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. Author manuscript; available in PMC: 2012 Mar 28.
Published in final edited form as: Child Youth Serv Rev. 2011 Feb;33(2):308–321. doi: 10.1016/j.childyouth.2010.09.014

Table 3.

Group Home Models - Outcome Studies

Study Question/ Study Design Setting/ Treatment Model Sample Characteristics Outcomes/ Measures Key Findings
Positive Peer Culture
Nas et al. (2005)
  • Can EQUIP successfully alter delays in moral judgment, distortions, in social information processing, deficits in moral skills?

  • Quasi experimental design w/treatment and non randomized comparison groups, pretest posttest

  • No follow-up

  • 3 high security correctional facilities in the Netherlands

  • EQUIP (Equipping Youth to Help One Another”) is based on PPC and ART

  • E: received a modified version of EQUIP + usual care

  • C: received usual care

  • N = 108; E = 61 (31 at post), C = 47 (25 at post)

  • Age: mean = 16.8; range = 12–21

  • Gender: males

  • Race: not provided

  • Incarcerated for having committed one or more serious crimes, awaiting sentencing, or on supervision order

  • SRM-SF: assessing moral judgment

  • HIT questionnaire: measuring cognitive distortions (self- centeredness, minimizing mislabeling, blaming others, covert antisocial behavior/lying or stealing, overt antisocial behavior/physical aggression)

  • IAP-SF- assessing moral beliefs and social skills under stressful circumstances

At post test:
  • Non-significant difference in change of moral judgment and social skills between groups

  • Significant difference in reduction of self- centeredness, minimizing/ mislabeling, blaming,

  • Significant reduction in covert antisocial behavior

  • No significant difference between groups observed for “assuming the worst” and overt antisocial behavior

Leeman, et al. (1993)
  • Evaluated EQUIP effectiveness in experimental subjects

  • Experimental design w/treatment and randomized control group

  • Follow-up at 1 year

  • Medium-security correctional facility in Midwestern US

  • EQUIP (Equipping Youth to Help One Another”) is based on PPC and ART

  • E: received EQUIP

  • C1: simple

  • C2: motivational

  • N = 57; E = 20; C = 37

  • Age: mean=16; range = 15–18;

  • Gender: male

  • Race: 38 white, 18 black, 1 hispanic

  • Incarcerated for parole violations and less serious felonies

  • Mediating process (SRM-SF- measuring moral judgment; IAP- SF- measuring social skills)

  • Behavioral outcomes (institutional conduct, post-release recidivism)

Treatment group:
  • Significant gains in institutional conduct and social skills in experimental group relative to control

  • Experimental groups recidivism rate 1/2 of control groups at 6 months after discharge, over 1/3 at 1 year follow-up

  • Non-significant difference in moral judgment between groups

Davis et al. (1988)
  • Assessed changes in self-concept in youth, following PPC in residential treatment

  • Pretest Posttest

  • Residential treatment (Woodland Hills, MN)

  • Average length of treatment: 8 months

  • N=231 delinquent youths

  • Age: 12–18

  • Gender: 173 males, 58 female

  • Race: 199 white, 11 black, 5 hispanic, 16 nat. american

  • Adjudicated delinquent youth – some with identified psychiatric d/o

  • Self-concept/Tennessee Self-Concept Scale

  • Youth who completed the program rated themselves as having a more positive self- concept and a higher level of psychological adjustment on discharge

Sherer (1985)
  • Examined PPC effectiveness

  • Pre test post test w/non-randomized comparison groups

  • No follow-up

  • PPC program in Israel

  • N = 48; (E=15; C1=30; C2=10)

  • Demographics: Mean age = 16.5 yrs, age range = 15 to 18 yrs

  • Gang members who had volunteered for activities directed by a paraprofessional

  • MOTEC- measuring moral development (resistance to temptation, moral development, feelings after offense, judgment about severity of punishment, confession)

At posttest:
  • PPC group members scored higher on resistance to temptation and moral development

  • PPC and control group-2 scored higher than control group-1 for feelings after offense and severity of punishment

  • Non-significant difference observed for confession category

Teaching Family Model
Lewis (2005)
  • Tested TFM- effectiveness

  • Experimental design w/treatment and randomized control group Pretest with 2 posttests (at 5 months and 8.5 months after referral)

  • Home based intervention for families in Utah

  • E: TFM as part of a family preservation program; intensive services for 6 months with crisis follow up

  • C: usual care family preservation services

  • N = 150; 105 treatment, 45 controls

  • Demographics: Mean age = 10.4 yrs, range = 3.9 to 17.3 years; 75% male; no race/ethnicity data

  • Children w/serious behavioral and school-related problems

  • Controls referred by school or court

63-item project developed questionnaire:
  • Child behavior

  • Child management

  • Family functioning

  • Parental effectiveness

Post-Intervention:
  • Significant impact of E condition on overall youth and family functioning at both posttests

  • No significant difference across groups for parental effectiveness/parent0child relationships due to control group’s improved score over time

Larzelere et al. (2004)
  • Systematic evaluation of TFM program

  • Is TFM effective for girls as well as boys?

