An Effective Family Skills-based Intervention for the Prevention of Health Problems in Children of Alcohol and Drug-Abusing Parents
AbstractIntroduction. There is a need forwide-scale dissemination of effective family-focused skills trainingprograms for the prevention of multiple developmental problems and later substance misuse amonghigh-risk children. Independent reviews have found the author’s Strengthening Families Program (SFP) tobe the most effective substance abuse prevention intervention. Cultural adaptations have resulted in successful SFP outcomes in many countries, including in Spain as detailed in the Orte article. This article reviews 30 year history of implementation and outcomes of SFP in different cultures with cultural adaptations. Methods: The SEM-tested Social Ecology Model (Kumpfer, Alvarado, &Whiteside, 2003) is presented and reveals that family factors (bonding, supervision, and communication) are the most protective of later substanceuse.Hence, this causal theory served as the etiological theory behind the design of the 14-session SFP.Social cognitive behavior theory (Bandura, 1989) is the intervention theory. The Strengthening Families Program(SFP) was the first family skills training program developed and found effective in a randomized control trial (RCT) to improve outcomes for children of dug abusers.Many countries requested to replicate SFP; hence, staff training systems were developed and a cultural adaptation process. Results: Eight RCTs, four conducted by independent research teams, and hundreds of quasi-experimental studies in different countrieshave demonstrated SFP’s effectiveness in reducing substance use in adolescents with up to 10-yearfollow-ups. Comparative effectiveness reviews including ones using statistical meta-analysis by theOxford University Cochrane Collaboration Reviews, found SFP to be the most effective alcohol and drug prevention program (Foxcroft, et al., 2003). A cost-benefit analysis by Miller and Hendrie (2008) found SFP prevented the highest percentage of youth from using alcohol and drugs. Cultural adaptation is a mandated element of SFP fidelity and was found in five studies to improve recruitment and retention by 40 percent. Discussion: SFP is being disseminated worldwide by the UN Office of Drugs and Crime and also by 27 governments. This article describes the contents and the outcomes of the Strengthening Families Programmes number of countries including Spain plus future directions in computer delivery with a new Home Use SFP8-16 DVD.
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