Role of the Family & Community
in Prevention & Treatment
Opiate Commission Interim Report Recommendation #10
Instructor: Dr. Dawn-Elise Snipes, PhD
Executive Director: AllCEUs.com, Counselor Education and Training
Podcast Host: Counselor Toolbox & Happiness Isnât Brain Surgery
Objectives
~ Define family and community
~ Explore skills and strengths to help prevent medical, emotional and behavioral disorders
Committee Recommendations
~ Evidence-based prevention programs for schools, and tools for teachers and parents to enhance youth knowledge of the dangers of drug use, as well as early intervention strategies for children with environmental and individual risk factors
~ Trauma
~ Foster care
~ Adverse childhood experiences (ACEs)
~ Developmental disorders
What are Family and Community
~ Community
~ Neighborhood
~ School
~ Social service organizations
~ Business
~ Local media
~ National media
~ Internet
~ Politicians
~ Family
~ Biological mother
~ Biological family
~ Significant-others non-blood related
Pregnancy, Infancy and Early Development
~ Preconception: Preventing High-Risk Pregnancies
~ Poor maternal nutrition and anemia
~ Maternal smoking and alcohol and drug use
~ Exposure to neurotoxic substances
~ Maternal depression (PPD correlated with lower child IQ)
~ Adrenal fatigue
~ Low birth weight
~ Low maternal weight
~ Multiple previous preterm deliveries
~ Periodontal diseases
~ Physical and emotional stress
Pregnancy, Infancy and Early Development
~ Fetal Development and Infancy
~ Preterm births have increased from 8-12.5%
~ Improved nutrition
~ Prevention of exhaustion
~ Identify and control bacterial vaginosis (29.2% of women)
~ Natural lack of lactobacilli bacteria or using antibacterial soaps
Pregnancy, Infancy and Early Development
~ Peri- and Post-partum Depression
~ Changes in sleep, appetite, weight, energy level, and physical comfort in women during pregnancy and postpartum can cause significant emotional strain.
Pregnancy, Infancy and Early Development
~ Trust-Mistrust
~ Maternal Sensitivity and Infant Attachment
~ Motherâinfant attachment is a well-established influence on infantsâ successful development
~ Home Visiting
~ Home visiting is an intensive intervention that targets successful pregnancies and infant development.
~ Overview of Early Intervention
~ Florida Early Steps
Early Childhood and Childhood
~ Autonomy, Initiative
~ Aggressive social behavior,
~ Typically begins to emerge during childhood
~ A key risk factor for progression of externalizing disorders
~ Harsh and inconsistent parenting practices contribute to it
~ Positive involvement with children and positive reinforcement of desirable behavior contribute to cooperative and prosocial behavior
~ Child Maltreatment
~ Programs that target child maltreatment have the potential to prevent multiple MEB disorders and promote healthy development across several domains of functioning
Early Childhood and Childhood
~ Family Poverty and Material Hardship
~ Family poverty is associated with
~ Increased parental depression
~ Increased spousal and parentâchild conflict
~ Ineffective parenting
Early Adolescence
~ Industry and Identity
~ Developmental period during which the prevalence of substance use, delinquency, and depression begins to rise
~ Psychological and behavioral problems tend to be interrelated
~ Risk Factors
~ Family conflict and poverty
~ Increase in the rates of teasing and harassment in middle school.
~ Significant physical changes
~ Social changes, including the transition from elementary to middle school
~ Increased concern about peer acceptance
~ Increased demand for autonomy
~ Inadequate parental monitoring
~ Deviant peer group formation.
~ Aggressive social behavior, which contributes to social rejection and deviant peer group formation
Early Childhood and Childhood Interventions
~ Teach and encourage parents to:
~ Use praise and rewards to reinforce desirable behavior
~ Replace criticism and physical punishment with mild and consistent negative consequences for undesirable behavior, such as time-out and brief loss of privileges
~ Increase positive involvement with their children, such as playing with them, reading to them, and listening to them.
Early Childhood and Childhood Interventions
~ Parent training in creating positive parentâchild interactions
~ Increasing effective emotional communication skills
~ Using time-out
~ Emphasize parenting consistency
~ Preventative interventions for divorcing families
~ The New Beginnings Program (NBP) is designed to strengthen parenting (warmth and discipline), increase fatherâchild contact and nonparental adult support, and reduce divorce stressors
Early Childhood and Childhood Interventions
~ School Based
~ CDC Task Force on Community Preventive Services recommends the use of universal school-based programs for preventing violence and improving behaviors in school.
~ The Good Behavior Game: An Elementary School Universal Intervention Targeting Classroom Behavior. (~$3500) The Good Behavior Game (GBG) is a simple universal program to reinforce appropriate social and classroom behavior in elementary school.
~ Fast Track: A Comprehensive, Long-Term, Multilevel Intervention for Students at High Risk of Antisocial Behavior (~$10,000)
Combined School and Family Interventions
~ Guiding Good Choices (~$2,500)
~ The Seattle Social Development project
~ Designed to:
~ Reduce risk
~ Build protective strengths in schools, families, and children themselves.