  • Pretest posttest

  • Follow-up at 3 months

  • Boys Town Family home Program

  • Group home with family-like treatment environment

  • Average length of stay: 1.8 years (range: 31 days to 9.7 years)

  • N = 440 discharged youth

  • Demographics: Mean age = 14.9 yrs, range = 8.6 to 18.6 yrs; 38% female; 60% Cauc., 20% AfAm, 10% Hispanic; 3% Nat. Am., 6% multi- ethnic

  • Excluded youth with <31 days in care

  • Youth referred by juvenile justice, social or mental health services, family or self

  • Behavior problems/CBCL

  • Clinical diagnosis/DISC

  • Restrictiveness of Living Environment/ROLES

  • Most youth improved from intake to discharge and were functioning at levels similar to national norms at a 3- month f/up

  • Similar improvement for girls and boys

  • Most youth discharged to less restrictive settings, but girls had greater reduction

  • Significant improvements in problem behaviors observed

  • Significant reductions in DSM-III and -IV diagnosis 12 months after intake

Jones & Timbers (2003)
  • Examined TFM’s effectiveness in reducing coercive behavior control interventions

  • Pretest posttest w/archival data

  • No follow-up

  • 2 campus-based long term care institutions in Southeast US and Midwest (Barium Springs and Bridgehouse Program)

  • N = not provided

  • Demographics: Age range = 8 to 18 yrs; male and female clients

  • Data reviewed over 2 year period

  • Physical restraint

  • Seclusion

  • Negative incidence reports

After TFM introduction:
  • Barium Springs: 40% reduction in physical restraint and 80% reduction in negative incidence reports

  • Bridgehouse program:75% reduction in physical restraint and seclusion

Thompson, et al. (1996)
  • Evaluated short- and long-term educational effects of TFM program

  • Quasi-experimental longitudinal design w/treatment and non- randomized comparison group

  • Follow-up at 4 years

  • Home campus program

  • N = 581; 497 treatment, 84 controls

  • Demographics: Mean age = 14.4 yrs (treatment), 14.7 yrs (controls); all males

  • Followed for 8 years

  • Grade point average (GPA)

  • Years of school completed

  • HS diploma/GED

  • Chance of college attendance

  • Request for help w/homework from adult

Treatment group:
  • Reported higher GPA while in residence than after discharge- (stayed higher than controls)

  • Years of school completed at faster rate

  • 83% completed high school/GED vs. 69% of controls

  • Increased chance of college attendance while in residence- decreased after discharge

  • Received more help with homework during and after program

Slot, et al. (1992)
  • Determined effectiveness of cross- cultural replication of TFM

  • Pre test post test, as well as experimental design w/treatment and non-matched and non-randomized control groups

  • Follow-up at 6 months for Studies 1 and 2, unknown for study 3

  • Residential care homes and state-run institutions in Canada and the Netherlands

3 separate studies:
  • Study 1: N = 58 Dutch youth (TFM); Mean age = 16.6 yrs, range = 14.2 to 19.1 yrs

  • Study 2: N = 529, 50 Dutch youth (TFM), 479 Canadian youth; Mean age = not available

  • Study 3: N = 114, 57 Dutch youth, 57 Canadian youth; Mean age = 16.4 yrs, range = 14 to 18.3 yrs

  • YEL- used in Study1: measures 3 dimensions of anti-social behavior and social competence

  • Study 2: Offense levels

  • Study 3: Problems, abilities for relationships outside families and for community participation

  • Study 1:

    • Improvements in overall adjustment, family adjustment, relationship w/parents, offense rates, problems at home, social competence, ability for relationships outside family

    • No improvement in community participation and employment rates

    • Significant increase in post- treatment drinking

  • Study 2:

    • Lower rates of staying at the same offense level, 24% vs. 48% (comparison group)

  • Study 3:

    • Both groups improved, no significant differences

  • LOS for TFM youth 270 days vs. 573 days for non- TFM youth

  • TFM program costs 75% lower than comparison

Bedlington (1988)
  • Examined treatment process features and milieu characteristics in TFM programs

  • Quasi-experimental design w/treatment and non-equivalent comparison group

  • No follow-up

  • 17 Group Homes located in Kansas (9 non-TFM)

  • N = 241; 91 treatment, 150 controls

  • Demographics: Mean age = 15.2 yrs (treatment), 15.8 (controls); all males

  • Court adjudicated

  • Followed for 2 years

  • Direct observation- measuring youth-adult interactions, proximity

  • SRD- measuring delinquency

  • Environmental positiveness

Treatment group:
  • Rated higher in teaching, talking, and proximity

  • Rated higher in fairness, pleasantness, concern, and effectiveness

Kirigin, et al. (1982)
  • Assessed during and posttreatment effectiveness of TFM programs

