandparents, uncles and aunts, or older siblings. It is also not uncommon for these youth to have been shuffled from household to household and to have been put into state or locally funded residential place- ments. The NDYCC population had tested, on the average, slightly more than two grade levels below their peers in the public school system. Based on this scoring, slightly more than 60 percent have been classified as eligible for Remedial Chapter 1 Educational Services. In addition, approximately 33 percent have been diagnosed as being learning disabled.
The pattern of problems underlying the delinquent behavior of NDYCC residents reveals several common themes. Approximately 80 to 85 percent of this population have been screened for some level of substance abuse problem with alcohol the most frequent drug of choice but often as part of poly-drug usage. There is a growing indica- tion that a history of inhalant use is common among Native American youth in this group of substance abusers. The reported incidence of physical, sexual and psychological abuse of the entire population is quite high. Overall, the pic- ture provided by this profile is one of a group of youth who are experiencing serious difficulties in major areas of their lives and are destined in many cases for protracted involve- ment with the justice system. Chamberlain (1994) has noted this prospect when profiling the population of youth being referred from the juvenile justice system:
It is a formidable challenge to devise effective treat- ments for adolescents with established patterns of anti- social behavior. The prognosis for their long-term adjustment is bleak; they are at-risk for a variety of problems in adulthood, including criminality, erratic employment, dependence on welfare systems, accidents, alcoholism, and poor relationships ... Once established, early antisocial patterns tend to follow a predictable developmental course that gradually leads to more extreme problem behaviors [p. 21
As this sobering profile suggests. when youth reach the point of secure institutional confinement due to their repeated delinquent acts, they tend to have a poor prognosis. This pattern of persistent illegal behavior is characteristic of a small proportion of juvenile offenders who develop elon- gated delinquent careers often extending into adulthood. Persistence of youthful offending behavior into adulthood has been documented in a variety of geographic settings and with data from a number of different points in system con- tact. Perhaps most distressing is the pattern of youth con- fined in juvenile correctional facilities who then graduate into the adult prison system. The primary results are a vir- tual lifetime of secure confinement and an enormous public financial burden.
Findings from research on persistence of criminality are clear about the potential for substantial numbers of chronic juvenile offenders to graduate into the adult system. A sample of youth from the original Philadelphia cohort study (Wolfgang, et al., 1972) was followed in a subsequent inquiry through the age of 30. Approximately one half of males with juvenile police contacts earlier in their youth had an officially recorded arrest by the age of 30 (Wolfgang, et al., 1987). A study of violent juvenile offenders in Columbus, Ohio found that 64 percent of the male subjects and 33 percent of the female subjects were rearrested as adults by the age of 25 (Hamparian, et al., 1985).
Further, this study revealed that juveniles with more chronic delinquent behavior had a far greater chance of reoffending as an adult: 36 percent with 1 juvenile arrest had an arrest by age 25, 62 percent with 2 to 4 juvenile arrests, and 78 percent with 5 or more juvenile arrests. Similarly, a follow-up study of male juveniles who had pre- viously been incarcerated in California Youth Authority institutions revealed that 94 percent were also arrested as adults, 82 percent for a major felony, 65 percent for a vio- lent offense, and 42 percent of these adult arrestees had more than 9 arrests each during an 8 year follow-up period (Haapanen, 1990). In a nationwide sample of state prisoners 40 and older, Langan and Greenfield (1983) found that 15 percent reported they had been incarcerated as juveniles. Clearly, all these findings speak dramatically to the price society pays when chronic delinquents are not remediated during their juvenile years.
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-gram Model The SFC model is similar to therapeutic foster care in that concentrated specialized services are provided to a special population of youth served by a social worker with a reduced caseload (See Figure 1). The SFC social worker serves as SFC team leader. Services are provided to from six to eight youth in ten family foster homes. Families not pro- viding planned long-term care are available to provide planned and emergency respite care to other SFC foster families. Additionally, SFC has developed a diagnostic com- ponent that assesses youth placed into SFC families to assess their ability to adjust to family based care. Transition services are provided to youth to prepare them for more independent living. Casey/SFC operate an internal scholar- ship program (CEJT) to assist with post-secondary educa- tion and training. It includes career counseling, job shadowing, work experience, and tuition support for post- secondary education. Operational guidelines were devel- oped to support implementation of the following program components which are summarized in the next sections:
Intensive supervision Intensive juvenile aftercare Specialized family care
INTENSIVE SUPERVISION
The first program component incorporated into the SFC Program is the existing intensive supervision approach DJS uses with juvenile offenders who have been designated as needing high levels of supervision in the community. Intensive supervision is that part of the larger DJS commu- nity case management framework designed specifically to intervene with high-risk youth moving through this system. It requires careful evaluation of each youth so that the most informed choices about supervision and service options can be made. Thorough screening and assessment provide the information needed to guide supervision and treatment.
