KEEP Standard
KEEP Standard (KEEP), formerly known as Keeping Foster Parents Trained and Supported, is a parent skills training and support program designed for foster and kinship parents of children ages 4–12. KEEP can be delivered to informal kinship parents who are caring for a child outside of the child welfare system (such as grandparents, aunts, or uncles) using KEEP Connecting Kin – Standard. KEEP aims to empower parents to be agents of change for the children in their care and ultimately decrease placement disruptions, increase permanency, and improve child outcomes. KEEP uses a trauma-informed approach focusing on: (1) reinforcing normative and pro-social behavior, (2) incentivizing positive behavior, (3) building cooperation, (4) teaching new behaviors, (5) using gentle and effective limit setting, and (6) managing emotions while parenting.
Each week, parents participate in a group session, complete a home practice assignment, and participate in individual discussions about their child’s behavior to help track progress and challenges. During the group session, group leaders share parenting strategies, lead peer-to-peer discussions about those strategies in the context of the parent’s unique home and the child they are caring for, and facilitate role-plays to practice new behaviors and parenting techniques.
Group leaders tailor KEEP content to the specific challenges that the parents share and their children’s developmental needs. Session 1 provides an overview of the program and introduces parents to each other. Session 2 focuses on the use of praise and positive reinforcement to encourage cooperation. Sessions 3–5 explore strategies to monitor and manage behavior, such as using charts and incentives. Sessions 6–8 explore limit setting, discipline strategies, and how to balance limit setting and discipline with encouragement. Session 9 discusses how parents can identify positive and safe behaviors in advance of a difficult situation, such as establishing a healthy relationship with technology. Sessions 10 and 11 focus on power struggles and addressing challenging behaviors. Sessions 12 and 13 address promoting school success and positive peer relationships. Session 14 focuses on stress management strategies for parents. Sessions 15 and 16 review earlier content and celebrate the parents’ strengths and successes.
KEEP Connecting Kin – Standard group sessions also include a peer-led discussion to share ideas and experiences finding and accessing financial, educational, and social support.
KEEP is rated as a promising practice because at least one study achieved a rating of moderate or high on study design and execution and demonstrated a favorable effect on a target outcome.
Date Research Evidence Last Reviewed: Sep 2024
Sources
The following sources informed the program or service description, target population, and program or service delivery and implementation information: the program or service manual, the program or service developer’s website, and the studies reviewed.
This information does not necessarily represent the views of the program or service developers. For more information on how this program or service was reviewed, visit the download the Handbook of Standards and Procedures, Version 1.0
Target Population
KEEP is designed for foster and kinship parents of children ages 4–12.
Dosage
Group leaders deliver KEEP to groups of 7–12 parents in 16 weekly 90-minute sessions. Two group leaders facilitate each KEEP session. A group leader also connects individually with each parent during a weekly 10-minute phone call.
Location/Delivery Setting
Recommended Locations/Delivery Settings
Group leaders deliver KEEP in person in community settings or online.
Location/Delivery Settings Observed in the Research
- Home
- Community Center (e.g., religious or recreational facility)
Education, Certifications and Training
Group leaders participate in a 5-day training on the core components of the KEEP program. Group leaders typically start leading KEEP groups within three weeks after completing training.
Group leaders may apply for certification after leading three groups. Group leaders who choose to obtain certification participate in weekly sessions with coaches from the Oregon Social Learning Center Developments, Inc. (ODI). All KEEP sessions are recorded to monitor alignment to the model and are submitted to ODI for use in the weekly coaching sessions.
For organizations that would like to implement KEEP, a 3-month pre-implementation planning process is required. Site certification and a train-the-trainer program are available for organizations that would like to grow the program in their area.
Program or Service Documentation
Book/Manual/Available documentation used for review
KEEP Standard:
Keeping Families Supported. (2023). KEEP group leader manual: Standard model.
KEEP Connecting Kin Standard:
Keeping Families Supported. (2023). KEEP group leader manual: KEEP Connecting Kin Standard model.
KEEP Connecting Kin Standard was not determined to have any substantial adaptations from KEEP Standard and therefore was not considered to be a different program or service for the purposes of the review.
Available languages
KEEP materials are available in English and Spanish.
