Pastor, what can I do? My teenage son is out of control. He may take his own life. I am too scared to sleep." Faced with such a cry, where do you turn for help? What referral do you give? As a minister how do you know if you can comfortably refer your church members to a particular facility? Over the years a variety of Christian ministries have emerged that help at-risk young people. Making a choice can be confusing. One way is to look at the outcomes achieved by the ministry.
Outcome has become an overriding concern with Christian residential treatment programs as they have with other nonprofit organizations. Each ministry has to prove its worth to an often skeptical church and public. More and more people are demanding measurable and measured results, and rightly so. Pastors, client's families, counselors, donors, watchdogs, and even academics all want to know about the successes and failures of a treatment program.
An article by Monique Busch1 looks at accountability and effectiveness in residential programs and services. Busch's research shows that the effectiveness of residential treatment programs is mixed. When evaluating treatment effectiveness, Busch states that there are five key areas that need to be examined:
- Clinical outcomes.
- Functional outcomes.
- Effectiveness of placement.
- Restrictiveness of living environment.
- Consumer satisfaction.
Against these prerequisites, a treatment plan known as Project PATCH (Planned Assistance for Troubled Children) is attempting to serve teens in trouble. As a Christian faith-based facility, it had its origin 20 years ago in a vision that Tom and Bonnie Sanford had to establish a ministry to help at-risk kids.
Originally a referral and foster care placement service, it grew into a residential treatment program in 1990 in Garden Valley, Idaho. Between 1984 and 1993, 1,796 children were referred and 397 were placed in foster care. Since 1993, over 300 children have been at the ranch in the residential treatment program. The average length of stay is 18 months.
How have the children fared? Project PATCH wanted to know what the parents felt about the success of the program and where it could be improved.
PATCH'S treatment coordinator Colleen Donald comments: "Our alumni have given us a pretty good idea that we are making a difference. Yet a past resident's view can differ significantly from that of their parents when it comes to defining 'doing well.'" The only way to find out is to seek the help of professional and qualified researchers.
So the staff and administration of Project PATCH approached Dr. Tedd McDonald of the Psychology Department at Boise State University (BSU) to research the functioning and the results of the project.
In an attempt to identify areas that needed further development, Dr. McDonald set out to evaluate the program and obtain an idea of the parents' perspectives. He and two of his students first visited Project PATCH in order to familiarize themselves with the program.
Subsequently a team of researchers comprised of faculty and students developed a 56-item survey. The survey measured, from the guardian's perspective, client behaviors before and after treatment at Project PATCH. The surveys were mailed out and returned by the guardians to the researchers at BSU in order to assure confidentiality. Results were then analyzed by the BSU Psychology Department under the direction of Dr. McDonald. The project was completed in June 2003.
Clinical outcomes were measured by asking questions about specific areas including: feelings of depression, hopelessness, despair; willingness to listen to others, showing responsibility; and dealing with issues of anger. All areas were measured before the PATCH experience. The results were compared with the experiences of the young people after they returned home.
In all areas examined, improvement over client's past behavior was noted across the board. With issues of concern such as arguing and hitting others, parents indicated a decrease in these behaviors after the child was at PATCH. Conversely, for areas such as willingness to discuss problems and working individually on projects, guardians indicated a significant increase or improvement after the client's experience at PATCH.
Two questions were asked regarding consumer satisfaction outcomes. Parents were asked to rate their satisfaction on a 7-point Likert-type scale, when it came to the program leaders/staff and the facilities. The mean rating for the program leaders was 5.6 and for the facilities 5.87, which is clearly above 4, the midpoint of the scale.
These results suggest that the parents in the sample, as a whole, felt positive about the quality of the staff that interacted with their children, and the quality of the facilities at the PATCH ranch.
Two "yes" or "no" questions were put to parents. Answers to these questions indicated that two out of three parents felt the program had been successful. In spite of meeting its pro gram goals there was a discrepancy between the expectations of some parents and the goals of the program This result shows an area where improvement can be made in diminishing the gap between expectations and outcomes.
Administration and staff are investigating ways of being more explicit to parents about the outcomes of the program as this would help parents with unrealistic expectations as well as concerns raised by parents in additional comments.
When asked how many of the responders to the survey would recommend Project PATCH to other families with children who are experiencing difficulties, 88.4 percent said they would do so. This is significant: Even though only 66.7 percent thought the program successful, 88.4 percent said they would recommend the program to others.
This study was understandably encouraging for Project PATCH staff. Colleen Donald commented on behalf of the staff, "We are a group of people who are not 'in the business' for profit but for the kids. God has placed each of us at the ranch. We know that there have been, and will continue to be, those teens who are not open to the help we offer. We also know that there are those kids who don't appear open, but who are positively influenced regardless." Like their counterparts in the public sec tor, managers of nonprofit agencies are aggressively measuring the out comes of their efforts. Next time you receive that telephone call from a desperate parent and you are not quite sure about a treatment program center, check to see what their outcomes have been and what accountability they have in place.
As far as Project PATCH is concerned, it is making a difference to this generation and the next. To learn more about Project PATCH, visit their Web site at <www.projectpatch.org> or call them at 503-653-8086 for brochures and more information.
1 Child Welfare League of America, Residential Group Care 4 (Summer 2003) 1. Visit <http://cwla.org/programs/groupcare/rgcq.htm>