Background: Youth living in poverty face compounding familial and environmental was challenges in utilizing effective community mental health services. Ongoing stressors increase their drop-out rate in mental health service use. Difficulties also exist in staying engaged in services when involved with the child welfare system. This study examines the 4Rs 2Ss Family Strengthening Program developed across four broad conceptual categories related to parenting skills and family processes that form a multiple family group service delivery approach. Methods: Families randomly assigned to the experimental condition received a 16-week intervention. Data was collected at baseline, midtest, posttest, and follow-up. Results: There was a higher engagement rate in the experimental condition and improved effects for child behaviors. Family stress and parental depression were also related to engagement. No moderation effects on family stress, child welfare involvement, or parental needs were found. This intervention appeared to be able to engage families with more complex “real-world” needs.
AbidinR. R. (1976). Parenting stress. New York, NY: Human Science Press.
2.
AbidinR. R. (1995). Parenting stress index: Professional manual (3rd ed.). Odessa, FL: Psychological Assessment Resources.
3.
AlvidrezJ. (1999). Ethnic variations in mental health attitudes and service use among low-income African American, Latina, and European American young women. Community Mental Health Journal, 35, 515–530.
4.
AngoldA.CostelloE. J. (2001). The epidemiology of depression in children and adolescents. In GoodyerI. (Ed.), The depressed child and adolescent: Developmental and clinical perspectives (2nd ed., pp. 143–178). New York, NY: Cambridge University Press.
5.
BankL.MarloweJ. H.ReidJ. B.PattersonG. R.WeinrottM. R. (1991). A comparative evaluation of parent-training interventions for families of chronic delinquents. Journal of Abnormal Child Psychology, 19, 15–33.
6.
BannonW. M.CavaleriM.RodriguezJ.McKayM. M. (2008). Conclusions and directions for future research concerning racial socialization. Social Work in Mental Health, 6, 9–29.
7.
BaumC. G.ForehandR. (1981). Long term follow-up assessment of parent training by use of multiple outcome measures. Behavior Therapy, 12, 643–652.
8.
BickmanL. (1996). A continuum of care: More is not always better. American Psychologist, 51, 689–701.
9.
Brooks-GunnJ.DuncanG. J. (1997). The effects of poverty on children. Future of Children, 7, 55–71.
10.
BrownL. K.DanovskyM. B.LourieK. J.DiClementeR. J.PontonL. E. (1997). Adolescents with psychiatric disorders and the risk of HIV. Journal of the American Academy of Child & Adolescent Psychiatry, 36, 1609–1617.
11.
BurnsB. J.HoagwoodK. (Eds.). (2004). Evidence-based practice part I: A research update. Child and Adolescent Psychiatric Clinics of North America, 12, 11–13.
12.
BurnsB. J.HoagwoodK. (Eds.). (2005). Evidence-based practices part II: Effecting change. Child and Adolescent Psychiatric Clinics of North America, 14, 15–17.
13.
BurtM. R.CohenB. E. (1989). Differences among homeless single women, women with children and single men. Social Problems, 36, 508–524.
14.
CapaldiD. M.StoolmillerM.ClarkS.OwenL. D. (2002). Heterosexual risk behaviors in at-risk young men from early adolescence to young adulthood: Prevalence, prediction, and association with STD contraction. Developmental Psychology, 38, 394–406.
15.
CottrellD.BostonP. (2002). Practitioner review: The effectiveness of systemic family therapy for children and adolescents. Journal of Child Psychology and Psychiatry, 43, 573–586.
16.
CrnicK. A.GreenbergM. T. (1990). Minor parenting stresses with young children. Child development, 61, 1628–1637.
17.
DumvilleJ. C.MilesJ. N.PorthouseJ.CockayneS.SaxonL.KingC., 2006. Can vitamin D supplementation prevent winter-time blues? A randomized trial among older women. Journal of Nutrition Health and Aging, 10, 151–153.
18.
DishionT. J.McCordJ.PoulinF. (1999). When interventions harm: Peer groups and problem behavior. American Psychologist, 54, 755–764.
19.
