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Part II:
Status of Research-Based Programs

Programs That Target Families

According to Dr. Karol Kumpfer, "Comprehensive family programs that combine social and life skills training to children and youth to improve their social and academic competencies with parent skills training programs to improve supervision and nurturance are the most effective in impacting a broader range of family risk and protective factors for drug use" (1998, p. 5). She notes that "there is no one single best family intervention program" and that "providers in the field must carefully select the best program for their target population" (p. 9). She does, however, list the following principles which are useful in reviewing and selecting family programs for implementation:

• Comprehensive interventions are more effective in modifying a broader range of risk or protective factors and processes in children.
• Family-focused programs are more effective than child-focused or parent-focused only.
• Sufficient dosage or intensity is critical for effectiveness.
• Family programs should be long-term and enduring.
• Tailoring the parent or family intervention to the cultural traditions of the families involved improves recruitment, retention, and outcome effectiveness.
• Addressing developmentally appropriate risk and protective factors or processes at specific times of family need when participants are receptive to change is important.
• Family programs are most enduring in effectiveness if they produce changes in the ongoing family dynamics and environment.
• If parents are very dysfunctional, interventions beginning early in the lifecycle (i.e., prenatally or early childhood) are more effective.
• Components of effective parent and family programs include addressing strategies for improving family relations, communication, and parental monitoring.
• High rates of recruitment and retention are possible with families if transportation, meals or snacks, and child care are provided.
• Videos of families demonstrating good and bad parenting skills helps with program effectiveness and client satisfaction.
• The effectiveness of the program is highly tied to the trainer's personal efficacy and characteristics (Kumpfer, 1998, pp. 9-14).

Kumpfer and Szapocznik co-chaired a panel of experts who determined that there is sufficient research evidence to conclude that only Behavioral Parent Training, Family Skills Training, or Behavioral Family Therapy have a "strong level of evidence of effectiveness" (Kumpfer, 1998, p. 6). Examples of programs within these approaches are as follows:

Family Skills Training

Family skills training involves multi-component interventions, including behavioral parent training, social skills training for children, behavioral framily therapy, and family role plays with coaching by the trainer. These are usually selective interventions targeting high-risk families, and they tend to have a positive impact on a large number of family and youth risk and protective factors. Examples of family skills training programs are:

• Strengthening Families Program
(Kumpfer, et al., 1989; Kumpfer, et al., 1996; Kumpfer, et al., 1997).

• Focus on Families: For physically and sexually abusive

(Haggerty et al., 1991)

• Families and Schools Together (FAST): For high-risk students in school. (McDonald, et al., 1991)
• Family Effectiveness Training (FET): To prevent drug abuse and problem behaviors in Hispanic adolescents.

(Szapocznik et al., 1989a)

• The Nurturing Program: To recude dysfunctional family interactions

(Bavolek, et al., 1983)

For reviews of these programs, see Kumpfer (1993).

Behavioral Family Therapy

Behavioral family therapy programs are usually indicated programs for families with children diagnosed with precursors of drug use such as conduct disorder, aggression, or depression. Examples of effective family therapy programs are:

• Structural Family Therapy

(Szapocznik, et al., 1988; Szapocznik, et al., 1989b)

Functional Family Therapy (Alexander & Parson,)

• Parenting Adolescents Wisely: An interactive computer program

(Gordon, et al., 1998)

• Family Therapy

(Liddle, in press)

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