Parent Education

Parent education is a critical issue for the field of IFPS.

A uniform, nationwide approach to protecting children from abuse and neglect is less than 50 years old. This is helpful to keep in mind when discussing aspects of the child welfare system. The advent of a nationwide public agency system in the mid-1960’s for identification of child abuse and neglect brought with it the need for prevention and treatment.

Preventing and treating child abuse and neglect, or its re-occurrence, often focused on parenting skills, with the intent of remedying skill deficiencies. One of the earliest parenting programs, Parents Anonymous, provided support groups and taught new skills to parents. For decades, parenting classes have been the main intervention—not only offered but generally mandated by courts—for parents involved in child abuse and neglect.

A Child Welfare Information Gateway Issue Brief (2013) defines parent education:

Parent education can be defined as any training, program, or other intervention that helps parents acquire skills to improve their parenting of and communication with their children in order to reduce the risk of child maltreatment and/or reduce children’s disruptive behaviors. Parent education may be delivered individually or in a group in the home, classroom, or other setting; it may be face-to-face or online; and it may include direct instruction, discussion, videos, modeling, or other formats (California Evidence-Based Clearinghouse [CEBC], n.d. & Centers for Disease Control and Prevention [CDC], 2009).

How does the field of IFPS address parent education?

Not surprisingly, the most frequently listed need of parents referred for IFPS is parenting skills. In a multi-state study of IFPS, the NCFAS assessment tool (measures family functioning in the domains of environment, parental capabilities, family interactions, safety, and child well-being), indicated that 71% of parents had mild to serious problems in the domain of parental capabilities, significantly higher than for problems in other domains. Parental capabilities includes measures of supervision and discipline of children, parental use of drugs/alcohol, and parental support of children’s education. Over a third of the parents had moderate or serious problems in these areas.

The study found that IFPS services had the most impact on parental capabilities: at the end of interventions parents showed the highest positive gains on this domain.

What is the secret to achieving these gains?

The Child Welfare Information Gateway Brief lists, among others, the following characteristics for effective parent education programs:

Strength-based Focus
Family-centered Practice
Qualified Staff
Targeted Service Groups
Ecological Approach

That pretty well sums up the characteristics of strong IFPS programs!

The classic book on IFPS, Keeping Families Together, says that the key is to teach parents how all people, including their children, learn. This involves three ways to facilitate learning:

Direct instruction—presenting information
Modeling—showing how to do something
Contingency management—encouraging learning by rewarding desired behaviors and ignoring or (rarely) punishing behaviors that parents want to discourage

There are also specific curricula that are used in IFPS programs and other models of service. Parent education curricula are now evaluated for effectiveness and assigned ratings ranging from evidence-informed to evidence-based. Twelve curricula are listed in the Child Welfare Information Brief along with seven registries that have rated parent education programs. For details, visit:
https://www.childwelfare.gov/pubs/issue_briefs/parented/

Please share what your IFPS program has found to be effective for parent education.

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Posted by Priscilla Martens, Executive Director
National Family Preservation Network

The Top Priority in IFPS

The highest priority in IFPS is safety—safety for family members, safety for the IFPS therapist and safety for others in the environment.

The following case example shows how the IFPS therapist dealt with a high risk incident. Key elements of the IFPS therapist’s response included:

Critical thinking about risk/danger
De-escalation and contingency management
Feedback to the mother

The Situation

A 16-year-old male client (diagnosed with Pervasive Developmental Disorder) gave the therapist the finger and repeatedly gestured angrily towards her and then towards the door. When she did not immediately leave, the boy made threatening gestures with a plastic baseball bat and a push pin, threatened to “end” the therapist, called her a “whore,” tried to take her bag from her, threw an apple on the floor, threw paper napkins at her, and grabbed the chair that she was sitting on. He also grabbed his mother by the wrist to try to prevent her from re-hanging a corkboard he tore down.

Critical Thinking about Risk/Danger

The boy had a history of making threats when frustrated, but no history of ever harming anyone that the therapist knew of.

