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Keeping Foster and Kin Parents Supported and Trained

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Evidence rating: 2+
Cost rating: 2

Keeping Foster and Kinship Parents Trained and Supported (KEEP) is a group-based programme for foster and kinship carers responsible for a child between the ages of 5 and 12 years with behavioural difficulties.

Foster carers attend 16 weekly sessions where they learn practical methods for developing a positive relationship with the children in their care and managing difficult child behaviour.

EIF Programme Assessment

Evidence rating: 2+
Level 2 indicates that the programme has evidence of improving a child outcome from a study involving at least 20 participants, representing 60% of the sample, using validated instruments. This programme does not receive a rating of 3 as its best evidence is not from a rigorously conducted RCT or QED evaluation
Cost rating: 2
A rating of 2 indicates that a programme has a medium-low cost to set up and deliver, compared with other interventions reviewed by EIF. This is equivalent to an estimated unit cost of €125 - €599. This figure is based on an analysis of UK costs and a conversion rate of 1.19.

What does the plus mean?

The plus rating indicates that a programme’s best available evidence is based on an evaluation that is more rigorous than a level 2 standard but does not meet the criteria for level 3.

Child outcomes

This programme can affect outcomes for children in Active and healthy, physical and mental wellbeing.

According to the best available evidence for this programme's impact, it can achieve the following positive outcomes for children:

Preventing child maltreatment

Improved placement stability

based on study 2

Preventing crime, violence and antisocial behaviour

Improved child behaviour

based on study 1

based on study 2

This programme also has evidence of supporting positive outcomes for couples, parents or families that may be relevant to a commissioning decision. Please see About the evidence for more detail.

Who is it for?

The best available evidence for this programme relates to the following age-groups:

Primary school

How is it delivered?

The best available evidence for this programme relates to implementation through these delivery models:

  • Group

Where is it delivered?

The best available evidence for this programme relates to its implementation in these settings:

  • Home
  • Community centre

How is it targeted?

The best available evidence for this programme relates to its implementation as:

  • Targeted selective

Where has it been implemented?

  • Denmark
  • Sweden
  • United Kingdom
  • United States

Ireland provision

This programme has not been implemented in Ireland.

Ireland evaluation

This programme’s best evidence does not include evaluation conducted in Ireland.

About the programme

What happens during the delivery?

How is it delivered?

  • KEEP is delivered in 16 sessions of 1.5 hours’ duration each by two practitioners to groups of 7-10 foster carers.

What happens during the intervention?

  • The primary aim of KEEP is to help foster and kinship carers learn effective strategies for managing unwanted child behaviour and emotional problems.
  • These strategies include effective use of the 5:1 rule, meaning that carers should aim to positively reinforce the child at least five times for every one time they correct or discipline the child.
  • The curriculum is heavily informed by social learning theory, but carers are helped to fit the techniques specifically to the child they are looking after.
  • Carers are also given many opportunities to learn and practise non-harsh methods of discipline, including the use of time-out (Take a Break) and the removal of privileges.
  • The facilitators use a mixed methods approach to delivering the content with a strong focus on carer participation.

What are the implementation requirements?

Who can deliver it?

  • The two practitioners who deliver this programme are KEEP facilitators with NFQ-7/8 level qualifications.


What are the training requirements?

  • Practitioners have 37 hours of programme training. 
  • Booster training of practitioners is recommended.

How are the practitioners supervised?

  • It is recommended that practitioners are supervised by one programme developer supervisor (qualified to NFQ 9/10 level) and one host-agency supervisor (qualified to NFQ-7/8 level), with 37 hours of programme training.


What are the systems for maintaining fidelity?

Programme fidelity is maintained through the following processes:

  • Training manual
  • Other printed material
  • Video or DVD training
  • Face-to-face training
  • Fidelity monitoring
  • KEEP-Up sessions (2x per year).

Is there a licensing requirement?

There is no licence required to run this programme.


How does it work? (Theory of Change)

How does it work?

  • Child behavioural problems are the primary reason for breakdowns in foster care placements.
  • Child behavioural problems are rooted in maladaptive and ‘coercive’ parent/child interactions.
  • Foster and kinship carers are trained to reduce children’s negative behaviour through the use of effective parenting practices.
  • In the short term, children’s behaviour improves and foster carers experience less stress.
  • In the longer term, children have greater placement stability and increased likelihood of reunification with their parents.
  • Foster parents also receive greater personal satisfaction and are more likely to experience more positive placements in the future.

