The Family First Prevention Services Act (FFPSA) is historic legislation with a noble and critical goal. It prioritizes family preservation and the well-being of young people by decreasing the necessity for placing children in foster care.
The FFPSA expands how states can spend certain Social Security funds by allowing states to allocate funds to evidence-based practices and programs offering various treatment and prevention services to children and families in the child welfare system.
The FFPSA Clearinghouse categorizes these evidence-based programs across levels—the top rating being "well-supported." But what does this mean? Why does it matter? What are the benefits? And how can you select and implement a well-supported program?
We'll answer these questions to understand not just the "what" but the “why" behind the importance of well-supported services that can transform the lives of children and families.
Understanding "Well-Supported" Programs and Services
Programs must offer mental health treatment and prevention services, substance abuse services, skills-based parental training, or kinship navigation to receive federal reimbursement under the Act.
The Prevention Services Clearinghouse, developed as part of the FFPSA, places programs, and services into four categories to demonstrate how well a program or service performs:
- Well-supported: The top-tier programs with solid evidence from studies in real-life settings that produce sustained positive effects for at least a year after treatment.
- Supported: Still strong but with slightly less evidence. These programs demonstrate positive effects for at least six months beyond treatment.
- Promising: On the rise. These programs show potential with positive effects, but there's more to learn.
- Does not currently meet criteria: If a program doesn't fit one of the above levels, it falls into this category.
In the simplest terms, well-supported programs and services are practices that stand out compared to others. These programs have been thoroughly studied and meet high standards in design and execution, often through rigorous trials.
Evaluation and Review Process of Family First Programs
To determine FFPSA-eligible programs, the Prevention Services Clearinghouse led a systematic review process that included six key steps:
- Identify Programs and Services: The Prevention Services Clearinghouse identified candidate programs and services aligned with its mission through an inclusive process. This approach actively sought recommendations from stakeholders, including states, ensuring comprehensive coverage across various programs or service areas.
- Select and Prioritize Programs: Candidate programs and services underwent assessment based on detailed eligibility criteria and were prioritized for review.
- Literature Search: The staff of the Prevention Services Clearinghouse conducts thorough literature searches to find pertinent and accessible research on the prioritized programs and services.
- Study Eligibility Screening: The studies found in the literature searches underwent screening against eligibility criteria. The studies deemed eligible for review were then assessed against prioritization criteria.
- Evidence Review: Trained reviewers assessed all eligible studies following the design and execution standards of the Prevention Services Clearinghouse. Prioritized studies received one of three ratings: high, moderate, or low support.
- Program and Service Ratings: Studies that received a high or moderate rating were considered for this last phase, evaluated further, and assessed for risk of harm. The selected programs and services were then categorized into four levels of evidence—well-supported, supported, promising, and "does not currently meet criteria."
This detailed evaluation process provides an objective, comprehensive overview of eligible, evidence-based programs (EBPs) and services. The systematic review and rating process also helps organizations and practitioners in the child welfare system make informed choices about the services they offer to those they serve.
Implementing Well-Supported FFPSA Programs and Services
Now that we understand the transformative potential behind "well-supported" programs let's explore how we can create opportunities to engage entire communities in implementing them.
Successful implementation means children accessing the support they need, families benefiting from tailored programs, and communities witnessing positive transformations. The opportunity here is nothing short of building a brighter, more resilient future for all.
Importance of Collaboration and Partnerships
Shared resources, diverse expertise, and a collective commitment can amplify the effectiveness of well-supported programs.
The practical implementation of the Family First Act relies on collaboration. For instance, a technical guide for agencies, policymakers, and other stakeholders outlines three key reasons why partnerships are critical for success:
- The provisions mandate that child welfare agencies collaborate with other public agencies with a proven track record of implementing evidence-based programs.
- The provisions related to non-family settings hinge on solid partnerships between child welfare agencies, the courts, and residential treatment centers.
- Establishing a solid partnership with foster parents and kinship caregivers is also crucial to ensuring the comprehensive support of family foster care and equipping caregivers with the necessary resources for the well-being and development of young people.
Successful implementation takes time and often involves navigating obstacles with resilience. Whether addressing logistical hurdles or adapting to evolving needs, overcoming challenges is part of the journey. But through partnership and collaboration, we can plan for potential roadblocks and leverage shared resources to overcome them.
