Implementation

Child welfare systems can upgrade their services to foster and kinship families by providing evidence-based support and parenting skills offered by the KEEP® program. The KEEP implementation team provides the planning, training, tools and support necessary to get started and to ensure success and sustainability. Implementation of KEEP involves the following:

  • Initial discussions about the model and how it fits with current practice
  • Readiness planning including development of an implementation timeline
  • Comprehensive five-day training for group leaders
  • Weekly coaching support for group leaders
  • Implementation progress reviews
  • Monitoring of fidelity to the KEEP model
  • Ongoing tech support for implementation


Sustainability

After conducting three 16-week groups with intensive support from the KEEP implementation team, group leaders who meet performance criteria can become KEEP certified group leaders. Certified group leaders can continue to run KEEP groups with bi-annual fidelity checks conducted by the implementation team.

To develop your own program infrastructure, certified group leaders can become KEEP local coaches and trainers. This involves five additional days of training and 6-12 months of ongoing contact with the implementation team.

For more information about implementing KEEP, listen to this inSocialWork podcast episode or look through these Frequently Asked Questions:

Q: Does KEEP replace the pre-service training foster parents complete before a child enters their home?

No. Parents who participate in KEEP have completed their state’s pre-service training requirements. KEEP is an additional support for the foster parents once they receive a placement. In all of our implementations so far, KEEP training has met the requirements for the foster parents’ mandated ongoing yearly training.

Q: How do you get foster parents to attend the groups?

Sessions are interactive and fun. In addition, foster/kin parent participation is incentivized. For example, in Oregon, each household receives $20 for each KEEP session they attend. In Tennessee, KEEP-certified foster homes receive an $1.50/day increase to their board rate. In some implementations, parents receive an additional bonus for graduating from a KEEP group.

Q: What are the requirements for graduating from KEEP?

In order to graduate, parents must complete at least 80% of the KEEP sessions. KEEP Group Leaders also offer make-up sessions for parents who miss a KEEP group session. The make-up sessions count towards that 80% attendance, but parents do not receive a weekly incentive for these home sessions.

Q: Do you offer childcare?

Yes. Sites that implement KEEP provide free childcare at the group location and snacks during the groups.

Q: Have you seen different outcomes for kinship and non-kinship families?

The baseline rates for disruption in kin and non-kin placements vary significantly. For example, in San Diego, the base rate for disruption in kin placements is about 9%, and 45-48% from non-relative placements. Therefore, for KEEP we see changes in disruption rates only for non-relative homes. However, data show reductions in the level of child problem behaviors and associated caregiver stress for both foster and kinship homes.

Q: Are kin and non-kin parents in same groups?

Yes, KEEP groups are a mix of kinship and non-relative parents. About 30% of overall participants in KEEP are kinship parents.

Q: Is there a supervision component?

Yes. Each KEEP session is recorded and uploaded to FIDO, our web-based fidelity system. KEEP Group Leaders fill out simple forms about attendance, engagement, and areas they want feedback on. The Parent Daily Report (PDR) is also uploaded to this system. Group leaders receive weekly coaching via videoconference and written feedback from a KEEP coach. Monthly reports are generated using FIDO data and are sent to sites and to system leaders (if applicable).

Q: Can you expand the model for older kids?

Yes. We have a program called KEEP SAFE that is designed for adolescents.

Q: What about timeline and costs?

We answer that question with a question: How many foster families to do you want to serve and on what timeline? This information determines how many groups you need to run and how many KEEP Group Leaders will need to be trained in order to set up a sustainable program.

Q: Have you done a cost-benefit analysis?

Not yet. NYC calculated that if they reduced disruptions by 17%, the program would be cost-neutral.

Q: Is Tele-KEEP available everywhere?

Not yet. Currently, Tele-KEEP is only available in parts of Oregon. We are happy to talk with you about whether Tele-KEEP could be a good fit for your community.

Model Developers

Our implementation team includes the researchers and clinicians who developed and tested the effectiveness of the KEEP® model.

Patricia Chamberlain, PhD, is the Science Director at the Oregon Social Learning Center (OSLC). OSLC is a nonprofit organization dedicated to conducting research to benefit families. Dr. Chamberlain developed the KEEP model and was the principal investigator on the National Institutes of Health randomized controlled trials that demonstrated its effectiveness. She is also founder of the Treatment Foster Care Oregon (TFCO) model (formerly Multidimensional Treatment Foster Care; MTFC).

Joseph Price, PhD, is a Professor of Psychology at San Diego State University and a research scientist at the Child and Adolescent Services Research Center (CASRC) in San Diego. Dr. Price was a co-investigator the National Institutes of Health randomized controlled trials that demonstrated KEEP’s effectiveness.

JP Davis was the lead clinician on the KEEP and TFCO clinical trials. She has more than 20 years of experience working with foster and kinship parents and with children and adolescents with behavioral and mental health problems. She is currently the Senior Clinical Supervisor for the KEEP team.

KEEP Sites

KEEP® is currently supporting foster families in the following locations:

  • Oregon
  • California
  • New York City
  • Tennessee
  • Denmark
  • United Kingdom
IMPLEMENTATION STORIES

‘Innovative Program Reduces the Number of Children in Foster Care’ 

Bill Baccaglini, director and CEO of The New York Foundling, discusses Child Success New York City (CSNYC) in The Huffington Post. CSNYC is a reform effort to implement KEEP, Parent Management Training, and R3 in five private child welfare agencies in New York City, including the Foundling.

Child Success New York City, an innovative program launched by New York City and implemented by several foster care agencies, aims to improve those children’s lives, by providing greater stability while they’re in foster care and a greater likelihood that they’ll be able to return to their natural families. To date, this program has shown very promising results and could prove to be a model for the future.

Thus far, the program has shown compelling results. A test group of 2,000 children who participated in Child Success NYC were 11% more likely to return home compared to their peers who received traditional services. That means there are many more children than usual who are back with their families, or in a permanent home who otherwise might be continuing in foster care.

While Child Success NYC is one of a number of initiatives the City has undertaken to reduce the foster care population, it is certainly contributing to the reduction of children in foster care in New York and we look forward to continued innovation and success.

‘We Are a Family Here’

The Tennessee Department of Children’s Services newsletter features this article about their goals and experiences to date implementing KEEP–and foster parents’ feedback about the style and content of the groups.

KEEP is an integral part of a federally sponsored pilot program in Tennessee that, if it all works as expected, will safely reduce the overall number of children in state custody. Make fostering a smoother, calmer experience for everyone, and the kids will reap the benefits. Foster parents will feel more competent and confident. Children will experience fewer disruptions and better outcomes.

And that, many DCS workers, planners, data analysts and administrators believe, will lower overall custody rates – the goal shared by the federal government, which funds the bulk of the state’s foster care programs. If it works as predicted, KEEP and the other strategies associated with Tennessee’s federal waiver program, will roll out across the state.

In short, it promises to revolutionize foster care in Tennessee.