# Presentation: 448473

## Philip A. Cowan and Carolyn Pape Cowan

- in low-income families:
- Interventions for fathers and couples

- University of California, Berkeley
- June 5, 2007

## Becoming a Family

- _Becoming a Family_
- Pregnancy to Kindergarten (Child 5.5)

- _Schoolchildren and their Families_
- Pre-school (age 4.5) to Gr. 11 (age 16.5)

-  Three Studies Spanning Three Family Transitions:
-  Pathways to Change in Parents and Children

- _Supporting Father Involvement_
- Child from birth to 7 years of age

## Slide 3

## Slide 4

## Slide 5

## In our assessments and interventions,

- _In our assessments and interventions,_
- _we focus on:_
- PARENTS AS INDIVIDUALS: To increase their coping with internal stressors and meet their needs as individuals
- THE COUPLE RELATIONSHIP: To increase parents’ collaborative problem-solving and decrease couple conflict
- PARENT-CHILD RELATIONSHIPS: To increase fathers’ involvement and age-appropriate parenting strategies
- FAMILY OF ORIGIN 	RELATIONSHIPS: To help parents find ways to break negative intergenerational cycles of harsh treatment, neglect, and abuse
- STRESSORS and SUPPORTS: To help parents develop strategies for coping with external stressors and increase support from family, friends, and social services

## Our Family Systems Risk Model

- Culture
- Economic forces

**Our Family Systems Risk Model**

- Work

- School

- Peers

- Friends

- Social support and Life Stress

- Social support and Life Stress

## Each aspect of family life makes

- a unique contribution to the children’s adaptation to school

- Parenting:
- Marital relationship:
- Three generations:
- Parents’ adjustment:
- Life stress/Social support:

- _It’s not simply parenting_

## Participants of  first two family studies: working-class and middle-class 

-  Families from 28 cities and towns in the San Francisco
-    Bay Area of California
-  Working-class, middle-class; 15% below median income
-  85% European American
-  15% African American, Asian American, Latino
-  Couples married or living together and co-parenting child

##  RANDOM ASSIGNMENT to:

- No intervention

- Comparable couples – no baby
- No intervention

- Expectant
- couples
- 24 wk groups

** **

-  **RANDOM ASSIGNMENT to**:

** ****Pre-intervention assessment for all 96 couples**** **
** ****Post-intervention assessments when child is:**
**      ****6 mo, 1-1/2, 3-1/2, and 5-1/2 years in Kindergarten**
***Funded by the National Institute of Mental Health**

**BECOMING A FAMILY PROJECT***

##  Each group has 5 or 6 couples  

**GROUPS FOR PARTNERS AND PARENTS**

-  Each group has 5 or 6 couples
-  Male-female co-leaders trained to work
-    with couple and parent-child relationships
-  2-hour weekly meetings
-  Transition to parenthood   (24 weeks)
-  Child’s transition to school (16 weeks)

## Our approach to couples groups

- Open-ended
- group therapy

- Didactic
- class

- Our approach

## Main goal

- To help participants be the partners and parents that they want to be
- We do not recommend a single model or blueprint

## BECOMING A FAMILY PROJECT: Marital Satisfaction Trajectories for Parents With and Without Intervention

- -3           6               18                           42	            66

**Couples Groups End**

*B*= -.071

*B*= -.225

## Brief Consultation

-  16 week
-   Groups:
- w. Marital emphasis

-  16 week
-   Groups:
- w. Parenting emphasis

** ****Post-intervention assessments: **
**       ****Kindergarten, and Grade 1, 4, 9, and 11**
***Funded by the National Institute of Mental Health**

-          **RANDOM ASSIGNMENT to**:

** ****Pre-intervention assessment for each parent**

**SCHOOLCHILDREN AND THEIR FAMILIES PROJECT***

-                           _**Parents**_
-   **Parenting focus            ****Parenting Improved**
-                                                 _**Children**_** **
-                              **Better Self-reported Adjustment**
**                    ****Fewer Internalizing Problems****                     in Kg, G1, G4****                                     **

-          _SCHOOLCHILDREN AND THEIR FAMILIES PROJECT_

**5-YEAR EFFECTS OF THE INTERVENTION**
**when children are 9 years old**

## Marital focus             Marital Conflict Declined                                       and Parenting Improved                 

-                                             _**Children**_
-                                 **Higher Achievement Scores****                                    ****Fewer Externalizing Problems****                                          in Kg, G1, G4**

**         **_**Parents**_

**   ****Wives’ Self-esteem goes up**
**Wives and Husbands report **
**less Conflict and Volatility**** **

## 10-YEAR EFFECTS OF THE INTERVENTION

-  parents’ satisfaction as a couple (greater)
-  parents’ conflict as a couple (less)
-  parents’ symptoms of depression (fewer)
-  parent-child relationship quality (more effective)
-  adolescents’ externalizing and internalizing behaviors (less)

**10-YEAR EFFECTS OF THE INTERVENTION**

- EFFECTS of the COUPLE FOCUS IS ALWAYS =
- or > than EFFECTS of the PARENTING FOCUS

## Supporting Father Involvement

- WILL THIS APPROACH WORK WITH
- LOW-INCOME FAMILIES?

