EditorJoann Grayson, Ph.D.

Editorial DirectorAnn Childress, MSW

Editorial AssistantWanda Baker

Computer ConsultantPhil Grayson, MFA

Student AssistantsKendra HatchettMadeline HartsokZachary Buchin

Sponsored by

Child ProtectiveServices Unit

Virginia Departmentof Social Services

Summer, 2013 Virginia Child Protection Newsletter Volume 97

continued on page 2

EVIDENCE-BASED PARENTEDUCATION PROGRAMS

There is increased attention on identifyingand delivering interventions that are sup-ported by scientific research. The evidence-based movement in child welfare is due inpart to the demands of various fundingsources in federal, state, and local govern-ments, as well as private foundations thatdesire to invest in practices with a provenrecord of success. While the base of solidempirical research evidence is still accumu-lating, this issue of VCPN will discuss someof the parenting education programs that arecurrently considered to have proven effec-tiveness.Parent education programs seek to help

parents develop appropriate child manage-ment techniques and to gain knowledge andunderstanding of age-appropriate behaviorand expected developmental milestones.These programs often contain a componentto help parents learn the skills of identifyingcommunity resources that provide support tofamilies. The Child Abuse Prevention andTreatment Act, as reauthorized by the Keep-ing Children and Families Safe Act of 2003,identifies parent education as a core preven-tion service. A significant number of Com-munity-Based Child Abuse and Prevention(CBCAP) grants are funding parent educa-tion programs as stand-alone efforts or aspart of more comprehensive strategies(Child Welfare Information Gateway, 2008). Successful parent education programs

help parents acquire and internalize parent-ing and problem-solving skills necessary tobuild a healthy and well-functioning family.According to references cited in the ChildWelfare Information Gateway (Lundahl &Harris, 2006), research has shown that effec-tive parent training and family interventionspromote protective factors and lead to posi-tive outcomes for both parents and children.Protective factors that can prevent child mal-treatment include: nurturing and attachment;knowledge of child development; under-standing of child management techniques;parent resilience; social connections; andconcrete supports for parents.

Program components

Parenting programs often share similarcontent. Many parenting programs teach par-ents communication skills and positive par-ent-child interaction skills. Some programshave parents practice the skills with theirchildren under supervision. Parenting pro-grams often teach specific methods for re-sponding to children’s externalizing behav-iors. Some programs have units on stressmanagement and time management. Infusedinto the teaching, one generally finds devel-opmental information. Some programsgroup parents by the ages of their children toenhance this learning. Other features of par-enting programs can include: encouragingpeer support; special incentives to involvefathers; features to enhance attendance suchas providing transportation, a meal andchild care; incentives for attendance such asdoor prizes and monetary incentives forprogram completion.

Training Methods and FacilitatorCharacteristics

A variety of training methods have beenshown to be effective in changing both par-ent behaviors and child behaviors. These in-

clude directly training parents in behavioralprocedures, teaching parents in groups, andthe use of written manuals with limited di-rect consultation (studies cited in Kaiser &Hancock, 2003). Kaiser & Hancock suggest that parent ed-

ucators require certain background and per-sonal characteristics in order to be optimallyeffective. • It is important that the parent educator actually have expertise in using the tech-niques and methods being taught. In modeling and when discussing the proce-dures, parent educators should be facile in their execution of the method. They must also understand and be able to ex-plain the rational for procedures and the theoretical background that supports their use. • The parent educator must be able to place interventions in the framework of a child’s current developmental status and unique needs (such as knowing modi-fications for children with developmental problems). • In addition to being skilled and knowl-edgeable, the parent educator must also be able to teach the skills to others. Teaching is a different skill than mastery of the material. • Parent educators must value the parent as a co-participant in the training process.

2

PARENT EDUCATIONPROGRAMScontinued from page 1

• Educators and parent should work to-gether to set goals for the parents and their children.• The parent educator should be able torelate the methods and teaching to parents’ goals for themselves and their children. • Effective parent educators seek feedback from parent participants and use that feedback to improve their instruction. The role of the parent educator, therefore,

is complex and challenging. Although it in-cludes aspects of teaching and case manage-ment, parent educators have a unique focus.They must be skilled in intervening withchildren, they must be able to teach parentshow to perform the interventions, and theymust manage the teaching process. Parenteducators must understand the conceptualbasis of the interventions and their core as-sumptions. They must be able to present thematerial in a way that it is understood by theparents and is applicable to their children. The parent educator must be able to im-

plement the intervention with children, in-struct the parent, and ‘trouble-shoot theparent’s attempts, providing specific feed-back, coaching, and guidance. Feedback toparents should be individualized, fit theirskill level and learning style, and should re-flect their education and reading levels.Feedback should be positive, encouraging,and specifically descriptive, rather than gen-eral (Kaiser & Hancock, 2003). According to Kaiser and Hancock (2003),

effective parent teaching requires outsidepreparation in addition to the time spentwith parents. For example, if videotapes ofparent-child interactions have been made,the parent educator will code or systemati-cally review the tapes to assess parentprogress in learning new skills and thechild’s progress due to the use of the newskills. Keeping notes of each session, notingparent concerns and progress, and reviewingthe notes prior to the next session can helpthe parent educator stay focused on the

needs of each family. Parent education is aclinical skill and apprenticeship training thatincludes practice and supervision is recom-mended prior to facilitators and parent edu-cators offering parenting instruction.

Can Parent Training Programs Prevent Child Abuse?

A meta-analysis of parent training pro-grams designed to reduce or prevent physi-cal child abuse, child neglect, or emotionalabuse was performed in 2006 by Lundahl,Nimer and Parsons. Twenty-three studieswere identified. The analysis showed thatparent training resulted in moderate, but sig-nificant positive gains in child-rearing skills,parents’ emotional adjustment, child-rearingattitudes, and recidivism (substantiated re-peated abuse). Parents completing parent ed-ucation programs modified their beliefsabout the efficacy of corporal punishment.They increased their understanding of chil-dren’s developmental capabilities. Parentsshowed improvements in parent well-being. From the studies in the meta-analysis,

there was evidence to suggest that home vis-itors made a positive impact on parents. Pro-grams that provided interventions through amixture of office and home settings weremore successful than those offering parenttraining in only one setting. Parent trainingprograms that relied solely upon group de-livery were less effective in changing child-rearing practices compared to programs thatoffered some amount of individual instruc-tion. This finding suggests that more effec-tive parenting programs will include anindividual component. The authors (Lundahlet al.) also recommend a combination of be-havioral and non-behavioral approaches.

Characteristics of Effective Programs

Researchers at the Centers for DiseaseControl did a meta-analysis of 77 programevaluation studies published between 1990and 2002 (Kaminski, Valle, Filene, & Boyle,2008; U. S. Department of Health andHuman Services, 2009). They only consid-ered parenting programs with active parentparticipation, since decades of research hadshown that active learning approaches aresuperior to passive approaches. The meta-analysis found three components were re-lated to better parent outcomes. These were:teaching parents emotional communicationskills; teaching parents positive parent-childinteraction skills; requiring parents to prac-tice with their child during program ses-sions. Emotional communication skills target re-

lationship-building and improve parent-childbonding. These skills can also increase chil-dren’s compliance to parental requests. Posi-tive interaction skills can help improvechildren’s self-esteem, provide attention, and

teach parents to demonstrate approval forchildren. Practice of skills is necessary dueto the complicated nature of the methodsbeing taught. The meta-analysis also found that some

programs were effective in helping parentsdecrease children’s aggressive and noncom-pliant or hyperactive behaviors. Four pro-gram components were related to successfuloutcomes in reducing children’s externaliz-ing behaviors. These were: teaching the cor-rect use of timeout; teaching parents torespond consistently to their child; teachingparents how to interact positively with theirchild; and requiring parents to practice skillsduring the program sessions. According to the Child Welfare Informa-

tion Gateway, certain program characteris-tics have been found to be strong predictorsof program effectiveness for parent trainingprograms:• Strength-based focus that reinforces protective factors.• Family-centered practices that are culturally appropriate and consistent with the beliefs and principles endorsed by the families.• A combination of individual and group approaches. • Qualified staff.• Targeted service groups with common needs or identifying characteristics. • Clear program goals and continuous evaluation including both individual and group plans made in partnership with the participants. Progress towards goals should be evaluated periodically. Others (Kaiser & Hancock, 2003) note

that participants need to be willing and readyto learn. Parent education programs will bemost effective when parents are interested inparticipating and consider the class a priorityfor themselves and their children. Parentsshould have the time and energy for partici-pating and be prepared to make a relativelylong commitment (some programs are 16weeks or more). Support from extended fam-ily and friends can enhance learning andchange. The reality is that parents who arecourt-ordered likely lack these characteris-tics. In those cases, it is an even higher prior-ity to use the most effective procedures toincrease the likelihood that parents will ben-efit.

Challenges

The success of a parenting education pro-gram may rest on the facilitators’ ability toattract parents, then engage and retain them.Even an effective program will have limitedimpact if parents don’t attend all of the ses-sions (National Center for Injury Preventionand Control, 2004). The parents who needthe program the most may have challengesto attendance such as variable work sched-ules, unreliable transportation, anxiety aboutbeing in a group, or lack of motivation.

3Ways to be attractive to parents who do notusually attend programs can be crucial toprogram retention. Parents involved with child protective

services may have multiple problems thatdetract from learning new information.These include high rates of domestic vio-lence, serious mental health problems, drugor alcohol abuse, and financial stress (Barthet al., 2005). Additionally many children ex-periencing abuse or neglect develop traumasymptoms and behavioral problems, furthercomplicating parenting tasks. Simply attending a set of classes does not

guarantee that information will translate intoskill acquisition. Most parenting programswill document attendance for child protec-tive services or for courts, but few actuallyprovide substantive information about theparent’s level of participation or observedchanges in competence. Many parenting education programs are

designed to help parents manage difficultchildren, avoid physical discipline and teachalternatives to corporal punishment. Whilethis effort is important, it is worth noting thatthe majority of parents involved in the childwelfare system are substantiated for neglectrather than for physical abuse (Barth et al.,2005). Parent education programs rarely ad-dress lack of supervision or physical neglect.Therefore, the degree of “fit” between neg-lectful parents and the goals and curriculumof many parent intervention programs maybe limited. That said, it is important to notethat neglectful parents can improve their in-teraction with their children due to gainingknowledge about child development (andcorrecting misperceptions about what chil-dren can handle on their own). The parentingprograms may help neglectful parents to de-velop a better understanding of their chil-dren’s needs. Learning about protectivefactors may be helpful to neglectful parentsand the encouragement and modeling fromother parents might improve vigilance andthe level of supervision.Parents should attend a program designed

to address the ages of children they are par-enting. If children span several developmen-tal stages (such as teens to preschool), nosingle program can be expected to help par-ents be effective with all of their children.However, expecting parents to attend two ormore lengthy programs may not be feasible. Adjusting programs to appeal to specific

cultural groups can be time-consuming andproblematic. Modifications can potentiallyenhance a program and render it more effec-tive for a specific group. However, withoutdata to show that the modifications are effec-tive, the impact of modifications is notknown. Modifications can threaten programfidelity (because there are deviations fromteaching the program in a manner known tobe effective). Program adaptations can ren-der a program less effective if a critical com-ponent is deleted or if there is reduced

continued on page 4

dosage. In contrast, allowing instructorsflexibility can increase the instructor’s senseof ownership towards program implementa-tion (Self-Brown, et al., 2011). As agencystaff consider which programs to adopt,checking to determine whether or not a pro-gram developer has already created andevaluated materials for specific subgroupsmight be one important consideration, espe-cially if the agency serves a significant seg-ment of parents from minorities orsubgroups. Currently, there is no compelling evidence

that program adaptations promote better out-comes for certain cultural groups. Even so,suggestions have been made to match partic-ipants and families by race or ethnicity andby preferred language (Self-Brown et al.,2011). Parents attending programs are a hetero-

geneous group. Nationally, parents of about400,000 children are referred by child wel-fare to voluntary or mandated parent trainingprograms (Barth et al., 2005). They join pro-grams that accept parents from the generalpopulation who may simply want to enhancetheir skills, parents of children with behav-ioral or developmental problems, parentswhose children are involved in the juvenilejustice system, and others. The parent educa-tor may have parents with varied educational

backgrounds, ranging from those who havecompleted higher education to those who areilliterate.

