A Multi-Family Approach: Families and Schools Together (FAST) Builds Protective Factors In Potentially Neglectful Families

Lynn McDonald, ACSW, PhD
Wisconsin Center of Educational Research
University of Wisconsin-Madison

Social Isolation, Stress, and Child Abuse and Neglect

Child neglect is now the most widespread form of child maltreatment. It has doubled in frequency between 1987 and 1993, and neglect is 22 times more prevalent in low income families than middle income families (Federal ACF report summarized in Capital Times, Madison, WI., Sept 18, 1996). We also know that the division between rich and poor in this country has escalated dramatically between 1980 and 1997. We know that the biggest impact of poverty on children is indirect--i.e. through the mother. If the mother is dispirited, dejected, marginalized, without emotional and physical resources, stressed with economic worries related to obtaining basic needs, such as housing and food, and is exhausted from work, she is probably emotionally unavailable to the children's emotional needs. If in addition, the parent is socially isolated and has no intimate trusted circle of support for her efforts, there is reduced protection for the child.

Prospective studies with longitudinal research data demonstrate that the combination of high levels of stress with social isolation is the biggest predictor of child abuse and neglect (Egeland et al.; Werner and Smith). What is it about social isolation which is so devastating? Bronfenbrenner argues for the importance of an ally and a buddy for the parent of small children. Without a context of intimate social support for the parent, she will have reduced energy, patience or focus left to parent the infant, small child, or school aged child:

Anonymous Poem: A mother's eyes are her children's skies.

When a child looks up at the world, she sees her mother's face as the source of strength and meaning; if the mother is distressed, the child will be distressed; if the mother's face is happy and serene, the child will be happy. Our job as professionals and as citizens is to insure that the societal context for parenting is supportive to parents on several levels:

Our society seems to have abandoned compassion and empathy for the plight of parents of young children, and especially the mother on public assistance who is trying to make it--and rather than respecting her for taking care of her small children as a contribution to society, she is treated as though she is exploiting the system. The blame being heaped onto the low-income mother is disproportionate, on television or in the grocery store using food stamps, etc., and the impact of that blame is felt by her children everyday. Her children look at her and see her beaten down, rather than treated with respect, and it makes them feel beaten down. All parents need to be celebrated, so they can celebrate their baby.

We know that women (Gilligan, 1990) are especially sensitive to contextual cues and relationship messages as they form their sense of identity and moral values. When all of the messages from every part of their social ecology are conflicted and degraded and negative, it is not surprising that a poor, perhaps single, mother with small children withdraws from societal involvement and then from her children. The coping decisions for poor mothers often involve living in very dangerous neighborhoods, because of costs of housing. Maybe a boyfriend is helpful in paying the rent, but then demands the right to deal drugs in the living room, with threats of violence; where are her options? If the children go outside, it is a life-threatening risk; this isolates the family unit from encounters with others. A single mother and small children stay together, isolated in an enclosed space, fearful of random bullets and knives--this is a picture of severe economic and contextual stresses combined with social isolation. A 1998 sociological study of social isolation in inner cities, reports isolation to have dramatically increased in the last 10 years...because people are afraid to go out.

When do we stand up and say: This is a toxic environment (Garbarino). We must take a stand and express our concern for our babies, our children, and our fellow human beings who are parents.

Families and Schools Together (FAST) Uses Effective Outreach and Engagement of Low Income, Stressed, Isolated Parents

Literature reviews report what we already know: most programmatic efforts to engage low income families are failures (Special Issue: Journal of Marriage and Family Therapy, January, 1996). Unfortunately, there seems to be a lack of professional and societal initiative and responsibility for finding the appropriate positive strategy to effectively reach out to low income families. Instead, the usual response when low-income parents and youth do not show up to participate in the parent education/family support interventions being offered, is to blame the families. This is yet another insult to manage, while the unmet need remains: poor, stressed and socially isolated families urgently need support for the sake of their children.

FAST has developed very effective outreach and engagement strategy with low income families which holds, across widely diverse locations, high program retention rates:

if a family attends once on a voluntary basis,
over 80%
will attend between 6-8 multi-family sessions and
will graduate from FAST--this holds
across over 400 schools and communities,
in 28 states, and in three countries

Research based strategies are used in training the outreach workers (a parent-professional team) and maintaining program involvement (Cialdini; Barth). Whether the families are from rural areas in Iowa, California and Wisconsin, or inner city areas of Watts, Chicago, Milwaukee, New Orleans, and Atlanta, the children and parents like FAST. Children urge their parents to attend FAST. Families described by the school staff as "Hard to Reach" families say that they feel respected by the program process. They say FAST is the only program they like.

Three domains of information were integrated by the program founder in this process:

  1. academic professional training of a Master's degree in clinical social work (1970) and a PhD in Psychology (1976) with twelve years as a social work faculty member instructing graduate social work students in state of the art theory, research and practice in family therapy, family stress and social support, child development (normal and abnormal), parent-mediated play therapy, couple counseling, and community organizing; respects research;
  2. practitioner background: twenty years of being a social worker and family therapist in family counseling agencies, private practice, and a field work supervisor; and being committed to applications of theory and research into practice and evaluating practice;
  3. personal background: having been raised in 5 countries and seen a range of cultural styles of parents working to be the best parent they can be; and raising two wonderful children to late adolescence, including having been a stressed-out single parent for several years.

