Self-reported care activities in a home-based intervention programme for families with multiple problems

Publication Date16 March 2015
Pages29-44
DOIhttps://doi.org/10.1108/JCS-07-2014-0034
AuthorTim Tausendfreund,Janneke Metselaar,Jelte Conradie,Maria Helena de Groot,Nicolien Schipaanboord,Jana Knot-Dickscheit,Hans Grietens,Erik J. Knorth
SubjectHealth & social care,Vulnerable groups,Children's services
Self-reported care activities in a
home-based intervention programme
for families with multiple problems
Tim Tausendfreund, Janneke Metselaar, Jelte Conradie, Maria Helena de Groot,
Nicolien Schipaanboord, Jana Knot-Dickscheit, Hans Grietens and Erik J. Knorth
Tim Tausendfreund is
PhD Candidate and
Dr Janneke Metselaar is
Research Associate and
Lecturer, both at the Special
Needs Education and Youth
Care, University of Groningen,
Groningen, The Netherlands.
Jelte Conradie is
orthopedagoog/
onderwijsadviseur at the
Landstede Expertise VO,
Groningen, The Netherlands.
Maria Helena de Groot is Care
Worker at Salvation Army,
Groningen, The Netherlands.
Nicolien Schipaanboord is
orthopedagoog at the
Molendrift, Groningen,
The Netherlands.
Jana Knot-Dickscheit is
Assistant Professor,
Hans Grietens is Full Professor
and Erik J. Knorth is
Full Professor, all at the
Special Needs Education and
Youth Care, University of
Groningen, Groningen,
The Netherlands.
Abstract
Purpose The purpose of this paper is to describe the development and application of the KIPP-list of care
activities. The acronym KIPP stands for Knowledge and Insight into Primary Processes. The instrument is
intended as a tool for family coaches to systematically report care activities conducted in the Dutch family
support programme Ten for the Future (in Dutch: Tien voor Toekomst).
Design/methodology/approach The design of the instrument was based on the components of the
programme and a literature search for similar instruments used in the Netherlands, complemented by a staff
survey. A series of three studies was carried out to test the instruments validity and user-friendliness, and
to assess its potential for programme evaluation.
Findings The majority of care activities were performed in cooperation with one or both parents alone, and
less frequently with children or external professionals. Although the main focus of the work of the family
coaches fell into the categories of collecting informationand working towards (behavioural) change
with families, the relatively high frequency of all the types of care contacts emphasises the intensity of this
family support programme with a complex target group.
Originality/value Data gathered with the instrument provided meaningful information by descriptive
analysis. KIPP thereby proved its general feasibility in increasing insight into service provision. The instrument
can be useful in several stages and on several levels of quality assurance and service optimisation, including
reflective practice, supervision, team management and research.
Keywords Care activities, Family coaching, Family support, Primary care processes, Self-reports,
Service use, Systems orientation, Vulnerable families
Paper type Research paper
Introduction
There is considerable demand for interventions proven as effective in child welfare (Axford and
Morpeth, 2013; Carr, 2009). Evaluation studies are meant to provide knowledge about and
insight into the effects and effectiveness of interventions, and they can do so via various research
methods and with differing degrees of certainty (Veerman and Van Yperen, 2007). The focus
of evaluation studies often lies on pre-post-test designs that compare the clients situation before
the intervention to relevant outcomes after. While this method can provide valuable information
at either time, the conclusions that can be drawn about possible connections between the
intervention and the observed changes are limited if no comparison group is available or detailed
data about the inner workings of the intervention is non-existent.
Group comparisons certainly have scientific value, such as that attributed to randomised control
trials, but these are not always feasible in child and youth care (Otto et al., 2009) and may
have undesirable consequences when used for research into less controllable interventions like
DOI 10.1108/JCS-07-2014-0034 VOL. 10 NO. 1 2015, pp. 29-44, © Emerald Group Publishing Limited, ISSN 1746-6660
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family-oriented services (Boddy et al., 2011) or those with complex target groups such as families
with multiple problems (Devaney and Spratt, 2009).
Both the target group of families with multiple problems, as well as the provision of intensive
long-term family support programmes for them, are issues of international interest. The need to
specifically and adequately address this target group in child welfare has been articulated
repeatedly in publications from various countries (e.g. Morris, 2013; Sousa and Eusébio, 2007;
Spratt and Devaney, 2009) and descriptions of long-term family interventions that are geared
to specifically address the problem have been widely reported (De Melo and Alarcão, 2011;
Krasiejko, 2011; Marsh et al., 2006; McCartt Hess et al., 2000; Sousa and Rodrigues, 2012;
Thoburn et al., 2013).
For intensive home-based programmes that are accredited in the Dutch database of effective
interventions (Netherlands Youth Institute, 2014), the following characteristics have been
identified as common to best practice:
parenting-related support in the familys home, with a contact frequency of at least once a
week, aimed at multiple areas of life;
establishment of a needs-led care plan, with participation and empowerment of the family
members as guiding principles;
a systemic focus on the family as a whole, and interventions driven by social learning
theory to improve parenting skills, child behaviour and the involvement of social
networks; and
professional training and regularly performed supervision of care workers to enhance
programme integrity and advance collaborative work (Van der Steege, 2007, p. 34).
The conclusions of a recent Dutch meta-analysis on programmes for families with multiple
problems, conducted by Holwerda et al.s (2014), support these findings. Additionally they
mention two other important characteristics, namely, a relatively low caseload of five to
ten families per full-time professional and the provision of material and financial support.
The above components can be identified by compiling the features that are common in
effective or promising programmes. However, despite this progress, a lack of structural,
substantive information about direct activities in the primary care processes has been observed,
a surprising omission given that most evaluation studies focus on the outcomes of services
(Sinclair, 2010). For this reason, the primary care process has also been referred to before as a
black box(Staff and Fein, 1994), and a need for more detailed scientific insight into it has
been articulated, especially for home-based interventions such as family preservation services
(Craig-van Grack, 1997).
Intensive family support is a somewhat unstructured form of social services, given that it is
geared towards a relatively wide target group presenting a variety of problems (Morris, 2011).
One example of such a service is the Salvation Armys home-based long-term care
programme entitled Ten for the Future (TF) (in Dutch: Tien voor Toekomst), which is targeted
towards families with multiple problems with children under the age of 18. This is a wide
target group, not only because of variations in the ages of the children and parents, but also
because of the high levels of diversity in family composition, differences in levels of child
development, diverse cultural backgrounds and the number of areas in which the clients
experience difficulties.
In the period 2006-2014 a research project was carried out at the University of Groningen in
order to develop more knowledge about the characteristics of the target group and results of the
services provided in TF, as well as to gain more detailed insight into the primary care processes
intrinsic to the intervention. The research project was based on theoretical foundations about
care arrangements for families with multiple problems (Tausendfreund et al., 2012a, b), the
characteristics of the targetgroup, related client based outcomes(Tausendfreund,Knot-Dickscheit
et al., 2014) and the content of the intervention programme (the subject of this article). In TF, the
primary process the black box is shaped by the contact between the familycoaches (in Dutch:
gezinscoaches) and the clients family. Gaining insight and knowledge about these processes
through self-reported care activities would not only allow us to draw more rigorous inferences in
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