Home Program

Family Connections (FC)

Topic Areas
Scientific Rating
Child Welfare Relevance
Casework Practice
3  — Promising Research Evidence
High
Interventions for Neglect
3  — Promising Research Evidence
High
Prevention of Child Abuse and Neglect (Secondary) Programs
3  — Promising Research Evidence
High

About This Program

Target Population: Families at risk for child maltreatment

For children/adolescents ages: 0 – 18

For parents/caregivers of children ages: 0 – 18

Program Overview

FC is a multifaceted, home-based service program that works with families in their homes and in the context of their neighborhoods to help them meet the basic needs of their children and prevent child maltreatment. Nine practice principles guide FC interventions: ecological developmental framework; community outreach; individualized family assessment and tailored interventions; helping alliance; empowerment principles; strengths-based practice; cultural competence; outcome-driven service plans with SMART goals; and a focus on the competence of the practitioner. Individualized family intervention is geared to increase protective factors, decrease risk factors, and target child safety, well-being, and permanency outcomes.

Program Goals

The goals of Family Connections (FC) are:

  • Strengthen family functioning
  • Enhance social support
  • Build positive parenting attitudes
  • Reduce parenting stress
  • Strengthen family resources
  • Strengthen household safety and stability
  • Support families to meet the basic needs of their children
  • Reduce the risk of child abuse and neglect

Logic Model

The program representative did not provide information about a Logic Model for Family Connections (FC).

Essential Components

The essential components of Family Connections (FC) include:

  • Intake and screening
  • Outreach and engagement
  • Emergency assistance/concrete services
  • Comprehensive family assessment including the use of standardized assessment instruments
  • Outcome driven plans with SMART goals
  • Change-focused intervention:
    • Minimum of 1 hour per week of home-based purposeful change-focused intervention targeting specific outcomes and SMART goals
    • Advocacy/service facilitation of community interventions to support families to achieve outcomes and SMART goals
  • Case plan evaluation/progress assessment (at least every 90 days after the initial case plan)
  • Case closure
  • FC philosophical principles used in the delivery of services:
    • Community outreach
    • Family assessment
    • Individualized, tailored intervention
    • Helping alliance
    • Empowerment approaches
    • Strengths perspective
    • Cultural competence
    • Developmental appropriateness
    • Outcome-driven service plans
  • FC practitioner activities:
    • Uses, at a minimum, screening criteria that indicate a risk of maltreatment based on the original screening criteria or based on locally determined risk factors for child maltreatment
    • Initiates the therapeutic relationship through face-to-face contact with the family within one business day of acceptance into the FC program
    • Is assigned to work with the qualified family on an ongoing basis
    • Provides at least one hour of face-to-face FC services to families at least once per week for at least three months
    • Provides most FC services in the community, meeting families where they live
    • Uses standardized clinical assessment instruments to guide the identification of risk and protective factors associated with child maltreatment as part of the comprehensive family assessment
    • Provides emergency/concrete services to address initial concrete needs and additional concrete on an ongoing basis as needed
    • Conducts comprehensive family assessments to guide the service delivery process
    • Develops outcome-driven case plans geared to decrease risk and increase protective factors associated with child maltreatment
    • Delivers tailored and direct therapeutic services to help families reduce risks, maximize protective factors, and achieve service outcomes and goals
    • Advocates on behalf of families in the community and facilitates services delivery by other organizations/individuals
  • FC program leadership activities:
    • Provides a minimum of 1 hour of individual supervisory coaching to each practitioner
    • Provides a minimum of 1 hour of group supervisory coaching each week
    • Implements an assessment of individual and organizational readiness and assessment of organizational culture and climate and develops and implements strategies to support implementation
    • Tailors the intervention manual with state/local policies and procedures including link to information systems
    • Develops and employs an implementation leadership team
    • Develops and implements an implementation work-plan
    • Forms and utilizes a community advisory committee that incorporates consumer input
    • Implements process for evaluation of client change over time and at case closing
    • Self-evaluation of fidelity and participation in external assessments of fidelity at least every six months, and use of results to implement improvement strategies

Program Delivery

Child/Adolescent Services

Family Connections (FC) directly provides services to children/adolescents and addresses the following:

  • Externalizing and internalizing behaviors, inconsistent school attendance, antisocial behaviors

