Detailed Description of
Strengthening Families Program (SFP)

Karol L. Kumpfer, Ph.D.
Department of Health Promotion and Education
University of Utah
1901 East South Campus Dr. Room 2142
Salt Lake City, Utah 84112

Phone (801) 581-7718 (Dr. Kumpfer’s Direct Line)
Fax (801) 581-5872
E-mail: Karol.Kumpfer@health.utah.edu

Highly Acclaimed

Selected as one of three science-based, substance abuse prevention programs by the National Institute on Drug Abuse (NIDA) for replication and featured on NIDA’s video, Coming Together on Prevention as well as in NIDA’ s publications Drug Abuse Prevention for At-risk Groups, Preventing Drug Use Among Children and Adolescents: A Research-based Guide, and Drug Abuse Prevention Through Family Intervention.

Disseminated since 1987 by the Office of Juvenile Justice and Delinquency Prevention’s (OJJDP) Strengthening America’s Families Initiative and showcased at national conferences, and reviewed in a new Family Strengthening Series bulletin (OJJDP, 2000) and on their web site,

Recently selected in May, 2000 by CSAP as an Exemplary Program and including in CSAP’s What Works in the Prevention of Drug Abuse (CSAP, 1997), reviewed in CSAP’s Family-based Prevention Enhancement Protocol Series (PEPS), and includedas a science-based model by CMHS, DoEd, ONDCP, NIAAA, and the Communities That Care (Hawkins, et al.,.2000).

Published in Journal of Children in Contemporary Society (1986); The International Journal of the Addictions (1990/91); Substance Use and Abuse (1996), Journal of Primary Prevention, American Psychologist, and Botvin and associates (1996), Drug Abuse Prevention with Multi-ethnic Youth and Peters & McMahon’s (1996) book, Childhood Disorders, Substance Abuse, and Delinquency.

Featured on Fox TV Morning News Show (1998), the British Broadcast Company (1996), Ontario Television documentary on families and addiction, and programs.

SFP outcomes

• Decreased use and intention to use alcohol, tobacco and other drugs.
• Enhanced children’s protective and resilience factors by improving children’s social and life skills, peer resistance, and communication skills.
• Improved parent/child attachment and family relations, communication, and organization.
• Improved adults’ parenting skills, reductions in excessive punishment or lax discipline and improvements in parenting self-efficacy,
• Reduced youth behavior problems (i.e., substance use, conduct disorders, aggression, violence, and juvenile delinquency) as well as reduced emotional problems such as depression and psychosomatic disorders.

Target Domains

• Individual
• Family

What is the Strengthening Families Program?

The Strengthening Families Program involves not just parents or children alone, but the whole family. It was developed specifically as a selective prevention strategy for 6 to 12 year old high-risk children of substance-abusing parents. In multiple replications with diverse ethnic groups in universal settings (schools, churches, neighborhoods), it has been found effective in reducing risk factors and increasing protective and resilience factors. The most immediate results are improvements in children’ s pro-social behaviors, mental status, and grades combined with reductions in aggression, violent behaviors, and substance use. Longitudinal follow-ups find reductions in alcohol, tobacco, and other drugs after up to five years.

The Strengthening Families Program (SFP) is a science-based family skills training program designed to increase resilience and reduce risk factors for behavioral, emotional, academic and social problems. SFP builds on protective factors by improving family relationships, parenting skills, and improving the youth’ s social and life skills. SFP has been modified for African American families, Asian/Pacific Islanders, Hispanic and American Indian families, rural families, and families with early teens. Although originally developed for children of high-risk substance abusers, SFP is widely used with non-substance abusing parents.