At the point of commitment to DJS, a youth is assigned to a case manager. Within 45 days, the case manager must develop a comprehensive, written TreatmentRehabilitation Plan (ideally in close cooperation with the youth and birth family members). This plan consists of a social assessment, a risk assessment, and a Strategies for Juvenile Supervision (SJS) interview. This set of procedures identifies both short- term objectives and long-term goals.
The plan is shared with all other professionals who will be involved in supervision and treatment. For youth with more difficult problems and who are at higher risk of reof- fending, the supervision and treatment strategies include more intense levels of contact and intervention. Case man- agers may see these youth in the community as often as once or twice a week. Case managers must also be available for contact with the youth and their families 24 hours a day. The intensity, frequency, and content of the contacts depend upon the case manager's perception of a youth's behavior at any given time.
INTENSIVE JUVENILE AFTERCARE
The second major source of input is the Intensive Community-Based Aftercare Programs (IAP) model formu- lated and tested over the past decade by researchers at Johns Hopkins University and California State University, Sacramento (Altschuler & h s t r o n g , 199 1, 1994a, 1994b, 1994~. 1995a, 1995b, 1996). The IAP approach is the result of an ongoing research and development effort funded in 1988 by the Office of Juvenile Justice and Delinquency Prevention (OJJDP). Currently being tested at four pilot sites nationwide (Colorado, Nevada, New Jersey, Virginia) this model of intervention is best described as empirically grounded, theory-driven, and risk and need assessment ori- ented. It stresses the highly structured management of chronic and serious juvenile offenders as they transition into community from correctional facilities but is heavily ori- ented toward individualized service provision.
Findings from the research underlying this project point to a set of assumptions that must be taken into account to translate theory into practice:
(a) defining the overall aftercare function to guarantee inclusion of staff and programs across the entire con- tinuum from the point of judicial commitment and resi- dential placement to termination of community supervision;
(b) designing the network of community-based service provision to respond comprehensively to the problems and needs of chronic, multi-problem delinquents;
(c) devising a framework for case management that insures continuity of supervision and service delivery, that matches clients with appropriate interventions, and that
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brings the most objective procedures to inform decision making in the areas of risk and need: and,
(d) focusing upon collaborative. interagency approaches to supervision and service provision.
Structurally, aftercare in the IAP approach is viewed as a system consisting of three distinct, yet overlapping seg- ments: ( 1 ) pre-release and preparatory planning activities during the residential confinement phase of youth correc- tions: (2) structured transitioning involving the participation of residentialhstitutional and aftercare staffs both prior to and following community reentry; and (3) long term reinte- grative activities to insure adequate service delivery and the required level of social control.
The theoretical orientation of the model that is under- girded by an integration of social control, strain and social learning theories is consistent with a number of previously applied research initiatives to develop an intervention framework for serious, chronic juvenile offenders (Elliott, et al., 1985; Fagen & Jones, 1984; Greenwood & Zimring, 1985; Weiss & Hawkins, 1981). Distinctive to the IAP Model, however, is a critical focus upon the numerous issues and concerns arising out of the largely disconnected and fragmented movement of offenders from court disposi- tion to state correctional commitment/institutionalization, to parole/aftercare supervision, and finally to discharge from the juvenile correctional system.
SPECIALIZED FAMILY CARE
The third program component is the specialized foster care approach developed by The Casey Family Program and tailored for use with high-risk juvenile offenders. Although treatment foster care has been touted for more than a decade as an effective placement intervention for seriously dis- turbed children and adolescents (Hawkins, et al., 1985; Webb, 1988), the application of this approach to delinquent youth has been a relatively recent development.
The range of behaviors most often identified as appro- priate for this form of intervention has included incorrigi- bility, depression, destruction of property, drug abuse, running away, sexual problems, self-destructiveness, and physical aggressiveness (Timbers, 1990). Yet delinquency has not often been targeted as a specific criterion for referral and treatment, despite the fact that delinquent youth fre-
quently exhibit many of the behavioral characteristics and problems supposedly best suited for this intervention strategy. Consequently, the SFC program has built upon a rather narrow knowledge base and set of practical experi- ences that have emerged recently as foster care providers across the nation try to expand their services into more ther- apeutic modes for delinquent youth.
