As indicated in the companion paper on current family preservation programs, one of the most striking features of these efforts is their diversity. They vary on a number of dimensions, including the extent to which the focus is on placement prevention versus other goals, such as the improvement of family functioning.2 There is also variation in the intensity and duration of services provided to families and in adherence to various "models" of family preservation.3 One criticism of the research in this area is that it has not adequately encompassed this diversity. In this section, we review research on the effects of intensive, in-home services programs in which placement prevention was either the primary goal or one of several objectives. Since the central concern of family preservation programs has been the prevention of placement, this has been a major focus of evaluations. We begin with an examination of what is known about the placement prevention effects of programs.4
2 For example, the prevention of placement was the primary objective in programs studied by Yuan, McDonald, Wheeler, Struckman-Johnson, and Rivest (1990); Feldman (1991); Fraser, Pecora, and Haapala (1991); Schwartz, AuClaire, and Harris (1991); and Schuerman, Rzepnicki, and Littell (1994). The program described by Jones, Neuman, and Shyne (1976) emphasized placement prevention and other goals. Placement prevention was not a primary goal in the Family Support Project in Los Angeles (Meezan and McCroskey 1993).
3 For descriptions of various models, see Nelson, Landsman, and Deutelman (1990) and Cimmarusti (1992).
4 Much of the material in this section is a revision of material in Schuerman, Rzepnicki, and Littell (1994).
Prevention of Subsequent Child Maltreatment
The hope in family preservation programs is to prevent the placement of children without subsequent maltreatment. Few studies have examined the effects of family preservation programs on the recurrence of child maltreatment. Obviously, it is impossible to detect all maltreatment of children, so researchers have generally depended on reported incidents. In the five-year follow-up study of the New York Preventive Services Demonstration, Jones (1985) found that 21 percent of 98 families in the experimental group and 25 percent of 44 control group families had experienced one or more indicated reports of child maltreatment. The difference between groups was not statistically significant. Yuan et al. (1990) reported that approximately one- quarter of families in both the program and control groups experienced an investigation of child abuse or neglect within 8 months after referral. In the Illinois experiment, children in the family preservation program were somewhat more likely to be identified as victims of subsequent maltreatment than children in the control group; although statistically significant, the difference between the groups was small (Schuerman, Rzepnicki, and Littell 1994).32
As with placement, the rates of maltreatment in both the experimental and control groups in these studies were fairly low. Had placement been prevented, the results could be taken as indicating that this benefit was attained without increased harm to most children. However, most children in both groups remained in their homes, and the results indicate that the experimental services did not reduce an already low rate of subsequent harm.
32 The large number of children in this study made it relatively easy to detect statistically significant differences. There were no sites in which significant reductions in the recurrence of maltreatment were found, nor did the program affect the risk of subsequent maltreatment for any of the subgroups of cases examined.