Gale Held

1. Intergenerational Substance Abuse & Resiliency SAMHSA Model Programs Gale Held Women Across the Life Span: A Conference on Women, Addiction and Recovery July 12, 2004

2. Child Welfare and Substance Abuse • Face many of the same issues and population • Need the cooperation of parents, substance abuse and mental health providers and the child welfare system • SAMHSA’s National Registry of Effective Programs identifies effective, evidence-based programs that can help both fields

3. Model Programs • Offer some resources to assist child welfare professionals in addressing some of the critical needs of their parent and child clients • Child welfare professionals can use them as part of their repertoire of healing and reconciliation for children and between children and parents

4. Model Programs Offer • Evidence-based opportunities for • Parents to learn how to be better parents • Children to work on mental health or behavioral issues • Children to learn strategies to improve their functioning with families and peers • Families to learn how to reunite and stay connected • Parents to maintain custody of their child/children.

5. Prevention Framework • Framework • Needs Assessment • Capacity Building • Program Selection • Implementation • Evaluation

6. SAMHSA’s Model Program National Dissemination System

7. 1 2 3 4 5 Effective or Model Promising Effective or Model Score: Promising Model SAMHSA National Registry of Effective Programs & Practices (NREPP) 1) Theory 2) Intervention Fidelity 3) Process Evaluation 4) Design 5) Method of assignment 6) Sample size 7) Attrition 8) Analyses of attrition 9) Methods to correct biases 10) Outcome Measures – substantive relevance 11) Outcome Measures –psychometric properties 12) Missing Data 13) Treatment of missing data 14) Outcome data collection 15) Analysis 16) Other threats to validity 17) Integrity 18) Utility

8. Program Designations • Scoring: Effective programs = 5.0 – 4.0 Promising programs = 3.99 – 3.33 Insufficient Current Support = 3.32 – 1.0 • Model Programs have received Effective scores and willing and able to go to scale. • Promising, Effective and Model programs listed: (modelprograms.samhsa.gov). • Model programs receive SAMHSA promotion

9. What Makes a Model Program

10. Programs Reviewed by NREP 1051 submitted 971 reviewed 50 Promising 46 Effective 57 Model

11. NREP Topics • Substance abuse • Mental health • Co-occurring disorders • Child welfare • Juvenile justice • Violence • Post traumatic stress • Adolescent substance abuse treatment • Workplace

12. What Kinds of Models are Being Disseminated? A selection of rigorously evaluated programs with strong outcomes for: • Prevention of alcohol and drug abuse, steroid abuse, school drop out, violence, and other high risk behaviors • Beginning to look at related conditions, e.g., PTSD, co-occurring disorders

13. What Kinds of Models are Being Disseminated? (contd.) • Diverse ethnic populations • Community, family, school, workplace, child welfare, juvenile justice and faith settings • Initially, youth aged 2 to 18 (being expanded to other life stages)

14. Child Welfare and Juvenile Justice Settings • Foster family care • Group homes • Homeless shelters and public housing • Juvenile court programs • Residential and alternative schools • Mental health and family clinics • Adolescent treatment centers

15. SAMHSA Model Programs

16. How are Model Programs Disseminated? • Awareness & Promotion • Capacity Building

17. Awareness and Promotion • Excellence Awards • Web site • Toll-free line • Printed materials • Direct promotion activities • National Partnerships

18. Model Programs Web Site

19. Awareness & Promotion: Model Programs Fact Sheets • Target Population • Proven Results, Outcomes • Benefits • How It Works • Targeted Protective & Risk Factors • Implementation Essentials: Training & Materials • Program Background • Evaluation Design • Program Developer • Contact Information

20. National Partners • Child Welfare League of America • National Association of State Alcohol and Drug Abuse Directors/National Prevention Network • National Council of Juvenile and Family Court Judges • National Center on Substance Abuse and Child Welfare • Others in substance abuse prevention and mental health fields, e.g., Community Anti-Drug Coalitions of America, National Mental Health Association, Phoenix House

21. Capacity Building • Support training and technical assistance by developers to States and communities • Interactive Program Implementation CD (IPIC) - under development • National, State and regional training events • Both implementation and training of trainers (TOT) events

22. Selecting Model Programs Program Selection Tools: • Overview Matrix (web) • Model Program Fact Sheets (web) • Search Web site Program Listings (web) • IPIC—Interactive Program Implementation CD

23. Parenting Wisely Creating Lasting Family Connections Positive Action Strengthening Families Second Step Residential Student Assistance Program Cognitive Behavioral Therapy for Child Sexual Abuse Families and Schools Together (FAST) Project ACHIEVE Trauma-Focused Cognitive Behavioral Therapy Life-Skills Training STARS for Families Strengthening Families: 10-14 Lions-Quest SFA Al’s Pals Model Programs to Consider (in order of most child welfare and juvenile justice settings)

24. Mental health programs for children • Therapeutic intervention and early intervention programs primarily delivered in therapeutic or mental health settings that focus specifically on mental health needs of individual children, caused by such events and needs as trauma, loss, grief, lack of minimally nurturing environment, children of alcoholics or substance abusing parents, child abuse and neglect, etc.