Central to the design of the SFC model is the use of specially recruited and trained SFC foster parents. They serve as key agents in helping to achieve the goals of each youth’s treatment plan. In addition to providing routine care in the home setting, SFC foster parents are responsible for ongoing treatment. This feature most clearly distinguishes specialized from standard foster care (Meadowcraft, et al.. 1990). This treatment orientation is predicated upon solid theoretical arguments and empirical practice showing that therapeutic interventions by paraprofessional foster parents can have a substantial impact on the antisocial behavior of youth. Research findings suggest a positive effect from parent-mediated treatment of antisocial behavior (Altschuler & Armstrong, 1990).
SFC foster parents possess a number of characteristics similar to standard foster care providers: they are substitute caregivers, and their homes have been evaluated for inherent strengths and areas of potential growth for future service as foster parents. Also, both types of foster parents are reim- bursed for the costs associated with providing care to the youth(s) in their homes.
SFC foster parents, however, differ from standard foster parents in significant ways. SFC foster parents receive more intense, specialized training than do their counterparts in nonspecialized foster families. Because of the limited case- load size of aftercare youth, SFC foster parents have more contact with the social worker. In addition to the time the social worker and SFC foster parents may spend with an individual youth, SFC foster parents are an integral part of the SFC team that meets weekly. Another significant differ- ence between non-SFC and SFC providers is that SFC foster parents receive a dificulq-of care payment to recog- nize the additional care required to serve these special needs youth.
Most significantly, SFC foster parents are the primary treatment agents in implementing the youths individualized case plan. Not only do they provide the basic care and nur-
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turance, but they also stand as partners with the SFC social worker, DJS case managers, and all others in helping the youthful offenders in SFC learn new skills, make healthy life adjustments to achieve a self-sufficient, crime-free adulthood. .
Specialized foster care is a delivery system in which the foster parents provide both treatment services and behav- ioral management. Behavioral control techniques are inte- grated with other treatments to ensure that the overall goals of the aftercare approach are conveyed to and internalized by the youth within the framework of specialized foster family instruction, interaction, and nurturance.
To achieve this level of expertise in managing the daily lives of high-risk juvenile offenders in home-based settings, considerable attention must be directed to both the recruit- ment and training of SFC foster parents. They must be care- fully identified and then comprehensively prepared for the dual role of treatment and social control agents. Their ability to manage and change behavior according to the the- ories underlying the proposed model comes from a formal process of highly detailed training, close supervision, fre- quent peer interaction, and strong administrative support. All research on the potential impact of specialized foster care supports this argument for well-designed recruitment and training activities (Gross & Campbell, 1990; Meadowcroft & Trout, 1990).
d
To achieve long-term positive behavioral change in high- risk juvenile offenders the SFC model stresses a set of struc- tural features, organizational arrangements, program procedures, and service activities essential to the programs design and operation. These service components and the implementation challenges associated with them will be dis- cussed in this section.
REDUCED CASELOADS FORTHOSE INDIVIDUALS
WITH CASE MANAGEMENT RESPONSIBILITIES
Individual cases in the SFC Program are jointly man- aged by a Casey social worker and a DJS case manager. The intensity and complexity of staff roles, responsibilities, and interactions; the substantial number of prescribed activities for the youth; and the need for informed decision making
and close monitoring all require a reduced caseload. Having fewer cases to manage and more time for frequent, high- quality contacts with the youth and important others (peers, schools, employers, service providers) is a plus for supervi- sion when the caseload is composed of multiproblem, high- risk offenders. The caseload size for the SFC social worker is six youth.
EARLY AND CONTINUAL CONTACT BY SFC STAFF
WITH POTENTIAL PROGRAM PARTICIPANTS ONCE
THEY HAVE ENTEREDTHE DJS SYSTEM
Case management begins as soon as possible after a youth has been referred by the courts to the DJS system and appears to be a potential candidate for admission into the Program. Once DJS has identified a possible candidate for the program, the Casey Social Worker begins to monitor the youths progress in whichever residential setting he or she is located. The Casey social worker will attend case staffings, visit with the child care workers in the institution and keep in contact with the DJS case manager to monitor the poten- tial participants development in the treatment setting.
The Casey social worker closely monitors the progress of these youth during their institutional stays. When steps such as pre-release conferences begin before the youths actual transition back into the community, these cases are formally assessed for possible admission into the SFC Program. As each youth is accepted, the Casey social worker's involvement increases in collaboration with the designated DJS case manager. Together, they develop detailed plans for program placement.