FarmerE. Z. M.ComptonS. N.BurnsB. J.RobertsonE. (2002). Review of the evidence base for treatment of childhood psychopathology: Externalizing disorders. Journal of Counseling and Community Psychology, 70, 1267–1302.
20.
FieseB. H.TomchoT. J.DouglasM.JosephsK.PoltrockS.BakerT. (2002). A review of 50 years of research on naturally occurring family routines and rituals: Cause for celebration?Journal of Family Psychology, 16, 381–390.
21.
FristadM. A.Goldberg-ArnoldJ. S.GavazziS. M. (2003). Multi-family psychological groups in the treatment of children with mood disorders. Journal of Marital & Family Therapy, 29, 491–504.
22.
GarbarinoJ.KostelnyK. (1992). Child maltreatment as a community problem. Child Abuse & Neglect, 16, 455–464.
23.
GhandourR. M.KoganM. D.BlumbergS. J.JonesJ. R.PerrinJ. M. (2012). Mental health conditions among school-aged children: Geographic and sociodemographic patterns in prevalence and treatment. Journal of Developmental and Behavioral Pediatrics, 33, 42–54.
24.
GillbergI. C.GillbergC.RasmussenP. (1983). Three-year follow-up at age 10 of children with minor neurodevelopmental disorders, II: School achievement problems. Developmental Medicine and Child Neurology25:566–573
25.
GopalanG.BannonW.Dean-AssaelK.FussA.GardnerL.LaBarberaB.McKayM. (2011). Multiple family groups: An engaging intervention for child welfare–involved families. Child Welfare, 90, 135–156.
26.
GopalanG.GoldsteinL.KlingensteinK.SicherC.BlakeC.McKayM. M. (2010). Engaging families into child mental health treatment: Updates and special considerations. Journal of the Canadian Academy of Child and Adolescent Psychiatry, 19, 182–196.
27.
GreshamF. M.ElliottS. N. (1990). Social skills rating system (SSRS). Circle Pines, MN: American Guidance Service.
28.
HammenC.RudolphK.WeiszJ.RaoU.BurgeD. (1999). The context of depression in clinic-referred youth: Neglected areas in treatment. Journal of the American Academy of Child and Adolescent Psychiatry, 38, 64–71.
29.
HarrisonM. E.McKayM. M.BannonW. M. (2004). Inner-city child mental health service use: The real question is why youth and families do not use services. Community Mental Health Journal, 40, 119–131.
30.
HausmanB.HammenC. (1993). Parenting in homeless families: The double crisis. American Journal of Orthopsychiatry, 63, 358–369.
HoagwoodK. E.BurnsB. J.WeiszJ. R. (2002). A profitable conjunction: From science to service in children’s mental health. In BurnsB. J.HoagwoodK.. (Eds.), Community treatment for youth: Evidence-based interventions for youth with severe emotional and emotional disorders. Oxford, England: Oxford University Press.
33.
HoagwoodK.JensenP. S.McKayM.OlinS. (Eds.). (2010). Children’s mental health research: The power of partnerships. New York, NY: Oxford University Press.
34.
HorowitzK.McKayM.MarshallR. (2005). Community violence and urban families: Experiences, effects, and direction for intervention. American Journal of Orthopsychiatry, 75, 356–368.
35.
HouckC. D.LescanoC. M.BrownL. K.Tolou-ShamsM.ThompsonJ.DiclementeR.…SilverB. J. (2006). “Islands of risk”: Subgroups of adolescents at risk for HIV. Journal of Pediatric Psychology, 31, 619–629.
36.
JarrettR. L. (1995). African American children, families, and neighborhoods: Qualitative contributions to understanding developmental pathways. Applied Developmental Science, 2, 2–16.
37.
KazdinA. E.WhitleyM. K. (2003). Treatment of parental stress to enhance therapeutic change among children referred for aggressive and antisocial behavior. Journal of Consulting and Clinical Psychology, 71, 504–515.
38.
KerkorianD.McKayM.BannonW. M. (2006). Seeking help a second time: Parents’/caregivers’ characterizations of previous experiences with mental health services for their children and perceptions of barriers to future use. American Journal of Orthopsychiatry, 76, 161–166.
