At a glance
Strengthening Families 10-14 is a seven-session programme for families with young adolescents that aims to strengthen family protection and resilience-building processes and reduce family risk related to adolescent substance abuse and other problem behaviours. The weekly two-hour sessions include separate parent and child skills-building followed by a family session where parents and children practise the skills they have learned independently, work on conflict resolution and communication, and engage in activities to increase family cohesiveness and positive involvement of the child in the family.
Parents are taught how to clarify expectations based on child development norms relating to adolescent substance use, how to use appropriate disciplinary practices, how to manage strong emotions regarding their children and how to communicate effectively. Children are taught refusal skills to help them deal with peer pressure and other skills for personal and social interaction. These sessions are led by three-person teams and include an average of eight families per session.
Overview of results from the European studies
The programme has been evaluated in four randomised controlled trials (RCTs) in, respectively, Germany (1), Poland (1) and Sweden (2). There is also one quasi-experimental study in England.
In the German RCT, families with a young person aged 12-13 years were eligible to participate. The programme had a booster session 4-6 months later, and assessments were conducted at post-test, six months (i.e. after the booster) and 18 months after posttest. The primary outcomes were self-reported lifetime tobacco, alcohol and cannabis use at 18 months. Parents and young people also reported on behaviour problems. There were no statistically significant intervention effects on any outcome.
In the Polish RCT, communities were randomised and families with children aged 10-14 could participate. The primary outcomes were self-reported alcohol, cigarette and other drug use, alcohol use without parent permission, drunkenness and binge drinking in the past 30 days at 12 months and 24 months after baseline. There were no effects on primary outcomes, parenting skills, parent-child relations or child problem behaviour.
The Swedish cluster RCT study involved children aged approximately 12 years and the programme included additional material on alcohol and drugs. It conducted three yearly assessments i.e. mid-programme, post-test and a one-year follow-up. There was no statistically significant effect at any time-point on any measure of self-reported smoking, alcohol or drug use.
In the other Swedish RCT, at-risk young people aged 12-18 years (indicated by one of delinquent behaviour, bullying, repeated conflicts regarding family rules, use of alcohol, tobacco or drugs, or excessive computer use) were randomised to ParentSteps (similar to Strengthening Families 10-14, and therefore considered to be the intervention condition, although it only involves parent sessions), Comet (a programme aiming to help parents develop parenting skills) or a control group. No effects were found for parent-reported problem child behaviour or adolescent-reported anti-social behaviour, delinquency, alcohol or drug use or psychosocial functioning.
The English study involved children aged 10-14 years. It did not find any effects at post-test or three months after the intervention ended on self-reported alcohol initiation and use, other drug initiation and use, or aggressive and destructive behaviours.
The programme has been rated as Promising by Blueprints for Healthy Youth Development based on a review of studies conducted world-wide.
Countries where evaluated
Description of programme
The seven-session programme for families with young adolescents is based on the biopsychosocial model and aims to strengthen family protection and resilience-building processes and reduce family risk. Sessions are conducted once weekly for seven weeks. The first six sessions last two hours, consisting of one hour of separate parent and child skills-building followed by a one-hour family session where parents and children practise the skills they have learned independently, work on conflict resolution and communication, and engage in activities to increase family cohesiveness and positive involvement of the child in the family. The final session is a one-hour family interaction session without the concurrent parent and child training sessions.
Parents are taught means of clarifying expectations based on child development norms relating to adolescent substance use, how to use appropriate disciplinary practices, how to manage strong emotions regarding their children and how to communicate effectively. Essential programme content for the parent skills training sessions is contained on videotapes that include family interactions illustrating key concepts. Children are taught refusal skills to help them deal with peer pressure and other skills for personal and social interaction. During the family sessions, family members practise conflict resolution and communication skills and engage in activities designed to increase family cohesiveness and the positive involvement of the child in the family. These sessions are led by three-person teams and include an average of eight families per session. The length of the intervention may depend on where it is delivered, that is, in a school, in a group or at home. The programme is delivered by certified group leaders, site coordinators or supervisors.
In Sweden, a version of the Strengthening Families 10-14 programme adapted to Swedish conditions, including through some modifications to the programme format agreed with the programme’s developer, is implemented. The Swedish version consists of two parts. Part one comprises seven sessions, delivered over seven consecutive weeks in grade 6 (12 years of age); there are six separate sessions for children and their parents, with one joint family session. Part two comprises five sessions, delivered over five consecutive weeks in grade 7 (13 years of age); there are four separate sessions for children and their parents, with one joint family session. This differs from the original programme, where each weekly session includes a separate hour for parent and child, and then one hour with parents and children together.
The programme content is similar to the original Strengthening Families 10-14 programme to a large extent, although some family session topics are omitted due to the change in format/delivery. Whereas the original programme is held in community centres with parent and child sessions run at the same time, for practical reasons, the child sessions in the Swedish version are run during school hours and parent sessions are run separately in the evening, so ‘some family components were lost’. Youth sessions are conducted by class teachers, with the assistance of a group leader. Group leaders conduct parent sessions. All group leaders are trained by certified Strengthening Families 10-14 trainers. The Swedish version also includes some new material in part two, designed to enhance the alcohol and drug content.