Evaluation of Family Preservation and Reunification Programs: Final Report - Volume Two. 4.4.1 Services During the Treatment Period


In the second interview with caretakers and caseworkers, we asked questions about services offered and received during the period since random assignment. Experimental and control group responses to these questions were compared. This analysis documents the services received by both groups (thereby beginning to get into the "black box" of services) and determines whether the experimental group in fact did receive more services and more intense services than the control group.

Caseworker Activities. Caretakers were asked to indicate whether the caseworker provided help with a number of specific problems. Table 4-5 shows the number of affirmative responses in each group. According to caretakers, the most common activities in which workers engaged were discussing discipline, providing transportation, and telling caretakers about other agencies that offer services. Of the 19 items on which caretakers were questioned, the control group workers reportedly engaged in one activity, advising on substance abuse, more than the experimental group workers (26% vs. 18%), however, the difference was not statistically significant (p = .16). For 8 of the 19 items, experimental group workers reportedly engaged in the activity significantly more often than control group workers (all at p = .05 or less). (61) The activities engaged in more often by experimental group workers include: help with money for other things, providing transportation, talking with caretaker about discipline, advising how to get medical care, discussing how to get a better place, advising on job training programs, talking about how to get a paying job, and advising on how to continue school.

Table 4-5
Philadelphia Caretaker Reports of Caseworker Activities, Post-treatment Interview
  Control % Experimental % p
Caseworker helped with money for rent/elect./phone 3 4  
Caseworker helped with money for other things 5 22 .001
Caseworker provided transportation 35 50 .03
Caseworker discussed proper feeding of child 22 28  
Caseworker talked with you about discipline 32 53 .002
Caseworker talked with you on relations with spouse 13 20  
Caseworker helped you clean house 6 7  
Caseworker helped with painting/house repairs 01 4  
Caseworker discussed how to get childcare 21 32 .08
Caseworker helped with welfare/food Stamps 4 9  
Caseworker advised how to get medical care 10 23 .02
Caseworker talked with you how to handle anger 31 37  
Caseworker advised you on substance abuse 26 18  
Caseworker discussed with you how to get a better place 25 38 .05
Caseworker advised on job training programs 23 36 .04
Caseworker talked about how to get a paying job 19 33 .02
Caseworker advised on how to continue school 21 34 .03
Caseworker arranged for some childcare 5 8  
Caseworker told you about other agencies 39 47  

A total count of the number of these 19 caseworker activities reported by caretakers also shows significant differences between the experimental and control groups. Caretakers in the experimental group reported an average of 4.6 caseworker activities (n = 148, s.d. = 3.8) while caretakers in the control group reported an average of 2.9 caseworker activities (n = 113, s.d. = 3.1) (p = .001). (62) When asked which of the caseworker activities were especially helpful, experimental group caretakers judged significantly more activities to be helpful than did control group caretakers (2.2 vs. 1.5, p = .02). (63)

Social Program Participation. In the second interview, caretakers were again asked about their participation in the set of social programs listed in Table 4-6, except this time they were asked to report their participation since the time of the first interview. The proportions of involvement were remarkably similar to those in the first interview with a change of 2 percent or

Table 4-6
Philadelphia Participation in Social Programs, Post-treatment Interview
Program C % E % p
Food stamps 78 80  
Job training 20 26  
WIC 40 44  
AFDC 65 70  
Housing vouchers 10 5  
Social security disability 29 23  
Alcoholism program 8 7  
Drug treatment program 13 16  
Marriage counseling 2 2  
Community mental health program 13 13  
Head Start/pre-school 29 32  
Note: C = Control Group, E = Experimental Group

less for most programs. Exceptions to this were a 4.1 percent decrease in participation in WIC services, and a 6.1 percent decrease for participation in Head Start or Pre-school programs, perhaps due to the aging of youngest children. There were no significant differences between experimental and control groups for participation in any of the social programs at the time of the second interview. No significant differences were found with respect to the total number of income support programs or treatment programs in which respondents participated since the time of the first interview.

