Last month, the clearinghouse that greenlights foster care prevention services approved several iterations of a mental intervention known as Dialectical Behavior Therapy, as well as a positive reinforcement approach to treating substance abuse.
The clearinghouse was established in relation to the Family First Prevention Services Act, passed in February of 2018. The law enables states to use the Title IV-E entitlement — previously reserved for foster care and adoption support — to fund services aimed at working with parents to help avoid the need for a family separation.
Those services must be evidence-based and apply to three areas: parenting, substance abuse treatment and mental health interventions. The clearinghouse also reviews kinship navigator programs, which serve as one-stop contact points for a variety of services and support for relatives caring for loved ones.
Dialectical Behavior Therapy, or DBT, works in tandem on acceptance of current situations while working toward improved health. The overarching goal therein is to regulate one’s emotions.
The clearinghouse tagged the general DBT model as Supported (the second-best rating for approved options) along with a variety of models tailored to working with people that suffer from overcontrol disorders. Two other variations, one for adolescents and one for binge eating and bulimia, received a rating of Promising.
Two other, more targeted adolescent versions of DBT were found not to have enough evidence to meet the criteria for inclusion.
The clearinghouse awarded a Supported rating to Prize Contingency Management, the name brand for a concept that has grown in popularity as a strategy for helping people remain sober. As the name suggests, participants are rewarded with drawings from a prize bowl for hitting positive achievements that include negative drug tests and attendance in individual therapy sessions.
While most of the studies reviewed by the clearinghouse found no effect, one highly rated 2013 study found favorable effects of this model in curbing cocaine use, especially among participants who began the program testing positive for drugs.
Thus far, 42 states and Washington, D.C., have received the required federal approval to use these foster care prevention services with federal funds. Another four states and Puerto Rico have submitted plans for approval, and are awaiting word from the Administration for Children and Families.
Four Native American tribes have received direct approval for prevention plans — Cherokee Nation, the Eastern Band of Cherokee, Salt River Pima and Port Gamble S’Klallam.
Only four states have yet to submit a prevention plan to the feds, which is required to access the funds: Alabama, Alaska, South Dakota and Texas.
