A reunification program designed to address the transition needs of high school youth, with or at risk of emotional and behavioural disorders.
The Evidence Summaries presented on this site were drawn from the best available evidence of the program’s effectiveness from this review. It does not necessarily reflect all the evidence about the program. The research was selected and assessed for inclusion on the Menu and towards the evidence rating because it met selection criteria related to the specific topic area, study design, quality assessment and the outcomes of interest.
Overview
Evidence Rating
Pathway
- Targeted and specialist
- Continuing care
Australian Study
Risk of Bias
Cost
Target Age Group
About
On the Way Home (OTWH) is a 12-month reunification program developed to address the transition needs of high school youth with or at-risk of, emotional and behavioural disorders. The program in the included study was adapted to address the transition needs of youth, with or at-risk of disabilities, reintegrating into the home and community school settings following a stay in out-of-home care. Services are provided by a trained family consultant in the family home, school and community, and primary objectives are to promote youth home stability and prevent school dropout.
Aims
- Improve youths’ social-emotional needs
- Prevent the need for additional placements in out-of-home care
- Connect youths with educational and community supports.
Impact
Evidence shows that OTWH was effective in improving family preservation and transitioning youth and their families after residential care. Youth participating in OTWH were 3 to over 5 times less likely to return to care or discontinue enrolment in the community school compared to youth in the control condition who received the traditional transition supports provided by the residential agency. School dropout rates were reduced 12 months following discharge from residential care.
| Outcome domain | Outcome measured | Positive effect | No effect | Negative effect |
|---|---|---|---|---|
| System | Family preservation | Yes | Not found | Not found |
| Child | Education | Yes | Not found | Not found |
How to read the table:
When ‘Yes’ is indicated for one of the three directions of effect, this means there is evidence of ‘positive’, ‘no effect’ or ‘negative effect’. Evidence is mixed and inconclusive when ‘Yes’ is indicated for two or more directions of effect. Further information about direction of effect can be found on the Using the Menu page.
OTWH has an evidence rating of Supported+.
This means that OTWH has evidence from one randomised controlled trial (RCT) or quasi-experiment (QE) demonstrating positive, long-term impact on at least one child and family outcome.
This assessment is based on one research outputs of RCT design. OTWH has not received a Well-supported rating as it has not yet replicated its results in another rigorous RCT or QE with a different population or setting.
| Study design | Number of research outputs included |
|---|---|
| Systematic review with meta-analysis | Not identified or included |
| Randomised controlled trial | 1 |
| Quasi-experiment | Not identified or included |
The evidence has low concerns with risk of bias.
We can be confident about the results and quality of evidence from the included study.
The study was conducted in the United States and does not include Aboriginal children and families.
Aboriginal knowledge and evidence is critical to recognise, document and share practices that lead to improved outcomes for Aboriginal children and families. The department is consulting with the Aboriginal community and stakeholders on how Aboriginal knowledge and evidence is defined and included on the Menu.
Location
- The RCT was conducted in the United States.
Sample
- 82 youth (43 intervention, 39 control) participated in the study.
- The youth were aged 13 to 18, had a disability and were discharging from a large residential care program in the Midwest between 2009 and 2011. Slightly more than 80% of the youth received special education services.
- Participants identified as Caucasian (60%), African-American (14.1%) and Hispanic (3.5%).
Implementation
Delivery model, mode and setting
- OTWH is delivered in-person, to parents individually and together with the family.
- The program is typically conducted in the adoptive home, birth family home, foster/kinship care or school setting including day care and day treatment programs.
Target cohort
- Parents and caregivers with, or are at-risk of,emotional and behavioural disorders transitioning from residential placements back into the home and community school settings.
- Children aged 12 to 18.
Program delivery
- Services vary according to the needs of the families and youth, but at a minimum, consultants are expected to make weekly contact with the parents, youth and school mentor to work on family and youth objectives.
- OTWH consultants work with families to provide support in preventing school drop-out using a modified version of 3 interventions:
- Check and Connect: A dropout prevention program. In the ‘check’ component, the consultant monitors risk factors on a weekly basis and works with the mentor, teachers, family and youth to implement an intervention. In the ‘connect’ component, the consultant then engages in weekly communication with the youth, parents and mentor to ensure the youth is engaged in their academic environment and to help problem solve when challenges arise.
- Common Sense Parenting: A parenting training program. Parents are taught skills in a series of 6 one-on-one sessions that include areas of effective consequences, praise, staying calm and problem solving. Sessions include direct instruction, observations of video-taped live modelling and role playing. The family consultant reviews newly taught skills with parents weekly to further problem-solve and reinforce skills.
- Homework support: A homework support strategy. Pairs parent monitoring with several self-management techniques, which include establishing a homework environment and structure, such as setting, rules and materials). Students are taught methods to track homework assignments and check for completion with their teachers and parents. For students requiring additional assistance, secondary support such as connecting the youth with a tutor is provided.
Duration and intensity
- OTWH is a 14-month reunification program. In the study included in this review, the participants received up to 12 months of OTWH services.
- Over the 12-month period, consultants in the study spent an average of 138 hours per case, with 102 of those hours including direct care services.
Guides and manuals
- OTWH has implementation guidelines and materials for measuring provider readiness, program fidelity, training protocols, satisfaction outcomes and staff development.
- Consultants are provided with a OTWH manual during the one-week workshop.
Additional information
- The College of Education and Human Sciences website has more information about current research on the program.
Staffing
- The minimum qualifications to be a OTWH consultant is a bachelor’s degree in a human services or related field.
Training
- The duration of OTWH consultant training is 40 hours over 5 days and supervisor training is 16 hours over 2 days.
To our knowledge, OTWH is not available and has not been implemented in Australia.
Cost
We were unable to locate any information on the cost of OTWH.
References
Studies identified and included in the review
- Trout AL, Lambert MC, Epstein MH, Tyler P, Thompson RW, Stewart M, Daly DL. (2013). "Comparison of On the Way Home aftercare supports to traditional care following discharge from a residential setting: a pilot randomized controlled trial." Child Welfare 92(3): 27-45.
Studies identified but not counted towards the evidence rating due to study quality
No studies that were identified were excluded due to study quality.