Table 1: Comparison Celebrating Families!™
& NIDA Prevention Principles
Principle 1 - enhance protective factors and reverse or reduce risk factors.
Principle 2 - address all forms of drug abuse
Principle 3 - address the type of drug abuse problem in the local community
Principle 4 - be tailored to address risks specific to population.
Principle 5 - should enhance family bonding and relationships and include parenting skills; practice... and training in drug education and information (Ashery et al. 1998).
Principle 6 - can be designed to intervene as early as infancy.
Principle 7 - for elementary school children should target improving academic and social-emotional learning.
Principle 8 - Prevention programs for middle or junior and high school students should increase academic and social competence with the following skills
Celebrating Families!™ has been shown by outside evaluation to increase protective factors and decrease risk factors.
All age groups (except 0-3) learn about: alcohol, tobacco and drug use (illegal and prescription) their impact on physical, mental, social and spiritual aspects of individuals’ lives, risks of early use, binge drinking by pre-teens, use during pregnancy, progression of the disease, brain chemistry, warning signs, intervention & recovery; impact of addiction on family.
CF! encourages sites to adapt the curriculum. The curriculum includes a session specifically on Risk and Protective Factors.
CF! was developed specifically for families affected by or at high risk for addiction. It includes safety planning, relapse and impact on children, and in- utereo exposure. See Principle 1.
CF! strengthens attachment and stable, nurturing homes, including family meals and activities; enhances: parental/caregiver involvement in child’s life; social/emotional competency; identification of safe people, recognition part of something larger than themselves. CF! reinforces parent/caregiver and child learning: each age-group learns the same topic with a related Family Activity, providing everyone with similar terminology and skills to discuss and learn from each other. Parent/Caregiver sessions address: positive discipline, nurturing parenting; family rules, age-appropriate, consistent limits & consequences, monitoring and supervision, and praise/encouragement.
CF! serves families with children birth to 17. The 0-3 component specifically addresses early risk factors by: strengthening attachment; decreasing parental stress; increasing children’s sense of empowerment and self-regulation; enriching environment; and. increasing child and parent physical health.
Children’s groups teach skills of self-control: centering; anger management; using reducers and staying out of fights; social/emotional competency: communication, identification and appropriate expression of feelings; problem- solving, decision making, Saying NO to others, recognizing and establishing boundaries; academic support: helping participants become aware of learning styles and strategies; identification of the characteristics of a safe person. Application to Parenting activities strengthen families which in turn strengthens school performance. Parent/caregiver groups teach skills of: reading and talking to children; setting age-appropriate limits; helping children safely express feelings; advocating in the school; and communication.
Pre-adolescents’/adolescents’ groups teach: learning styles and strategies; social/emotional competency; healthy Relationships; self-efficacy and assertiveness; drug resistance skills; and strengthening of personal commitments. Parent/caregiver groups teach skills of: communicating with children; setting age-appropriate limits; helping children safely express feelings; and advocating for children in the school system
Table 2: Principles of a Good Family Skills Training Program UNODC 2009
A family skills training program
Principle 1: ... should be based on theory about which causes of substance abuse would be addressed ... and a theory of why the proposed interventions would be effective.
Principle 2: ... should be based on a Needs Assessment.
Principle 3: ...should be matched to level of risk of target population.
Principle 4: A family skills training program should be matched to the age and level of development of children in the target population.
Principle 5: The intensity and duration ... should be adequate.
Principle 6: ... sessions should use interactive activities and techniques, with groups of no more than 8-12 families.
Principle 7: ... should provide parents with skills ... to strengthen positive family relationships, supervision and monitoring, and assist them in communicating family values and expectations.
A. Content and skills for parents
Teaching parents to be responsive.
Teaching parents to provide structure.
Teaching parents to become involved in their children’s school and studies and community.
B. Content and skills for children
Content and skills related to self
To acquire motivation and orientation to the future, children should learn and practice...
To build their self-esteem, children should ...
To acquire problem-solving skills...
To care for themselves...
Content and skills related to children’s relationships to other people
To build social relationships, children should ...
To respect others, children should ...
To communicate effectively, children should ...
To resist peer pressure, children should ... Develop new skills and interests through hobbies and out-of-school activities;
To read the social context, children should ...
C. Content and skills for families
To acquire communication skills, families should learn and practice how to:
To set limits and provide structure,
To maintain goals for the future of the family
Principle 8: A family skills training program should focus resources on recruiting and retaining families, including reaching them at important transition points.
Principle 9: A family skills training program should be chosen on the basis of its level of evidence of effectiveness.
Principle 10: ... program replicated in a different community ... should be adapted to meet the cultural and socio-economic needs of the target population through a well-resourced, careful and systematic
Principle 11: ... should provide adequate training and ongoing support for carefully selected staff.
Principle 12: ... should include strong and systematic monitoring and evaluation components.
Celebrating Families!™ (CF!) theoretical basis is that substance abuse/addiction has both genetic and environmental components. Thus it addresses reducing risks and increasing protective factors.
CF! encourages sites to select the appropriate program, ensuring it (1) is a family-based program, compared to one parent/one child (2) was written specifically for the age-group served; and (3) it meets the needs of the population. CF! was written specifically for families dealing with or at high risk for addiction.
CF! serves all members of the family and is a multi-level prevention program: universal, indicated or selective. Originally developed as an indicated program for families mandated to participate by dependency drug courts with identified substance use disorders and impacted by child abuse, family violence, and substance, CF! has been used in school settings and shown effective with non- identified families (general population) as a universal program it.