The SFP curriculum includes three 14-week courses: Parent Training, Children’s Skills Training and Family Life Skills Training.Parents learn to increase desired behaviors in children by using attention and rewards, clear communication, effective discipline,substance use education, problem solving and limit setting. Children learn effective communication, understanding feelings, social skills, problem solving, resisting peer pressure, consequences of substance use, and compliance with parental rules. During the second hour families engage in structured family activities, practice therapeutic child play, conduct family meetings, learn communication skills, practice effective discipline, reinforce positive behaviors in each other, and plan family activities together. SFP uses creative retention strategies such as special incentives for attendance, good behavior in children, and homework completion. To reduce barriers to attendance family meals, transportation, and child-care should be provided. To increase generalization and use of skills learned, booster sessions are encouraged as well as providing on-going family support groups for SFP graduates at the agency site.

What are SFP Outcomes?

Positive outcomes have been found in NIDA-, NIAAA-, and NIMH-funded research and in independent CSAP-funded program evaluations. Outcome results are consistent across replications and modifications for ethnic families and based on pre-test, post-test, and 6 month to five year follow-up measures demonstrate that:

• The Parent Training (PT) program was very effective in reducing the children’s antisocial behaviors, aggression, and conduct disorders by improving the parent’s effective discipline, family management skills, and supervision of the child and reducing physical punishment.
• The Children’s Skills Training (CT) program improved the children’s social and life skills, including improved peer resistance, problem solving, communication, ability to make positive friends, identify feelings,and control anger.
• The Family Skills Training (FT) program improved the family’s time together, communication, cohesion, planning and organization, and reduced their high levels of family conflict, however.
• The full Strengthening Families Program (SFP) including the complete three-component program is the most powerful because it improves more risk and protective factors predictive of later problem behaviors.

Project Developers

The original Strengthening Families Program (SFP) was first developed by Dr. Karol Kumpfer and associates in 1983 on a four year NIDA prevention research grant. Other research practitioners have developed adaptations of SFP for different target groups, the most notable is the shorter 7-session SFP version for 10-14 year olds developed by Dr. Virginia Molgaard and Dr. Kumpfer also with NIDA funding. The elementary school-aged version of SFP is disseminated by the Strengthening Families staff at the University of Utah. Training of group leaders, training of certified trainers, grant and proposal writing, staff and board development, needs assessments and program evaluation services are also available from SFP staff. To help disseminate effective family-based prevention interventions, SFP staff have also conducted a number of national and regional conferences and trainings for federal agencies (CSAP and OJJDP) showcasing up to 34 different science-based parenting and family programs. They are available to arrange regional, state or county family strengthening conferences and trainings.

Evaluation Design

The Strengthening Families Program has been evaluated in as many as 15 different research studies by independent evaluators. The original NIDA study (1983 to 1987) involved a true pre-test, post-test, and follow-up experimental design with random assignment of families to one of four experimental groups: 1) parent training only, 2) parent training plus children’ s skills training, 3) the total three component SFP program including thefamily relational skills component, or to 4) no treatment that included drug treatment as usual with no parent or child training. Because of the positive results, SFP was then replicated and evaluated on five CSAP High Risk Youth Program grants with diverse ethnic groups by independent evaluators using quasi-experimental, pre-, post- and 6-, 12-, 18-, and 24-month follow-up statistical control group designs comparing drug-abusing families with non-drug abusing families. SFP has also been evaluated on a CSAP Predictor Variable grant in two rural Utah school districts employing a true experimental pre-, post-, 12 and 24 month follow-up design which randomly assigned elementary schools to either: 1) the full SFP, 2) a child-only school-based program–I Can Problem Solve (ICPS), 3) a combination of SFP with ICPS, or 4) no new family intervention services. SFP was found highly effective in decreasing anti-social behaviors, conduct disorder, and aggression with Effect Sizes (ES) ranging from .85 to 1.11 range depending on outcomes measured. Currently, the preliminary two year results of a NIDA effectiveness research study with 195 African-American and White WDC families randomly assigned to parent training only, children’ s skills training only, the full SFP, or minimal contact control suggest very positive results in reducing children’s behavior problems (e.g., aggression and conduct disorders) and improving children’s social skills.

Who Can Benefit?

