Research School of Psychology, Australian National University, Australia.
Department of Psychology, Simon Fraser University, Canada.
Child Abuse Negl. 2021 Oct;120:105178. doi: 10.1016/j.chiabu.2021.105178. Epub 2021 Jul 6.
Kinship care placements are increasing in many Western countries, however families in kinship care are underserved partly due to the lack of evidence-based interventions addressing their unique needs.
We conducted a pilot randomized controlled trial (RCT) to examine research feasibility and the acceptability, fidelity, and preliminary outcomes of an attachment- and trauma-focused intervention for kinship caregivers in Australia.
Participants included 26 kinship caregivers (M = 55.00 years; 54% grandparents) with youth (M = 10.58 years; 38% female), and 19 practitioners from child protection, out-of-home care and other services.
Kinship caregivers were randomized to Connect for Kinship Parents (Connect-KP) or care-as-usual (CAU), and completed assessments at baseline, post-intervention, and 6-month follow-up. Placement changes were evaluated at 6-month follow-up. A subset of practitioners received both training and supervision in implementing Connect-KP, and their videorecorded sessions were coded for fidelity.
Practitioners rated the training highly and demonstrated excellent fidelity to program content and process. Results supported the research feasibility and all kinship caregivers reported high levels of program satisfaction and had very high attendance and completion rates. Direction of effects favored Connect-KP vs. CAU for all nine caregiver and youth outcomes, with the largest effects observed for significant reductions in caregiver strain, caregiver psychological aggression, and youth affect suppression following intervention. At 6-month follow-up, more youth from CAU (15%) vs. Connect-KP (0%) experienced an unplanned placement change.
Our findings show promise of Connect-KP as a potentially effective intervention that can be successfully implemented in child welfare services, and provide impetus for a larger-scale RCT.
在许多西方国家，亲属照顾安置的数量正在增加，但由于缺乏针对他们独特需求的基于证据的干预措施，亲属照顾者的服务需求得不到满足。
我们进行了一项试点随机对照试验（RCT），以检验针对澳大利亚亲属照顾者的依恋和创伤为重点的干预措施的研究可行性、可接受性、保真度和初步结果。
参与者包括 26 名亲属照顾者（M=55.00 岁；54%为祖父母）和有孩子的亲属照顾者（M=10.58 岁；38%为女性），以及来自儿童保护、家庭外照顾和其他服务的 19 名从业者。
亲属照顾者被随机分配到亲情父母联系计划（Connect-KP）或常规护理（CAU），并在基线、干预后和 6 个月随访时完成评估。在 6 个月随访时评估安置变化。一部分从业者接受了实施 Connect-KP 的培训和监督，他们的视频记录会话被编码以评估保真度。
从业者对培训给予了高度评价，并在方案内容和过程方面表现出极高的保真度。结果支持了研究的可行性，所有亲属照顾者都报告了对项目的高度满意度，并且参与率和完成率非常高。在所有 9 项照顾者和青少年结果中，Connect-KP 与 CAU 相比都表现出了更好的效果，干预后照顾者压力、照顾者心理攻击和青少年情绪抑制的显著减少效果最大。在 6 个月随访时，更多来自 CAU（15%）的青少年经历了计划外的安置变化，而不是 Connect-KP（0%）。
我们的研究结果表明，Connect-KP 作为一种潜在有效的干预措施具有希望，它可以在儿童福利服务中成功实施，并为更大规模的 RCT 提供动力。