Parent/Caregiver Services

Family Connections (FC) directly provides services to parents/caregivers and addresses the following:

  • Poor household conditions, financial stress, inadequate social support, parenting stress and poor parenting attitudes, unsafe caregiver/child interactions, poor family functioning, poor adult functioning (e.g., mental health problems/substance abuse) that impacts parenting, poor family resources

Recommended Intensity:

A minimum of one hour of face-to-face contact between the social worker and clients weekly

Recommended Duration:

3-4 months with an optional 90-day extension if needed

Delivery Settings

This program is typically conducted in a(n):

  • Birth Family Home
  • Community-based Agency / Organization / Provider

Homework

Family Connections (FC) includes a homework component:

It is structured in the case plans that specify family activities/tasks that family members complete in between weekly sessions targeted toward outcomes and SMART goals.

Languages

Family Connections (FC) has materials available in languages other than English:

Cambodian, Korean, Spanish

For information on which materials are available in these languages, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

  • Trained social worker
  • Office space
  • Computer and printer
  • Mobile device to facilitate computer assisted interviews (incorporating standardized assessment instruments) with families in their home
  • Transportation for meeting clients in their homes and in other community settings
  • Emergency/concrete needs fund
  • Weekly individual and group supervision
  • Quality Improvement system for tracking outputs and change over time in outcomes

Manuals and Training

Prerequisite/Minimum Provider Qualifications

Master's level worker or Bachelor's level worker supervised by a staff member with a Master's degree or higher

Manual Information

There is a manual that describes how to deliver this program.

Training Information

There is training available for this program.

Training Contact:
Training Type/Location:

Onsite at replicating agency or in a region accessible by multiple agencies, delivered by a FC training and technical assistance team affiliated with ACTION for Child Protection. Options for delivering some program content online are available. Agencies may collaborate to share the costs of implementation through Learning Collaboratives.

Number of days/hours:
  • Two Days of training for supervisors and managers focused on supervisory coaching.
  • Five days of training for supervisors and workers split in 3 phases with practice in between phases focused understanding and practice of the core components.
  • Follow-up technical assistance and coaching individualized to site, targets supervisors to practice coaching skills and steps.

Implementation Information

Pre-Implementation Materials

There are pre-implementation materials to measure organizational or provider readiness for Family Connections (FC) as listed below:

Assessments of Individual and organizational readiness and of organizational culture and climate are available.

Formal Support for Implementation

There is formal support available for implementation of Family Connections (FC) as listed below:

Training and technical assistance (including coaching) is provided by a team at ACTION for Child Protection.

Fidelity Measures

There are fidelity measures for Family Connections (FC) as listed below:

There are two fidelity instruments available for use: the Fidelity Self-Assessment and the Case Review Instrument.

Implementation Guides or Manuals

There are implementation guides or manuals for Family Connections (FC) as listed below:

A Replication Implementation Manual was developed for the 8 federally funded sites. Current replications collaborate with the FC Technical Assistance Team during the installation stage to develop an implementation work plan.

Research on How to Implement the Program

Research has been conducted on how to implement Family Connections (FC) as listed below:

  • Filene, J. H., Brodowski, M. L., & Bell, J. (2014) Using cost analysis to examine variability in replications of an efficacious child neglect prevention program. Journal of Public Child Welfare, 8(4), 375-396. doi:10.1080/15548732.2014.939249

Relevant Published, Peer-Reviewed Research

Child Welfare Outcomes: Safety and Child/Family Well-Being

DePanfilis, D., & Dubowitz, H. (2005). Family Connections: A program for preventing child neglect. Child Maltreatment, 10(2), 108–123. https://doi.org/10.1177/1077559505275252

Type of Study: Randomized controlled trial
Number of Participants: 154 families

Population:

  • Age — Adults: 19–72 years; Children: Newborn–20 years
  • Race/Ethnicity — Adults: 88% African American; Children: 86% African American
  • Gender — Adults: 98% Female; Children: Not specified
  • Status — Participants were referred due to concerns about neglect, but not currently involved with child protective services.

