U.S. Department of Justice

Office of Justice Programs

Office of Juvenile Justice and Delinquency Prevention

John J. Wilson, Acting Administrator April 2000

From the Administrator

Often juvenile crime and violence arerooted in an array of interrelated prob-lems, such as child maltreatment andneglect, drug and alcohol abuse, andyouth conflict, that may originate withinthe family. As part of its mission to pre-vent juvenile delinquency and protectchildren, the Office of Juvenile Justiceand Delinquency Prevention (OJJDP) iscommitted to working to enhance thepositive influence of families throughproven family-strengthening programs.

This Bulletin, one of OJJDP’s FamilyStrengthening Series, features theStrengthening Families Program. Theprogram reflects research that indicatesthat the most effective interventionsbuild parent, child, and family skills.

Originally designed as a drug abuseprevention program to help drug-abusing parents and their children,the Strengthening Families Programhas developed into a family-change pro-gram that has served the needs of cul-turally and geographically diverse fami-lies and their children across the Nation.

Several examples of such varied ad-aptations of the program’s strategyare described in these pages. Sug-gestions for implementing the pro-gram in communities are also pro-vided, as are additional resourcesthat should prove useful.

When we strengthen the family, westrengthen the child—and the futureof our Nation.

John J. WilsonActing Administrator

their children avoid drug use. Programdevelopers (Kumpfer and DeMarsh, 1983)believed that, to reduce risk factors inchildren of substance abusers, one mustimprove the family environment and theparents’ ability to nurture and provideappropriate learning opportunities fortheir children. SFP was initially testedwith clients who were participating ineither outpatient treatment for drugabuse or a methadone maintenance pro-gram through community mental healthservices. The families in the experimentalgroup were randomly assigned to one ofthree groups, each of which attended adifferent type of session: a 1-hour parenttraining session; separate 1-hour trainingsessions for parents and for children; orseparate 1-hour classes for parents andfor children, followed by a 1-hour sessionfor the entire family. Families in the con-trol group received no treatment. Eachgroup met for 14 weeks and received in-centives, including transportation, child-care, snacks, and prizes for attendanceand homework completion, to increaseretention.

The research results indicated that theintervention that combined all three com-ponents (parent skills, child skills, andfamily skills) was the most successful. SFPincreased children’s positive behaviorand prosocial skills, improved adults’parenting skills, and enhanced the family

Family SkillsTraining for Parentsand ChildrenKarol L. Kumpfer and Connie M. Tait

The Office of Juvenile Justice and Delin-quency Prevention (OJJDP) is dedicated topreventing and reversing trends of increaseddelinquency and violence among adoles-cents. These trends have alarmed the pub-lic during the past decade and challengedthe juvenile justice system. It is widely ac-cepted that increases in delinquency andviolence over the past decade are rooted ina number of interrelated social problems—child abuse and neglect, alcohol and drugabuse, youth conflict and aggression, andearly sexual involvement—that may origi-nate within the family structure. The focusof OJJDP’s Family Strengthening Series is toprovide assistance to ongoing efforts acrossthe country to strengthen the family unit bydiscussing the effectiveness of family inter-vention programs and providing resourcesto families and communities.

HistoryThe Strengthening Families Program (SFP)began in 1983 as a 4-year prevention re-search project funded by the National In-stitute on Drug Abuse (NIDA). Because ofthe project’s promising results, SFP hasbeen replicated, revised, and adapted fordiverse population groups throughout theNation. The program was designed as adrug abuse prevention program for high-risk, drug-abusing parents to help themimprove their parenting skills and help

Fam

ilyStrengthening Series

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environment by improving communica-tion, clarifying family rules, and decreas-ing family conflict.

PurposeThe Strengthening Families Program is oneof the most powerful family change pro-grams in the Nation because it involves thewhole family instead of the parents or thechildren alone (Kumpfer, 1994a). The initialgoal was to design and test the relativeeffectiveness of three family-based andbehavior-oriented prevention interventions(a Parent Training Program, a Children’sSkills Training Program, and a Family SkillsTraining Program) in reducing the riskthat children (ages 6 to 10) living withsubstance-abusing parents would be-come substance abusers themselves.

SFP was designed to reduce environmen-tal risk factors and improve protectivefactors with the ultimate objective of in-creasing personal resiliency and minimiz-ing susceptibility to drug use in high-riskyouth. The program is theoretically basedon the Values-Attitudes-Stressors-Coping(VASC) Skills and Resources Model theoryof drug abuse (Kumpfer and DeMarsh,1985) and the social ecology model ofadolescent substance abuse (Kumpferand Turner, 1990–91). These modelssuggest that family environment is animportant factor in deterring the useof␣ alcohol and/or other drugs in youth.Family climate and parenting factors arethe major determinants of self-efficacyand the second major determinant, afterpeer pressure, of alcohol and other druguse. Recent research (Ary et al., 1999)finds family attachment, supervision, andfamily norms are strategies and pathwaysthat protect youth from drug use. Becausefamily environment influences every as-pect of a child’s life, improving parent-child relations should be a major goal ofany prevention/intervention program.

SFP has been tested, evaluated, and repli-cated in a variety of settings. Positive re-sults have been documented in inner-cityDetroit, MI; rural Alabama and Iowa; Ha-waii; and urban Utah. SFP has been modi-fied to provide culturally appropriate in-terventions for African American, Hispanic,Asian/Pacific Islander, and low-incomerural families. These modifications havebeen funded by a series of independentCenter for Substance Abuse Prevention(CSAP) Federal grants to prevention/treatment agencies that target differentethnic populations. New versions of SFP

have been developed for English-speakingAustralian families and French- and English-speaking families in Canada. The TexasCommission on Alcohol and Drug Abuse(TCADA) is funding replications in Texas.NIDA has selected SFP as one of 10 exem-plary delinquency prevention programsand funded research on SFP in the Wash-ington, DC, area.

