Model Program Descriptions
The selection criteria identified above establish a high standard, one that has proved difficult for most programs to meet, thus explaining why there are only 11 Blueprints programs. This high standard reflects the level of confidence necessary, however, for recommending that communities replicate these programs with reasonable assurances that they will prevent violence. The programs, which are described below in a developmental sequence, have been identified as Blueprints because they have met this standard and have been proven effective in reducing adolescent violent crime, aggression, delinquency, and/or substance abuse. As time goes on and new research findings are published, CSPV hopes to add other credible, effective programs that communities can use confidently.
Prenatal and Infancy Home Visitation by Nurses
The most serious and chronic offenders often show signs of antisocial behavior as early as the preschool years (American Psychiatric Association, 1994). Three risk factors associated with early development of antisocial behavior can be modified: adverse maternal health-related behaviors during pregnancy, child abuse and neglect, and troubled maternal life course.
Prenatal and Infancy Home Visitation by Nurses sends nurses to the homes of low-income, first-time mothers to improve their health, parenting skills, and chances of giving birth to children free of health and developmental problems. Nurses begin visiting first-time mothers during pregnancy and continue the visits until the child is 2 years old. During home visits, nurses promote the physical, cognitive, and social-emotional development of the children and provide general support and instruction in parenting skills to the parents. The following components are fundamental to the program’s effectiveness:
- Trained and experienced nurses who have strong interpersonal skills and a maximum caseload of 25 families make the home visits.
- Families are visited every 1 to 2 weeks.
- Nurses focus simultaneously on the mother’s personal health and development, environmental health, and quality of caregiving.
Visiting nurses help young parents gain the confidence and skills necessary to set and achieve goals such as completing their education, finding work, and avoiding unplanned pregnancies (Olds et al., 1997).
Nurse home visitation has had positive
outcomes on obstetrical health, psychosocial
functioning, and other health-related
behaviors. One study found that
women who smoked 10 or more cigarettes
per day during pregnancy when they
entered the nurse home visitation program
reduced their smoking by approximately
3 cigarettes per day and improved
their diets. On followup, the children of
these women showed no intellectual
impairments, whereas the children of
mothers who smoked 10 or more cigarettes
per day during pregnancy and did
not receive nurse home visits did have
impaired intellectual functioning (Olds,
Henderson, and Tatelbaum, 1994a, 1994b).
The program also has helped reduce rates of child abuse and neglect by helping young parents learn effective parenting skills and deal with a range of issues such as depression, anger, impulsiveness, and substance abuse. One study found that participation in the program was associated with a 79-percent reduction in State-verified cases of child abuse and neglect among mothers who were poor and unmarried (Olds et al., 1997). In their second year of life, nurse-visited children had 56 percent fewer visits to emergency rooms for injuries and ingestions than children who were not visited (Olds et al., 1986).
During the first 15 years after delivery of their first child, low-income, unmarried women who received nurse home visits had 31 percent fewer subsequent births, longer intervals between births (an average of 2 years), fewer months on welfare (60 versus 90 months), 44 percent fewer behavioral problems, 69 percent fewer arrests, and 81 percent fewer criminal convictions than those in the control group.
Adolescents whose mothers received nurse home visits more than a decade earlier were 60 percent less likely to have run away, 55 percent less likely to have been arrested, and 80 percent less likely to have been convicted of a crime than adolescents whose mothers did not receive visits (Olds et al., 1998). They also smoked fewer cigarettes per day, had consumed less alcohol in the past 6 months, and exhibited fewer behavioral problems related to alcohol and drug use.
When the program focuses on low-income women, program costs are recovered by the time the first child reaches age 4 (Olds et al., 1993). The RAND Corporation estimated that once the child reaches age 15, cost savings are four times the original investment because of reductions in crime, welfare expenditures, and healthcare costs and as a result of taxes paid by working parents (Karoly et al., 1998).
Contact Information
Matthew Buhr-Vogl, Site Development
Specialist
National Center for Children, Families,
and Communities
1825 Marion Street
Denver, CO 80218
303–864–5839
303–864–5236 (fax)
buhr-vogl.matthew@tchden.org
The Incredible Years Series
Aggression in young children is escalating—and at younger ages (Campbell, 1990). Young aggressive children may have already established a pattern of social difficulty in preschool that continues and becomes fairly stable by middle school. Many children with conduct problems (defined as high rates of aggression, defiance, and oppositional and impulsive behaviors) have been asked to leave four or five schools by age 6, and by the time they enter middle school, their negative reputation and their rejection by peers and parents may be well-established (Coie, 1990). Early intervention is key in reducing aggressive behavior and a negative reputation before they develop into permanent patterns.