CF! consists of: (1) a Family Meal; (2) age-appropriate groups for children 4-17 and parents/caregivers; (3) a Family Activity. Each age-group studies the same topic with the Family Activity related to the session’s teaching. The early childhood component (for families with children 0-3 years of age) has an additional parent/child or infant activity time.
Celebrating Families!™ consists of 16 sessions of 2.5 hours each. Curriculum is divided into four components: Developing Trust (Sessions 1-5), Addressing Addiction and ATOD (Sessions 6-8), Becoming a Safe Family (Sessions 9-13), Preparing for Graduation (Session 14-16).
Celebrating Families!™ utilizes multi-modal techniques including role playing and written for 8-10 families. All age-groups being facilitated by two trained group leaders.
Outside evaluation found that CF! has a positive effect size:
family organization, cohesion, strengths and resilience, and communication
parenting involvement, supervision, efficacy, and positive style (LutraGroup,2007).
Parent/caregiver group teaches skills of: affirming and encouraging children; reading to children; communication skills; identification and appropriate expression of feelings including anger management and keeping out of fights (especially with
children); nurturing parenting; Recognizing/clarifying values; centering; turn-taking with young children; Responsive Parenting.
CF! parent/caregiver group teaches skills of setting attachment-based, clear, consistent, age-appropriate limits and consequences; decision making and problem solving; protecting children; recognizing and celebrating each person’s uniqueness; and importance of active parenting – thinking ahead and visible monitoring of children; routines and consistency recognizing, clarifying, and discussing personal and family values; and strengthening family relationships through family meals and family times. CF! states that children do not cause, cannot cure, and cannot control what happens to their parents (especially as related to addiction and domestic/family violence).
CF! parent/caregiver group teaches: advocating for children in the school system, especially if they have learning differences or were exposed in-utereo; importance of regular medical check-ups and sharing family medical history; communication skills; and connection to resources.
CF! has specific groups for children 0-18months, 2-3, 4-6, 7-10, pre-adolescent and adolescents.
CF! children’s groups teach: identification and appropriate expression of feelings; centering and impulse-control; anger management, avoiding conflicts; saying NO, decision making, and problem solving; Acts of Kindness (doing something kind for another person); communication: “I” messages and active listening; values clarification; exercises looking at “past, present, and future” of their lives and “Dreams for the Future”; goal setting and taking small steps; recognizing and celebrating each person’s uniqueness; ANTS (automatic negative thoughts); physical, spiritual, psychological and social components of a Healthy Life. Session 3 addresses nutrition and exercise, including the impact of sugar. Sessions 7-8-9 discuss the impact of substances. CF!’s teaching style is strength-based, trauma- informed, multi-modal teaching, providing an atmosphere of support and success, building the confidence of participants.
CF! children’s groups teach skills of: Choosing Safe and Trustworthy Friends, How to be A Good Friend, What Kind of Friend Am I?; finding safe people; identifying who is important in your life and who uses ATOD; appropriate expression of feelings; recognizing and establishing boundaries; recognizing and celebrating each person’s uniqueness; Acts of Kindness, Knowledge Part of Something Larger than Ourselves; communication: active listening and use of “I” messages; asking for help; anger management, keeping out of fights, avoiding conflicts; facts about ATOD, addiction, and its impact on individuals and families; saying NO, with role plays and practice; Truth Statements: I cannot control, cure or change another person, I am responsible for myself, My Body Belongs to Me.
In Family Activity families: practice communication skills including listening; organize a Family Night (Session 14); set family chores; and engage in activities related to ATOD and healthy relationships. In Parent/Caregiver group adults determine age-appropriate attachment-based, consistent disciplinary methods. In age-groups participants identify resources and create a family list; clarify personal and family values. Often participants continue meeting after the conclusion of CF! .
CF! serves all age groups. Written for families with identified substance use disorders, impacted by child abuse and family violence, it has successfully been used in school-based settings in high-risk communities (non-identified families). In the Family Activity set a Healthy Living Family Goal, which is followed up weekly.
Listed on SAMHSA’s National Registry of Evidence-Based Programs & Practices (NREPP) CF! was also listed as a preferred program by SAMHSA’s Request for Children Affected by Methamphetamine in Families and is being implemented at 80+ U.S. sites. Evaluation studies indicate: “9 of 10 parenting and family outcomes were statistically significantly increased - normally not possible in research” (LutraGroup, 2007).
CF! significantly reduced time to reunification to 6-12 months while increasing reunification rates to 73%, from national rate of 33% (Quittan 2004 & Brooks, 2013).
CF! statistically significantly increased family communication, cohesion, strengths and resilience; skills of listening, appropriate expression of feelings, anger management, problem solving, empathy and choosing healthy relationships; and parent involvement, supervision, efficacy, and style
CF! has been used with various ethnic groups in the United States with proven success.
* ... CF! may be effective among different ethnic groups... and a valuable resource for practitioners working in ethnically diverse communities ... Similar programs might learn from the strategies and curriculum offered by CF! (Coleman, 2006)
* CF! has been shown to be as effective as a family-centered intervention for Spanish-speaking participants as for White participants (Sparks, Tisch & Gardener, 2013).
* ... showed that the African American group made changes from pre to post-test that were at least as positive as the White group and they made even more positive changes in some of the behaviors (Sparks 2014).
* Keys to Healthy Families (predecessor program to CF)! ̧ was successfully implemented in Russia.
Training and implementation support is available through NACoA (National Association for Children of Alcoholics). Implementation materials were ranked by NREPP evaluators at 4.0 (of 4.0) and Training & Support Services at 3.8.
CF! evaluation Instruments and Fidelity Forms are available through NACoA.