Evidence Based Practice and Related Issues

This webpage identifies the major literature in the field of perinatal and family services: evidence based practice and related issues. The time frame is from January 2000 through December 2014.

Barnett, E., Sussman, S., Smith, C., Rohrbach, L. A., & Spruijt-Metz, D. (2012). Motivational Interviewing for adolescent substance use: A review of the literature. Addictive Behaviors, 37(12), pp. 1325–1334. DOI: 10.1016/j.addbeh.2012.07.001

This article is a literature review which summarizes the most up-to-date MI interventions with adolescents, looks at differences between intervention format and design, and discusses possible theory-based mechanisms of change. Of the 39 studies included in this review, 67% reported statistically significant improved substance use outcomes. Chi square results show no significant difference between interventions using feedback or not, or interventions combined with other treatment versus MI alone.

Brook, J., McDonald, T. P., & Yan, Y. (2012). An analysis of the impact of the Strengthening Families Program on family reunification in child welfare. Children and Youth Services Review, 34(4), pp. 691–695. DOI: 10.1016/j.childyouth.2011.12.018

This study examines reunification outcomes of children of alcohol or other drug involved parents placed in foster care who received the Strengthening Families Program as part of their child welfare service intervention to predict reunification rates. The study reflects that families who participated in the Strengthening Families program had significantly higher reunification rate than families who did not receive the intervention.

Coombes, L., Allen, D., Marsh, M., & Foxcroft, D. (2009). The Strengthening Families Program (SFP) 10-14 and substance misuse in Barnsley: The perspectives of facilitators and families. Child Abuse Review, 18(1), pp. 41-59.

The aim of this study was to evaluate the Strengthening Families Program for young people aged ten to 14 and their parents (SFP 10-14) in Barnsley, a northern English city, based on the experience of facilitators and families who had participated in the program. The authors found that following the programs, parents reported significant changes in communication limit setting, emotional management, prosocial behavior and drugs/alcohol use. For young participants, communication, and emotional management improved, and drug use decreased. According to the authors, qualitative evidence indicated that families who participated in the study found the SFP 10-14 useful in preventing young people's alcohol and drug use in terms of: learning more about alcohol and drugs, using knowledge and skills to reduce behaviors that might lead to alcohol and drug use and, for young people, dealing with peer pressure that might lead to drug and alcohol use. Parents/caregivers and young people reported that the SFP 10-14 had played a part in improving family functioning through strengthening the family unit. The findings from this exploratory study suggest that the SFP 10-14 may be a useful primary prevention intervention in helping to prevent drug and alcohol misuse in young people.

Damashek, A., Bard, D. & Hecht, D. (2012). Provider cultural competency, client satisfaction, and engagement in home-based programs to treat child abuse and neglect. Child Maltreatment, 17(1), pp. 56-66. DOI: 10.1177/1077559511423570

The authors of this article claim that home-based programs to treat child abuse and neglect suffer from high rates of attrition, limiting their impact, thus the aim of this article is to identify factors related to client engagement. Families in SC completed more treatment goals than those in SAU. In addition, provider cultural competence and client satisfaction were higher in SC than in SAU. Higher provider cultural competence was associated with higher goal attainment and satisfaction, and these effects partially mediated the service program differences. The effects of service type and cultural competence on goal attainment and satisfaction varied somewhat by client ethnicity. Findings suggest that clients receiving manualized programs for child maltreatment may be more likely to meet their goals and may perceive such programs to be culturally appropriate and satisfactory.

Haggerty, K. P., Skinner, M., Fleming, C. B., Guiney, R. R., & Catalano, R. F. (2008). Long-term effects of the Focus on Families project on substance use disorders among children of parents in methadone treatment. Addiction, 103(12), ) pp. 2008-2016.

