KEEP

1. www.inom.com KEEP Keeping foster and kinship parents trained and supported

2. www.inom.com Familjeforum's KEEP-team • Liv Nilsson, program-supervisor liv.nilsson@familjeforum.com • Anneli Andersson, facilitator anneli.andesson@familjeforum.com • Jennie Börjhagen, co-facilitator Jennie.borjhagen@familjeforum.com

3. www.inom.com Presentation • Who are we that work with KEEP? • Status of foster care in Sweden? • What is KEEP? • KEEP in USA • KEEP in Sweden • KEEP and MTFC

4. www.inom.com The status of foster-care in Sweden? • The government's investigation of maltreatment within the social services for children showed serious abuse and maltreatment in institutions and in foster homes between the 20's and the 90's http://www.socialstyrelsen.se/pressrum/nyhetsarkiv/regeringendelrapporteraromplaceradebarnssituation • The Child Welfare Inquiry recommends that the Social Welfare Board's responsibility to educate, support and guide the fosterhomes should be more clearly emphasized in the legislation. (http://www.socialstyrelsen.se/oppnajamforelser/barnochunga/Documents/metodbilaga_barn.pdf

5. www.inom.com What becomes of the placed children ? • The children who have been placed in foster homes are at risk for future adverse outcomes such as suicide, suicide attempts, severe mental illness, addiction, crime, teenage parenthood, supply problems and more. (Vinnerljung 2009) • The primary adverse outcome appears to be school and education. (Vinnerljung 2009) • The breakdown frequency among children in foster care aged 5-11 years is 37% (Jönsson 1995)

6. www.inom.com Fostercare + scientific evidence =? • MTFC, tested and researched, good effect! • Pride, limited research material indicating moderate or no effect. • Consultant Supported foster care, not studied.

7. www.inom.com KEEP - Basics • Addressing foster families with children aged 5-12 years. • 16 group sessions, once a week. • The sessions last for 60-90 minutes. • The sessions are led by two course leaders. • The groups consist of 4-10 foster parents. • At each session a new skill is taught and feedback and support is given. • Group sessions are designed to be informative and fun.

8. www.inom.com • Course leaders call every week to the fosterfamilies and collect the PDR. • Homework. • Each session is filmed. • Missed sessions will lead to makeup-sessions. • Refreshments will be served. • Babysitting is offered when needed.

9. www.inom.com KEEP in USA • The San Diego Project. • RCT study in which over 700 foster families were offered KEEP. • The results showed that the families who where offered KEEP reduced the number of behavioral problems of the child, decreased the amount of breakdown and increased output of successful exits). • Research and implementation linked to OSLC Oregon Social Learning Center.

10. www.inom.com KEEP in Sweden • Collaboration between the School of Social Work, Oregon Social Learing Center and INOM Familjeforum. • Ongoing marketing efforts to link municipalities and foster homes to KEEP. • All cases are studied.

11. www.inom.com KEEP in Sweden • Implementation in four steps: • 1. Training of a KEEP-team (fall 2010) • 2. Implementation of KEEP-groups (ongoing) • 3. Certification Process • 4. Training of new KEEP-teams

12. www.inom.com KEEP in Sweden • Voice-over and streaming of the film material. • Cultural adaptations of the manual.

13. www.inom.com Structure of the KEEP-team • Counselor • Supervisor • Facilitator • Co-faciliatator

14. www.inom.com The chapters in KEEP • Foster parents as teachers, the importance of cooperation. • Foster parents as teachers, teaching new behaviors. • Using charts and incentives. • Setting limits. • Discipline strategies • Balancing encouragement and limit setting. • Avoiding power struggles.

15. www.inom.com • Pre-teaching • Super tough behaviors. • Promoting school success. • Promoting positive peer relations. • Supporting the child´s contact with the biological system. • Stress management.

16. www.inom.com A taste of KEEP • A practical approach where role play is used as a technique to practice the skill ”how to ignore negative behavior”. • Role play is one of many techniques used in Keep. It is often used to give the parents opportunity to practice new skills and also a way to give them a better understanding of the child´s situation.

17. www.inom.com What tools or approaches can be used in MTFC? • Track concrete behaviors , ”what is the child doing” • ”Catch them being good”, focus on positive behavior • ”The things you give attention to you get more of” • Asking explorative questions • Giving suggestions of alternative strategies • The chart should always include a behavior that the child already manages • Reasonable expectations of the child achievements , when to reward the child?

18. www.inom.com • The four roles of foster homes: teacher, detective, guardian angel and referee. • Stick to your plan when dealing with behaviors. • To train behaviors by making formal / informal agreements. • Pre-teaching. • The balance between positive reinforcement and limit setting. • How to use predictable consequences for the child. • To avoid power struggles. • Stress management. • Escalation curve. • Roleplay.

19. www.inom.com Differences between KEEP and MTFC • The KEEP-facilitator is explorative and advisory, not controlling. • KEEP is addressed to the foster homes who have children in the right age and are interested, we have not chosen foster homes. • Foster homes may have multiple placements.

20. www.inom.com Thank you for your attention!

21. www.inom.com Readable about KEEP http://www.svd.se/nyheter/idagsidan/barnunga/placerade-barn-far-angel-och-detektiv_5953313.svd • http://www.preventionaction.org/what-works/keep-proves-its-worth-keeping-across-us • http://www.preventionaction.org/node/458 • http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2441918/