The original SFP was developed to improve behavioral problems in 6to12 year old children of alcohol or drug abusers. It has been culturally adapted and tested with urban and rural families with elementary school-aged children. SFP has proven successful with high-risk children whose parents are not drug or alcohol abusers andwith families of diverse backgrounds. Separate training manuals have been developed for African American families, which contain the same basic content as the original SFP but have culturally appropriate pictures and language with some specific information regarding African American families and communities. SFP has also been modified for Asian/Pacific Islandersin Utah and Hawaii, rural families, early teens in the Midwest, and Hispanic families. Currently offered to court-ordered parents, homeless families, and parents with children in protective services.

Suitable Settings

The Strengthening Families Program has been implemented in many different community settings, such as schools, drug treatment centers, family or youth services agencies, community mental health centers, housing projects, homeless shelters, churches, recreation centers and drug courts.

Suitable Settings

Successful replication of the Strengthening Families Program includes the following:

• Implementation of three structured components: Parent Skills Training, Children’s Skills Training, and Family Life Skills Training, conducted in fourteen two-hour sessions.
• Implementation by experienced or effective group leaders who are also genuine, warm, and empathetic.
• Incentives for participation and program completion, such as rewards for homework and program completions, meals, child care and transportation when needed.
• Booster sessions every six months lasting about 3 hours with a family outing following.

How the Program Works

Implementing the Strengthening Families Program involves the following activities:

• Hiring and training at least four effective group leaders, two to run the children’s groups and two for the parent’s groups, and a program or site coordinator.
• Recruiting families by stressing improvements in family relationships, parenting skills,and youth’s behaviors and grades.
• Using creative recruitment and retention strategies matched to the needs of participating families, such as special incentives, family meals, transportation, and child care.
• Implementing the full Strengthening Families Program once per week for 14 weeks or in alternative formats, such as twice per week or at retreat weekends.
• Eating meals together as a family, attending separate parent training classes and children’ s skills training classes and then in the second hour participating in structured family activities including practice sessions in therapeutic childplay, family meetings, communication skills, effective discipline, reinforcing positive behavior and planning fun family activities together.
• Conducting a needs assessment and evaluating the program using standardized family, parent, and child outcome measures and using the outcome and process measures for continuous quality improvement.

What You Can Achieve

The Strengthening Families Program is designed to achieve the following goals and objectives:

• Decreased use and intention to use tobacco, alcohol and illicit drugs.
• Decreased children’s behavior problems.
• Increased children’s social and life skills.
• Increased family cohesion, communication and organization.
• Increased family cohesion, communication and organization.
• Lowering of risk factors and increases in resilience, assets, and protective factors.

What You Need To Implement The Program

Positive and Skilled Group Leaders:The program can be delivered by teachers, community agency staff, counselors, or persons hired from the community who are effective at facilitating groups with parents or children. Minimum staffing requirement for the Strengthening Families Program is two trained adults for the parents’ group and two trained adults for the children’ s group. It is helpful that the leaders are parents or are comfortable and skilled in dealing with young children. Experience and knowledge of behavioral psychology or token economy systems is also helpful. The time commitments of the staff are typically aboutsix hours per week per leader (including two hours for preparation and 3hours for program delivery and one hour for processing the session and evaluation paperwork). Especially if recruitment is likely to be an issue, some sites also hire a Program or Site Coordinator who also works on referrals and recruitment of families, supervision of staff, payroll and budget, and logistics (child care, transportation, meals, janitors, and space). The Site Coordinator should work about half-time in staff supervision, site logistics, and family recruitment. Group leaders and site coordinators should be trained in the Strengthening Families Program by trainers authorized by the program developers.

Rooms, Equipment, and Supplies: The ideal group size is 8 to 12 families, although the SFP project has found that groups as few as four families and as many as 14 families can be effective. Access to at least two training rooms large enough for the separate youth and parent sessions, with extra space for meals, child care, and later for the family session in the second hour is necessary. Equipment needed includes an overhead projector, a VCR/Monitor for videos, and tables for the meals and family interaction exercises. Supplies required include a flip chart, masking tape, markers, name tags, puppets and toys (to demonstrate parent/child play), balloons, and meals.

