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Recommended Reading

Intervening in Children’s Lives: An Ecological, Family-Centered Approach to Mental Health Care, by Thomas J. Dishion and Elizabeth A. Stormshak (APA Books, 2007)
Intervening in Children's Lives

Researchers

The Family Check-Up is a family-centered intervention grounded in the ecological model and developmental science. The FCU is unique in three ways: (a) interventions are tailored and adapted to family needs on the basis of assessments and collaborative agreements with caregivers, (b) parents’ motivation to change is explicitly targeted in the initial interviews and feedback sessions, and (c) a health maintenance model of intervention is used, with interventions repeated yearly. These features underlie its cost effectiveness and viability for the prevention of long-term patterns of problem behavior and emotional distress in children and adolescents and the promotion of family management practices. The FCU model involves a menu of intervention services that are adapted and tailored to each family’s needs. Briefly, the FCU involves three meetings with the caregivers. The first meeting is an initial interview during which the practitioner facilitates the discussion about goals and concerns with parents, as well as their personal motivation for change. This meeting establishes a collaborative base for future meetings. The second session involves a brief assessment packet given to the parent, child, and teacher and a videotaped family interaction assessment. The third meeting is a feedback session to discuss the results of the assessment in terms of (a) providing motivation to change and (b) identifying the appropriate resources with respect to a MENU of family-based intervention options.

The FCU has been tested across multiple randomized trials (Connell et al., 2007; Dishion et al., 2002; Stormshak, Dishion, Light, & Yasui, 2005; Stormshak, Fosco, & Dishion, 2010), including a large sample of young children age 2–5 years (Dishion et al., 2008) and three different samples of adolescents. Through the use of growth curve modeling, the FCU intervention was found to be associated with a consistent pattern of intervention effects relevant to reduced problem behavior. In samples of young children, the FCU has been associated with reductions in externalizing behavior. In addition, the intervention effects on conduct problems were mediated by changes in parents’ observed positive behavior support (PBS), a critical dimension of family management in early childhood. Notably, the effect of the intervention on children’s growth in problem behavior was mediated by increases in the parents’ use of PBS strategies (Dishion et al., 2008). Random assignment to the FCU intervention was associated with improvements in children’s language skills (assessed using the Fluharty test; Simmons, 1988) and maternal reports of inhibitory control on the Children’s Behavior Questionnaire (Rothbart, Ahadi, Hershey, & Fisher, 2001) from ages 2 to 4; improvements associated with intervention status were mediated by changes in positive behavior support from ages 2 to 3 (Lunkenheimer et al., 2008).

In adolescence, we have followed three different samples who were randomly assigned to receive the FCU or middle school as usual. The FCU was associated with reductions in teacher reports of behavior problems (Stormshak et al., 2005), reductions in arrest rates and substance use in late adolescence (Connell et al., 2007), and improvements in attendance and grades in late adolescence (Stormshak et al., 2010). Improvements in depression, parental monitoring, family conflict, and problem behavior have all been outcomes associated with the FCU in our longitudinal follow-ups of these families.

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