Results from a Pilot Study of a Youth-Guided Incentive Program Aimed at Increasing Engagement in Child Welfare Services

Purpose:Lack of engagement in child welfare services is a salient issue impeding client outcomes. Providing incentives, particularly if receiving the incentive is contingent upon participation and meeting treatment goals, can increase client engagement.

In response to low youth engagement and repeated re-entry into services, a Southeastern child welfare agency developed an incentive program aimed at increasing youths’ participation and success in meeting treatment goals. Grounded in principles of behavioral modification and a youth-guided approach, therapists and youth partnered to create individualized treatment goals and identified incentives for active participation and successful goal attainment. In this study, we examined the incentive program’s effects when used as a supplement to usual services.

Methods: We used a mixed methods design to examine program effectiveness.  Qualitative data included a transcript of a focus group with seven practitioners administering the incentive program and detailed notes from regular adherence calls with supervisors and the agency director.  We conducted a thematic analysis of the qualitative data to identify practitioners’ perceptions of youth engagement through the program. The quantitative data for the study were derived from a sample of 17 male adolescents (M = 15.11, SD= .94) in a group home for youth with high level needs. We used a time-series design to measure weekly goal attainment. Baseline data was collected for a five weeks (phase 1) followed by six weeks of the incentive program (phase 2). Simulation Modeling Analysis (Borckardt, 2006) for short time series data streams was used to test for statistically significant changes in goal attainment between phases.

Results: After correcting for autocorrelation, results showed the increase in average percentage of goal attainment from baseline to the incentive condition was statistically significant (Phase 1, M = 48.34; Phase 2, M = 60.62; r = .645, p< 0.02). Examples of treatment goals included decreasing incidents of aggression, following directions, using appropriate language and showing respect to others. Incentive rewards ranged from Lego sets and i-tunes cards to having opportunities to participate in extracurricular community activities outside of normally scheduled program activities. Qualitative analyses found practitioners believed the incentive program assisted with engaging youth and changing targeted behaviors. Practitioners explained that incentive programs need to be 1) child specific and child driven, 2) timely, 3) flexible, and 4) widely available to all youth. Practitioners reported observing an increase in youths’ motivation over time. They described how earning tangible rewards for meeting client-driven goals, allowed the youth to gain an increased sense of control and to see the progress they were making.

Conclusion: We found preliminary support for the effectiveness of using a youth-guided approach to increase youth participation and treatment goal attainment. Continued progress toward effectively engaging youth in child welfare services is contingent upon service providers’ willingness to explore and invest in developing and testing innovative strategies aimed at motivating youth to engage in a process most often entered into unwillingly and under complex pre-existing circumstances. In this presentation we discuss key findings, lessons learned, and implications for practice and policy.