Family support in the home: lessons from pioneer programs - analysis of three programs funded by the Office of Human Development Services

Family support programs for low income and minority children and families can serve a vital role in linking families to services available to assist them in their educational, health and social needs. Many family support programs are provided in the home and bring the services directly to the doorstep of the families they seek to reach.

Several years ago the Office of Human Development Services funded three fledgling family support programs as part of a private-public partnership initiative. These included: Kamehameha Schools' Center for Development of Early Education in Honolulu (Roberts, 1988a), the Center for Successful Child Development in Chicago, and the Families Facing the Future Project in Pittsburgh. Each of these programs evolved into more mature programs, and in each case the directors moved on to other efforts. Even so, the lessons learned from these programs during their formative years were important ones which helped shape the next generation of programs offered. Program directors had the unique opportunity to work together and share common concerns over the years the programs were in operation.

Program Values and Principles of

Practice

All three programs shared a common set of values with respect to the family-centered nature of practice, including the following: families are composed of basically competent individuals as well as competent caregivers; the family is an important social institution that needs to be preserved; families should and can make important decisions about their interactions with agencies and service providers; the rights and the beliefs of the family need to be recognized and preserved (Roberts, 1988b).

These beliefs about families lead to a set of principles about the practice of family support programs and how services should be provided. Services which are family centered are based on the strengths, wants, and needs of the family and should be designed to help them achieve their own potential. Services should be culturally competent and integrated into community networks. They should not supplant the informal networks of social and family support that naturally occur within communities that maintain families while formal programs wax and wane with the exigencies of budgets and other uncertainties.

Programs Need to Become Part of a

Community

The three projects were important opportunities to examine the nature of these family-centered beliefs as they were applied to the everyday operation of programs in the field. As project directors, we had to learn how to involve communities in the development of family support efforts within their boundaries that would make sense to their constituencies. As other programs begin similar efforts, we would hope that they could learn from our mistakes and our successes. From this perspective, these projects should not be directly replicated. Rather they should serve as guideposts and give a sense of direction to the process of involving communities in supporting families and children.

Perhaps the most important lesson we learned concerns involvement of the community in program design and implementation. Regardless of their size and target population, programs must be created by intimately involving the community in program development at the most basic level of operation in order for them to be truly helpful and supportive of families. Program development takes time, and the timelines which we set for ourselves in grant proposals and program planning are often unrealistic when it comes to implementing them in the field. The process of understanding a community and its needs is a development one. It cannot be rushed as programs are implemented to meet other exigencies and deadlines. Without exception this is a common theme across the three programs, each serving quite different communities.

The CDEE program served several rural communities on Oahu, the main island in Hawaii. As programs were begun in each community the carryover from one area to the next was minimal. The lessons learned by the staff were not how to transplant a program from one community to the next as we had originally planned. Rather we discovered we needed to find the natural leaders of a community and seek their advice. New programs had to be integrated into the ebb and flow of the already existing formal programs sponsored by other agencies as well as the more informal social support systems within the community.

The Center for Successful Child Development and the Families Facing the Future programs faced similar issues. For example, in the FFF Pittsburgh effort, three community sites were being developed to house home visitors in three different existing community agencies. Though this model had the advantage of integrating staff into ongoing efforts and reducing administrative costs, it was in fact a difficult administrative structure which diffused responsibility too much and needed to be modified.

The Center for Successful Child Development experienced its own set of growing pains in developing home and center based services for families in the Robert Taylor Homes Public Housing Project in South Chicago. The community had been socially and economically isolated from the rest of the city, and residents were naturally cautious about opening up their homes and becoming involved in yet another social experiment in a community which had experienced too many social reform failures.

Careful, consistent nurturing of community residents and of opportunities within the program for input and control was an essential element in gaining acceptance from the residents. Each program handled the issue of community involvement in program operation in different ways. One method did not provide all of the right answers. The key to community involvement was responsiveness to community input.

Families Have Valuable Lessons to

Teach

Families in each of the efforts were very heterogeneous. Though each was a member of the target community, individual differences, skills and family strengths were apparent and were important elements in program design. In order to really support families, the program had to have room to support and nurture these individual differences. For example, a participant in the FFF Pittsburgh program with great skills in budgeting, finding resources and using free or reduced cost services wrote an ongoing article in the FFF newsletter to help other parents. Eventually she was hired by the program.

In order to be useful to families, program components must be relevant to the very specific needs families bring to the program. Families vote with their feet and if the program does not meet the needs of the community, it will not survive long. Within the CSCD program, for example, the parent drop-in center was designed as a place to foster parent-child interaction along a specific theoretical model. As the program got rolling and the staff learned more about the parents who should be using the parent drop-in center, they discovered why attendance was so low and why they were not seeing the types of interactions anticipated.

In this case, parents isolated in individual apartments all day with their children did not want to go to a social setting and spend that entire time interacting with their kids. They wanted time and activities to nurture themselves and to validate their own experiences both as parents and as adults. Gradually, the staff members came to understand this dynamic. It took some time to reorient the center to meet both the original intent of the program and the needs of the parents once they were known.

Within the home visiting program for Hawaiian parents, other issues emerged concerning the same theme of responsiveness to parent input. Though culture was a unifying theme around the development of the curriculum and the entire program, Hawaiian families vary greatly in the degree to which they are involved in more Hawaiian or more western views of caretaking and child rearing. Home visitors had to learn over time to be responsive to individual family needs with respect to cultural style of interaction.