Because his threats occurred immediately after he gestured for the therapist to leave, she believed that leaving or retreating in response to his threats might reinforce this problematic behavior. This clinical assessment factored into her decision-making. She was able and prepared to leave if needed and she actively assessed for her own and the clients’ safety.

During the incident, she sat in a chair beside the door so that she could immediately leave if she felt a sincere threat. She made sure that the boy never stood between her and the door except when he removed the corkboard from the wall. Her cell phone was in her back pocket.

She assessed that the items the boy used to threaten the therapist (a hollow plastic baseball bat and a push pin) were unlikely to cause serious injury. She remained far enough away while he held the items that he could not easily make contact with them. He put down each of these items after holding them for a matter of seconds.

She noted that each time the boy came closer than a few feet from the therapist, he soon stepped back. She also noted that the boy’s gestures were increasingly less threatening. When the boy grabbed her chair and her bag she was forced to stand up, but later sat down again in an attempt to project calm control without force.

De-escalation and Contingency Management

The therapist remained calm throughout the incident and repeatedly reflected the boy’s anger. Her reflections and statements included:

She could see he was angry and he seemed to want her to know this.
It seemed he was trying to get the therapist to leave by making threats, but she didn’t really think he wanted to hurt anyone.
He didn’t seem to have the words to express himself when he was angry and this must be frustrating.
Making threats, even when it was successful in frightening people, seemed to be causing problems for him.
She hoped she could help him learn other ways to communicate and to manage his frustration.

When the boy grabbed his mother’s wrists to prevent her from re-hanging the corkboard, the therapist told him clearly that if she thought there was any chance he might hurt anyone, even accidentally, she would call the police, and he let go of his mother immediately.

The boy’s behaviors progressively de-escalated to gestures of anger that were not directed towards others (e.g., throwing an apple on the floor, throwing paper napkins on the floor). He calmed down after approximately 10-15 minutes. When he chose safer expressions of anger she told him she was glad he was making safer decisions.

When the boy’s mood seemed to change from anger to frustration to sadness, she reflected this. When he calmed down she noted how impressed she was that he was able to calm down. She told the boy that she hoped she could help him find new ways to express his anger.

She also told him that she was very glad that he spoke to her, even though he was angry and said some things she didn’t like. She told him she wouldn’t hold a grudge because she knew how hard it can be to be angry and not be able to say so, and that she hoped he would talk with her again.

Feedback to the Mother

The following day the therapist reviewed the incident with the boy’s mother. She explained that because his threats seemed to be intended to make the therapist leave, and because she did not think he would cause injury, she chose not to leave in this instance because she didn’t want him to learn that he could get what he wants by making threats.

While the boy wanted the therapist to go away, he wanted his mom with him. The therapist clarified that if the mom were to leave in response to his threats, this would not be a reward for him. She therefore encouraged the mom to leave promptly if he made threats towards her in the future, as this would both keep her safe and would provide a disincentive for making threats. She also encouraged her to call the police if she ever felt that anyone was in danger in the future.

She told the mom that they would complete a written safety plan the next time they met.

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Posted by Bethany Rice, IFPS Therapist, Institute for Family Development

Sex Trafficking Awareness

Lately, human trafficking seems to be increasing in many of our communities. On December 31, 2013, President Barack Obama declared January 2014 as National Slavery and Human Trafficking Prevention Month:

NOW, THEREFORE, I, BARACK OBAMA, President of the United States of America, by virtue of the authority vested in me by the Constitution and the laws of the United States, do hereby proclaim January 2014 as National Slavery and Human Trafficking Prevention Month, culminating in the annual celebration of National Freedom Day on February 1. I call upon businesses, national and community organizations, faith-based groups, families, and all Americans to recognize the vital role we can play in ending all forms of slavery and to observe this month with appropriate programs and activities.

As IFPS professionals we need to ask ourselves how much we really know about “human trafficking.”

According to the U.S. Department of Homeland Security, human trafficking is “a modern-day form of slavery involving the illegal trade of people for exploitation or commercial gain.” This includes using adults or children for sexual slavery and forced labor.