Incentives:To improve recruitment and attendance, it is very helpful with high risk families to have enough funds or donations to provide rewards for completion of homework exercises and for completion of the program. The children get points or stars for good behavior during the sessions that are traded at the end of the evening or at graduation for prizes. The families typically receive food coupons or movie, sports, or entertainment tickets as graduation gifts and meals prior to the program sessions as well as transportation to get to the site when needed.

Implementation Timeline: Startup: 3 to 6 Months
Allow enough time to hire a site or program coordinator, hire group leaders, and arrange the training workshop for the staff team members. You also need to assure adequate recruitment from your existing client base or from referral sources. Arrangements must be made for child care, transportation, adequate space, and incentives.

Implementation: Minimum 16 sessions: The ideal group size is 8 to 12 families, although the SFP project has found that groups as few as four families and as many as 14 families can be effective. The time needed depends on whether the program is run once or twice a week or in a retreat setting. The program typically involves one week of pre-testing, 14 weeks of family groups, and one week for post-testing.

How Strengthening Families Program Staff Can Help You

Training and Technical Assistance
Training and technical assistance are available from the Strengthening Families Program staff. Up to 30 trainees can be provided a two to three day training on-site or through regional SFP trainings. The SFP group leaders training workshop is generally run by two SFP trainers covering the following topics: the underlying theoretical concepts, program mechanics, recruitment and retention of families overview of the curriculum, facilitating groups, ethical situations, and role plays. Video tapes help to illustrate key concepts. Participants learn skills by co-presenting a 20 minute portion of a parent or child session. It is recommended that one of the trainers return to conduct a site visit after implementation of four or five sessions to check for program fidelity and trainer quality and to deal with staff implementation questions. Additional implementation consultation and technical assistance with periodic site visits every six months is recommended (particularly on research or evaluation grants) and available as negotiated on an individual basis. Authorized SFP training is coordinated by LutraGroup. Please contact Henry O. Whiteside at lutragroup@att.net or (801) 583-4601 for details.

Grant Writing and Program Evaluation
The Strengthening Families Program staff also offer grant writing and program evaluation consultation services including: proposal and grant writing, community and family needs assessments surveys and focus groups to determine needs. Process evaluation materials and data analysis are available with optional site visits, fidelity checklists, or reviews of session video tapes to critique fidelity and implementation quality. Outcome evaluation testing batteries can be custom tailored to the needs of the agency and include a pre-test, post-test, and booster session follow-up test. Outcome data analysis with written reports is also available.

Program Materials and Resources
Six books are needed to implement the program: 1) the Parent’s Skills Training Group Leader’s Manual, 2) the Children’s Skills Training Group Leader’s Manual, 3) the Family Skills Training Group Leader’ s Manual, 4) thea Parent’s Handbook, 5) the Children’s Handbook, and 6) the Implementation Manual. The smanuals contain full lesson plans, worksheets, activity sheets, experimental activities, and homeworkfor the group leaders to implement during the sessions. A full set of books on either hard copy or CD can be purchased for $200 including postage, paid in advance using the included form, from the Strengthening Families Program of the Department of Health Promotion and Education at the University of Utah at the address at the top of this form. For more information concerning purchase, contact. Purchasers may make copies as needed for the use of their own agency. An evaluation packet and manual are also available.

Cultural and Local Modification Consultation
Culturally-adapted African American, American Indian, and Spanish language versions of SFP are also available. SFP staff can also help local agencies develop even more locally relevant manuals and video materials by providing technical assistance consultation on how to modify or adapt the SFP for your local target population. While research suggests the content of the basic SFP manuals is effective with diverse populations, modifying the language, examples, exercises, and visual material to match the targeted population increases acceptability, recruitment, and retention.