Dr. Karol L. Kumpfer, developer of SFP, was recently retained as a consultant for an October 2007 United Nations expert meeting in Vienna, Austria on family-based approaches to prevention. The conference reflects the widening acceptance of family-based approaches at the most effective prevention strategies worldwide. Overseas SFP trainings and implementation in recent years include Sweden, England, the Netherlands, Portugal, Italy, Ireland, Russia, Thailand, Spain, Costa Rica, and El Salvador. Translation and adaptations of language, exercises and graphics and supporting materials are typically involved in creating a national adaptation of an SFP program.
In trials on the east and west coasts, an adaptation of SFP 6-11 for high risk families with pre-school children ages 3 to 5 years released in 2006 has produced successful initial results. Core skills of SFP 3-5 for parents and younger children are essentially the same as in SFP6-11, but presentation, exercises, and language have been adapted for the understanding and attention spans of younger ages.
Lessons in SFP3-5 completely parallel SFP6-11 and both versions are easily presented together to accommodate families with children in both age groups. Parallel presentation of both versions requires only more group leaders for the additional children’s group and dividing the Family Session into a shorter first period for the younger children and a longer second period for older children.
The original Strengthening Families Program (SFP 6-11) was created in 1984 for high-risk “selected or indicated” children ages 6 to 11 and their families. Growing requests led in 2004 to SFP12-16, an adaptation of SFP for high-risk teens. Resilience lessons on dreams and goals from SFP10-14 for general/universal populations were retained and adapted for higher risk youth. This program was tested on a SAMHSA/CSAT grant with youth in foster care and residential drug treatment in multiple sites in New Mexico and Utah. The Trimbos Institute also tested SFP12-16 for youth in residential drug treatment in multiple sites in the Netherlands and found positive outcomes similar to SFP6-11. A recent analysis of results in Ireland showed even larger effectiveness (effect sizes averaging d = .80) in their population of indicated youth involved in probation or mental health services. Implementations in Canada, Italy, and Thailand are expected to produce publishable results.
Core skills of SFP12-16 for parents and teens are essentially the same as in SFP6-11, but presentation, exercises, and language have been adapted for early teens. A lesson preparing parents and teens to talk about relationships and sexuality has also been added. Because teens have a more nearly adult understanding, parents and teens usually work on the same or similar skills in each session (compared to roughly half the sessions in SFP3-5 and SFP6-11).
SFP12-16 returns frequently to the theme of helping teens identify their goals and dreams and helping parents support pursuing those goals. Peer resistance skills also receive expanded treatment in SFP12-16. Peer resistance is presented as encouraging teens to make their own choices, determining what they will do and who they will be.
The first International Cochrane Collaboration Systematic Review in Public Health and Medicine to review programs for the prevention of alcohol abuse found that SFP10-14 was the most effective universal, school-based prevention program in the world.
The Cochrane Collaboration authors (Foxcroft and associates 2003) at Oxford University found only 56 programs in the world with research data solid enough to include in their review of what works in substance abuse prevention. About 20 of these programs were found to have negative results or no positive results. Of the remaining programs, the Cochrane review found that SFP10-14, a 7-session plus four boosters version for low risk universal populations, had twice the effectiveness (effect size) of the next best school-based program. SFP was found three times as effective as any life or social skills training program implemented with youth only.
Because this review covered only school-based universal prevention, SFP3-5, SFP6-11, and SFP12-16 await a future Cochrane Collaboration evaluation for effectiveness with higher risk selected or indicated populations.
Foxcroft, D. R., Ireland, D., Lister-Sharp, D.J., Low, G., & Breen, R. (2003) Longer-term primary prevention for alcohol misuse in young people: A systemic review. Addiction, 98, 3978-411.
For the fourth time in two years, Dr. Whiteside has gone to train in Ireland for both Youth Corrections and several Regional Drug Abuse Task Forces. The results of the first two groups have already been analyzed by LutraGroup and the results are better than the US norms.
The University of London Kings College has created a new National Parenting Academy for the UK. After extensive reviews they have selected Strengthening Families Program for dissemination along with several other parenting programs. This spring Dr. Kumpfer and Dr. Whiteside trained in Nottingham, Devon, and also in London.
The UN family initiative reflects a widening acceptance of family-based approaches as the most effective prevention strategies worldwide. This support came from the World Health Organization’s (WHO) recent meta-analyses conducted by Oxford Brooks University researchers under the supervision of Dr. David Foxcroft (WHO, 2007). These meta-analyses of substance abuse prevention programs having at least two years of longitudinal outcomes have concluded that the Strengthening Families Program (SFP) and interventions targeting parents are the most effective approaches (Foxcroft, et al., 2003). Overseas SFP trainings and implementation in recent years include Sweden, Norway, the Netherlands, Spain, Portugal, Italy, Ireland, United Kingdom, Russia, Costa Rica, El Salvador, Peru, Chile and this last year the first Asian country, Thailand. Translation and adaptations of language, exercises and graphics and supporting materials are typically involved in creating a national adaptation of an SFP program.