These three knowledge bases were integrated into FAST--a multi-dimensional program which builds protective factors for children and families. FAST combines the results of several empirical, published longitudinal studies from social sciences, particularly funded by National Institute of Mental Health, into an accessible program for practitioners and families.

McDonald conceptualized a multi-family approach to prevention, based on Hill's ABCX theory of family stress, which could offer opportunities to build relationships to parents of school children; at FAST one can both build active informal support networks across stressed and isolated families, while systematically strengthening the bonds within the families, (based on family therapy by Minuchin and by Alexander, and play therapy by Kogan), and to do this while having fun and building hope in the family.

Hill's Theory of Family Stress and Buffer Factors

As we review family systems or family stress research studies to examine the critical variables which lead to child neglect, there is a need to not only assess family stressors, but also to identify the protective factors which help families to survive multiple contextual stressors, and to competently parent despite chronic and acute stressors. These include within family variables, e.g. attachment, positive family bonds, effective communication, as well as across family variables: i.e. informal and formal social support networks.

Hundreds of studies have documented the positive relationship between illness and stress. Individuals who experience too many stressors at one time, i.e., multiple changes in their daily routines and circumstances, are at increased risk within one year for having an accident, for becoming physically ill (Ell, 1984), for having an impaired immune system, for becoming violent, or for relapsing (Pianta, Egeland and Sroufe, 1990; Rutter, 1983). Not only individuals, but families that experience too many stressors at one time are at increased risk for experiencing aggravated family crises. However, not ALL families with multiple stresses have crises. Why not?

Professor Reuben Hill's theory of family stress was formulated after the Great Depression (1947, 1959, 1983, University of Minnesota) based on extensive observations of families who survived contrasted with those whose families did not. Given the economic circumstances of families of today's high risk youth, his theory may have some currency for us. As Hill interviewed families who had lost their jobs and were existing in extreme poverty, he looked for factors which contributed to family survival of these circumstances. From these qualitative data, Hill theorized that there are two complex variables which act to buffer the family from acute stressors and reduce the direct correlation between multiple stressors and family crisis. These were formulated into what he called his ABCX theory of family stress (see Figure I; and Wikler, 1983, for further discussion).

The "B" variable refers to the complex of internal and external family resources and social support available to the family, i.e., the social connectedness within the family, as well as social connectedness outside the family. Hill theorized that social isolation would significantly increase the impact of the multiple stresses on the family functioning; in contrast, positive social supports would minimize the impact. Hill's "C" variable, the perception factor, was the second predictor of the extensiveness of the impact of stress on the family. This second complex factor referred to the shared family cognition and perceptions held about the stressors, e.g., the extent to which the family perceived the changes as a disaster vs. an opportunity. Hill suggested that some families had positive appraisals which they could make of changes, which increased their ability to accept their circumstances. Hill's family stress theory has been significantly expanded upon by McCubbin et al. (1983).

(B) Internal Family Resources & Informal/Formal Social Supports
Family Stressors (A) ----------------------> Family Crisis (X)
(C)Family Perception & Parental Self-Efficacy

Research studies have since offered support for Hill and McCubbin's theoretical constructs. The combination of high stress with social isolation (the "B" variable) for families has been highly correlated with many forms of dysfunctional family outcomes (Garbarino and Abramowitz, 1982; Belle, 1980; Cyrnic, Greenberg, Robinson and Ragozin, 1984; Egeland, Breitenbucher and Rosenberg, 1980; Ell, 1984; Lindblad-Goldberg, 1987; Marks and McLanahan, 1993; Simons, Beaman, Conger and Chao, 1993; Tracy, 1990; Wahler, 1983). Hill and McCubbin consider the lack of "B" and "C" variables as similarly potent and equally predictive of a family crisis. If a family experiences multiple stressors AND 1) they are socially isolated and emotionally disconnected to one another, AND 2) they are depressed, hopeless, and disempowered, THEN they will be at increased risk for illness, accidents, child abuse and neglect, and substance abuse, delinquency and school failure (Attneave, 1986; Belle, 1980). With a positive set of cognitions, an empowered attitude, and an active informal and formal support network, there would be a reduction in the likelihood that the stressful life experiences would result in a family crisis.

Assessing Hill's "B" and "C" Factors as Protective Factors

Family based prevention research for children at risk for neglect could increase our understanding of the definition, the development, and the maintenance of Hill's two complex protective factors: the "B and "C" factors. We can assume that the family of each high-risk youth involved in a prevention program has experienced multiple chronic and acute stresses; how do these interact with the protective factors for families? How do these two variables modify the impact of the stressors on parental functioning? what is the interactional process of the two factors? how does the social support network affect the positive family perception, or visa versa. We know that people who are depressed stop reaching out socially, and that isolation further affects the depression. How does depression increase vulnerability to chronic or acute stressors, and then to parenting? Are the two factors actually equally potent in predicting parenting behaviors of families under stress? Does the building up of the two complex buffer factors identified by Hill and McCubbin's theory, really wrap a significant protective-factor shawl around the family and the high-risk youth that can be described in pathway models? Is a family with strong "B" and "C" factors a resilient family as it copes with current circumstances and structural stresses over time?