Appropriate TargetPopulationsThe original Strengthening Families Pro-gram has been culturally adapted andtested with urban and rural families withelementary school-age children. (Kumpfer,1995; Aktan, Kumpfer, and Turner, 1996).SFP has proven successful with high-riskchildren whose parents are not drug oralcohol abusers and with families of di-verse backgrounds. Separate trainingmanuals have been developed for AfricanAmerican families. The African Americanmanuals contain the same basic contentas the original SFP but have culturallyappropriate pictures and language withsome specific information regarding Afri-can American families and communities.

Program DescriptionSFP is presented in 14 consecutive weeklysessions, each approximately 2 hourslong. The program has two versions: SFPfor elementary school children and theirfamilies and SFP for parents and youth10 to 14 years of age. Each version in-cludes skills training for parents, children,and families. Parents and children meettogether at the beginning of each session

for announcements, and some programsprovide a snack or a small meal. Follow-ing this group time, parents and childrenspend the first hour in their respectivegroups. They spend the second hour to-gether in family skills training. Researchhas demonstrated that, for both the par-ents and children, family skills practicehelps families make and sustain improve-ments in their interactions.

The SFP curriculum includes 6 manualscovering each of the 3 components of the14-session courses. The manuals are thefollowing:

◆ A Parent Trainer’s Manual and ParentHandbook, which include behavioraland cognitive strategies and homeworkexercises for 14 sessions, to help par-ents improve their parenting, communi-cation, and nurturing skills.

◆ A Children’s Skills Trainer’s Manual andChildren’s Handbook, which includelife and social skills training and home-work exercises for 14 sessions, to helpyouth improve their behavior andsocial competence.

◆ A Family Skills Trainer’s Manual,which includes family involvementand homework exercises for 14 ses-sions, to allow family members topractice what they have learned intheir separate parent and youthsessions.

◆ An Implementation Manual for trainers,which includes training and setup in-formation, materials, program logis-tics, group facilitation techniques, andethical questions.

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Parent Skills TrainingEach session begins with a review ofhomework and concepts covered duringthe previous week. The training materialis presented in a variety of ways includingexercises, videos, lectures, discussions,and role-plays. New concepts are thenreviewed and new homework is assigned.

The optimum number of participants forparenting groups is 8 to 12 sets of par-ents. Child care should be available forparticipants with children under age 6.

The Parent Training Therapist Manual in-cludes group exercises and homeworkforms, a communication section adaptedfrom the Relationship Enhancement Pro-gram (Guerney, 1997), and sections ondevelopmental age/stage-appropriatebehaviors and drug education. A sessionfor parents on changing problem behaviorhas been empirically demonstrated toincrease the endurance of appropriatebehavior.

Outline of Parent SkillsTraining Sessions◆ Introduction and group building: This

session presents group building exer-cises and a short lecture on learningtheory. Goals include discussingchange, focusing on positive thoughts,and encouraging parents to observetheir child’s good behavior.

◆ Developmental expectancies andstress management: This session dis-cusses physical, mental, social, andemotional development with a focuson appropriate and realistic expecta-tions for children at different ages. Asection on stress and anger manage-ment teaches parents what to dowhen they feel overwhelmed.

◆ Rewards: This session covers reward-ing children for good behavior, “at-tends” (describing and emphasizingpositive behavior), and providing so-cial rewards. Parents are encouragedto “catch their children being good.”

◆ Goals and objectives: This session fo-cuses on setting general goals, defininggood behavior, setting behavioral goalsand objectives, and making positivestatements to children.

◆ Differential attention/Charts and spin-ners: This session teaches parents theskill of rewarding good behavior andignoring bad behavior. Charts and

spinners are described as a way to en-courage good behavior. Charts list andrecord the child’s progress on targetbehaviors the parent wants to improve(e.g., making the bed, brushing teeth,or cleaning the bedroom). The spinnerhas rewards for achieving target be-haviors the parent and child havechosen together.

◆ Communication I: This session teachesparents about listening and speaking,“I” messages, and roadblocks tocommunication.

◆ Communication II: This session rein-forces concepts covered in the previ-ous session with extensive role-play.

◆ Alcohol, drugs, and families: This ses-sion introduces the parent’s role in pre-vention of children’s problem behaviorsand awareness of at-risk behaviors.

◆ Problem solving, giving directions:This session teaches the basic steps ofproblem solving and reinforces themwith role-play. Making requests, givingclear directions, and delivering effec-tive commands are discussed.

◆ Limit setting I: This session introducestimeouts, overcorrection, positivepractice, and the parents’ game.

◆ Limit setting II: This session covers theissue of punishment, including how tosolve a child’s problem behavior bysetting appropriate limits.

◆ Limit setting III: This session helps par-ents continue to solve problems in avariety of situations, including thosesupplied in the handbook, that may berelevant to their individual needs.

◆ Development/Implementation of be-havior programs: This session reviewsthe process of implementing the abbre-viated behavioral program. Parentsdevelop a plan for the first week of abehavior program for their child.

◆ Generalization and maintenance: Thissession teaches parents to fade re-wards (rewarding every other time forseveral weeks and then rewarding onlyoccasionally if the desired behaviorcontinues), look for naturally occurringrewards, troubleshoot, and maintainbehavioral changes in their children.

Children’s SkillsTrainingIn each SFP session, the children meetin groups to learn how to increase theircommunication, social, and peer resis-tance skills. The curriculum was designedto teach a variety of prosocial skills usinga modified Social Skills Training Program(Spivack and Shure, 1979).

Ideally, there should be two trainers pergroup. The optimum number of partici-pants in the children’s group is 6 to 8.Like the parents’ sessions, each children’ssession begins with a review of homeworkassigned and concepts presented duringthe previous week’s meeting. Children arethen taught new material through exer-cises, games, coloring and workbook ac-tivities, role-plays, puppet shows, and dis-cussions. The trainers then review thematerial and assign new homework. Chil-dren may receive prizes for good behavior.

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Outline of Children’s SkillsTraining Sessions◆ Hello and rules: This session welcomes

children to the group with games andsongs. Group rules and a DynamicDoer’s chart are developed.

◆ Social skills I: This session discussesconversation skills, especially listen-ing. Role-play reinforces the conceptof social skills.