The Incredible Years Parent, Teacher, and Child Training Series is a comprehensive set of curriculums—parent training, teacher training, and child training—designed to promote social competence and prevent, reduce, and treat conduct problems in young children. Program targets are children ages 2 to 8 who exhibit or are at risk for conduct problems. Trained facilitators use interactive presentations, videotape modeling, and roleplaying techniques to encourage group discussion, problem solving, and sharing of ideas.
The parent training component comprises three series: BASIC, ADVANCE, and SCHOOL. BASIC is the core element of program delivery; the other two series in the parent training component—and the teacher and child training components discussed below—are recommended elements of program delivery. BASIC teaches parents interactive play and reinforcement skills, nonviolent discipline techniques, logical and natural consequences, and problem-solving strategies. ADVANCE addresses family risk factors such as depression, marital discord, poor coping skills, poor anger management, and lack of support. SCHOOL focuses on ways to further youth’s academic and social competence.
The teacher training component focuses on strengthening teachers’ classroom management skills. It seeks to help teachers encourage and motivate students, promote students’ prosocial behavior and cooperation with peers and teachers, teach anger management and problem-solving skills, and reduce classroom aggression.
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The child training component, known as the Dina Dinosaur curriculum, emphasizes skills related to developing emotional literacy, having empathy with others or taking their perspective, making and keeping friends, managing anger, solving interpersonal problems, following school rules, and succeeding at school. It is designed for use as a “pull out” treatment program for small groups of children who exhibit conduct problems.
In six randomized trials, the parent training component of The Incredible Years Series has been shown to reduce conduct problems and improve parenting interactions; these improvements have been sustained up to 3 years after the intervention (Webster-Stratton, 1990). The cycle of aggression appears to have been halted for approximately two-thirds of families whose children have conduct disorders and who have been treated in clinics. In two randomized trials, the teacher training component has been shown to improve children’s behavior in the classroom (improvements include less hyperactivity, antisocial behavior, and aggression and more social and academic competence) and teachers’ classroom management skills (Webster-Stratton, Reid, and Hammond, 2000). The child training component resulted in significantly improved social skills and positive conflict management strategies with peers, in addition to reduced child behavior problems at home and school (Webster-Stratton and Hammond, 1997).
Several hundred service agencies in the United States, Canada, the United Kingdom, Norway, and Australia have adopted at least one of the three series in the Incredible Years parent training component. Funding to purchase the programs may be obtained from local PTA (Parent Teacher Association) groups or from charitable organizations. Once the initial costs of the materials and group leader training have been assumed, these programs can be offered at minimal cost.
Contact Information
Carolyn Webster-Stratton
1411 Eighth Avenue West
Seattle, WA 98119
206–285–7565 (phone and fax)
888–506–3562 (toll-free phone and fax)
incredibleyears@seanet.com
www.incredibleyears.com
Promoting Alternative THinking Strategies
The need for universal, school-based curriculums promoting social and emotional competence and decreasing risk factors associated with maladjustment prompted the creation of Promoting Alternative THinking Strategies (PATHS). The program, a school-based intervention, is taught by teachers of students in kindergarten through fifth grade as part of the regular curriculum. PATHS, which is designed to be taught 3 times per week for at least 20 minutes per session, includes lessons in self-control, emotional understanding, self-esteem, relationships, and interpersonal problem-solving skills. Focusing on these protective factors provides youth with tools that enable them to achieve better academically in elementary school. In addition, PATHS helps enhance classroom atmosphere and the learning process.
Lessons are sequenced according to increasing developmental difficulty and include activities such as dialoguing, role-playing, storytelling, modeling by teachers and peers, and social and self-reinforcement. Among other lessons, youth are taught to identify and label their feelings; express, understand, and regulate their emotions; understand the difference between feelings and behaviors; control impulses; and read and interpret social cues. Youth are given activities and strategies to use inside and outside the classroom, and parents receive program materials to reinforce behaviors at home.