A current review of prevention research (Institute of Medicine, 1994) criticized the field for its confusing range of concepts, terms and outcome criteria; they called for an effort to conceptualize prevention as either the building of protective factors or the reducing of risk factors to enhance child resiliency, for the sake of building a coherent prevention field. They also called for expanding the knowledge base for preventive interventions, and conducting well-evaluated preventive interventions and urged that this be done across all relevant federal agencies. Hill has specified two theoretically derived multi-variable, buffer factors for families of high risk youth; this is one step removed from the protective factors of the high risk youth; by identifying, understanding and ultimately strengthening the family protective factors -- i.e. positive social connections and an empowered, positive outlook -- high-risk youth and their families should better survive the multiple chronic and acute stresses of poverty and neighborhood disorganization over time, and reduce their drug dependency and associated crime.

The Fast Program Builds Family Resources and Positive Perceptions

Each of FAST's multi-family program activities deliberately build the "B" and "C" factors. Positive bonds are directly promoted on six distinct levels of the child's ecology (Bronfenbrenner; Garbarino): at-risk child-to-parent bond, family unit bonds, parent-to-parent bond, parent to self-help group bonds, parent affiliation to school, and parent linkages to community treatment/counseling agencies. Each of these specified relationships is systematically altered with highly structured, mental health research-based interactive activities to decrease child neglect (See Table on FAST Program Components and Child Neglect). The routine activities are: 1)a family meal; 2)creating a family flag; 3)singing as a large group; drawing as a family and taking turns talking; 4)acting out feelings in a charades game as a family and taking turns talking; 5)buddy time--listening and talking with one other adult; 6) self-help parent group; 7)child initiated, non-directive, parent-child play time; and 8) lottery prizes and hosting the meal; and 9)a closing circle with personal achievement announcements. FAST ends after 8 weeks with a multi-family graduation ceremony. The 2 1/2 hours, weekly meetings are process oriented, i.e. structuring the participants for each of the interactional units: 1) family table based activities for one hour; 2) adults pair up in dyads for 15 minutes; 3) adults meet in a self-help group for 45 minutes; while 4) children build peer connections in age appropriate activity groups for 1 hour; 5) parent and high-risk youth spend 15 minutes of quality time together; and, finally, 6)the whole group assembles for lottery prizes, personal achievement announcements, and a final goodbye ritual.

The multiple strategies are tightly sequenced to produce change at multiple levels of functioning in the family and between families. Conflict and criticism are explicitly blocked through instructions to the parent and support for the parent. The activities consistently promote laughter and sharing within families, as well as across families; they are non-verbal as well as verbal, allowing multi-age participants, with multi-levels of literacy, to enjoy them together. The synergy of multiple interventions in each family adds to the program impact.

FAST Builds Protective Factors in Potentially Neglectful Families

  1. Protective Factor of Support Networks

  2. Protective Factor of Strong Family Unit

  3. Protective Factor of Parenting

  4. Protective Factor of Mother as Adult Woman

  1. Protective Factor of Support Networks

    Increase Positive Informal and Formal Social Support Network For Parents and Family

    FAST offers opportunities for multiple families to gather together on a voluntary basis, and on a weekly basis for 8 weeks, to interact with one another repeatedly, positively, personally, in small combinations, to build relationships with each other.

    1. Increase Daily Positive Contact With an Adult Confidant/Buddy/Partner/Best Friend

      1. Attend 8 weeks of FAST groups and spend 15 minutes each week in Buddy time with another adult, conversing about daily stresses and sharing details of parenting challenges, and listening to one another without criticism. This is a form of stress reduction and the experiential learning is that it feels good to talk even briefly with another parent in similar circumstances--just hanging out and clearing the air of hassled living helps get along. Seeing others do it, too.

      2. During FASTWORKS being encouraged to continue to make contact with another Buddy to share daily hassles of child rearing or life in general.

    2. Increase Frequent Contact With a Few Friends/Small Group of Positive Supportive People, With Whom Various Types of Help Are Exchanged

      1. Attend 8 weeks of FAST groups and spend 45 minutes each week in a self-help parent group with other parents of young children where neglect is an issue, as well as low-income, unsafe neighborhoods, etc. During this time the very critical experiential learning is:

        • I am not alone--there are others like me, and they are neat people; so am I.
        • I can give advice to others who will listen about my successes as a parent/person. I must know something after all.
        • I can listen and learn new ideas from other mothers who have been through it.
        • Small groups of folks with whom you can honestly share on an equal level, i.e. friends, make a huge difference in quality of life and of parenting
      2. Maintain contact with the FAST parents from the self-help parent group on a structured monthly basis (FASTWORKS), as well as additional contacts through other informal connections of exchanging baby-sitting, going food shopping, helping each other to move, going to a public park event, sharing a cup of coffee, etc.

      3. In addition, at FASTWORKS, the new FAST graduate parent meets other FAST graduates from other 8 week cycles. Because of their common experience a bond exists prior to meeting because they have all been through FAST. Gradually this informal FAST social structure grows. These positive community connections form a basis for parenting with social support.

    3. Increase Familiarity, Partnership and Positive Feelings of Affiliation With Schools, Community Agencies, and Churches, Etc.

      1. Home visits, i.e. respecting the parental home turf, from a community agency professional and a FAST parent graduate to invite voluntary participation in a positive program, gives a hint of a different approach to human services. These home visits are repeated on an as needed basis throughout the program to link families with services on an individualized, as needed basis.