What is meant by ‘evidence-based’?

An evidence-based practice has a combi-nation of three factors:

1. The practice has the best re-search evidence to support effectiveness;

2. The practice has been proven through clinical experience;

3. The practice is consistent with the client’s values (Crayton, Wilson & Walsh, 2010)

Where does one find programs thatare evidence-based?

The VCPN website contains reviews ofsources of information for evidence-basedpractices in teaching parenting. Each clear-inghouse uses somewhat different criteriafor program inclusion. Each site also pro-vides somewhat different information aboutthe program. Some of the sites used mostfrequently in this issue of VCPN are:• California Evidence-based Clearing-

CHARACTERISTICS OF EFFECTIVE PARENT EDUCATION PROGRAMS

• Clearly defined program goals and objectives• Measureable outcomes• A strengths-based focus• Targets a family rather than children or parents• Responsiveness to parents’ learning needs and language levels• Responsiveness to parents’ attitudes• Respects parent authority and appreciates individual differences among parents• Curriculum that addresses needs of parents served (for example tailored to needs of new parents or parents of adolescents) • Program is of sufficient length and intensity relative to family risk factors• Trained, knowledgeable, compassionate and engaging staff• Enhancement of protective factors• Acknowledges the impact of neighborhoods, schools, and communities• Culturally responsive• Opportunities for parents to practice skills• Evaluation and adjustments due to evaluation data• High rates of program completion• Follow up and support

Adapted from the Virginia Statewide Parent Education Coalition and from Colosi & Dunifon, 2003

4based and label them as such or if an evi-dence-based practice is implemented withoutfidelity, diluting the effects, funding sourcesmay feel the ‘evidence-based practice’ is justanother false promise. The authors also notethat child welfare clients have many com-plex needs. Some evidence-based practiceshave been developed and tested on popula-tions with fewer needs, thus the benefits maynot be as evident when used with popula-tions that have a different baseline of skills.Stakeholders should not expect a ‘magic bul-let’ when adopting evidence-based practicesand then using the program with parents whoare overwhelmed or who have extra-ordinaryneeds. If the agency is contracting for services,

community partners will need to welcomethe impetus towards evidence-based pro-grams. Strategies should be developed toidentify and address barriers in having com-munity providers adopt the most effectiveparent training approaches. Offering re-sources to help community providers retoolor identifying resources for retooling is oneapproach that agencies can consider.

Concluding Thoughts

As noted by Lundahl, et al. (2006), childabuse results from complex transactional in-teractions among characteristics of parents,children, culture, and the environment. Par-ent education programs attempt to improveparents’ abilities to raise children without vi-olence. They teach child-rearing skills andprovide information designed to change un-healthy or inaccurate child-rearing beliefs.Many programs strive to enhance parents’sense of competence and well-being. Posi-tive changes on such variables lower the riskthat parents will maltreat children in the fu-ture. Parent education is one potentially suc-cessful approach to reducing the risk of childabuse and neglect.

References Available on the Website or by Request

house for Child Welfare• Promising Practices Network• SAMHSA’s National Registry of Evidence-based Programs and Practices• FRIENDS National Resource Center for Community-based Child Abuse Preven-tion (CBCAP)• Office of Juvenile Justice and Delin-quency Prevention (OJJDP) Model Programs• Blueprints for Healthy Youth Develop-ment

Choosing an evidence-based program

Adopting evidence-based practices is not‘cost neutral.’ Training and supervision maybe required in addition to the expenditureson the teaching materials. There may evenbe organizational changes required in orderto adopt some evidence-based programs.Therefore, choosing the programs best suitedto the populations served will eliminate falsestarts and will result in more satisfaction,both for workers and for clients. Many factors may influence an agency’s

or individual’s choice of a program. In addi-tion to considering the evidence of effective-ness and the cost, those choosing a programmight consider the length, the equipment re-quired, the time required for training prior tooffering the program, and the program’sfocus and curriculum (topics covered). Those choosing a program may be influ-

enced by success of others in implementingthe program or the program’s general reputa-tion. The evidence-based programs high-lighted in this issue of VCPN are varied intheir purpose and scope and they representonly a few of the successful parenting pro-grams available.

Implementation

Implementation is crucial. An incorrectlyor poorly implemented program is unlikely

to be effective or at minimum the effective-ness will be diminished. For example, if theprogram was tested and proven effectiveusing 16 weeks of parent training, reducingthe program to 8 weeks or 4 weeks meansthat similar results are unlikely to occur.While adaptations for specialized popula-tions (parents who can’t read; parents withEnglish as a second language) may be neces-sary and can enhance the intervention forthat subset of parents, adaptations should beresearched and proven before placed intowidespread practice. Implementation can be compromised by

failing to follow the program guide, by delet-ing key topics, or by trying to deliver aquicker program. The program must offerthe needed dosage and the curriculum needsto be appropriate for the ages of children inthe family. Leaders must be skilled in thegroup learning methods used to deliver thecontent (such as role playing, modeling, orbehavioral practice). Parent educators mustbe skilled in building alliances with parentsand engaging them in the learning process.Leader praise, enthusiasm, and group sup-port can all be components that are essentialto learning. Leaders must also be skilled inaddressing barriers to program participation(Webster-Stratton & Reid, 2010). Selectionand training of parent educators is obviouslyimportant, but ongoing supervision is also acomponent to consider.Adapting to specialized populations might

mean lengthening the program for parentswhose baseline of parenting knowledge islow. Parents who have children with devel-opmental delays or special needs may needadditional or modified curricula. If there areparents whose children are in foster care,they may have no way to practice the skillsat home and alternatives (such as having thechildren come to a special session for prac-tices or having the parents practice the skillswith each other or having the parents set pre-dictable schedules in their own lives) willneed to be found (Webster-Stratton & Reid,2010). Crayton et al. (2012) note that if adminis-

trators adopt practices that are not evidence-

PARENT EDUCATIONPROGRAMScontinued from page 3

800-CHILDREN800-CHILDREN is a statewide, toll-free parent helpline that operates six days a weekfrom 8:00 a.m. to 9:00 p.m. Trained specialists offer guidance on issues ranging from understanding stages of a child’s development, dealing with stress, strengthening par-ent-child bonding, linking with community agencies, and reporting child maltreatment.

In addition to the toll-free number, questions or concerns can be addressed through e-mail at 800Children@pcav.org A response is sent within 48 hours.

800-CHILDREN is a proven resource for parents from all socioeconomic backgrounds,parenting orientations, and educational backgrounds. Calls are accepted from relativeswho help care for children, concerned citizens, and professionals who work with chil-dren. A For Parents page on the website (http://pcav.org/1-800-children/) offers helpfultips and parenting resources.

5

VIRGINIA STATEWIDE PARENT EDUCATION COALITION (VSPEC)In 2005, the Virginia Department of Health and Prevent Child Abuse Vir-

ginia organized VSPEC as part of the Virginia Early Childhood ComprehensiveSystems (VECCS) state plan through the Maternal Child Health Bureau. VSPECconsists of state and community stakeholders and service providers who worktogether to support a common vision, mission, and set of core values. The Coali-tion works to identify gaps in parent education and to strengthen services.

A three-person panel presented a workshop about VSPEC at the “InsureTheir Future: Invest in Children” Child Abuse Prevention Conference in Rich-mond in April, 2013. The panel included Angela Borsella, Ph.D., Patricia Hein,MSW, and Carol Dolber McMurray, MSW, ACSW, all members of the VSPEC BestPractices Committee.

An overall goal of VSPEC is to increase the quality of parent education programs. They want to acquaint par-ent educators with evidence-based programs that have been proven effective. Efforts starting in 2007 were toidentify what programs were currently offered in the Commonwealth, how accessible the programs were and toidentify the costs associated with each program. The survey garnered 190 responses. “We realized that peoplewere eager for information and training,” said McMurray. “That revelation led to offering an annual conference.The first conference was in 2007 and this year will be our fifth conference.” In an effort to publicize VSPEC to alarger audience, the group was one of the co-sponsors for the annual Child Abuse Prevention Conference inApril, 2013 sponsored by the Virginia Department of Social Services and Prevent Child Abuse Virginia. Anyoneinterested in being placed on the VSPEC mailing list may contact Allison Perry at PCAV: aperry@pcav.org

Another effort is identifying the characteristics common to evidence-based programs. While compiling thisinformation, members realized that parenting programs were not a single entity. “Programs differ by level of in-tensity and the populations they are designed to assist,” noted Hein. “We are creating a guide to help people de-termine what level a program represents,” added Dr. Borsella.

The draft guide describes three levels of parent education programs: Primary; Secondary; and Tertiary. Pri-mary programs are sometimes termed ‘universal’ programs. They are geared towards the general population andenhance parent knowledge and skills on a wide range of topics. Secondary programs are offered to parentsand/or children who may be at risk for child maltreatment. They focus on increasing parent knowledge and skillin areas known to be associated with maltreatment risk. Parents participating in Secondary programs may or maynot have court involvement. Tertiary programs are offered to parents and children who have experienced abuseor neglect. These programs not only address risk areas, knowledge, and skills, but also foster understanding ofhow parents’ early experiences and belief systems influence their parenting choices. Parents are empowered touse their knowledge gained to make changes in parenting practices. Parents participating in Tertiary programsare often, but not always, court-referred.

Panelists stress that the needs of the parents must “fit” the design of the program. “We need to determinewhat research tells us about which program is most effective for the parent’s level of need,” says McMurray.“Then we can send parents to a program that is likely to meet their need.” The panel stressed that parenting ed-ucation is not therapy. “There is a need for wrap-around services or a parent coach to help parents who needmore intensive assistance transfer knowledge gained in classes into practice,” notes Dr. Borsella.

According to Johanna Schuchert, Co-chair of VSPEC, the Coalition currently has about 100 members. Thereis no fee for membership and there are many benefits. Members receive e-mailed information; meeting an-nouncements; access to a toolkit that helps members choose parenting programs that fit their needs; notifica-tions about the annual conference; and minutes of the bi-monthly steering committee. Members can assist withpolicy development, network with others offering similar programs, and market their program. Schuchert notesthat some states offer certification for parent educators and that topic has been discussed at Coalition meetings.

Contact the VSPEC at: Prevent Child Abuse Virginia, 2211 Dickens Road, Suite 204, Richmond, VA 23230Web site: www.vahealth.org/childadolescenthealth/EarlyChildhoodHealth/VSPEC/index.htmContact Johanna Schuchert: jschuchert@pcav.org Angela Borsella: aborsella@grscan.comCarol Dolber McMurray: c.mcmurray@cfdsva.com Patricia Hein: patricia.hein@richmond.gov.com

6

The Nurturing Parenting Programs (NPP)are family-based programs for the preven-tion and treatment of child abuse and neg-lect. The programs were developed to assistfamilies identified by child welfare agenciesas founded or at risk for child abuse and neg-lect. The goals of the program are:• To increase parents’ sense of self-worth, empathy, bonding, and attachment to their children.

• To increase use of positive strategies for child management and reduce harsh and abusive practices.

• To increase parents’ knowledge of age-appropriate developmental expectations.