Studies have compared classrooms receiving the intervention with matched controls using populations of normally adjusted students, behaviorally at-risk students, and deaf students. Compared with the control groups, youth in the PATHS program have done significantly better in recognizing and understanding emotions, understanding social problems, developing effective alternative solutions, and decreasing frequency of aggressive/violent solutions. Teachers reported significant improvements in children’s self-control, emotional understanding, ability to tolerate frustration, and use of conflict resolution strategies. Among special needs youth, teachers reported decreases in internalized symptoms (sadness, anxiety, and withdrawal) and externalized symptoms (aggressive and disruptive behavior).
Contact Information
Mark T. Greenburg, Ph.D.
Prevention Research Center for the
Promotion of Human Development
Pennsylvania State University
110 Henderson Building South
University Park, PA 16802–6504
814–863–0112
814–865–2530 (fax)
prevention@psu.edu
www.prevention.psu.edu
Bullying Prevention Program
The Bullying Prevention Program was developed, refined, and systematically evaluated in Bergen, Norway, after three young Norwegian boys committed suicide as a consequence of severe bullying by peers. The original project, which took place from 1983 to 1985, involved 2,500 youth in 42 schools throughout the city. According to more than 150,000 Norwegian and Swedish students ages 7–16 who completed a bully/victim questionnaire, 15 percent had been involved in bully/victim problems. Of these, 5 percent had been frequent targets of bullies or had bullied frequently (once a week or more). In a recent U.S. study, 23 percent of more than 6,000 middle school students in rural South Carolina reported that they had been bullied several times or more during the past 3 months; 20 percent claimed they had bullied others with the same frequency (Melton et al., 1998). Because bullying is such a prevalent problem, the Program has been replicated throughout Norway and in other countries, including the United States.
Bullying causes its victims humiliation,
unhappiness, and confusion. Many tend
to lose their self-esteem and become anxious
and insecure; often their concentration
and learning suffer and they may fear
and refuse to go to school. Many who suffer
persistent bullying as youth feel the
impact of that experience into adulthood
(Olweus, 1993b). Moreover, bullies often
begin acting out in other ways, such as
vandalizing property, shoplifting, skipping
school, and using drugs. School bullies
also are at increased risk for committing
crime in adulthood: 60 percent of males
who were bullies in grades 6–9 were convicted
of at least one crime as adults,
compared with 23 percent of males who
did not bully; and 35 to 40 percent of
these former bullies had three or more
convictions by age 24, compared with 10
percent of those who did not bully
(Olweus, 1993a).
The Program’s major goal is to reduce bullying among elementary, middle, and junior high school children by reducing opportunities and rewards for bullying behavior. School staff are largely responsible for introducing and carrying out the Program, and their efforts are directed toward improving peer relations and making the school a safe and pleasant environment. Bullying Prevention increases awareness of and knowledge about the problem, actively involves teachers and parents, develops clear rules against bullying behavior, and provides support and protection for bullying victims. Core components of the Program are at three levels:
- School. School personnel disseminate an anonymous student questionnaire to assess the nature and prevalence of bullying, discuss the problem, plan for program implementation, form a school committee to coordinate program delivery, and develop a system of supervising students during breaks.
- Classroom. Teachers and/or other school personnel introduce and enforce classroom rules against bullying, hold regular classroom meetings with students, and meet with parents to encourage their participation.
- Individual. Staff hold interventions with bullies, victims, and their parents to ensure that the bullying stops.
The use of school, classroom, and individual interventions ensures that students are exposed to a consistent, strong message from different people in different contexts regarding the school’s views of and attitudes toward bullying.
In Bergen, Norway, the frequency of bullying problems decreased by 50 percent or more in the 2 years following the original project. These results applied to both boys and girls and to students across all grades studied. In addition, school climate improved and the rate of antisocial behavior in general such as theft, vandalism, and truancy dropped during the 2-year period. In the South Carolina replication site, the Program slowed the rate of increase in youth’s engagement in antisocial behavior. In addition, students reported that they bullied other students less after 7 months in the Program (a 25-percent reduction in the rate of bullying).
Contact Information
Dan Olweus, Ph.D.
University of Bergen
Research Center for Health Promotion
Christies gt. 13, N–5015
Bergen, Norway
47–55–58–23–27
47–55–58–84–22 (fax)
olweus@psych.uib.no
Susan Limber, Ph.D.
