Division Mental Health and Addictions Alcohol and Drug Abuse Prevention Services (ADAPS)

1. Division Mental Health and Addictions Alcohol and Drug Abuse Prevention Services (ADAPS) Frances B. Phillips, R.N., M. H. A. Health Officer

2. ORCC Demographics An estimated 6,000 a year Arrive at ORCC from JRDC

3. More ORCC Numbers… • ADP: 91 Females, 317 Males • The avg. age: 33 for males & females and 66% reside in AA County • ORCC Women: 63% white/47% black • ORCC Males: 56% white/42% black

4. Charge Summary

5. What is Prevention? • Creation of conditions, opportunities and experiences which encourage and develop healthy people (MAPPA). • Prevention aims to forestall behaviors or render it impossible rather than taking corrective action later (MAPPA).

6. Alcohol Drug Abuse Prevention Services (ADAPS) Mission • To promote public health by reducing substance abuse and violence among residents of Anne Arundel County.

7. ADAPS Programs • Presentations, Trainings, and Exhibits • Combating Underage Drinking • Community Grants • Strengthening Families Program

8. Strengthening Families Program • Center for Substance Abuse and Prevention (CSAP) model program. • Builds family relationships and improves parenting and life skills. • Targets families with a member in treatment and/or incarcerated.

9. Strengthening Families Program • 1st research-based family program designed specifically for substance abusing parents and their children • Developed on NIDA grant, 1982-1988 • Developed for elementary school-aged children, ages 6-11 • Adapted for junior high school, ages 10-14 • Selective prevention for at-risk groups of children but successful as universal prevention

10. Workshop Objectives • Present and explain all necessary components for logistics and SFP implementation • Provide an overview and understanding of the three SFP curricula and their integration

11. Parenting Is Prevention

12. Critical Role of Families • Effective parenting is the Anti-Drug. • Parenting is the most important component in prevention programs. • A root cause of substance abuse is dysfunctional family relationships. • Parents teach values and habits by their actions and by their words.

13. Biological Family Risk Factors • Genetically Inherited Risks • Personality Disorders • Hyperactivity or Rapid Tempo • Rapid Brain Waves • Decreased Verbal IQ (Prefrontal Cognitive Dysfunction) • Lead Poisoning during Childhood • Fetal Alcohol and Drug Syndrome • Co-occurring Mental Illness

14. Family Environment Risks • Family conflict • Lack of love, care, & support • Pre-occupation with distractions such as television • Meals not eaten together, irregular work hours and shift work • Lack of supervision or discipline • Lack of family rituals • Low expectations for school success • Lack of communication

15. Family Environment Risks • Family conflict • Lack of love, care, & support • Pre-occupation with distractions such as television • Meals not eaten together, irregular work hours and shift work • Lack of supervision or discipline • Lack of family rituals • Low expectations for school success • Lack of communication

16. Family Environment Risks (continued) • Sexual or physical abuse • Stress due to medical, legal or economic problems • Grieving loss due to death, divorce and family break-ups

17. Child Risk Factors • Deficits in skills valued by self and others • Low Self-Esteem and Behavior Problems • Low Academic Motivation • Rejection of anti-drug educational messages • Psychological Disturbances • Lack of Peer Refusal Skills • Rejection of Pro-Social Values & Religion • Experimentation with Tobacco and other Risky Behaviors

18. How do we neutralize risk factors?How do we give kids what they need for success?

19. Parents’ Influence = Peers • National Longitudinal Adolescent Health Survey (Resnick, et al., 1998) • Kumpfer & Turner (1990/1991)’s Social Ecology Model (1990/1991) • CSAP’s High Risk Youth Pathway Models (CSAP, 1999) • Models for Substance Abuse, Delinquency, Teen Pregnancy, and School Failure (Ary, et al., 1999)

20. Self-Control Academic Self-Efficacy Social and Community Prevention Environment SFP Expected to Strengthen Major Protective Factors for Drug Use Family Bonding Family and Peer Norms Family Supervision No Substance Use

21. Family Responsibilities • Physical necessities • Emotional support • Learning opportunities • Moral guidance • Building skills and resilience

22. Why it makes sense to work with Families • Children succeed when the family works well • Communities benefit when families work well • When children succeed, family pride goes up and stress goes down

23. Family Protective Processes • Parent/child attachment • Parental monitoring and discipline • Consistent, predictable parenting • Parents’ communication of values and expectations not to use drugs

24. SFP Focuses on Building Resiliency • Why does one child in a family or one family in a community do well despite adversity? • Resilient youth • do well despite family and personal problems or set-backs • learn from failures and bounce-back • are capable of positive change after life stressors

