The Dutch Families First Effectiveness Study

In this study the hypothesis is being tested that in case of a family crisis
that heightens the risk of an out-of-home placement of one or more children a
short-term intensive family treatment (Families First) will be more effective
than an out-of-home placement in residential or foster care.

The study addresses the following research questions:
1. Do children who receive Families First have fewer days in out-of-home
placement than children who receive residential and foster care services?
2. Do children who receive Families First call upon fewer youth care services
than children who receive residential and foster care services?
3. Do children and their families who receive Families First fare better on
indicators of child well-being and family functioning, as compared to children
who receive residential or foster care services?

In addition the following research questions are answered:
1. Do children who receive Families First with strong adherence to the
treatment model have fewer days in out-of-home placement.
2. Do children who receive Families First with strong adherence to the
treatment model call upon fewer youth care services?
3. Do children who receive Families First with strong adherence to the
treatment model fare better on indicators of child well-being and family
functioning?
4. Do children who fare better on indicators of child well-being and family
functioning have fewer days in out-of-home placement than children who receive
residential and foster care services?

A random assignment procedure is used to assign children to one of the
following conditions: (1) in-home intervention (Families First), (2)
out-of-home placement (residential treatment or foster care). The out-of-home
placement is of the same length (4 weeks) as the in-home intervention. Data
will be gathered up to one year after treatment.

Families First is a family preservation program for families in crisis in which
children run the risk to be placed out-of-home. By means of a fast, short and
intensive treatment delivered at home it is attempted to decrease the risk of
placement and to increase child and family competencies. Although this program
is already being carried for several years in Dutch youth care, to date no
controlled effect study have been done.

The burden and risk are low because (1) the study examines treatments which are
already offered for several years, (2) safety of the child is an explicit
exclusion criterion, (3) questionnaires filled out by parents will not cost
much time, and (4) questionnaires filled out by parents are for the greater
part already used in the practice of Dutch youth care.