KEEP SAFE is a parenting intervention for foster and kinship carers of young people between the ages of 11 and 17. The young person and carer attend six group sessions in parallel over a three-week period that commences the summer prior to the young person entering secondary school. During these sessions, carers learn strategies for supporting the needs of a young person in care, while the young person engages in activities aimed at building self-esteem and promoting positive relationships. After the initial three-week intervention is completed, carers participate in weekly support groups for a period of a year, while the young person receives weekly advice on a 1-2-1 basis.
The information above is as offered/supported by the intervention provider.
11 to 17 years old
Group, Individual
Child outcomes:
UK available
UK tested
KEEP SAFE is an adaptation of the Keeping Foster and Kinship Carers Supported model for carers of young people aged between 11 and 17 years (also known as KEEP Standard). KEEP SAFE seeks to build young people’s prosocial skills and self-efficacy while improving the parenting skills of caregivers and enhancing the young person’s placement stability.
KEEP SAFE is designed to be offered over a three-week period during the summer before young people start secondary school. Groups of six to seven young people attend two weekly group sessions delivered by a facilitator and three assistants while their caregivers attend two group sessions per week facilitated by two experienced foster carers.
The KEEP SAFE content for caregivers uses a trauma-informed approach focusing on: (1) reinforcing normative and pro-social behavior; (2) incentivising positive behavior; (3) building cooperation; (4) teaching new behaviours; (5) using gentle and effective limit setting; and (6) managing emotions while parenting.
The KEEP SAFE content for young people includes activities aimed at building social skills, fostering positive relationships, and developing self-confidence. This phase concludes with a ceremony where participants share their goals and commitments.
Over the following year, caregivers participate in weekly support groups to continue building their parenting skills and share experiences of fostering. Over this same time period, young people receive weekly one-on-one coaching sessions to reinforce skills learned over the summer and address topics like substance use and relationships.
11 to 17 years old
Children in foster care aged 11 to 17 years old.
Disclaimer: The information in this section is as offered/supported by the intervention provider.
Science-based assumption
Increasing levels of autonomy in adolescence increases the risks associated with substance misuse and antisocial behaviour.
The risks associated with adolescence are amplified in young people in care.
Science-based assumption
Effective parenting practices and positive family relationships decrease the risks associated with adolescent development.
Science-based assumption
All foster parents and kinship carers with an adolescent child can benefit from knowledge about the risks associated with the adolescent years and effective parenting behaviours for managing these risks.
Intervention
Foster parents learn to:
Communicate effectively with their young person
Provide age-appropriate autonomy
Set age-appropriate limits
Manage family conflict
Enforce age-appropriate discipline.
Short-term
The relationship between foster parents and young person improves
Family conflict decreases
Carers effectively implement age-appropriate autonomy and limits.
Medium-term
The young person’s behaviour improves
The young person is better able to manage their autonomy and make responsible choices.
Long-term
Young people in care are at reduced risk of substance misuse or antisocial behaviour
Young people in care are better prepared to make the transition into adulthood.
Children in foster care aged 11 to 17 years old.
KEEP SAFE is delivered in a total of six sessions (two weekly sessions over three weeks) by one facilitator and three assistants to groups of six to seven young people.
Caregivers also attend a total of six sessions (two weekly sessions over three weeks). These group sessions are facilitated by two practitioners who have experience fostering young people.
The sessions for young people focus on increasing their social skills for:
The three-week intervention for young people concludes with a ceremony where young people announce their goals and commitments to each other as well as to their foster parents.
The sessions for caregivers focus on:
Through homework assignments, caregivers are encouraged to practise new parenting skills at home.
Both caregivers and young people are then provided with follow-up support over the course of a year:
Foster carers trained in the model can deliver the intervention.
There is no information available on the qualifications needed for practitioners who facilitate the sessions for young people.
The practitioners have five days of intervention training.
The first three times facilitators deliver the full intervention, group meetings are recorded and reviewed, and there are weekly consultations with facilitators to support fidelity and address any questions. After the third completion of the full intervention, facilitators can get certified if they achieve fidelity benchmarks.
Certified practitioners have quarterly check-ins where development plans are put in place if needed to support fidelity.
Intervention fidelity is maintained through the following processes:
Contact person: Emma Turnham
Organisation: KEEP
Email address: Emma.Turnham@mft.nhs.uk
Website: https://www.keep.org.uk/
*Please note that this information may not be up to date. In this case, please visit the listed intervention website for up to date contact details.
KEEP SAFE’s most rigorous evidence comes from one RCT conducted in the United States consistent with Foundations’ Level 3 evidence threshold, and one other RCT conducted in the United States consistent with Foundations’ Level 2+ evidence threshold. KEEP SAFE receives a Level 3+ rating overall.
The first RCT is consistent with Foundations’ Level 3 evidence strength criteria, observing statistically significant improvements in KEEP SAFE girls’ reports of substance abuse, antisocial behaviour, and risky sexual behaviour three years post-intervention completion in comparison to adolescent girls not receiving the intervention. This study also observed significant improvements in KEEP SAFE’s carer’s reports of their girls’ prosocial behaviour, and on placement stability after 12 months.
