Program Profile: Creating Lasting Family Connections Fatherhood Program: Family Reintegration

This is a community-based program for adult males who received substance abuse treatment while incarcerated and are reentering the community. The goals are to reduce recidivism, substance abuse, and HIV/hepatitis infection rates, and promote fatherhood and relationship skills. This program is rated Promising. Program participants had a statistically significant lower likelihood of recidivating and demonstrated an increase in relationship skills, compared with the comparison group members.

A Promising rating implies that implementing the program may result in the intended outcome(s).

Program Goals/Target Population

Creating Lasting Family Connections (CLFC) was originally designed as a family-strengthening program for youth and parents, with the goal of reducing a variety of negative youth outcomes such as use of alcohol and other drugs. The program was later adapted for adults who were experiencing marital stressors or any form of physical and emotional separation (such as separation due to incarceration) and was designed to increase healthy marriage skills and improve responsible parenting skills (Shamblen et al. 2018). The program was further culturally adapted for adult males who received substance abuse treatment while in prison and were reentering the metropolitan Louisville, Ky., community.

The culturally adapted version of CLFC, Creating Lasting Family Connections Fatherhood Program: Family Reintegration (CLFCFP), uses a multifaceted approach to address the interconnected challenges for individuals with substance abuse issues who are reentering the community, including family strengthening, substance abuse and recovery support, violence, HIV/hepatitis, and risk of recidivism. The goals are to reduce prison recidivism, substance abuse, and HIV/hepatitis infection rates, and to promote fatherhood and relationship skills and healthy sexual practices of program participants.

Research has shown that family connectedness is an important factor for psychological well-being and positive outcomes for individuals with substance abuse issues (Field, Diego, and Sanders 2001). Other studies have found that having social support systems and personal relationships during treatment improved outcomes (Knight and Simpson 1996). To encourage strong family harmony, CLFCFP promotes nine relationship skills as they closely align with the program content and principles. These include 1) communication skills, 2) conflict-resolution skills, 3) intrapersonal skills, 4) emotional awareness, 5) emotional expression, 6) interpersonal skills, 7) relationship management skills, 8) relationship satisfaction, and 9) relationship commitment.

Program Components

The CLFCFP program consists of three multisession facilitator-led, group-learning modules, in addition to a brief module on HIV and other sexually transmitted disease prevention and sexual health. The four modules are based on research regarding the role of family in recovery and the changing family systems to support recovery (McKiernan et al. 2013). The four modules comprise the following topics:

• Developing Positive Parental Influences. In this module, the training promotes an awareness of personal thoughts, feelings, attitudes, beliefs, and experiences along the continuum of chemical abuse, use, and dependency. Information is also provided on approaches for intergenerational family substance use prevention, as well as providing a practical understanding of intervention, referral procedures, and treatment options. There is also an in-depth look at the dynamics of chemical dependency, its impact on families, and the importance of abstinence and recovery for the entire family.
• Raising Resilient Youth. In this module, the training focuses on a broad range of relationship skills for individual and family strengthening. Individuals and their families learn and practice communication skills, which include listening and validating others’ thoughts and feelings, and learning and practicing how to successfully manage their own thoughts and feelings. Individuals and families are also asked to examine and enhance their ability to develop and implement expectations and consequences for all areas of interest and concerns to others (such as spouses, coworkers, friends, and children). Parents are taught to include their children’s active participation in setting both expectations and consequences in areas of interest and concerns to parents, such as alcohol and drugs. This communication strategy encourages a dialogue that enhances a sense of competence, connectedness, and bonding between parent and child.
• Getting Real. In this module, the training encourages participants to examine personal responses to the verbal and nonverbal behavior they experience in their interactions with others and offers personalized coaching on communication skills, including speaking with confidence and sensitivity, listening to and validating others, sharing feelings, and matching body language with verbal messages. There is also information on how to promote skills of self-awareness and mutual respect, while focusing on helping participants combine thoughts, feelings, and behavior in a way that instructs them to deliver powerful and meaningful messages to others.
• The ABC 3D Approaches to HIV Prevention . In this module, the training covers the primary modes of transmission of HIV, hepatitis, and other sexually transmitted diseases in a serious and candid, but often humorous way. Information is provided on preventive measures to reduce or eliminate risk of infection. There is also recognition, discussion, and support of healthy sexual expression. Onsite HIV testing—which is voluntary, free, rapid, and confidential—is also offered.

There is a total of 20 module sessions; the classes are 2 hours long and offered once or twice a week from 6:00 to 8:00 p.m. (usually after work hours). To incentivize program participation, program staff provide meals and the opportunity for informal interactions for those interested, 30 minutes before each session.