Intended outcomes

  • Achieving in all areas of learning and development
  • Active and healthy, physical and mental wellbeing
  • Active and healthy, physical and mental wellbeing
  • Active and healthy, physical and mental wellbeing

Contact details

Colin Waterman
Director (and Systemic Family Psychotherapist) 
National Implementation Service
colin.waterman@mft.nhs.uk

www.evidencebasedinterventions.org.uk
www.oslc.org
www.oslcdevelopments.org


About the evidence

KEEP has preliminary evidence from two pre-post studies conducted in the UK and USA. These studies identified statistically significant positive impact on a number of child and parent outcomes. Each study is rated as level 2 and so, the programme receives a level 2 rating overall.

Study 1

Citation:Warburton & Glynn. (2015)
Design:Pre-post
Country:United Kingdom
Sample:869 children (average age 8 years 8 months)
Timing:Post-test
Child outcomes:
  • Improved child behaviour
Other outcomes:
  • Improved parental discipline style
Study rating:2

Warburton, J., Glynn, G. (2015). NIS Programme Report - KEEP Keeping Foster and Kinship Carers Trained and Supported. National Implementation Service.

Request acess by contacting
joanna.warburton@cmft.nhs.uk

Roberts, R., Glynn, G., & Waterman, C. (2016). “We know it works but does it last?” The implementation of the KEEP foster and kinship carer training programme in England. Adoption & Fostering, 40(3), 247-263.

Available at
http://journals.sagepub.com/doi/abs/10.1177/0308575916657956

Rowan H. (2017). KEEP Update Day Audit. National Implementation Service.

Request access by contacting
joanna.warburton@cmft.nhs.uk

Study Design and Sample

This study is a pre-post study, conducted in the UK. The study included a sample of 849 children and KEEP carers who received the standard KEEP programme.

The children in the sample were on average 8 years 8 months old, and in the vast majority of cases there were behavioural concerns. In terms of ethnicity, 82.3% of the children were White, 7.2% were Black British/Black Other, 3.9% were Asian British/Asian Other, and 7.6% were of mixed heritage.

Measures

  • Child behaviour problems were measured using the Strengths and Difficulties Questionnaire (carer report).
  • Parental discipline styles were measured using the Parenting Scale (carer report).

Findings

At post-test this study identified statistically significant positive impact on a number of child and parent outcomes, including:

  • Child behaviour (Strengths and Difficulties Questionnaire; carer report)
  • Parental discipline style (Parenting Scale; scale).

Study 2

Citation:Greeno et al., (2016)
Design:Pre-post
Country:United States
Sample:65 children (average age 7 years 7 months)
Timing:Post-test
Child outcomes:
  • Improved placement stability
  • Improved child behaviour
Other outcomes:
    Study rating:2

    Greeno, Elizabeth J., Mathew C. Uretsky, Bethany R. Lee, Jessica E. Moore, Richard P. Barth, and Terry V. Shaw. (2016) Replication of the KEEP Foster and Kinship Parent Training Program for Youth with Externalizing Behaviors. Children and Youth Services Review 61 (February 1, 2016): 75–82.

    Available at
    https://www.researchgate.net/profile/Elizabeth_Greeno/publication/286927400_Replication_of_the_KEEP_Foster_and_Kinship_Parent_Training_Program_for_Youth_with_Externalizing_Behaviors/links/568add9b08ae1975839db8e2/Replication-of-the-KEEP-Foster-and-Kinship-Parent-Training-Program-for-Youth-with-Externalizing-Behaviors.pdf

    Study Design and Sample

    This study is a pre-post study, conducted in the USA. The study included a sample of 65 children and KEEP carers who received the standard KEEP programme.

    The children in the sample were on average 7 years 7 months old. In terms of ethnicity, 48% of children were Black, 32% were White, 17% were classified as Other, and 3% were of unknown ethnicity. 

    Measures

    • Child behaviour problems were measured using the Child Behaviour Checklist (carer report).
    • Placement stability and permanency were assessed using state administrative data (administrative data).

    Findings

    This study identified statistically significant positive impact on a number of child and parent outcomes, including:

    • Child behaviour on the Child Behaviour Checklist (carer report)
    • Placement stability (administrative data). 

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