Saturday, May 21, 2016

Generalist Practice: Proposal for Change

Current Services and Clientele

The Karlis Family Center’s purpose is to “provide a safe environment for children to spend time with their non-residential parent(s), keeping the safety of the child and victim parent as the highest priority” (Parenting time program, n.d.) Karlis strives to fulfill this purpose by providing the following services:

* Supervised parenting time: Staff members supervise nonresidential parents as they visit with their children, intervening if the parents pose a threat to their children’s emotional or physical safety.

* Therapeutic supervised parenting time: Licensed therapists, in addition to providing supervised parenting time, intervene “to help develop parenting skills” and foster “communication between child and parent” (Karlis internal document, September 1, 2014).

* Safe exchanges: Staff members receive children from one parent and watch them until the second parent picks them up

* Parenting class: A staff member teaches a four-hour class that some divorcing parents take to meet a county requirement (Domestic relations case management order, n.d.).

Most of the parents Karlis serves are going through high-conflict divorces or separations. Many, perhaps most, of the mothers at Karlis have been victims of domestic violence. Research has shown that children who grow up in such conditions are at risk of developing numerous internalizing and externalizing problems.

Unmet Needs

Divorce, of course, does not affect all children equally, with some adjusting better than others. Generally speaking, the key is the amount of divorce-related risk factors a child faces. A child is less likely to adjust well when the divorce is accompanied by one or more of the following factors: less contact between the child and nonresidential parent, continuing interparental conflict, ineffective parenting by the residential parent, hindered psychological functioning of the residential parent, and diminished family income (Amato, 2010, pp. 656-657).

The Karlis Center already strives to mitigate some of these risk factors. The supervised parenting time program gives nonresidential parents an opportunity that they might not otherwise have to visit their children. The supervised parenting time program also allows children to visit their nonresidential parents without being exposed to interparental conflict, and the safe exchange program allows children to be transferred from one parent to the other without being exposed to conflict.

Another way that Karlis could mitigate these risk factors would be to help residential parents become more effective parents. Sigal, Sandler, Wolchik, and Braver (2011) note that “considerable research” has shown that effective parenting by the residential mother—that is, parenting characterized by “personal warmth, effective discipline and active involvement in the child’s life”—“is associated with better post-divorce child adjustment outcomes and mitigates the negative effects of post-divorce stressors.” (p. 124).

Karlis already offers a four-hour parenting class that many parents take to fulfill a county requirement, but it is unlikely that this class is going very far towards improving parenting skills. This conclusion is based on evaluations of similar court-mandated classes, evaluations which suggest that such classes might play a part in reducing interparental conflict, at least temporarily, but that they do not alter other parenting behaviors. Brandon (2008) posits that these classes do not achieve greater results because they are too short and are not accompanied by other interventions, e.g., ongoing support groups (p. 182).

The New Beginnings Program

The New Beginnings Program is an empirically-based parent education program for residential mothers. Along with teaching effective parenting methods, the program emphasizes the importance of limiting interparental conflict and encouraging contact between children and their nonresidential fathers.

The program “consists of ten 1.75-hour, weekly group sessions and two 1-hour individual sessions. Each group is led by two masters’ level counselors and is composed of 8 to 10 [residential] mothers” (Wolchik, Sandler, Weiss, and Winslow, 2007, p. 30). Sessions are largely structured around DVDs, each containing 25-30 slides “which provide didactic material or serve as prompts for the leader to conduct an activity. Each DVD also includes two to five short (2–3 minute) video segments, which involve demonstrations of program skills or testimonials by previous NBP participants” (Wolchik et al., 2009, p. 426).

The individual sessions occur after the third and sixth sessions. In the first individual session, “leaders review and troubleshoot the skills taught so far in the program” (Wolchik et al., 2007, p. 37). The second individual session focuses on the child-father relationship and any “[o]bstacles to visitation” (Wolchik et al., 2007, p. 41).

Considerable research has been conducted on the program, and the results are impressive. Tein, Sandler, MacKinnon, and Wolchik (2004) interviewed participants six months after the initial program ended and found that it had improved “mother-child relationship quality” and “parental methods of discipline,” which had consequently reduced the internalizing and externalizing problems of participants’ children (pp. 622-623). Zhou, Sandler, Milsap, Wolchik, and Dawson-McClure (2008) interviewed participants six years after the program ended and found that it had improved “maternal effective discipline,” which in turn had improved the grades of participants’ children; these authors further found that the program had improved “mother-child relationship quality,” which in turn had mitigated the mental health problems of participants’ children (p. 579). Wolchik et al. (2002) interviewed participants six years after the program ended and found that, for higher risk children, the program “led to lower levels of externalizing problems” and “significantly less alcohol, marijuana, and other drug use” (p. 1880).

