Crary E 1997 Help! The Kids Are at It Again Seattle Wa Parenting Press Inc

June R. Wyman

Two NIDA-funded studies are finding that working with the family is more effective in reducing risks of drug corruption than working with parents or children solitary. Both projects target families at risk. The Strengthening Families Program works with parents and children in families where the parents abuse drugs, while Focus on Families works with parents who are in methadone handling. Children from such families, research shows, are at risk for condign drug abusers themselves.

Strengthening Families

The Strengthening Families Program is aimed at 6- to ten-year-old children of drug abusers and their parents.

"We work on improving parent-child relationships - their time together, their advice patterns," says Dr. Karol Kumpfer of the University of Utah in Table salt Lake City, the project'southward primary investigator. "We try to change the family unit dynamics, to create a more autonomous family where they actually have family meetings, talk together, and programme activities together. Then the child feels that he or she belongs to something, that 'we are a family, we believe certain things, we stand for certain things, and nosotros work together as a unit.'"

Defining Prevention Programs Past Their Audiences

Any plan works best when it is tailored to its audience - and the same is true of drug abuse prevention efforts. While some programs try to reach whole communities, others target specific at-risk subgroups. To describe the different approaches, researchers have adopted new definitions:

• Universal programs accomplish the general population, but in a defined setting. Example: all students in a school.
• Selective programs target groups within the general population that enquiry has defined as at risk for drug abuse. Examples: children of drug abusers, poor school achievers.
• Indicated programs are designed for people who already accept tried drugs or show other risk-related problem behaviors. Example: loftier school students at risk for dropping out considering of multiple problems such as depression, poor grades, and substance abuse.

A project may employ one, two, or all of these strategies. The family unit-focused programs on this folio are selective prevention projects; the school-based programs described on page 8 are indicated programs.

Dr. Kumpfer devised her programme after reviewing more than than 500 family drug abuse prevention programs. From this survey, she designed a study to compare three promising approaches: a xiv-session parent training program; the same programme combined with a children's skills training program; and a three-way merger of the parent and child programs with a family unit skills training program.

Her written report, done in Salt Lake City, involved families with parents who were in methadone treatment programs or who were substance-abusing outpatients at community mental wellness centers. The inquiry showed that the three-role intervention was the nigh powerful in reducing problem behaviors. Compared with families that did not receive any intervention, families that went through the three-part program showed significant improvements in adults' parenting skills, children's social skills, and family unit relationships. Children achieved meaning reductions in aggressiveness and other problem behaviors. Older children significantly reduced their use of tobacco, drugs, and alcohol, and parents reduced their depression and drug use substantially.

The iii-part curriculum became the Strengthening Families Program and has since been adapted and tested with unlike ethnic populations beyond the country. Although these modified versions of the programme differ in cultural content, all utilize the same basic framework: parent grooming, children'southward training, and family skills grooming. In each of 14 weekly sessions, groups of parents and children are taught separately for the commencement hour. In the 2d hr, they come together to practice their new skills. After, the whole group shares dinner and a film or other amusement.

In their sessions, children learn how to exist direct, to talk most problems, and to enquire for what they need. For example, "A lot of the kids say that they would similar to tell their parents to cease using drugs, and they just don't know how - so we teach them those skills," says Donna Lee Picaso, a caseworker with the Denver Area Youth Services Agency who led children's classes in the Denver study. Children also learn how to resist peer pressure level, handle anger, deal with criticism, and cope with problems without resorting to drugs.

Parents are trained in techniques such as establishing goals, giving incentives and reinforcements, and setting limits. "They're right upwardly front with saying they have very limited skills, and they're anxious to learn new ones," says Donna Martinez, a social worker in the Denver written report.

Sessions are held in facilities that are easy for participants to attain such as family support centers in urban housing projects, community centers, local churches, and schools. Grouping size has ranged from 5 to 14 families. Session leaders are recruited from local social service agencies and have counseling or social work feel.

Focus on Families

Average Drug Apply During Past 30 Days Past Parents, 12 Months Afterward Finishing Focus on Families Plan. Parents in the Focus on Families parenting plan, all recruited from methadone treatment clinics, reported using heroin and cocaine less oftentimes than did clinic parents who did non participate in Focus on Families.

