A Synthesis of Research on Family Preservation and Family Reunification Programs. Results of Controlled Studies


We know of only two well-controlled studies of special services designed to reunify children in foster care with their biological families. One was conducted before the passage of Adoption Assistance and Child Welfare Act of 1980 and one after that Act. These two experiments are described below and in Table 3.47

The New York State Preventive Services Demonstration Project, described above, provided both placement prevention and reunification services to families in the mid 1970s (Jones Neuman, and Shyne 1976; Jones 1985). Here, we focus on the subgroup of 314 children (in 195 families) who were in foster care (81%) or had recently been discharged from care (19%). Cases were randomly assigned to experimental and control groups. Intensive services were provided to families by seven private and two public agencies. Workers carried caseloads of 10 and the duration of services averaged 8.5 months. At the end of the demonstration, 47% of 205 children in the experimental group and 38% of 109 children in the control group had been reunified with their families. At a six month follow-up, 62% of the children in the experimental group and 43% of those in the control group had returned home. At a five-year follow-up, Jones (1985) found no significant differences between groups in the proportion who had been discharged from foster care.

The Utah Family Reunification Services project. The most recent experiment in this area, reported by Walton and her colleagues, assessed the effects of an intensive, in-home family reunification project implemented in 1989 in four social service districts in Utah (see Table 3). Services were limited to 90 days and involved at least three visits per week with each family. Caseworkers carried caseloads of no more than six families at a time and spent an average of 3.1 hours per week with each family; contacts during the first two weeks of services were somewhat more intensive (an average of 5.4 hours per week). The program provided concrete services (e.g., financial assistance, transportation, clothing, food) and training in communication skills, parenting skills, and anger management. Follow-up services were arranged for all of the families in the treatment group. A total of 110 families with children in substitute care were randomly assigned to treatment and control groups (Walton, Fraser, Lewis, Pecora, and Walton 1993).48 Most (76%) of the children were in foster care at the time of their inclusion in the study (Walton et al. 1993); others were in shelters, group homes, residential placements or inpatient psychiatric care (Walton 1991). Families in the control group received services from regular foster care workers, who had average caseloads of 22 and were expected to visit families at least once a month.

At the end of the 90-day treatment period 93 percent (53) of 57 children in the treatment group had been returned to their homes, compared with 28 percent (15) of 53 control children--a significant difference (Walton et al. 1993). Six months after termination 70 percent (40) of the children in the program group and 42 percent (22) of those in the control group were at home. At the one-year follow-up, 75 percent (43) of the children in the program group and 49 percent (26) of those in the control group were living at home. Differences between the groups were statistically significant at each point in time but decreased over time. Fifty-six children (all but one) in the treatment group were returned home at some point during the 15 month study period; seventeen (30%) of these children reentered out-of-home care, although 5 of the 17 were returned to their homes again before the end of the study.49 In contrast, of the 30 children in the control group who returned home, 5 (17%) reentered care. Children in the treatment group spent significantly more time (days) at home during the study period than those in the control group (Walton et al. 1993). Walton (1991) found no significant differences between groups on several measures of individual and family functioning at the end of the 90-day period. Thus, the intensive services program appeared to facilitate reunification, although some of these children did not remain at home.

47 In addition to the studies described here, Stein, Gambrill, and Wiltse (1978) reported results of a controlled study of the Alameda County project, which provided intensive services to biological parents of children in out-of-home care. Services were aimed at increasing parents' participation in decisions about future living arrangements for their children. The goal of the project was to increase continuity of care for children in out-of-home placement--thus the project was not aimed at reunification per se. Yet, 48% of children in the experimental group were returned to their homes, compared with 30% of those in the control group.

48 In an earlier report on this project, Walton (1991) stated that after random assignment, 7 treatment cases and 14 control cases were considered inappropriate for the project and excluded from the study. Then an unspecified number of cases was recruited for the control group (only) to make up for this loss. Walton (1991) reports data on total of 120 cases in the experiment. We assume that 10 cases recruited for the control group outside of random assignment were dropped from the study reported by Walton et al. (1993).

49 This adds to 44 children at home at the end of the study, compared to the 43 cited above.