PROJECT TALC

FOR PARENTS WITH AIDS AND THEIR ADOLESCENT CHILDREN

 

OVERVIEW:

 

Project TALC is an intervention designed to improve behavior and mental health outcomes among parents with AIDS and their adolescent children. In a random assignment study, families assigned to take part in Project TALC were compared with families assigned to a control group. Over the two-year follow-up period, adolescents assigned to take part in the intervention reported significantly and substantially lower levels of emotional distress, conduct problems, and family-related stressors and higher levels of self-esteem than did control group adolescents.

 

DESCRIPTION OF PROGRAM

 

Target population: parents with AIDS and their adolescent children

 

Project TALC (Teens and Adults Learning to Communicate) is designed to improve behavioral, social, and mental health outcomes among parents with AIDS and their adolescent children. The intervention, based on social learning theory, includes 24 sessions spaced out over a period of 12 Saturdays. The first eight sessions are delivered only to AIDS-infected parents. These sessions address issues of disclosure, emotional reaction to AIDS, and coping with stigma. The remaining 16 sessions are delivered to both parents and adolescents. These sessions address issues such as making custody plans, expressing love and affection, and maintaining positive family routines with a very ill parent. Each of these sessions involves some activities for which parents and children are separated and some activities for which parents and children meet together. All sessions include goal-setting and problem-solving activities.  

 

EVALUATION(S) OF PROGRAM

 

Borus-Rotheram, M. J., Lee, M. B., Gwadz, M., & Draiman, B. (2001). An intervention for parents with AIDS and their adolescent children. American Journal of Public Health, 91(8), 1294-1302.

 

Evaluated population: 307 financially-needy, AIDS-infected parents and 412 adolescent children constituted the study sample for this investigation. The majority (80%) of the parents were mothers.  Approximately one-half of the study participants were Latino and over one-third were African American.

 

Approach: The Division of AIDS Services in New York City provided researchers with a list of financially needy persons with AIDS. Persons on this list who were parents of adolescent children were recruited to participate in the study. Families (parent and all adolescent children) who consented to participate were randomly assigned to either the treatment group or the control group. Families assigned to the treatment group were given the opportunity to participate in Project TALC. Project TALC sessions were led by social workers and graduate students in clinical psychology who had completed a 5-day training program and received ongoing supervision. Families assigned to the control group did not receive an intervention.  Among parents in the treatment group, three-quarters attended at least one session. 

 

All study participants were interviewed at baseline. Interviews assessed emotional well-being, problem behaviors, and self-esteem.  Follow-up interviews occurred every three months for a period of two years. 

 

Over the course of the two-year follow-up period, 134 of the AIDS-infected parents died - 62 from the intervention group and 52 from the control group.

 

Results: During the first 15 months after baseline, adolescents assigned to the treatment group experienced a reduction in emotional distress that was significantly greater than that experienced by adolescents assigned to the control group. Treatment adolescents also experienced a significantly greater decrease in anxiety. Reductions in emotional distress and anxiety did not differ significantly between groups after the 15-month follow-up, however.

 

Over the two-year follow-up period, adolescents assigned to the treatment group decreased their problem behaviors and conduct problems to a greater extent than did adolescents assigned to the control group.  Specifically, adolescents in the treatment group had four times fewer behavior problems and 2.4 fewer conduct problems.  Treatment adolescents also experienced significantly fewer family life stressors and experienced significant gains in self-esteem.

 

Parents also benefited from Project TALC. Compared with control parents, treatment parents reported lower levels of emotional distress and problem behaviors. Three-quarters of parents had disclosed their health status to their children before the program; however, the intervention did not have an impact on parents' willingness to disclose their HIV-positive status to their children or on their formation of custody plans for their children.

 

SOURCES FOR MORE INFORMATION

 

Program manual available at:

http://chipts.ucla.edu/interventions/manuals/intervhra1.html

 

References:

Borus-Rotheram, M. J., Lee, M. B., Gwadz, M., & Draiman, B. (2001). An intervention for parents with AIDS and their adolescent children. American Journal of Public Health, 91, 8, 1294-1302.

 

Program categorized in this guide according to the following:

Evaluated participant ages: 11-18

Program age ranges in the guide: Middle Childhood, Adolescence, Youth

Program components: Parent or Family Component, Counseling/Therapy

Measured outcomes: Social and Emotional Health, Mental Health, Behavioral Problems

 

KEYWORDS: Middle Childhood (6-11), Adolescence (12-17), Young Adulthood (18-24), Children, Youth, Young Adults, Parents with HIV/AIDS, Self Esteem, Behavioral Problems, Conduct Problems, Social/Emotional Health, Mental Health, Anxiety, Depression, Clinic-based, Counseling/Therapy, Family Therapy, Hispanic or Latino, Black or African-American, Skills Training.

 

Program information last updated on 9/18/07.

 

 

© Child Trends 2003