Process evaluation of the New Orleans Intervention Model for infant mental health in Glasgow Working with infants and their carers after abuse and neglect

Parents and babyThe Chief Scientist Office in Scotland has funded an exploratory randomised controlled trial (RCT) comparing two new services for maltreated infants and children who have come into local authority care:

  • NSPCC's Glasgow Infant Family Team (GIFT) - a multidisciplinary infant mental health team delivering the New Orleans Intervention Model of assessment and intervention
  • Family Assessment and Contact Team (FACS) - a social work service delivering enhanced version of assessments.

Both services help professionals and judges decide whether young children should return to their birth families or have a permanent alternative such as adoption.

We asked the University of Glasgow to undertake a qualitative evaluation of perceptions and experiences of GIFT, how it fitted within existing service and decision making networks and how it compares to the FACS service. This ran alongside the RCT. The researchers investigated how key features of GIFT impact on the wider system and barriers to implementation. This report is part of our Impact and evidence series.

Authors: Fiona Turner-Halliday, Nicholas Watson and Helen Minnis
Published: 2016

Interviews and focus groups were conducted with trial participants including GIFT and FACS professionals, birth parents and foster carers.

The mental health component of GIFT

  • Participants viewed the mental health focus of GIFT as a positive addition to the assessment and treatment of infants and families after abuse and neglect.
  • There was a perception that GIFT could have more influence (termed by researchers as the GIFT 'clout') than 'services as usual' in decision-making about the future of infants in care.
  • However, as the evidence generated by GIFT is perceived as more influential, some social workers felt this undermined their assessments in cases where there were differences of opinion.

GIFT timescales

  • GIFT, like FACS, typically follows a 3 month assessment model. Unlike FACS, GIFT then provides 6 to 9 months of treatment.
  • Participants felt the treatment phase was necessary to improve the quality of evidence in a case and therefore the accuracy of decision-making.
  • There were concerns about GIFT's longer timescales when working with parents who
    • struggle to achieve change in the first place
    • are unable to sustain change following treatment.
  • GIFT's timescales do not fit with the timings of social work permanence reviews.
  • The current legal framework does not fit with or support the longer GIFT timescales.

GIFT's work with foster carers

  • Foster carers appreciated GIFT's thorough assessment which supported them in understanding the child's needs. It is a level of support they had never received before.
  • Some foster carers found that their involvement in GIFT challenging and time-consuming.
  • Working with foster carers took more resources than anticipated partly because of significant variation in the quality of emotional care they provided and their commitment to the process.
  • GIFT highlights the challenge of working in a system where many foster carers are not registered as prospective adopters, known as dual-registration, so the service is unable to work with the children's future carers.
Key findings 4
Executive summary 6
Introduction 10
Research questions 15
Methods 16
Findings 19
Summary and conclusions 61
References 67
Appendices 68

"When you do have a case like that with a child who has got additional needs, things can be masked, like her development. GIFT had picked up on the clinical side of it, which has gave us a much better and thorough assessment."

Please cite as: Turner-Halliday, F., Watson, N. and Minnis, H. (2016) Process evaluation of the New Orleans Intervention Model for infant mental health in Glasgow.

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