39.
KeileyM. K. (2002). The development and implementation of an affect regulation and attachment intervention for incarcerated adolescents and their parents. The Family Journal, 10, 177–189.
40.
KilgoreK.SnyderJ.LentzC. (2000). The contribution of parental discipline, parental monitoring, and school risk to early-onset conduct problems in African American boys and girls. Developmental Psychology, 36, 835–845.
41.
KotchickB. A.DorseyS.HellerL. (2005). Predictors of parenting among African American single mothers: Personal and contextual factors. Journal of Marriage and Family, 67, 448–460.
42.
LauA. S.WeiszJ. R. (2003). Reported maltreatment among clinic-referred children: Implications for presenting problems, treatment attrition, and long-term outcomes. Journal of the American Academy of Child & Adolescent Psychiatry, 42, 1327–1334.
43.
LeslieL. K.HurlburtM. S.JamesS.LandsverkJ.SlymenD. J.ZhangJ. (2005). Relationship between entry into child welfare and mental health service use. Psychiatric Services, 56, 981–987.
44.
LiebermanA. F.Van HornP. (2004). Don’t hit my mommy: A manual for child parent psychotherapy with young witnesses of family violence. Washington, DC: Zero to Three Press.
45.
LiawF.R.Brooks-GunnJ. (1994). Cumulative familial risks and low-birthweight children’s cognitive and behavioral development. Journal of Clinical Child Psychology, 23, 360–272.
46.
LoeberR.FarringtonD. P. (1998). Serious & violent juvenile offenders: Risk factors and successful interventions. Thousand Oaks, CA: Sage.
47.
McKayM. M.BannonW. (2004). Engaging families in child mental health services. Child and Adolescent Psychiatric Clinics of North America, 13, 905–921.
48.
McKayM. M.GonzalesJ. J.StoneS.RylandD.KohnerK. (1995). Multiple family therapy groups: A responsive intervention model for inner city families. Social Work with Groups, 18, 41–56.
49.
McKayM. M.GonzalesJ.QuintanaE.KimL.Abdul-AdilJ. (1999). Multiple family groups: An alternative for reducing disruptive behavioral difficulties of urban children. Research on Social Work Practice, 9, 593–607.
50.
McKayM. M.GopalanG.FrancoL. M.KalogerogiannisK. N.Olshtain-MannO.BannonW.…UmpierreM. (2010). It takes a village to deliver and test child and family-focused services. Research in Social Work Practice, 20, 476–482.
51.
McKayM. M.GopalanG.FrancoL.Dean-AssaelK.ChackoA.JacksonJ.FussA. (2011). A collaboratively designed child mental health service model: Multiple family groups for urban children with conduct difficulties. Research on Social Work Practice, 21, 664–674.
52.
McKayM. M.HarrisonM. E.GonzalesJ.KimL.QuintanaE. (2002). Multiple-family groups for urban children with conduct difficulties and their families. Psychiatric Services, 53, 1467–1468.
53.
McKayM. M.McCadamK.GonzalesJ. J. (1996). Addressing the barriers to mental health services for inner city children and their caretakers. Community Mental Health Journal, 32, 353–361.
54.
McKayM. M.StoeweJ.McCadamK.GonzalesJ. (1998). Increasing access to child mental health services for urban children and their caregivers. Health & Social Work, 23, 9–15.
55.
MilichR.LoneyJ. (1982). Hyperactivity, inattention, and aggression in clinical practice. In WolraichM.RouthD. D. (Eds.), Advances in developmental and behavioral pediatrics (Vol. 3, pp. 1213–2147). Greenwich, CT: JAI Press.
56.
MonuteauxM. C.FaraoneS. V.MichelleG. L.BiedermanJ. (2007). Predictors, clinical characteristics, and outcome of conduct disorder in girls with attention-deficit/hyperactivity disorder: a longitudinal study. Psychological Medicine, 37, 1731–1741.
57.
McKayM.PaikoffR. (Eds.). (2007). Community Collaborative Partnerships: The Foundation for HIV Prevention Research Efforts. New York: Haworth Press.
58.
