The Family Check-Up enables us to adapt and tailor family-centered interventions to the needs of children and adolescents. Figure 2 (below) shows the overall strategy of EcoFIT and the Family Check-Up. Each check-up includes:
Initial interview. This 60-minute “get to know you interview”
- gives the parent consultant (the school–home liaison) an opportunity to meet with parents and children or adolescents to better understand their current mental health needs and concerns
- involves the completion of a brief questionnaire
- includes a discussion about family needs
- acknowledges that each family is a unique set of individuals
- helps clarify how we can best serve the family
Ecological assessment. Long experience has taught us how important it is to carefully assess each family’s experience before making decisions about intervention options.
- We typically visit the family’s home to videotape family members interacting and to ask them to complete questionnaires.
- We assess each child’s adjustment to school, even if it is an area of strength; a strengths-based approach allows us to look at positive adjustment in addition to behavior that needs attention.
- This information helps us formulate a tentative plan to discuss with each family.
Feedback session. In this review of the findings from the assessments,
- the parent consultant considers the caregiver’s input and motivation for taking action
- current family practices and behaviors that are areas of strength are carefully identified
- feedback is given about family practices and behaviors that may need attention or that may benefit from our services
- feedback is based on many years of working with children and families and on assessments used with numerous and diverse families
- the caregiver and the parent consultant then collaborate to participate in one or more of the available intervention options in the service menu
All the interventions that follow the Family Check-Up have been shown in previous studies to help children and adolescents improve their social behavior and their emotional adjustment. The current intervention options are:
Brief family-centered interventions
- These one, two, or three face-to-face meetings with caregivers help us tailor an intervention strategy that best meets the needs of the family.
- We focus on family management practices and positive behavior support.
- Some parents benefit from periodic meetings with other parents to review research-based strategies for improving caregiving and parenting practices.
- Current parenting strengths are emphasized.
- The curriculum that guides the parent group meetings has been tested in several research projects and has been found to be effective.
- Once or twice a week families and the parent consultant meet to identify and support caregivers’ efforts to change family interaction patterns.
- The emphasis is on motivation and collaboration.
- Family therapy can last from one month to one year or longer.
- When we work directly with children and adolescents, the primary focus is to support development of positive skills such as self-control and interaction skills with family and peers.
- Because our approach is family centered, these interventions typically occur at the same time as sessions with a child's caregivers; we rarely work only with children.
- Our usual focus is to improve child and adolescent self-regulation, and it often involves cognitive behavioral strategies.
- Because our intervention is ecological, we assess all children’s adjustment at school.
- Some children do well in school and require only a brief consultation visit.
- When the majority of behavioral and emotional issues occurs in the school context, we collaborate with key school personnel and develop a positive behavior support plan that bridges home and school.
- Family resource centers in the school provide resources about various parenting topics. The goal, through collaboration with school staff, is to
· engage parents
· establish norms for parenting practices
· disseminate information about risks for problem behavior and substance use
· help parents learn how to identify observable risk factors and how to use effective family management skills, including positive reinforcement, monitoring, limit setting, and relationship skills
The FRC in participating schools also provides
· Home visits to increase participation in family-centered interventions, which increase parental engagement
· Videotape examples of effective family management skills, and a simple rating form to help parents identify observable risk factors in the context of parent–child interaction
· A six-week health curriculum promoting school success, reduced substance use, and reduced conflict
· Direct professional support to parents, including a brief family intervention, school monitoring system, parent groups, behavioral family therapy, and case management services
Ecological management and advocacy
- When child and family clients are involved in other services in the community, we can coordinate our intervention with those services.
- Families may be benefiting from related service providers or periodic service coordination. For example, if medication is required for one or more family members, we work collaboratively with psychiatric services to ensure that medications are helpful and periodic reviews occur.