The Adolescent Transitions Program (ATP) is a
multilevel, family-centered intervention delivered in the middle
school setting. The intervention works within a “tiered” strategy (universal, selective, and indicated), where each level builds on the previous level.
The universal level of the ATP strategy, directed to the parents
of all students in a school, establishes a Family Resource Center. The goal, through
collaboration with the school staff, is to engage parents, establish norms for
parenting practices, and disseminate information about risks for problem behavior
and substance use. The videotape "Parenting in the Teenage Years" helps
parents identify observable risk factors and focuses on the use of effective and
ineffective family management skills, including positive reinforcement, monitoring,
limit-setting, and relationship skills to facilitate evaluation of levels and
areas of risk.
The
selective level of intervention, the Family Check-Up, offers family assessment
and professional support to identify those families at risk for problem behavior
and substance use.
The
indicated level, the Parent Focus curriculum, provides direct professional support
to parents for making the changes indicated by the Family Check-Up. Services may
include behavioral family therapy, parenting groups, or case management services.
Following this tiered strategy, a family in the indicated parenting intervention
would have participated in a Family Check-Up and received information from the
school's Family Resource Center about risk factors for early substance use and
parenting practices that reduce the risk of drug use for their children. Each
level of intervention builds on the previous level to reach parents within the
school setting, to address the needs of at-risk families, and to provide family
treatment.
The
Family Resource Center is an infrastructure established for collaboration between
school staff and parents during the school year. We support norms for protective
parenting practices and we disseminate information to encourage family management
practices that promote school success and prevent the development of early-onset
alcohol and other drug use. In addition, we provide:
Home visits to increase participation in family-centered interventions, which increase parental engagement.
Videotape examples and a simple pencil-and-paper rating form to help parents identify observable risk factors in the context of parent–child interaction. The videotape focuses on the use of effective family management skills (positive reinforcement, monitoring, limit-setting, and relationship skills) to facilitate parents’ evaluation of their own level of risk, as well as their child’s.
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.
In our initial
research, over 999 families were assigned randomly to the comprehensive family-based
intervention in the schools. We followed 66% of those families through
the
middle school
years on
a variety of measures, including a self-report survey assessing deviant peer
involvement,
antisocial behavior, and substance use.
We
are now in the process of evaluating the impact of the
ATP. As of July 15, 2003, we have completed 2,000 home
visits, with an 80% retention rate, which makes the current
study one of the top five longitudinal studies on children
and families ever completed, given the assessments and
the randomized intervention trial.
To reach high-risk
parents (and maximize effectiveness), intervention services must be embedded within
the school context. Proactive engagement of families can increase engagement of
high-risk families in interventions shown to improve parenting and reduce problem
behavior during the middle school years. This engagement addresses a critical
transitional phase between ages 11 and 13 years, before large numbers of youth
disengage (drop out, are placed in alternative schools, and so forth) from the
public-school environment.
It is important
to add that our research has moved collectively toward a set of principles that
are critical to preventing and reducing problem behavior in early adolescence.
Of particular import is targeting parenting practices, especially among high-risk
youth. We also have discovered that creating “artificial” peer group
environments actually may lead to iatrogenic effects (increases in substance use,
delinquency, and violence, as well as adjustment difficulties in adulthood).
Until recently,
family-based interventions have been difficult to integrate within a prevention
model, primarily because of the expense of the service, but also due to the issue
of reaching families in need. We have found that integration of parent interventions
into typical parent–school communications, such as homework assignments, parent–teacher
conferences, and discipline contacts, is possible.
Dishion, T. J., Nelson, S. E., & Kavanagh, K. (2003). The Family Check-Up for high-risk adolescents: Motivating parenting monitoring and reducing problem behavior. In J. E. Lochman & R. Salekin (Eds.), Behavior oriented interventions for children with aggressive behavior and/or conduct problems [Special Issue]. Behavior Therapy, 34, 553–571.
Dishion,
T. J., & Kavanagh, K.
(2002). The Adolescent Transitions Program: A family-centered prevention
strategy for schools. In J. B. Reid, J. J. Snyder, & G. R. Patterson
(Eds.), Antisocial behavior in children and adolescents: A developmental
analysis
and the Oregon
model for intervention (pp. 257–272). Washington, DC: American Psychological
Association.
Dishion, T. J., Kavanagh, K., Schneiger, A., Nelson, S., & Kaufman, N. (2002).
Preventing early adolescent substance use: A family-centered strategy for the
public middle-school ecology. In R. L. Spoth, K. Kavanagh, & T. J. Dishion
(Eds.), Universal family-centered prevention strategies: Current findings and
critical issues for public health impact [Special Issue]. Prevention Science,
3, 191–201.
National Institute on Drug Abuse Red Book, Preventing Drug Use among Children and Adolescents: A Research-Based Guide for Parents, Educators, and Community Leaders (2nd ed.)