Other supporting materials
For More Information
Website: https://keepforfamilies.org/
Contact Form: https://keepforfamilies.org/contact/
Note: The details on Dosage; Location; Education, Certifications, and Training; Other Supporting Materials; and For More Information sections above are provided to website users for informational purposes only. This information is not exhaustive and may be subject to change.
| Results of Search and Review | Number of Studies Identified and Reviewed for KEEP Standard |
|---|---|
| Identified in Search | 8 |
| Eligible for Review | 3 |
| Rated High | 1 |
| Rated Moderate | 1 |
| Rated Low | 1 |
| Reviewed Only for Risk of Harm | 0 |
| Outcome | Effect Size
 and Implied Percentile Effect
|
N of Studies (Findings) | N of Participants | Summary of Findings |
|---|---|---|---|---|
| Child permanency: Planned permanent exits |
0.52
19 |
1 (2) | 564 |
Favorable:
2 No Effect: 0 Unfavorable: 0 |
| Child well-being: Behavioral and emotional functioning |
0.30
11 |
2 (3) | 642 |
Favorable:
3 No Effect: 0 Unfavorable: 0 |
| Adult well-being: Family functioning |
0.34
13 |
1 (2) | 74 |
Favorable:
0 No Effect: 2 Unfavorable: 0 |
Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group. Effect sizes for some outcomes were not able to be calculated by the Prevention Services Clearinghouse.
| Outcome | Effect Size
and Implied Percentile Effect
|
N of Studies (Findings) | N of Participants | Summary of Findings |
Months after treatment when outcome measured
|
|---|---|---|---|---|---|
| Child permanency: Planned permanent exits |
0.52
19 |
1 (2) | 564 |
Favorable:
2 No Effect: 0 Unfavorable: 0 |
- |
| Study 15132 - KEEP vs. BAU (Price, 2008) | |||||
| Positive Exits from Foster Care |
0.52
*
19 |
- | 564 | - | 0 |
| Positive Exits from Foster Care (Survival) |
Favorable
*
not calculated |
- | 564 | - | 1 |
| Child well-being: Behavioral and emotional functioning |
0.30
11 |
2 (3) | 642 |
Favorable:
3 No Effect: 0 Unfavorable: 0 |
- |
| Study 15118 - KEEP vs. Standard Care Comparison Group (Greeno, 2016a) | |||||
| Parent Daily Report |
1.07
*
35 |
- | 78 | - | 2 |
| Parenting Stress Index – Short Form: Difficult Child |
0.62
*
23 |
- | 74 | - | 2 |
| Study 15132 - KEEP vs. BAU (Price, 2012) | |||||
| Parent Daily Report |
0.24
*
9 |
- | 564 | - | 0 |
| Adult well-being: Family functioning |
0.34
13 |
1 (2) | 74 |
Favorable:
0 No Effect: 2 Unfavorable: 0 |
- |
| Study 15118 - KEEP vs. Standard Care Comparison Group (Greeno, 2016a) | |||||
| Parenting Stress Index – Short Form: Total Score |
0.38
14 |
- | 73 | - | 2 |
| Parenting Stress Index – Short Form: Parent-Child Dysfunctional Interaction |
0.30
11 |
- | 74 | - | 2 |
*p <.05
Note: For the effect sizes and implied percentile effects reported in the table, a positive number favors the intervention group and a negative number favors the comparison group. Effect sizes and implied percentile effects were calculated by the Prevention Services Clearinghouse as described in the Handbook of Standards and Procedures, Section 5.10.4 and may not align with effect sizes reported in individual publications. Effect sizes for some outcomes were not able to be calculated by the Prevention Services Clearinghouse.
Only publications with eligible contrasts that met design and execution standards are included in the individual study findings table.
Full citations for the studies shown in the table are available in the "Studies Reviewed" section.
The participant characteristics display is an initial version. We encourage those interested in providing feedback to send suggestions to preventionservices@abtglobal.com.
The table below displays locations, the year, and participant demographics for studies that received moderate or high ratings on design and execution and that reported the information. Participant characteristics for studies with more than one intervention versus comparison group pair that received moderate or high ratings are shown separately in the table. Please note, the information presented here uses terminology directly from the study documents, when available. Studies that received moderate or high ratings on design and execution that did not include relevant participant demographic information would not be represented in this table.