• To reduce rates of child maltreatment. NPP instruction is based upon psycho-ed-

ucational and cognitive-behavioral ap-proaches to learning. The program focuseson ‘re-parenting’ the parent and helping par-ents learn new patterns and reactions. Overmany years, the programs have becomecompetency-based and more specific aboutthe learning process. A Family NurturingPlan is created prior to the start of theclasses. The parents have input into theirplan. There is a list of lessons with specificcompetencies. The facilitator talks with theparents about what they want to learn andwhat competencies they want to be able todemonstrate to the court. According to pro-gram developer, Stephen Bavolek, Ph.D.parents become excited about the possibili-ties. “It is amazing,” he said in a recent inter-view with VCPN staff. “When parents haveinput into the program, their attitudes turnaround!” he asserts. Dr. Bavolek mentions that the program is

flexible. The parents can be taught and re-taught until they show a comfort level withthe material and can demonstrate the compe-tency. Parents can show their learning eitherduring class or during home visits. The NPPhas worked with the Casey Family Founda-tion to pilot this individualized approach.Between each of the 16 classes, a coach goesto the family’s home to help them practicethe skills taught. The coaching continuesuntil the parents master the skills anddemonstrate the competencies. “What tradi-tionally happens is that parenting programsoffer one lesson each session. However, itmay take more than one session to teach aparticular parent the competency. The NPP is‘parent-centered’ and allows parents to pro-ceed at their own pace,” explains Dr. Bav-olek. “This concept is so different thancounting attendance. In our program, the

parent demonstrates competency regardlessof how long it takes,” he adds. The Casey Foundation did a cost analysis

of the NPP approach (Maher & Corwin,2010; see also Maher, Corwin, Hodnett, &Faulk, 2012). NPP was delivered to all care-givers in Louisiana with prior maltreatmentreports where parenting education was anappropriate intervention. The sample of 204families was taken from five of the 11 re-source centers delivering the program. Theauthors found that the program is cost neu-tral. The $1,165 cost per caregiver (in 2010dollars) was offset by savings in reductionsin repeat maltreatment. NPP saves moneybecause parents do not return into the systemand are able to maintain gains over time. Ad-ditional benefits not computed in the costequation were benefits of enhanced childfunctioning and improved parent well-being.These outcomes likely mean less use of pub-lic systems and increased productivity interms of employment, earnings, and familystability. Dr. Bavolek comments, “In so many other

parenting programs the information is putout there but there is no way to know if theparent learned the skill and to know if theparent is practicing that skill. NPP assuresthat the parent have mastered the skill priorto moving forward.” Dr. Bavolek relates,“The education in the program is sequenced,but the key is to observe and hear how theparent is integrating the lessons.” Dr. Bavolek notes that parents may want

to learn but have challenges. Some are illit-erate, others have learning disabilities andsome have concentration problems orADHD. They don’t process informationwell. The home visits and tutoring processafford an opportunity for learning that thetypical parenting program does not offer.Seven home coaching visits are the mini-mum, with several assessments, includingthe intervention plan, a re-assessment partway through the program and a review at theend of the program. The NPP are also comprehensive. “Parent

education cannot exist without addressingdomestic violence, mental health issues, andaddiction. We have to address these issues inorder to create a nurturing parent,” assertsDr. Bavolek. “My goal is that parents do notfail in parenting tasks. We need to do what-ever it takes to get the parent into a stableenvironment and help the parent create apositive environment for child growth,” headds.

Dr. Bavolek notes that prevention effortsare different. These parents are voluntaryand desire to improve their skills. Some ofthe Virginia agencies using NPP are exam-ples of how the program can be used as aprevention intervention, rather than a com-prehensive training program.

Cheryl Keiper, Social Work Supervisor forFairfax County, talked recently to VCPNstaff. She explained that Fairfax Countystarted using the Nurturing Parenting Pro-grams in the 1990’s. Someone who had beenusing the NPP in Ohio joined the FairfaxCounty agency and introduced the program.Keiper explains that the use of NPP beganon a small scale. “It is a labor-intensivemodel,” she explained,” but we found it tobe workable. In 1996, the agency obtained agrant to expand the use of NPP. The successof the program resulted in obtaining Countysupport as well. Since 1996, the program has grown. This

year there will be 42 parenting groups of-fered. Last year the groups served 433 fami-lies. The NPP is offered in area high schoolsto pregnant and parenting teens. Last year,90 were served and this year 94 parents arealready enrolled. “We have trained substanceabuse counselors in the Nurturing Parentingcurriculum and we are also partnering withdomestic violence prevention staff,” ex-plained Keiper. The Fairfax County Depart-ment of Family Services ParentingEducation Program has three Spanish-speak-ing staff and groups are offered in Spanish tothe large Hispanic population in FairfaxCounty. There are also classes tailored toAfrican-American parents, although theclass is open to parents of any race. Keipernotes, “African-American parents who haveexperienced both the generic class and theculture-specific class tell us that they feelmore connected in the culture-specific class.We purchased the African American supple-ment for NPP in 2004 and offered classes forfamilies with children ages 5 to 11. The fol-lowing year we added a class for parents ofchildren from birth to four with an African-American focus. About 10 to 12% of ourpopulation in Fairfax County is African-American so we wanted to offer something

Nurturing Parenting Programs

7

with a cultural focus. Nationally, African-American children are over-representedwithin the child welfare system and this par-enting program considers parenting from acultural view.” Referrals to the parenting programs come

from a variety of sources. About 20% of thereferrals are from social services. There is nocharge for the classes. “We accept 12 fami-lies for each class,” said Keiper, “and weoften have a waiting list.” The classes areheld weekly and, depending upon the age ofthe child, differ in the number of weeks. Theclass for children from birth to age four is 24weeks (almost six months). The class forchildren from ages 5 to 11 is 13 weeks andthe class for parents of adolescents is 12weeks in length. Both parents and childrenattend the classes which are held from 5:30to 8:00 in the evening with dinner provided.According to Keiper, the parenting classesalso function as a support group. The per-centage of parents who drop out of theclasses varies between 17 and 23%. The rea-sons for drop-out include employment de-mands, lack of transportation, maritalproblems, moving out of the area, and prob-lems with substance abuse or mental health. The location of the program varies. Fair-

fax County is large and by having groups indiffering locations, the transportation burdenon parents can be eased. The program workswith the faith community and often useschurches with kitchens and large meetingrooms for the sites of the group. With par-ents, staff, and children, there can be asmany as 60 people in the group to feed. Pro-viding food for that number can be challeng-ing. Girls Scout Troops, other communitygroups, former class participants and repre-sentatives of the faith community have as-sisted. Additionally, many volunteers assistwith the program as facilitators or child carestaff. The Fairfax County program is entirely

group-based and does not include home vis-its. They do stress practice, and allow timeduring the class for parents and children topractice the lesson together. Keiper com-ments, “The Centers for Disease Controlpublished information about research whichdemonstrated that when parents and childrenpracticed the skills taught and were coachedin the class setting, the parents were better

able to implement the skills in their homes.Therefore, five of the thirteen classes forchildren ages 5-11 are centered on parent-child skill practice,” says Keiper. One of themost important class lessons is taught thesecond week where each family works indi-vidually with a staff member to create familyrules. Keiper relates, “When they graduateand talk about what was most useful to them,many parents mention setting family rules astheir most important class lesson.” Keiperalso talks about the pre- and post-measuresthat NPP provides. “We strive for improve-ments in parenting attitudes in the five keyconstructs of the program that can be docu-mented by the testing. We achieve improve-ment in 85% of families,” she says.

VCPN staff also talked with RasheedahFarid who is a lead facilitator for NurturingParenting Skills groups. Farid has had exten-sive experience with parent education since2003. For the last two years, she has workedwith the Nurturing Parenting Skills program.“Facilitators can choose which classes theywant to present,” she notes. “I love that as-pect of the program! You can offer parentswhat they need, not simply a pre-determinedapproach.” Farid serves a mixed group ofparents who range from those wanting skillenhancement to parents who need to satisfya court-order after being adjudicated forchild abuse. She feels that mixed groupswork well. Farid discusses her philosophy. “The class

is a reciprocal relationship. We all learn fromeach other. The class has to be a safe place.It must be warm and inviting. It is astrength-based approach.” Farid continues,“The first class has to be captivating. Facili-tators let parents know how much they areappreciated.” Farid relates that after her firstparent education experience, change was in-evitable. “I tell parents that I had to makechanges. I can tell you how I changed. Iknow this works. I made the changes and itwas for the best for me and my child,” shesays. The groups that Farid facilitates are 15

weeks in length and for parents of childrenages 0 to 5. A parent education coordinator

does the initial interview and the pre-andpost-tests. There are facilitators for the chil-dren. They have a group meal and a closingcircle that is brief and ends the session butdo not do parent-child activities. Participantsare given home practice assignments. Thereare home visiting services available throughreferral agencies but those are not part of theclasses. The program provides attendancedocumentation but no other information isgiven to courts or agency referral staff. Farid concludes, “I have a passion for par-

ent education. I believe in what I am doing. Idon’t consider the odds of improvement. In-stead, I look at the possibilities of each indi-vidual family. I take this program with meeverywhere. It is me and I am it. I’ll talkabout parenting even on weekends and atholiday celebrations! I’m on a mission, onefamily at a time.”

Cheryl Matteo-Kerney, M. Ed. is Directorof the Prevention Services Division of theMiddle Peninsula Northern Neck Commu-nity Services Board (MPNNCSB) and hasworked with NPP for 23 years. As an NPPNational Trainer and consultant, Matteo-Kerney has conducted NPP Facilitator Train-ing throughout the Commonwealth ofVirginia. Matteo-Kerney is enthusiasticabout NPP. “NPP is extremely positive andaffirming with a strong philosophy of pro-moting alternatives to corporal punishment.NPP develops empathy and awareness, whileremaining very respectful to parents,” sheexplains. For the last 15 years, the MPNNCSB,

through grant funding from the Virginia De-partment of Behavioral Health and Develop-mental Services, has offered NPP tohundreds of parents. They offer all the re-quired NPP components. They do not inte-grate the optional in-home contacts with thegroup, but they do offer the NPP individu-ally to parents in their home on an as-neededbasis. They have also been piloting an“open” NPP class which allows for continualenrollment. This option offers flexibility forparents to start classes. The option is particu-larly beneficial for parents who are court re-ferred by decreasing long waiting times.“We are continuing to evaluate this option.The preliminary data indicates that it isequally effective when compared to the tra-ditional format,” she explained.

Stephen J. Bavolek, Ph.D.

Rasheedah Farid

continued on page 8

8

Virginia Nurturing Network

For the last 18 years, Virginia providerswho use the Nurturing Parenting Programhave had access to the Nurturing Network.The purpose of the Network is to serve as avehicle to make nurturing a way of life in theCommonwealth by sharing information on:program development; implementation;training for facilitators; how to recruit andretain parents and volunteers; and fundingmechanisms. It offers a way for providers tomeet and share experiences, brainstorm ideasand solutions, and offer positive support to

each other. Carol Dolber McMurray, MSW,ACSW, a NPP National Trainer/Consultantis the coordinator. Attendance is not limitedto those offering NPP. Persons interested inlearning about NPP’s philosophy and valuesare also welcome. McMurray describes theNurturing Network as a place for any parenteducator to meet, exchange ideas and learnmore about NPP and available trainings.Meetings are held three times a year. For more information, visit the website:

www.childfamilydevelopment.com or contact Carol D. McMurray (804) 673-7060or e-mail: c.mcmurray@cdfsva.com

General Information

A variety of Nurturing Parenting Pro-grams are available. The Nurturing Skillsfor Families contains 80 skill lessons tochoose from to create a parenting programthat meets a family’s specific needs. TheNurturing Skills for Teen Parents is a 59-lesson program assembled into a LessonGuide. Nurturing America’s MilitaryFamilies is designed for military parentswith children ages 0 to 5.

The FRIENDS National Resource Center for Community-based Child Abuse Prevention lists NPP as a “Promising” Program.

The California Evidence-based Clearinghouse rates NPP as a “3” (Promising).

The OJJDP Model Program Guide rates NPP as “Promising.”

The SAMHSA Model Programs rates NPP as “Promising.”

The NREPP’s four Quality of research ratings range from 2.9 to 3.2 with 4 being the highest rating.

