The findings of this study are not new. A number of previous evaluations with relatively rigorous designs have failed to produce evidence that family preservation programs with varying approaches to service have placement prevention effects or have more than minimal benefits in improved family or child functioning. The work reported here may be thought of as three independent evaluations, in three states, adding to the set of previous studies with similar results, this time focusing on Homebuilders programs. The accumulation of the findings from a number of studies in several states, with varying measures of outcome, is compelling.
The findings should not be taken as showing that these programs serve no useful purpose in the child welfare system. The results can be seen as a challenge to keep trying, to find new ways to deal with the problems of families in the child welfare system. The findings indicate the grave difficulties facing those who devise approaches to these problems, failure in such undertakings should not be surprising, and those who risk trying to find solutions should not be punished when evaluations such as this indicate they may have come up short.
The accumulation of findings suggests that the functions, target group, and characteristics of services in programs such as this need to be rethought. Obviously, function, target group, and services are closely intertwined. The foremost of these issues concerns the objectives of the programs. A number of observers have suggested that placement prevention be abandoned as the central objective in intensive family preservation services in favor of other objectives, notably the improvement of family and child functioning. Targeting these services on families at risk of placement is unlikely to be successful, so if these services are to continue, they will continue to serve "in-home" cases, families in which there has been a substantiated allegation of abuse or neglect or serious conflicts between parents and children but in which children remain in the home. Many, if not most, of these "intact" families need help. Relatively intensive and relatively short-term services such as those provided by family preservation programs are one source of such help. In this respect, family preservation programs can be thought of as an important part of the continuum of child welfare services.
There are some positives in the findings of this study. Services provided to Homebuilders clients were considerably more extensive and intensive than those provided to control group families. This translated into more positive assessments by caretakers of the relationships they had with workers (Homebuilders clients also rated their overall improvement during the service period as greater). Unfortunately, this apparently better relationship did not translate into observable effects on placement rates or changes in functioning. The challenge for programs is to make use of better relationships to bring about changes in functioning.
Another question that program designers must address is that of specialization. Subgroups for which the program was successful were not found, but these programs are quite generalist in character, and thus may sacrifice some of the benefits of specialization. Among those benefits are a clearer focus of services, tighter target group definition, specification of service characteristics such as length and intensity based on needs of the target group, and the development of more specific competencies on the part of workers. Specialization could be in terms of problems (e.g., substance abuse) or characteristics of clients (young, isolated mothers). There are clear drawbacks to specialization, including the tendency to define problems in terms of the service one offers. Furthermore, limiting target groups inherently limits the impact of programs. Nonetheless, it may be better to mount a series of small programs rather than putting all of one's resources into large, undifferentiated efforts.
Program planners must also address the issue of length and intensity. The extent to which the intensive-short-term-crisis approach of these services fits the needs of child welfare clients needs to be reexamined. The lives of these families are often full of difficulties — externally imposed and internally generated — such that their problems are better characterized as chronic, rather than crisis. Families with chronic difficulties can no doubt benefit from short-term, intensive services, but those services are unlikely to solve, or make much of a dent in the underlying problems. Of course, the hope is that family preservation programs will be able to connect families with on-gong services to treat more chronic problems, but that appears to happen far less than needed. The central point here is that we need a range of service lengths and service intensities to meet the needs of child welfare clients. It is essential that policy makers, planners, and program providers maintain realistic expectations of the effects of short-term family preservation programs.