Reports from external sources

Monitoring Vulnerable Families - A Two-year Outcome Study by Mark Turner, May 2009
Good Practice Programme by New Zealand Family Violence Clearinghouse, June 2008
Evaluation of FHT - Twelve-Month Outcomes, October 2006
Audit Report of the Implementation of the Recommendations of the Canterbury University, 2003
Safer Families Evaluation, External Report, August 2003
Tindall Foundation Report on Preventing Child Abuse, October 2002

Monitoring Vulnerable Families - A Two-year Outcome Study by Mark Turner, May 2009

Family Help Trust’s "Monitoring Vulnerable Families" report (2009) provides evidence that the risk of child abuse among the most socially deprived families can be significantly reduced through effective home visitation. In particular, significant outcomes are indicated within the first two years through:

enabling mothers to end relationships with abusive partners;
convincing mothers to stop hitting their children;
assisting mothers to complete methadone programmes and therefore stop using drugs;
encouraging positive parental behaviours associated with child rearing; and
no differences were found in outcomes between Mäori and non-Mäori in any of the core indicators.

Home visitation services that target those under the most extreme risk of child abuse and neglect are extremely rare. The one published study suggests the only known similar service elsewhere was ineffective. Contrary to such findings, the Family Help Trust "Monitoring Vulnerable Families" research indicates that it is possible to significantly improve the outcomes of the families and infants where maltreatment is most likely to occur, and therefore to markedly decrease its incidence.

Read the report summary here » (PDF, 550KB)
If you want to obtain the full report, contact Family Help Trust

Good Practice Programme by New Zealand Family Violence Clearinghouse, June 2008

New Zealand Family Violence Clearinghouse is a national centre for providing all family/whanau violence information, on contract to the Ministry of Social Development. In June 2008 it added to its database details of Family Help Trust in its "Good Practice Programme" database where it lists "family violence-related programmes that are 'promising' or 'emerging' practice examples".

In this category, it says "Only a few programmes are subject to rigorous external evaluation and there is limited publicly available research information about what works to prevent family violence, keep victims safe and hold perpetrators of violence accountable. However, some programmes can be said to show promise or are 'emerging good practice' in that the agency and wider practice community identify that the programme works to acceptable standards and appears to be producing positive outcomes."

Read their report here »

Evaluation of Family Help Trust - Twelve-Month Outcomes,
External Report, October 2006

Prepared by Mark Turner PhD. Edited excerpts below.
If you want a copy of the complete report, please contact Libby Robins.

Executive Summary

This evaluation provides an account of the twelve month outcomes of 55 Family Help Trust families. The design, major outcomes and conclusions of this evaluation are summarised in the report.

Chapter 1 sets the background for the evaluation of the Family Help Trust programme and provides a brief overview of home visiting. Examination of the literature shows that many home visiting services are not effective in preventing child abuse. The key features of successful services include:
• A strongly theory-based approach using evidence-based best practice
• The use of professionally-trained staff
• Support from community and governmental stakeholders
• Emerging evidence and opinions of key researchers suggest that services should be re-tooled to focus on families most at-risk of child abuse.

The present evaluation examines a crucial gap in the current understanding of home visitation services by studying the twelve month outcomes of a group of ultra highrisk clients.

Chapter 2 describes the evaluation design and the limitations of this methodology. When using prospective longitudinal research designs without a control group, the results must be treated with caution as it is not possible to say that any improvements wouldn’t have occurred without Family Help Trust input. Nevertheless it is possible, and extremely informative, to examine any changes in this challenging population.

Chapter 3 examines the referral process and provides a descriptive profile of the socio-demographic backgrounds of the families recruited. Comparison with previous cohorts showed Family Help Trust families are socially disadvantaged. The mothers reported a background of adversity in childhood, and there were relatively high levels of criminality, substance use and mental health problems. Of significance, threequarters (78.2%) had prior Child, Youth and Family Services (CYFS) involvement.

Internationally, many similar programmes specifically exclude those with prior child protection agency involvement.

Chapter 4 provides an examination of changes over the first twelve months on a series of key issues that have previously been associated with poor prognosis for children and low family functioning generally. Fifty-five families (78.6% of those recruited) had twelve month data available. The results of Section 1, which focused on key child-related outcomes are extremely encouraging and point to significant improvements in a number of key areas including parental behaviours associated with child rearing and the health and safety of child(ren) in the household. Section 2 also found indications of significant improvements in social support and family violence. However, there was less evidence of positive changes in lifestyle behaviours (such as parental substance abuse, mental health and family economic circumstances) of the Mothers of Baby (MOB).

Chapter 5 provides an overview and analysis of the results of this evaluation and places these findings in the context of previous studies. Given the difficulties previous research studies have had finding any positive improvements from home visitation services, the results of the present evaluation are extremely encouraging. This is all the more so given that these clients have only been receiving Family Help Trust input for twelve months and many authors report that it is unlikely results can be achieved in this timeframe.

