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About Family Check-Up


Recommended Reading

Intervening in Adolescent Problem Behavior, by Thomas J. Dishion and Kate Kavanagh (Guilford Press, 2003)

This book presents a multilevel intervention and prevention program for at-risk adolescents and their families. Grounded in more than 15 years of important clinical and developmental research, the Adolescent Transitions Program has been nationally recognized as a best practice for strengthening families and reducing adolescent substance use and antisocial behavior. The major focus is to support parents' skills and motivation to reduce adolescent problem behavior and promote success.

To view Table of Contents/purchase this book

Overview

The Family Check-Up is a parent-centered intervention for reducing children’s problem behavior through changing parent-child interactions. This program of parent-centered intervention to address these problems is the result of 30 years of continuous feedback from basic research in the development of problem behaviors in children from infancy through adolescence. The Family Check-Up combines comprehensive assessment tools with motivation-enhancement strategies to better engage parents in parenting interventions.

WHAT is it?

The Family Check-Up is a three-session process that consists of an initial interview, comprehensive assessment, and feedback that includes discussion about family management skills and processes and a list of services. A guiding principle is that clinical decisions are based upon empirically validated assessments of parenting and child behaviors. Family data gathered from caregivers, youth and other professional helpers (e.g. teachers, physicians) are used to create a written profile of family strengths. The three main areas of the profile - background support, family management and relationships and youth adjustment -  have been determined through numerous research studies to be the factors predictive of positive youth outcomes throughout development. The profile describes family functioning in these areas and gives parents an objective view of their situation, builds motivation for change, and reduces resistance to receiving feedback and therapeutic direction.

WHO is it for?

The Family Check-Up can be used by any service provider who works with families with children and adolescents who have problem behaviors. It has been used by community mental health agencies, public schools, university clinics and reservation communities.

WHY use the FCU?

The Family Check-Up is an effective, brief intervention to engage families in treatment and motivate behavioral change. Assessments and family profiles have been developed and tested for use with parents of toddlers to parents of adolescents. Outcome research shows that it decreases typical treatment time. The Family Check-Up, when used as the initial intervention for families, provides uniformity in practice in helping settings and provides an opportunity to tailor the process to individual family situations. It can be used for initial treatment planning, for follow-up evaluation of progress made, and to reengage or restart treatment that has bogged down. Overall, it is a simple, family-friendly method to evaluate child adjustment, client process, and achievement of therapeutic goals.

WHERE did it come from?

In the late 1980s the parent training work being done at the Oregon Social Learning Center was used to formulate a 12-session psycho-educational curriculum for parents of early adolescents who showed signs of risk for substance use and delinquent behavior problems. The intervention, called the Adolescent Transitions Program, comprised two components grounded in social learning and cognitive-behavioral principles of intervention: family management skills delivered in parent groups and self-regulation skills delivered in peer groups. A sample of 120 parents and teens were randomly assigned to four intervention groups to evaluate the ATP components, and intervention results led to modifications and enhancements in the program. The first important finding was that random assignment to the peer group intervention resulted in increased problem behavior, even in the context of improved family interactions. These outcomes are consistent with those from other studies of social-cognitive interventions delivered to youth group settings or to school settings. The programs have shown limited effects, especially in the absence of a strong parenting component. Second, a focus on family management was the most likely to reduce problem behavior. Parents who received the family management curriculum reported reduced family conflict and negative engagement with their youth. It soon became clear that the most powerful treatment is to work solely through parents to effect change in youth problem behavior. These findings were replicated by an independent group of researchers. The ATP was rated as “best practice” by the Center for Substance Abuse and Prevention, as “exemplary” by Strengthening America’s Families and by the Office of Juvenile Justice and Delinquency Prevention, and as “proven to be effective” by the National Institute on Drug Abuse.

FCU Intervention for At-risk Youth

The next steps in developing the Family Check-Up model emerged from our attempts to deliver the ATP intervention to parents in a school setting. It became clear that very few parents were willing to attend these groups. Because we were not conducting a research study that targeted children at risk, we needed to tailor the model and its delivery in the school setting to better match the needs of students and parents.at risk, we needed to tailor the model and its delivery to better match the needs of students and parents within a school setting.

These circumstances led to our current model, which can be best described as multilevel because it can address child and family needs at the universal, selected, and individual levels. At the universal level we offer information and self-assessment to all families in the context of a school-based family resource center. When parents or school personnel report that a child is showing signs of risk for problem behavior, the family then moves into the next level of intervention, the selected level. The Family Check-Up is used to guide services for youth who are showing moderate to serious signs of risk for developing life course problems that could interfere with positive adjustment. It provides caregivers with a realistic appraisal of their family functioning that is based on a comprehensive assessment. Feedback about assessment findings is delivered using motivational interviewing skills to build caregiver self-efficacy and readiness to make needed changes. The feedback emphasizes strengths and targets challenges in family management and provides choices for parent participation in the next level of service, the individual level, during which families work on improving specific family management skills and areas of family relationships.

For the past 15 years we have conducted several trials funded by the National Institutes of Health to test the effectiveness of the model in schools, university clinics, reservation communities, and community mental health agencies.

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