For more information:

Website; www.nurturingparenting.com

Stephen Bavolek: E-mail: sbavolek@ gmail.com

Cheryl Kieper: (703) 324-7691, E-mail: Cheryl.keiper@fairfaxcounty.gov

Rasheedah Farid: E-mail: rasheedah.farid@dss.virginia.gov

Cheryl Matteo-Kerney: (804) 642-5402, E-mail: cmatteo-kerney@mpnn.state.va.us

Carolyn Webster-Stratton, Ph.D.The Incredible Years(IY) ® is a set of in-

terlocking evidence-based group trainingprograms for parents, teachers, and children.There are separate IY parenting programsthat target key developmental stages: Babyand Toddler; Preschool; and School Age.There are also several adjunct IY programsthat can supplement the basic curricula. AnAdvanced Program for parents of childrenages 4 to 12 addresses parent anger and de-pression management, problem-solving, andfamily meetings. A School Readiness Pro-gram focuses on reading readiness and lan-guage development for children ages 3 to 6.An Attentive Parenting Program for parentsof children ages 2 to 6 helps strengthen par-ent-child bonding and child regulationstrategies. The IY program was established in the

mid-1980’s to assist parents of children with

behavioral disorders and conduct problemsand to help teachers institute classroom poli-cies as a preventative to dealing with diffi-cult behaviors. The program has beenevaluated in over a dozen randomized con-trol group trials and these studies are avail-able on the program’s website. A teacherprogram and a child training program (‘Di-nosaur School’) and a Small Group ChildProgram are also offered. According to Peter Loft, social worker and

Certified Trainer for Incredible Years, IYprograms have also been used successfullywith court-referred parents who have mal-treated their children. “We focus on the par-ent-child bond. Our program results inreductions in stress on the Parenting StressIndex. If the parent is less stressed, they cando a better job of caring for children. The In-credible Years helps parents increase warmth

Nurturing Parenting Programscontinued from page 7

Carol Dolber McMurray

and improve the consistency of respondingto children.” Loft mentions that studies withhigh-risk populations have shown significantimprovements, including: increases inparental praise; improved quality of parentinteractions; decreases in the frequency ofharsh discipline; reductions in stress level;reductions in anger; and lower levels of de-pression.One publication (Webster-Stratton &

Reid, 2010) addresses adapting the Incredi-ble Years for families involved in the childwelfare system. The article offers specificsuggestions about how to teach parentswhose children have been removed fromtheir homes. The publication mentions astudy of Head Start participants where 20%

9of the parents had had past involvement withchild protective services (Webster-Stratton,1998; Webster-Stratton, Reid & Hammond,2001). Both the parents with and those with-out prior CPS involvement appeared to ben-efit from attending the Incredible Yearsprogram. Since families attending were vol-untary, the authors note that it is unknownwhether or not court-ordered families mightshow similar benefits. A second randomized study mentioned in

Webster-Stratton & Reid (2010) was con-ducted by Linares et al. (2006) and used par-ticipants who were foster parents paired withmandated biological parents who had chil-dren in foster care due to abuse or neglect.Those who attended more than six sessionsshowed improvements in positive parenting. The Incredible Years program requires 12

to 28 weeks depending upon which pro-grams are being used, and Loft recommendsadditional sessions for parents who havemaltreated children. The first six sessionsconcentrate on improving the parent-childbond. “We don’t mention discipline untilparents have some familiarity and compe-tence in relating to their child,” explainsLoft. The additional sessions in the ad-vanced program teach parents about givingand getting support. Since participants areoften single mothers and are isolated, theybenefit from learning self-care skills andhow to connect with the community. Thereis instruction based on cognitive-behavioraltherapy to help parents learn to think aboutproblems, to challenge their negative self-talk, and to improve problem-solving abili-ties. Parents are also taught how to teachtheir children to problem-solve. The addi-tional sessions address various life skills. Loft notes, “The ideal intervention with

parents who have maltreated children is the16-18-week program plus the 6 advancedsessions and 4 to 6 home visits.” During thehome visits, facilitators can coach the parentin practicing the skills taught in the classes.“It is sometimes difficult for the parents totransfer the skills into their homes,” notesLoft. Loft says the more intensive programcan be very effective, but often agencies donot want to fund the more intensive inter-vention.

Reagan Eshleman, Coordinator of Rock-ingham Memorial Hospital’s Family Con-nection, in Harrisonburg, Virginia, wastrained in 2000 and has been offering The

Incredible Years classes since 2001. She andher staff offer The IY program three times ayear to those in Rockingham, Page and Au-gusta counties and are on their 37th offering.The program is available to parents free ofcharge. The approximate $40,000 in costsare covered by grants from the United Way,the Virginia Department of Social Services,and a federal grant. The parents and childrenreceive a meal prior to each session. Theyoffer child care but do not offer the chil-dren’s Dinosaur Program. Eshleman explains the evolution of the

program. “A community needs assessmentwas done and the need for parenting educa-tion ‘rose to the top’ of the list of needs,”she explained. Eshleman relates that theclasses are a mix of referrals from school,self-referrals, and from social services or thecourts. They limit the class size to 20 andare generally full. Drop out is not a problem.According to Eshleman, if a parent comes tothe first three sessions, that parent will gen-erally complete the program. “The buddysystem works well to help the parents en-gage,” she says. Loft explains that the pro-gram has the facilitators assign parents a“buddy” who is another parent in the pro-gram. They have some contact outside ofgroup and support each other. Most pro-grams offer “cool” prizes such as gift certifi-cates for groceries if the buddies meet orhave contact outside of the class. A fewweeks later, “buddies” (who are always ofthe same sex) are switched.

Cheryl Keiper, Social Work Supervisor atFairfax County Department of Family Serv-ices also offers the Incredible Years pro-gram. Fairfax County just started to offerthis program. They have offered NurturingParenting Programs since the 1990’s andthese are their main offerings. However, forsome families, a different program wasneeded. Keiper explains. “We were seeingparents with mental illness. Their childrenappeared depressed and engaged in severetemper tantrums. The Incredible Years pro-gram addresses children’s behavioral prob-lems. The parents of these children need amore intensive curriculum.” Fairfax County staff was trained to offer

The Incredible Years and has offered oneprogram. “It is very intensive and is taughtdifferently than other parenting programs,”says Keiper. “We had to provide more childcare than in other programs because manyparents have more than one child. Keiper

says the IY Program takes into account thechildren’s special needs. Their pilot of theprogram went well and they plan to offer anIY parenting class in Spanish next year. The Incredible Years program and materi-

als can be purchased without training. How-ever, training is highly recommended.According to Loft, the training emphasizeshow to develop collaborative relationshipswith parents. The training requires three fulldays, either in Seattle or hosted by theagency. It is followed by telephone and liveconsultations that can lead to accreditationor certification, indicating fidelity to the pro-gram model. Since purchase and implemen-tation of The Incredible Years can beexpensive, Loft recommends that those in-terested in the program visit the website. Itcontains articles on how to determinewhether an agency is ready to offer the pro-gram and there is also an implementationguide.

RATINGS

The California Clearinghouse on EBP inChild Welfare rating for the Incredible Yearsprogram is “1” which is “Well-Supported” and “Effective Practice.”

The Incredible Years is listed as a Model Program in SAMHSA’s NREPP.

The OJJDP Model Program Guide lists the Incredible Years as “Exemplary.”

The Promising Practices Network lists the Incredible Years as “Proven.”

Blueprints for Healthy Youth Develop-ment ranks the Incredible Years as “Promising.”

The What Works Clearinghouse (U.S. De-partment of Education) identified 166 stud-ies of The Incredible Years published orreleased between 1989 and 2011. However,none of the studies fell within the scope ofthe Early Childhood Education Interventionfor Children with Disabilities review proto-col, so WWC did not assign an effectivenessrating. The Incredible Years is used throughout

the United States and in 40 countries. Read-ers can learn more by visiting their websiteat: http://www.incredibleyears.com There is also a You Tube site:www.youtube.com/user/TheIncredibleYearsand a Face book page: http://www.face-book.com/TheIncredibleYears Questions can be addressed to:

Lisa St. George, Administrative Director, (206) 285-7565 or (888) 506-3562, E-mail: lisageorge@comcast.net or to Peter Loft: peterloft399@gmail.comReagan Eshleman can be contacted at: rbeshlem@sentara.com

Cheryl Keiper can be reached at: Cheryl.keiper@fairfaxcounty.gov

10

Dare to be You is a universal preventionprogram designed for parents of children ages2 to 5 to improve aspects of parenting thatcontribute to children’s resiliency. DTBY combines three supporting aspects-

educational activities for children, strategiesfor parents or teachers, and environmentalstructures. The original curriculum, developedin 1979, was geared towards multiagencycommunity organizations who provided services to youth. The parent component ofthe current DTBY program evolved from thecommunity trainings, starting in 1989. Program developer Jan Miller-Heyl spoke

recently to VCPN staff. “The program worksfirst with self-efficacy. Parents must first be-lieve that they are capable. The next set of ses-sions examines consequences brought aboutby parental actions. Parents need to believethat their actions will make a difference,” sheexplained. Decision-making and stress man-agement are covered. Then child managementtechniques are taught. “The strategies helpchildren learn self-management and how tomake their own decisions,” adds Miller-Heyl.The curriculum proceeds into communicationand problem-solving. While parents meet, children are also in

group and cover the same topics, at a develop-mentally-appropriate level. Each session endswith a parent-child activity that allows the par-ents and children to practice the skills thatwere learned. Miller-Heyl stresses that the curriculum is

very interactive. “It is not didactic,” she ex-plains. “Parents are not listening to a lecture.They are not being judged. Instead the pro-gram helps them identify strengths. We all

have them. We find the strengths and buildupon them.” Miller-Heyl adds, “The informa-tion is shared in a way that parents can processit.” Dare To Be You was designed to work with

a range of risk factors, but it does not targetmaltreating parents. Miller-Heyl suggestsavoiding a group where all parents have simi-lar risk factors. She prefers including a fewcourt-referred parents into a group containinghigher-functioning parents. “Parents who arehigher-functioning can assist others. Thegroup social norm is different if all the parentsare struggling, and having a mixture of parentsde-stigmatizes the program,” she notes. Sessions are two hours and occur over a 10-

week period. Ten to twelve families per groupare recommended. There are curriculum adap-tations for special populations. The curriculumfor Native American tribes uses their culturalbase of stories. The curriculum has also beenused with Hispanic, Asian, and African-Amer-ican families. Program Specialists who use thecurriculum need to be trained. The training is20-24 hours on site and the minimum numberfor training is five. After training, technicalsupport is provided. Miller-Heyl stresses that Dare to be You is

effective. “It works!” she proclaims. “Parentsenjoy it.” There is also a curriculum K-12 forschools or after-school programs or for youthgroups. A special curriculum for teens trainsthem to be peer educators. Miller-Heyl is cur-rently working on a Child Success Program toensure that children reach Kindergarten readyto learn. A program termed “Bridges” has ateacher component. The 12-week program al-lows parents and teachers to work togetherwith work in both the home and the class-room. A 14-week Teen Program has been piloted and implemented well, but fundingended for this program. Kelly Hill Bulin is the Prevention Services

Supervisor for the Eastern Shore CommunityServices Board in Virginia. She has been usingthe Dare to be You program for over 13 years.Her agency funds the program through a fed-eral substance abuse prevention block grantfor substance abuse prevention through theVirginia Department of Behavioral Health andDevelopmental Services. Bulin’s program isfunded to provide at least three replications ofthe DTBY program and serve at least 50 par-ents and their children a year. Bulin is very enthusiastic about Dare to be

You. “It has been a wonderful program. Welove it!” Bulin explains that the Eastern Shore

is a peninsula which is 70 miles long. Theyrotate the location of the program each ses-sion. Because the DTBY program is an evi-dence-based prevention program and isfunded as such, Bulin states that it is notsuited for parents diagnosed with a mentalhealth or substance abuse disorder. Most par-ticipants come from ‘word-of-mouth’ or directsolicitation. “Because we are rural, we recruit.We go to Wal-Mart and to McDonald’s andset up a booth. We put up a booth at schooland community events. Our youth-servingpartners disseminate flyers. Churches help byencouraging members with young children toattend,” explains Bulin.Bulin said the efforts are successful. Fur-

thermore, their retention rate is extremelyhigh- 90 to 95% complete the program. Dur-ing each session, a family meal is providedand grandparents and extended family mem-bers are welcome to attend. Most programsare held in the summer, since parents and chil-dren are more available then. Transportation isprovided if needed. The Eastern Shore Community Services

Board’s prevention staff is trained in theBridges curriculum and plan to offer that pro-gram soon. They offered the Teen programfor three years through a grant. “The parentswere very motivated and involved,” saidBulin. “Since the funding ended, we haven’tbeen able to offer that curriculum because ofthe high staffing level required. We hope tofind a way to continue to offer that program inthe future.” Bulin concludes, “I’ve used a number of

parenting programs over the years. Dare to BeYou is the most meaningful for parents.”

Dare to be You is rated as a “proven” programby the Promising Practices Network.

The Office of Juvenile Justice rates Dare to beYou as “Promising.”

The FRIENDS National Resource Center forCommunity-Based Child Abuse Preventionrates Dare to be You as “Promising.”

SAMHSA’s National Registry of Evidence-based Programs and Practices rates Dare to beYou as 2.8 out of 4.0.