This study examines the efficacy of the Focus on Families project (currently called Families Facing the Future), a preventive intervention to reduce substance use disorders among children in families with a parent in methadone treatment. One hundred and thirty families were assigned randomly to a methadone clinic treatment-as-usual control condition or treatment-as-usual plus the Focus on Families intervention between 1991 and 1993. This study examines the development of substance use disorders among the 177 children (56.84% male) involved in the program using data from a long-term follow-up in 2005, when these participants ranged in age from 15 to 29 years. The intervention was delivered through group parent-training workshops at the methadone clinics and through individualized home-based services, and taught parenting skills and skills for avoiding relapse to drug abuse. Findings show that the intervention and control participants did not differ significantly in risk of developing substance use disorders. However, there was evidence of a significant difference in intervention effect by gender. There was a significant reduction in the risk of developing a substance use disorder for intervention group males compared to control group males (hazard ratio = 0.53, P = 0.03), while intervention versus control differences among females were non-significant and favored the control condition. Results from this study suggest that helping parents in recovery focus on both reducing their drug use and improving their parenting skills may have long-term effects on reducing substance use disorders among their male children. However, the overall long-term benefits of this program are not supported by the results for female children.

Kumpfer, K. L., Whiteside, H. O., Greene, J. A., & Allen, K. C. (2010). Effectiveness outcomes of four age versions of the Strengthening Families Program in statewide field sites. Group Dynamics: Theory, Research, and Practice, 14(3), pp. 211-229.

Family dysfunction is unacceptably high nationally and internationally with high costs to society in adolescent problems. A number of evidence-based (EB) parenting and family interventions have been proven in research to improve children's outcome. This article addresses the question of whether these EB family programs are as effective in practice. This article summarizes research outcomes from a quasi-experimental, 5-year statewide study of the 14-session Strengthening Families Program (SFP) with over 1,600 high-risk families. The study compared outcomes including effect sizes for the four different age versions of SFP (SFP 3–5, 6–11, 10–14, and 12–16 years).

Morgenstern, J., Neighbors, C., Kuerbis, A., Riordan, A., Blanchard, K., McVeigh, K., Morgan, T. J., & McCrady, B. (2009, February). Improving 24-month abstinence and employment outcomes for substance-dependent women receiving temporary assistance for needy families with intensive case management. . American Journal of Public Health, 99(2), pp. 328-333.

The authors examined abstinence rates among substance-dependent women receiving Temporary Assistance for Needy Families (TANF) in intensive case management (ICM) over 24 months and whether ICM yielded significantly better employment outcomes compared with a screen-and-refer program. Results show that abstinence rates were higher for the ICM group than for the usual care group through 24 months of follow-up. A statistically significant interaction between time and group on number of days employed indicated that the rate of improvement over time in employment was greater for the ICM group than for the usual care group. ICM group participants had greater odds of full-time employment than non-participants did. The authors believe ICM is a promising intervention for managing substance dependence among women receiving TANF and for improving employment rates among this vulnerable population.

Nenide, L., Sontoski, S. (2014). Breaking the cycle: Supporting parent-child relationships through the “Parents Interacting with Infants” intervention. Zero to Three, July 2014. Pp. 31

In this article, the authors present the theoretical basis for the parents interacting with infant’s intervention as well as how this intervention is relevant for working with populations affected by domestic violence, trauma, substance abuse, mental illness, and other stressors.

O'Farrell, T. J., Murphy, M., Alter, J., & Fals-Stewart, W. (2008). Brief family treatment intervention to promote aftercare among substance abusing patients in inpatient detoxification: Transferring a research intervention to clinical practice. Addictive Behaviors, 33(3), pp. 464-471.

Two earlier studies showed that a brief family treatment (BFT) intervention for substance abusing patients in inpatient detoxification increased aftercare treatment post-detox. BFT consisted of meeting with the patient and a family member with whom the patient lived to review aftercare plans for the patient. Based on the earlier research results, the authors trained a newly hired staff person to continue providing BFT. They monitored key process benchmarks derived from the earlier research studies to ensure ongoing fidelity in delivering BFT. This method proved successful in transferring BFT from delivery in a research study to ongoing delivery in routine clinical practice after the research ended. It also ensured that a high proportion of patients had their families contacted and included in planning the patients' aftercare.