ATEAM APPROACHTHAT INVOLVES INTERAGENCY
COLLABORATION AND COSTSHARING BETWEEN
CASW, DJS,AND DHS
Teamwork in the SFC model operates at two levels. At an interagency level, Casey, DJS and DHS work closely together to ensure that all relevant resources and administrative supports are provided promptly and effi- ciently. At the community-based staff level, representa- tives of Casey and DJS (the Casey social worker, Casey specialized foster parents, and the DJS case managers) combine their efforts in a carefully designed model of team supervision. Close interaction and communication among these team members is required at each stage in
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the movement of youth through the SFC Program. The SFC social worker and the assigned DJS case man-
ager provide case management of the adjudicated delinquent youth. In addition, the SFC social worker provides case management services to the SFC foster homes. Youth and foster parents communicate first with the SFC social worker, who will be the lead case manager of SFC. This system avoids role confusion and maximizes clear commu- nications. The SFC social worker serves as team leader of the SFC Team.
Care, custody, and control of the identified adjudicated delinquent youth remain with DJS, especially while they remain in SFC. It is expected that care, custody, and control could be transferred to Casey or another entity once a youth has demonstrated over a period of time that he or she has successfully adjusted to family care and is no longer prone to delinquency. At times maintaining the necessary level of communication and commitment has been difficult; pro- gram intake and other efforts have suffered as a result. This is an area for continual monitoring and finetuning for any collaborative program of this type.
All three participating agencies-Casey, DJS, and DHS- are jointly responsibility for funding SFC. Treatment ser- vices are purchased partly by using federal Medicaid (Title-XIX) and state general funds, in addition to Casey, DJS, and DHS staff time such as permanency planning staffings. DJS meets its financial responsibility by con- tributing existing resources, such as use of its case man- ager(s), trackers, and other existing or future programs.
Casey meets its financial responsibility through foster care payments that include room and board, and reim- bursement for clothing expenses. In addition. Casey pro- vides a difficulty-ofcare payment to each SFC foster home and makes available the services of a full-time social worker for the six identified youth and associated SFC foster families. Casey also assumes responsibility for pro- viding other services that may be necessary to maximize the SFC youths chances for success. Program costs per day have varied somewhat with expansion of the program and currently are at $133.70 per day. This amount is calculated on the basis of the program operating at full capacity with six youth in regular placement and 3 youth in interim or transition care. This per day figure includes the Medicaid reimbursed portion of the costs. [Note 21 The only
excluded cost is for the time of the DJS case manager. It is difficult to make an accurate cost benefit compar-
ison for SFC to other existing programs serving deep end delinquent youth. Data are available on the daily rates for traditional foster care programs as well as therapeutic foster care programs. However, available data typically quote only a room and board rate; sometimes specialized payments to foster parents will be included, but a true and accurate pic- ture of the total costs of operation is usually not presented. Also, treatment options often necessary to respond to the difficult mix of behavioral and emotional problems pre- sented by this population are not taken into account in developing cost projections.
The costs per child care day figures quoted for SFC include the traditional figures indicated above but also include everything from professional and paraprofessional salaries to the costs of purchased counseling and therapy, from services provided to the birth families of SFC youth to the costs of educationhition and from outside consultants to office supplies. The SFC daily rate is a comprehensive and accurate representation of the cost of serving high risk delinquents in family based foster care.
Cost comparisons to SFC are more accurately made by examining treatment facilities and even residential programs serving delinquent youth. These settings more accurately reflect comparable staffing patterns, programming and ther- apeutic resources as well as the reality that such interven- tions are frequently the last resource available to this population before secure confinement or graduation into the adult correctional system occurs.
USE OF BROKERAGE AND PURCHASE-OF-SERVICE
AGREEMENTS
Targeting multiproblem youth within the DJS system for participation in the SFC Program requires the ready availability of many services and resources for therapeutic treatment, education, skill development, and supervision. It is unrealistic to expect the program to provide all of these options and opportunities in-house. Consequently, links with appropriate agencies and organizations in the sur- rounding community become key factors in obtaining the services and resources these youth need. The roles of the Casey social worker and the DJS case managers are partly defined as brokerage agents. They are responsible not only
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for locating services and matching them to the youth, but also for monitoring and holding providers accountable for quality of service.
EXTENSIVE USE OF FORMALIZED ASSESSMENT AND
CLASSIFICATION PROCEDURES
Assessment for the purposes of the SFC model includes the following overall goals:
To accurately identify the appropriate population for program participation. To ascertain the nature and extent of personal needs, problems, and deficits that require response. To determine the required level and mode of supervi- sion that assures a reasonable level of public safety. To match these youth with the optimum community- based services and resources.
