Families Facing the Future
(previously called Focus on Families)
Summary
Outcomes
Curriculum
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Families Facing the Future Summary of Findings
The Families Facing the Future
research program was developed for parents receiving methadone treatment
and for their children. The primary goals of the project were to reduce
parents' use of illegal drugs and to reduce risk factors for their children's
future drug use while enhancing protective factors. This summary provides
a listing of publications from the intervention, and a summary of the
intervention. Five key findings from the project are listed below.
Finding One:
Children of recipients of methadone treatment displayed higher levels
of problem behavior than similarly aged children in a general population
sample and differ in patterns of socialization (Catalano, Haggerty &
Gainey, in press; Gainey, Catalano, Haggerty & Hoppe, 1997; Fleming,
Brewer, Gainey, Haggerty & Catalano, 1997; Hoppe, Wells, Haggerty,
Simpson, Gainey & Catalano, 1998).
Finding Two:
Parents in methadone treatment can successfully be engaged and will
participate in intensive family interventions (Gainey, Catalano, Haggerty
& Hoppe, 1997).
Finding Three:
Families Facing the Future, the risk and protective-focused intervention, increased
parent relapse prevention skills, self efficacy and had important effects
on reducing parents' drug use, domestic conflict, and increasing the
number of family rules (Catalano, Gainey, Fleming, Haggerty & Johnson,
1999; Catalano, Haggerty, Gainey & Hoppe, 1997).
Finding Four:
Children reported less involvement in drug use and other problem behaviors
at the 24 month follow-up, at a trend level of significance. (Bry, Catalano,
Kumpfer, Lochman & Szapocznik, 1998).
Finding Five:
A meta-analysis of 69 published studies on predictors of continued drug
use among opiate users finds 10 variables show statistically significant
and longitudinally predictive relationships (average r >.1) with
continued use, including: high level of pretreatment opiate/drug use,
prior treatment for opiate addiction, no prior abstinence from opiates,
abstinence from/light use of alcohol, depression, high stress, unemployment/employment
problems, association with substance abusing peers, short length of
treatment, and leaving treatment prior to completion (Brewer, Catalano,
Haggerty, Gainey & Fleming, 1998).
Families Facing the Future
Published Reports:
Brewer, D. D.,
Catalano, R. F., Haggerty, K., Gainey, R. R., & Fleming, C. B. (1998).
A meta-analysis of predictors of continued drug use during and after
treatment for opiate addiction. Addiction, 93(1), 73-92. (SDRG
#167)
Brewer, D.D., Fleming,
C. B., Haggerty, K. P., & Catalano, R. F. (1998). Drug use predictors
of partner violence in opiate-dependent women. Violence and Victims,
13(2), 107-115. (SDRG #176)
Bry, B. H., Catalano,
R. F., Kumpfer, K. L., Lochman, J. E., & Szapocznik, J. (1998).
Scientific findings from family prevention intervention research. In
R. S. Ashery, E. B. Robertson, & K. L. Kumpfer (Eds.), NIDA Research
Monograph: Vol. 177. Drug abuse prevention through family interventions
(pp. 103-129). Rockville, MD: National Institute on Drug Abuse. (SDRG
#168)
Catalano RF, Haggerty
KP, Fleming CB, Brewer DD, Gainey RR (2002). Children of substance abusing
parents: Current findings from the focus on families project. In R.
J. McMahon & R. D. V. Peters (Eds.), The effects of parental dysfunction
on children (pp. 179-204). New York: Kluwer Academic Press/Plenum
Publishers. (SDRG #213)
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. (SDRG #166)
Catalano, R. F.,
Haggerty, K. P., & Gainey, R. R. (in press). Prevention approaches
in methadone treatment settings: Children of drug abuse treatment clients.
In W. J. Bukoski & Z. Sloboda (Eds.), Handbook of drug abuse
theory, science and practice. Plenum. (SDRG #127)
Catalano, R. F.,
Haggerty, K. P., Gainey, R. R., & Hoppe, M. J. (1997). Reducing
parental risk factors for children's substance misuse: preliminary outcomes
with opiate-addicted parents. Substance Use and Misuse, 32(6),
699-721. (SDRG #143)
Catalano, R. F.,
Haggerty, K. P., Gainey, R. R., Hoppe, M. J., & Brewer, D. D. (1998).
Effectiveness of prevention interventions with youth at high-risk of
drug abuse. In W. J. Bukoski & R. I. Evans (Eds.), NIDA Research
Monograph: Vol. 176. Cost-benefit/cost-effectiveness research of drug
abuse prevention: Implications for programming and policy (pp. 83-110).