Contact Jan Miller-Heyl at: jan.miller-heyl@colostate.edu

Contact Kelly Hill Bulin at: (757) 442-5388 or kbulin@verizon.net

Jan Miller-Heyl

© Commonwealth of VirginiaDepartment of Social Services

VCPN is copyrighted but may be re-produced or reprinted with permis-sion. Write for “Request to Reprint”forms. Request or inquiry is ad-dressed to: Joann Grayson, Ph.D.,Department of Psychology, MSC7704, James Madison University,Harrisonburg, VA 22807, or call (540)568-6482. E-Mail: graysojh@jmu.edu

Triple P evolved over the past 35 yearsfrom the work of Matthew R. Sanders andcolleagues at the University of Queensland,in Brisbane, Australia. The population-basedprogram is now offered in 26 countries and37 states in the United States. The Triple Psystem meets the standards-of-evidence cri-teria for dissemination promulgated by theSociety for Prevention Research (2004).These standards include: substantial evi-dence of efficacy; professionally-developedresource materials; standardized training andaccreditation for service providers; cost ef-fectiveness information; evaluation tools forproviders; and identification of the condi-tions needed to promote program sustain-ability and quality assurance. The substantial evidence base supporting

Triple P to date includes 43 controlled trialsaddressing efficacy, effectiveness, and dis-semination, as well as 22 service-based fieldevaluations. Triple P as a population strategyhas been shown to strengthen parenting, toreduce the prevalence of conduct problemsin preschool-aged children from high-riskneighborhoods, and to reduce coercive par-enting practices. The media and communica-tion strategy, an important part of a publichealth approach to supporting and strength-ening families, helps normalize and ac-knowledge parenting difficulties, de-stigma-tize obtaining help, reduce the sense of par-ent isolation, imparts parenting knowledge,and changes the community context for par-enting.

Cheri J. Shapiro, Ph.D. is a clinical psy-chologist who is a Training Consultant with

Triple P. She has a background in offeringclinical services through the juvenile justicesystem, health and mental health settings,and other agencies. She left clinical practiceto become a prevention researcher, and cur-rently is a Research Associate Professor atthe Institute for Families in Society at theUniversity of South Carolina. After decadesof clinical work, she is excited to be work-ing in the prevention arena. She explainsTriple P’s versatile programs. “Triple P is amulti-layered system of interventions. Apositive feature is its flexibility.” The target population is broad- parents

and caregivers of children birth through age18. It contains five “layers” of interventions:• Universal Triple P (or Stay Positive) is a population-wide media strategy designed to raise awareness of parenting issues and de-stigmatize the concept of parent-ing interventions. • Brief Interventions- Several Triple P programs are designed to deliver parent-ing information during a single contact, with either larger groups of parents or individual families. Two seminar series are available. One seminar promotes child development for younger children and one is aimed at parents of teenagers. Each contains four different programs aimed at different groups and provides three 1.5- to 2-hour seminars. There is also brief consultation for specific child behavioral problems or one brief individ-ual consultation for parents of teens. These programs function best as antici-patory guidance.• Primary Triple P (Level 3) is for families without significant family dysfunction. The four sessions over 1 to 2 months offer one-to-one consultation and active skills training. This is appropriate for parents with specific developmental or behavioral concerns who do not require intensive treatments or who have already completed an intensive intervention. Several variations exist including a program targeting younger children; a program for parents of teens; and one designed specifically for parents of chil-dren with disabilities. This type of program is also available as a single session, 2-hour discussion group for parents who may need occasional support.• Intensive Intervention (Level 4) is for parents who are struggling with parent-ing challenges. Parents learn a variety of

management skills and how to apply them. The Level 4 Triple P is a 10-session intervention of about 60 minutes per session, but an 8-week group version is also available. The group intervention consists of five 2-hour sessions that are supplemented by three telephone consul-tation sessions of about 20 minutes in length. Curricula is available for parents of younger children; parents of teens; parents of children with disabilities; parents whose children have moderate to severe behavioral problems; parents whose teens have moderate to severe behavioral problems; and parents of chil-dren with disabilities when the children also have moderate to severe behavioral problems. • Level 5 is for families with additional risk factors. As an adjunct to level 4 interventions, the Enhanced Triple P contains modules on partner communica-tion, mood management, and stress cop-ing skills for parents, as well as addi-tional practice sessions. In addition, special curricula are available for parents of overweight or obese children (Lifestyle Triple P); for parents going through separation and divorce (Family Transitions Triple P); for parents with adjustment difficulties (such as depres-sion or partner conflict) where children have concurrent behavioral difficulties; and for parents with anger management issues that put them at risk for child abuse and neglect (Pathways Triple P). Dr. Shapiro discusses how Triple P is dif-

ferent than some other offerings. “It startswith the decision to implement the pro-gram,” she begins. “We help agencies orsystems consider who they want to reach;how many parents they wish to impact; whatsorts of issues and problems they want to ad-dress. We ask them to consider how workersgenerally interact with families. Do theyhave frequent contact or see the family onlyone time? Sponsors also need to considerhow workers will be supported and encour-aged.”

continued on page 19

11

POSITIVE PARENTING PROGRAM(TRIPLE P)

Matt Sanders, Ph.D.

12

FAMILIES AND SCHOOLS TOGETHER

Families and Schools Together is a multi-family group intervention designed to buildrelationships between families, schools, andcommunities to increase well-being amongchildren and youth. The program’s objectivesare to enhance family functioning, preventschool failure, prevent substance misuse bychildren and other family members, and re-duce daily living stress. FAST includes threecomponents: outreach to parents; eight weeklymultifamily group sessions; and ongoingmonthly reunions for up to 24 months to sup-port parents as the primary prevention agentsfor their children. Collaborative teams of par-ents, substance abuse and mental health pro-fessionals and school staff facilitate the groupswhich meet at the school at the end of theschool day, for 2.5 hours, typically from 5:30to 8:00 or from 6:00 TO 8:30. With each cycleof FAST implementation, 30 to 50 students inone grade level and their families can partici-pate. Bryan McIntosh, FAST Training and Edu-

cation Coordinator, talked to VCPN staffabout the program. “We are celebrating our25th anniversary!” he exclaimed. “June of1988 was when the program began in Madi-son, Wisconsin. Lynn McDonald, Ph.D., theprogram developer, wrote the first FAST pro-gram grant. As a former faculty member in so-cial work, she used the University ofWisconsin, Madison as a base for effective-ness research and further program develop-ment. In the 1990’s Dr. McDonald receivedgrants to expand the program throughout Wis-consin. That effort was very successful andthe program began to be disseminated nation-ally. It has now been implemented throughoutthe United States and in 16 additional coun-tries.” FAST teams have implemented groupsin about 2,000 schools in 48 states and havereached more than 450,000 individuals. McIntosh explains the program philosophy.

“One of the keys is that FAST is not curricu-lum-based. We are not trying to teach parents.Teaching ruins the dynamic. In FAST the par-ent is the authority and we work with parentsas mutual partners,” he explains. “We use in-teractive games and strategies to help familiesbuild relationships within their own familyand with school and community partners,” headded. FAST’s flexibility also allows differentcommunities to address different needs. The typical partners on a FAST team are a

substance abuse specialist, a mental healthprovider, a school staff, and a local parent.“The key is to blend the parents with the pro-fessionals. Our parent partner is a role modelto aid other parents,” said McIntosh. He ex-

plains that the team members facilitate, butthe parents lead. In the first few weeks, the fa-cilitators do most of the leading, but parentsgradually take control. “We aren’t in thehome, so the parent is always the familyleader,” he adds. At the start of each session, the families

gather at a family table for an hour of activi-ties, including a meal, singing, and communi-cations games. The parents lead that hour withsupport from the team. Then the parents andthe children meet separately for an hour. Theparents are able to discuss their daily strug-gles. After separate time, parent and childspend 15 minutes together in a one-on-oneplay activity. The parent is to encourage thechild but follow their lead. FAST providesthemed play boxes for the activity. The parentremains 100% focused on the child. Trainedteam members circulate (the space is gener-ally a cafeteria with each parent and childworking at a separate table). The team mem-bers offer encouragement and coaching. Forolder children the one-to-one time is centeredon talking. The children are given “fiddletoys” such as stress balls. The conversation isto be whatever the youth wants to talk about.After the activity time, there is a closing rou-tine where everyone assembles into a group. McIntosh comments that the program origi-

nated with families targeted because ofteacher concern but since 2001 switched to auniversal model to avoid stigma. “A familycannot be mandated by a court to attend,” henoted. All families of kindergarten age or infirst grade are invited and there is special out-reach for parents who may distrust schools. Operating costs for FAST programs are typ-

ically covered by grants, according to McIn-tosh, and parents do not pay in order to attend.Incentives such as lottery baskets worth $40to $50 and weekly meals are required features.The play boxes that are part of the programtypically cost under $5 a box. Costs can range,as some teams are volunteer or staff is paid bytheir agency. Other FAST programs pay staffseparately for participation. FAST’s integrity is monitored by a check-

list, and also by site visits by a certified FASTtrainer for each new group cycle. In addition,FAST requires pre- and post-questionnaires becompleted by the parents and teachers. Thesequestionnaires are sent to a central office forprocessing of a final report that is reviewedwith the local team to identify the impact oftheir local program and to recommend im-provements. The published evaluation research on FAST

has received high ratings from NREPP

(SAMHSA’s National Registry of Evidence-based Programs and Practices). Four RCT(randomized controlled trials) have demon-strated that children participating showed a de-crease in externalizing behaviors as reportedby parents and teachers and that gains weresustained at a one-year follow up. Improve-ments were also found in child participantsover control children on anxiety, depression,attention problems, aggressive behaviors, andother problem behaviors. Some studies docu-mented improvements in social skills and aca-demic performance. According to the program developer, sev-

eral Virginia communities (Virginia Beach;Lynchburg) are using the FAST program. FAST offers four models of their program.

The FAST program for pre-Kindergartenthrough 5th grade was the original one and isthe program that has been tested in the RCTresearch. The other three are theory-basedadaptations. They are: Baby FAST (from notyet born to age 2); Preteen FAST (for MiddleSchool) and Teen FAST(for freshman andsophomores). FAST was cited as a model program by

SAMHSA in 2003 and by NREEP in 2008.In 2010, the United Nations recognized

FAST as one of 24 programs in the world tobe listed in their United Nations Office ofDrug and Crimes website. FAST was consid-ered the 11th highest of 150 programs re-viewed. In 2007, the Office of Juvenile Justice rated

FAST as “Effective.” FRIENDS rates FAST as “Well-Supported.”

More information is available from:www.familiesandschools.org,

Bryan McIntosh- E-mail: bmcintosh@familiesandschools.org

Lynn McDonald, Ph.D. E-mail: lynn.mcdonald@gmail.com

Lynn McDonald, Ph.D.

13

1-2-3 Magic

Thomas W. Phelan, Ph.D. is a clinical psy-chologist who started his career in Chicago inthe 1970’s. He received many referrals frompediatricians to help families with behaviorproblems. He began to notice several things:a) Parents need direct suggestions; b) It is im-portant to ‘keep it simple’; c) Talking has dys-functional aspects. In considering how to besthelp parents, Dr. Phelan noted that designinga program is easy but getting parents to attendit is hard. He decided that it is important toconvey one’s message in as short a time pe-riod as possible. Dr. Phelan mentions other is-sues. Getting fathers involved is important.Parents need child care in order to attend. Theprogram must be entertaining and filled withuseful information and humor. Dr. Phelanstresses using only down-to-earth language.“It is important to make parents feel goodabout being at the program. I want them tofeel that we are all in this together,” explainedDr. Phelan. 1-2-3 Magic stresses that parents should

not talk, persuade, argue, yell, or hit. “The es-calating continuum would not happen if par-ents realized that talking is useless,” says Dr.Phelan. The program teaches how to count,warn, give five seconds, and then administer aconsequence. “ The key is keeping quiet,”adds Dr. Phelan. Sarah Jane Schonour, M.A., is a behavioral

intervention teacher with Fairfax CountySchools in Virginia. She became enthusiasticabout 1-2-3 Magic when she was teaching ina center for students with emotional disabili-ties. Her success with the program led her tocontact Dr. Phelan and the two later co-au-thored a book. Schonour now teaches parents,teachers, and other professionals how to usethe program. “I also use the program with myson, Luke,” says Schonour. “I can’t imagineparenting without 1-2-3 Magic!” Schonourexplains that the program techniques elimi-nate the power struggle from the parent-childrelationship. “The techniques keep me calm,and I know exactly what to do,” explainsSchonour. Schonour describes the 1-2-3 Magic pro-

gram. “This is a 3-step program. Step One is‘counting for misbehavior.’ The countingleads to ‘time out.’ The ‘time out’ is differentthan the usual procedure. It is ‘short andsweet.’ There is no discussion. The child en-ters ‘time out’ and then goes right back out.”

