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Intervention

HOMEBUILDERS is an intensive, in-home family preservation and reunification program for families with children (birth to 18) returning from or at risk of placement into foster care, group or residential treatment, psychiatric hospitals, or juvenile justice facilities. The HOMEBUILDERS Model is designed to eliminate barriers to service, while using research-based interventions to improve parental skills, parental capabilities, family interactions, children’s behavior, and family safety.

The core program strategies are

• Accessibility. Services are provided in the family’s home and community (e.g., school) at times convenient to families, including evenings, weekends, and holidays. HOMEBUILDERS therapists are available 24 hours a day, 7 days a week for crisis intervention.
• Flexibility. Intervention strategies and methods are tailored to meet the needs, values, and lifestyles of each family.
• Time limited and low caseload. Families can be referred for either a 4- to 6-week high-intensity intervention (therapist caseload of two) or for a 90-day moderate-intensity intervention (therapist caseload of five to six). Service duration is based on safety and treatment needs; 80–100 hours of total service are provided, with an average of 45 hours of face-to-face contact with the family.
• Strengths based. Therapists help clients identify and prioritize goals, strengths, and values and help them use and enhance strengths and resources to achieve their goals.
• Ecological/holistic assessment and individualized treatment planning. Assessments of family strengths, problems, and barriers to service/treatment, and outcome-based goals and treatment plans are completed collaboratively with each family.
• Research-based treatment practices. Therapists use evidence-based treatment practices, including motivational interviewing, behavioral parent training, cognitive behavior therapy and change strategies, and relapse prevention. Therapists teach family members a variety of skills, including child behavior management, effective discipline, positive behavioral support, communication skills, problem-solving skills, resisting peer pressure, mood management skills, safety planning, and establishing daily routines.
• Support and resource building. Therapists help families assess their formal and informal support systems and develop and enhance ongoing supports and resources for maintaining and facilitating changes.
• Critical thinking framework. Therapists, supervisors, and managers use a critical thinking framework for assessing, planning, implementing, and evaluating progress and outcomes.

The primary intervention components of the HOMEBUILDERS Model are engaging and motivating family members; conducting holistic, behavioral assessments of strengths and problems; developing outcome-based goals; using evidence-based cognitive/behavioral interventions; teaching skills to facilitate behavior change; and developing and enhancing ongoing supports and resources. HOMEBUILDERS programs have been successfully implemented in diverse and multiethnic/multicultural communities across the United States and other countries.

Evaluation

HOMEBUILDERS has been evaluated both formally and informally since it was established in 1974. The most comprehensive evaluation was the Michigan Families First Effectiveness Study. Michigan Families First uses the HOMEBUILDERS Model with its clients. The evaluation consisted of an experimental design with randomization to Families First (n=120) or foster care (n=82). The treatment group was 55 percent male, with an average age of 7.7 (SD=5.4 years). The comparison group was 48 percent male, with an average age of 7.3 (SD=4.6 years). The parents of the children in both groups were mostly African-American (77.5 percent and 62 percent, respectively) or white (18.5 percent and 27.5 percent, respectively). Data was collected from the birth parent or primary caregiver at baseline, then again at 6 months’ and 12 months’ follow-up.

Outcome

The Michigan Families First study showed that at 12 months 93 percent of treatment children were still living at home, while only 43 percent of those in the comparison group were living at home. Both groups reported little to no subsequent abuse and neglect after the start of the study. Also, there was little police involvement and there were few arrests in both groups. School behavior between the two groups was similar.

Other evaluations of the HOMEBUILDERS program generally report positive outcomes. For instance, a single-group study of 1,506 children reported that 83 percent avoided out-of-home placement 12 months after intake. Another study of 453 families showed that few children in the treatment group were in out-of-home placement by the end of treatment, and 12 months after the start of treatment this increased to about one third of the sample. In addition, placement rates were higher for the comparison group than for the treatment group (85 percent of the comparison group compared with 44 percent of the treatment group) 12 months after the program. Some program outcomes produced mixed results, possibly owing to the use of heterogeneous client samples.

Endorsements

• OJJDP/CSAP: Strengthen Families

References

Blythe, B.J., and S. Jayaratne. 1999. Michigan Families First Effectiveness Study: A Summary of Findings. State of Michigan Family Independence Agency.

Fraser, M.W.; P.J. Pecora; and D.A. Haapala. 1991. Families in Crisis: The Impact of Intensive Family Preservation Services. Hawthorne, N.Y.: Aldine de Gruyter.

Kinney, J.; D.A. Haapala; and Charlotte Booth. 1991. Keeping Families Together: The HOMEBUILDERS Model—Modern Applications of Social Work. Hawthorne, N.Y.: Aldine de Gruyter.

Pecora, P.J.; M.W. Fraser; and D.A. Haapala. 1991. “Intensive Home-Based Family Preservation Services: Client Outcomes and Issues for Program Design.” In K. Wells and D.E. Biegel (eds.). Family Preservation Services: Research and Evaluation. Newbury Park, Calif.: Sage, 30–32.

Contact

Charlotte Booth, Executive Director
Institute for Family Development
34004 16th Avenue South, Suite 200
Federal Way, WA 98003–8903
Phone: (253) 874-3630
Fax: (253) 838-1670
E-mail: info@institutefamily.org
Web site: http://www.institutefamily.org

Technical Assistance Provider

Shelley Leavitt, Associate Director
Institute for Family Development
34004 16th Avenue South, Suite 200
Federal Way, WA 98003
Phone: (253) 874-3630
Fax: (253) 838-1670
E-mail: sleavitt@institutefamily.org
Web site: http://www.institutefamily.org