Both Casey and DJS conduct thorough screening and assessment as part of their evaluation process at the point of intake into their respective programs. Currently, DJS con- ducts an initial assessment for all youth referred to NDYCC in seven primary areas that focus upon both risk and need factors. Likewise, Casey conducts a comprehensive assess- ment of a youth’s needs and strengths at intake, evaluating eight major areas that guide treatment decisions, and using standardized assessment measures such as the Child Behavior Checklist, Teacher Report Form (Achenbach, 199 la,b), and the Ansell-Casey Life Skills Checklist (Nollan, et al., 1997).
The SFC Program uses information drawn from both sets of screening and assessment procedures. In general, eli- gibility for SFC referral and participation depends upon the presence of the following factors identified through these procedures:
Inability of a youth to live with his or her birth family A profile suggesting the youth is at high risk of reof- fending An indication that the youth has a good chance of being successful in a long-term specialized foster care placement
INTENSIVE SUPERVISION AND SOCIAL CONTROL
TECHNIQUES
The history of these youths’ continuing legal problems
and disruptive behaviors requires an intensive approach to aftercare supervision as a complement to the supportive environment and services the SFC Program provides. Quite simply, highly structured programs and sophisticated tech- niques for imposing higher levels of social control are often required to stabilize such offenders in the community so necessary treatment and services can be delivered.
Over the past decade, the intensive supervision move- ment has made a number of technical and organizational advances to ensure that the required level of social control is imposed. Technical advances include electronic monitoring and broad-spectrum drug/alcohol testing. Organizational advances include special staffing patterns such as team supervision, community service work crews, and special- ized supervision roles (trackers, for example). Collectively, these approaches range from procedures that are only slightly more structured than standard supervision (such as stringently enforced curfew) to highly intrusive and restric- tive procedures (such as electronic monitoring and house arrest).
SPECIALIZEDTREATMENT MODALITIES AND SERVICE
PROVISION
The youth targeted for participation in this program are regularly plagued by a variety of social problems linked to family dysfunction, negative peer influence, school difficul- ties, and substance abuse. Psychological and physiological problems are also commonly associated with this population such as varying degrees of emotional disturbance/mental disorder, learning disabilities, developmental disabilities, and neurophysiological impairment. This range of prob- lems, often manifested as a constellation of difficulties in individual offenders, requires highly specialized treatment modalities. In contrast, the youth are also survivors of abu- sive or neglectful birth family environments and bring with them personal strengths in various areas that can be devel- oped further.
USE OF COGNITIVE AND BEHAVIORAL SKILLS
TRAINING
Skills training with youth categorized as delinquent is designed to enhance the youths cognitive and behavioral social skills. Research has found that delinquent youth dis- play a low level of social skills (both behavioral and cogni-
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tive) when compared with nondelinquent youth (Feindler & Ecton. 1986; Goldstein, et al., 1989). Although it would be incorrect to deduce that low social skills cause delin- quency, the high correlation between lack of social skills and delinquency indicates that increasing social skills in delinquent youth may lower recidivism rates and prevent drug abuse (also highly correlated to delinquency). The major goal of skills training is to teach social skills to delinquent youth (or enhance the skills they have) so that they can respond in new ways to high-risk situations. Enhanced social skills can certainly be used to improve other social relationships as well, including those at home, school, and work.
SETTING INTAKE AGE CRITERIATHAT MATCHESTHE
PROGRAM MODEL
Age limits have presented implementation challenges to the SFC program. Casey has a long-standing age limit, requiring children to be admitted to the program prior to their seventeenth birthday (to enable them to stay with the program long enough to learn crucial skills and develop helpful relationships). Through practice experience, how- ever, we have found that many delinquents do not become well suited for the SFC program until after the age of fif- teen. Only at that stage in their careers have they run the gamut of treatment services and reunification attempts, thereby making long term foster care possibly the best option.
We find, at that point, the potential candidates to be more accepting of the fact that they will not be returning to their parental home. This acceptance appears to be a major factor in their success in this type of program. As long as the youth strongly believes that reunification is feasible, he or she will tend not to participate fully in the program. These youth often engage in efforts to discontinue their foster care placement-escalating in their delinquent acts, with the hope of future placement back in the parental home. If they have accepted the fact that reunification will not happen, they can more fully commit to the SFC program and participate in moving their lives forward.