Another component of the program includes comprehensive and culturally sensitive case-management services for participants. Case managers provide support, advice, and referrals to community-based services to address a variety of barriers to recovery and reentry (i.e., job skills, child case issues, transportation).

Key Personnel

In addition to the facilitators and case managers, state-certified substance abuse prevention specialists and/or certified alcohol and drug counselors (CADC) co-facilitate program sessions.

Study

McKiernan and colleagues (2013) conducted a quasi-experimental study to determine the effects of the culturally adapted version of Creating Lasting Family Connections—Creating Lasting Family Connections Fatherhood Program: Family Reintegration (CLFCFP)—on adult males who received substance abuse treatment while in prison and were reentering the Louisville, Ky., metropolitan community following a period of incarceration. Participants were voluntarily recruited for the study and then semi-randomly assigned to the intervention and comparison groups based on their release date from the Kentucky Department of Corrections. The majority were released from prison before participating in the program (78 percent); however, the others were still incarcerated at the time of their participation.

Of the 500 total male participants, 387 were assigned to the treatment group, and 113 were assigned to the comparison group (which received a standard reentry program). The average age of participants was 33.8 years. Of the participants, 62 percent were white, 36 percent were African American, and 2 percent were Hispanic. Twenty-five percent were living with their partners, 27 percent lived independently, and 27 percent indicated they had a child living with them. About 77 percent of clients reported having a child. Regarding education and employment, 94 percent had a high school diploma or GED, and 43 percent were employed. To address threats of selectivity bias, adjustments were made by using the Heckman two-step procedure.

Outcomes of interest included recidivism and relationship skills and determining a relative change in recidivism and relationship skills between pretest (Time 1) and posttest (Time 2), and between posttest and follow-up period (Time 3). Of the 500 participants, 385 participated in the pretest to posttest period, 364 participated in the posttest to follow-up period, and 136 did not participate at either the posttest or follow-up period. There were no adjustments made for attrition. The focus of the CrimeSolutions review of this study was on the outcomes at Time 3 (posttest to follow up).

Relationship skills were measured by a 71-item questionnaire, which measured the nine facets of relationship skills in CLFCFP. The self-report instrument (Olson et al. 1986; Olson and Schaefer 2000) asked participants to rate their relationship skills on a 5-point Likert scale. Item scale scores were determined by calculating the response average for each scale item. Significance was determined by aggregating relationship skills together. Recidivism was measured by examining individual participants at posttest and follow-up periods, and determining whether a revocation, arrest, or abscond was reported. Recidivism records were retrieved from the Kentucky Department of Corrections. Since some of the participants were incarcerated during data retrieval, recidivism data were only available for 389 participants (i.e., those who were not currently incarcerated). A hierarchal linear model (HLM) analysis was used to examine the relationship skills data, and a multiple logistic regression model was used to examine recidivism data. The study authors did not conduct subgroup analyses.

In 2000, the Kentucky Department of Corrections (KDOC) began increasing the availability of substance use treatment programs (six prison programs, increased from four, and 18 regional jail programs, increased from two). In addition to increasing facility treatment programs, the KDOC increased collaborations with community-based organizations to expand support of reentry populations, to reduce recidivism and increase community protection. KDOC wanted a community-based partnership that offered community-based programming designed to enhance aftercare services using evidence-based practices that focused on deficits of reentry across multiple domains, including psychiatric, employment, and family problems. This led to the partnership between KDOC and the Council of Prevention and Education: Substances, Inc. (COPES, Inc.), to implement the Creating Lasting Family Connections Fatherhood Program: Family Reintegration (CLFCFP) curriculum (McKiernan et al. 2013).

For more information on CLFCFP, please see the COPES, Inc. website: http://copes.org/recommended-process-for-reviewing-selecting-and-implementing-the-clfc-fatherhood-program-family-reintegration/

These sources were used in the development of the program profile:

These sources were used in the development of the program profile:

Following are CrimeSolutions-rated programs that are related to this practice:

Adult Reentry Programs

This practice involves correctional programs that focus on the transition of individuals from prison into the community. Reentry programs involve treatment or services that have been initiated while the individual is in custody and a follow-up component after the individual is released. The practice is rated Promising for reducing recidivism.

Evidence Ratings for Outcomes

Crime & Delinquency - Multiple crime/offense types

Rehabilitation Programs for Adults Convicted of a Crime

This practice includes programs that are designed to reduce recidivism among adults by improving their behaviors, skills, mental health, social functioning, and access to education and employment. They may become participants in rehabilitation programs during multiple points in their involvement with the criminal justice system. This practice is rated Promising for reducing recidivism among adults who have been convicted of an offense.

Evidence Ratings for Outcomes

Crime & Delinquency - Multiple crime/offense types

Why might a practice's outcome ratings differ from the ratings of specific programs encompassed by that practice?