Evidence-Based Parenting Programs supported by Children’s Administration in Region 2 North

1. Evidence-Based Parenting Programs supported by Children’s Administration in Region 2 North July 28, 2011 Michael Tyers, MA and; Jennifer Paddock, MA,MACRegion 2 North, Children’s Administration(425) 339- 1830

2. What constitutes an Evidence- Based Program? • In Washington State we follow the California Evidence-Based Clearinghouse for Child Welfare (CEBC) CEBC rating scale is to evaluate each practice based on the: • Best research evidence • Best clinical experience • Consistency with patient (family/client) values.

3. Programs covered in this presentation: • NCAST Assessments • Promoting First Relationships • Project SafeCare • Incredible Years • Triple P- Positive Parenting Program • Homebuilders-Intensive Family Preservation Services • Wrap-Around High-Fidelity • Parent Child Interaction Training (PCIT) • Functional Family Therapy

4. Nursing Child Assessment Satellite Training(NCAST) • Valid and reliable measure for assessing parent-child interaction • Describes observable behavior brought to the interaction by caregiver and child • Easily identifies strengths as well as areas needing improvement The most widely used scales for measuring parent-child interaction today, birth to age 3.

5. PCI Subscales • Assesses Child and Parent in the • Feeding Element for up to age 1 • Teaching Element for up to 3 years of age • Four subscales describe the parent's responsibilities to the interaction. • Two subscales describe the child's responsibilities.

6. Parent Subscales • Sensitivity to Cues • Response to Distress • Social-Emotional Growth Fostering • Cognitive Growth Fostering Child Subscales • Clarity of Cues • Responsiveness to Caregiver

7. Typical cases referred for NCAST • To evaluate the adequacy of the caregiver-child interaction, of the caregiver style, ability or the environment • Failure to thrive? • Determine the need for an intervention plan for the caregiver-child pair • Drug positive baby at birth • Assess responsivity between caregiver and child

8. Promoting First Relationships (PFR) • Promoting First Relationships is a prevention program dedicated to promoting children's social-emotional development through responsive, nurturing caregiver-child relationships. • Appropriate for ages birth to 3.

9. Features of the PFR training program include: • Videotaping caregiver-child interactions to provide insight into real-life situations. • Giving positive feedback that builds caregivers' competence with and commitment to their children. • Focusing on the deeper emotional needs underlying children's challenging behaviors.

10. What happens during the 10 sessions? • Caregivers learn about 10 basic social and emotional needs infants/toddlers have. • Caregivers learn behaviors that help create healthy attachments • Staying connected with infants and toddlers during difficult times is also discussed • Where challenging behaviors come from in infants and toddlers • How to reach out and get support • Building reflective capacity through video taping parent-child interactions

11. Project SafeCare • Project SafeCare is a parent-training curriculum for parents who are at-risk or have been reported for child maltreatment. • The program is appropriate for children birth to 5. • Through SafeCare, trained professionals work with at-risk families in their home environments to improve parents’ skills in several domains.

12. The Project SafeCare Modules 1. Parent-child or parent-infant interaction 2. Child Health 3. Home Safety and cleanliness 4. Problem Solving worksheet

13. Common Elements of each PSC module: • Describe desired target behaviors • Explain the rationale or reason for each behavior • Model each behavior (demonstrate desired behavior) • Ask parent to practice behavior • Provide positive feedback (point out positive aspects of performance) • Provide constructive feedback (point out aspects of performance needing improvement) • Review parent's performance, have them practice areas that need improvement, and set goals for the week.

14. Incredible Years • Appropriate for ages birth – seven • Families have a need to learn appropriate parenting skills & discipline or improve bonding Short Term Objectives • To prevent and reduce aggression and behavior problems in young children. • To promote social, emotional and academic competence in young children. Long Term Objectives • To prevent delinquency, substance abuse and violence in adolescence.