Older youth also tend to reduce their propensity toward criminal behavior, become more future oriented, become fed-up with institutional life, and become more motivated for a more normal family life. They also have
received sufficient treatment services to enable them to begin changes in attitude. In other words, they are at the point of becoming ready to change, if positive change is to occur in their lives. At this point they are most likely to have experienced a successful stay in a treatment facility. We see this developmental factor as critical in their prepa- ration for community adjustment. Without a successful treatment stay reflecting some degree of personal maturing, they are likely to continue impulsive behavior and are less likely to be serious about any commitment to a foster placement or participation in this program. Raising the maximum age of eligibility for youth being referred also reflects the fact that substantial numbers of juvenile offenders being processed through the system are being transitioned from correctional confinement after their 18th birthday. As a result of these factors the intake age limits have been modified by Casey to accept youth in the SFC Program up to their 17th birthday.
Rssearcb Data EVALUATION STUDY
Through use of a time series research design, and the addition of a matched sample comparison group, a variety of questionnaires and interviews were designed to measure change among SFC participants in a number of areas. These areas include monitoring behaviors which might be classi- fied as status offenses and delinquency, as well as some con- tributors or deterrents to delinquency such as drug and alcohol use.
Questionnaires and interviews are administered at intake. Several are re-administered yearly thereafter until case closure. A follow-up administration is planned for one and two years after case closure. In addition to data col- lected from SFC participants, many questionnaires are designed to gather similar data from participants teachers, parents, and DJS case managers.
The matched sample comparison group is comprised of two youth for every SFC participant (to address possible high levels of attrition among adjudicated youth). DJS case managers identified comparison group youth from within their caseload who closely match SFC participants on a number of risk factors and correlates for delinquent behavior. These youth complete the same questionnaires and interviews as SFC participants.
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PRELIMINARY FINDINGS
Youth enter the Specialized Family Care (SFC) Program at an average age of 15 years old. Of the 14 youth served by the program by September 1996, 83% of the youth (N=12) were boys; 18% (N=2) were girls. Slightly over half the youth (57%) served have been Caucasian and 43% were Native American or Alaskan Native. Family income of the home in which the youth has lived the longest (prior to the SFC project) varied, with 42% of the youth having been in homes where the family income was less than $lO,OOO per year.
Data on behavior is collected using the Child Behavior Checklist (CBCL) and the Teacher Report Form (TRF) (Achenbach, 1991a, b). On the CBCL Behavior Problem Scales, the average intake score for each of the scales was below the borderlineklinical range, but most youth had at least one Problem scale score in the clinical or borderline range, with two youth having six of the eight scale scores in the borderline or clinical range. Not surprisingly, 12 of the 14 youth had borderline or clinical scores on the Delinquent Behavior scale. (It is likely that secure confinement or spe- cial treatment resulted in improved recent behavior in the other two youth). Seven youth had borderline or clinical scores on the Withdrawn Scale, and five had high scores on the Anxious Depressed Scale.
On the TRF Behavior Problem scales, the average score for each of the scales was below the borderlineklin- icd range for the group. In contrast to their CBCL scores, where most youths had at least one Problem Scale score in the borderline/clinical range, on the TRF, only two youth had borderline/clinical scores on any individual behavior problem scales. This may indicate a benefit of the added structure of the school setting the youth was in or that the teacher completing the form did not know the youth very well. On the summary scales (Internal, External, and Total), seven of the youth had a borderline or clinical range score on at least one of the summary scales.
Information about youth substance abuse is collected from youth using the Personal Experience Inventory (PEI). All youth in the project report using alcohol at some point in their lives, with 67% reporting having used it more than 20 times. Other substance use reported by youth include inhalants (75%). Marijuana (92%), and LSD (50%).
Data on delinquent activity are collected anonymously
from youth. The average age at first offense for any single behavior ranged from 10.2 years of age (stealing something worth less than $5.00), to 14.0 (sold hard drugs such as LSD or heroin). The average age across all acts was 12.6. The most frequently occumng behavior was stealing something worth between five and fifty dollars. Twelve youths reported this action.
In addition to intake data, data are collected yearly from youth in the program (Le Prohn & Pecora, 1997). Thus far, only six youth have been in the SFC program one year or longer, and thus aggregate data should be viewed with caution. For the CBCL behavior problem scales, many of the youth are in the clinical range for withdrawn, anxious/depressed, delinquent and aggressive behavior scales at year 1. On the TRF Behavior Problem scales, the findings are mixed, with some youth experiencing more behavior problems at year 1, while others have decreased the number of behavior problems experienced. It may be that the added structure or supports of a school setting help many of the Casey youth. Alternatively, the difference in scores may be due either to the reduced sensitivity of the teachers to certain problem behaviors like aggression because it may be occurring on the school grounds and not in the classroom, or to the differences in types of behaviors rated on the TRF vs. the CBCL.
