Lifelong Families Model Shows Early Success

Posted March 27, 2012, By the Annie E. Casey Foundation

Blog lifelongfamiliesmodelshowssuccess 2012

The Brochero family’s well-kept, green ranch house sits on a gen­tle knoll in a qui­et sub­urb of Hart­ford, Con­necti­cut. Their yard pro­vides ample space for their chil­dren and three exu­ber­ant dogs to romp and play.

Inside, the house is warm and wel­com­ing, and painstak­ing improve­ments show the love and pride that Gina and Luis Brochero have invest­ed in cre­at­ing a home for their chil­dren. Both born in Colom­bia, they immi­grat­ed to this coun­try in the mid-1980s and became cit­i­zens 10 years lat­er. The fam­i­ly has grown by two, with the arrival in 2011 of fos­ter sis­ters Caitlin, now 11, and Car­ol, 13 (not the girls’ real names), whom the cou­ple is prepar­ing to adopt. Son Tim­o­thy, 23, is away in the Air Force. Adam, 15, is a high school sophomore.

Both autis­tic, Caitlin and Car­ol were sep­a­rat­ed for years after being tak­en into state cus­tody and now must get to know one anoth­er again. Their birth moth­er, who strug­gled with seri­ous men­tal health issues, was unable to care for them and keep them safe. Caitlin was last in a group home after sev­er­al unsuc­cess­ful fos­ter home place­ments; Car­ol also has moved sev­er­al times while in fos­ter care.

Caitlin’s dis­abil­i­ty is mild. She is some­times with­drawn and has trou­ble with form­ing words, com­plet­ing her fifth grade school­work, and build­ing rela­tion­ships. Carol’s strug­gles are greater. Her speech is often dis­joint­ed and slurred, her bal­ance uncer­tain, and her resis­tance to author­i­ty pro­nounced. Car­ol, a sev­enth grad­er, can­not read or write and receives spe­cial edu­ca­tion services.

Today, Caitlin, beam­ing, proud­ly holds up an art class cer­tifi­cate earned in recog­ni­tion of excel­lence.” Car­ol leaps into the cen­ter of the liv­ing room floor. One hand on the brim of her black Fedo­ra, the oth­er swing­ing in time with her danc­ing feet, I’m going to be a rock star when I grow up!” she announces. Caitlin dash­es off to get her gui­tar and begin an ener­getic accom­pa­ni­ment. The girls, vir­tu­al strangers when they arrived, now have fun togeth­er. But Car­ol has had the hard­est time adjust­ing to her new life. She can be aggres­sive and volatile.

At first, I couldn’t con­trol her,” Gina Brochero, a reg­is­tered nurse, recalls. Her frus­tra­tion would build, and she would act out, cry­ing and scream­ing.” Last night, near wit’s end, Gina called her Casey Fam­i­ly Ser­vices social work­er, Col­in­da Hunter, for advice.

In deal­ing with these mini-crises, Adam, Gina, and Luis have called upon skills and tools they have learned in train­ing and team meet­ings pro­vid­ed as part of Casey’s Life­long Fam­i­lies mod­el, which works to ensure that all chil­dren exit fos­ter care to per­ma­nent, lov­ing fam­i­lies and get the sup­port need­ed to sus­tain them.

Per­ma­nen­cy teams,” which engage fam­i­ly mem­bers, pro­fes­sion­als, and oth­er impor­tant peo­ple in a child’s life, are the back­bone of the mod­el, pro­vid­ing con­tin­u­ous sup­port and guid­ance and mak­ing the child the cen­tral and pri­ma­ry focus. The Brocheros’ team includes Hunter as well as a Casey fam­i­ly sup­port work­er, the children’s state social work­er, Carol’s for­mer fos­ter moth­er, a psy­chol­o­gist, and oth­er clin­i­cians. Togeth­er, they have helped the Brocheros under­stand the girls’ diag­noses and needs.

The Life­long Fam­i­lies mod­el focus­es on five core com­po­nents to help chil­dren in the child wel­fare sys­tem move toward life­long fam­i­lies as quick­ly as pos­si­ble: team­ing, prepa­ra­tion, case man­age­ment, fam­i­ly iden­ti­fi­ca­tion and engage­ment, and sup­port plan­ning. Casey Fam­i­ly Ser­vices, the Annie E. Casey Foundation’s child wel­fare agency, is con­duct­ing a com­par­a­tive out­come study and col­lect­ing data in order to devel­op this mod­el into an evi­dence-based prac­tice, mean­ing one with sci­en­tif­i­cal­ly demon­strat­ed results through rig­or­ous eval­u­a­tion. As it works to final­ize the Life­long Fam­i­lies mod­el for repli­ca­tion, Casey is devel­op­ing fideli­ty” mea­sures to ensure that prac­ti­tion­ers adhere to the model’s core components.