Riesch, S. K., Brown, R. L., Anderson, L. S., Wang, K., Canty-Mitchell, J., & Johnson D. L. (2012). Strengthening Families Program (10-14): Effects on the family environment. Western Journal of Nursing Research, 34(3), pp. 340–376. DOI: 10.1177/0193945911399108

This study examined whether parent–youth dyads participating in the Strengthening Families Program 10-14 (SFP 10-14) would demonstrate greater post program family cohesion, communication, involvement, and supervision and if youth would report less alcohol, tobacco, and other drugs involvement in contrast to a comparison group. From 16 randomly selected schools, we recruited 167 parent–youth dyads: 86 from intervention and 81 from comparison schools. The intention-to-treat analysis found one significant change in family environment. Among dyads receiving a full dose, all the outcomes were in the expected direction and effect sizes were moderate. Among dyads receiving a partial dose, 10 of 18 outcomes were in the direction opposite that expected. Youth participation in alcohol, tobacco, and other drugs was very low and did not differ post-program. Although the expected outcomes were not realized, findings descriptive of dosage effects make a valuable contribution to the field. The authors recommend further study of factors that distinguish intervention completers from non-completers.

Self-Brown, S., Whitaker, D., Berliner, L. & Kolko, D. (2012). Disseminating child maltreatment interventions: Research on implementing evidence-based programs. Child Maltreatment, 17(1), pp. 5-10. DOI: 10.1177/1077559511436211

This article looks at implementation science in the field of child maltreatment using definitions of implementation and stages of implementation provided by the National Implementation Research Network. They identify the following six stages as critical to effective implementation: 1) exploration/adoption; 2) program installation; 3) initial implementation; 4) full operation, 5) innovation and 6) sustainability.

Suchman, N., DeCoste, C., Castiglioni, N., Legow, N., & Mayes, L. (2008). The Mothers and Toddlers Program: Preliminary findings from an attachment-based parenting intervention for substance-abusing mothers. Psychoanalytic Psychology, 25(3), pp. 499-517.

The authors examined pilot data from an attachment-based parenting intervention for substance-abusing mothers of toddlers (ages 12-36 months). The Mothers and Toddlers Program (MTP) is a 20-week individual therapy intervention that aims to help mothers develop more balanced representations of their children and improve their capacity for reflective functioning (i.e., recognition of the intentional nature of children's behavior). The authors hypothesized that improvement in maternal representational balance and maternal capacity for reflective functioning would correspond with improvements in maternal behavior with toddlers (e.g., sensitivity to cues, responsiveness to distress, and social-emotional growth fostering) and reduction in maternal psychiatric distress and substance abuse. The authors also compared MTP completers and non-completers on sociodemographic and psychosocial indexes and examined the validity of the intervention's proposed mechanisms of change. Preliminary findings support the importance of attachment mechanisms and indicate that attachment-based interventions may strengthen substance-abusing mothers' capacities to foster their toddlers' socioemotional development.

Templeton, L. (2014). Supporting families living with parental substance misuse: the M-PACT (Moving Parents and Children Together) program. Child & Family Social Work, 19(1), pp. 76-88. DOI: 10.1111/j.1365-2206.2012.00882.x.19fs

The Moving Parents and Children Together (M-PACT) program is one of the growing number of interventions tailored to meet the multiple and complex needs of children and families affected by parental substance misuse. This article is a literature review on qualitative findings from 13 evaluated Moving Parents and Child Together (M-PACT) programs in England. Six themes are discussed: engaging with M-PACT, shared experiences, understanding addiction, changes in communication, healthier and united families, and ending M-PACT. The majority of families benefitted in a range of ways from the program: meeting others who were experiencing similar problems, greater understanding about addiction and its impact on children and families improving communication within the family. Key findings include a discussion of the potential for interventions of this kind to reduce family-related harm from parental substance misuse.

Whitaker, D. J., Ryan, K. A., Wild, R. C., Self-Brown, S., Lutzker, J. R., Shanley, J. R., Edwards, A. M…Hodges, A. E. (2012). Initial implementation indicators from a statewide rollout of SafeCare within a child welfare system. Child Maltreatment, 17(1), pp. 96-101.

This article presents findings from a study looking into a statewide effort to implement the evidence based practice SafeCare into a child welfare system. Findings suggest that only 25% of providers who participated in the training actually implemented the model after training. Findings are in line with the literature that demonstrate issues with implementation often depend on organizational and system-level variables.

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