Parenting skills and family support programs for drug-abusing mothers

Children born to drug-using mothers can suffer from fetal alcohol or drug syndrome (FAS/FDS) or fetal alcohol or drug effect (FAE/FDE). Such children have a greater likelihood of developing acute or chronic physical, cognitive and behavioral problems. In-utero exposure to tobacco, alcohol or drugs impact on the developing fetus and, after birth, the family environment and family system exert effects on the infants and children of substance-abusing parents. Evidence-based prevention and maternal drug treatment programs focus on enhancing parental childcaring abilities, supporting parent-child attachment and encouraging family support systems to improve children's health and cognitive outcomes. FAS/FDS prevention programs, as well as selective and indicated prenatal and postnatal interventions, can improve the support given both to mother and to child, and evidence-based, in-home parenting and family-skills-training approaches are particularly useful.     

Advancing Intervention Science Through Effectiveness Research: A Global Perspective

Background  

Effectiveness research is maturing as a field within intervention and prevention science. Effectiveness research involves the implementation and evaluation of the effectiveness of the dissemination of evidence-based interventions in everyday circumstances (i.e., type 2 translational research). Effectiveness research is characterized by diverse types of research studies. Progress in this field has the potential to inform several debates within intervention science [e.g., fidelity versus local and cultural adaptation; identification of core components, effective dissemination systems).     

Family-based interventions for substance use and misuse prevention

Because "substance abuse" is a "family disease" of lifestyle, including both genetic and family environmental causes, effective family strengthening prevention programs should be included in all comprehensive substance abuse prevention activities. This article presents reviews of causal models of substance use and evidence-based practices. National searches by the authors suggest that there is sufficient research evidence to support broad dissemination of five highly effective family strengthening approaches (e.g., behavioral parent training, family skills training, in-home family support, brief family therapy, and family education). Additionally, family approaches have average effect sizes two to nine time larger than child-only prevention approaches. Comprehensive prevention programs combining both approaches produced much larger effect sizes. The Strengthening Families Program (SFP) is the only one of these programs that has been replicated with positive results by independent researchers with different cultural groups and with different ages of children. Few research-based programs have been adopted by practitioners, partly because of technology transfer issues. Overall, research on ways to improve dissemination, marketing, training, and funding is needed to improve adoption of effective prevention programs.     

Strengthening Families Program: An Evidence-Based Family Intervention for Parents of High-Risk Children and Adolescents

This article reviews the contents and research on the Strengthening Families Program (SFP), a family evidence-based seven- to 14-session intervention for drug prevention in high-risk children ages 0 to 17. Twelve Randomized Control Trials (RCTs) found significant improvements in youths' behavioral health, including 50% reductions in substance misuse, depression/anxiety, and child maltreatment. Culturally adapted SFP versions have improved family relations and the children's behavioral health in 36 countries. To reduce costs of SFP's family groups, a SFP Years DVD was developed and found effective in schools, health clinics, child welfare, and juvenile justice. Future directions include putting SFP on the Web and on smartphones.     

Bridging the Gap Between Family-Focused Research and Substance Abuse Prevention Practice: Preface

This paper introduces the contributions of this special section on connecting family-focused substance abuse prevention research and practice. Other expert reviews and the meta-analyses discussed in this and the following papers have given us a good idea about what works in this area. They have specified a number of family-focused substance abuse prevention approaches and programs effective in decreasing substance abuse in youth. Unfortunately, some practitioners are still primarily implementing untested, ineffective programs. A number of recommendations are made by the authors of this special section to help improve the adoption of evidence-based family programs to prevent substance abuse by youth.     

Parent/child transactional processes predictive of resilience or vulnerability to "substance abuse disorders"

This article discusses implications of a theoretical model of resilience--the Resilience Framework, including the impact of parent/child transactional processes in moderating or mediating a child's biological or environmental risks and later substance misuse. Research is presented on behavioral and emotional precursors of substance abuse disorders in children of substance users. Detrimental processes within dysfunctional family environments are presented followed by a listing of strategies for increasing resilience in youth by improving family dynamics. The value in elucidating these interactive processes is to increase our understanding of ways to reduce the impact of risk factors. Prevention providers should use these strategies as benchmarks for selecting or developing effective family-focused prevention programs. Resources are presented for finding effective family interventions as well as an example of a family intervention based on resilience principles, namely the Strengthening Families Program. Recommendations are made for future research and better dissemination of evidence-based family interventions.     

The impact of an incentive-based worksite health promotion program on modifiable health risk factors

A health promotion program consisting of an annual health screening and financial rebates for good health practices was offered to all 2540 employees of Salt Lake County in Utah. Changes in health risks were measured for the 304 full time employees who participated in assessments for four years. Significant improvements were seen in body fat, cholesterol, systolic and diastolic blood pressure, seat belt use, and overall physical health among the high risk group and the low risk group. There was a net increase in the number of people in the high risk group over the four year period.     

Differential SCR Conditioning With Two Control Baselines: Random Signal and Signal Absent

Thirty-six Ss, informed about the contingencies, were given differential SCR training with 3 different signals: CS+, CS?, and a signal which was random with respect to UCS occurrence. UCSs occurred randomly between trials and during random signal trials, were correlated with CS+ presence, and were absent during CS?. Employing nonspecific response frequency and amplitude, as well as responding during random signal trials, as baselines for comparison, evidence for both inhibitory and excitatory influences was obtained. The pattern of these influences was such as to question the proposition that a CS+ acquires general excitatory properties and a CS? acquires general inhibitory properties.