With funding from the U.S. State Department, the Thai governmental office for substance abuse prevention, the Thai National Control Board, has selected the Strengthening Families Program for dissemination in Thailand. Their first step was to form a collaboration with a research team headed by Dr. Methinin Pinyuchon from Taskin University in Songkla, Thailand who researched likely effective programs. Because of the Thai emphasis on families and fact that the Cochrane Collaboration Reviews and NIDA say SFP is a very effective program, she selected the 14-session version of SFP for high-risk families. For a year, Dr. Pinyuchon and team worked on the cultural adaptations following a rigorous cultural adaptation protocol just published in Evaluations and the Health Professions (Kumpfer, Pinyuchon, de Melo, & Whiteside, 2008). In Spring 2007, Dr. Kumpfer and Dr. Whiteside trained over 80 prevention specialists from all over Thailand to become certified SFP group leaders. Several SFP groups have been completed with good results. The Thai training team are now conducting their own trainings in the Strengthening Tai Families Program as shown in the attached picture. The long term goal of this Southeast Asian project is to eventually culturally adapt SFP for Laos. Vietnam and other Golden Triangle and Asian countries.
Dr. Karol L. Kumpfer, developer of SFP and Professor at the University of Utah, was recently retained as a consultant to support the efforts of the United Nations Office of Drugs and Crime (ODC) in Vienna, Austria on dissemination of evidence-based family approaches to drug prevention. A systematic approach is being taken that included creating an international expert work group of professionals and university researchers in parenting and family interventions worldwide. This expert group met at the UN in Vienna in October to discuss suggestions for a Guideline Protocol on ways local NGOs or family services agencies could select the best evidence-based parenting or family interventions matching the needs of their families and agency resources. The protocol also includes suggestions on how to culturally adapt the program and implement it in developing countries. These steps for culturally adapting SFP has already been published with Dr. Pinyuchon from Thailand, Ana de Melo, and Dr. Henry Whiteside.
Additionally, with support by the ODC program staff, Dr. Kumpfer and Ana Melo, M.D. in Portugal conducted an international search for evidence-based parenting programs worldwide. Over 180 programs have been located and their program developers have submitted research articles and program descriptions. These will be added to the UN ODC website and Dr. Kumpfer’s web site www.strengtheningfamilies.org after expert reviews this summer of their levels of evidence of effectiveness to be made available for community agencies and governments worldwide.
Karol to add picture and link to UN website about initiative.
For descriptions of the prior expert review process used to determine the 34 evidence-based parenting and family programs for the Strengthening America’s Families web site for the federal government offices of the NIJ Office of Juvenile Justice and Delinquency Prevention and SAMHSA’s Center for Drug Abuse Prevention (CSAP) see Kumpfer and Alvarado’s 2003 article in the American Psychologist or the criteria for review use listed on www.strengtheningfamilies.org
Dr. Kumpfer presented last January to the White House Office of National Drug Control Policy (ONDCP) as part of the Advisory Board of Dr. Kerby Alvy’s National Effective Parenting Initiative (NEPI) on the importance of targeting parents in media campaigns. Luckily the ONDCP media contractors who were in attendance and with support of ONDCP’s Robert Denniston, Director of the National Youth Anti-Drug Media Campaign, listened and launch their first major Federal effort to educate parents about teen prescription drug abuse.
This national public awareness campaign began with advertising during this year’s Super Bowl, and is ONDCP’s first paid TV advertising targeting parents in nearly two years since highly successful Parents the Anti-Drug media campaign. Their prior effort was also designed by ONDCP’s former Director, General Barry McCaffrey, after being presented data by Dr. Kumpfer, Director of SAMHSA’s Center for Substance Abuse Prevention (CSAP) on the importance of parents in preventing drug abuse in their children. The new media campaign effort includes broadcast, print, and online advertising, community outreach, and new print and online resources to help parents and communities combat the troubling trend of teen prescription drug abuse. The Administration will leverage $14 million to generate nearly $30 million in advertising. The ads were made in collaboration with the Partnership for a Drug-Free America (The Partnership), with pro bono creative provided by Draftfcb New York. Watch for more of these ads targeting parents to help prevent prescription medication abuse in your community.
For more information for parents and practitioners about this important media campaign and the important role parents play in drug prevention, go to http://theantidrug.com/pdfs/prescription_report.pdf