Institute on Family and Neighborhood Life
Clemson University
158 Poole Agricultural Center
Clemson, SC 29634
864–656–6320
864–656–6281 (fax)
slimber@clemson.edu
Big Brothers Big Sisters of America
Big Brothers Big Sisters of America (BBBSA) began in the early 20th century as a means to reach youth who were in need of socialization, firm guidance, and connection with positive adult role models. BBBSA, with a network of more than 500 local programs throughout the Nation, continues to operate as the largest and best known mentoring organization in the United States, maintaining more than 100,000 one-to-one relationships between youth and volunteer adults.
Volunteer mentors are screened and
trained, and matches are made carefully
using established procedures and criteria.
Individual BBBSA agencies adhere to
national guidelines but customize their
programs to fit local circumstances. The
program serves youth ages 6 to 18, a significant
number of whom are from disadvantaged
single-parent households. A
mentor meets with his or her youth partner
at least three times a month for 3 to
5 hours, participating in activities that
enhance communication skills, develop
relationship skills, and support positive
decisionmaking. Such activities are determined
by the interests of the child and
the volunteer and could include taking
walks, attending school activities or
sporting events, playing catch, visiting
the library, or just sharing thoughts and
ideas about life.
Sites may run into two obstacles when setting up a mentoring program in their communities: the limited number of adults available to serve as mentors and the scarcity of organizational resources necessary to carry out a successful program. Although BBBSA maintains more than 100,000 matches between volunteers and youth, estimates reveal that between 5 and 15 million children could benefit from a mentoring program (Grossman and Garry, 1997). An 18-month study of eight BBBSA affiliates found that when compared with a control group on a waiting list for a match, youth in the mentoring program were 46 percent less likely to start using drugs, 27 percent less likely to start drinking, and 32 percent less likely to hit someone. Mentored youth skipped half as many days of school as control youth, had better attitudes toward and performance in school, and had improved peer and family relationships.
Contact Information
Big Brothers Big Sisters of America
230 North 13th Street
Philadelphia, PA 19107
215–567–7000
215–567–0394 (fax)
www.bbbsa.org
Life Skills Training
The most common approaches to substance abuse prevention for the past two decades have involved either the presentation of information concerning the dangers of drug use or the use of classroom discussion and classroom activities designed to enrich youth’s personal and social development. These approaches do not address the risk factors for substance abuse among youth and therefore are largely ineffective. Life Skills Training (LST), however, is based on an understanding of the causes of tobacco, alcohol, and drug use and has been designed to target the psychosocial factors associated with the onset of drug involvement.
LST, a drug prevention program focusing on tobacco, alcohol, and marijuana, targets the psychosocial factors associated with the onset of drug involvement by providing drug-related resistance skills training and general life skills training to middle school students beginning in sixth or seventh grade. The 3-year curriculum includes 15 sessions taught in the first year of the program by regular classroom teachers with booster sessions provided in years 2 and 3. The three basic components of the program teach youth (1) personal self-management skills (e.g., decisionmaking and problem solving, self-control skills for coping with anxiety, and self-improvement skills), (2) social skills (e.g. communication and general social skills), and (3) information and skills designed to have an impact on youth’s knowledge and attitudes concerning drug use, normative expectations, and skills for resisting drug use influences from the media and peers.
LST has been found to cut alcohol, tobacco, and marijuana use among young adolescents by 50 to 75 percent. Long-term results of the program reveal a 66-percent reduction in polydrug use (use of tobacco, alcohol, and marijuana), a 25-percent reduction in pack-a-day smoking, and a decrease in the use of inhalants, narcotics, and hallucinogens. Long-term followup data reveal that reductions can last through 12th grade.
Contact Information
Gilbert Botvin, Ph.D., President
National Health Promotion Associates, Inc.
141 South Central Avenue, Suite 208
Hartsdale, NY 10530
914–421–2525
914–683–6998 (fax)
www.lifeskillstraining.com
Midwestern Prevention Project
Many researchers, policymakers, and drug prevention program planners have begun to question whether single-channel programs (i.e., those implemented entirely within one setting) are effective in promoting significant and lasting changes in youth’s drug use behavior. To ensure that its drug prevention message is heard throughout the community in many settings, the Midwestern Prevention Project (MPP), also known as Project STAR, integrates a school-based program with parent, community, mass media, and local policy components.
