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.