Abstract
A case study in program development and refinement is presented. We describe the Teaching-Family model and its history, the original research goal of developing a community-based program that was more humane, more effective in teaching communityliving skills, and less expensive than the traditional large state institutions prevalent when we began. We present the research on the components of the model and the outcome research on the complete model. We share the serious problems that occurred when we attempted to replicate the program in other communities. We argue that the subjective consumer feedback questionnaire (and the other components of the comprehensive quality refinement system that have evolved over the past 25 years) have played an important role in the survival and success of the model. We recommend that people interested in increasing the quality and survival rates of their human services programs may want to consider developing a similar technology driven by systematic reciprocal feedback from consumers and line staff instead of relying on unplanned consumer and staff feedback, as many programs do now. Such feedback helps us to continue improving the quality of the always evolving Teaching- Family model.