The Department of Homeland Security reports that “every year, millions of men, women, and children worldwide, including in the United States are victims of human trafficking. Victims are often lured with false promises of well-paying jobs or are manipulated by people they trust, but instead are forced or coerced into prostitution, domestic, servitude, farm or factory labor, other types of forced labor.”

It is critical that IFPS providers be aware of and alert to possible sex trafficking of the vulnerable children and families we serve. Truancy or dropping out of school, frequently running away, lack of basic needs, fear of seeking help, and restriction of freedom of movement are some of the indicators of potential sex trafficking of youth.

Last fall, a congressional committee addressed sex trafficking of youth in foster care (http://waysandmeans.house.gov/calendar/eventsingle.aspx?EventID=355668). Two witnesses were from Washington State.

Bobbe Bridge is a retired judge and Founding President/CEO of Center for Children and Youth Justice. Following is a portion of her testimony:

Washington State was relatively early among state governments to recognize that trafficking in persons, whether domestically or internationally, was an issue of statewide significance. The Task Force Against Trafficking of Persons was created by the legislature in 2002, and in 2003 Washington became the first state in the nation to prohibit trafficking in persons. The term “child prostitute” has been all but removed from our lexicon. Instead we refer to the children and youth who are the victims of sex trafficking as commercially sexually exploited youth (“CSEC”).

You can read Judge Bridge’s full testimony here: (PDF, 3.3 MB)
http://waysandmeans.house.gov/uploadedfiles/bobbe_bridge_testimony_hr102313.pdf

Another witness, Melinda Giovengo, the Executive Director of YouthCare in Seattle, Washington, established the connection between at-risk and foster-care youth and sex trafficking. According to Giovengo:

Studies indicate that between 55% and 90% of prostituted individuals report a history of child sexual and/or physical abuse.
Youth in foster care are disproportionately at risk for victimization through sex trafficking due to prior abuse and a lack of social/familial support. Furthermore, sex trafficking constitutes violence and abuse of vulnerable youth.
Youth in foster care are often victims of sex trafficking long before social workers, foster parents, or other providers are aware.
Youth who have run away, or are missing from care, are at significant risk for sex trafficking.

You can read Ms. Giovengo’s full testimony and recommendations here: (PDF, 188 KB)
http://waysandmeans.house.gov/uploadedfiles/melinda_giovengo_testimony_hr102313.pdf

“This month, I call on every nation, every community, and every individual to fight human trafficking wherever it exists. Let us declare as one that slavery has no place in our world, and let us finally restore to all people the most basic rights of freedom, dignity, and justice” (President Barack Obama, Presidential Proclamation, December 31, 2013).

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Posted by Moneefah D. Jackson and Peg Marckworth

Celebrating 40 Years of IFPS – Part 2

In this post we look at the target populations with which IFPS has been found to be effective and an assessment tool for use with IFPS.

IFPS is Effective with High-Risk Families

Dr. Ray Kirk from the University of North Carolina-Chapel Hill conducted a retrospective study (NC DSS, 2001) of more than 1,200 children who had received IFPS services in North Carolina and compared them with over 110,000 children who had not received these services.

IFPS outperformed traditional child welfare services in every case by reducing the number of placements or delaying placements. IFPS interventions improved family functioning and were most effective with the highest risk families.

IFPS Reduces Disproportionality

In this study, high-risk minority children receiving traditional services were at higher risk of placement than white children, but minority children receiving IFPS were less likely to be placed than white children.

Note: a future blog post will provide details of this study.

IFPS is Effective with Older Youth

A study showed that IFPS services resulted in a 92% placement prevention rate for older youth (ages 12-17) in comparison to an 88% placement prevention rate for younger children (ages 0-11). For more details of this study, visit:
http://ifpscoasttocoast.wordpress.com/2013/10/23/ifps-is-effective-with-older-youth/

IFPS is Effective with Juvenile Offenders

HOMEBUILDERS® received funding from the U.S. Administration for Children, Youth and Families to provide services to youth and families referred from the Pierce County Juvenile Court.