This program began with a fairly standardized curriculum beginning as early in pregnancy as possible and extending until the child was two. Again, families were heterogeneous in their knowledge and needs so a standard curriculum did not meet all needs or all levels of background. In FFF, families chose the activities they wanted to work on based on the individual child's needs.

Families in all programs have been insistent that the program be locally based. The community defines itself and the program has to be recognized as being within the boundaries of that community. If programs are truly supportive of families, they will not create other barriers that make it difficult for the family to avail themselves of services. For example, transportation is a significant issue. Cars are expensive and frequently not available. Public transportation is very time consuming and inconvenient. As they become part of the program and begin to take leadership roles within it, families can help create solutions to these types of problems if the program is well grounded in the support systems of the community itself.

Families have also taught us much about the tyranny of teaching and preaching. As we said in the beginning, one of the values which guide each of these programs is that families are basically competent caregivers. We have learned to respect the knowledge and practices of families in the way they raise their children. This does not mean that families can not use help. Rather it means that the help must be offered in a way which honors the cultural backgrounds and roles of family members and must understand the social supports already existing within families to nurture each other and children.

Families exist within ecosystems that have developed to meet needs and to provide support over time. Programs which come in for relatively short periods of time must examine their roles within these structures and not supplant the naturally occurring ways things are accomplished.

The Staff Have Much to Teach Us

In each program some combination of professional/paraprofessional partnership was developed in hiring staff. In most cases paraprofessional staff came from the communities to be served and the professional staff came from outside the community. Even though this is probably fairly typical of family support programs across the country, it creates a dynamic tension which must be addressed.

Many paraprofessional staff may not have been employed prior to the onset of this program. This is another factor which must be recognized, and will require different supports for new staff and for the more seasoned worker. We have found that support of staff and supervision of staff are not the same thing. Supervision suggests a more hierarchical structure, and support suggests a recognition that each worker is unique and brings a set of strengths to the programs which must be recognized and nurtured. Workers also bring a cultural and familial background that has a significant impact on how well they will be able to do their jobs. Each project has handled this issue in different ways.

FFF, for example, has hired an outside psychologist to create a support group for the family advocates. Meeting weekly, they used this time to help support each other and to explore the impact of the program on their own lives as well as on the families they serve. Within this context, each program has seen the tremendous responsibility paraprofessional home visitors and staff are asked to assume within their roles. They become jacks-of-all-trades to the families because they are often the only trusted support families have. Without careful assistance in helping them to understand the limitations of what staff are able to do for and with families given the time and the skill limitations of their positions, serious staff burnout can result.

The minimal formal training each of the programs are able to provide indigenous workers is always supplemented with ongoing in-service as distinct from supervision or support. Even so, family advocates and home visitors are likely to take on situations where they can place themselves and families at risk because they want to help in areas where they have little training and less experience. Thus, one lesson we have learned in supporting, training, and supervising family support workers is to help them see the limitations of what they can and cannot do. One solution to this problem in the CSCD project has been to create a team approach to visiting families, utilizing skills of professionals and the home visitor. Each member of the team has specific areas of responsibility which are equally valued.

Summary

Condensing our combined experiences from managing family support programs in very different settings is, of course, a very difficult task. In general, we know that the issues of poverty, discrimination and social programs gone awry are not easily solved; family support programs within these conditions are at best bandaids for very complex issues. Though there are data to suggest that these programs are effective in limited ways in helping families to raise their children (Olds & Kitzman, 1990), they are not panaceas. Social Social policies could benefit from a closer tie with applied research in helping us to understand the areas where family support programs can be effective (Roberts, Wasik, Casto and Ramey, in press).

The blend between empirically validated programs and the need for flexibility in family support programs is not an easy one to make. Programs such as the ones we have directed do best when they are not locked into a fixed model but have the ability and resources to evolve according to the input of families, community and program developers. These collaborative family-community partnerships are critical in developing community-based programs which meet their objectives in supporting families as they nurture their children. To this end we would suggest that models cannot drive program development -- families must drive program development. Interventions, to be effective, must make sense within the culture and experiences of those they seek to support.

Richard Roberts, Ph.D., is the former Director of the PREP program, Center for Development of Early Education, Honolulu, Hawaii. He is currently the Co-Director of the Early Intervention Research Institute, Utah State University. He has a Ph.D. in clinical psychology. Gina Barclay-McLaughlin is the former Director of the Center for Successful Child Development, Chicago, Illinois. Currently, she is enrolled in a Ph.D. program in education and psychology at the University of Michigan. Laurie Mulvey, ACSW, is the former Director of Families Facing the Future in Pittsburgh, Pa. She is currently Project Director for the Comprehensive Child Development Program, Office of Child Development, University of Pittsburgh, Pennsylvania.

References

Olds, D. L., & Kitzman, H., (1990), "Can Home Visitation Improve the Health of Women and Children at Environmental Risk?," Pediatrics, 86, 1, 108-116.

Roberts, R. N. (1988a) "Ka Ho' okipa 'Ana I ka Kaua Pepe: Welcoming Our Baby," Children Today, 17, 4, 6-10

Roberts, R. N. (1988b), "Family Support in the Home: Home Visiting and Public Law 99-459," Washington, DC: Association for the Care of Children's Health.

Roberts, R. N., Wasik, B. H., Casto, G., & Ramey, C. T. (In press), "Family Support in the Home: Programs, Policy, and Social Change," American Psychologist.

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