We have tak­en proven best prac­tices in the field and blend­ed them togeth­er in one uni­fied whole,” explains Lau­ren Frey, per­ma­nen­cy direc­tor for Casey Fam­i­ly Ser­vices. Many chil­dren in fos­ter care have com­part­men­tal­ized the rela­tion­ships in their lives and have had to end some in order to begin oth­ers,” notes Frey. Bring­ing all those rela­tion­ships into the pic­ture and talk­ing about them is impor­tant, and bring­ing oth­er sym­pa­thet­ic’ adults into those rela­tion­ships — coach­es, teach­ers, friends — helps these kids build extend­ed fam­i­ly relationships.”

To find and engage a poten­tial­ly per­ma­nent fam­i­ly, Frey says, We look to every­one who knows and cares about these kids for help in locat­ing a birth fam­i­ly mem­ber who may well be able to par­ent now, even though they could not in the past.” Adding to the com­plex­i­ty of the work, most chil­dren referred to Casey Fam­i­ly Ser­vices are old­er and have severe chal­lenges and needs. In 2011, 61% were age 9 or older.

In 2009, the most recent year for which the fol­low­ing data are available:

  • 50% had a failed fam­i­ly reuni­fi­ca­tion pri­or to com­ing to Casey; 
  • 50% had mul­ti­ple psy­chi­atric diagnoses; 
  • 38% had a spe­cial edu­ca­tion clas­si­fi­ca­tion; and 
  • 55% had been in group care or a psy­chi­atric hospital.

Cur­rent­ly, Casey pro­vides high-lev­el care, known as treat­ment fos­ter care, to youth in Con­necti­cut, Mass­a­chu­setts, Maine, New Hamp­shire, Rhode Island, and Ver­mont, as well as to young par­ents and their chil­dren in Bal­ti­more, Mary­land. Since Casey imple­ment­ed the Life­long Fam­i­lies mod­el in 2005, the num­ber of chil­dren and youth who achieve per­ma­nence with­in 18 months has steadi­ly increased. In 2005, 36% of youth exit­ing fos­ter care achieved per­ma­nence, 15% of whom did so with­in 18 months. In 2011, the share of youth exit­ing fos­ter care to per­ma­nent homes jumped to 58%, with 67% doing so with­in 18 months.

Pre­lim­i­nary data from 2008 through the third quar­ter of 2011 also show that:

  • In cas­es where youth were age 12 or over, 87% par­tic­i­pat­ed in their per­ma­nen­cy teams; 
  • 73% of teams involved birth fam­i­ly member(s); 
  • 100% of teams involved fos­ter fam­i­ly member(s); 
  • 84% of youth said that their opin­ions were includ­ed in their plans; and 
  • 77% of team par­tic­i­pants inter­viewed said that the plans addressed all of their concerns.

One of the most sig­nif­i­cant gains, in the view of Diane Kindler, Casey Fam­i­ly Ser­vices clin­i­cal direc­tor, is that we are much clear­er about work­ing on trau­ma, and that strength­ens the mod­el.” Whether the per­ma­nen­cy goal is reuni­fi­ca­tion, adop­tion, or guardian­ship, she notes, every­one involved needs to under­stand the long-term impact of trau­ma, which most fos­ter chil­dren have experienced.

Of the chil­dren and youth in the care of Casey Fam­i­ly Ser­vices, a third reuni­fy with birth fam­i­lies; a third are adopt­ed or in the guardian­ship of kin; and a third leave to live inde­pen­dent­ly. Casey is work­ing to ensure that all leave with per­ma­nent fam­i­ly connections.

Ulti­mate­ly, suc­cess depends on rec­og­niz­ing that fos­ter care place­ment, no mat­ter how sta­ble and safe, is only a tool, a path­way to lead the child back to a fam­i­ly,” notes Frey, who is pleased with the promis­ing pre­lim­i­nary results of the Life­long Fam­i­lies mod­el and the inter­est sev­er­al states have shown. For Caitlin and Car­ol, per­ma­nence may come just in time. Despite her dif­fi­cul­ties with read­ing and writ­ing, Car­ol express­es it pow­er­ful­ly in her rap music lyrics:

The music of my heart is coming, 
And you will see me happy. 
Stay togeth­er. Don’t argue. Don’t say, Is this happening?’
For­get about the sad stuff. 
Some­body teas­es you…Forget about it. Don’t cry. 
Some­times fam­i­lies fly away and you miss them.
Some­times they for­get you and you miss them.
Your love is coming.”

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