Schonour describes Step Two. “Step Two areseven tactics for encouraging children to en-gage in positive behaviors,“ she explains.Step Three is strengthening relationships.“Relationships drive everything,” declaresSchonour. Schonour prefers two two-hour sessions.

However, the program can be offered to par-ents and others in various formats. She men-tioned a Book Club where parents read thebook and the group engaged in three nightsof discussion. Schonour feels that 1-2-3Magic is ideal for parents with children whoreceive Special Education services. “The pro-gram is simple and repetitive, which tends towork well with children who have specialneeds,” she said. Tracy Lewis of Jarratt, Virginia, also

teaches 1-2-3 Magic. When she began her jobas the Family Resource Coordinator forColonial Heights Public Schools, she re-searched parenting programs. She explains,“This program is easy for parents to learn. Ittakes the negative emotions out of the inter-actions. The response from parents is fantas-tic!” Lewis has taught 1-2-3 Magic seminars to

groups of parents that are small (about five)to large (about 250). She teaches the programin two nights for 2.5 hours each evening or ina single 4-hour session. There is PowerPointpresentation, handouts, and small group ac-tivities. The volume 1-2-3 Magic has sold 1.4 mil-

lion copies and has been translated into 22languages. In addition to the book, DVDsand audio presentations are available. A ToolKit has charts, stickers, and parenting tips.There is a book written for children (1-2-3Magic for Kids). Parents receive a bookletand a workbook. There is even an ‘App’available and the program has a Face bookpage. Training to use the program can be in-person or online and after training, consulta-tion is available at no charge. Research located by VCPN staff showed

positive results but had small samples. Bai-ley, Van Der Zwan, Phelan, & Brooks (2012)had 9 subjects with four assigned to a controlgroup and five receiving the program. Therewere improvements in the treatment group inchild behaviors and parent attitudes and con-fidence. Yvonne Benson and Mike Simmons(2011) evaluated two one-day sessions of 1-

2-3 Magic in 2010. Pre- and Post- testingshowed learning gains and changes in childbehaviors using data from four families. A more comprehensive study recruited par-

ents who were experiencing problems manag-ing the behaviors of their 3- or 4-year oldchild (Bradley et al., 2003). Of those re-cruited, 89 completed a four-session programusing 1-2-3 Magic and 109 caregivers wereassigned to a control condition. The subjectswere largely middle-class and well-educated.Parents who received the program reportedsignificantly greater improvement in parent-ing practices and a significantly greater reduc-tion in child problem behavior. The gains inpositive parenting were maintained at a 1-yearfollow up on 25 of the original group. Theauthors state that the brief 1-2-3- Magic inter-vention may be a useful first intervention forparents of young children with behavioralproblems. The Authoritative Guide to Self-Help Re-

sources in Mental Health (Norcross, Santrock,Campbell, Smith, Sommer, & Zuckerman(2003) reports on a series of national studiesover 10 years to determine the most usefuland most frequently recommended self-helpresources. Over 8 studies, 3,500 psychologistsresponded with their ratings of self-help re-sources. Based on how often and how highlyresources were rated, a designation was givenranging from a ‘dagger’ (negative) to 5 stars(most positive). 1-2-3 Magic was rated as “5stars.” The FRIENDS National Resource Center

for Community-Based Child Abuse Preven-tion rates 1-2-3 Magic as an “Emerging/Evi-dence- Informed” Program. The California Evidence-Based Clearing-

house rates the program as “2” (“Supportedby Research”)More information is available from: 1-2-3Magic, Parent Magic, Inc., 800 RooseveltRoad, B-309, Glen Ellyn, Il 60137, (800) 442-4453 or (630) 208-0031, FAX: (800) 635-8301 or (630) 208-7366, E-mail: ordercenter@parentmagic.com Website: www.123magic.com/Thomas W. Phelan, Ph.D.: pmi@pmi.cnchost.com

Sarah Jane Schonour, M.A.: sarahjane.schonour@gmail.com

Tracy Lewis: tracy@tracy-lewis.com

Thomas W. Phelan, Ph.D.

14

CREATING LASTING FAMILY CONNECTIONS (CLFC)

and drug prevention program in allCatholic schools in the Archdiocese ofLouisville and in all of the JeffersonCounty Public Schools. Strader’s experi-ence was useful when he began to developthe CLFC program.CLFC is designed to encourage empathy,

understanding and effective communica-tion for oneself, for one’s partner, and be-tween parents and youth. “In a family, it isa hard job to be a parent and it is a hard jobto be a child!” exclaims Strader. After several successful research studies

were published showing the effectivenessof the CLFC program, the Substance Abuseand Mental Health Services Administration(SAMSHA) awarded Strader a specialService to Science grant for $30,000 to ex-amine the underlying operational mecha-nisms in his work and to establish exactlyhow the success was happening. The pro-gram has shown good results including:

• Reducing substance abuse by youth and adults;

• Reducing violent behaviors;• Reducing prison recidivism;• Enhancing communication and refusal skills;

• Enhancing emotional awareness and expression skills;

• Enhancing family bonding; • Enhancing partner relationships;• Enhancing fatherhood skills;

In 2000, Strader wrote a book, BuildingHealthy Individuals and Families andCommunities: Creating Lasting FamilyConnections. “We help people to under-stand how to manage their emotions so inthe process, they improve their well-beingand relationships,” notes Strader. He com-ments that people who feel connected toeach other do not harm each other, destroyor take others’ property, and they respectthe other person’s efforts to grow. “Our‘core skills’ are emotional awareness, emo-tional expression, and validation of selfand others,” he adds. People in all 50 states and all American

territories are using the Creating LastingFamily Connections program. VCPN stafftalked with Lora Maynard, M.S., DeputyDirector for West Virginia’s Juvenile DrugCourt program. Maynard explained that alljuvenile drug courts in West Virginia are

requiring parents and youth to participatein CLFC as a supplement to required fam-ily counseling. “We felt that the parents ofthe youth under court supervision neededassistance and education in how to be a re-sponsible parent. For six to nine months,we examined parent curricula. Approxi-mately 20 were considered. What we foundwith the CLFC were 5 curricula, all evi-dence-based and well-rated, that we canuse in so many ways.” The West Virginia Juvenile Drug Court

brought in Ted Strader and his wife Teresafor training. They invited the PreventionOfficers in schools to come to be trained.Maynard comments, “It has spread likewildfire. There are so many ways this pro-gram can be used. We are considering usein our adult drug courts as well.” Maynardsays “When an agency finds somethingcost-effective, we partner. The courts aswell as agencies in the community offeranger management training and smokingcessation as well.” The Juvenile Drug Court meets once a

week. Right after court, CLFC sessions areheld. Youth and parents attend separategroups. Lunch is provided by communitypartners. The basic curriculum is 28-weeksminimum, but most families have addi-tional sessions. There are 6 to 8 sessionsthat include family counseling and help thefamily transition into family counseling. Maynard says that the feedback from the

parents is quite positive. “Some parents askto continue past the end date,” she says.“The Probation Officers are enthusiasticbecause they have seen the parents’ attitudechange. They were skeptical at first.” May-nard notes that 15 of West Virginia’s 55counties have a juvenile drug court and usethe CLFC program. Also the 12 Youth Re-porting Centers are using the program. The most expensive part of the program,

according to Maynard, was the week-longtraining and the costs associated withbringing in the Straders. “This is an ‘up-front’ expense and well worth it,” com-ments Maynard. Now the program costsare minimal. Maynard is very enthusiastic about

CLFC. “The curriculum just fits our popu-lation. It can be used in so many ways. Ican’t imagine why any youth-servingagency would not be interested in this cur-riculum. We are very happy with it! We

CLFC is a family-based program with aprimary goal of reducing substance abuseand violence in teens. Since its beginningsin the 1980’s the program has expanded.CLFC now offers programs designed foryouth, parents, fathers, marriage strength-ening and family strengthening. Versionsof the program have been adapted to spe-cial populations such as prisoner re-entryand substance-recovering adults. The basic program consists of six mod-

ules, three each for parents and youth. Par-ent modules are: “Developing PositiveParental Influences;” “Raising ResilientYouth;” and “Getting Real.” The youthmodules are: “Developing a Positive Re-sponse;” “Developing Independence andResponsibility;” and “Getting Real.” Eachparent module includes five to six lessonseach lasting 1.5 to 2.5 hours, depending onbreaks and whether or not a meal is of-fered. Each youth module includes five tosix sessions, with each lasting 1 to 2.5hours, again depending upon breaks,snacks, activities, or a meal being part ofthe session. For maximum effectiveness,parents and youth are involved simultane-ously in separate tracks lasting from 15 to18 sessions. Ted Strader, the program developer, ex-

plains the evolution. In high school in the1970’s, Strader experienced the merging ofschools and busing to achieve integrationgoals. He was one of five Caucasians at thehigh school where he did student teaching.There he learned skills to interact effec-tively with diverse and changing popula-tions. He became a teacher. Based on anover dose situation at his school, Straderlater decided that he wanted to leave theclassroom to engage in prevention work.“At the time, the research indicated thatprevention programs were achieving nega-tive to neutral results,” he commented in aninterview with VCPN staff. “No one haddemonstrated positive results.”Strader searched and finally located a

promising program in Boston. After exam-ining the program, he decided that the‘missing’ component was working withparents in addition to doing preventive in-terventions with youth. His hypothesis in1980 was ‘If we can move the parents, wecan influence their youth.’ Strader wasable to create and lead a city and county-wide effort to implement a K-12 alcohol

15

Ted Strader

have written a federal grant to try to coverthe costs of implementing the CLFC Fa-therhood Program and the Family Reinte-gration Marriage and Family StrengtheningProgram as well.”

The FRIENDS National Resource Center lists CLFC as “Promising.”

The Promising Practices Network lists CLFC as “Promising.”

The OJJDP Model programs guide lists CLFC as “Effective.”

More information about Creating LastingFamily Connections is available onVCPN’s website and at: www.CPOES.orgContact Ted Strader at: tstrader@sprynet.com

Contact Lora Maynard at: lora.maynard@courtswv.gov

Strategies for Teaching Parents• Create a safe and supportive environment for learning.• Set goals for the child and for the parent collaboratively with parent.• Focus on the child and the child’s development first; change parent behavior second.• Apply principles of responsive interaction in the facilitator’s interactions with parent: listen to them; respond to them; make the conversation give-and-take. • Teach the parent: positive behaviors and communication; praise; how to omit negative feedback; how to ask for clarification.• Plan content and activities of individual sessions and the sequences of sessions to insure mastery of key behaviors.• Teach both the behavioral principle and the specific application; provide multiple examples.• Teach by using concrete, positive examples; provide supporting materials to illustrate examples.• Include practice in implementing the procedures with the child in each session.• Coach and give specific feedback to support parent during practice with child.• Teach for generalization and maintenance; when possible teach across settings, involve other caregivers, and provide booster sessions.• Adjust teaching style, teaching methods, and criterion performance levels to the skills of the parent and child, and offer feedback that is individualized.• Invite formal and informal feedback from parent at frequent intervals.

Source: Kaiser & Hancock, 2003

Two local Virginia agencies recommendedthe Strengthening Families Program. VCPNstaff was not able to interview a program de-veloper of this program. Bonnie Favero,MA, Prevention Manager for the PiedmontCommunity Services Board, has been offer-ing parenting programs for 13 years. She re-cently switched from another parentingprogram to Strengthening Families. Prior toimplementing the program, she receivedthree days of training from program devel-oper Karol Kumpfer. Favero uses the pro-gram for parents of children ages 6 to 11.She has been offering the program a littleover a year and is in her third cohort.

Favero serves parents with many risk fac-tors, often single parents who are experienc-ing considerable stress. “People love theprogram! It is easy to understand and easy topractice,” she exclaimed. “The children areengaged in a parallel program and are alsolearning skills,” she related. “Then there istime together so that the parent can practicethe skills while coaches are there to help.”Favero says her agency will target a schooland recruit families from that school. “Weprovide a meal, child care, five staff, and in-centives.” Cheryl Keiper, MA of Fairfax also has

used Strengthening Families. “We needed a

program in Spanish for parents of teens,” sherelated. “Last summer we used the programin both English and Spanish.”

