Parent Action on Drugs: Strengthening families for parents and youth

By Tatyana Krimus

In brief

How do you convince a teenager to participate in a program with his or her parents? And how do you convince parents to participate in a skills-building program with their teenage children? 

These are some of the questions that Parent Action on Drugs had to consider while developing Strengthening Families for Parents and Youth (SFPY). This program is based on a 14-week, evidence-based, family skills training program called Strengthening Families Program (SFP), which was developed in the United States for at-risk families. 

Parent Action on Drugs adapted the program for youth 12 to 16 years old and their parents and caregivers, and shortened it to nine weeks. This adapted program has been shown to be effective at addressing mental health and substance use when provided in neighbourhood centres, schools, and youth-serving agencies. 

In this issue of Evidence in Action, we profile Strengthening Families for Parents and Youth. Evidence in Action profiles knowledge generation, exchange, and implementation activities across Ontario.

About the program

Strengthening Families for Parents and Youth focuses on prevention by training staff in local organizations who work with families and youth to build family resiliency. 

While the original model was designed for families in which the parent or caregiver was involved with alcohol and other drugs, Strengthening Families for Parents and Youth was adapted to help families with diverse risk factors, including high levels of family conflict as well as family isolation, economic stress, and living in vulnerable communities. The program has also been carried out in neighbourhoods identified by high economic need or violence.

The program can accommodate families with single or multiple parents and caregivers and those with single or multiple children in the 12 to 16 year age range. The primary caregiver(s) can include foster parents and their partners, step-parents, adoptive parents, grandparents, or other forms of kinship. 

How the program works

The original 14-week, evidence-based program was developed and tested in the mid-1980s by Dr. Karol Kumpfer. Subsequent randomized control trials have found similar positive results with families in various ethnic, cultural, and adolescent groups. 

Parent Action on Drugs adapted the program to create a curriculum with increased activity-based learning and proven youth engagement activities. The curriculum includes discussions and activities about communication, praise, anger and stress, and other issues that affect family relationships. 

The weekly sessions, led by trained facilitators, are broken down into three separate but inter-related parts. The first part is spent eating a healthy family meal with all program participants. In the second part, parents and teens go into different rooms to talk separately. These discussions are kept confidential. In the last part of the weekly sessions, youth are brought back together with adults to participate in joint activities that focus on the same issues which were discussed separately. 

From 2009 to 2011, the program served 69 families, including 87 adults and 91 youth, and included 32 facilitators from 10 different agencies in Toronto. There was a 76% completion rate.  

Participant responses to the program evaluation questionnaires were promising. Parents and caregivers said they learned parenting and communication skills, and gained a better understanding of their teen’s behaviours. The youth said they had more self-awareness and sense of responsibility, were better able to manage their anger, were communicating better with family members, and had improved relationships with their parents and caregivers. 

Applying the research

Parent Action on Drugs has adapted the content, language, or timing of the program according to the needs of participants. Currently, the organization is partnering with nine agencies/collaboratives across the province to build capacity for the adoption of the program throughout Ontario.

It is also partnering with Health Nexus, a bilingual organization, and a designated French language service provider, to develop a French language version of the program that was tested in Sudbury and Eastern Ontario. They also are currently working with La Passerelle, a Toronto agency serving French-speaking children, to introduce the French program in Toronto. 

The effectiveness of this program depends on users implementing the curriculum with fidelity. However, agencies are encouraged to use their creativity to fully engage participants, whether they belong to newcomer or First Nations communities. For example, serving culturally appropriate dinners and recognizing religious holidays and cultural traditions can make a big difference in how families view this program. And agencies serving diverse Aboriginal families can make the experience more meaningful by engaging an elder to lead inaugural prayers, smudging, and concluding with a traditional closing circle.

Service providers involved with the program consider the program to be an innovative, effective way to engage youth and their parents/caregivers as it allows for open communication and engagement between them. To date, over 30 cycles have been implemented across Ontario with more than 280 families impacted. Staff in 25 agencies have been trained to implement the program and it continues to be implemented, with numbers expected to grow in the coming years. 

There are many success stories and testimonials from communities, agencies, and families. Participating youth, parents, and caregivers who have participated agree that the program supports their needs and gives them an increased understanding of each other’s perspective, which can improve family functioning. 

What participants have to say:

Teens say…
“My parents make more of an effort to support me.”
“What I liked was getting to be with kids in my own age group and hearing how much their lives were like mine.”

Parents say…
“It brought our family a lot closer.”
“I liked that parents and teens learn the same skills so we are all on the same page. The family activities are a good way to reinforce those skills.

Facilitators say…
“Participants start to realize that a little change in their attitudes and behaviours can make a difference in addressing major challenges within their families.”

By participating in the program, families learn from each other. Social interaction is a key element of this process as both teens and adults are able to develop connections with other individuals experiencing similar family dynamics and issues.

Lessons learned

Parent Action on Drugs has learned some key lessons in the areas of recruitment, participant retention, capacity building, and sustainability for Strengthening Families for Parents and Youth. 

It is important to recruit at least 12 to 14 families for the initial session because about 10 to 12 of these families will begin the program, while 8 to 10 families will complete it. Simply issuing an open invitation for participants to attend the program, through flyers and posters, is unlikely to produce results.

A good recruitment strategy is to look for multiple referral sources and work closely with them to ensure they have a thorough understanding of the program and can present it to potential families in a realistic, engaging, and non-judgmental way. Also, having a referring agent meet directly with the youth and their parent or caregiver, to reassure them of the active, empowering nature of the program can help motivate youth to attend the first session.

It can be challenging for families to attend sessions for the entire nine-week program. To support consistent attendance, program planners can provide a family meal of good quality and variety, childcare for younger siblings, and help with transportation. It also helps if site coordinators call each family between sessions as a reminder and give the family an opportunity to discuss any possible barrier to attendance. If possible, a youth facilitator can call, text, or email the youth directly to ensure they will attend. 

Attrition is typically higher in the initial weeks of the program — after the fourth session, program commitment increases greatly. Additionally, participant engagement usually increases following the third sessions.

For these reasons, Parent Action on Drugs has guidelines for providing incentives or small gifts to participants to acknowledge their efforts. These incentives can be adjusted according to the program’s budget and can be minor, but the youth and parents must see them as valuable. These incentives are more important in the early sessions of the program to overcome participants’ initial hesitation. Once they have established social connections within the program and adjusted to the routine, external rewards can become less necessary. 

Partnering with other agencies can help organizations navigate the various challenges they may face in implementing Strengthening Families for Parents and Youth. This can expand program reach and recruitment as well as promote information-sharing among organizations. Finally, a consistent funding source helps keep the program sustainable. 

For more information contact Parent Action on Drugs, pad [at] parentactionondrugs [dot] org at 416-395-4970 or 877-265-9279. 

Useful links

strengtheningfamiliesprogram.org  
www.sfpy-pad.org
www.parentactionondrugs.org 

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