      2. Attend the multi-family FAST groups for 8 weeks, where the meeting is run by the professional/FAST parent graduate 4 member team, and see that although they direct the activities, the parental experiences of bonding and connecting are with their own children, family, Buddy, and self-help group, and that the professionals stay in the background, only coming forward to ask the question, respectfully, "is there anything I can do to support you as you manage your, or play with your, children. This is experiential learning of a new role for the professional from the perspective of the parent/consumer of services.

      3. The professionals attend the large meetings wearing casual clothes, working in the kitchen, playing with the children while the parents have respite and a cup of coffee, providing fun activities for the families, staying at a friendly, respectful distance but available to support if they are needed. The experiential learning is that they are not trying to get into my business, I am in charge of boundaries in my family, they are human beings--not just a role (e.g. school principal or social worker), they laugh and eat and hangout like the rest of us. This goes on for 8 weeks, without a hidden agenda, Then they congratulate the parents for successfully completing the positive program. The professionals let the families know where they work and what they usually do outside of FAST, but FAST is not where they do their substance abuse counseling, etc.

      4. During FAST and FASTWORKS, parents can refer themselves, or their friends to professionals or their agencies, whom they know on a casual, respectful, human level, rather than from a position of Need and Shame, they can take charge of this process by self-referring. (Of 191 families who had completed FAST 2 to 4 years later (28% of whom never attended FASTWORKS), 27% self-referred to counseling, 8% to substance abuse counseling.)

  2. Protective Factor of Strong Family Unit

    Increase Family Strengths: Cohesiveness, Family Unity, Family Pride

    1. Family Strengths/Cohesiveness/Unity

      1. Participate each week at the multi-family FAST session, graduate, and then continue participation at the FASTWORKS monthly sessions for 2 years. The activities are based on family therapy techniques developed by Dr. Salvador Minuchin, Dr. James Alexander, Ms. Virginia Satir, Dr. Gerald Patterson, and the family systems theory underlying the activities are family stress theory by Dr. Reuben Hill, and Dr. Hamilton McCubbin.

      2. Structural family therapy experiential activities include to help parent experience being in charge of her children successfully, each week for 2 1/2 hours for 8 weeks at FAST sessions; FAST coaches support the children serving the parent the meal to differentiate hierarchy; FAST coaches are taught to relate to the family only through the parent; FAST coaches are taught to give instructions and information only to the parent, which elevates the parent in the child's eyes. The parent is put in charge of the family. (Minuchin)

      3. Functional family therapy experiential activities include helping families to have structured communication in which each person takes a turn to speak, each person makes positive inquiry to other family members, and practices listening with respect. Conflict is blocked here, to help develop experience of successful family communication. These experiences will help the family to be capable of resolving and mediating family conflicts in the future. (Alexander)

      4. Satir family therapy expects optimum functioning families, family members can say, I want, I think, and I feel to one another. Experiential exercises in the family at FAST practice this every week in feeling charades and in scribbles. Differentiation of self within the family is practiced.

      5. McDonald family therapist says families need to have fun together/play together/laugh/singing together; this happens throughout FAST evenings.

      6. Have family routines/rituals together; this will bring families closer and will reduce substance abuse risks over time. FAST activities are routines which are repeated every week. There is a FAST song, and a FAST closing circle.

      7. Have meals together. McDonald says families that eat together, stay together. At FAST, each family sits at a family designated table, and shares a meal.

      8. Win together. Families naturally feel a benefit from being a unit. This is made overt and over the top in FAST: each family Wins the Lottery, totally fairly distributed across the group--but the family does not know which week they will win, and the children are not told that the lottery is rigged to be fair--instead the parents are told and they tell the children with confidence that their family will also win once.

      9. Work together--the FAST meal each week is planned, purchased, and prepared by the family that won the lottery the previous week--in a reciprocal exchange, the child learned that you win, and then you pay back. Nothing comes for free--always there is respectful exchange of give and take. The family hosts the meal (money is provided by FAST) and is publicly. (Dunst; McDonald)

      10. Anticipate things and afterwards remember together--shared memories for families provide for cohesion and strength. This is fostered in FAST with scrapbooks and with reflective conversations modeled.

    2. Family Pride

      1. Family flag activity

      2. Family picture

      3. Family Graduation Certificate

      4. Family Introduction--Hello

  3. Protective Factor of Parenting

    Increase Four Parenting Skills: Nurturing, Effective Discipline, Feelings Identification, and Communication

    1. Nurturing

      Increase parental ability (and time spent doing it) to positively engage the child in play interactions ("Special Play") without judgement, instruction or direction, to result in stronger attachment and maternal bonding towards the child, i.e. building a positive, caring, intense relationship

      1. To develop skills in conducting parent-mediated, play therapy with child

        Attend FAST multi-family program for 8 weeks and learn "Special Play" and practice it every week for 15 minutes at the sessions with trained FAST coaches providing supportive and corrective feedback during the enactment. Special Play is non-judgmental, non-directive, non-instructive play time. This experience will feel extremely nurturing to the child.

      2. To increase the number of days in which parent spends 15 minutes of one to one time in positive, play time with the neglected child

        Discuss the homework of practicing "Special Play" at home for 8 weeks with the other FAST mothers and develop strategies for finding one to one time during our busy lives and ways to manage home-life so that one can do "Special Play" at home successfully; during FASTWORKS, 2 years of monthly multi-family meetings continue to mutually monitor and support "Special Play"

    2. Effective Discipline

      Increase parental ability to gain compliant behavior of child without threats/abuse by repeated practice of 1 hour per week of making small requests to the child and giving positive attention for compliance, thus reducing need to use coercion practices in parenting

      1. To develop skills in requesting, following through, and praising compliant child behaviors, rather than using threats or physical power to control the child by practicing for one hour/week at 8 FAST sessions, i.e. public, supervised, supportive environment. FAST coaches join the parent by offering support to her, asking her to delegate their behavior to achieve successful control of her children at the FAST family table for behavioral rehearsals, using successive approximation and gradually achieving success with positive control strategies.