For More information on StrengtheningFamilies, see “Programs That Work” onVCPN’s website or go to:http://www.strengtheningfamiliesprogram.org/index.html (and) www.copes.org

Bonnie Favero: bfavero@piedmontcsb.org

Cheryl Keiper: Cheryl.keiper@fairfaxcounty.gov

16

Guiding Good Choices ®

The Guiding Good Choices program is ascience-based substance abuse preventionprogram that teaches parents of preteens andyounger adolescent youth skills to improvefamily communication and family bonding.It draws on extensive research that demon-strates the critical importance of bonding inreducing or inhibiting adolescent participa-tion in antisocial behaviors, including druguse, truancy, and delinquency. The goal ofthe Guiding Good Choices program is toprevent substance abuse among teens byteaching parents effective family manage-ment and communication skills prior to theirchildren entering adolescence. Parents of children in grades 4 to 8 (or

ages 9 to 14) attend five 2-hour workshopsguided by workbook and video-based dis-cussion modules. The workshop sessionscover: the nature and extent of drug useamong adolescents; risk and protective fac-tors; how to set guidelines and standards; re-fusal skills; managing conflict; and how tostrengthen family bonds. Youth are invitedto the session that deals with refusal skills. The Guiding Good Choices program has

been shown to produce significant, sustainedimprovements in parenting skills and parent-child relationships. Studies have shown thatthe program reduces alcohol use in adoles-cents; reduces the rates of initiation for mar-ijuana use and drunkenness; reduces thelikelihood that experimental adolescentusers will advance to heavier use; increasesthe likelihood that non-users will remaindrug-free; reduces the likelihood that youngpeople will commit delinquent acts; and re-duces the rate of adolescent depression. One of the developers, David Hawkins,

Ph.D. talked with VPCN staff about the evo-lution of the program. Dr. Hawkins is theFounding Director of the Social Develop-ment Research Group at the University ofWashington and his philosophy and orienta-tion is to promote development in a pro-social manner. Dr. Hawkins explains thatbonding is the basis for healthy develop-

ment. “Active engagement with children al-lows them to respond. When children are en-gaged with the parent and receiverecognition and reinforcement, bonding be-tween children and parents is strengthened.Bonding increases children’s motivation tofollow standards for behavior and their com-mitment to standards set by parents.” Dr. Hawkins and his collaborator, Richard

Catalano, Ph.D. are committed to preven-tion. They considered the Framingham stud-ies on heart and lung disease where a changein risk factors resulted in a 40 percent reduc-tion in disease over a 30- to 40-year time pe-riod. He comments, “I said, ‘Let’s take thatsame approach.’ We considered the risk fac-tors for teen drug abuse and tried to designinterventions to affect those factors. We alsoconsidered protective factors as a way toprevent adolescent problems.” Drs. Hawkinsand Catalano have developed several pro-grams, one of which is the Guiding GoodChoices program. In 2000, the ChanningBete Company bought the program. Theyare now the distributor and publisher whileDr. Catalano serves in an advising role onthe Channing Bete Company Board of Di-rectors. Dr. Hawkins summarizes, “Poor family

management practices predict substanceabuse, delinquency and school drop-out inadolescents. The Guiding Good Choices pro-gram teaches parents how to set clear expec-tations, how to monitor, how to avoidexcessive discipline, and how to reward andrecognize their youth. The Guiding GoodChoices program is a universal program thatshould be available to everyone. All parentsshould learn these skills.” VCPN staff interviewed several people

who are using or have used the GuidingGood Choices program in the past. The Pre-vention Council of Roanoke County has,over the past 11 years, offered the GuidingGood Choices program to about 1,500 fami-lies. Nancy Hans, Director, relates their his-tory with the Guiding Good Choicesprogram. “The program was started through

a state incentive grant in 2001-2002. I at-tended the training and became a ‘trainer oftrainers.’ There were ten of us that did theoriginal training- I’m the only one left!” sheexplained. “Our Prevention Coalition is 12years old and the Guiding Good Choicesprogram is our only direct service.”

Hans explained that the Guiding GoodChoices program uses risk and protectivefactors that are based on scientific research.“The program is based on a model of pro-moting healthy behaviors,” she says, “andour mission is to promote healthy develop-ment of youth and of families. We want tolower the risks.” Hans describes the Guiding Good Choices

program as “an excellent program that uses aresearch-based social developmental model.”She also notes some limitations. “Over thepast 11 years of using this program, we havehad to include some information and activi-ties that are not currently part of the curricu-lum such as risk behaviors associated withinternet and smart phones.” Brooks Michael,the Prevention Education Coordinator alsoteaches the Guiding Good Choices program.She adds, “Guiding Good Choices is uniqueas a parenting program and we have used itin a variety of settings and with a diversepopulation of both adults and youth. Whilethe content is relevant, a drawback is that thevideos are so outdated that our parents can’trelate to them. We are trying to find our ownvideos to replace the outdated ones thatcame with the curriculum,” she adds. “Wealso had to reword the pre- and post-test lan-guage to reflect current phrases.” The Prevention Council has recently been

offering the Guiding Good Choices programto the Western Regional jail for the womeninmate population and there is a waiting list.“The program is so successful that the jailhas budgeted next year for three 12-week

Richard Catalano, Ph.D.David Hawkins, Ph.D.

Nancy Hans

17sessions,” relates Michael. “We have offeredthe program in elementary schools, at theYMCA, in a church, and at the Parks andRecreation Center. We will be doing out-reach to grandparents of adolescents at aGrandparents’ Fair,” says Michael. The Prevention Council charges $40 for

program participants. The majority of par-ents have attended for the purpose of gainingmore knowledge as their children enter mid-dle schools. However, they do accept court-ordered parents. They offer the program infour two-hour sessions and typically do notprovide child care or meals. Cheryl Matteo-Kerney, M.Ed., is Director

of Prevention Services for the Middle Penin-sula Northern Neck Community ServicesBoard. Matteo-Kerney, an InternationallyCertified Prevention Specialist, has used theGuiding Good Choices program in the past.When the agency had grant money, the pro-gram was offered to the general public inpublic libraries. They used a 5-session modeland attracted a wide range of parents. Theprogram was offered several times a year forfive years. “The parents enjoyed the programand responded well to it,” said Matteo-Ker-ney. “For us it worked well to offer it in thesummer, and we may again if we can iden-tify funding.” Matteo-Kerney said parentshave an easier time committing to a shorterprogram than to a longer program. “The con-tent is very useful, however, if parents arestruggling, they will need a longer, morecomprehensive program. The typical parentwho benefits from the Guiding GoodChoices program is a parent who is doingwell but wants to enhance skills,” she ex-plained. Rasheedah Farid, an independent contrac-

tor, also has past experience with the Guid-ing Good Choices program. As a TruancyCase Manager, she felt that of the problemsshe encountered in youth, the most importantcomponent was the parent, and parent in-volvement needed strengthening. The Vir-ginia Department of Juvenile Justice (DJJ)sponsored the Guiding Good Choices pro-grams. Farid worked for them as an inde-pendent contractor. She speaks of some“fantastic” video segments, especially for re-fusal skills and she felt the segment on angermanagement was outstanding. She recom-mends the program to others although thelocal DJJ is no longer offering it. Ellen Ravens-Seger, a representative of

Channing Bete Company says that someGuiding Good Choices implementers chooseto purchase a new edition of the Power-PointCD with more current statistics. The videoclips have not been redone. Ms. Ravens-Seger notes that although the video clips donot incorporate recent clothing and hair-styles, the essential elements of effectiveparent-child communication and familybonding are timeless. Also, Channing BeteCompany offers supplementary materials

Parenting ResourcesParenting Resources1275 First Street, NEWashington, DC 20417

Website: http://www.usa.gov/Topics/Parents.shtml

Phone: 1 (800)-333-4636

Parenting Resources is sponsored by the U.S. government and works to provide trusted, timely, valuable government in-formation and services. The topics they offer involve child care child support, education issues for parents, health issues forparents, safety and crime prevention for parents, and youth employment. They work with expecting parents, adoptive parents,and parents of children of all ages. The easy-to-use website provides a plethora of resources that any parent can use to de-velop strong, long-lasting bonds with their child.

24/7 DadNational Fatherhood Initiative FatherSOURCE Resource Center20410 Observation Dr., Suite 107Germantown, MD 20876

Website: http://store.fatherhood.org/default.aspx

Phone: (301)-948-0599FAX: (301)-948-6776E-Mail: fathersource@fatherhood.org

24/7 Dad is a comprehensive fatherhood program that uses innovative tools, strategies, and exercises to help fathers of allraces, religions, cultures, and backgrounds. This program was developed by fathering and parenting experts and focuses onthe characteristics men need to be good fathers. It includes everything needed to successfully market, run, and evaluate the fa-therhood program. 24/7 Dad is a 12-session curriculum that can be used for organizations, families, or even expecting parentswho need help dealing with the stress of fatherhood. The program also conducts research to improve attitudes towards father-ing, fathering knowledge, and fathering skills.

((() ) ) ) ) ( " " " "" " " " " " " ""

""

"" " " " " "

" " " " " "" " " "

"" "

" ""

" " """ " " " " " " " " " " " " " "

" " " " " " " " ""V&+"9.0:.-3"';")+;':2+)"4 " " " " " " " " " " " "

" " " " " " " " " " " " " """V&';"400(#0\"0,,+.;"4+S&2'YA+;"40")+S.+-;+"4&+"A;+"0,"9&$;'S-(")';S'9('2+">&'(+"

A " " " " " ""=4"&+(9;"9-.+24;"0."S-.+4-U+.;";4.A::('2:">'4&"- " " " " " " " " " " " "

" " "" " " " " " " " " "" " " " " " " " "

" " """"

"

"""

Anger Management Tool Box for Parentsby Mikki Bixler, Eric Killian, & Jo Anne Kock, 2009, 70 pages.

University of Nevada Cooperative Extension---Southern Area2345 Red Rock Street, Suite 100Las Vegas, Nevada 89146-3160

Phone: 702-222-3130Fax: 702-222-3100

Avalaible at: http://www.unce.unr.edu/publications/files/hn/2003/cm0309.pdf

This workshop provides parents with a positive way to manage their anger and stress while dealing with the stressful situa-tions associated with parenting. The program is designed to help staff, parents, and childcare providers develop skills for moreproductive communication with children which will, in turn, reduce stress, hostility, or rejection. This toolbox offers tech-niques to decrease the use of physical discipline while utilizing consistent parenting. It helps parents or caretakers strugglingwith anger management by developing positive problem solving skills and decreasing conditions that cause child maltreat-ment. This resource teaches how to approach, confront, and overcome stressful situations while promoting non-violence andstrengthening relationships between parent and child.

Family and Morale, Welfare and Recreation8000 Jefferson Davis HighwayRichmond, Virginia 23297

Website: http://www.mwrrichmond.com/

Phone: (804) 279-1091Fax: (804) 279-3340Email: dlaavnmwrmarketing@dla.mil

Family and Morale, Welfare and Recreation program works with military parentsto give them services and procedures that will help with struggles of being in the mili-tary. They create, deliver, and sustain programs and services that enhance the readiness and well-being of the community.The programs they offer help bond military families and parents and allow them to develop effective communal skills. For ad-ditional resources for military families please see VCPN Volume 86.

continued on page 19

18

Kids Priority One250 W. Brambleton Ave., Suite 100 Norfolk, VA 23510

Website: http://www.kidspriorityone.org/

Phone: (757) 244-5373Fax: (757) 962-2147Email: info@kidspriority.one.org

Kids Priority One is a “one stop” resource center where families and those working withfamilies find local resources and valuable information related to raising healthy and happychildren. The website hosts a database of more than 1,000 organizations that serve children andfamilies across Hampton Roads—Southside Peninsula. The services included opportunities forchildren with special needs, youth development, parenting support, and basic or emergencyneeds.