◆ Social skills II: This session coversspeaking skills such as eye contact, ap-propriate distance, appropriate voicevolume, praise, and complimenting.

◆ Creating good behavior: This sessionteaches children the secret rules ofsuccess. Children role-play relevantsituations to practice the rules.

◆ How to say “no” to stay out of trouble:This session teaches children fourbasic steps to stay out of troublethrough discussion, games, stories,and role-plays.

◆ Communication I: This session dis-cusses family talks and “I feel” mes-sages. A family meeting is assignedas homework.

◆ Communication II: Using puppets androle-plays, this session illustrates theconcept of asking a friend for help.

◆ Alcohol and drugs: This sessionteaches children the effects and conse-quences of alcohol and drug use withstories, lectures, and discussion.

◆ Problem solving: This session presentsseven steps to solving problems. Chil-dren role-play several examples to re-inforce the concept.

◆ Introduction to parents’ game: Thissession teaches children to give effec-tive directions through discussion anddemonstration.

◆ Coping skills I: This session teacheschildren to recognize feelings in them-selves and others and to understandthat different people may have differ-ent feelings about the same situation.

◆ Coping skills II: This session focuseson how to give and receive criticism.

◆ Coping skills III: This session allowschildren to discuss things that makethem mad and offers strategies for cop-ing with, controlling, and expressinganger.

◆ Graduation, resources, and review:This session teaches children aboutother resources that can help them ifthey have problems when their parentsare unavailable. Children then reviewall 14 sessions.

Family Skills TrainingThis intervention program, the final com-ponent in SFP, brings parents and childrentogether. It incorporates the curriculumdescribed in Helping the NoncompliantChild (Forehand and McMahon, 1981).The Family Skills Program follows theparents’ and children’s groups. Thesesessions are designed to help parentsempathize with and enjoy their children.The nonpunitive environment helps chil-dren and parents express their feelingsand thoughts with the support of programfacilitators. The goal of the family sessionis to increase the cooperation of all familymembers.

During the second phase of these ses-sions, elements of the Family RelationshipEnhancement Program (Guerney, 1997)are introduced. The parents practice ap-propriate behavior modeled by the facili-tator. Two facilitators introduce a prob-lem and model appropriate problemsolving and communication skills. Thefamilies then role-play problem situationsusing the communications skills theyhave learned and observed. The therapistprovides immediate reinforcement bypraising appropriate actions. In the thirdphase of sessions, parents learn to con-trol their children’s play. The parentspractice setting appropriate limits andrewarding good behavior.

The Family Skills Training program, eachsession of which lasts 1 hour, includesboth parents’ and children’s groups. Theformat includes both didactic and experi-ential activities. At least two trainersper group are needed to assist with thechildren’s and parents’ games and toprovide individual support. The didacticactivities include brief lectures on behav-ior change, rewards, giving directions,and commands. The experiential activi-ties include families participating in thechildren’s game, parents’ game, and role-plays on communication and problemsolving.

Outline of Family SkillsTraining Sessions◆ Introduction and group building: This

session presents the rationale, format,and mechanics of the family compo-nent and begins the children’s game.

◆ Children’s game: This session helpsparents conceptualize problems in thecontext of the parent-child interactionand begins training for the children’sgame.

◆ Children’s game/Rewards: Parents andchildren practice the children’s gamewhile trainers review attending skills(describing good behavior the parentsees and emphasizing good behaviorthe parent wants).

◆ Goals and objectives: Parents and chil-dren continue to practice the children’sgame.

◆ Differential attention/Charts and spin-ners: Families make charts and spin-ners and continue the children’s game.

◆ Communication I: Families prac-tice level 1 communication skills

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(i.e., addressing nonthreatening is-sues that have nothing to do with thefamilies).

◆ Communication skills II: Families prac-tice communication skills at levels 2, 3,and 4. In level 2, the topic of conversa-tion is again restricted to areas that donot involve the families to concentrateon using their skills. In level 3, thefamilies begin discussing a topic ofinterpersonal relevance. In level 4,families begin discussing actual prob-lems or issues in their families.

◆ Learning from parents: Families con-tinue to practice communication skills,this time discussing drug and alcoholissues.

◆ Parents’ game/Problem solving, givingdirections: This session introduces giv-ing effective commands and requestsand using timeouts.

◆ Parents’ game/Giving commands:Families continue the parents’ gameand practice giving clear and specificcommands.

◆ Parents’ game/Consequences for com-pliance and noncompliance: Familiescontinue to practice the parents’ gameand introduce consequences for notfollowing directions.

◆ Parents’ game/Family talks: This ses-sion introduces families to family meet-ings with a sample agenda.

◆ Development/Implementation of be-havior programs: Trainers encourageparents to apply the skills they havelearned to any problem situations andto continue practicing the children’sgame.

◆ Termination and graduation: This lastfamily session is a graduation party forall participants. Families receive cer-tificates of completion and play games.

ImplementationManualThe Implementation and Training Manualassists trainers in facilitating theStrengthening Families Program by pro-viding information and answering ques-tions about getting started. The followingare some of the topics included in themanual:

◆ Training, setup, and materials.

◆ Logistics.

◆ Problem solving.

◆ Group facilitation techniques.

◆ Ethical questions.

Trainers are the program’s most valuableresource. SFP functions best with differ-ent trainers and cotrainers for the par-ents’ and children’s skills-training groups.During the family skills sessions, if thenumbers are large and the families aredivided into two groups, two trainers areneeded for each group. If the families re-main in one group, it is recommendedthat all four trainers facilitate the familysession. In SFP for youth ages 10 to 14,the entire program is on videotape, soonly one trainer is required for the par-ents’ training and two additional trainersare needed for the children’s training.

The selection of trainers is based on therequirements of the target populations.For example, when the program was con-ducted with parents who were concur-rently enrolled in treatment for alcoholand/or other drug abuse problems, pro-gram implementers were staff members oftreatment facilities or community mentalhealth centers who received special train-ing in conducting the parent and childcomponents of the Strengthening FamiliesProgram. When implementing SFP withrural African American families, staff fromcommunity crisis and counseling centersin the target areas were trained. WhenSFP was implemented in inner-city De-troit, MI, a wide range of youth and familyservice providers, including teachers andclergy, were hired to work hourly in theevening to accommodate working parents(Aktan, 1995). Since SFP involves bothbehavioral and cognitive changes, train-ers who are knowledgeable in behavioraltraining and communication and/or cogni-tive therapy are well suited to facilitatethe program.