15. The BASIC IY program • Incredible Years Basic Preschool Program • 18 group sessions (for high risk populations) • Increase developmentally appropriate & nurturing parenting practices • Persistence, academic, social and emotional coaching & child directed play • Praising and Motivating Children

16. The BASIC IY program continued… • Predictable routines & schedules • Using non-punitive and more consistent discipline approaches for misbehavior • Learning how to help children self-regulate, use appropriate social skills, problem solve & develop imaginary play • Promoting parent-teacher collaboration

17. Incredible Years Parenting Program GroupMethods & Process • Developmentally based • Culturally sensitive • Emphasizes the therapeutic relationship: “collaborative process” • Coping (vs. Mastery model) • Video modeling/DVDs • Role play practice & rehearsal • Home assignments • Group support • Sensitive to socioeconomic barriers

18. Research tells us: • Parent training remains the single most effective strategy for preventing behavior problems and promoting social and emotional competence in young children!

19. Triple P- Positive Parenting Program • Appropriate for birth to 12. • The program is based on self-regulation. • The goals are for children to develop emotional self-regulation and for parents to become resourceful, independent problem-solvers. • As families determine their own particular goals, the program is tailored to suit their aspirations. • Practitioners consult and guide through active skills training. • Parents decide what they wish to take on.

20. Triple P levels for Child Welfare involved Families. • Standard Triple P • This 10-session program incorporates sessions on causes of children’s behavior problems, strategies for encouraging children’s development and strategies for managing misbehavior. • Skills training includes: • modeling • rehearsal • self-evaluation • homework tasks • Home or clinic practice sessions are also conducted in which parents self-select goals to practice. • They are then are observed interacting with their child and implementing parenting skills, and subsequently encouraged to self-evaluate their progress toward meeting their goals.

21. Homebuilders-Intensive Family Preservation Services • Appropriate for birth to 18 • One of the oldest and best documented programs in the U.S. • Intensive in-home crisis intervention, counseling and life skills education.

22. Homebuilders Elements • One or more children is in imminent danger of being placed out of home or is returning home from placement. • Client seen within 24 hours of referral • Treatment is in home and therapists are responsive 24/7. • Targeted 4 week concentrated service. • Therapist are flexible and carry only 2-3 cases at a time. • Service is in-home and averages 40-50 hours of direct service.

23. Homebuilders continued… • Therapist has flexibility to address crisis in variety of ways: • Food, clothing, gas • Shelter • Transportation • Parent skill training • Counseling (Financial, Anger, Development, Communication etc.)

24. Parent Child Interaction Training (PCIT) • PCIT is appropriate for ages 2-7. • PCIT is a parent training program that: • helps parents improve parenting skills • helps establish a warm and responsive relationship with their child • helps to decrease child behavior problems

25. PCIT continued: • The service includes: • 20 weeks of individualized, one-hour parent-child sessions • Trained therapists coach the parents: • use of a one way mirror in which therapist uses a microphone device from another room in clinic • completed in family’s home • Child management techniques include: • praising appropriate behavior • ignore undesirable behavior • give clear age-appropriate instructions • appropriate discipline methods

26. High Fidelity Wraparound Program • Currently a Promising Practice moving towards becoming Evidence-Based. • Appropriate for ages 3 to 17. • Provides a community-based team that focuses on the “voice and choice” of the family.

27. Wraparound Program continued… • Family focused approach that assesses family and individual strengths, natural supports and cultural importance's.

28. Wraparound Principles • Family and Youth Voice • Unconditional/Persistent • Strength Based • Culturally/Linguistically Competent • Community Based • Individualized • Natural Supports • Collaboration • Team based • Outcome based

29. Phases of Wraparound Program • Phase One; Engagement and Team Preparation • Initial Plan Development • Plan Implementation • Transition Services and support are offered through multiple community agencies

30. Functional Family Therapy (FFT) • Appropriate for ages 11-18. • FFT is a family therapy that is provided usually in a family home.  • FFT focuses reducing conflict in the family, improving communication, increasing use of age appropriate parenting skills, and improving parent supervision of children.  • The program lasts an average of 4 months.  • The entire family participates in FFT. 

31. FFT Service Steps • Step 1- Case Processing Gather client information, establish appointment times with the family • Step 2- Engagement and Motivation Initial face to face meeting, increase family’s interest and motivation for change Conduct assessments • Step 3- Behavioral Change, Generalization and Closure Individualized change plans that reduce risks and increase protective factors, relapse plan developed and family/community connections established to sustain treatment gains.

32. Evidence-Based Parenting Programs supported by Children’s Administration in WA State Thank you for attending