Caretakers' Reports of Services. In the second interviews, caretakers were asked if they had received any of a set of specific services in the time since the first interview. As shown in Table 4-7, there were no significant differences between the experimental and control groups in receipt of any of these services in the primary analysis. (64) In a separate question, caretakers were asked whether the agency provided homemaker services or the assistance of a parent aide.

Table 4-7
Philadelphia Caretaker Report of Services, Post-treatment Interview
  Control % Experimental % p
Daycare 11 15  
Help in finding a place to live 9 9  
Staying at an emergency shelter 4 3  
Medical or dental care 33 39  
Transportation 25 39  
Education services/GED 9 11  
Parent education/training classes 16 37  
Legal services 7 10  
Counseling 21 26  
Respite care 3 3  
Homemaker services 1 1  
A parent aide to help you 1 3  

Fewer than 3 percent of all caretakers reported having a homemaker or receiving assistance from a parent aide, with no significant differences reported between the experimental and control groups (again, see Table 4-7 for details). When caretakers were asked whether they did not receive any services they felt were needed, 21 percent of the control group responded affirmatively and 18 percent of the experimental group responded affirmatively, a difference that was not statistically significant. (65)

Relationship with Caseworker. Table 4-8 shows results from a number of questions in which caretakers were asked about their relationships with caseworkers. Reports of the quality of the relationship were positive overall, with more than half of the respondents from both the experimental and control group indicating that the caseworker listened to their concerns, understood their situation, and agreed on the goals most of the time. A greater proportion of

Table 4-8
Philadelphia Caretakers' Reports on Relationship with Caseworker, Post-treatment Intervi
  Control % Experimental % p
Worker listened to your concerns most of the time 81 80  
Worker understood your situation very well 82 82  
You and worker agreed on goals most of the time 67 71 .10
Did worker sometimes talk with you about issues that were not easy to talk about? 27 36  
Caseworker helped you to see your good qualities 68 82 .01
Caseworker helped you to see your problems 74 76  
Did you see your caseworker      
More often than you wanted 21 25  
As often as you wanted 59 57  
Not often enough 20 18  

experimental group caretakers felt their workers helped them see their good qualities (82% vs. 68%, p = .01). With respect to the frequency of contact with the workers, approximately 20 percent of caretakers from both the experimental and control groups indicated they did not see their caseworkers often enough. A slightly greater proportion of caretakers in the experimental group indicated they saw their workers "more often than [they] wanted" (25% vs. 21%) and a slightly greater proportion of caretakers in the control group indicated they saw their workers "as often as [they] wanted" (59% vs. 57%). (66)

Caseworkers' Reports of Services. In the second interview, caseworkers were asked whether they had helped any member of the family with any of 25 services, such as child care, homemaker services, income programs, treatment programs of various sorts, and health care. Table 4-9 provides a list of these 25 items and the proportion of caseworkers who indicated this service was provided. Caseworkers from the experimental group reported helping their clients with an average of 4.9 of these services (s.d. = 3.5), while caseworkers from the control group reported helping their clients with an average of 3.8 of these services (s.d. = 3.0; p = .0004). (67) In the primary analyses, an examination of individual services reveals 6 services that were provided significantly more often to the experimental group than to the control group (significance levels were all at p = .05 or less). These services include: childcare or babysitting, parent training, other housing assistance, emergency financial assistance, recreational services, and household management. No services were provided significantly more often to the control group. (68)

Table 4-9
Philadelphia Caseworkers' Report of Services Provided to Family, Post-treatment Interview
  Control % Experimental % p
Childcare or baby sitting 6 16 .02
AFDC or other public income (except SSI) 6 12  
SSI for adult or child 3 0 .06 (FE)
Food stamps 6 9  
Drug treatment 17 16  
Alcoholism treatment 8 8  
Legal aid 4 9  
Help with education 19 24  
Respite care 6 6  
Parent training 34 62 .001
Health care 28 35  
Inpatient mental health 2 2  
Outpatient mental
20 24  
Health assessment 23 31  
Housing financial assistance 3 8 .08
Other housing services 10 21 .02
W.I.C. 8 6  
Emergency financial assistance
other than housing
23 54 .001
Job training 7 11  
Emergency shelter 1 2  
Recreational services 26 38 .05
Family planning 23 21  
Self help groups 9 16  
Household management 21 38 .004
Homemaker services 6 9  
Other 16 13  
N 99 151  
Note: "FE" indicates significance determined by Fisher's exact test