Evaluation ResearchStudiesThe Strengthening Families Program hasbeen evaluated in 12 research studies byindependent evaluators. Research resultsfrom a grant funded by NIDA found posi-tive effects for alcohol- and drug-abusingfamilies. SFP’s effectiveness has been dem-onstrated in CSAP program evaluationswith rural and urban low-income AfricanAmerican families (Aktan, Kumpfer, andTurner, 1996), Asian/Pacific Islander fami-lies (Kameoka and Lecar, 1996), familiesin three counties in Utah with a 5-yearfollowup (Harrison, 1994), and in a doc-

toral dissertation with a general popula-tion of high-risk families recruited throughelementary schools. Three years of follow-up data, through the ninth grade, foundsignificantly less substance abuse amongyouth participating in the Iowa SFP thanamong their nonparticipating peers(Spoth, 1998).

The first 5 years of CSAP grants haveyielded positive results for the SFP sitesin Colorado. The results are available inan evaluation report that has not yet beenpublished. Changes reported by partici-pating families are clinically significantreductions in family conflict (p=0.002) andimprovements in family communication(p=0.000) and organization (p=0.000) asmeasured at the 0.05 level by the Moos(1974) Family Environment Scale. Reduc-tions in youth conduct disorders, aggres-siveness, and emotional problems, suchas depression, were demonstrated usingthe Achenbach (1991) Child BehaviorChecklist.

Research indicates similar results withseveral different ethnic groups. Becauseof these positive results in culturallymodified adaptations of SFP, the programhas been selected by NIDA as the onlyfamily program disseminated in the Tech-nology Transfer Program Packets on Pre-vention. In addition, a videotape, ComingTogether on Prevention, describes the pro-gram for Hispanic families in Denver, CO,and its impact.1

CSAP ReplicationStudiesBecause of SFP’s positive results, agen-cies in five States succeeded in attractingdemonstration/evaluation research fund-ing from CSAP. These five grants involvedeight different community agencies serv-ing high-risk families. The studies in-cluded the Alabama State Department ofMental Health and Mental Rehabilitationstudy of low-income, African American,drug-using mothers in rural Alabama andthe Detroit City Health Department’sstudy of inner-city African Americandrug abusers. Both studies documentedpositive results (Aktan, 1995; Aktan,Kumpfer, and Turner, 1996; Kumpfer,Molgaard, and Spoth, 1996). Additional

1 The videotape can be ordered from the NationalClearinghouse on Alcohol and Drug Information(NCADI) or online from www.health.org.

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studies demonstrated similar improve-ments among low-income Hispanic fami-lies from housing complexes in Denver,CO (Kumpfer, Wamberg, and Martinez,1996); Asian/Pacific Islanders and His-panic families in three Utah countiesserved by four agencies (Harrison,Proskauer, and Kumpfer, 1995); andAsian/Pacific Islander families in Hawaii(Kameoka and Lecar, 1996). A study ofone SFP that was linguistically and cul-turally modified for high-risk FrenchCanadian families and funded by theCanadian Government is complete, anda new culturally modified SFP for English-speaking families in Canada and Australiahas been developed and implemented.

African AmericanSFP Results

Rural African American SFPThe Alabama SFP program was imple-mented in Selma, AL, by the Cahaba Men-tal Health Center. In a quasi-experimental,CSAP-funded study involving a pretest,posttest, and 1-year followup, researcherscompared low-drug-use families whoseuse was limited to alcohol with high-drug-use families that used both alcohol andillegal drugs. Sixty-two families partici-pated in the program, and 51 families (82percent) completed at least 12 of the 14sessions. Pretest and posttest compari-sons of the two experimental groups re-vealed significant reductions in familyconflict in high-drug-use families and in-creased organization in low-drug-use fami-lies (Kumpfer, 1990, 1991a). One unex-pected benefit of the family program wasthat even without substance abuse treat-ment, high-drug-use mothers significantlyreduced their substance use as measuredby a composite index of the quantity andfrequency of alcohol and drug use over a30-day period.

By the end of the program, the children ofhigh-drug-use mothers were rated as sig-nificantly improved on both the internaliz-ing and externalizing scales and on allsubscales, except the subscale that mea-sures communicativeness. Children of low-drug-use mothers improved only on theclinical scales for which they manifestedrelatively higher scores on the intake pre-test, namely obsessive-compulsive be-havior, aggression, and delinquency.These results suggested that SFP waseffective in reducing maternal reportsof children’s problem behaviors when

the children showed problems in theclinical or subclinical diagnostic rangeon the intake measures before the pro-gram began. SFP was equally effectivewith mothers of every education level inimproving their parenting style and thebehavior of their children.

Because this study used a quasi-experimentalcomparison group design without a ran-domly assigned, no-treatment controlgroup, it is impossible to determinewhether these positive results can beattributed to SFP participation. How-ever, the results are consistent with thepositive findings of other studies of di-verse populations.

Urban African American SFPThe SFP for African American parentsdeveloped for the State of Alabama wasmodified for use in the 12-session SafeHaven Program in Detroit, MI (Kumpfer,Bridges, and Williams, 1993). Parents insubstance abuse treatment were invitedto volunteer for the program. Fifty-eightfamilies met the program completion cri-teria of attending 10 of the 12 SFP ses-sions, and the average completion ratewas 82 to 86 percent after 3 cohorts fin-ished the program (Aktan, 1995). The re-sults indicated that SFP had a significantpositive impact on the participating fami-lies (Aktan, Kumpfer, and Turner, 1996),including a marked increase in family co-hesion in the total sample and decreasedfamily conflict in the low-drug-use sample.The families reported spending more timetogether and participating in more parent-child activities.