The level of all types of delinquent behavior dramati- cally decreased from intake to year 1 compared to the com- parison group youth. (Some of these differences are illustrated in Table 1.) Of the 24 activities that youth were questioned about, 17 activities were reported as occurring by any youth. One SFC youth reported committing no delin- quent acts in the past 12 months. Three SFC youth reported committing only one type of delinquent act, with two youth reporting three types of delinquent acts. A seventh youth reported committing 15 different types of delinquent acts. A wide variety and higher number of delinquent acts were rep- resented by the comparison group youth.
In summary, based on a small sample of SFC and com- parison group youth, there are some important differences emerging regarding delinquent behavior and substance use as measured by anonymous youth surveys and official arrest records (Le Prohn et al., 1996). These data must be viewed with caution because of the small sample size but are encouraging. Yearly monitoring of key outcomes and life
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Activity
Attacked Mother with intent to hurt or kill Been loud, rowdy, unruly in public
Carried a hidden weapon other than pocket knife Purposely caused property damage worth more than $200
pwrposely causad prapsy damage between $50 and $200.
Fought with group of Mends vs.anothargFoup
K h o w h r g ~ r o M , a r h a k t s t d r # r ~
Purposely cause property damage worth less than $50
Ran away
Sold marijuana or hashish
Wdcoaknormdc Sold other hard drugs
Stolen a motor vehicle
Stolen goods worth more than $200.00
Stolen pods worth fess than $200.00 and more than $50.00 Stolen goods worth less than $50.00 and more than $5.00 Stolen something worth lass than $5.00 Stolen something worth more than $50.00
Wen a W i d e for ride withow owners permission
Threatened another with weapon or object
T h ~ r n o t h a r w i t h o u c o ~ o r a b j s c c Tried to get something by lying about who you were or how old you were.
Tricd to get something by lying about whet you would do forthem
Broken into a building or car
PERCENT OFYOUTH REPORTING ACTIVITY
( ~ 7 ) (n=6)
I 4% 50% 29% 50%
0% 33% 14% 17%
I 4% I 7% 14% I 7% 43% 67% 43% 50%
57% 83% 0% 50%
0% 0% 0% 0% 0% 33% 0% 33%
14% 83% 29% 83% I 4% 67% 29% 100%
I 4% 67% 0% 67%
57% 67% 43% 83% 29% 67% 29% 33%
SFC Youth Comparison Youth
course analyses of the youth over time will be used to fur- ther explore the differential effectiveness of this program.
Cmclus~on This article has discussed the design and implementation of an experimental program model currently being tested in North Dakota and has described the programming chal- lenges of serving youth adjudicated as severely delinquent in a specialized foster home setting. Social control, strain,
and social learning theories as expressed through negative peer influence, lack of positive opportunities, and absence of bonding to conventional social institutions are three of the major perspectives guiding the design of the SFC inter- vention model. Structurally, the approach addresses a number of problems and concerns linked to the complex process of transitioning delinquent youth from secure con- finement back into the community. The program uses a col- laborative framework that blends funding streams from the
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Division of Juvenile Services, The Department of Social Services, and The Casey Family Program, as well as exten- sive empowerment of foster parents and an intensive wrap- around of supportive services. We believe SFC is a model for inter-agency collaboration and integration of both cate- gorical funds and programming strategies.
Existing research has shown the value of selectively placing high risk delinquents in more familial settings as opposed to referring them to larger, congregate and less per- sonalized surroundings. Yet, it is widely acknowledged by juvenile justice professionals working in the area of out-of- home placement that such youth tend to fail at unacceptable high rates in traditional foster home placements. This dual perspective presents a strong argument for developing a far more highly structured and complexly configured foster care model. The SFC Program represents an experimental effort to respond to these perceptions.
The initial program implementation phase was marked by staff turnover and youth discharges to more restrictive placement options. In the wake of the redesign of certain
components and procedures the SFC Program is currently helping a substantial proportion of enrolled youth to make demonstrative progress in many areas of their daily lives. Maintaining the full commitment of all agency partners, reaching full implementation of the essential treatment com- ponents, and minimizing program model drift are key chal- lenges being met by the SFC Program administrators and staff on an ongoing basis.
End Notes 1. An evaluation study using a modified time-series
design where SFC youth and a group of comparison youth are periodically assessed has been implemented to measure the impact of services over time and across a range of outcomes.