MPP’s goals are to decrease the rates of onset and prevalence of gateway (tobacco, alcohol, and marijuana) and other drug use in youth ages 10–15 and, secondarily, to decrease drug use among parents and other community residents. To achieve these goals, MPP targets the person-, situation-, and environment-level factors believed to be responsible for higher levels of drug use, including prior use, low level of resistance skills, perceived norms for use, peer pressure to use, lack of social support for nonuse, and school and community norms.
The program consists of five components: school program, parent education campaign, mass media, community organization and training, and local policy change. The school program teaches active social learning techniques (e.g., modeling, role-playing, discussion) and assigns homework designed to involve family members. The parent education campaign involves parent-child communication training and a parent-principal committee that meets to review the school drug policy. The other three components deliver a consistent message to the community supporting drug-free living. Collectively, the components focus on promoting youth’s drug use resistance and counteraction skills (direct skills training), parents’ and other adults’ prevention practices and support of adolescent prevention practices (indirect skills training), and the community’s dissemination and support of social norms and expectations against drug use (environmental support).
MPP has been shown to reduce marijuana use and daily cigarette smoking by approximately 40 percent among program participants, with smaller reductions in alcohol use. These reductions were maintained through age 12. Reductions in daily smoking, heavy use of marijuana, and use of some hard drugs have been shown through early adulthood (age 23). MPP also has helped decrease parental alcohol and marijuana use and increase positive parent-child discussion about drug use prevention.
Contact Information
Mary Ann Pentz, Ph.D.
U.S.C. Norris Comprehensive Cancer Center
University of Southern California
1441 Eastlake Avenue, MC9175
Los Angeles, CA 90089–9175
323–865–0327
323–865–0134 (fax)
pentz@hsc.usc.edu
Functional Family Therapy
Many communities turn to punitive measures to deal with juvenile crime. Mounting evidence suggests, however, that removing youth from their homes and families is costly and ineffective. Punitive programs that separate youth and their families can be detrimental to a youth’s long-term progress. Youth’s behavioral problems are deeply embedded in their psychosocial systems (e.g., family and community); to be effective, therefore, interventions should treat youth while addressing their complex multidimensional problems.
Functional Family Therapy (FFT) is a short-term, well-documented program that has been applied successfully to a wide range of problem youth and their families in various contexts (e.g., rural, urban, multicultural, international) and treatment systems (e.g., clinics, home-based programs, juvenile courts, independent providers). Researchers designed this multisystemic program to help diverse populations of underserved and at-risk youth and their families who often enter the system angry, hopeless, and/or resistant to treatment.
On average, participating youth attend 12 1-hour sessions spread over 3 months; more difficult cases require 26 to 30 hours of direct service. FFT clearly identifies three treatment phases, each of which includes descriptions of goals, requisite therapist characteristics, and techniques:
- Phase 1: Engagement and motivation. Phase 1 applies reattribution and related techniques to address maladaptive perceptions, beliefs, and emotions.6 Use of such techniques serves to help targeted youth and their families increase hope and their expectations of change, respect for individual differences and values, and trust between family and therapist; reduce resistance; and overcome the intense negativity within the family and between the family and community that can prevent change.
- Phase 2: Behavior change. FFT clinicians develop and implement intermediate and long-term behavior change plans that are culturally appropriate, context sensitive, and tailored to the unique characteristics of each family member.
- Phase 3: Generalization. FFT clinicians help families apply positive family change to other problem areas and/or situations, maintain changes, and prevent relapse. To ensure long-term support of changes, FFT links families with available community resources.
Success has been demonstrated and replicated for more than 25 years with a wide range of interventionists, including paraprofessionals and trainees representing the various professional degrees. Controlled comparison studies with followup periods of 1, 3, and 5 years have demonstrated significant and long-term reductions in youth reoffending and in sibling entry into high-risk behaviors. Comparative cost figures demonstrate very large reductions in daily program costs compared with other treatment programs.
In the Nation’s largest FFT research and practice site, 80 percent of the families receiving FFT services completed the treatment, a high completion rate compared with the rate for standard interventions. Of those who completed the program, 19.8 percent committed an offense in the year following completion, compared with 36 percent of youth in the control group.