Parents reported decreases in drug use,depression, and use of corporal punish-ment and an increase in their perceivedeffectiveness as parents. According toparental reports, children’s behaviorproblems decreased significantly inaggression and hyperactivity and ap-proached a significant decrease in delin-quency. Significant pretest to posttestimprovements in other behavioral prob-lems—school-related difficulties, generalpsychological and emotional problems,and more specific measures of depres-sion, uncommunicativeness, obsessive-compulsive tendencies, social with-drawal, and schizoid tendencies—werefound only among the children of high-drug-use parents. Parents in both thehigh- and low-drug-use groups reportedthat their children had more bonding ex-periences at school and spent more time

on their homework. These parental re-ports matched trainer reports on behav-ioral improvements in the participatingfamilies.

Utah CommunityYouth ActivityProject ResearchThe Utah State Division of SubstanceAbuse implemented a quasi-experimentalpretest, posttest, and 3-month followupstudy comparing the effectiveness ofthe 14-session SFP with an 11-sessionparenting program (Communities Empow-ering Parents Program) that did not in-clude the family skills component. Thestudy was implemented in three countiesin Utah with CSAP funds. Researchersrecruited 421 parents and 703 high-riskyouth (ages 6 to 13) to attend one of thetwo programs. Sixty-nine percent of thefamilies were ethnic minorities, includingAsian/Pacific Islanders, Hispanic, andAmerican Indians. Completion of thepretest program was very high, averaging85 percent across the three county sites.Unfortunately, because of a lack ofcompletion incentives, only 203 parentsand 448 youth completed the posttest.

Analysis of the pretest and posttestchange scores in Utah suggested signifi-cant improvements in family environment,parenting behaviors, and children’s be-havior and emotional status. Although

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the comparison program also yielded posi-tive results, they were less significant(Harrison, Proskauer, and Kumpfer, 1995).

In a 5-year followup study of participantsin the three-county Utah Community YouthActivity Project/SFP study (Harrison,Proskauer, and Kumpfer, 1995), 87 familieswere interviewed confidentially. The resultssuggested that SFP had a long-term positiveimpact on members of the subsample fami-lies (Kumpfer, Molgaard, and Spoth, 1996).A majority of families were still using skillsthey had learned years earlier in SFP.Ninety-seven percent of the families were“catching their children being good,” 99percent believed they were giving cleardirections, 95 percent used reasonableconsequences, 84 percent improved theirproblem solving with children, 94 percentenjoyed each other more, and 85 percentscheduled regular family playtime. Mostimportant to the continued success of thefamily program, 62 percent of all familiesinterviewed continued family meetings upto 5 years after participating in SFP. Familymeetings bring parents and children to-gether weekly to discuss family issues,schedules, children’s chores and responsi-bilities, and plans for enjoyable family ac-tivities. The parents reported fewer familyproblems, reduced stress-conflict levels,more family fun, and greater expression ofpositive feelings.

The StrengtheningHawaii FamiliesProgramThe Coalition for Drug-Free Hawaii hasrevised SFP to be more culturally appro-priate for Hawaiian Asian/Pacific Island-ers. The Strengthening Hawaii Families(SHF) Program has a 20-session curricu-lum that emphasizes awareness of familyvalues, family relationships, and commu-nication skills. A 10-session family andparenting values curriculum precedesthe 10-session SFP family managementcurriculum to increase parental readi-ness for change. The revised curriculumcovers topics such as connecting withone another, using caring words, build-ing generational continuity, appreciatingculture, communicating, ensuring hon-esty, making choices, building trust,expressing anger, and developing problem-solving, decisionmaking, and stress man-agement skills. Audiotapes and videotapesaccompany the new curriculum manuals.

An independent evaluation was con-ducted (Kameoka, 1996) using a quasi-experimental, pretest-posttest, non-equivalent control group design toevaluate the effectiveness of hypoth-esized outcome variables on programobjectives. The original 14-session SFPwas implemented in 4 sites and com-pared with the 20-session, culturally re-vised SHF program implemented in 9sites. The measurement battery, whichwas culturally modified by alteringwords and expressions not common inHawaii, included several different as-sessment instruments.

Because of SFP’s high attrition (48 per-cent) and the lack of risk-level equiva-lence between the SFP and SHF groups,results of the outcome comparisonsmust be interpreted with caution. Thesample size was small, the populationwas low drug users, and the curriculumwas adapted to a value-based versus asocial learning/social skills curriculum.The evaluator interpreted the SHF pro-gram as an educational program de-signed for families not in treatment ortherapeutic programs. Participants re-ceiving professional mental health ser-vices were eliminated from the dataanalysis to reduce bias due to theirclinical status.

The outcome evaluation results indicatedthat both SFP and SHF programs attainedthe goal of strengthening family relation-ships and produced significant improve-ments in areas such as family conflict,family cohesion, and family organization.Only the original SFP resulted in statisti-cally significant (p<0.01) improvementsin attitudes and ability to reward positivebehavior. Treatment and nontreatmentgroups differed significantly on parentingattitudes toward physical punishment.The mean posttest for the nontreatmentgroup was 1.66, compared with 2.39 forthe treatment group on this variable. Be-cause of low numbers and high variance,however, this positive result can be re-ported only as a nonsignificant trend.Similarly, the original SFP resulted in alarger mean decrease from pretest toposttest in parental depression comparedwith the culturally modified SHF. Becauseof its larger sample size, which gave morepower to the analysis, however, only SHFproduced a statistically significant result.Even with a smaller sample size, SFP wasmore effective in improving children’s

mental health by reducing their hostility,depression, anxiety, somatization (psy-chological distress manifested in physicalsymptoms), interpersonal problems, pho-bias, and paranoia. The SHF program, incontrast, had a positive impact only onhostility, paranoia, and depression. Sub-stance use decreased for SFP parents,siblings, and children but increased sig-nificantly for SHF children and nonsignifi-cantly for SHF parents. It is not clear whythe original SFP was more effective thanthe culturally tailored SHF. The shift froma behavior- to a values-based programmay have decreased the emphasis onbehavior change.