      2. Maintain these positive control parenting skills over two years through monthly FASTWORKS contact with informal social support network of FAST parents similarly empowered with skills, and with positive individual connections with professionals from agencies providing mental health and from substance abuse services, who can be contacted for therapy interventions/education.

    3. Feelings Identification

      Increase parental ability to tune into child's feelings, to help child to identify his feelings, and to articulate his feelings, and to feel his feelings are understood. Emotional intelligence predicts success in society as adults (Goleman);

      Eight universal basic human feelings identified in research are used each week in a feeling cards and feeling charades family game led by the parent. It involves taking turns choosing a feeling card, acting it out non-verbally, having family members guess what it is, and then briefly discussing it; families engage in experiential learning about how each person shows feelings differently and how to translate identification of feelings into non-verbally showing feelings, and reading each others feelings non-verbally and then translating that into words. Families practice over the 8 weeks of FAST.
    4. Communication

      Increase parental ability to get child to talk, listen to child talk, and respond in talk, by experiential learning and supported, repeated practice, thus, building trusting communication lines where child can use words to articulate needs and anticipate a verbal response. This provides the underpinning for conflict mediation/resolution.

      1. Practice communication skills with child for a half hour at each FAST session for 8 weeks, in a safe and supportive environment with structured exercises that maximize the parents success; FAST coaches available to give immediate feedback and intervention as needed to help parent be successful with process rules: make sure each child gets a turn to speak; make sure each one asks positive questions of one another (insuring that they listen); make sure that there is no teasing, criticism, negative communication;

      2. A draw and talk game called "Scribbles" is played each week at FAST by each family at their family table; each person draws a creative something out of a basic common design, and then the parent leads the discussion of each family members drawing.

  4. Protective Factor of Mother as Adult Woman

    Increase Emotional Well Being of Parents/Adult Functioning

    1. Self-Confidence

      Increase parental sense of competence, reduce depression, increase self-esteem, increase hope and positive outlook, perception of self as a winner

      1. Participate in FAST 8 weeks of multi-family sessions in which relevant activities and graduate; then participate in FASTWORKS monthly meetings for 2 years.

      2. Experiencing success in the role of parent with her children helps to establish a positive perception of self as an effective person in one of her primary social roles, that of mother; multiple small successes reinforces this feeling.

      3. Win a family prize and host a meal for the FAST families at one session, including planning, purchasing (with program providing $) food, cooking, and bringing the food to the public event.

      4. "Parent Affirmations" presented at the last week to each FAST parent graduate by the FAST team are individualized, behaviorally specific, rejoicings of demonstrated parental competencies during the FAST sessions. They are written up in beautiful form, read out loud to the parent group, and given in a frame personally to the parent. These explicit recognitions in tangible form of good parenting practices are treasured by their recipients.

      5. Feeling respected and valued in the social context of positive, regular social encounters with others helps to shift a woman's self-perception into a positive one through multiple social feedback loops of mini-behavioral sequences with ones' own family, with other families and peers, and with the FAST team of professionals and paraprofessionals. Multiple successful interactions with conflict explicitly blocked and with fun, laughter, conversation, sharing, build self-esteem.

    2. Developing Coping Skills

      Increase adult coping skills through structure of FAST/experiential learning

      1. Modeling by the FAST team, which includes a graduated FAST parent in a paid position, offers opportunities for parents in 8 weeks to see watch accomplished other women in both professional and paraprofessional roles; learning through close and positive exposure; modeling by other FAST parents on distinct areas of accomplishment, hearing and seeing each others' successes helps to energize the mothers.

      2. Becoming comfortable in a public setting (usually the school) relating to large groups as a respected participant is gradually accomplished through the 8 weeks by making the connections within the context of your supportive family/children being with you, and by learning the routines through repetition so that you can have a sense of mastery.

      3. Articulating thoughts and sorting out solutions to problems of the family and of life, in a supportive context, enables you to practice talking it out in FAST during Buddy Time and during the Self-Help group for 2 years.

      4. Impulse control: FAST structure assures fairness and helps each person to wait for their turn to win the lottery, and wait for their turn to explain their scribble, etc. Getting in touch with one's own feelings, identification, acting them out, talking about them with the children.

      5. How to ask for help: FAST coaches are taught to bring resources/support to the parent and help the parent to assess when she needs extra support, during the FAST sessions, within a respectful relationship, and the parent learns how to use social support effectively, i.e. how to ask for it or say no thanks. In FASTWORKS, the parent can ask for help from other FAST families and or skillfully get family counseling or substance abuse treatment without shame.

      6. Social skills are practiced in context which is safe and positive; meeting new people, singing and eating together, making new friends, doing skills for confidant building, family social skills, small group social skills and large group.

    3. Opportunities for Parent Development in Community

      1. More involvement in FAST, and as a volunteer leader in schools

      2. More involvement in FAST as a paid parent liaison, paid by schools, etc.

      3. Increase parent involvement in self-help activities outside FAST or schools, e.g. further education, employment, church, community activities, family counseling, drug/alcohol treatment, etc.