The second RCT is consistent with Foundations’ Level 2+ evidence strength criteria, observing statistically significant improvements in young people’s reports of substance abuse and reduced association with antisocial peers in comparison to young people not receiving the intervention.
KEEP SAFE can be described as evidence-based: it has evidence from at least one rigorously conducted RCT or QED demonstrating a statistically significant positive impact on at least one child outcome.
Reduced Substance abuse
Improvement index
Interpretation
Study
Reduced association with delinquent peers
Improvement index
Interpretation
Study
Reduced internalising and externalising behaviours
Improvement index
Interpretation
Study
Improved pro-social behaviour
Improvement index
Interpretation
Study
Reduced heath risking sexual behaviour
Improvement index
Interpretation
Study
Improved placement stability
Improvement index
Interpretation
Study
| Identified in search | 2 |
| Studies reviewed | 2 |
| Meeting the L2 threshold | 1 |
| Meeting the L3 threshold | 1 |
| Contributing to the L4 threshold | 0 |
| Ineligible | 0 |
| Study design | RCT |
| Country | United States |
| Sample characteristics | 100 girls aged 10 to 12 (mean age 11.54) who were in foster care and were transitioning to middle school, as well as their caregivers |
| Race, ethnicities, and nationalities |
|
| Population risk factors |
|
| Timing |
|
| Child outcomes |
|
| Other outcomes | None |
| Study rating | 3 |
| Citations | Study 1a: Kim, H. K. & Leve, L. D. (2011) Substance use and delinquency among middle school girls in foster care: A three-year follow-up of a randomized controlled trial. Journal of Consulting and Clinical Psychology. 79 (6), 740–750. Study 1b: Smith, D. K., Leve, L. D. & Chamberlain, P. (2011) Preventing internalizing and externalizing problems in girls in foster care as they enter middle school: Impact of an intervention. Prevention Science. 12(3), 269–277. Study 1c: Kim, H. K., Pears, K. C., Leve, L. D., Chamberlain, P. & Smith, D. K. (2013) Intervention effects on health-risking sexual behaviour among girls in foster care: The role of placement disruption and tobacco and marijuana use. Journal of Child & Adolescent Substance Abuse. 22 (5), 370–387. Study 1d: Hu, A., Van Ryzin, M. J., Schweer-Collins, M. L. & Leve, L. D. (2021) Peer relations and delinquency among girls in foster care following a skill-building preventive intervention. Child Maltreatment. 26 (2), 205–215. |
| Study design | RCT |
| Country | United States |
| Sample characteristics | 259 young people aged 11 to 17 years in kin or non-kin foster care and their caregivers |
| Race, ethnicities, and nationalities |
|
| Population risk factors |
|
| Timing |
|
| Child outcomes |
|
| Other outcomes | None |
| Study rating | 2+ |
| Citations | Kim, H. K., Buchanan, R. & Price, J. M. (2017) Pathways to preventing substance use among youth in foster care. Prevention Science. 18 (5), 567–576. |
No further studies were identified for this intervention.
Note on provider involvement: This provider has not agreed to Foundations’ terms of reference (or the Early Intervention Foundation's terms of reference), and the assessment has not been conducted and published with the full cooperation of the programme provider. Some or all information on this programme has been obtained from publicly available sources, and so assessments may not include all relevant evidence, and published information may contain inaccuracies on programme details.
Rated 1: Set up and delivery is low cost, equivalent to an estimated unit cost of less than £100.
Rated 2: Set up and delivery is medium-low cost, equivalent to an estimated unit cost of £100–£499.
Rated 3: Set up and delivery is medium cost, equivalent to an estimated unit cost of £500–£999.
Rated 4: Set up and delivery is medium-high cost, equivalent to an estimated unit cost of £1,000–£2,000.
Rating 5: Set up and delivery is high cost. Equivalent to an estimated unit cost of more than £2,000.
Set up and delivery cost is not applicable, not available, or has not been calculated.
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Supporting children’s mental health and wellbeing: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing child maltreatment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Enhancing school achievement & employment: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing crime, violence and antisocial behaviour: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing substance abuse: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
Preventing risky sexual behaviour & teen pregnancy: Lorem ipsum dolor sit amet, consectetuer adipiscing elit. Aenean commodo ligula eget dolor. Aenean massa. Cum sociis natoque penatibus et magnis dis parturient.
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Rated 2: Has preliminary evidence of improving a child outcome from a quantitative impact study, but there is not yet evidence of causal impact.
Rated 2+: Meets the level 2 rating and the best available evidence is based on a study which is more rigorous than a level 2 standard but does not meet the level 3 standard.
Rated 3: Has evidence of a short-term positive impact from at least one rigorous study.
Rated 3+: Meets the level 3 rating and has evidence from other studies with a comparison group at level 2 or higher.
Rated 4: Has evidence of a long-term positive impact through at least two rigorous studies.
Rated 4+: Meets the level 4 rating and has at least a third study contributing to the Level 4 rating, with at least one of the studies conducted independently of the intervention provider.
Rating has a *: The evidence base includes mixed findings i.e., studies suggesting positive impact alongside studies, which on balance, indicate no effect or negative impact.
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