Interventions Addressing the Effects of Family Context on Parenting and Delinquency
In view of the disruptive effects of family adversity on parenting processes,
family relationships, and adolescent behavior, it is important to consider
how to the family context affects the outcome of intervention. Studies
have shown that poor, single-parent, socially isolated, and multiply stressed
families are less likely to benefit from family treatment or maintain gains.
[123] Based on a review of behavioral parent training outcomes, Douglas
Griest and Karen Wells add parent psycho-pathology, especially depression,
marital distress, and faulty cognitions to the list. [124] Not surprisingly,
other research has found that similar factors contribute to treatment families
dropping out. In these studies, children in families that dropped out were
also more severely aggressive or delinquent, suggesting that the families
most in need of treatment may be the least likely to receive it. [125]
George Holden found that poverty, single-parent status, and minority-group
status were associated with higher rates of attrition in parent training.
[126] The implication of these findings in conjunction with research on
causal pathways from family adversity to adolescent dysfunction are critical
for the design of intervention program.
The contextual stresses that affect families rarely occur independently,
and, in particular, economic disadvantage is inextricably intertwined with
other aspects of adversity. Pervasive poverty often offers little hope
of resolution, although families can be helped trough periods of economic
hardship with job skills training and employment counseling, financial
counseling, and government assistance programs. As social workers, we must
continue to concern ourselves with advocating for policies, as well as
lobbying and voting for legislation, that enable basic economic support
for all children and families. At the same time, particularly given the
current political climate, interventions that help families cope with the
stresses and disruptions in families processes associated with economic
disadvantage are called for. These might include interventions that focus
on alleviating depression and anger, helping couples resolve conflicts
arising from financial strain, and working with parents to help them maintain
effective family management practice. [127]
In social workers' multiple roles, interventions can target family disadvantage
indirectly or directly by modifying the environment and stressors. Although
we recognize the important role of macro-level interventions, we will focus
here on the research related to interventions to help families cope with
contextual stress.
Family preservation programs augment parenting interventions for multistressed
families by helping parents obtain concrete services and assisting families
to negotiate the complex service system with which they are usually involved.
Helping parents deal with the day-today stresses that disrupt their role,
one hopes, reduces irritability associated with excessive parental stress
and frees parents to effectively monitor and discipline aggressive youth.
Furthermore, home-based family preservation increases treatment accessibility;
both accessibility and concrete services promote treatment engagement.
[128] Research on multisystemic family therapy, an intensive family preservation
model discussed in the next section, shows impressive effects on reducing
delinquency, although other family preservation program evaluations are
more mixed. [129]
Several developments to enhance parent training effectively by addressing
parental concerns and stresses have been systematically evaluated and are
promising. For example, Ronald Prinz and Gloria Miller found that, compared
with treatment that focuses exclusively on parental management. A program
that included social learning-based parent, management training, plus opportunities
to discuss adult concerns not directly related to child behavior, significantly
decreased the rates of treatment drop-out for families of younger aggressive
children, particularly for high-adversity families. [130] Using synthesis
training, Wahler and his colleagues systematically teach mothers of aggressive
children how to identify the effect of extrafamilial stresses on parenting
and child behavior in order to improve their monitoring skills and decrease
indiscriminate responding. [131] Elaine Blechman goes one step further
and teaches parents a structured problem-solving strategy for coping with
the identified stressors. [132] At this time, both these latter approaches
are underevaluated.
There is much emphasis in the literature on enhancing social support for
parents, yet we know little about how to translate research on social support
into interventions. For example, researchers found that single parents
of conduct-disordered children were more likely to respond to parent training
when they had high social support from friends, but a social support plus
parent training intervention produced no gains over parent training alone
for parents with low social support. [133] These findings highlight the
importance of social support while simultaneously pointing to the complexity
of incorporating social support into treatment programs. Because others
have also found that friendship support helps predict parent response to
treatment, further research is needed on how social support might enhance
the intervention process. [134] It is likely that there are individual
and cultural variations in what parents consider support and that individualized
assessment might lead to more effective targeting of support needs for
parents participating in family treatment.
Partner support training in combination with social-learning-based family
management has also been shown to enhance treatment outcomes. [135] For
example, in controlled study of martially distressed and nondistressed
couples with conduct-disordered children, enhanced marital communication
training in addition to social learning family therapy intervention significantly
improved long-term treatment effects for parenting and child behavior for
the martially discordant couples but not for the nondistressed couples.
[136] Because marital distress impedes parent training success and martially
focused intervention can enhance it, we suggest that marital discord be
assessed prior to family management training with parents of aggressive
children and consideration be given to martially focused intervention where
appropriate. In the same vein, research has clearly demonstrated the importance
of assessing and addressing parental depression in stressed and disadvantaged
families in order to attenuate its effects on the marital relationship
and on parenting practices that promote antisocial and delinquent behavior.
[137]
Finally, intervention that increase the ability to monitor adolescents
in impoverished and dangerous neighborhoods, either by parents or by enlisting
extended family and other supportive adults, might decrease delinquency
risk. Monitored after-school and weekend programs could provide protective
havens within the community if care is taken in grouping together youth.
Voluntary organizations, such as the YMCA and Big Brothers and Big Sisters
of America, may partially support parenting roles, and mentoring may help
protect at-risk minority youth in inner-city neighborhoods. [138] Social
workers might also assist parents in seeking out scarce neighborhood resources
or bringing in any available outside resources to support positive social
youth development. However, individual isolated efforts will probably not
make as much of a difference in children's lives as neighborhood initiatives
that help parents gain more control over their community and their children's
environment. [139]
As previously noted, parenting and neighborhoods also interact such that
parenting is strengthened when other parents in the neighborhood are competent.
[140] This suggest that having a range of activities and programs that
enhance parenting in a neighborhood would support more intensive individual
parenting interventions for families of antisocial children. Given the
deterioration of the infrastructure and the breakdown of community ties
in some inner-city neighborhoods, as well as the difficulty of developing
neighborhood-wide programs, alternative strategies may be indicated. For
example, helping families build and strengthen functional networks may
be more productive than neighborhood-specific strategies for decreasing
at-risk adolescent behavior and enhancing youth development. [141]
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