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A Quasi-Experimental Study of Intensive Alternative Family Treatment to Prevent Entry of Youth to Psychiatric Residential Treatment

Abstract

Intensive Alternative Family Treatment (IAFT®) is an enhanced therapeutic foster care program that serves children and youth at risk for entry into a more restrictive level of care. The purpose of this study was to examine the effectiveness of IAFT in reducing first entry into psychiatric residential treatment compared to usual care. We linked IAFT program data to Medicaid claims data in order to develop a quasi-experimental study design to compare outcomes for two groups (N = 1655): (a) youth referred to IAFT who received services and (b) youth referred to IAFT who did not receive IAFT services (i.e., usual care). Propensity score analysis was used to balance treatment and comparison groups on pre-referral indicators. Cox regression analysis was used to examine group differences. Findings supported a significant reduction in risk for entry to psychiatric residential treatment favoring IAFT (hazard ratio  0.72; 95% CI 0.55, 0.93). Results of this study support IAFT’s efficacy as an intensive therapeutic foster care model for delivering mental health services and viability as an alternative to residential care.

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Funding

This study was funded by Rapid Resources for Families, the purveyors of Intensive Alternative Family Treatment (IAFT). This research was funded by Rapid Resource for Families (https://ncrapidresource.org/).

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Authors and Affiliations

Authors

Contributions

PL was the principal investigator for this study, has full access to all data, and is responsible for the integrity of the data in the study and accuracy of the data analysis. RR led the study design development including methodology and data analysis approach. GC conducted the literature review and supported development of the manuscript. We want to thank the Rapid Resources for Families staff (DN, RL, PM, and BR) for their support with development of the research plan.

Corresponding author

Correspondence to Paul Lanier.

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Conflict of interest

This research is funded by Rapid Resource for Families and may lead to the development of services, such as Intensive Alternative Family Treatment, which may be licensed to Rapid Resource for Families. We have disclosed those interests fully to the University of North Carolina at Chapel Hill, the publisher, and have in place an approved plan for managing any potential conflicts arising from this arrangement.

Ethical Approval

This study was approved by the University of North Carolina at Chapel Hill Office of Human Research Ethics #18-2267.

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Lanier, P., Chung, G. & Rose, R. A Quasi-Experimental Study of Intensive Alternative Family Treatment to Prevent Entry of Youth to Psychiatric Residential Treatment. Child Adolesc Soc Work J 39, 303–311 (2022). https://doi.org/10.1007/s10560-021-00758-9

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  • DOI: https://doi.org/10.1007/s10560-021-00758-9

Keywords

  • Mental health
  • Residential treatment
  • Foster home care