While the lack of a control group does not allow definite conclusions about causality, this evaluation shows that ultra high-risk families can make significant improvements in crucial child abuse prevention areas over twelve months. As such, this research is the first evaluation to show that positive changes can occur in the lives of this ultra high-risk cohort. It provides valuable information that can help guide clinical practice and provide governmental social agencies and policy analysts with an evidence base for improving family functioning and reducing the incidence of child abuse and neglect.

Foreword by Lesley Max, Co-Patron Family Help Trust

This report is of particular interest. Family Help Trust's intervention is revealed as highly unusual if not unique in its targeting only high-risk families and is thus likely to be of interest internationally.

Evaluator Dr Mark Turner is candid about the limitations of the evaluation, noting that it is "indicative of possible trends, not confirmed evidence of programme effectiveness". Evaluation is complicated by the fact that the service "is designed to meet the specific requirements, circumstances and problems of a given high-risk family, rather than imposing a standardized programme on all families".

Programme families represented a substantial challenge in the light of the incidence of head injury or concussion, mental health problems, substance abuse, criminal offending, adversity in childhood and prior CYFS involvement.

Significant decreases were noted in CYFS involvement and in reported violence of mothers toward their child/ren. An extremely encouraging pervasive and consistent trend towards decreasing partner violence and abuse was also found.

In an interesting echo of the "Early Start" evaluation, the Family Help Trust was found to be most effective in assisting mothers to acquire new skills and behaviours in parenting their children but was less effective in addressing long-standing lifestyle issues relating to substance abuse, mental health issues and families' economic circumstances.

The report concludes that "FHT families were successful in improving maternal child-rearing skills and reducing child abuse risks over the first 12 months involvement with the service".

The Family Help Trust has established a rare expertise in one of the most difficult but critically important areas of social service. To my mind it represents social enterprise of a remarkable kind. It is an organization that deals proactively and effectively with a population that would otherwise be unlikely to receive necessary assistance.

This report should be read by all those concerned for New Zealand's children and families, but most particularly by policy analysts and Government decision-makers.

(If you want a copy of the complete report, please contact Libby Robins.)

2004 Audit Report of the Implementation of the Recommendations of the Canterbury University, 2003

Prepared by Fiona Robertson, consultant.
For more information on this report, please contact Libby Robins.

Safer Families Evaluation - Summary of Independent External Report, August 2003

The Family Help Trust started the Safer Families service in 2001 after midwifery services identified a gap in services aimed at preventing child abuse in Christchurch. When they identify that a baby is likely to be born into high risk circumstances, the mother is linked up to Safer families before the birth, with the aim of providing long-term, seamless intensive support until the child goes to school.

Safer Families was evaluated in 2003 by the University of Canterbury Social Work Department.

It aimed to evaluate:

the effectiveness of the service
client satisfaction
the views of the referral agencies
which major parental risk factors decreased over time

Additionally, all Safer Families staff and two board members were also interviewed, but to protect client privacy, these interviews are not part of this summary.

The baseline and progress (non-identifiable) documentation of 32 current client families were examined by the researcher, together with client interviews and a mail-out questionnaire to referrers.

Although most clients agreed to be interviewed, only 12 had the ability to keep the arranged appointments.

The results of the evaluation

The results are highly satisfactory, given the limited time involvement with the clients. It found the clients overwhelmingly found the service extremely helpful and valuable. It also gave them the confidence to ask for support.

The referrers' questionaires also came back very positive, with all but one finding the referral devices easy to use. The referrers were happy with the service, would continue making referrals, and most said they had seen change in the families. Several said of the clients they had referred, those who began on the service ante-natally had better outcomes.

Major parental risk factors

These included criminal offending, drug and alcohol use, family violence, unsuitable housing, care and protection issues, and gang involvement.

The evaluation found:

Family violence decreased dramatically and by 12 months, only one family was still experiencing violent behaviours.
Criminal behaviour declined immediately after intake, although some confounding variables warrant further examination in this area.
There was a noticeable decrease in the number of families living in unsuitable accommodation. Once they were rehoused they made their environments much safer for babies/children.
There was a decline in substance abuse and gang involvement.

Tindall Foundation Report on Preventing Child Abuse, October 2002

This report, "A Role for The Tindall Foundation in Preventing Child Abuse", was prepared by Clinical Psychologist Bob Simcock. It aims to help the Foundation determine its funding strategy for the next five years.

It commends the commitment to early interventions like Family Start but expresses concerns about a lack of skills, focus, and Government agency support within these programs. "The quality is variable and there has not been adequate investment in skills development and evaluation of programs."

The comprehensive report recommends that the Tindall Foundation commits to supporting and funding agencies to deliver effective programs in workforce training, public education, program evaluation, and advocacy. If you are interested in reading the full report, get in touch with us and we can provide a hard copy.