Twelve months after intake, 73% of youth served were not placed in out-of home care. Data from the overflow comparison group showed that only 28% of the comparison youth avoided placement. For the full report, visit:
http://ifpscoasttocoast.wordpress.com/2013/11/13/ifps-with-juvenile-justice/

IFPS is Effective with Children with Mental Health Challenges

HOMEBUILDERS® was originally developed to prevent the psychiatric hospitalization of severely behaviorally disturbed children. From January 2009 through April 2013 the program served 3014 children at risk of placement, 383 of whom were reported to have serious mental health symptoms.

In the entire population, 97.5% of children successfully avoided placement at termination of services. Ninety-six percent of the 383 youth with serious mental health issues avoided out of home placement at termination of services. For additional studies involving IFPS and mental health visit:
http://ifpscoasttocoast.wordpress.com/category/mental-health/

IFPS is Effective with Adoptive Families

Dr. Marianne Berry and NFPN conducted a study on the use of IFPS with post-adoptive families in Missouri. 83% of the adoptive families studied were preserved by the end of IFPS. At a six-month follow-up point, 76% remained intact. No families contacted at the six or 12-month follow-up checks had legally disrupted. To view the complete report, visit:
http://nfpn.org/articles/ifps-with-post-adoptive-families

IFPS is Effective with Reunifying Families

The earliest study of the use of IFPS with reunifying families was conducted in Utah in 1995.

The IFPS intervention lasted 90 days and children were returned to the families within 15 days of referral. Following IFPS services, 92% of the children were at home vs. 28% of the control group. For additional information, view the IFPS ToolKit (chapters 10 and 11) here:
http://www.nfpn.org/preservation/ifps-toolkit

Assessment Tool Created for Use with IFPS

Development of the North Carolina Family Assessment Scale (NCFAS) for use with IFPS services provided an opportunity to measure a family’s progress following an IFPS intervention. The family’s progress is also closely tied to successfully remaining intact. Here’s a chart with typical pre/post ratings from research on use of the NCFAS with IFPS families (the percentages refer to the families that are at baseline or above, meaning that no intervention is required in that domain):

The NCFAS tools continue to demonstrate strong reliability and validity with IFPS programs. For a more detailed report, visit:
http://www.nfpn.org/assessment-tools/ncfases-scale-development-report

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Posted by Charlotte Booth, Executive Director, Institute for Family Development
and Priscilla Martens, Executive Director, National Family Preservation Network

Celebrating 40 Years of IFPS

Did you know that the term “family preservation” did not exist 40 years ago?

We’ve come a long way in the past 40 years! From no use of the term “family preservation” before 1974 to over 37 million Google listings for “family preservation” in 2014.

IFPS got off to a strong start, was boosted with a strong dose of private foundation and federal government support, experienced a rough patch for a period of time, and is now growing and stronger than ever.

Come along for the journey for the next 40 years!

Birth of IFPS

In 1974 the HOMEBUILDERS® program, a model of Intensive Family Preservation Services (IFPS), began in Washington State. Its goal—strengthen families and prevent unnecessary out-of-home placement.

The federal government provided impetus for nationwide replication of IFPS through the Adoption Assistance and Child Welfare Act of 1980. This act required states to provide reasonable efforts to prevent or eliminate the removal of children from their homes or make it possible for them to return home. Family preservation services were listed as an essential component of satisfying the reasonable efforts requirement.

Foundation and Federal Funding for IFPS

The private sector stepped up to provide key funding for IFPS.

In 1986 the Edna McConnell Clark Foundation awarded $3.3 million for development of model programs, training/technical assistance, and capacity building.
In 1992, the Clark Foundation funded 7 existing organizations to promote IFPS.
Both the Clark Foundation and the Annie E. Casey Foundation provided funding to establish a new organization, the National Family Preservation Network (NFPN). NFPN is the only national organization whose mission is to serve as the primary national voice for the preservation of families.

