(see Poster Gallery) Exploring the Effectiveness of Family Relational Therapy on Mitigating the Risk for Child Maltreatment and Improving Family Stability

Background and Purpose: Factors such as lack of family social supports, family violence, and unaddressed caregiver mental health or substance use issues can contribute to risk of child maltreatment and involvement with the child welfare system. The family disruption that accompanies repeat exposure to the child welfare system can traumatize or re-traumatize children and families, but helping caregivers build a stable and nurturing environment can disrupt this cycle. Family Relational Therapy (FRT) is a comprehensive approach that aims to mitigate child maltreatment risk and improve family stability. Working with families whose children have entered or are at risk of entering foster care, therapists provide caregivers with developmentally informed strategies to improve family dynamics and enhance social support. This study examined the impact of FRT on short-term outcomes related to social support, family wellbeing, caregiver decision-making, and caregiver knowledge of child development. Long-term outcomes including reunification, re-entry into foster care, and subsequent maltreatment were also assessed.

Methods: This study utilized a quasi-experimental design to evaluate the effectiveness of FRT. In this design, state administrative data was used to compare long-term outcomes for children whose families received FRT with children in the same child welfare region whose families received services as usual. Propensity score matching was used to match participants on key characteristics and control for differences between groups. Additionally, surveys were collected from therapists, clients and supervisors to assess short-term outcomes for the intervention group.

Results: Key findings include:

• Therapists and caregivers reported improvements across family social supports, caregiver decision-making capacity, family violence, parenting stress, substance use, and caregiver knowledge about child development.
• Caregivers reported more optimism regarding overall family dynamics and wellbeing, and therapists reported improvements in client in-home safety.
• The intervention group had statistically significantly fewer investigations with confirmed maltreatment allegations compared to the comparison group. Mann-Whitney U tests indicated that investigations with confirmed allegations in the past 6 months were greater for the comparison group (mean rank: 27.50) than for the comparison group (mean rank: 23.25; U=262.5, p=.039).
• The number of new foster care entries did not differ significantly between groups, though the intervention group had fewer entries in the 6 months prior.
• Neither the intervention group nor the comparison group had new family-based services cases.

Conclusion and Implications:

Findings revealed significant improvements across nearly all short-term outcomes. These findings are promising and speak to the emphasis of FRT on child development and family social support, which are clear areas of strength for the program which may contribute to overall family stability, an important factor in mitigating risk for child maltreatment. Regarding long-term outcomes, children in the intervention group had significantly fewer confirmed maltreatment allegations than children in the comparison group. While there were not many significant differences between groups, this is promising and suggests that families that participate in FRT may have more success in keeping their children safe than families who do not participate in FRT. These outcomes should continue to be assessed as the population of families served grows.