Rockville, MD: National Institute on Drug Abuse. (SDRG #153)
Fleming, C. B.,
Brewer, D. D., Gainey, R. R., Haggerty, K. P., & Catalano, R. F.
(1997). Parent drug use and bonding to parents as predictors of substance
use in children of substance abusers. Journal of Child and Adolescent
Substance Abuse, 6(4), 75-86. (SDRG #170)
Gainey, R. R.,
Catalano, R. F., Haggerty, K. P., & Hoppe, M. J. (1995). Participation
in a parent training program for methadone clients. Addictive Behavior,
20(1), 117-125. (SDRG #140)
Gainey, R. R.,
Catalano, R. F., Haggerty, K. P., & Hoppe, M. J. (1997). Deviance
among the children of heroin addicts in treatment: Impact of parents
and peers. Deviant Behavior, 18(2), 143-159. (SDRG #152)
Hoppe, M. J., Wells,
E. A., Haggerty, K. P., Simpson, E. E., Gainey, R. R., & Catalano,
R. F. (1998). Bonding in a high-risk and a general sample of children:
Comparison of measures of attachment and their relationship to smoking
and drinking. Journal of Youth and Adolescence, 27(1), 59-82.
(SDRG #155)
Keller, T. E.,
Catalano, R. F., Haggerty, K. P., & Fleming, C. B. (2002). Parent figure
transitions and delinquency and drug use among early adolescent children
of substance abusers. American Journal of Drug and Alcohol Abuse,
28(3), 399-427. (SDRG #289)
Plotnick, R. D.
(1994). Applying benefit-cost analysis to substance use prevention programs.
International Journal of the Addictions, 29(3), 339-359. (SDRG
#128)
Plotnick, R. D.,
Young, D. S., Catalano, R. F., & Haggerty, K. P. (1998). Benefits
and costs of a family-focused methadone treatment and drug abuse prevention
program: Preliminary findings. In W. J. Bukoski & R. I. Evans (Eds.),
NIDA Research Monograph: Vol. 176. Cost benefit/cost effectiveness
research of drug abuse prevention: Implications for programming and
policy (pp. 161-183). Rockville, MD: National Institute on Drug
Abuse. (SDRG #150)
Families Facing the Future Outcomes
We compared parents
and children who were in the program with those who were not one year
and two years after the intervention. Parents involved in the program:
-
were more likely
to use relapse prevention and refusal skills in drug use situations.
-
were less likely
to use drugs after difficult life events.
-
reported more
household rules than the comparison group.
-
reported a 65%
reduction in heroin use frequency one year later.
-
were six times
less likely to use cocaine in the last month one year after the
intervention.
Analysis of data
24 months following the intervention reveals lower rates of problem
behaviors by youth as well.
Here are some quotes
from Families Facing the Future participants:
You have all
been super, I swear, you must have been a god-send. Really! The support
you have all given us was and is really needed! Keep it goin!
You folks opened
new communication roads for us, besides giving us a whole box full of
tools to pull out when I need them. I can’t thank you enough.
I really don’t
think I could ever thank you enough. The best way I guess is to try
my best to use the skills you have taught us!
I have this weird
problem of holding my feelings in—thank-god, you guys wouldn’t
allow me to do that! I don’t know what we would have done without
your love and support. I’ll miss this group and look forward to
our reunions.
The research project
was funded by the National Institute on Drug Abuse. Funding for the
research intervention ended in June 1993. Therapeutic Health Services
has continued to conduct the Families Facing the Future intervention using agency
funds.
Families Facing the Future Curriculum
Authors: Kevin
P. Haggerty, Elizabeth Mills, and Richard F. Catalano (1993)
The Families Facing the Future curriculum was developed to address the needs of families
whose parents are addicted to drugs or alcohol. The curriculum has been
field tested at two methadone clinics in Seattle with funding from a
grant from the National Institute on Drug Abuse. As with previous curricula,
home based services accompany the delivery of this curriculum. A home
based service delivery manual is available.
The Families Facing the Future parent training curriculum consists of one five-hour family
retreat and 32 hour-and-a-half parent training sessions. Sessions are
conducted twice a week over a 16-week period. Children attend 12 of
these sessions to practice the skills with their parents. Session topics
are targeted at specific risk and protective factors and include:
Family Goal
Setting: This five-hour session focuses on bringing a variety
of families together to share a common, trust-building experience. Families
work together to develop goals for their participation.
Relapse Prevention:
These four sessions include identification of relapse signals or
triggers, anger and stress control, and creating and practicing a relapse
plan in the event of relapse. The primary focus during these sessions
is the impact of relapse on the client's children and skills to prevent
and cope with relapse situations.
