Family-based, in-home services for the severely emotionally disturbed child.

FBS was not conceived as a substitute for a residential treatment program. It was instead established to provide a greater array of services in the center's continuum of care and another treatment alternative. Although children were accepted into the FBS program when residential treatment was indicated, it was not because the program was considered an equal to residential treatment. Rather, we felt the child and family could receive greater benefits from an in-home approach [Willner et al. 1972]. The results of intensive family-based services speak for themselves in terms of cost-effectiveness, placement prevention, and family reunification [Bryce and Lloyd 1980a]. It has been the center's experience that the most vulnerable children are those who have been removed for extended periods of time to an institutional setting. Results of table 1 indicate that 68% of the children receiving FBS aftercare remained in their homes, while children who were served before any placement remained in their homes 97% of the time. In spite of major behavioral changes experienced by the child and family during the residential course of treatment, the staff reports the following obstacles to successful reunification: Child "identified" as the problem is often expected to return home as a different human being without needs or problems. Temporary expulsion of the identified child often immediately relieves family stress, yet begins a process of homeostatic adjustment whereby the system closes, excluding the child.(ABSTRACT TRUNCATED AT 250 WORDS)