Results and Evaluation of FAST

  1. Child Functioning Improves At Home and At School

    Measurement of the functioning and mental health of the FAST child at home and at school, as reported by parents and by teachers, pre, post, and 2 year follow-up, using standardized instruments with established reliability and validity.

  2. Two Buffer Factors of Family Relationships and Social Supports, and Family Hope Reduce Child Abuse and Neglect

    These two factors, the social support and the perception factors, identified by Reuben Hill, a family stress theorist and sociologist, buffer the family against the crippling, chronic and acute stresses of poverty.

Data Collection Procedures:

  1. Parents filled out the Quay Peterson's Revised Behavior Problem Checklist a mental health tool, Pre FAST, post FAST, 6 months later, 2 years later;

  2. Teachers filled out the Quay Peterson Revised Behavior Problem Checklist Pre FAST and post FAST, but very few participated in follow up;

  3. Parents were interviewed 2-4 years after graduating from the 8 week FAST to determine their perception of how they and the child are doing, and the amount of involvement with informal and formal support networks.


  1. Calculated means and standard deviations;

  2. Because there were no control groups, the FAST children were contrasted with three comparison groups:

    • the published norms of the instrument for normal children and for clinical (emotionally disturbed) children
    • themselves over time: pre, post, 6 month follow-up
  3. Administered 2 tailed, paired t-tests to look for change over time and for level of significance.

  4. Aggregated follow-up responses to questionnaire on social involvement in community and with friends, and family perceptions;

  5. Conducted a factor analysis, rotated matrix, of responses to questionnaire to determine whether Hill's B and C factors clustered statistically.


  1. FAST children improved statistically significantly on mental health scores on several sub scales, pre, post, and 6 month and 2-4 year follow up. FAST seems using a standardized instrument with established validity to help parents help their children improve in school (by teacher reports) and at home, and these child functioning improvements seems to hold with repeated observations over time using the Revised Behavior Problem Checklist. They moved closer to the normal comparison group on every scale over time.

  2. 191 families reported that since FAST the parents have become more active in community activities, gotten jobs, returned to further education (44%), gone to church, stayed involved in FASTWORKS (28% never went to FASTWORKS) become more involved in children's school as partners; 35% reports that they had sought out counseling for mental health or substance abuse. After 2-4 years, parents were less isolated, had friends, more involved in the community. Of the FAST parent graduates, 86% said that they made new friends at FAST.

  3. Parents, 28% of whom had never attended FASTWORKS, reported 1)an increase in positive perception of child functioning at school, at home, the child's self esteem, the relationship with the parent, in their attitudes towards school, and 2)an increase in their positive perception of themselves as partners with the school, as powerful in helping their own child, and as having more self-esteem. Their attitudes seemed more positive and hopeful about their own prospects and about the community.

Awards and Recognition

Although FAST is not known to many of the child welfare professionals, it has garnered numerous national awards starting in 1990, (with an Office of Substance Abuse Exemplary Program Award) from an unusual range of different groups and has been put on a number of short lists of exemplary, research based, programs. The recognitions have crossed the divide of public and private sector organizations and types of federal bureaucracies and funding streams, each of which has reviewed hundreds of programs to generate a short list of 10 to 20 model programs. This diverse recognition has implications for shared funding as policy makers make decisions about how to institute widespread replication of research based programs to help children. FAST is included on the following national shorts lists:

In 1998, Ms. Eloise Anderson recommended FAST as an excellent child abuse and neglect prevention process to Polygram Records, which makes charity CD's through Hammer and Lace. They released a record in summer 1998 highlighting FAST with many feature artists singing for FAST including: Shania Twain, Patti LeBelle, Aretha Franklin, Joan Baez, Rod Stewart and many others. It is called "Saving Grace" to raise awareness of the issues of supporting families to reduce abuse and neglect.

Theoretical and Research Underpinnings of FAST

The theory underlying FAST is the family stress theory by Reuben Hill, and adapted by Hamilton McCubbin. Hill studied and interviewed hundreds of families after the Great Depression, and postulated that the impact of multiple stressors on families can be buffered by two important factors: family social connectedness (within and across families) and family attitude/optimism. The FAST program addresses both of these protective factors in order to reduce the impact of multiple risk factors on the child (McDonald and Sayger, 1998). The interactive opportunities of the 8 week program pull together NIMH funded research from the last two decades in child and family functioning, and apply findings from play therapy, marital therapy, family therapy, and small group and community organizing practice knowledge. Six distinct types of bonding and social connectedness are addressed each week at the multi-family program with effective experiential activities bringing people together in different combinations.

Ultimate Outcomes Expected

Ultimate child outcomes:

An elementary school/community which implements FAST should observe a decrease eventually in the likelihood of their adolescents:

  • to fail at school/or be suspended
  • to enter the court system
  • to become addicted to drugs or alcohol
  • to be out of control at home/or placed in residential care as adolescents.

Ultimate family outcomes:

Families which participate in FAST would have more friends, more informal and formal social supports, and would be less likely to abuse and neglect kids.