By 1993 IFPS programs existed in 35 states with 12 states passing specific family preservation legislation. That was also the year that federal funding first became directly available for IFPS through the Family Preservation and Support Act, later changed to the Promoting Safe and Stable Families Program (PSSF).

The program was expanded to include funding for reunification and adoption services as well as family preservation and prevention. About one-fourth of the annual federal funding goes to family preservation.

Title IV-E Waivers

In 1994, Congress passed Public Law 103–432, which established Section 1130 of the Social Security Act (SSA) and gave the Secretary of the Department of Health and Human Services (HHS) the authority to approve state demonstration projects, now referred to as IV-E waivers.

Conceived as a strategy for generating new knowledge about innovative and effective child welfare practices, waivers give states flexibility in the use of federal funds for alternative supports and services that promote safety, permanency, and well-being for children in the child protection and foster care systems.

Waivers allow funding and programs to prevent foster care, including authorization for IFPS as well as reinvestment of public funds that are saved through prevention of costly out-of-home placement. Congress is currently authorizing up to 10 new waiver projects annually.

Fidelity Validates IFPS

In 2001 a federal study indicated that IFPS was not effective in preventing out-of-home placements of children. Subsequent studies addressed methodological problems in the federal study. A breakthrough came in 2006 with a study conducted by the Washington State Institute for Public Policy (WSIPP). WSIPP did a meta-analysis of 14 IFPS evaluations based on fidelity to the Homebuilders® model of IFPS. The results from the combined 14 studies showed no significant effect on out-of-home placements.

But the programs with demonstrated fidelity to the Homebuilders® model reduced out-of-home placement by 31%. In addition, the high-fidelity programs produced $2.54 of benefits for each dollar of cost.

IFPS is Effective With a Variety of Families

A study conducted by NFPN found that the positive results of IFPS are not diminished when working with families of color, families involved with substance abuse, or families referred for neglect.

In the next post we’ll take a closer look at the target populations with which IFPS has been found to be effective.

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Posted by Charlotte Booth, Executive Director, Institute for Family Development
and Priscilla Martens, Executive Director, National Family Preservation Network

New Year’s Quiz Winner

In our New Year’s post we posed the question, “In what state did IFPS originate?”

The correct answer is, Washington State.

We offered the choice of one of two prizes to the first person to leave a comment with the correct answer.

PRIZE #1 — 15-minute consultation with an IFPS expert, Charlotte Booth

Charlotte Booth, Institute for Family Development

Prize #2 — A copy of Keeping Families Together, the classic book on IFPS

And our prize winner is . . .

David Gillock

Congratulations, David! To claim your prize, please check your e-mail for a message from us or contact director@nfpn.org.

Thank you for participating in our first blog quiz!

New Year’s Quiz

Happy New Year from the IFPS Coast-to-Coast Blog. We’re excited to have you along on our journey in 2014!

Through our survey at the end of last year, we heard about topics you are interested in and ones that don’t appeal to you. We’ve learned that practice tips are always a popular topic, so we will continue to make that a major focus. We will also include posts on research in the field, views of IFPS from an international perspective, and profiles of IFPS programs in states across the country.

Let’s kick off the New Year with a quick quiz about IFPS:

In what state did IFPS originate?
How many states have strong IFPS programs?
Do IFPS programs include reunification services to preserve families?
What is the average number of face-to-face hours that a therapist spends with families during an IFPS intervention?
What is the average success rate of families remaining together at case closure in strong IFPS states?
What is the average percentage of older youth (ages 12–17) served by strong IFPS programs?
What is the hallmark of all strong, effective IFPS programs?

You can find the answers to these questions, except for question #1, in the IFPS Nationwide Survey available here:
http://nfpn.org/preservation/ifps-nationwide-survey

The first person to post a comment with the correct answer to QUESTION #1 will win a 15-minute consultation with an IFPS expert or the classic book on IFPS, Keeping Families Together. Winner chooses the prize and the consolation prize goes to second place. Sorry, those who live or work in the state where IFPS originated do not qualify.

