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10 Year Longitudinal Evaluation of the Spilstead Model of Milieu Intervention

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Abstract

Although international research has defined best-practice intervention for children from vulnerable families as integrated and comprehensive, limited implementation and longitudinal evaluation of this approach has been conducted. The Spilstead Model (SM) of early years milieu intervention provides a uniquely integrated one stop shop model of care incorporating a comprehensive range of best-practice programs within a trauma-informed approach. Results from an initial evaluation involving 23 families (mean child age 3.7 years) indicated large effect size improvements 12 months post entry in family functioning as well as child development and emotional wellbeing (ES 0.8 -1.46, p < 0.001). This study aimed to evaluate the sustainability of these outcomes for both children and families via follow-up of the initial study co-hort 10 years post the initial evaluation. The study targeted families who participated in the original evaluation. Clinician and parent-rated adolescent measures paralleled the original assessments of parent, child and family functioning. Qualitative evaluation was also conducted via a semi-structured interview with parents. 83% of the original sample participated. Mean youth age was 13.2 years. Results indicated sustained improvements in parent-child relationship, child-wellbeing and reduction of parent stress with large effect size (1.14 – 1.92 p < 0.001). On average 73% of the adolescents scored within the normal range on each measure of functioning. Few had repeated school grades or been suspended. None had been arrested. Emerging themes from the qualitative evaluation confirmed the value of the integrated model. The results further support the value of the one stop shop Spilstead Model and have the potential to inform international policy and practice.

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Data Availability

Raw data were generated at the Northern Sydney Local Health District. Derived data supporting the findings of this study are available from the corresponding author (K.G) on request.

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Acknowledgements

The authors wish to thank Dr. Bruce Perry for his vision, leadership and tremendous support for the Dalwood Spilstead Service over many years. We also wish to extend our gratitude to Dr. Elisabeth Murphy, Dr. Michael Zilibowitz and Mr. Frank Bazik, for their tireless support and mentorship. Our greatest thanks, however, goes to the families and young people from the Dalwood Spilstead Service who so generously and enthusiastically gave their time and feedback as participants of the study and to the Dalwood Spilstead multi-disciplinary team for their care and commitment to the needs of vulnerable families.

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Authors and Affiliations

  1. Dalwood Spilstead Service, Child Youth & Family Health Service, Northern Sydney Local Health District, 21 Dalwood Ave, Seaforth, NSW, 2092, Australia

    Kerry Gwynne, Gabrielle Duffy, Bijou Blick & Bronwyn Dowling

  2. Charles Sturt University, Wagga Wagga, NSW, Australia

    Kate Louise Angel & Gene Hodgins

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  1. Kerry Gwynne
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Correspondence to Kerry Gwynne.

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Gwynne, K., Angel, K.L., Duffy, G. et al. 10 Year Longitudinal Evaluation of the Spilstead Model of Milieu Intervention. Journ Child Adol Trauma 16, 699–715 (2023). https://doi.org/10.1007/s40653-023-00523-3

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