Intermediate Outcomes

Intermediate child outcomes:

The child identified at ages 4-9 by the teacher as being at-risk for later problems based on observed, within classroom behaviors, would demonstrate in just 8 weeks a reduction of mental health and behavior problems at school and at home, which would be maintained over two years, as reported by teachers and parents on standardly used mental health screening instruments with established validity and reliability (specifically on the RBPC/Quay-Peterson, 1987) in the areas of :

  • conduct disorder
  • motor excess
  • anxiety/withdrawal
  • short attention span

Intermediate family outcomes:

The families of the "at-risk" youth would attend FAST once, 85% would graduate from FAST, and 50% would participate in ongoing monthly meetings over two years.

The families of the "at-risk" youth would report an increase in family closeness as reported by parents on instruments with established validity and reliability (specifically on the FACES III, by Olsen, with linear analysis by Barnes, 1993)

The parents of the at-risk youth would report a decrease in social isolation as reported on instruments with established validity and reliability (specifically the Abidin scales)

The parents of the at-risk youth would report an increase in parent involvement in schools on instruments with established validity and reliability (specifically the Epstein scale and/or the Witte scale)

The parents would report an increase in friendships, in a feeling of partnership with the school, and an increase in community involvement in a range of activities.

Who Gets Invited to FAST: Universal or "At-Risk" Families

In 1988, FAST was initially developed for 5-9 year olds (and their whole families) in elementary school who were identified as being at-risk for later problems by teachers. The teachers were in charge of referrals, and once the parents sign a release, the collaborative FAST team makes home visits to recruit them into voluntary participation. This is the target age and at-risk is the way in which the FAST program which has been so widely replicated.

In 1991, a "universal invitation FAST model" to younger children aged 3-5 was developed by McDonald. With Center for Substance Abuse Prevention funding (1991-1996), FAST was adapted and evaluated with Head Start and pre-school aged children and their whole families. Whole kindergarten classrooms of children and their families are invited in inner city Chicago schools, whole classrooms at second grade in inner city Milwaukee are invited in Latino dominant and African American dominant schools, and in working with three different Native American Nations, school-wide invitations to FAST have become traditional. In Australia, the two neighborhoods with the highest rates of child abuse and neglect referrals were identified, and the elementary schools serving those neighborhoods were invited to become FAST schools. Universal invitations to FAST were made in the schools. FAST was extremely popular with the participants and outcomes showed significant improvement in child and family functioning in just 8 weeks.

Any two generation family is welcome at FAST: although the national profile shows that 51% FAST families are married, in Madison, 95% of the parents are single mothers. Grandmothers, uncles, etc. are all welcome; kids attend with an adult in the parenting role.

Each FAST site defines the population which the school wishes to invite, and this varies widely in terms of social class, ethnicity, and culture. For example, in San Antonio, Texas, FAST families are 80% Hispanic, and in Chicago and northern California the program is run in Spanish (materials have been translated); in New Orleans, Louisiana., Newark, New Jersey, and Flint, Michigan, FAST families are 100% black; in northern rural Wisconsin, Iowa, Minnesota, North Dakota, FAST families are 100% white. In some California sites, FAST families are multi-cultural demanding several interpreters. There have been 100% Hmong/Asian families in several FAST groups in Wisconsin. Most FAST programs are a mix of ethnicity and culture. Overall, nationally, FAST families are 51% white.

Literacy levels are not relevant to FAST since the program is set up to accommodate two year olds to 85 year olds and their literacy respective levels. There are no written materials for families. Migrant workers in Chicago reported finding out that they can help their child succeed in school even through they were themselves illiterate in English and Spanish. Very specific cultural adaptations are made at the family table by the participating families to reflect their values and language. Cultural support of the FAST team is assured with this rule: teams must look like the group families which is being invited to participate.

The average number of graduating whole families per 8 week FAST cycle is eight. The largest number in a FAST graduating class was 24 families in San Jose, California, where whole classrooms were invited. Because of evaluation purposes and in order to maximize two year programming, five families must graduate to become certified.


The name of the program is positive or neutral--not stigmatizing. Families and Schools Together. It is not called: a program for mothers who might beat her children, or a program for people who have no friends, etc.

There are three phases to the FAST program: outreach, engagement, and parent run monthly meeting.

  1. Outreach

    Parent/professional trained recruitment teams doing home visits, Recruitment home-visits are usually done by a peer parent (paid position) with a community based agency, professional. Because many families have neither car nor phone, repeated visits are often made. FAST teams are trained in recruitment techniques, also based on research, for example, using Professor Doug Maynard's, University of Indiana, research on delivering bad news and getting high medical regiment compliance. Recruitment is systematically broken down into small steps (based on Professor Cialdini, University of Arizona) and families are encouraged to attend just one session to check it out. Over 85% of those families nationally who attend one session, graduate from FAST. Obstacles to attending are reduced by offering transportation, meals, and child care.

  2. Engagement

    Eight, weekly, 2 l/2 hours multi-family meetings, with highly interactive opportunities to have fun, with meals and prizes, and with a final, formal graduation ceremony for the families to recognize and celebrate their achievement. Retention of families is systematically achieved with contingent and non-contingent social and primary reinforcers. Every recommendation made by Professor Richard Barth (University of California-Berkeley) for reaching hard to reach families is followed. Parents most enjoy having a meal served to them by their child, having respite--through adult time and self-help parent group. Each family wins a "fixed" lottery (of $30 worth of prizes and a big dramatic event which looks like TV), and the parents hear about this at the home visit, but are told not to tell their children; they do not know when they will win--so it is a high maintenance reinforcer. Once the family has become the Winning Family, the next week they are requested to cook the meal for all of the participants, so they become the Host Family (FAST gives them money to feed 60 people). Children are extremely proud of their parents when they bring in the food. This is based on the reciprocity principle identified by Dr. Carl Dunst (and also Dr. Cialdini) which transcends all cultures; families do not passively receive, but rather as in a partnership, one week they get something special, and the next week they give back something special.

