Focus on Families

OVERVIEW

 Focus on Families (FOF) is a program for parents in methadone treatment and their children.  FOF is a joint program, consisting of parent skills training and home-based case management services. The program concentrates on the risk factors for relapse among opiate addicts, but mainly addresses the risk factors for substance abuse among the addicts’ children.  The experiment consisted of replacing regular methadone treatment for drug addicts with the parent skills training and home-based management services for families.  Parents and their children were interviewed prior to the intervention, and at 6 and 12 months after the completion of parent training. While the findings do report significant positive changes among parents, significant changes were not found for in children’s behavior and attitudes by 12 months.

DESCRIPTION OF PROGRAM

Target population: Families with parents in methadone treatment, and one or more children in the age range of 3-14.

The FOF program focuses on risk factors for relapse among drug addicts and prevention for drug abuse among their high-risk children.  The program involves 53 hours of group training sessions, which consists of a 5-hour family retreat and follow-up with 32 90-minute meetings twice a week. In order for parents to be eligible to participate they must have been in a methadone treatment clinic for a minimum of 90 days. Children are required to attend 12 of the 32 sessions to allow families to apply the new skills they learn with the help of professionals. Each family receives up to 5 hours of direct services per week, including the 3 hours of group sessions mentioned before and 2 hours of case management by case managers. Monetary reinforcement, transportation, and childcare were offered to the families. Professional parent trainers conducted the sessions using a structured cognitive-affective-behavioral-skills training curriculum developed specifically for the program.  The sessions included motivation talks, discussion of drug abuse risks, modeling of family management skills, guided practice, independent practice and generalization. The program contained a skills training for parents that works on relapse prevention and coping, anger management, child development, holding family meetings, and setting clear expectations.

The home-based case management part of the program lasted 9 months and focused on parents and children together and helped them sustain the skills learned from the sessions. The program helps families work on communication through family meetings, positive involvement in the family for each family member, and children’s involvement in healthy activities outside of the family.

EVALUATION (S) OF PROGRAM

Evaluated population: The evaluated population consisted of 130 families, including 144 parents and 178 children. 

Approach: A higher proportion of eligible families were assigned to the experimental group (n=75), than to the control group (n=55) because of anticipated attrition from the program itself.  Of the 144 parents in the 130 families who initially enrolled in the program, 94 percent (N=135: 78 experimental, 57 control) continued with the program, including an interview 6 months after finishing the group sessions portion of the intervention.  Lastly, at the end of 12 months, 92 percent of the original participants (N=132; 74 experimental, 58 control) completed the 12- month follow- up interview.  The 178 children (97 experimental, 81 control) were between the ages of 3 and 14 at baseline; however, only children ages 6 and older were interviewed.  Ninety percent (N=104; 58 experimental, 46 control) of the children ages 6 and older were contacted 6 months after completing the group intervention, and 87 percent (N=100; 57 experimental, 43 control) were contacted after 12 months for another follow-up. Approximately 90 percent of all participants completed interviews, therefore providing a conservative test of hypotheses on the effectiveness of the program.

 The age range of parents was not reported specifically in the report; however, the mean age of the 137 parent participants is 35.3 years, with a standard deviation of 5.8.

Results: Data on all participants initially assigned to a condition were examined. The outcome for the child-focused aspect of the experiment did not prove to have significant effects.  The case managers looked at 11 measures, finding the only significant difference to favor the control children in the prosocial involvement with parent’s portion.  They also reported no substantial differences in problem behaviors and negative peer networks. Results from a 6-month follow up show that the older children reported fewer activities with their parents than the younger children, who increased their activities with their parents. There was little significance reported in the areas of drug use and delinquency.

 The lack of significant changes in children involved in the control group of the experiment is to be noted.  The goal of the program was to positively affect parenting behaviors, therefore directly affecting the growth and development of their children.  The program shows improvement for the parents, but trivial improvement for the children.  However, it may be too early to see the effects on children, since effects may only become recognizable as children reach adolescence where the prevalence of drug use and delinquent behavior rises.

 The research report does include the outcome for the parents, indicating less drug use at 12 months though not at 6 months, less domestic conflict, more family rules, and better problem-solving in drug-related situations but not otherwise. Only the outcomes of children are commented on in this evaluation.

SOURCES FOR MORE INFORMATION

References

Catalano, R. F., Gainey, R. R., Fleming, C. B., Haggerty, K. P., Johnson, N. O. (1999). An experimental intervention with families of substance abusers: one-year follow- up of the focus on families project. Addiction, 94 (2), 241-254.

Program categorized in this guide according to the following:

Evaluated participant ages: 3-14 years/ Program age ranges in the Guide: 0-5, 6-11, 12-14

Program components: clinic-based/home visiting/parent or family component

Measured outcomes: behavioral problems, physical health, social/emotional

Program information last updated 09/17/04.

© Child Trends 2004