The StrengtheningHispanic FamiliesProgramThe Denver Area Youth Services (DAYS)in Denver, CO, modified the StrengtheningFamilies Program for greater effectivenesswith Hispanic children and families inseveral inner-city housing projects. This5-year program with high-risk youth,funded by a grant from CSAP, was recentlycompleted. Preliminary results suggestthat the program was successful in at-tracting and maintaining high-risk familiesin SFP.

SFP and a child-only Basic PreventionProgram (BPP) comparison interventionwere implemented with 311 participants.Twenty-five percent of referrals camefrom schools and other community agen-cies, and 75 percent came from DAYS’ ag-gressive outreach efforts in housing com-plexes. The children ranged in age from5 to 12. One major success of this pro-gram was its high completion rate of 92percent, which was based on two criteria:attending at least 70 percent of the ses-sions and participating in the graduationceremony to receive a certificate ofcompletion (Kumpfer, Wamberg, andMartinez, 1996).

Retention was an integral part of thefollowup design; 87 percent of familiescompleted the 6-month followup, and 75percent completed the 1-year followup. Arelatively low level of risk factors is beingreported for these children, possibly be-cause, unlike the original NIDA researchor Alabama, Michigan, and Utah studies,this program was not targeted to childrenof substance abusers. Also, families oftenunderreport problems at the pretest stage

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because they are unsure about the confi-dentiality of the information they provide(Kumpfer, 1991a). Baseline data suggestthat the greatest increase in exposure totobacco, alcohol, and other drugs occursin these Hispanic children at age 8 or 9.As in the Utah studies, many of the His-panic children (33 percent) reported be-ing sad or depressed, and 28 percent saidthey have thought about hurting them-selves or committing suicide. As many as20 percent of these elementary schoolchildren were having difficulties adjustingto school, and 44 percent had been in-volved in fistfights.

The levels of satisfaction and perceptionof usefulness reported by children andparents in each of the two comparisonprograms were almost identical. Parentsrated SFP slightly higher in almost all cat-egories, but they rated BPP about 20 per-cent higher than SFP on the variables ofhelping children do better at school andmaking friends. The children consideredboth programs equally useful.

The IowaStrengtheningFamilies ProgramThe Center for Family Research in RuralMental Health at Iowa State University se-lected SFP for a clinical research trial tar-geting 10- to 14-year-old youth and theirfamilies in 19 economically disadvantagedcounties in rural Iowa. SFP was modified toplace greater emphasis on youth resiliency(Kumpfer, 1994b; Richardson et al., 1990).The modified program focused on protec-tive factors associated with seven basicresiliency characteristics in youth (opti-mism, empathy, insight, intellectual com-petence, self-esteem, direction or purposein life, and determination or perseverance)and seven coping or life skills (emotionalmanagement skills, interpersonal socialskills, reflective skills, academic and jobskills, ability to restore self-esteem, plan-ning skills, and life skills and problem-solving abilities).

Thirty-three schools were selected on thebasis of the high percentage of families par-ticipating in free or reduced-price schoollunch programs. The true experimental de-sign randomly assigned each school to oneof three conditions: (1) Iowa StrengtheningFamilies Program (ISFP), (2) Preparing forthe Drug-Free Years (Hawkins, Catalano,and Miller, 1992), a five-session youth andfamily program; or (3) a minimal-contact

control condition. Families in the controlcondition received four Cooperative Exten-sion Service leaflets that provided informa-tion on the developmental changes of pre-teens and teens in physical, emotional,cognitive, and relational domains.

To facilitate universal implementationamong families of all sixth graders, thenumber of sessions was reduced from 14to 7. The standard SFP content and formatwere used, including separate parentingand youth sessions for the first hour and afamily session for the second hour. A totalof 161 families, including 114 families thatcompleted an inhome pretest assessment,participated in 21 SFP groups at 11 differ-ent schools. Approximately 94 percent ofpretested participants completed five ormore sessions, 88 percent attended atleast six sessions, and 62 percent attendedall seven sessions.

Outcome evaluations included the use ofmulti-informant, multimethod measure-ment procedures at pretest, posttest,1-year, 2-year, and 3-year followup data-collection points (Molgaard, Kumpfer, andSpoth, 1994). The assessment includedinhome videotapes of families in struc-tured family interaction tasks, inhomeinterviews, and standardized instrumentmeasures.

Fidelity of program delivery was randomlymonitored by trained research staff whoattended two sessions each of youth andparent groups. These skilled researchersused detailed checklists to guide their ob-servations and ratings of adherence tostandardized SFP content and quality ofleader delivery. Analysis of the pretest-posttest followup data showed significantchanges and improvements in the parents’and children’s behavior, knowledge, andskills. Most important, 3 years after theprogram ended, substance abuse amongSFP youth was still significantly lower thanthat of the control group counterparts.Youth in the control group also consumedgreater quantities of alcohol than youth inthe ISFP group (Spoth, 1998).

Suggestions forImplementation

Recruiting and RetainingHigh-Risk FamiliesRecruiting and retaining families is a chal-lenge for any family-focused preventionprogram. Enlisting the support and assis-tance of family-serving agencies in the

community has been a successful methodof recruitment. Schools, local churches,drug treatment agencies, housing authori-ties, mental health centers, youth and so-cial service agencies, and tribal councilsare examples of groups that have sup-ported SFP and other family interven-tions. Collaborative efforts with localleaders can greatly enhance the abilityto contact and attract hard-to-reach fami-lies (Kumpfer, 1991a).

Retention is also an important issue forprogram success. An interesting programthat meets families’ needs and involvesthem in meaningful activities is crucial toretention. Parents and youth can becomeinvolved in the practical aspects of theprogram by bringing snacks or meals,helping with attendance, and setting upthe room. Group leaders must be able tocommunicate and develop positive rela-tionships with participants. Incentives,such as coupons for food or video rentals,payments for testing time, graduationgifts, prizes for completion of homework,and small gifts (e.g., pencils, pens, orstickers) for the children based on goodbehavior, can also enhance retention.Hawkins and colleagues (1992) found thatreducing barriers to participation was acritical aspect of retention. They sug-gested the following:

◆ Provide transportation; a safe, conve-nient, and nonstigmatizing place forthe program; and childcare.