2. Please note that many similar programs are unable to identlfy all of the costs that are paid through Medicaid. For example, a program may have a youth receive therapy from a third-party therapist, but not have access to the costs for that service. This makes cost of com-
ABOUTTHE AUTHORS Troy L Armstrong, Ph.R, is Professor in the Anthropology Department a t California State Unhrsity, Sacramento, is currently Co-Principal Investigator on the Office of Juvenile Justice and Delinquency Prevention (0JJDP)-funded Intensive CommunigBased Aftercuo hgtarn. Over the past decade, Dr.Armstrong has served as a consultant on a variety of juvenile jurtice-related projects at the national, state and local levels. He has published widely on a number of prognmming issues including serious and violent offenders, restitution and community services, school crime, intensive probation supervision, and community-based alternatives to formal justice system processing. Dr.Armsvong has also recently renewed a long-term interest in Native American juvenile justice issues and is cumntly serving as the prin- cipal investigator on an OJJDP-funded project studying youth gangs on the Navajo Nation.
lama Dds.ACSW is Director of the Bismarck Division ofThe Casey Family P r o p . Mr. Davis has spent his entire cam in human services in North Dakota. He has served as adjunct faculty a t the University of Mary, Bismarck, ND, the University of North D a b Grand Fork, ND and the Universiy of Iowa. Iowa C i , IA He has taught courses in rural social workgroup t h e w and served as a field inmctor for graduate and undegnduate students.
Junes Edmondron, M A is Regional Manager with The Casey Family Program. Mr. Edmondson's paccice and adminiswatjve work has focused on children's mental health, managed can. juvenile corrections, family court mediationand long term foster care.
Lowell Flemmer,ACSW BCD, is the lead Social Worker with the SFC unit of The Casey Family Program, Bismarck. North Dakott division. Mr. Flemmer has special- ized mining in family t h e w from Washington University in S t Louis and his practice work currently 4cuses on intensive akercare services with youths adjudicated as delinquent
Joyce E. Gerhardt, B.S.W. is the Family Devaloper wlth the Specialiied Famity Care Program ( S K ) and has been on staff since its inception five p~ ago. Employed by The h e y Family Program, MS. Gerhardt served In the capacity of Family Developer for the Bismarck Division for 8 years previous to joining the SK unit Prior to Casey, Ms. Gerhardt worked in the public sector in the field of child welfare. MS. Gerhardt is presently pursuing a Masters in Public Adminiswation degree through the University of North Dakota
Kent Henderson, ACSW is Regional Manager of the Southern Region of The Cas9 Family Program. His administrative and practice work of over 24 years has focused on a range of Child Welfare, Child Mental Health and Juvenile Justice programs serving children, p t h and families.
Chatley Joyce,ACSW is the Social Work Supervisor for the Bismarck Division of The h e y Family Pmgram, Bismardc Division. Mr. Joyce's professional experience includes work as an outpatient mental health therapist and director of a psychiatric unit He is also a formerV.I.S.TA volunteer.
Nicole S. Le Prohn, Ph.R, is Director of hc t i ce Research for The Carey Family Program. Dr. Le Prohn joined Caseiy after three pan as an Assistant Professor at the University of Southern California School of Social Work, where she taught courses in research, social work practice, and human behavior. As Director of Practice Research, Dr. Le Prohn coordinates the research study of the Specialized Family Care Progm. Her other work focuses on the evaluation of agency prognms, research with the Achenbach Child Behavior Checklist and providing research technical assistance to Carey DMsions.
Glen B. Paddock, Ph.0. is Director of Clinical Practice for The Casey Family Program and Adjunct Professor, Department of Family Psychology, Seattle Pacific University. His writing and teaching has focused on practitioner and supervisor skill development for the application of an outcomeoriented methodology to case p c - tice with youth living in hmily-based foster care. h e r J. hcorp, Ph.R is Manager of Research Services for The Carey Family Program, and Associate Rofassor, School of Social Work. University of Washington, Seade,Washington. His research and publications have focused on implementing quality improvement and outcomeoriented case planning systems. collecting data on the progress of children in family-based services and foster care,and developing instruments for assessing independent living skills and other outcomes.
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parisons across various programs difficult. The SFC cost figure is inclusive of all costs of care other than DJS case manager time.
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The authors thank James Traglia, Vncent Payne, Paige Pederson, and Lynn Keenan for contributing to the theoretical perspectives section of this paper, review of earlier drafts of this article, and for consultation regarding SFC program impkmentation.
For more information on the program models, please contact Jim Davis at The Casey Family Program Bismarck Division, 300 West Century Avenue, Bismarck, ND 58501 (701) 222-8193. For more information about the evaluation research, contact Nicok Le Prohn at The Casey Familj Program, 1300 Dexter Avenue North, Suite 400, Seaitle, WA 98109. (206) 270-4925.
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