Location/Institution: Baltimore

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to report the results of an initial evaluation of two versions of Family Connections (FC). Participants were randomly assigned to receive FC for either 3- or 9-months. Measures utilized include the Center for Epidemiologic Studies-Depression Scale (CES-D), the Parenting Stress Index, the Everyday Stressors Index, the Adult-Adolescent Parenting Inventory, the Parenting Sense of Competence Scale, the Self-Report Family Inventory, the Social Provisions Scale, the Child Well-Being Scales, and the Child Behavior Checklist. Results indicate that there were positive changes in protective factors (parenting attitudes, parenting competence, and social support); diminished risk factors (depressive symptoms, parenting stress, life stress); improved safety (physical and psychological care of children); and improved behavior (decreased internalizing and externalizing). There was no advantage seen in the 9-month versus the 3-month intervention with the exception of child behavior. Families served for 9 months demonstrated greater or more sustained reported improvements in child behavior. Limitations include small sample, length of follow-up, and a possible self-selection bias of families willing to accept a home-based intervention.

Length of controlled postintervention follow-up: 6 months.

Girvin, H., DePanfilis, D., & Daining, C. (2007). Predicting program completion among families enrolled in a child neglect prevention intervention. Research on Social Work Practice, 17(6), 674-685. https://doi.org/10.1177/1049731507300285

Type of Study: Randomized controlled trial
Number of Participants: 136 families

Population:

  • Age — Adults: 19–72 years; Children: Newborn–20 years
  • Race/Ethnicity — Adults: 88% African American; Children: 86% African American
  • Gender — Adults: 98% Female; Children: Not specified
  • Status — Participants were referred due to concerns about neglect, but not currently involved with child protective services.

Location/Institution: Baltimore

Summary: (To include basic study design, measures, results, and notable limitations)
The study used a subset of the same sample as DePanfilis & Dubowitz (2005). The purpose of the study was to examine the factors that predict program completion among families enrolled in Family Connections (FC). Participants were randomly assigned to receive either 3- or 9-months of services. Measures utilized include the Center for Epidemiologic Studies-Depression Scale (CES-D), the Everyday Stressors Index, the Helping Relationship Inventory, and the Parent Outcome Interview. Results indicate that more families in the 3-month condition completed services. Those who completed also had significantly more children and reported a better alliance with their worker. Depressive symptoms also correlated with higher completion rates. Limitations include that research has not yet been done to show a link between completion rates and outcomes, high attrition, and length of follow-up.

Length of controlled postintervention follow-up: 6 months.

DePanfilis, D., Dubowitz, H., & Kunz, J. (2008). Assessing the cost-effectiveness of Family Connections. Child Abuse & Neglect, 32(3), 335–351. https://doi.org/10.1016/j.chiabu.2007.06.005

Type of Study: Randomized controlled trial
Number of Participants: 154 families

Population:

  • Age — Adults: 19–72 years; Children: Newborn–20 years
  • Race/Ethnicity — Adults: 88% African American; Children: 86% African American
  • Gender — Adults: 98% Female; Children: Not specified
  • Status — Participants were referred due to concerns about neglect, but not currently involved with child protective services.

Location/Institution: Baltimore

Summary: (To include basic study design, measures, results, and notable limitations)
The study used the same sample as DePanfilis & Dubowitz (2005). The purpose of the study was to assess the cost-effectiveness of two alternate forms of Family Connections (FC), in relation to changes in risk and protective factors and improvements in child safety and behavioral outcomes. Participants were randomly assigned to receive FC for either 3- or 9-months. Measures utilized include the Center for Epidemiologic Studies-Depression Scale (CES-D), the Parenting Stress Index, the Everyday Stressors Index, the Adult-Adolescent Parenting Inventory, the Parenting Sense of Competence Scale, the Self-Report Family Inventory, the Social Provisions Scale, and the Child Well-Being Scales. Results indicate that the 3-month intervention was more cost effective than the 9-month intervention in relation to positive changes in risk and protective factors and child safety. However, cost-effectiveness analysis indicated that the 9-month intervention was more cost effective (CE ratio=$276) than the 3-month intervention (CE ratio=$337) in relation to improved unit changes in the child’s behavior between baseline and 6 months after service closure. Limitations include the limited length of follow-up, may not be generalizable to other families served by similar or other prevention programs, and reliance on self-reported measures.

Length of controlled postintervention follow-up: 6 months.

Theriot, M. T., O-Day, K. R., & Hatfield, K. (2009). Client and service use predictors of successfully completing a child maltreatment prevention program. Protecting Children, 24(3), 39–50.