◆ Increase the sense of ownership andcultural relevance by using indigenousleaders and involving parents in pro-gram modifications.

◆ Hold discussions on possible barriersto attendance.

◆ Extend personal invitations and con-tact participants who miss sessions.

Program Site, Location, andGroup SizeThe group size and location of the pro-gram are important factors to considerwhen implementing a family preventionprogram. SFP requires at least two roomsfor the separate youth and parent ses-sions, with one room large enough to holdthe combined family session. Site loca-tions can include family support centersin housing projects, community centers,local churches, and schools. Holding theprogram in schools increases involve-ment by school personnel and enhancesparent-school communication. Churches

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are good locations because they are likelyto have child-friendly rooms and socialhalls with kitchens to prepare and servemeals; they also can provide access tobasic needs (e.g., clothes, housing, andfood) and volunteers for childcare andmeal preparation.

The developers of SFP originally deter-mined the ideal group size to be 8 to 12families. The SFP projects found thatgroups of as few as 5 families and asmany as 14 families can also be effective.

Training of FacilitatorsSFP can be delivered by teachers, commu-nity agency staff, counselors, or personshired from the community who are skilledat facilitating groups of parents or chil-dren. Groups of 10 to 30 facilitators aretrained for 2 days in the underlying con-cepts, program mechanics, recruitmentand retention of families, curriculum,group facilitation, ethical situations, androle-plays. Videotapes illustrate key con-cepts. Participants may choose to presenta portion of a session for parents or chil-dren to experience leading an SFP groupwith feedback from the trainer. Trainingtypically takes place at the requestingagency. Additional consultation and tech-nical assistance concerning programimplementation and evaluation are avail-able on a program-by-program basis.

ConclusionThe Strengthening Families Program is apowerful and comprehensive program forfamily change based on the most recentresearch. SFP has demonstrated a numberof positive results, including decreaseduse of and intention to use alcohol, to-bacco, and other drugs; a reduction inother youth behavior problems; and alowering of risk factors. At the same time,SFP has enhanced children’s protectivefactors by improving family relations andexpanding adults’ parenting skills, includ-ing parental knowledge of appropriatechild-rearing, supervision, and relationshipskills, and developmental expectations. Anumber of evaluation and demonstrationprojects have assessed the effectivenessof SFP for children of substance abusers,children at risk for placement outside thefamily because of child abuse and neglect,and low-income rural and urban parents ofdifferent ethnic groups.

The SFP program has been tested, evalu-ated, and replicated in a variety of set-

tings. Positive results have been shown ininner-city Detroit, MI; rural Alabama; theislands of Hawaii; agricultural areas ofIowa; and metropolitan communities ofUtah. SFP has been implemented andtested with African Americans, Hispanics,Asian/Pacific Islanders, American Indians,and rural families in low socioeconomicgroups.

The Strengthening Families Program isbased on the VASC Theory of Drug Abuseand the Social Ecology Model of AdolescentSubstance Abuse. These models suggestthat family environment is an importantfactor in deterring the use of alcohol and/orother drugs in youth. Improving parent-child relations should be a major goal ofany prevention/intervention program.

For Further InformationFor more information about the Strength-ening Families Program, contact:

Connie Tait, Ph.D.University of UtahDepartment of Health Promotion

and Education300 South 1850, East Room 215Salt Lake City, UT 84112–0920801–585–9201801–585–8498801–581–5872 (fax)E-mail: connie.tait@health.utah.edu

For more information about the Strength-ening Families Program for Parents andYouth 10–14, contact:

Virginia Molgaard, Ph.D.Institute for Social and Behavioral

Research2565 North Loop, Suite 500Iowa State UniversityAmes, IA 50010515–294–8762515–294–3613 (fax)E-mail: molgaa@iastate.eduInternet: www.extension.iastate.edu/

pages/families/sfp.html

For more information about the Strength-ening Hawaii Families Program, contact:

Sandra L.W. LacarExecutive DirectorCoalition for Drug-Free Hawaii1130 North Nimitz Highway, Suite A–259Honolulu, HI 96817808–545–3228808–545–2686 (fax)E-mail: cdfh@alpha.netInternet: www.drugfreehawaii.org

For more information about the Strength-ening La Familia Program, contact:

Donna MartinezDenver Area Youth Services Program1240 West BayaudDenver, CO 80223303–698–2300

ReferencesAchenbach, T.M. 1991. Teacher ReportForm (TRF). Burlington, VT: Center forChildren, Youth, and Families, Universityof Vermont.

Aktan, G. 1995. Organizational frameworksof a substance use prevention program.International Journal of the Addictions30(2):185–201.

Aktan, G., Kumpfer, K.L., and Turner, C.1996. Effectiveness of a family skills train-ing program for substance use preventionwith inner city African-American families.Substance Use and Misuse 31(2):157–175.

Ary, D.V., Duncan, T.E., Biglan, A., Metzler,C.W., Noell, J.W., and Smolkowski, K. 1999.Development of adolescent problem be-havior. Journal of Abnormal Child Psychol-ogy 27(2):141–150.

Forehand, R.L., and McMahon, R.J. 1981.Helping the Noncompliant Child: A Clinician’sGuide to Parent Training. New York, NY:Guilford Press.

Guerney, B.G., Jr. 1997. Relationship En-hancement Skills Training Program forTherapy, Problem Prevention and Enrich-ment. San Francisco, CA: Jossey-Bass.

Harrison, S. 1994. Evaluation Report onUtah CSAP/CYAP Project. Submitted to theUtah State Division of Substance Abuse.Salt Lake City, UT: University of Utah,Graduate School of Social Work, SocialResearch Institute.

Harrison, S., Proskauer, S., and Kumpfer,K.L. 1995. Final Evaluation Report on UtahCSAP/CYAP Project. Submitted to the UtahState Division of Substance Abuse. SaltLake City, UT: University of Utah, Gradu-ate School of Social Work, Social ResearchInstitute.