Implementing New Beginnings

There are two main obstacles to implementing the New Beginnings Program at Karlis. First, the program is not inexpensive. Assuming a group of ten participants, group materials would be only $720, but, to implement the program as intended by its creators, group leaders would need to attend a 30-hour training in Arizona and receive ongoing supervision, which would cost an additional $9,000 (New Beginnings Program, n.d.). And this price does not include the cost of traveling to Arizona nor the cost of paying group leaders, who would work a combined 60 hours for each ten-week class.

One might be tempted to forgo the 30-hour training and supervision, but one of the program’s creators, Sharlene Wolchik (personal communication, January 30, 2015), believes that, “for the program to be effectively implemented,” the training and supervision are necessary. If the Karlis Center has any questions for the agencies that have implemented the program, Wolchik (personal communication, January 30, 2015) will facilitate communication

A second obstacle to implementing the New Beginnings Program is that it is generally difficult to attract and retain participants in such parent education groups. One problem, as Brandon (2008) writes, is that “divorced parents often function as single parents” and therefore do not “have easy access to child care or the means to pay for such care in order to attend a parenting class” (p. 182). If Karlis provided childcare, this would likely increase attendance (Jensen, 2010, p. 240), but this would place yet another financial burden on the agency.

I have not yet given my proposal to my supervisor, but I plan to do so soon.


References

Amato, P.R. (2010). Research on divorce: Continuing trends and new developments. Journal of Marriage and Family, 72(3), 650-666.

Brandon, D.J. (2008). Can four hours make a difference? Evaluation of a parent education program for divorcing parents. Journal of Divorce & Remarriage, 45(1-2), 171-185.

Domestic relations case management order. (n.d.) Retrieved January 22, 2015, from http://www.coloradodivorcemediation.com/tools/Colorado-Divorce-Case-Orders/Jefferson-County-CMO.pdf

Faircloth, W.B., & Cummings, E.M. (2008). Evaluating a parent education program for preventing the negative effects of marital conflict. Journal of Applied Developmental Psychology, 29(2), 141-156.

Flory, B.E., Dunn, J., Berg-Weger, M., & Milstead, M. (2001). An exploratory study of supervised access and custody exchange services: The parental experience. Family Court Review, 39(4), 469-482.

Jensen, S.A. (2010). Increases in parent attendance to behavioral parenting training due to concurrent child treatment groups. Child & Youth Care Forum, 39(4), 239-251.

Legal advocacy program. (n.d.). Retrieved November 9, 2014, from http://www.thefamilytree.org/en/domestic-violence-services/234

New Beginnings Program. (n.d.). Retrieved January, from http://www.nrepp.samhsa.gov/ViewIntervention.aspx?id=27

Parenting time program. (n.d.). Retrieved from http://www.thefamilytree.org/en/domestic-violence-services/105

Perkins, D.F., & Ansay, S.J. (1998). The effectiveness of a visitation program in fostering visits with noncustodial parents. Family Relations 47(3), 253-258.

Schramm, D.G., & Calix, S. (2011). Focus on Kids: Evaluation of a research-based divorce education program. Journal of Divorce & Remarriage, 52(7), 529-549.

Sigal, A., Sandler, I., Wolchik, S., & Braver, S. (2011). Do parenting education programs promote healthy postdivorce parenting? Critical distinctions and a review of the evidence. Family Court Review, 49(1), 120-139.

Tein, J.Y., Sandler, I.N., MacKinnon, D.P., & Wolchik, S.A. (2004). How did it work? Who did it work for? Mediation in the context of a moderated prevention effect for children of divorce. Journal of Consulting and Clinical Psychology, 72(4), 617-624.

Wolchik, S.A., Sandler, I.N., Jones, S., Gonzales, N., Doyle, K., Winslow, E.,…Braver, S.L. (2009). The New Beginnings Program for divorcing and separating families: Moving from efficacy to effectiveness. Family Court Review, 47(3), 416-435.

Wolchik, S.A., Sandler, I.N., Millsap, R.E., Plummer, B.A., Greene, S.M., Anderson, E.R., …Haine, R.A. (2002). Six-year follow-up of preventive interventions for children of divorce: A randomized control trial. The Journal of the American Medical Association, 288(15), 1874-1888.

Wolchik, S. A., Sandler, I., Weiss, L., & Winslow, E. B. (2007). New Beginnings: An empirically-based program to help divorced mothers promote resilience in their children. In J. M. Briesmeister & C. E.Schaefer (Eds.), Handbook of parent training: Helping parents prevent and solve problem behaviors (pp. 25–62). New York: Wiley.

Zarling, A.L., Taber-Thomas, S., Murray, A., Knutson, J.F., Lawrence, E., Valles, N.,…Bank, L. (2013). Internalizing and externalizing symptoms in young children exposed to intimate partner violence: Examining intervention processes. Journal of Family Psychology, 27(6), 945-955.

Zhou, Q., Sandler, I.N., Milsap, R.E., Wolchik, S.A., & Dawson-McClure, S.R. (2008). Mother-child relationship quality and effective discipline as mediators of the 6-year effects of the New Beginnings Program for children from divorced families. Journal of Consulting and Clinical Psychology, 76(4), 579-594.

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