For more information on how Clearinghouse reviewers record the information in the table, please see our Resource Guide on Study Participant Characteristics and Settings.
| Characteristics of the Participants in the Studies with Moderate or High Ratings | ||||||
|---|---|---|---|---|---|---|
|
Study Location
|
Study Year
|
Age or Grade-level
|
Race, Ethnicity, Nationality
|
Gender
|
Populations of Interest*
|
Household Socioeconomic Status
|
| Study 15132 - KEEP vs. BAU | ||||||
| Characteristics of the Children and Youth | ||||||
| San Diego, CA, USA | 1999 | Average age: 9 years; Age range: 5-12 years |
22% Multi-Ethnic 22% Caucasian 21% African American 1% Native American 1% Asian/Pacific Islander |
52% Female 48% Male |
Foster children | -- |
| Characteristics of the Adults, Parents, or Caregivers | ||||||
| San Diego, CA, USA | 1999 | Average Age: 49 years |
37% Latino 27% Caucasian 26% African American 6% Multi-Ethnic 3% Asian/Pacific Islander 1% Native American |
94% Female 6% Male |
-- | -- |
| Study 15118 - KEEP vs. Standard Care Comparison Group | ||||||
| Characteristics of the Children and Youth | ||||||
| Maryland, USA | 2010 | Average age: 8 years |
42% Black 37% White 13% Other 8% Missing |
57% Female 43% Male |
100% Child in kinship or foster care; Longest length of stay in foster or kinship care: 11% 0-6 months, 15% 7-12 months, 12% 13-18 months, 9% 19-24 months, 54% >24 months | -- |
| Characteristics of the Adults, Parents, or Caregivers | ||||||
| Maryland, USA | 2010 | Average age: 50 years |
48% Black/African American 42% White/Caucasian 9% More than one race 2% Hispanic |
98% Female | Provider type: 34% Relative/kinship provider, 66% Licensed state foster provider |
56% Employed full-time 15% Unemployed 15% Retired 11% Employed part-time 4% Student |
“--” indicates information not reported in the study.
* The information about disabilities is based on initial coding. For more information on how the Clearinghouse recorded disability information for the initial release, please see our Resource Guide on Study Participant Characteristics and Settings. The Clearinghouse is currently seeking consultation from experts, including those with lived experience, and input from the public to enhance and improve the display.
Note: Citations for the documents associated with each 5-digit study number shown in the table can be found in the “Studies Reviewed” section below. Study settings and participant demographics are recorded for all studies that received moderate or high ratings on design and execution and that reported the information. Studies that did not report any information about setting or participant demographics are not displayed. For more information on how participant characteristics are recorded, please see our Resource Guide on Study Participant Characteristics and Settings.
Studies Rated High
Study 15132Chamberlain, P., Price, J., Leve, L. D., Laurent, H., Landsverk, J. A., & Reid, J. B. (2008). Prevention of behavior problems for children in foster care: Outcomes and mediation effects. Prevention Science, 9(1), 17-27. https://doi.org/10.1007/s11121-007-0080-7
Price, J. M., Chamberlain, P., Landsverk, J., Reid, J. B., Leve, L. D., & Laurent, H. (2008). Effects of a foster parent training intervention on placement changes of children in foster care. Child Maltreatment, 13(1), 64-75. https://doi.org/10.1177/1077559507310612
Price, J. M., Chamberlain, P., Landsverk, J., & Reid, J. (2009). KEEP foster-parent training intervention: Model description and effectiveness. Child & Family Social Work, 14(2), 233-242. https://doi.org/10.1111/j.1365-2206.2009.00627.x
DeGarmo, D. S., Chamberlain, P., Leve, L. D., & Price, J. (2009). Foster parent intervention engagement moderating child behavior problems and placement disruption. Research on Social Work Practice, 19(4), 423-433. https://doi.org/10.1177/1049731508329407
Goldhaber-Fiebert, J. D., Bailey, S. L., Hurlburt, M. S., Zhang, J., Snowden, L. R., Wulczyn, F., Landsverk, J., & Horwitz, S. M. (2012). Evaluating child welfare policies with decision-analytic simulation models. Administration and Policy in Mental Health, 39(6), 466-477. https://doi.org/10.1007/s10488-011-0370-z
Hurlburt, M. S., Chamberlain, P., DeGarmo, D., Zhang, J., & Price, J. M. (2010). Advancing prediction of foster placement disruption using brief behavioral screening. Child Abuse & Neglect, 34(12), 917-926. https://doi.org/10.1016/j.chiabu.2010.07.003
