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
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
EVALUATION (S) OF PROGRAM
Evaluated population: The evaluated
population consisted of 130 families, including 144 parents and 178
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
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.
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.
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
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),
KEYWORDS: Home-based, Clinic-based, Home Visitation, Substance Abuse, Early Childhood, Middle Childhood (6-11),
Adolescence (12-17), Toddlers, Children, Adolescents, High-Risk, Family
Therapy, Parent or Family Component, Parent Training/Education, Skills Training, Social/Emotional Health, Physical Health, Illicit
Drugs, Behavioral Problems
information last updated 09/17/04.