Contact Data. One page contact reports were to be completed by all caseworkers for each face-to-face contact with a family member during the time period designated for family preservation services. On these forms, workers provided information about the date, time, persons involved, and the services delivered during each contact. Some data on contact forms are presented in Table 4-10. At least one contact form was submitted for 85 (59%) of the control group cases and 124 (59%) of the experimental group cases. The following analyses were limited

Table 4-10
Philadelphia Contact Forms
  C E p
Number of cases with at least one form submitted 85 124  
Average number of forms per case 9.9 17.6 .01
Average number of home visits 7.8 13.9 .01
Average number of visits with caretakers 8.2 15.4 .01
Average number of visits with the other parent 1.2 1.5  
Average number of visits with children 7.3 13.3 .01
Average number of contacts with service
Concrete Services C E P
Transportation 2.5 5.2 .01
Buying food 1.3 1.0  
Child care 2.1 1.2 .06
Clothing, furnishings, and supplies 0.9 1.5 .07
Topics of Discussion
Discipline of children 3.5 4.4  
Goals 5.7 7.2 .10
Caretaker's interaction with children 4.4 4.2  
Child's anger management 1.8 2.0  
Supervision of children 4.1 4.3  
Money management 3.4 5.1 .05
Employment 2.7 4.6 .01
Conflict among adults 1.9 2.7 .10
Note: C = Control Group, E = Experimental Group
The contact forms contained additional concrete services and topics of discussion (see Appendix K, Volume 3). Only those that were most often reported are shown here. Entries are average numbers of times per family that an item was reported, for those families with at least one form submitted.

to those families with contact reports. On average, more contact forms were submitted for the experimental group than for the control group (17.6 vs. 9.9; p < .001). In addition to the overall number of reports submitted, the experimental group received significantly more home visits (13.9 vs. 7.8; p < .001), visits with caretakers (15.4 vs. 8.3; p < .001), and visits with children (13.3 vs. 7.3; p < .001). As experimental group families received significantly more contacts than the control group families, they also received significantly more individual activities. The most common concrete service was the provision of transportation (an average of 5.2 times for the experimental group vs. 2.5 times for the control group; p < .001). Child care was the second most common concrete service (an average of 1.2 times for the experimental group vs. 2.1 times for the control group; p < .1). Additional concrete services included clothing, furnishings, and supplies (1.5 times for the experimental group vs. 0.95 for the control group; p < .1).

Contact forms also captured general information about the topic of discussion, counseling, or instruction. The most common topics of discussion were the goals of working together (7.2 times in the experimental group vs. 5.7 times in the control group; p < .1), money management (5.1 vs. 3.4; p < .05), employment (4.6 vs. 2.7; p < .01), and conflict among adults (2.7 vs. 1.9; p < .1).

Additional data on experimental group contacts are shown in Table 4-11. These data confirm the fact that services to the experimental group often did not begin until sometime after random assignment. Only 8 percent of the cases had an in-home contact within 7 days and a relatively small proportion of contacts occurred in the first month.

Table 4-11
Philadelphia Experimental Group Contacts
  N %
Number of families with contact data 124 60
Total number of contact forms submitted 2182  
Contacts in week 1 18 1
Contacts in month 1 479 16
Contacts in month 2 912 30
Contacts in month 3 825 27
In-home contact within 72 hours 3 2
In-home contact with 7 days 10 8
Concrete service within 7 days 8 7
Hours of contact N Mean
Average hours of contact overall 122 34.1
Average hours contact in month 1 89 8.8

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