Hawkins, J.D., Catalano, R.F., and Miller,J.Y. 1992. Risk and protective factors foralcohol and other drug problems in ado-lescence and early adulthood: Implica-tions for substance abuse prevention.Psychological Bulletin 112(1):64–105.

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Kameoka, V.A. 1996. The effects of afamily-focused intervention on reducingrisk for substance abuse among Asian andPacific-Island youths and families: Evalua-tion of the Strengthening Hawaii’s Fami-lies Project. Honolulu, HI: University ofHawaii, Social Welfare Evaluation andResearch Unit.

Kameoka, V.A., and Lecar, S. 1996. The ef-fects of a family-focused intervention onreducing risk for substance abuse amongAsian and Pacific-Island youths and fami-lies: Evaluation of the StrengtheningHawaii’s Families Project. Available fromthe Coalition for a Drug-Free Hawaii, Uni-versity of Hawaii.

Kumpfer, K.L. 1990 (March). Services andprograms for children and families. Paperpresented at the National Forum on theFuture of Children and Families: Work-shop on Children and Parental Illicit DrugUse. Washington, DC: National Academyof Sciences.

Kumpfer, K.L. 1991a. How to get hard-to-reach parents involved in parenting pro-grams. In Parenting as Prevention: Prevent-ing Alcohol and Other Drug Abuse Problemsin the Family, edited by D. Pines, D. Crute,and E. Rogers. Publication No. (ADM) 91–1715. Washington, DC: U.S. Department ofHealth and Human Services, pp. 87–95.

Kumpfer, K.L. 1991b. Safe haven AfricanAmerican parenting project: Final evalua-tion report. Manuscript submitted forpublication. Salt Lake City, UT: Universityof Utah, Department of Health Education,Health Behavior Laboratory.

Kumpfer, K.L. 1994a (December). Predic-tive validity of resilience for positive lifeadaptation. Paper presented at NIDA con-ference, The Role of Resilience in DrugAbuse, Alcohol Abuse, and Mental Illness,Washington, DC.

Kumpfer, K.L. 1994b. Strengthening Fami-lies Program: Implementation Manual. SaltLake City, UT: University of Utah, Gradu-ate School of Social Work, Social ResearchInstitute.

Kumpfer, K.L. 1995. Strengthening Hawaii’sFamilies Demonstration/Evaluation grantsubmitted to OSAP/ADAMHA on Novem-ber 14, 1990.

Kumpfer, K.L., Bridges, S., and Williams, K.1993. The safe haven program: Strength-ening African-American families. Submit-ted to the Detroit City Health Departmentby the Department of Health Education,

University of Utah. Salt Lake City, UT: Uni-versity of Utah.

Kumpfer, K.L., and DeMarsh, J.P. 1983.Strengthening Families Program: ParentTraining Curriculum Manual. Salt Lake City,UT: University of Utah, Graduate School ofSocial Work, Social Research Institute.

Kumpfer, K.L., and DeMarsh, J.P. 1985.Prevention of chemical dependency inchildren of alcohol and drug abusers.NIDA Notes 5(5):2–3.

Kumpfer, K.L., Molgaard, V., and Spoth, R.1996. Family interventions for the preven-tion of delinquency and drug use in spe-cial populations. In Proceedings of the1994 Banff International Conference, ed-ited by R. Peters and R. McMahon. Thou-sand Oaks, CA: Sage Publications.

Kumpfer, K.L., and Turner, C.W. 1990–1991. The social ecology model of adoles-cent substance abuse: Implications forprevention. International Journal of theAddictions 25(4A):435–463.

Kumpfer, K.L., Wamberg, K., and Martinez,D. 1996 (October). Strengthening FamiliesProgram. Workshop at second NationalTraining Conference in StrengtheningAmerica’s Families, Snowbird, UT.

Molgaard, V., Kumpfer, K.L., and Spoth, R.1994. The Iowa Strengthening Families Pro-gram for Pre- and Early Teens. Ames, IA:Iowa State University.

Moos, R.H. 1974. Family EnvironmentScale. Palo Alto, CA: Consulting Psycholo-gist Press, Inc.

Richardson, G.E., Neiger, B.L., Jensen, S.,and Kumpfer, K.L. 1990. The resiliencymodel. Health Education 21:33–39.

Spivack, G., and Shure, M. 1979. Interper-sonal cognitive problemsolving and pri-mary prevention: Programming for pre-school and kindergarten children. Journalof Clinical Child Psychology 8(2):89–94.

Spoth, R. 1998 (September). Results ofISFP over 2 years. Presentation at theNational Prevention Network ResearchConference, San Antonio, TX.

Additional Resources

In addition to this Bulletin, the following Family Strengthening Series Bulletins areavailable from the Juvenile Justice Clearinghouse (JJC):

Effective Family Strengthening Interventions. NCJ 171121.

Parents Anonymous: Strengthening Families. NCJ 171120.

Preventing Violence the Problem-Solving Way. NCJ 172847.

Preparing for the Drug-Free Years. NCJ 173408.

Treatment Foster Care. NCJ 173421.

Families and Schools Together: Building Relationships. NCJ 173423.

To order the publications listed above, contact JJC and request the appropriateNCJ numbers.

Juvenile Justice ClearinghouseP.O. Box 6000Rockville, MD 20849–6000800–638–8736301–519–5212 (fax)E-mail: puborder@ncjrs.orgInternet: www.ncjrs.org

For online access to JJC’s library, search the NCJRS Abstracts Databaseat www.ncjrs.org/database.htm. Directions for obtaining documents from the libraryare available at www.ncjrs.org/cgi/help.html.

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Points of view or opinions expressed in thisdocument are those of the authors and do notnecessarily represent the official position orpolicies of OJJDP or the U.S. Department ofJustice.

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Acknowledgments

Karol L. Kumpfer, Ph.D., is theDirector of the Center for SubstanceAbuse Prevention (CSAP). Connie M.Tait, Ph.D., is an assistant researchprofessor in the Department ofHealth Promotion and Education atthe University of Utah.

Photographs pages 2, 3, and 6copyright © 1999 Weststock; photo-graph page 4 copyright © 1999PhotoDisc, Inc.

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