Our goal with the IFPS Coast-to-Coast blog is to provide a nationwide forum for exchanging knowledge and expertise about IFPS. We want to extend our reach in 2014. Here’s how you can help:

Send this post to your colleagues through their preferred social media.
Ask colleagues to join the IFPS blog family. Tell them that the easiest way to receive new posts is through e-mail. Sign up by clicking the “Follow” button in the right-hand sidebar.
Commit to posting a comment at least once in 2014. Comments help keep the blog interesting, interactive, and insightful.

Remember, a new post comes out every Wednesday. And, don’t forget to submit your answer to the quiz now!

Happy New Year!

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Posted by Peg Marckworth

2013 Wrap-up and Survey

The IFPS Coast-to-Coast Blog launched on April 10, 2013, with a new post issued every Wednesday. We’re so glad that you have joined us on this blog journey as we all strive to make a positive impact in the lives of the families that we serve.

A blog is an ideal way to share both content and comments about IFPS, and the blog links to other social media as well. We have followers via e-mail, Facebook, and Twitter. And we have a pool of authors! Ten contributing authors wrote posts this year and we extend our hearty thanks to all of them.

Our authors have produced three dozen posts in 13 categories. You can quickly find topics by scrolling down the right-hand side of the blog home page until you see “Categories.” After selecting a topic and viewing the most recent post, you can view other posts on that topic by selecting “Older Posts.”

The purpose of the IFPS blog is to increase visibility and knowledge of IFPS, share expertise, and expand the reach of IFPS. While we feel that we made a good start in 2013, we want to do even better in 2014. Here’s where you can help:

Please take our 2-question survey right now to provide feedback on what you liked about the blog this year and what you would like to see next year.

Here is the link to the survey:
https://www.surveymonkey.com/s/FGTTFCN

Thank you for your participation, inquiries, and comments the past year.

We will be taking a break over the holidays and will resume with new posts on January 8. In the meantime, Happy Holidays, Merry Christmas, and Happy New Year!

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Posted by Peg Marckworth

IFPS and Medicaid

In some states, IFPS services are paid through Medicaid. Arizona is one of these states. Arizona has a Medicaid waiver that allows for a wide range of services delivered through our behavioral health system.

Medicaid reimburses the state for IFPS services on a shared cost basis with federal dollars covering most of the cost and the state the balance. Children in foster care automatically qualify for Medicaid. In-home services are covered by Medicaid if the family meets income eligibility requirements.

Medicaid will only pay for specific services so an IFPS intervention is broken down and coded into those services. Typically these services include:

Individual Therapy
Family Therapy—with or without child
Family Support
Respite
Case Management
Living Skills
Health Promotion

IFPS providers in Arizona are licensed through behavioral health services. The licensing standards are extensive and the list can be viewed here:
http://www.azdhs.gov/bhs/provider/provider_main.htm

You can see how Medicaid reimburses for IFPS in the following chart which lists the coding number, the description of services, unit of cost, and amount for typical IFPS services:

H2017	Psychosocial rehabilitation living skills training services, per 15 minutes	$23.30
H2025	Ongoing support to maintain employment, per 15 minutes	$9.13
H2027	Psychoeducational service (pre-job training and development), per 15 minutes	$13.08
S5110	Home care training, family (family support), per 15 minutes	$23.30
S5150	Unskilled respite care, not hospice, per 15 minutes	$7.49
S5151	Unskilled respite care, not hospice, per diem	$211.45
T1016	Office case management by behavioral health professional, each 15 minutes	$25.00
T1016	Out of office case management by behavioral health professional, each 15 minutes	$33.74
T1016	Office case management, by BHT, each 15 minutes	$17.50
T1016	Out of office case management, by BHT, each 15 minutes	$23.87
T1019	Personal care service, each 15 minutes	$5.80
H0004	Office, individual behavioral health counseling and therapy, per 15 minutes	$25.00
H0004	Home, individual behavioral health counseling and therapy, per 15 minutes	$33.74
H0004	Group behavioral health counseling and therapy, per 15 minutes	$7.58
H0004	Office, family behavioral health counseling and therapy with client present, per 15 minutes	$25.50
H0004	Out of office, family behavioral health counseling and therapy with client present	$36.85
H0004	Office, family behavioral health counseling and therapy without client present, per 15 minutes	$25.50
H0004	Out of office, family behavioral health counseling and therapy, without client present, per 15 minutes	$36.85
H0025	Behavioral health prevention/promotion education service	$14.00
H0031	Mental health assessment, by non-physician	$140.00
H2011	Crisis intervention service, per 15 minutes	$32.18
H2014	Skills training and development, per 15 minutes	$23.30
H2014	Group skills training and development, per 15 minutes per person	$11.60