MorganJ.RobinsonD.AldridgeJ. (2002). Parenting stress and externalizing child behaviour. Child and Family Social Work, 7, 219–225.
59.
MurrayL. (1992). The impact of postnatal depression on infant development. Journal of Child Psychology and Psychiatry, 33, 543–561.
60.
O’sheaM.PhelpsR. (1985). Multiple family therapy: Current status and critical appraisal. Family Process, 24, 555–582.
61.
PalmerS.MaiterS.ManjiS. (2006). Effective intervention in child protective services: Learning from parents. Children and Youth Services Review, 28, 812–824.
62.
PettersonS. M.AlbersA. B. (2001). Effects of poverty and maternal depression on early child development. Child Development, 72, 1794–1813.
63.
RadloffL. (1975). Sex differences in depression. Sex roles, 1, 249–265.
64.
RadloffL. S. (1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1, 385–401.
65.
RodriguezJ.McKayM. M.BannonW. M.Jr. (2008). The role of racial socialization in relation to parenting practices and youth behavior: An exploratory analysis. Social Work in Mental Health, 6, 30–54.
66.
RossiP. H. (1994). Troubling families: Family homelessness in America. American Behavioral Scientist, 37, 342–395.
67.
RussellM.HarrisB.GockelA. (2008). Parenting in poverty: Perspectives of high-risk parents. Journal of Children and Poverty, 14, 83–98.
68.
SalernoT.MargoliesP.CleekA.PollockM.GopalanG.JacksonC. (2011). Wellness self-management: An adaptation of the Illness Management and Recovery Practice in New York State. Psychiatric Services, 62, 456–458.
69.
SextonT. L.AlexanderJ. F. (2002). Family-based empirically supported interventions. The Counseling Psychologist, 30, 238–261.
70.
StoneS.McKayM. M.StoopsC. (1996). Evaluating multiple family groups to address the behavioral difficulties of urban children. Small Group Research, 27, 398–415.
71.
TolanP. H.HenryD. (1996). Patterns of psychopathology among urban poor children: Comorbidity and aggression effects. Journal of Consulting & Clinical Psychology, 64, 1094–1099.
72.
TolanP. H.McKayM. (1996). Preventing serious antisocial behavior in inner-city children. Family Relations, 45, 148–155.
73.
TubmanJ. G.GilA. G.WagnerE. F.ArtiguesH. (2003). Patterns of sexual risk behaviors and psychiatric disorders in a community sample of young adults. Journal of Behavioral Medicine, 26, 473–500.
74.
WahlerR.DumasJ. E. (1989). Attentional problems in dysfunctional mother-child interactions: An interbehavioral model. Psychological Bulletin, 105, 116–130.
75.
WaschbuschD.WilloughbyM. (2008). Attention-deficit/hyperactivity disorder and callous-unemotional traits as moderators of conduct problems when examining aggression and impairment in elementary school children. Aggressive Behavior, 34, 139–153.
76.
Webster-StrattonC. (1985). Case studies and clinical replication series: Predictors of treatment outcome in parent training for conduct disordered children. Behavior Therapy, 16, 223–243.
77.
Webster-StrattonC. (1998). Preventing conduct problems in Head Start children: Strengthening parenting competencies. Journal of Consulting and Clinical Psychology, 66, 715–730.
78.
Webster-StrattonC.HammondM. (1990). Predictors of treatment outcome in parent training for families with conduct problem children. Behavior Therapy, 21, 319–337.
79.
WeiszJ. R.JensenA. L. (2001). Child and adolescent psychotherapy in research and practice contexts: Review of the evidence and suggestions for improving the field. European Journal of Child and Adolescent Psychiatry, I0, 1/12–1/18.
80.
WeiszJ. R.HawleyK. M.DossA. J. (2004). Empirically tested psychotherapies for youth internalizing and externalizing problems and disorders. Child & Adolescent Psychiatry Clinics of North America, 13, 729–815.
81.
ZillN. (1996). Family change and student achievement: What we have learned, what it means for schools. In BoothA.DunnJ. F. (Eds.), Family-school links: How do they affect educational outcomes? (pp. 139–174). Mahwah, NJ: Lawrence Erlbaum.
