1 gale held intergenerational substance abuse & resiliency samhsa model programs women across...

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Gale Held

Intergenerational Substance Abuse & Resiliency

SAMHSA Model Programs

Women Across the Life Span: A Conference on Women, Addiction and Recovery

July 12, 2004

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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

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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

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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.

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Prevention Framework

Framework Needs Assessment Capacity Building Program Selection Implementation Evaluation

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SAMHSA’s Model ProgramNational Dissemination System

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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

SAMHSA National Registry of Effective Programs & Practices (NREPP)

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2 3 4 51Score:

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Program Designations

Scoring:Effective programs = 5.0 – 4.0Promising programs = 3.99 – 3.33Insufficient 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

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What Makes a Model Program

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1051 submitted

971 reviewed

Programs Reviewed by NREP

50 Promising 46 Effective 57 Model

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• Substance abuse

• Mental health

• Co-occurring disorders

• Child welfare

• Juvenile justice

NREP Topics

•Violence

•Post traumatic stress

•Adolescent substance abuse treatment

•Workplace

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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

What Kinds of Models are Being Disseminated?

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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)

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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

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SAMHSA Model Programs

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How are Model Programs Disseminated?

Awareness & Promotion Capacity Building

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Awareness and Promotion

Excellence Awards Web site Toll-free line Printed materials Direct promotion activities National Partnerships

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Model Programs Web Site

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Target Population

Proven Results, Outcomes

Benefits

How It Works

Targeted Protective & Risk Factors

Awareness & Promotion: Awareness & Promotion: Model Programs Fact SheetsModel Programs Fact Sheets

Implementation Essentials: Training & Materials

Program Background

Evaluation Design

Program Developer

Contact Information

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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

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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

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Selecting Model ProgramsSelecting Model Programs

Program Selection Tools:

Overview Matrix (web) Model Program Fact Sheets (web) Search Web site Program Listings (web) IPIC—Interactive Program

Implementation CD

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Model Programs to Consider (in order of most child welfare and juvenile justice settings)

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

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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.

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Mental health programs for children, continued

Cognitive Behavioral Therapy for Child Sexual Abuse

Residential Student Assistance Program Trauma-Focused Cognitive Behavioral

Therapy

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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.

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School-based programs that build skills and provide support for children, continued

Al’s Pals LifeSkills Training Positive Action Project ACHIEVE Second Step

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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.

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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

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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.

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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 Connections to residents and their families in a local Section 8 housing complex, through county drug elimination funds.

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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

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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

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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.

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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

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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

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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

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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?

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SAMHSA Model Programs

SAMHSA Model Programs Web address: http://modelprograms.samhsa.gov

SAMHSA Model Programs Toll-free line: 1-877-773-8546

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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

National Registry of Effective Programs

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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.org or 1-800-729-6686

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SAMHSA Model Programs Contacts

Gale Held - 301-294-5741, gale.held@ngc.com

Ben Smith – 301-294-5714 ben.smith@ngc.com

Suite 400, 1700 Research Blvd.

Rockville, MD 20850