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Posted by Anne Cornell, Clinical Consultant, Arizona.
If you have questions or need more information, please contact Anne at mustbinsun@aol.com.

10 Steps to a Successful Intervention Plan

The previous post focused on creating goals and objectives with families. In this post, we discuss how to create an effective intervention plan. These ten steps provide a framework you can use to help your client families reach their goals and objectives.

1. Start on a positive note.

Families in crisis are often overwhelmed by things not going well. They may not know how to make changes and may not believe it’s even possible. You can set the stage for success by explaining that change is possible. Share with families that you will be helping them discover why things aren’t working and learn new skills to make things better.

2. Consider each family member’s learning style (i.e., visual, auditory, kinesthetic).

People learn in different ways. What works for one person may not work for another. It is important to ask each person how they think they learn best; observe them in teaching situations; and offer different ways for them to access material.

3. Identify the skill you are going to teach and define small steps to master the skill.

People learn best in small, easily understandable steps. When people succeed with the first step they are more likely to take the next step—and the ones after that. What is a small step for one person may be an overwhelming step for another, so gather information about the person’s abilities before you start and evaluate as you go. Don’t be afraid to make the steps smaller in order to get success.

4. Discuss and explain the importance of using the skill.

Most people, including children, want to know why they need to do things differently. We all want to know “what’s in it for me.” Discuss with family members how changing a behavior or using a new skill will benefit them.

5. Describe and show the steps of using the skill.

Show people the path you want them to take and link it back to how it will benefit them and their family. The “Four Stages of Competence” model can be a useful way to help them understand how people learn new skills.

Use the “show—tell—do” model. Show the skill, explain it in small steps, and then have the person try it with you coaching and giving feedback. This process will help the person understand and gain confidence to try it on their own.

6. Rehearse the skill with the families and provide assignments.

Few people are one-trial learners. We all need to practice. Look for ways to make practice fun—during and between meetings with you. Give homework assignments that are manageable and reinforcing. Offer rewards for simply doing the homework.

7. Practice skills with families until they accomplish their goals.

Once is probably not enough. Five or ten or 50 times may be needed. Practicing with families can give them the confidence to continue on their own.

8. Evaluate as you go.

Make sure you ask for, and observe, each family member’s understanding about the skill being taught to them. Do this at each step in the process. Stop as needed to review and reteach. Break the skill into smaller or different steps as needed. Offer other ways to learn and practice the skills. Make sure you are doing everything you can to make the experience rewarding.

9. Provide effective feedback about progress toward the goal.

Explaining: “We’ve come this far and we have this far to go.” may not seem necessary. It is. Helping people see their progress can be motivating. We’re asking families to make big changes in their behavior and in their lives. It can seem overwhelming. When we put things in perspective we help people move forward toward their goals.

10. Always provide encouragement, praise and reinforcement to families.

Rewards work for all of us. Encouragement, praise and reinforcement are an integral part of a successful behavior change plan. Be sure you provide reinforcement that has meaning to each person. What is rewarding for one person may not be for another. Talk about this in advance with families. A disinterested kid may be more willing to try if they get to do more of the thing they love as a reward. Rewards don’t have to be prizes. Listening, encouraging, even a high-five can make a difference in how a person feels about the hard work they’re doing. We have a huge role in providing that reinforcement.

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Posted by Moneefah D. Jackson