Type of Study: Randomized controlled trial
Number of Participants: 94

Population:

  • Age — Mean=30.5–33.9 years
  • Race/Ethnicity — 56 African American
  • Gender — Not specified
  • Status — Participants were identified as high-risk for child maltreatment by local schools, social service agencies, the court system, or medical settings.

Location/Institution: Knoxville, Tennessee

Summary: (To include basic study design, measures, results, and notable limitations)
The purpose of the study was to report on findings from the Bridging the Gap program, which replicated Family Connections (FC) with a population very similar to the one served by the original FC program in Baltimore. Participants were randomly assigned to receive 3- or 9-month interventions. Measures utilized include the Center for Epidemiologic Studies Depression Scale (CES-D), the Pearlin Mastery Scale, the Everyday Stressors Index (ESI), the Support Functions Scale (SFS), and the CAGE Questionnaire Adapted to Include Drugs (CAGE-AID). Results indicate that participants in the 3-month treatment group are more likely to complete the program than participants in the 9-month. Results also found that difficulties completing the program were associated with housing problems and having more children in a family. Limitations include small sample size, and lack of follow-up.

Length of controlled postintervention follow-up: None.

Lindsey, M. A., Hayward, R. A., & DePanfilis, D. (2010). Gender differences in behavioral outcomes among children at risk of neglect: Findings from a family-focused prevention intervention. Research on Social Work Practice, 20(6), 572–581. https://doi.org/10.1177/1049731509349713

Type of Study: Randomized controlled trial
Number of Participants: 265 (154 Adults, 111 Children)

Population:

  • Age — Adults: 19–72 years; Children: 5–11 years
  • Race/Ethnicity — Adults: 88% African American; Children: 86% African American, 11% Caucasian, and 3% Other
  • Gender — Adults: 98% Female; Children: 67 Male and 44 Female
  • Status — Participants were families at risk for neglect or abuse.

Location/Institution: Baltimore's Westside Empowerment Zone

Summary: (To include basic study design, measures, results, and notable limitations)
The study used the same sample as DePanfilis & Dubowitz (2005). The purpose of the study was to examine the impact of the Family Connections (FC) intervention on preventing behavioral problems among urban, predominantly African American children at risk of neglect. Participants were randomly assigned to one of four conditions: (a) FC intervention for 3 months; (b) FC intervention for 3 months enhanced with group intervention; (c) FC intervention for 9 months; or (d) FC intervention for 9 months enhanced with group intervention. Measures utilized include the Child Behavior Checklist (CBCL). Results indicate that from intake to closing, boys appeared to experience a larger decrease in internalizing and externalizing behaviors than girls. At follow-up, boys’ behaviors remained stable relative to results at closing, and girls showed a slight decrease in behaviors over the same period. Findings also indicate a greater decrease in problem behaviors for participants in the 9-month versus 3-month version of FC. Limitations include lack of a no treatment control group, reliance on self-reported measures, limited length of follow-up, and possible variation in the implementation of FC across providers.

Length of controlled postintervention follow-up: 6 months.

Additional References

Collins, K. S., Strieder, F., DePanfilis, D., Tabor, M., Freeman, P., Linde, L., & Greenberg, P. (2011). Trauma Adapted Family Connections (TA-FC): Reducing developmental and complex trauma symptomatology to prevent child abuse and neglect. Child Welfare, 90, 29-47.

DePanfils, D. (2015). Family Connections: Using collaborative partnerships to support dissemination. New Directions in Child and Adolescent Development, 149, 57–67. https://doi.org/10.1002/cad.20113

Lindsey, M. A., Hayward, R. A., & DePanfilis, D. (2010). Gender differences in behavioral outcomes among children at risk of neglect: Findings from a family-focused prevention intervention. Research on Social Work Practice, 20(6), 572-581. https://doi.org/10.1177/1049731509349713

Contact Information

Diane DePanfilis, PhD, MSW
Title: Professor
Agency/Affiliation: Hunter College
Department: Silberman School of Social Work
Website: action4cp.org/our-services/family-connections
Email:
Phone: (917) 435-2296

Date Research Evidence Last Reviewed by CEBC: September 2022

Date Program Content Last Reviewed by Program Staff: March 2020

Date Program Originally Loaded onto CEBC: May 2008