Background
Objectives
As part of the system’s development and validation process, this initiative sought to collect baseline information on the characteristics and needs of the children in residential care facilities, significant life events they had experienced, prior interventions, their strengths, and the extent to which desired outcomes were achieved.
Methods
- Two structured questionnaires were developed: one for initial assessment and formulation of the personal intervention plan (T-0), and another for monitoring implementation (outputs) and measuring outcomes (T-1).
- The T-0 pilot was conducted in December 2022, with 3,441 questionnaires completed (response rate: 55%). The T-1 pilot was conducted in November 2023, with 3,065 questionnaires completed (response rate: 49%).
Findings
Findings from the first measurement (T-0) were published in February 2024.
Results from the second measurement (T-1) indicate that the most common intervention outputs in residential care facilities include maintaining and strengthening contact with the children’s families (e.g., family and sibling meetings, ongoing communication, shared decision-making, and home visits), individual emotional therapy, development of basic life skills (e.g., hygiene and daily routines), academic enrichment or learning support, and periodic follow-up conversations with the children.
Across all seven life domains (emotional/mental, behavioral, academic, social, physical health, family, and exposure to violence or exploitation outside the family) a significant increase was observed in the types and levels of needs reported. This trend is consistent with findings from other studies of children and adolescents in Israel in 2023–2024 and can largely be attributed to the Israel-Hamas war, which occurred between the two measurement points and affected the children directly, as well as indirectly through its impact on parents, the out-of-home care system, and residential care staff.
At the same time, strategies and intervention approaches were identified that mitigated the increase in reported needs across the various life domains. In the emotional/mental domain, these included the use of an authoritative approach (setting boundaries and prohibitions to prevent exposure to danger and ensure the children’s protection), regulation of home leave, psychiatric follow-up, and dental treatments. In the behavioral domain, mitigating strategies included acquisition of basic life skills, use of an authoritative approach, and follow-up by a dietitian. In the academic domain, effective strategies included academic enrichment lessons and learning support. In the health domain, mitigating strategies included maintaining and strengthening contact with the child’s family, individual emotional therapy, periodic follow-up conversations with the child, follow-up by a nurse, and follow-up by a dietitian. In the domain of exposure to violence or exploitation outside the family, mitigating strategies included periodic follow-up conversations with the child and use of an authoritative approach.
Key Recommendations
- Strengthen emotional and mental health responses during periods of emergency.
- Expand the use of intervention strategies found to be more effective in moderating increases in children’s needs.
- Pay particular attention to especially vulnerable populations, as identified by the children’s background characteristics.
- Promote partnership-oriented interventions with the children and their parents.
- Continue assessing the alignment between the children’s needs and the services provided, while accounting for individual background characteristics (e.g., age, gender, population group).
- Continue to implement and reinforce a strengths-based approach among professionals.