On average, FFT treatment in this practice site cost between $700 and $1,000 per family for a 2-year study period. By contrast, the average cost of detention was at least $6,000 per youth, and the average cost of a county residential program was at least $13,500 per youth for the same time period.
Contact Information
James F. Alexander, Ph.D.
Department of Psychology
University of Utah
390 South 1530 East, Room 502
Salt Lake City, UT 84112
801–585–1807
jfafft@psych.utah.edu
www.fftinc.com
Multisystemic Therapy
Multisystemic Therapy (MST) was developed to provide scientifically validated, cost-effective, community-based treatment to youth with serious behavior disorders who are at high risk of out-of-home placement. Before MST, such treatment was generally unavailable, and youth often were placed out-of-home in expensive treatment or psychiatric facilities or were incarcerated. MST views individuals as living within a complex social network encompassing individual, family, and extrafamilial (peer, school, neighborhood) factors. Behavioral problems can stem from problematic interactions within the social network, and MST specifically targets the multiple factors that can contribute to antisocial behavior. MST uses the strengths in each youth’s social network to promote positive change in his or her behavior. The overriding purpose of MST is to help parents deal effectively with their youth’s behavioral problems; help youth cope with family, peer, school, and neighborhood problems; and reduce or eliminate the need for out-of-home placements. To empower families, MST also addresses identified barriers to effective parenting (e.g., parental drug abuse, parental mental health problems) and helps family members build an indigenous social support network involving friends, extended family, neighborhoods, and church members.
To increase family collaboration and enhance generalization, MST is typically provided in home, school, and community locations. Treatment is designed with input from the family being served, and this approach encourages collaboration and participation. Therapists with low caseloads—who are available 24 hours per day, 7 days per week—provide the treatment, placing developmentally appropriate demands for responsible behavior on youth and their families. Intervention plans include strategic family therapy, structural family therapy, behavioral parent training, and cognitive behavior therapies.
To address the known causes of delinquency, MST focuses on the individual youth and his or her family, peer context, school/vocational performance, and neighborhood/community supports. Family interventions seek to promote the parents’ capacity to monitor and discipline their children, peer interventions remove offenders from deviant peer groups and help them develop relationships with prosocial peers, and school/vocational interventions enhance the youth’s capacity for future employment and financial success. The average duration of treatment is approximately 4 months, which includes approximately 60 hours of face-to-face therapist-family contact.
Program evaluations have revealed 25- to 70-percent reductions in long-term rates of rearrest and 47- to 64-percent reductions in out-of-home placements. Moreover, families receiving MST reported extensive improvements in family functioning and decreases in youth’s mental health problems. Positive results were maintained after almost 4 years.
Despite its intensity, MST has been demonstrated as a cost-effective treatment for decreasing the antisocial behavior of violent and chronic juvenile offenders. According to Henggeler (1997), MST cost approximately $3,500 per youth in one replication site in South Carolina, which compared favorably with the average cost of the State’s institutional placement at approximately $18,000 per youth for a time period of about 59 weeks post referral.7
Contact Information
Keller Strother
MST Services, Inc.
268 West Coleman Boulevard, Suite 2–E
Mt. Pleasant, SC 29464
843–856–8226, ext. 14
843–856–8227 (fax)
ms@mstservices.com
www.mstservices.com
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Multidimensional Treatment Foster Care
Incarceration of youth is costly and may have negative long-term effects on the youth involved. Alternatives to incarceration typically involve placement in a group care setting. However, as association with delinquent peers has been shown to be a strong predictor of future aggressive and delinquent behaviors, placing youth in group care with other juvenile delinquents may facilitate further bonding and social identification among group members.
A viable and cost-effective alternative to group care, Multidimensional Treatment Foster Care (MTFC) recruits, trains, and supervises foster families to provide participating youth with close supervision, fair and consistent limits and consequences, and a supportive relationship with an adult. In MTFC, youth’s contact with delinquent peers is minimized. The youth are supervised closely at home, in the community, and at school and are disciplined for rule violations and mentored by their MTFC parents. MTFC parent training emphasizes behavior management methods to provide youth with a structured and therapeutic living environment.
