An Evaluation of the Life Model for Trauma-Affected Foster Children

Background: Youth served in residential care represent a higher-risk subset of the foster care population. Compared to the general foster care population, children in residential care have more severe trauma histories and behavioral health problems resulting in poorer developmental outcomes. Calls for identifying effective programs for youth in residential care are longstanding but remain largely unaddressed. Further, the Family First Prevention Services Act of 2017 (FFPSA), which cuts federal funding for most existing residential programs, will drastically reduce the number of available placements for high-risk foster youth and research identifying effective alternatives is lacking. Thus, the need for research aimed at identifying effective programs for high-risk foster children is urgent.

The LIFE Model targets high-risk foster children with severe trauma-related behavioral health problems and life skill deficits that warrant a level of care that is between family-foster care and intensive residential treatment. Combining a family-style care setting with the structure and services available in residential care, services aim to facilitate positive skill development and well-being through providing a trauma-informed, relationship-based approach and opportunities for life skills development focused in five core areas: social, physical, educational, vocational, spiritual/cultural.

Purpose: In collaboration with a local child welfare agency, researchers developed a two-stage process and outcomes evaluation of the LIFE model. In this presentation, we summarize results from stage one.  

Methods: We used a mixed methods design. First, we conducted semi-structured interviews with 13 program staff. Next, the Community-Oriented Programs Environment Scale (COPES) was administered to youth and staff at baseline (youth = 34, staff = 19), 3 months (youth = 30, staff = 16) and 6-months (youth = 30, staff = 12) to assess therapeutic characteristics of the care environment. To measure outcomes, we reviewed youth case files (n = 42). Outcome measures included the Child Assessment of Needs and Strength (CANS) and the LIFE Assessment.  

Results: Themes from the interviews characterizing the model included: Family, Safety and Trust, Community Connections, and Personal Growth. Results from the COPES indicated moderate-high scores in the relationship, personal growth, and system maintenance dimensions by both youth and staff. Results of paired-samples t-tests showed significant youth improvements in life functioning (d = .51), behavioral/emotional needs (d = .57), and strengths (d = .72). Results of a RMANOVA of the LIFE Assessment across four time points, showed youth experienced significant growth in three core areas: spirituality/culture (η² = .24), educational (η² = .14), and vocational (η² = .23) and overall development (η² = .21). Finally, a majority of youth discharged to family-based placement or supported independent living (n = 31; 83.8%).

Conclusions: Youth demonstrated notable improvements across multiple functional domains, which suggests that the LIFE model is a promising program for higher-risk foster youth whose needs fall somewhere between family-foster care and intensive residential treatment. In this presentation, we will highlight mechanisms through which the LIFE model achieved positive outcomes and discuss implications for practice with similar foster care populations.