Principles of Effective Family Focused Interventions

Source: Kumpfer, K.L., Alvarado, R. Family-strengthening approaches for the prevention of youth problem behaviours In: American Psychologist vol. 58, June/July 2003, p. 465.

1. Comprehensive multi-component interventions are more effective in modifying a broader range of risk or protective factors and processes in children than single component programmes.
2. Family-focused programmes are generally more effective for families with relationship problems than either child-focused of parent-focused programmes, particularly if they emphasize family strengths, resilience, and protective factors rather than deficits.
3. Components of effective parent and family programmes include addressing strategies for improving family relations, communication, and parental monitoring.
4. Family programmes are most enduring in effectiveness if they produce cognitive, affective and behavioural changes in the ongoing family dynamics and environment.
5. Increased dosage [regularity] or intensity of the intervention (25 to 50 hours) is needed with higher risk families with more risk factors and fewer protective factor processes than low-risk universal families who need only about 5 to 24 hours of intervention.
6. Family programmes should be age and developmentally appropriate with new versions taken by parents as their children mature.
7. It is important to address developmentally appropriate risk and protective factors or processes at specific times of family need, when participants are receptive to change.
8. If parents are very dysfunctional, interventions beginning early in life (i.e. prenatal or in early childhood) are more effective.
9. Tailoring the interventions to cultural traditions of the families improves the recruitment, retention and sometimes effectiveness.
10. High rates of family recruitment and retention (in the range 80-85 %) are possible with the use of incentives, including food, childcare, transport, rewards for homework completion or attendance, and graduation.
11. The effectiveness of the programme is highly dependant on the trainers' personal efficacy and confidence, humour and empathy, and their ability to structure sessions.
12. Interactive skills training methods (e.g. role play, active modelling, family practice sessions, homework practice and videos/CDs of effective and ineffective parenting skills etc.) as opposed to didactic lecturing increase programme effectiveness and client satisfaction, particularly with low socio-economic level parents.
13. Developing a collaborative process whereby clients are empowered to identify their own solutions is also important in developing a supportive relationship and reducing parent resistance and drop out.