  • Quasi-experimental design with treatment and non-randomized comparison group

  • Follow-up at 1 year

  • 22 Group Homes (9 non-TFM)

  • N = 192, 102 treatment, 90 controls

  • Demographics: Age range = 12 to 16 yrs; 124 males, 68 females

  • Youth assigned by court

  • Number of alleged offenses,

  • % of youth involved in offenses

  • % of youth institutionalized

Treatment group:
  • Decrease in offense rates during treatment

  • No significant difference in institutionalization during and after treatment

  • Consistently rated higher by youth

Sanctuary Model
Rivard (2005)
  • Examined implementation and short-term effects of the Sanctuary Model

  • Experimental design w/treatment and non- randomized control group

  • No follow-up

  • Residential treatment facilities in Northeastern US

  • N = 158

  • Demographics: Mean age = 15 yrs, age range = 12 to 20 yrs; 63% male;

  • Youth with history of maltreatment

  • CBCL

  • TSCC

  • Rosenberg Self Esteem Scale

  • Nowicki-Strickland Locus of Control Scale

  • Inventory of Parent and Peer Attachment (peer form)

  • Youth coping index

  • Social Problem Solving Questionnaire

Treatment group:
  • Scored lower on measure of coping strategies that tend to increase interpersonal conflict

  • Exhibited greater sense of personal control

  • Reduced verbal aggression

  • Scored better on support, spontaneity, autonomy, problem orientation, and safety at 6 months after intake

Stop-Gap Model
McCurdy & McIntyre (2004)
  • Summarizes elements of Stop-Gap program

  • Experimental design w/treatment and non- randomized control group

  • No follow-up

  • 2 units within a residential treatment center providing traditional RTC services and Environment Based Intervention (E-BI) in the Western US

  • N = 50; 25 treatment, 25 control

  • Demographics: Age range = 13 to 18 yrs; all females

  • Presenting DSM-IV diagnosis of conduct

  • Histories of sexual and/or physical abuse

  • Mean therapeutic holds

Treatment group:
  • Mean therapeutic holds per resident for E-BI condition decreased at 12 months

  • Therapeutic holds under RTC condition increased

Re-ED Model
Fields (2006)
  • Examined preliminary effectiveness of Project Re-ED at residential treatment centers for children

  • Pretest posttest

  • Follow-up at 3 and 6 months

  • State sponsored residential treatment facility (location unknown)

  • N = 98

  • Demographics: Mean age = 10.7, age range = 7 to 13; 13% female

  • Majority diagnosed with ADHD, an externalizing disorder, or mood disorder

  • Parent with substance abuse disorder

  • CBCL- measuring the degree of severe behavioral symptoms

  • BERS- assesses children’s strengths (intra- and inter- personal)

  • CASA- assesses range of services that children may use to address mental health problems (i.e. hospitalization)

  • Younger age related to substantial change during treatment

  • Longer LOS associated with more positive outcomes

  • Significant improvement in CBCL and BERS during treatment and significantly better at follow-up compared to intake

  • Shorter stay indicates lower likelihood of receiving recommended services after discharge

Hooper (2000)
  • Addressed post- discharge outcomes of students from a program employing a formal Re-ED model

  • Pretest posttest, cross- sectional

  • Follow-up at 6, 12, 18, and 24 months

  • State-run residential treatment program operating on Re-ED program in NC

  • N = 111

  • Demographics: Mean age = 15, age range = 13 to 16 yrs; 67% male

  • 85% on some type of pharmacological management

  • 80% experienced abuse in past

  • Mean education level of mother’s = 11th grade

3 domains:
  • Key demographics (age, race, gender, maternal education)

  • Psychoeducational (verbal IQ, performance IQ, full-scale IQ, reading, math, writing)

  • Social-behavioral (Child Behavior Checklist)

  • 58% of students rated at performing satisfactorily across 24-month time span

  • Nearly all students rated satisfactorily in at least one domain following discharge; 71% functioned satisfactorily in 2 of 3 domains at 24 months and 97% at 6 months

  • Tendency for successful groups to include females, slightly younger, have higher IQ scores, better core reading and writing skills, fewer psychiatric diagnosis

Weinstein (1969)
  • Examined the home and school adjustment of children referred to residential treatment facilities by child welfare workers

  • Pretest Posttest with posttests at 6 and 18 months post- intervention

  • Residential treatment programs utilizing Re- ED

  • N=103

  • Age: 10–11 at enrollment

  • Race: Site 1 – 78% white; Site 2 – 96% white

Parent and teacher ratings on behavior problems, adjustment and academic functioning Measures:
  • Symptom Checklist

  • Social Maturity Scale

  • Student Role Behavior Scale

  • Semantic Differential

  • At 6 months, reductions were noted in symptomatology and undesirable behaviors as well as improvements in social competence

  • Teachers rated students as significantly improved on all dimensions after the Re-ED intervention