## LINDA HOCKMAN

-          Assistant Chief, Office of Child Abuse Prevention,
-          California Department of Social Services
- CAROLYN PAPE COWAN and PHILIP A. COWAN
-          University of California, Berkeley
- MARSHA KLINE PRUETT
-          Smith College
- KYLE PRUETT
-         Yale University Medical School

##         		SFI OVERVIEW

**        ****	****	****SFI OVERVIEW**
- The Basics:
-    _4 California counties are involved_:
-     San Luis Obispo, Santa Cruz, Tulare, Yuba
-  Housed in County Family Resource Centers
-  289 low-income families
-  Primarily Latino and European American
-  A 5th site in Contra Costa County has just begun to                                    recruit African American families

## Screening of families

-  No open CPS case
-  No _severe_ mental illness or substance abuse
-  Youngest child from birth to 7 years
-  Biological parents, not necessarily married
-    or living together but parenting jointly

## Information

-    Session*

-  16 week
-   Fathers
-    groups*

-  16 week
-   Couples
-    groups*

- *_Bi-monthly consultation for site staff_
- _*Case__ __management for all families_

-  Post-intervention assessment: 9 and 18 months after
-    baseline

-            **RANDOM ASSIGNMENT to**:

-  Pre-intervention assessment for each parent

**SUPPORTING FATHER INVOLVEMENT**

## Participants

- 276 families completed pre and posttests
-  67% Mexican American
-  75% married
- Median family income: $28,000
-  67% below twice the Federal poverty line

## A central finding with important implications

-  Fathers are more likely to be involved with their children when they are more satisfied with the relationship with the children’s mother

## Recruitment and 

- Retention

## Retention from Pre to Post1

-   Completed
-     baseline                 371 couples
-     (pre) assessment
-   Completed
-     first posttest
-     and
-     at least one           276 couples
-     meeting                (75%)

##   Assignment to study condition  

-   Higher income (above $40,000 household)
-   Married (84%) vs. Cohabiting (74%)

-   Assignment to study condition

- NO DIFFERENCES IN RETENTION BASED ON:

-   European American vs Mexican-American

## Psychological characteristics

- RETENTION LESS LIKELY when
- Participants are not functioning well _as individuals_:
-  more anxious and depressed
-  higher parenting stress, more life stressors
-  more dissatisfied with couple relationship

## Retention to POST 2:

-  Data collected:     285 families
-                               99% of Post 1

-  (18 months after baseline)

## Intervention 

- effects

## PARENT-CHILD RELATIONSHIPS

## Fathers’ involvement in daily care of the child

- CONTROL
- GROUP
- NO CHANGE

- FATHERS        COUPLES
- GROUP           GROUP
-  FATHER
-       INVOLVEMENT
-     _INCREASED_

## Parenting Stress (fathers and mothers)

- CONTROL
- GROUP
- NO CHANGE

- FATHERS        COUPLES
- GROUP           GROUP
- PARENTING STRESS
- _DECREASED_

## FATHERS/MOTHERS AS INDIVIDUALS

## Individual functioning: anxiety and depression symptoms

- CONTROL
- GROUP
-    Anxiety and     Depression
-    _INCREASED_

- FATHERS        COUPLES
- GROUP           GROUP
-  Anxiety and
- Depression
-  _DECREASED_

## THE COUPLE RELATIONSHIP

## Satisfaction with couple relationship

- CONTROL
- GROUP
- SATISFACTION
- _DECREASED_

- FATHERS        COUPLES
- GROUP           GROUP
-    SATISFACTION
-   _MAINTAINED_

## Conflict about the children

- CONTROL
- GROUP
- NO CHANGE

- FATHERS        COUPLES
- GROUP           GROUP
-   Conflict about
- the children
-  _DECREASED_

## THE CHILD

## Children’s aggression and hyperactivity (described by parents)

- CONTROL
- GROUP
-   Aggression and Hyperactivity
-   _INCREASED_

- FATHERS        COUPLES
- GROUP           GROUP
-   Aggression and
-   Hyperactivity
-   _NO CHANGE_

## Stresses and Supports

## Household income

- CONTROL
- GROUP
- NO CHANGE

- FATHERS        COUPLES
- GROUP           GROUP
- INCOME
-  _INCREASED_
-      $2,505               $3,770

## No intervention effects on:

-  Perception of family of origin       relationships - past or present
-  Perception of life stressors (but income increased)
-  Social support (but the groups did provide a support network, and the referrals increased the range of available resources)

## FATHERS GROUPS VS. COUPLES GROUPS

- At the first followup (2-3 months after groups end)
- COUPLES GROUPS: stronger effects on
-  Father involvement
-  Mothers’ and Fathers’ parenting stress
-  Mothers’ and Fathers’ anxiety
-  Parents’ conflict about children
-  Family income

- FATHERS GROUPS: stronger effects on
-  Parents’ symptoms of depression

## The intervention was equally effective for:

-  Mexican American and Anglo participants
-  Lower-income and Higher-income participants
-  Married and Cohabiting couples
-  More and less depressed parents
-  More and less satisfied couples

## Organizational 

- change

## A second goal: Changing the agencies’ organizational climate

- “Pictures on the walls”
- Having a place where fathers are recognized and welcome

## Father Friendliness Self-assessment (OSA)

-  Support in the FRC for providing support to fathers
-  Reputation for serving fathers
-  Father-inclusive policies and procedures
-  Staff prepared to provide services to fathers
-  Programs for fathers
-  Active approaches to fathers
-  Physical environment
-  Consideration of couple co-parenting issues in clients
-  Positive treatment of fathers in the agency

## BASELINE   FIRST     SECOND    THIRD   

-                  YEAR        YEAR       YEAR

-  Significant improvement on all scales, baseline to end of first year
-  Maintained through second and third year

## Conclusions

- Low-income Mexican American and European American families will participate in a 16-week intervention and remain in the study over time.
- Couples and fathers groups with clinically trained leaders provided benefits for both fathers and mothers.

## Because the Supporting Healthy Marriage Project will be using curricula that cover the five domains of family life we described,

- It is reasonable to expect that these couples group interventions will increase positive father involvement.
- Data from intervention and correlational studies suggest that strengthening couple relationships and increasing fathers’ positive involvement will enhance their children’s development and adaptation.