• By Dartington SRU
  • Posted on Tuesday 20th October, 2009

Washington feels the weakness of Strengthening Families

Family therapy sessions designed to reduce antisocial behavior and alcohol abuse have not had the promised impact on high-risk young people in Washington DC, says new research.Led by Denise Gottfredson from the University of Maryland, the evaluation looked at the effect of Strengthening Families on the behavior of children from over 700 families from disadvantaged neighborhoods spread across the capital. It found that children of families who participated in the 14-week schedule of family, parent and child therapy were no better behaved than their counterparts who did not receive any treatment. Worse, over the course of the research, some kids taking part actually developed more negative relationships with their peers. The Washington randomized controlled trial was the first to look at the Strengthening Families Project (SFP) in a community context. Delivered by outreach organizations in disadvantaged areas, it represented a far more realistic portrayal of how the intervention would look were it to be widely implemented. It was also the first study to use stringent experimental methods. In all of the previous trials, which had generally shown it to be effective in reducing antisocial behavior, implementation was closely supervised by the developers. The failure of proven programs in less tightly controlled community conditions is all too common.The logic of SFP is based firmly enough in child development research, which has established an association between antisocial behavior and negative parent-child relationships, family conflict and a lack of parental supervision. On the flip side, clear and consistent discipline and warm supportive parenting are just as strongly associated with well behaved children. The program seeks to support the positives and offer alternative strategies to combat the negatives through work with parents, children and other members of the extended family. It is meant for children between the ages of seven and 11. Families in the study were recruited by five organizations in Washington DC, one of which was a pre-release center for parents in prison. The others were based in the community. Children were selected because of their residence in deprived neighborhoods. Unemployment rates in the selected communities ranged between 25 and 50%.The research team have several theories as to why a previously very effective program should have run into the sand in Washington. First, their assessment of the implementation process indicated that the family therapy component was not carried out properly, meaning that children spent a lot of time playing together unsupervised.They point to research by Tom Dishion and his team at the Child and Family Center at the University of Oregon which shows that putting together children who are antisocial, even for the purpose of therapy, will tend to reinforce their negative behavior.“The program has the potential to produce negative outcomes perhaps by providing a social context in which youths are free to socialize in an unstructured environment,” the authors suggest. They go on to argue that the program may not be geared to the issues encountered in deprived areas and among African American families. Persuading parents that it was a worthwhile use of their time proved a huge challenge.Another study of the program among predominantly African American families in Philadelphia, one where the developers were involved in its implementation, showed a similar lack of effect. Staff turnover was also a big issue. During the five years of the study more than 20 different people worked in the five site coordinator roles. As the researchers explain, “site coordinators and trainers complained regularly that their jobs required far more work than they had expected, for not enough pay."They recommend that communities considering implementing SFP should make sure they have adequate financial, technical and training support. They also caution against a lack of good reconnaissance. Some locations are not well suited to the intervention, so before launching full-scale dissemination, a “pipeline study” is likely to be needed to test recruitment procedures, and to check that the anticipated numbers of antisocial children are within reach. The current strategy of “installing” model programs into communities may not be the best way. Other processes that find a suitable fit between research knowledge and specific environments may be more productive, they conclude. • For Prevention Action articles on the work of Tom Dishion, see: When togetherness can do more harm than good, Sometimes it can be better to be in with the out-crowd and Putting brain science back on the streets of Los Angeles.See: Gottfredson D, Kumpfer K, Polizzi-Fox D, Wilson D, Puryear V, Beatty P and Vilmenay M (2009), “The Strengthening Families Washington DC Project: A Randomized Effectiveness Trial of Family-Based Prevention”, Prevention Science, 7, 1, pp.57-74

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