A dissimilar approach is taken in Focus on Families, a parenting programme for methadone handling patients adult by Dr. Richard Catalano and his colleagues at the Academy of Washington in Seattle. The goal of this program is to reduce parents' apply of illegal drugs by teaching them how to cope with bug without resorting to drug abuse and how to manage their families amend.

The plan was tested in Seattle with families recruited from two Seattle-surface area methadone clinics. Although all parents were in methadone treatment to reduce their drug apply, 54 per centum reported that they had used heroin, marijuana, cocaine, and other illegal drugs in the calendar month before entering the family program. Families were randomly assigned to the experimental grouping, which went through the Focus on Families program, or the control group, which did not.

Subsequently families attended an initial v-hour retreat, parents completed 4 months of twice weekly 90-minute training sessions. Children attended 12 of the sessions to practice advice skills with their parents.

Example managers visited each family at domicile every week for 9 months to help employ new skills and solve family bug. These business firm calls were critical, says Kevin Haggerty of Dr. Catalano's research team. "Families need hands-on coaching to reinforce the skills they larn and to deal with the never-ending crises in the lives of addicted parents."

To assess the programme'south impact, parents were interviewed before the program, correct afterward their 4-month training, and again at 6, 12, and 24 months after the cease of training. Children age 6 and older in the treatment families, as well as control group families, were interviewed at the same intervals.

"A lot of the kids say that they would similar to tell their parents to cease using drugs,and they but don't know how - and so we teach them those skills."

At the 12-month interview, program parents reported dramatic reductions in their heroin and cocaine utilize and significantly better parenting skills compared with the command group, Dr. Catalano reports. At the 24-month followup, parenting and problem-solving skills remained significantly better, but "we lost the significant treatment furnishings on drug use," says Haggerty. "Family interventions need to exist ongoing with parents who are drug addicts," he concludes.

The program had a mixed touch on the children, who ranged in age from iii to xiv years. At the 24-month followup, program children reported a trend toward less delinquent behavior and marijuana use, and those 9 years and older reported lower rates of alcohol initiation. The program appears to take had a greater impact on younger children than older ones. This finding suggests that children of addicts may benefit more than if they are exposed to improved parenting earlier and longer, the researchers conclude.

Next Steps

Despite promising results from these models, there is much to learn about preventing drug abuse in families, says Dr. Rebecca Ashery of NIDA'southward Prevention Enquiry Co-operative. More research is needed on issues such equally:

• how to accommodate successful programs to different cultural and ethnic groups equally was done with the Strengthening Families Program.
• how males and females respond differently to drug abuse prevention training.
• how to attract and retain families in prevention studies.
• intervening with the extended family.
• intervening with the almost dysfunctional families - for case, parents who take drugs, are physically or emotionally calumniating, and endure from major mental illnesses.

Some other side by side pace is to put more than emphasis on very young children. "Through inquiry nosotros're finding out that it's not too soon to intervene early on in schoolhouse or even before schoolhouse," says Dr. Ashery.

"In the long run, what it will take is a comprehensive approach. You lot tin can't do the family unit in isolation, the school in isolation, the community in isolation," she says. "You have to do information technology all in concert: school, family, and customs together."

Sources

• Catalano, R.F.; Haggerty, M.P.; Fleming, C.B.; and Brewer, D.D. Focus on Families: Scientific findings from family prevention intervention enquiry. NIDA Enquiry Monograph, in press.
• Kumpfer, One thousand.L.; Molgaard, V.; and Spoth, R. The "Strengthening Families Plan" for the prevention of delinquency and drug apply. In: Peters, R., and McMahon, R., eds. Preventing Childhood Disorders, Substance Corruption, and Malversation. Thousand Oaks, CA: Sage Publications, pp. 241-267, 1996.

For more information:

• About the Strengthening Families Program, contact Dr. Karol Kumpfer, Department of Health Education, University of Utah, Salt Lake Urban center, UT 84112, (801) 581-7718.
• About Focus on Families, contact Kevin Haggerty, Social Development Enquiry Group, University of Washington, 9725 Tertiary Ave. N.E., Ste. 401, Seattle, WA 98115, (206) 543-3188.

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Source: https://archives.drugabuse.gov/news-events/nida-notes/1997/06/multifaceted-prevention-programs-reach-risk-children-through-their-families