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BJSW Advance Access originally published online on November 22, 2006
British Journal of Social Work 2008 38(3):444-461; doi:10.1093/bjsw/bcl352
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© The Author 2006. Published by Oxford University Press on behalf of The British Association of Social Workers. All rights reserved.

Preventive Services for Adolescents: Exploring the Process of Change

Nina Biehal

Nina Biehal is Assistant Director of the Social Work Research and Development Unit at the University of York. Her current research interests include family support, adoption, permanent foster-care and treatment foster-care.

Correspondence to Nina Biehal, SWRDU, Alcuin College B Block, University of York, York YO10 5DD, England. E-mail: nb6{at}york.ac.uk


   Abstract

This paper reports on a quasi-experimental study which compared outcomes for young people referred to specialist family support teams with those for others referred to mainstream social work teams. Although there was no evidence that the specialist service was more effective in promoting changes in child and family functioning, nevertheless, many young people in both groups showed improvement in this respect. This paper explores how, why and in what circumstances these positive changes occurred. The factors which moderated or mediated the effectiveness of interventions included both risk and protective factors for emotional and behavioural problems and aspects of the interventions themselves. The paper explores the mechanisms whereby these factors interacted to help or hinder workers’ efforts to promote change. Child and family attributes and histories, the duration of child and family difficulties, motivation and optimism all moderated the impact of interventions, making change more, or less, likely to occur. Aspects of the interventions themselves also mediated their effectiveness, such as their ecological approach, the strategies used to change child behaviour and parenting style and the development of a therapeutic alliance. These moderators and mediators of change had a stronger impact on the outcome of interventions than differences in service type.

Keywords: adolescents, family support, family preservation, prevention, motivation, therapeutic alliance


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