Methods: This study examines the program engagement and mental health outcomes of the FHF program. Participants included 426 children recently placed in out-of-home care who were randomized to intervention or control conditions. The study examined program engagement as well as FHF’s effects on key mental health outcomes measured 6-10 months post-intervention: a multi-informant (child, caregiver, teacher) index of mental health problems, youth-reported posttraumatic stress symptoms (including dissociation), youth-reported quality of life, and caregiver- and youth-reported use of mental health treatment (including psychotropic medications). Analyses then examined whether the following baseline variables moderated the impact of FHF on outcomes: gender, race/ethnicity, type of placement (foster vs kinship care), intellectual functioning, adverse childhood experiences, and mental health functioning.
Results: There were high rates of program initiation, retention, and engagement; 95% of those randomized to FHF started the program, 92% completed it, and over 85% of the mentoring visits and skills groups were attended. The FHF program demonstrated significant impact in reducing mental health symptomatology (Cohen’s ds ranging from .20-.29), especially trauma symptoms, and mental health service utilization (OR = .62). These program effects were consistent across almost all subgroups, suggesting that FHF confers benefit for diverse children.
Conclusions and Implications: Preventing the negative impact of maltreatment on children's mental health requires interventions to be contextually-sensitive, grounded in theory and research, and effective in reaching and retaining children and families. Results indicate that the FHF program is highly acceptable and engaging to diverse children and families and that it can positively impact trauma and its sequelae, thereby reducing inequity among this vulnerable population. As the child welfare system embraces new evidence-based programs and reduces structural barriers to funding and implementing innovative programming, we hope more contextually-sensitive and growth-promoting strategies to address mental health problems in vulnerable populations will be implemented.