Parent Training & Information Center100 N Washington St., Suite 234Falls Church, VA 22046-4523

Website: http://www.peatc.org/

Phone: 703-923-0010 (800) 869-6782Fax: (800)-693-3514Email: partners@peatc.org

The Parent Educational Advocacy Training Center (PEATC) is a parent training andinformation center that serves families of children with disabilities in the Commonwealth ofVirginia. PEATC promotes respectful, collaborative partnerships between parents, schools,professionals and the community that increase the possibilities of success for children withdisabilities. Although located in Virginia, their national organization and website providesinformation throughout the world and helps build parent relationships in families with dis-abilities. They provide on-demand training videos that can be accessed at any time as wellas interactive workshops where parents and families can learn to develop alongside theirchildren.ing, fathering knowledge, and fathering skills.

Latinos En RichmondP. O. Box 834Quinton, Va. 23141

Website: http://latinosenrichmond.com/

Phone: (804) 728-0048Email: manager@latinosenvirginia.com

Latinos En Richmond is an information provider focusing on the Hispanic communitythat resides in Richmond and Central Virginia. The website offers information, professionalservices, and assistance for Latino/Hispanic families in order to help with the acculturationprocess in the United States. This program will also support service providers in effectivelyreaching the Latino/Hispanic community, promoting their services, and becoming cultural bro-kers.

Programs for Parents1000 East High StreetCharlottesville, VA 22902

Website: http://www.cyfs.org/parents.php

Phone: (434) 296-4118Fax: (434) 295-2638Email: info@cyfs.org

Programs for Parents is operated by the Children, Youth, & Family Services and providesparents with resources to help children become healthy, happy, and productive adults. Thewebsite lists many programs that can be used by parents and families to help strengthen thebond between them and their children. The three main areas of focus are: early learning to stim-ulate young children’s development; counseling and shelter for youth in crisis; and educationand support for parents.

Families are MagicGreater Richmond

Website: http://www.famrichmond.org/

Phone: (800) 244-5373Email: lblock@grscan.com

Families are Magic helps parents raise, love, and care for their children during the stress-ful and demanding situations that are part of being a parent. FAM was founded by parent ed-ucation professionals who believe that asking for help is the sign of a good parent. Theprogram is a resource of information, a source of camaraderie, and a helping hand for anyonewho wants to be the best caregiver they can be. Local organizations dedicated to providinghigh quality and effective services for parents have joined together to form the FAM Net-work. Organizations throughout Richmond that work with FAM can help train and teachparents to raise children in the most effective ways possible.

Hampton Roads Parenting Education Network (HRPEN)Website: http://www.chkd.org/services/HRPEN/

Children’s Hospital of The King’s Daughters601 Children’s LaneNorfolk, VA 23507Website: http://www.chkd.org/hrpen

Contact: Michele TryonSouthside (757) 668-9304Peninsula (757) 727-1300

The Hampton Roads Parenting Education Network (HRPEN) offers education, supportgroups, information and referral for parents, grandparents, and childcare providers. A networkof agencies works together to provide and ensure access to comprehensive parenting educationopportunities that meet the needs of families in Hampton Roads. Parent education programs in-clude: topic-specific workshops; multiple session classes; court-referred programs; early child-hood/caregiver training; support groups; and play groups. Not all of these quality programs arefree, but they are affordable. There is no fee for membership and parents and professionalshave the ability to locate quality programs. Becoming a member provides monthly networkingopportunities and training for staff and volunteers. HRPEN provides quality programs by pro-moting “best practice standards” for parent education programs.

Positive ParentingP.O. Box 40 Chesterfield, VA 23832-0040

Website: http://www.chesterfield.gov/parenting/

General phone: (804) 748-1000Email at: http://www.chesterfield.gov/contact.aspx?id=8290

Chesterfield County has created Positive Parenting to help parents connect with re-sources. The website can help parents to find quality child care and offers guidance aboutdealing with parenting issues. The founders believe informed and supported parents will bet-ter achieve the goal of raising children who reach their full potential as productive citizens.This website lists many helpful practices that parents can use to affectively teach their chil-dren everyday skills.

Completely KidsWebsite: http://www.completelykidsrichmond.com/

Email at:http://www.completelykidsrichmond.com/contact-us/

Completely Kids is a website and organization that helps companies advertise their par-enting programs and techniques. Programs can post on this website which will then adver-tise the program across Richmond. The website provides an easy way to find multipleprograms at once and determine which one might be best for a particular family.

Virginia Resources

'' '

& & &&c & & &'

& &&

& & & && & &

&& & & & & ' ' & & & & & &

&&O*#&5#01(%#&)$-&1#-.&N,J&%,&3E$)#1&%,&7(-.&RJ$E(%N&)*(E.&)$"#&$-.&,77#"1&8J(.$-)#&$ & & & & &&O*#&7,J-.#"1&0#E(#I#&(-7,"+#.&$-.&1J33,"%#.&3$"#-%1&5(EE&0 & & & & & & & & & & & & & & &&O & & & & & & & & & & & & & & &

& &'

&&&&&

' '& & & & &

& & &&

&&

&& & && & & & && &

'' & ' ' & & & & & & & &

& & & & & & & & & & & & & && & & &&O*#("&7$+(EN&#.J)$%,"1&$-.&$))"#.(%#.&#Z3#"%1&$"#&),++(%%#.&

% & & & & & & & & & & & & && & & & &&O*#&3",8"$+&$E1,&5,"F1&5(%*&E,)$E&,"8$-(Q$%(,-1&$-.&

1 & & & & & & & & & & & & && & & & &

&

' ' ' ' ' ''&

&'

& & & && & & & &&

' & & &&

& & &&

D & &

&&

& & & & & & & & & & & && & & & & & & & & & & & & &

& & & & & & & & & & && & & & & & & & & & & & & & & && & & & & & & & & & & && & & & & & & & & & & & & & &

& & & & & & & & & & & & && & & & & & & & & & & & & &

& & & & & & & & & & & && & & & & & & & & & &&

'''''''

' ''

& &&

& &&

&& ' & & & & & & & & & & &

& & & &&9",8"$+1&)$-&3,1%&,-&%*(1&5#01(%#&5*()*&5(EE&%*#-&$ & & & & &&O*#&5#01(%#&3",I(.#1&$-&#$1N&5$N&%,&7(-.&+JE%(3E#&3 & & & & & & & & & & & & & &&

See the VCPN website for additional Virginia Resources.

19

Triple P operates on the principle of offer-ing what is minimally necessary. “More isnot necessarily better,” says Dr. Shapiro.“We stress parent self-sufficiency.” The phi-losophy also affects how the program ap-proaches parents. “We offer suggestions, notprescriptions,” explains Dr. Shapiro. “Werecognize that parents are unique and capa-ble and we have respect for the parent’s role.We do not work directly with the children.The parents work with their children.” Parents learn self-regulation and self-eval-

uation. They are taught to stop and reflect onwhat they do well and what needs improve-ment. Another aspect of the program that dif-fers from some others is the degree offlexibility in the program. Facilitators mayspend one session on a module or severalsessions on that topic. Triple P is truly a prevention program. “It

is a public health approach,” says Dr.Shapiro. “All parents need and deserve par-enting help. It should be widely availableand accessible and affordable.” Dr. Shapironotes that if a community reduces the num-ber of families needing intensive interven-tion, costs are lower and the community as awhole benefits from improved parentingskills in the majority of the population. As part of a large, randomized study

funded by the Centers for Disease Controland Prevention, all five levels of the Triple Psystem of intervention were implemented innine South Carolina counties while nineother counties served as comparison coun-ties. After two years of implementation, 649service providers were trained to deliverTriple P interventions to the families theywere already serving. An estimated 8,883 to

13,560 families participated in the Triple Pprogram, with most (71% to 75%) receivingLevel 2 or 3 services and the remainder re-ceiving Level 4 or 5 services. Public aware-ness of parenting issues showed significantchange in the target areas. Child maltreat-ment rose in all counties but raised signifi-cantly more in counties without the Triple Pprogram. Out-of-home placements rose incontrol counties and lowered in the countieswith the Triple P program. Injuries due tochild abuse increased in the control countiesand lowered in the counties with the Triple Pprogram. In a community with 100,000 chil-dren under age 8, the effects would translateinto 688 fewer cases of child maltreatment,240 fewer out-of-home placements, and 60fewer children requiring hospitalization oremergency department treatment ( Prinz,Sanders, Shapiro, Whitaker, & Lutzker,2009). The study demonstrates the benefits of

implementing a large-scale parenting inter-vention using a population-based approach.Dr. Shapiro notes that large-scale implemen-tations are currently underway in North Car-olina, in Connecticut, and in many countiesin Los Angeles, California. One Virginia site using Triple P is Hori-

zons Behavioral Health in Lynchburg. Thisagency has been offering Triple P four timesa year for approximately two years. Classeshave between 3 and 10 participants. Theclients are internal referrals or from depart-ment of social services. Melissa Johnson,M.A., Program Manager, explained that the8-week parenting class has a $45 fee. John-son feels that charging the fee helps withdropout rates, since 90 to 95% of parents

complete the program. Johnson says the program is strictly fo-

cused on the parent and parenting skills. Theparents, she says, like the group discussionsand the feedback. They also develop into asupport group. Johnson adds, “The pre- andpost-tests administered to participants showpositive and notable changes in parentingbehaviors.” At Horizons Behavioral Health, the Triple

P parenting classes are complemented by anarray of support services. A mother’s groupand a father’s group (‘Power Dads’) meetweekly and are free and open to the generalpublic. The agency also offers intensive in-home services, case management services,and outpatient therapy.Triple P is rated as “Well Supported, Ef-

fective Practice” by the California Clearing-house on Evidence-based Practice in ChildWelfare.

The Promising Practices Network ratesTriple P as “Promising.”

The FRIENDS National Clearinghouse onCommunity-Based Child Abuse Preventionrates Triple P as “Well-Supported.”

Blue Prints for Healthy Youth Develop-ment rates Triple P as “Promising.”

For more information, visit VCPN’s websiteor www.triplep.netCheri Shapiro, Ph.D. can be reached at: cshapiro@mailbox.sc.edu

Melissa Johnson can be reached at: melissa.johnson@horizonbh.org

continued from page 11

POSITIVE PARENTING PROGRAM (TRIPLE P)

Guiding Good Choices ®(not developed specifically for the GuidingGood Choices program) on many parentingissues, including safe and responsible use ofsocial media and the Internet.

A study by the Washington State Institute for Public Policy indicates the odds of a positive net value for the Guiding Good Choices program of 85%.

The Promising Practices Network lists the Guiding Good Choices program as “Proven.”

The Office of Juvenile Justice lists Guiding Good Choices as an “Effective” program.

FRIENDS Clearinghouse rates the Guiding Good Choices program as “Supported.”

Blueprints for Healthy Youth Develop-ment classifies the Guiding Good Choices program as “Promising.”

SAMHSA’s NREPP rates the research onGuiding Good Choices as between 2.6 and3.1 out of 4

For moreinformation, contact:Channing Bete Company: Eravens-Seger@channing-bete.com

J. David Hawkins: jdh@uw.edu

Nancy Hans: nhans@pc4y.org

Brooks Michael: sbmichael@carilionclinic.org

Cheryl Matteo-Kerney: cmatteo-kerney@mpnn.state.va.us

Rasheedah Farid: rasheedah.farid@dss.virginia.gov

continued on page 17

91 E. Grace Street, MSC 7704

Harrisonburg, VA 22807

Attn: J. Grayson

Department of

Psychology

Return Service Requested

540-345

Nonprofit OrganizationU.S. POSTAGE PAID

Harrisonburg, VA 22802PERMIT NO. 161

VCPN is on the web – Visit us at:http://psychweb.cisat.jmu.edu/graysojh/

Go GreenIf you prefer an electronic notice whenVCPN is published rather than a hardcopy, please e-mail your preference toJoann Grayson at graysojh@jmu.edu

20

Website: http://www.211virginia.org/211provider/consumer/index211.do

Phone: 2-1-1Email: 211info@councilofcommunityservices.org

2-1-1 Virginia is a program that connects people with free information onavailable community services. When 2-1-1 is dialed, a trained professionallistens to the situation and suggests sources of help using a large database ofhealth and human services in Virginia. This service of the Virginia Depart-ment of Social Services works with other Virginia organizations to provideinformation on community events and services.

More on Our Website!• Meet the Developers• Parenting ProgramsThat Work

• Cleaning houses for Evidence-based Programs

• Skills for Teaching Parents

• Resources• Reference List