~ Long-term follow-up revealed multiple positive effects on mental health, functioning in school and work, and sexual health 15 years after the intervention ended
School
~ Early Head Start
~ Early Head Start is a federally funded extension of the Head Start Program targeting low-income pregnant women and families with infants and toddlers
~ Those participating showed improvements on the Mental Development Index of the Bayley Scales of Infant Development
~ larger vocabularies
~ lower levels of aggressive behavior
~ higher levels of sustained attention
~ greater engagement with parents
~ less negativity toward parents.
School
~ Early Head Start
~ Families with four or five of the following risk factors did not benefit:
~ No high school education
~ Single parent
~ Teen parent
~ Receiving public assistance
~ Not employed or in school
School
~ Preschool
~ The CDCâs recommends publicly funded, center-based, comprehensive early childhood development programs for low-income 3-5 year olds
~ Preschool education positive effects:
~ The language skills
~ Literacy
~ General cognitive ability
~ High-risk preschool prevention programs which included home visiting, parent training, & preschool education impoved:
~ Cognitive functioning
~ Childrenâs social-emotional functioning
~ Family functioning
School
~ Preschool
~ Interventions directed toward childrenâs early cognitive development are associated with long-term improvement in multiple mental, emotional, and behavioral problems
~ Of note: Child outcomes due to reducing poverty remains limited
~ Several preschool classroom curricula are designed to improve teachersâ behavior management of classrooms by reducing child behavior problems and strengthening childrenâs social skills or executive functioning (or both). The Promoting Alternative Thinking Strategies (PATHS) curriculum
Community
~ Members
~ Influence legislation
~ Influence school
~ Volunteer at school
~ PTA
~ Advocate for children (school based counseling, health curricula promoting practical health and wellness behaviors, home-economics courses teaching basic life skills, school/life balance
~ School nutrition programs
Community
~ Members
~ Model healthy behaviors
~ Smoking
~ Alcohol and Drug use
~ Stress Management
~ Proper nutrition
~ Good sleep habits
~ Effective communication
~ Agencies and organizations
~ Make prevention and early intervention services affordable and available
~ SAMHSA Prevention Week
Community Interventions
~ Home visiting; community-based, multicomponent interventions providing services such as:
~ Family support
~ Preschool education
~ Child care
~ Community development
~ Media interventions
~ Intensive family preservation services (for families with maltreatment)
~ Social skills development
~ The school/community intervention added several elements
~ In-service training of school staff
~ Local task force to develop policies, conduct schoolwide fairs, seek funds for the school, and conduct field trips for parents and children
~ Parent training workshops
Community Interventions
~ Communities That Care, helps communities identify and prioritize risk factors and implement tested interventions that address those factors
~ The media and the Internet
~ Emerging as means to reach local communities beyond schools and families, as well as the broader community, more widely.
~ Their extensive use by todayâs young people makes development of evidence-based promotion and prevention interventions using these venues attractive.
~ Studies of the impact of electronic media (such as television, computer-assisted interventions, and websites) on other health-related behaviors have also found positive effects in such areas as
~ Cognitive-behavioral mood management skills
~ Mental health interventions
~ Smoking cessation
~ The National Institute for Health and Clinical Excellence in the UK has approved two computerized CBT interventions for depression and panic/phobia disorders
Community Interventions
~ The Ecological Approach to Family Intervention and Treatment (EcoFIT), consists of parenting information provided through a Family Resource Center, along with parentâchild homework interactions that encourage effective family management
~ Based on an empirically based model of child/adolescent problem behavior
~ Is family-centered, addressing adult leadership and support in the change process
~ Is assessment driven identifying intervention needs
~ Targets social interactions with parents and peers
~ Addresses client motivation to change as a core component
~ Utilizes a health maintenance model delivered in service settings that involve children and families
Targeting Problem Behaviors, Aggression, Violence, and Substance Abuse
~ Many of the target risk factors of preventive interventions are interrelated.
~ Both aggressive and withdrawn behaviors can co-occur, imparting much higher risk than aggressive behavior alone
~ Both risk factors are independently linked to concurrent and successive problems in concentration, attention, and poor achievement.
~ Depressive symptoms are also associated with poor achievement
~ Externalizing behavior across different social fields and deviant peer group contact in middle school predict later juvenile arrest, drug use, and higher levels of risky sexual behavior
Targeting Problem Behaviors, Aggression, Violence, and Substance Abuse
~ Many of the target risk factors are interrelated.
~ Social skills training using cognitive components that
~ Alter perception and attributions
~ Change behaviors to improve social relationships
~ Promote nonresponse to provocative situations
~ Universal interventions are designed to affect
~ Affect school structure
~ Improve classroom management
~ Improve studentsâ
~ Relationships
~ Self-awareness
~ Decision-making skills