If your organization wants to implement a well-supported EBP, make sure the program is:
- Adaptable to the local context and culture of those you serve.
- Flexible in its delivery style while maintaining core components.
- Feasible: Your organization has the necessary resources to run the program effectively.
Tailoring Well-Supported FFPSA Programs to Meet Specific Population Needs
Healthy Families America outlines the different populations that can benefit from well-supported programs and services under the Family First Act. They include:
- Children who are at imminent risk of entering foster care or candidates for entering foster care. While the legislation does not define imminent risk, agencies should explain it using broad criteria that cover young people's health, well-being, and economic stability. Each state must define the term for the services it provides.
- Parents or caregivers of foster care candidates. Particularly those who need services to prevent a young person's entry into foster care or services that directly relate to a child's permanence and well-being.
- Young people who are parenting or pregnant and currently involved in the child welfare system. Due to the intersecting needs of young parents and the intergenerational impact of the foster care system, services for this population can prevent abuse and neglect.
By understanding the needs of each of these populations and tailoring services to address them, well-supported EBPs can help keep families together. By meeting the specific needs, cultural nuances, and challenges unique to each group, well-supported services become more than interventions – they become personalized pathways to success.
The Importance of Evidence-Based Programs and Services
Choosing evidence-based programs shows a commitment to effectiveness because these programs are rooted in solid research and proven methodologies. By relying on evidence, we ensure that solutions have a track record of success, providing a reliable foundation for positive outcomes.
Better Outcomes for At-Risk Young People
Interventions with a foundational body of evidence provide a clear understanding of what works. The result? Improved well-being, strengthened family dynamics, and a lifeline for young people navigating complex challenges.
For example, Multisystemic Therapy (MST) is a well-supported FFPSA program that helps at-risk young people and their families. The program takes a holistic approach, addressing the multiple systems that impact a young person's life, such as family, school, and community. Over 70+ published studies showed that at the close of treatment, MST produced the following outcomes:
- 91% of young people live at home.
- 86% of young people are in school or working.
- 87% experienced no new juvenile arrests.
Evidence-based programs like MST pave the way for sustained positive effects, extending beyond immediate intervention. Families experience lasting improvements, and young people find enduring support that echoes through their lives.
Additionally, persistent research and evaluation of well-supported services remain critical for continued learning and improvement. By staying curious, seeking better solutions, and refining approaches, we ensure that the interventions under the Family First Act remain at the forefront of positive change.
Multisystemic Therapy (MST): A Well-Supported Family First Act Program
MST is a well-supported program with a dual focus: substance use prevention and treatment and treatment of mental health symptoms. This evidence-based program has a clear mission — empowering young people (aged 12-17) and their families for long-term success.
MST therapists provide comprehensive support in the home, school, and community. A team member is also on call 24/7 to provide support because crises can happen any time. With a commitment to individualized treatment, therapists maintain small caseloads, and the average length of treatment spans 3 to 5 months.
How MST Aligns with the Family First Act
MST mirrors FFPSA goals — keeping families together, preventing abuse and neglect, and delivering cost-effective, research-supported services. MST's individualized treatment programs work toward these same outcomes.
Research and Evidence Behind MST's Effectiveness
MST boasts an unparalleled body of evidence, with 74 studies, over $75 million in research funding, and publications in 140+ peer-reviewed journals involving 57,000 families.
The enduring impact is striking:
- 54% fewer rearrests over 14 years.
- 75% fewer violent felony arrests over 22 years.
- 54% reduction in out-of-home placements (median across all studies).
MST also delivers superior financial outcomes, with a remarkable return on investment (ROI) of up to $23.59 for every dollar spent and a net benefit of up to $200,000 per young person. MST emerges as an intervention and a transformative force with both clinical and financial benefits.
Empowering Change Through Well-Supported FFPSA Services
EBPs aren't just interventions; they're transformative forces shaping the well-being of children, families, and communities. Aligned with the Act's commitment to family preservation, well-supported programs like MST bring tailored solutions to diverse populations, leaving lasting impacts on lives.
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.
Additional References (Not Linked Above):
- FamilyFirstAct.org
- Public Consulting Group, Inc. & The Alliance for Strong Families and Communities: Family First Prevention Services Act Summary
- NACAC: Family First Prevention Services Act Becomes Law
- Child Trends: Applying the Research and Evaluation Provisions of the Family First Prevention Services Act