  3. Parent Run, Ongoing Monthly Multi-Family Meetings

    Two years of monthly multi-family meetings which are run by FAST parents, for maintenance of change and social support networks. Parent leadership skills develop with support from the FAST Team, and they receive a budget with which to plan their activities. The location varies by community/site, but most FAST programs are held at the same school that houses the participating children.


A minimum of four staff, the FAST team for program implementation. One represents the school, one represents a mental health, community based agency, one represents a drug and alcohol community based agency, and one is a consumer/FAST parent from the target population. The team can be much larger and include additional partners, reflecting the unique community. The team make-up is based on the concept that family support and family interdependence is the goal; however, if there are issues of substance abuse and addiction which plaque the family, or issues of domestic violence or mental illness, than family support will not be sufficient. By having the professionals there as a back-drop for personal self-referral on an as needed basis, we hope to facilitate self-initiated referrals to a now familiar professional. FAST will train up to 10 members for the team. Volunteers are extremely important as child care providers, and recreational coordinators, to assist the school partners in developmentally appropriate projects and activities for the many FAST children--however these decisions are made by each local FAST team. The size of the staff depends on the number of families invited, the number of children in those families, and the level of behavior problems of the target children. Larger numbers of families can be successful with universal class room invitations, than "at risk.".

Session Content

There is no formal presentation nor session content. There is no curriculum, and no teaching. Instead, social bonding is the goal, and connections are achieved not through content, but through interacting in small groups and experiencing one another in a systematically altered set of family interactions. Behavior change takes place and wellness promotion occurs, and protective factors are built, without any lecture. Experiential learning is woven throughout the interactive exercises and with the process instructions.

For example, parents are often told that they are in charge of their family--and then are provided support from the team members to accomplish the evening successfully as they transition their family from one activity to the next. Team members are taught how to relate respectfully to the parents throughout the parent empowerment exercises of the FAST training, and are explicitly blocked from relating directly to the children. Teams are trained to formally welcome the Parents to the evening program, to give the parents information about what to do next, and to acknowledge the parents authority with their children. Most of the evenings interactions with the children are only with their own parents (except during peer activity time). Activities develop or expand behavioral repertoires in which parents become more in charge of their children and also have fun with one another. The parents direct the communications with one another by taking turns, and making positive inquiries, and the parents are helped to successfully block conflict.

Thus, the session "content" is determined by who is bonding with whom:

  • 1 hour: WHOLE FAMILY UNIT: meal, songs, games of drawing and talking, miming feelings and talking about them, all at a family table designated by a family flag; interactional rules determined by research by Alexander; Minuchin; Satir; Wolin.


    • 15 min. Parent to parent--couple therapy, R. Stuart; adult intimate support, Belle

    • 45 min. Parents in Self-help Peer Group--parents find their own group voice and social connection to help each other help their children succeed in school and at home; based on research by Wahler; Egeland; Cochran; Wolf.

    • 1 hour Youth peer groups--developmentally appropriate activities are organized for youth peer groups; each site identifies their own activities.

  • 15 min. ONE TO ONE TIME: Parent/at-risk child--"special play", interactional rules are to not teach, not boss, and not criticize, and to follow the child's lead with full positive attention; research originally by Kate Kogan, Univ. of Wash./also documented by Barkeley; Webster-Stratton; Guerney; Greenspan; Shedler & Bloch.

  • 15 min. FULL GROUP Lottery, closing circle, announcements, and ending ritual "Rain" Parents with School and Community professionals, and everyone together sharing routines that are fun and positive.

Every week the structure is the same, with small exceptions for session l, 5, and 8; the first night there is a family flag to construct and introductions; session 5 is a family discussion on substance abuse; session 8 there is a graduation ceremony at the end.


I suggest that we can do something to help children in toxic environments. We can systematically provide research and theory based family support programming which enhances protective factors in potentially abusive and neglectful homes. Thus, children can experience positive parental, familial and peer bonds and sustain their optimal functioning over time. Basic supports of parents must include economic supports, health care supports, and informal and formal social supports. FAST-like family support programs can enhance development of positive informal and formal social support networks which parents need.

The motivation for providing this should come out of respect for all parents and basic social responsibility. At the same time, it make fiscal sense to start early. You pay now or you pay later. In collaboration with schools, Head Starts, or daycares, universal FAST groups make fiscal sense: a dollar for prevention and early intervention saves many dollars down the road. Doing outreach and home visits and bringing families of young children together in clusters supports the family strengths, informal networks, and builds community: Circles of FAST families reduce neglect and abuse of children.


[Update 2013-05-14]
Carol Goedken
CEO/Executive Director
2801 International Lane Suite 212
Madison, WI 53704
Toll free: 888-629-2481
Fax: 608-663-2336

Lynn McDonald, PhD. ACSW
The FAST Project
Wisconsin Center for Education Research
University of Wisconsin-Madison
1025 W. Johnson St.
Madison, Wisconsin 53706
tel-608-263-9476; FAX 608-263-6448
e mail: mrmcdona@facstaff.wisc.edu

Copyright © 1998 Lynn McDonald.

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