Family Communication
Skills: The skills of Paraphrasing, Open Questions, "I"
Messages are taught during these sessions. Families practice using the
skills during two practice sessions. Families also practice and use
Family Involvement Skills to develop family expectations and plans for
regular family meetings or family play and fun time. All subsequent
groups reinforce the use of the communication skills taught in these
early sessions. Families are asked to conduct weekly family meetings
to practice the skills learned in the training.
Family Management
Skills: Parents learn and practice setting clear and specific
expectations, monitoring expectations, rewarding and consequencing negative
behaviors. Parents practice implementing "the law of least intervention,"
using the smallest intervention to get the desired behavior from their
child. A variety of discipline practices are learned and practiced by
parents. These include, praise, ignoring, expressing feelings, if-then
messages, time-outs, and privilege restrictions.
Creating
Family Expectations about Drugs and Alcohol: Families work together
to define and clarify expectations about drugs and alcohol in their
families.
Teaching
Children Skills: Parents learn how to teach their children two
important skills, Refusal Skills and Problem Solving Skills, using a
five-step process.
Helping Children
Succeed In School: Parents build on the previously learned
skills to create, monitor and consequence a home learning routine for
their children.
Parent sessions
are conducted with groups of six to eight families. It is necessary
to provide practice opportunities as well as skill components that address
recurring problem behaviors specific to the needs of the parents. The
parent training format combines a peer support and skill training model.
The training curriculum teaches skills using the "guided participant
modeling." Skills are modeled by trainers and other group members,
then discussed by participants. Skills steps are reviewed and then parents
practice the steps. Video-tape is frequently used in modeling the skills
or during practice of the skills. The training focuses on affective
and cognitive as well as behavioral aspects of performance.
The curriculum allows
for participant practice in situations they currently face with their
own children. Parents complete home extension exercises after each session
to generalize the skills from the training setting to the home setting.
After parents learn and practice skills, family sessions are conducted
where parents and children practice using their new skills together.
The Families Facing the Future
case management intervention comprehensively addresses important aspects
of family life. The case management intervention is designed to test
the effectiveness of: (a) helping families to identify their goals and
empowering them to work toward those goals; (b) building on families'
strengths to stabilize their household through providing tangible services
and skills; (c) working directly with clients and their families to
reduce post-treatment relapse factors and risk factors for later drug
abuse by children; (d) motivating and encouraging continuation with
the parenting skills training; and (e) further reinforcing, practicing,
and generalizing parenting skills to the home environment. Case managers
approach these tasks by providing families with a prosocial model, offering
them opportunities for involvement in prosocial activities, networking
them into needed services, and changing their reward structure through
coaching and reinforcement of their new skills. Case managers also work
with families to accomplish the family goals established in the initial
parent training session.
PARENT TRAINING CURRICULUM
Each grouping of
sessions will address all of the following issues: Practice exercises,
Involvement activities, Developmental issues appropriate to topics,
Family meeting activities, Relapse, and Motivation to use the skills.
Marathon Session—Six
Hours/Overview
Relapse
Session 1--Relapse
prevention
Session 2--Relapse
signals/Anger/Stress
Session 3--Relapse
prevention practice
Session 4--Relapse
coping
Communication
Session 5--Do's
and Don'ts of child development (includes teaching skills)
Session 6--Listening/Paraphrasing--open
questions
Session 7--Practice
(non-verbals, play and talk)
Session 8--I
messages/Feeling expression
Session 9--Practice
session (play and talk)
Family Management
Session 10--Identify
what you want from child
Session 11--Monitoring
(law of least intervention)
Session 12--Positive
consequences
Session 13--Positive
consequences practice
Session 14--Negative
consequences
Session 15--Negative
consequences practice
Session 16--Choosing
the best skill--Practice session for family management
Session 17--Practice
with kids
Session 18--Position
on drugs--attitudes/own views
Session 19--Position
on drugs--developing a family position
Session 20--Position
on drugs--practice with kids
Teaching Your
Children Skills
Session 21--Refusal
skills--Parents learn
Session 22--Refusal
skills--Parents teach kids
Session 23--Refusal
skills--Parents and kids learn under pressure
Session 24--Problem
solving--SODAS
Session 25--Problem
solving--SODAS practice (no kids)
Session 26--Problem
solving--SODAS practice with kids
Session 27--Problem
solving--Putting it all together
Helping Your
Child Succeed In School
Session 28--Overview
Session 29--Monitoring
your child's success
Session 30--Monitoring
your child's success practice with kids
Session 31--Working
with school personnel
Session 32--Termination
potluck
Summary
Outcomes
Curriculum Order
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