1 division mental health and addictions alcohol and drug abuse prevention services (adaps) frances...

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Division Mental Health and AddictionsAlcohol and Drug Abuse Prevention

Services (ADAPS)

Frances B. Phillips, R.N., M. H. A.Health Officer

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ORCC Demographics

An estimated 6,000 a year

Arrive at ORCC from JRDC

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• 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

More ORCC Numbers…

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Charge Summary

40%

20%

12%

9%

6%

6%

2%

1% 1% 1%2% Property Crimes

Drug ChargesAssault/1 or 2DWI/DUIDWS/RViolentSex CrimesGun CrimesNon-SupportCHABMisc.

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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).

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Alcohol Drug Abuse Prevention Services (ADAPS)

Mission

• To promote public health by reducing substance abuse and violence among residents of Anne Arundel County.

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ADAPS Programs

• Presentations, Trainings, and Exhibits

• Combating Underage Drinking

• Community Grants

• Strengthening Families Program

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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.

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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

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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

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Parenting Is Prevention

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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.

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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

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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

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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

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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

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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

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How do we neutralize risk factors?

How do we give kids what they need for success?

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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)

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No Substance

Use

Family Supervision

Family and Peer

Norms

Family Bonding

Academic Self-Efficacy

Self-Control

Social and Community Prevention

Environment

SFP Expected to Strengthen Major Protective Factors for Drug Use

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Family Responsibilities

• Physical necessities

• Emotional support

• Learning opportunities

• Moral guidance

• Building skills and resilience

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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

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Family Protective Processes

• Parent/child attachment

• Parental monitoring and discipline

• Consistent, predictable parenting

• Parents’ communication of values and expectations not to use drugs

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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

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Seven Resilience Factors

1. Happy and Optimistic

2. Caring and Empathetic

3. Wise and Insightful

4. Intelligent and Competent

5. High Self-esteem

6. Direction, Mission and Purpose in Life

7. Determination and Perseverance

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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

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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

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SFP MAJOR OBJECTIVES

• Improve Family Relations

• Increase Parenting Skills

• Increase Children’s Skills

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SFP Evaluation and Outcomes

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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

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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

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SFP Results: Parent

• Increased parenting efficacy

• Increased parenting skills

• Increased marital communication

• Decreased stress

• Decreased depression

• Decreased alcohol and drug use

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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

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Evaluation Report

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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

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Multicultural SFP Replications

• African-American, rural and urban

• Hispanic - Spanish language translation

• Pacific Islander version

• Canadian version

• Australian version

• Native American Tribes

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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

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SFP Logistics and Mechanics

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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

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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

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SFP Typical Class Session

FAMILY STYLE MEAL

CHILD PARENT

GROUP GROUP

Childcare

2 FAMILY GROUPSTransportation

1 Hour Simultaneously+

1Hour

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Staffing

• Site Coordinator

• 4 Group Leaders: 2 for Parents’ Group, 2 for Children’s Group

• Babysitter/Child Care Provider

• Adolescent Tutor/Mentor

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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

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Site Coordinator: A Key Role• Course arrangements:

– Books, class materials, open-up, set-up– Meals– Transportation– Babysitting

• Communication with families and leaders• Coordinates recruitment• Supports and supervises Group Leaders

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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

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“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

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Successful Program Implementation

• Effective and well-trained staff• Sufficient resources

– incentives– child care transportation – transportation– food

• Interactive/Experiential techniques• Booster sessions

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Make the Program Fun!!!!!

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Questions or Comments?

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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