The Family First Prevention Services Act (FFPSA) was created to protect and empower children in the welfare system.
While previously, states could only use certain Social Security funds to finance foster care, the FFPSA allows states to use these funds to provide parental training, mental health services, and substance abuse treatment for children and their families in the child welfare system. The FFPSA empowers families at risk of separation, thus reducing the need for children to be placed in foster care.
However, these funds can only be used to finance evidence-based practices (EBPs) — programs researched, tested, and proven to work — to help children and families. To help practitioners select EBPs, the Clearinghouse offers a list of these programs, each carefully checked and rated for effectiveness.
While the Clearinghouse is designed to be user-friendly, it’s not always easy to know where to start when selecting an EBP from the FFPSA Clearinghouse. In this article, we'll look at important factors to consider when choosing an EBP, from practicality to levels of evidence. We'll end by focusing on Multisystemic Therapy (MST), a program that fits well with the goals of the FFPSA.
Alignment with Service Population and Needs
Choosing the right EBP starts with knowing who you're helping. It's about understanding their specific needs and the challenges they face. You want a program that matches the people it's meant for, reflecting their culture, life experiences, and the problems they need help with.
It's also about where the program will be used. It's essential that the program addresses the issues people are facing and supports their overall growth and well-being in that specific setting.
Level of Evidence
The FFPSA Clearinghouse doesn’t simply label programs as “evidence-based” or “not evidence-based.” Instead, it categorizes EBPs into levels of evidence, ranging from "promising" to "well-supported."
This categorization provides insights into the effectiveness of each program. Knowing these levels helps us understand how reliable and effective each program is.
However, selecting an EBP solely based on its level of evidence can be simplistic. It's also important to consider how well the program fits the population it's meant for and whether it can be adapted to different settings and communities.
Adaptability to the Local Context
An EBP needs to be flexible — it should be able to fit into the local culture and core values/beliefs of those it is designed to serve. A critical question to ask is whether an intervention can be tailored to align with cultural norms, values, and preferences.
This kind of adaptability ensures the program isn't just dropped into a community but is woven into it, respecting and responding to the unique needs of people. Practices that offer flexibility in delivery while maintaining core components tend to be more effective in diverse settings.
Feasibility and Fit with Existing Resources
When putting an EBP into practice, it's crucial to think about whether it's practical.
The practicality of implementing an EBP is as important as its effectiveness. Does the organization or community have what it needs to run the program properly? This includes having the right resources, being able to train staff, and the ability to adhere to program fidelity.
Taking into account these aspects ensures that the program is not implemented without considering its feasibility. But can be executed efficiently while having resources and processes in place to keep evolving and adapting to serve its intended beneficiaries in the best possible way.
FFPSA & MST
Multisystemic Therapy (MST) is an excellent example of an EBP that the FFPSA Clearinghouse supports.
Specifically, the Clearinghouse supports Multisystemic Therapy – Building Stronger Families (MST-BSF), an adaptation of MST that is designed specifically for families with children aged 6-17 who come under the guidance of child protective services due to co-occurring parental substance use and physical abuse or neglect of a child.
The MST Model is flexible and tailors engagement strategies and interventions to the needs of each client. MST therapists meet with caregivers and young people in various locations within their ecology (e.g., in their homes, communities, and schools )
MST works by providing families with whichever interventions they might need, including but not limited to:
- Substance use interventions
- Parental training
- Mental health symptoms treatment
- Crisis support
- School and vocational support
- Family therapy
MST often connects families with resources that support their overall treatment progress while maintaining alignment with their ecology. For example, MST might engage with local community programs, psychiatrists, and prosocial activities where necessary. This is one of the reasons why MST is highly cost-effective.
Beyond being cost-effective, MST’s evidence base is substantial. Research demonstrates that MST is effective at helping children and their families.
For example, in studies on Multisystemic Therapy for Child Abuse and Neglect (MST-CAN):
- 95% of families have no re-abuse incidents
- 86% of children remain at home
- 91% of youth leave the program without symptoms of post-traumatic stress disorder (PTSD)
MST aimed at juvenile offenders also works well, resulting in the following:
- 54% fewer rearrests over a 14-year period
- 75% fewer violent felony arrests over a 22-year-period
- 54% fewer out-of-home placements
MST families experience:
- 40% reduction in sibling arrests
- 55% reduction in sibling felony arrests
- 94% fewer caregiver felonies
- 70% fewer caregiver misdemeanors
Generally speaking, research shows that MST also reduces:
- behavioral problems
- family problems
- mental health crises
- need for psychiatric hospitalization
- substance abuse
MST not only meets the high standards of the FFPSA but also serves as a model for how EBPs can effectively address complex social issues in various community settings.
Read our whitepaper on The Family First Prevention Services Act and Multisystemic Therapy here.
Choosing an EBP: Final Thoughts
When selecting an EBP from the FFPSA Clearinghouse, practitioners must balance multiple considerations. The program should fit the people it's helping, be right for the local community, have strong evidence behind it, and be practical to use.
Multisystemic Therapy is a good example of an evidence-based intervention that offers effective, culturally responsive services with a focus on long-term maintenance of gains for young people and their families.
By making informed choices, we can ensure we're offering the best possible help to children and families, improving the overall quality of care in child and family welfare systems.
MST is an evidence-based alternative to incarceration or severe system consequences due to serious externalizing, anti-social, and/or criminal behaviors. MST effectively treats young people and their families by utilizing a built-in suite of interventions within the home, school, and community settings. Treatment is tailored to the family and their individual strengths and needs, which could include but is not limited to the following types of therapies: Family Therapy, Cognitive Behavioral Therapy, Drug and Alcohol Treatment, Mental Health Services, Peer Ecology Assessment and Intervention, Trauma-informed treatment, and Educational/ Vocational Support.
If you or someone you know is interested in learning more about Multisystemic Therapy, contact us here.