25. Mental health programs for children, continued • Cognitive Behavioral Therapy for Child Sexual Abuse • Residential Student Assistance Program • Trauma-Focused Cognitive Behavioral Therapy

26. School-based programs that build skills and provide support for children • Support and skill building programs primarily delivered in school settings that address comprehensive substance abuse prevention and early intervention, bullying and other types of violence, improving academic achievement outcomes, behavioral problems, etc.

27. School-based programs that build skills and provide support for children, continued • Al’s Pals • LifeSkills Training • Positive Action • Project ACHIEVE • Second Step

28. Comprehensive family and parent support programs • Programs delivered by a variety of community based organizations that provide support services to families with high risk children and youth, serving children and parents together or parents on behalf of their families and addressing issues of family management, parental skill building and training, substance abuse prevention, etc.

29. Comprehensive family and parent support programs, continued • Creating Lasting Family Connections • FAST (Families and Schools Together) • Lions-Quest Skills for Adolescence • Parenting Wisely • STARS for Families • Strengthening Families • Strengthening Families 10-14

30. Some Funding Strategies for Model Programs • CA counties applied for funds the State received from the DHHS Administration of Child Abuse and Neglect to prevent delinquency, and implemented Families and Schools Together (FAST) . • A community-based organization in MD provided substance abuse prevention services to at-risk children within the child welfare system through the local school system – funds were matched with the Lions Club Foundation to train staff in the model program, Lions Quest.

31. More Funding Strategies for Model Programs • The Alcohol Council in WI through its SAMHSA State Incentive Grant (SIG) subcontracted with a local hospital to train staff of the adolescent treatment center in Start Taking Alcohol Risks Seriously (STARS) for Families. • A public housing authority in Louisville, KY subcontracted with a local nonprofit which provided training in Creating Lasting Family Connectionsto residents and their families in a local Section 8 housing complex, through county drug elimination funds.

32. Risk Factors Model Programs Address • Individual • Anxiety and depression • Lack of Self-control • Aggressive or disruptive behavior • Family • Ineffective discipline • Family conflict • Child abuse and neglect • Parental and other family substance abuse

33. Risk Factors Models Programs Address, contd. • Peer • Association with aggressive youth • Pro-drug influences • School • Lack of parental support and involvement in school work • Tardiness, absence, truancy • Academic failure

34. Other National Dissemination System Activities: Core Components Analysis • Reviewed Model programs to isolate program elements related to program success, such as program content, community building, delivery, adaptation, parental involvement. • The CCA provides guidance on what elements you want to be cautious about changing if you want to adapt these programs.

35. Other National Dissemination System Activities: Prevention Performance Outcome Monitoring System (PPOMS): • Assess the national distribution of SAMHSA evidence-based programs, • Document barriers to and facilitators of evidence-based program implementations; • Identify the degree of fidelity to original program curricula and protocol

36. Where do we go from here? • Continue to identify new models relevant to child welfare agencies and programs and make them available to the child welfare community • Learn more about how model programs have been implemented in child welfare; clarify costs • Identify outcomes specific to child welfare • Increase the number of national partners, e.g., CWLA, NCJFCJ RESULT: Strengthening of the national infrastructure for child welfare and substance abuse

37. Questions For You!Accessing SAMHSA Model Programs • What are the top 5 services that children in your community need but are currently lacking? • What are the top 5 services that families in your community need but are currently lacking? • How is your organization currently accessing services needed for children and families, and what funding strategies are you using? • What, if any, ways is your organization accessing juvenile justice funding streams to serve your child welfare clients

38. More Questions for You!!! • What are your suggestions for how best to showcase relevant Model Programs to the child welfare community? • Do you have programs to submit? • Can you give us key contacts and programs that might be interested in working with us? • What are financing sources for implementing model programs in child welfare?

39. SAMHSA Model Programs • SAMHSA Model Programs Web address: http://modelprograms.samhsa.gov • SAMHSA Model Programs Toll-free line:1-877-773-8546

40. National Registry of Effective Programs • Send program submissions to: • Steven Schinke National Registry of Effective Programs Intersystems, 30 Wall Street, 4th Floor New York, NY 10005 Toll-free Phone: 866-43NREPP Toll-free Fax: 877-413-1150 Email: NREPP@intercom.com

41. Other Resources • CSAP’s Centers for the Application of Prevention Technologies (CAPT): www.captus.org • National Clearinghouse for Alcohol and Drug Information (NCADI): www.health.orgor 1-800-729-6686

42. SAMHSA Model Programs Contacts • Gale Held- 301-294-5741,gale.held@ngc.com • Ben Smith – 301-294-5714ben.smith@ngc.com Suite 400, 1700 Research Blvd. Rockville, MD 20850