After they complete a preservice training, MTFC parents are matched with participating youth. A case manager, with the help of the MTFC parents, develops an individualized daily program for each youth that specifies the youth’s schedule of activities and behavioral expectations and sets the number of points he or she can earn for satisfactory performance. The intervention is a gradual process based on youth’s compliance with each level of program treatment. Three levels of supervision are defined in MTFC: level 1 requires adult supervision at all times, level 2 grants youth limited free time in the community, and level 3 allows for some peer activities that require less structure.
Routine consultation with and ongoing supervision of MTFC parents is a cornerstone of the program; parents are called daily to check on youth’s progress and they also attend weekly group meetings. Family therapy is provided for the youth’s biological (or adoptive) families, who are taught to use the structured system being used in the MTFC home to increase the likelihood of parenting success when the youth returns home.
One of the most significant problems in implementing an MTFC program is recruiting and training a group of competent MTFC parents. Another implementation problem is developing effective methods of communication for treatment staff and MTFC parents. The quality of teamwork is crucial to the success of MTFC cases.
Evaluations of MTFC youth show they had significantly fewer arrests during a 12-month followup than a control group of youth who participated in residential group care programs (an average of 2.6 offenses versus 5.4 offenses). During the first 2 years after treatment and program completion, youth who participated in the MTFC program spent significantly fewer days in lockup than youth who were placed in other community-based programs, resulting in a savings of $122,000 for the program in incarceration costs. In addition, significantly fewer MTFC youth were ever incarcerated following treatment (Chamberlain, 1990). MTFC also has been shown to be effective for youth ages 9–18 leaving State mental hospital settings. Results showed that MTFC youth were placed out of the hospital at a significantly higher rate. During a 7-month followup, 33 percent of the control group remained in the hospital because no appropriate aftercare services could be found.
Contact Information
Patricia Chamberlain, Ph.D.
Oregon Social Learning Center
160 East Fourth Avenue
Eugene, OR 97401
541–485–2711
541–485–7087 (fax)
pattic@oslc.org
www.oslc.org
Quantum Opportunities Program
The Quantum Opportunities Program (QOP) was developed and implemented to benefit youth from families receiving public assistance. QOP provides participating youth with an intensive array of coordinated services and a sustained relationship with peers receiving similar services for the 4 years they are in high school.
QOP was designed to help youth overcome
their disadvantaged backgrounds
by compensating for their perceived and
real lack of opportunities, providing them
with a prosocial environment conducive
to success, enhancing their skills levels to
equip them for success, and reinforcing
their achievements and positive actions.
A QOP coordinator, who acts as surrogate
parent, role model, advisor, and disciplinarian,
provides services to a small group
(no more than 25) of high-risk youth just
entering the ninth grade. The group environment
helps youth bond with each
other and with a caring adult, and this
bonding appears to make the largest
difference in student motivation and success.
The program includes 250 hours
per year of (1) educational opportunities
(e.g., peer tutoring, computer-based
instruction) to enhance basic academic
skills, (2) development opportunities
(e.g., family planning, career and college
planning, cultural enrichment, personal
development), and (3) community service
opportunities (e.g., volunteering, working
at public events). Financial incentives are
offered to increase participation, completion,
and long-range planning.
Results from the pilot test of this program, which was held from 1989 through 1993, indicated that QOP participants, when compared with a control group, were less likely to be arrested during the juvenile years (19 versus 23 percent), more likely to have graduated from high school (63 versus 42 percent), more likely to be enrolled in higher education or training (42 versus 16 percent), more likely to attend a 4-year college (18 versus 5 percent), and less likely to become a teen parent (24 versus 38 percent). Six months after completing the program, 21 percent of QOP youth had taken part in a community project; 28 percent had volunteered as a tutor, counselor, or mentor; and 41 percent had volunteered at a nonprofit, charitable, school, or community group. In comparison, the percentages of control youth were 12, 8, and 11, respectively.
Contact Information
C. Benjamin Lattimore
Opportunities Industrialization Centers
of America, Inc.
1415 North Broad Street
Philadelphia, PA 19122
215–236–4500, ext. 251
215–236–7480 (fax)
oica@aol.com
www.oicworld.org
6 Reattribution, or reframing, assigns negative consequences to situational causes rather than to individual pathologies. 7 Revised estimates reveal that the cost for MST treatment was $4,000 plus an additional $4,000 for use of other community services, which still compares favorably with a revised estimate of $20,000 per youth in institutional placement (M.E. Swenson, MST Services, personal communication, March 27, 2001).
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