Price, J. M., Roesch, S., & Walsh, N. E. (2012). Effectiveness of the KEEP foster parent intervention during an implementation trial. Children and Youth Services Review, 34(12), 2487-2494. https://doi.org/10.1016/j.childyouth.2012.09.010
This study was conducted in a usual care or practice setting (Handbook Section 6.2.2)Studies Rated Moderate
Study 15118Greeno, E., Lee, B., Uretsky, M., Moore, J., Barth, R., & Shaw, T. (2016a). Effects of a foster parent training intervention on child behavior, caregiver stress, and parenting style. Journal of Child & Family Studies, 25(6), 1991-2000. https://doi.org/10.1007/s10826-015-0357-6
Greeno, E. J., Uretsky, M. C., Lee, B. R., Moore, J. E., Barth, R. P., & Shaw, T. V. (2016b). Replication of the KEEP foster and kinship parent training program for youth with externalizing behaviors. Children & Youth Services Review, 61, 75-82. https://doi.org/10.1016/j.childyouth.2015.12.003
Uretsky, M. C., Lee, B. R., Greeno, E. J., & Barth, R. P. (2017). Trajectory of externalizing child behaviors in a KEEP replication. Research on Social Work Practice, 27(3), 283-290. https://doi.org/10.1177/1049731515576546
This study was conducted in a usual care or practice setting (Handbook Section 6.2.2)Studies Rated Low
Study 15124Price, J. M., Roesch, S., Walsh, N. E., & Landsverk, J. (2015). Effects of the KEEP foster parent intervention on child and sibling behavior problems and parental stress during a randomized implementation trial. Prevention Science, 16(5), 685-695. https://doi.org/10.1007/s11121-014-0532-9
Price, J. M., Roesch, S., & Burce, C. M. (2019). The effects of the KEEP foster parent training intervention on child externalizing and internalizing problems. Developmental Child Welfare, 1(1), 5-21. https://doi.org/10.1177/2516103218812092
This study received a low rating because the standards for addressing missing data were not met.Studies Not Eligible for Review
Study 15112
Chamberlain, P., Price, J. M., Reid, J. B., Landsverk, J., Fisher, P. A., & Stoolmiller, M. (2006a). Who disrupts from placement in foster and kinship care? Child Abuse and Neglect, 30, 409-424. https://doi.org/10.1016/j.chiabu.2005.11.004
This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).Study 15114
Chamberlain, P., Feldman, S. W., Wulczyn, F., Saldana, L., & Forgatch, M. (2016). Implementation and evaluation of linked parenting models in a large urban child welfare system. Child Abuse & Neglect, 53, 27-39. https://doi.org/10.1016/j.chiabu.2015.09.013
This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).Study 15116
Ek, A., Chamberlain, K. L., Ejderhamn, J., Fisher, P. A., Marcus, C., Chamberlain, P., & Nowicka, P. (2015). The More and Less Study: A randomized controlled trial testing different approaches to treat obesity in preschoolers. BMC Public Health, 15, 735-751. https://doi.org/10.1186/s12889-015-1912-1
Ek, A., Lewis Chamberlain, K., Sorjonen, K., Hammar, U., Etminan Malek, M., Sandvik, P., Somaraki, M., Nyman, J., Lindberg, L., Nordin, K., Ejderhamn, J., Fisher, P. A., Chamberlain, P., Marcus, C., & Nowicka, P. (2019). A parent treatment program for preschoolers with obesity: A randomized controlled trial. Pediatrics, 144(2), Article e20183457. https://doi.org/10.1542/peds.2018-3457
Sandvik, P., Ek, A., Eli, K., Somaraki, M., Bottai, M., & Nowicka, P. (2019). Picky eating in an obesity intervention for preschool-aged children — What role does it play, and does the measurement instrument matter? The International Journal of Behavioral Nutrition and Physical Activity, 16(1), 76. https://doi.org/10.1186/s12966-019-0845-y
This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).Study 15123
Leathers, S. J., Spielfogel, J. E., McMeel, L. S., & Atkins, M. S. (2011). Use of a parent management training intervention with urban foster parents: A pilot study. Children and Youth Services Review, 33(7), 1270-1279. https://doi.org/10.1016/j.childyouth.2011.02.022
This study is ineligible for review because it is not a study of the program or service under review (Study Eligibility Criterion 4.1.6).Study 15125
Roberts, R., Glynn, G., & Waterman, C. (2016). We know it works but does it last? The implementation of the KEEP foster and kinship carer training programme in England. Adoption & Fostering, 40(3), 247-263. https://doi.org/10.1177/0308575916657956
This study is ineligible for review because it does not use an eligible study design (Study Eligibility Criterion 4.1.4)