25. Seven Resilience Factors • Happy and Optimistic • Caring and Empathetic • Wise and Insightful • Intelligent and Competent • High Self-esteem • Direction, Mission and Purpose in Life • Determination and Perseverance

26. SFP Teaches Resiliency Skills • Social skills: speaking and listening • Planning & organizing: family meetings • Problem solving • Peer resistance • Restoring self-esteem • Identifying feelings, taking criticism • Emotional management, coping with anger • Finding inner strength

27. SFP Enhances Resiliency Factors • Stresses importance of one caring adult • Increases opportunities to help others • Increases social skills for home & away • Increases self-discipline • Increases communication of family expectations about drugs & alcohol • Stresses parents should help children with critical life decisions

28. SFP MAJOR OBJECTIVES • Improve Family Relations • Increase Parenting Skills • Increase Children’s Skills

29. SFP Evaluation and Outcomes

30. Strengthening Families Program • NIDA (1982-1986) research and 15 SFP replications found positive results in: • Improved parenting knowledge & skills • Improved family relationships • Improved children’s social skills and behavior

31. SFP Outcomes • Parent Training: increased parenting skills and decreased children’s conduct disorders and decreased family conflict • Children’s Skills Training: Increased children’s social skills • Family Skills Training: Increased family cohesion and organization • Reduced parent and child alcohol/drug use

32. SFP Results: Parent • Increased parenting efficacy • Increased parenting skills • Increased marital communication • Decreased stress • Decreased depression • Decreased alcohol and drug use

33. SFP Results: Child • Decreased depression • Decreased conduct disorders • Decreased aggression • Increased cooperation • Increased number of pro-social friends • Increased social competencies • Increased school grades • Decreased tobacco, alcohol or drug use

34. Evaluation Report

35. Strengthening Families Program: An Evidence-based Practice • NIDA Red Book • OJJDP Strengthening America’s Families • CSAP Model Program • CMHS Model Program • ONDCP Model Program • National Mental Health Association National Partner

36. Multicultural SFP Replications • African-American, rural and urban • Hispanic - Spanish language translation • Pacific Islander version • Canadian version • Australian version • Native American Tribes

37. SFP Fiscal Year 2003/2004 Activities • Since May 2003, SFP model program initiative has served 30 families. • 90 participants • Currently enrolled: 10 families, including 31 participants

38. SFP Logistics and Mechanics

39. SFP in Practice • SFP: 3 Life Skills Courses for Parents, Children, & Family Skills • All three are taught together, typically over 14 weeks • Courses can be “unbundled,” but are most effective when taught together

40. A Typical Weekly Session • Dinner - families sit together, with other families & Group Leaders • 1st Class Hour: Parents’ Group and Children’s Group • 2nd Class Hour: families rejoin & divide into two Family Groups • Babysitting: for children under 6

41. SFP Typical Class Session FAMILY STYLE MEAL CHILD PARENT GROUP GROUP Childcare 2 FAMILY GROUPS Transportation 1 Hour Simultaneously + 1Hour

42. Staffing • Site Coordinator • 4 Group Leaders: 2 for Parents’ Group, 2 for Children’s Group • Babysitter/Child Care Provider • Adolescent Tutor/Mentor

43. Top Qualifications for Leaders • Sincere desire to help families learn SFP • Interpersonal skills: one-to-one & group • Understanding why and how SFP works • Balance teams to include men & women, ethnicities

44. Site Coordinator: A Key Role • Course arrangements: • Books, class materials, open-up, set-up • Meals • Transportation • Babysitting • Communication withfamilies and leaders • Coordinates recruitment • Supports and supervises Group Leaders

45. Site: Safe, Welcoming, Accessible • 3 rooms minimum: • 1 large room for meals, babysitting • 2 smaller rooms for Parents’ & Children’s Groups and then Family Groups • Agency site or community partner: church, housing authority • Size: Large enough for 6-12 families

46. “Extras” -- that aren’t • Meals: remove an obstacle and provide an incentive to attend • Transportation: know what you can do to get families there • Babysitting: for children under 6 • Small rewards for attending and home practice • A BIG graduation: ceremony & party

47. Successful Program Implementation • Effective and well-trained staff • Sufficient resources • incentives • child care transportation • transportation • food • Interactive/Experiential techniques • Booster sessions

48. Make the Program Fun!!!!!

49. Questions or Comments?

50. For more information or to request a presentation or exhibit: Contact: Virgil Boysaw, Jr. or Anissa Walker Alcohol and Drug Abuse Prevention Services (ADAPS) 407 S.Crain Highway, Suite B Glen Burnie, MD 21061 (410) 222-6724 hdvboysa@aacounty.org