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Focus on Families is designed for families with parents who are addicted to drugs. Based on the social development model, the program aims to prevent parents’ relapse, help them cope with its occurrence (if it did occur), and reduce the likelihood of substance abuse among their children. It is most appropriate for parents enrolled in methadone treatment who have children ages 3 to 14. Eligible families participate in a 5-hour “family retreat” in which they learn about the curriculum, identify their goals, and participate together in trust-building activities. The first session is followed by 32 curriculum sessions (90 minutes each), conducted twice weekly for 16 weeks. Parent sessions are conducted in the mornings, with practice sessions held in the evenings for parents and children together. Content covered includes family goal setting, relapse prevention, family communication skills, family management skills, creating family expectations about drugs and alcohol, teaching skills to children, and helping children succeed in school. Parent sessions, follow-up, and home-based care management are provided by masters-level social workers using a structured cognitive-affective-behavioral skills training curriculum.
The evaluation used an experimental pre–post design with parent treatment and control groups. Eligibility requirements mandated that parents had been in methadone treatment at one of the two participating clinics in Seattle, Wash., for a minimum of 90 days prior to participation, that they have one or more children ages 3–14 years who lived with them at least 50 percent of the time, and that they resided within 25 miles of their methadone clinic.
One hundred forty-four parents and 178 children between ages 3–14, representing 130 families, participated in the study. Parents who completed the baseline interview and either the 6- or 12-month follow-up (n=137) had a mean age of 35.3 years, first used opiates at an average age of 19.1 years, and had been in methadone treatment for 15 months before enrolling in Focus on Families. Seventy-five percent of the sample was female. In terms of ethnicity, 77 percent of the sample was white, 18 percent African-American, and 5 percent “other.” Children who completed the baseline interview and either the 6- or 12-month follow-up (n=105) had a mean age of 10.4 years. At baseline, 28 percent had smoked cigarettes, 27 percent had drunk alcohol (more than one sip), and 7 percent had smoked marijuana.
Seventy-five families were assigned to the experimental condition and 55 to the control condition. The experimental condition supplemented methadone treatment with 33 sessions of family training in conjunction with 9 months of home-based case management. Conversely, control condition families received no supplemental services. Parents were assessed by interview at baseline, posttest, and 6 and 12 months following the intervention on measures including relapse and problem-solving skills, self-report measures of family management practices, deviant peer networks, domestic conflict, and drug use. Ninety-four percent (n=135; 78 experimental, 57 control) completed the 6-month follow-up, and 92 percent (n=132; 74 experimental, 58 control) completed a 12-month follow-up interview. Children (ages 6 and up) were assessed by interview at baseline and 6- and 12-month follow-up points on measures including self-report measures of rules, family attachment, parental involvement, school attachment, misbehavior, negative peers, substance use, and delinquency. Ninety percent (n=104; 58 experimental, 46 control) of the children old enough to be interviewed were contacted 6 months following completion of the group intervention, and 87 percent (n=100; 57 experimental, 43 control) were contacted at 12-month follow-up.
The evaluation revealed that the experimental parents had significantly higher scores than control group parents in parent skills, parent drug use, deviant peers, and family management. At the 6-month follow-up, there were few significant differences related to family factors between the experimental and control groups. However, at the 12-month follow-up, experimental parents reported that more rules were defined in their households and reported less domestic conflict than control participants. In addition, experimental parents reported less drug use than controls at 12 months. Few significant changes were noted in children’s attitudes and behaviors.
The study did have several limitations. First, children’s self-reports were not verified. Second, it was not possible to engage all parents in the methadone clinics. Third, participants were recruited from only two branches of a single methadone clinic in Seattle and, therefore, the participants may not be generalizable to other methadone programs or clientele. Also, these results were noted at 1-year follow-up, and long-term follow-up may be needed to analyze program effects. Finally, most participants remained in the data collection portion of the study.
Catalano, Richard F., Randy R. Gainey, Charles B. Fleming, Kevin P. Haggerty, and Norman O. Johnson. 1999. “An Experimental Intervention With Families of Substance Abusers: 1-Year Follow-Up of the Focus on Families Project.” Addiction 94(2):241–54.
Catalano, Richard F., Kevin P. Haggerty, Charles B. Fleming, Devon D. Brewer, and Randy R. Gainey. 1997. “Focus on Families: Scientific Findings From Family Prevention Intervention Research.” Final Report to the National Institute on Drug Abuse.
Kevin Haggerty
Social Development Research Group
9725 Third Avenue NE, Suite 401
Seattle, WA 98115–2024
Phone: (206) 543-3188
Fax: (206) 543-4507
E-mail: haggerty@u.washington.edu
Web site: http://depts.washington.edu/sdrg
