Evidence Based
*This information was last updated on 10.8.23. If you are aware of information related to these promising or evidence-based practices and their use in Alaska, please contact us at [email protected].
Coordination, Advocacy, Resources, Education, and Support (C.A.R.E.S.)
About
C.A.R.E.S. (Coordination, Advocacy, Resources, Education and Support) is a community-based prevention and diversion model utilizing High Fidelity Wraparound to serve families (primary caregivers) with a least one child under the age of 18 at risk for abuse, neglect, or abandonment. C.A.R.E.S. engages and builds upon families’ strengths using the Wraparound Principles to prevent children from entering or penetrating deeper into the formal child welfare and/or juvenile justice system.
C.A.R.E.S. identifies the family’s strengths and needs, convenes customized family team meetings inclusive of natural and community supports, and drafts an individualized and well-coordinated plan of care to improve family functioning and reduce the likelihood of child abuse and neglect. The model focuses on family strengthening, using measurable goals and outcomes that result in family stabilization and preservation support so that children may remain in their homes, community, and schools free from system involvement.
Target Population
Families at high risk for abuse or neglect with children aged 0-17 or a primary caregiver or caregivers of at least one child under the age of 18 who is at risk for abuse, neglect, or abandonment and their family.
Evidence-Based Ratings
Title IV-E Clearinghouse
Unrated
The California Evidence-Based Clearinghouse
Prevention of Child Abuse and Neglect (Secondary) Programs – Promising Research Evidence
Use in Alaska
AK Child & Family operates a CARES Program www.akchild.org. For more information, contact David Pantaleone 907-792-4138.
Information Sources
https://ncfie.org/what-we-offer/c-a-r-e-s-model-and-replication/
Critical Incident Stress Debriefing (CISD)
About
Critical Incident Stress Debriefing (CISD) is a facilitator-led group process conducted soon after a traumatic event with individuals considered to be under stress from trauma exposure. When structured, the process usually (but not always) consists of seven steps: Introduction; Fact Phase; Thought Phase; Reaction Phase; Symptom Phase; Teaching Phase; and Re-entry Phase. During the group process, participants are encouraged to describe their experience of the incident and its aftermath, followed by a presentation on common stress reactions and stress management. This early intervention process supports recovery by providing group support and linking employees to further counseling and treatment services if they become necessary.
Target Population
Anyone who has experienced a traumatic event leading to stress from trauma exposure.
Evidence-Based Ratings
Title IV-E Clearinghouse
Unrated
The California Evidence-Based Clearinghouse
Unrated
Use in Alaska
Many organizations in Alaska use CISD. It is commonly used by hospitals, schools, corrections institutions, police, and clinicians. If you are aware of anyone providing CISD training, please send it to [email protected].
Information Sources
https://www.osha.gov/emergency-preparedness/guides/critical-incident-stress
Eye movement desensitization and reprocessing therapy (EMDR)
About
EMDR is a structured therapy that encourages the patient to focus briefly on the trauma memory while simultaneously experiencing bilateral stimulation (typically eye movements), which is associated with a reduction in the vividness and emotion associated with the trauma memories. Eye Movement Desensitization and Reprocessing (EMDR) therapy is an extensively researched, effective psychotherapy method proven to help people recover from trauma and PTSD symptoms. Ongoing research supports positive clinical outcomes showing EMDR therapy as a helpful treatment for disorders such as anxiety, depression, OCD, chronic pain, addictions, and other distressing life experiences (Maxfield, 2019). EMDR therapy has even been superior to Prozac in trauma treatment (Van der Kolk et al., 2007). Shapiro and Forrest (2016) share that more than 7 million people have been treated successfully by 110,000 therapists in 130 countries since 2016.
Target Population
EMDR – Standard Protocol is designed to treat individuals experiencing distress associated with traumatic memories. It is also applied to a variety of other mental health problems.
Evidence-Based Ratings
Title IV-E Clearinghouse
Mental Health Programs & Services – Supported
The California Evidence-Based Clearinghouse
Trauma Treatment (Adult) – Well Supported By Research Evidence
Trauma Treatment – Client-Level Interventions (Child & Adolescent) – Well Supported By Research Evidence
Use in Alaska
Chugach Counseling and Consulting offers EMDR certification. Find out more at https://chugachcounseling.com/emdr/.
EMDR Consulting offers several virtual training and certification options at https://emdrconsulting.com/training/calendar/.
Information Sources
https://www.emdria.org/about-emdr-therapy/
Facilitating Attuned Interactions (FAN)
About
FAN (Facilitating Attuned Interactions), is a conceptual model and practical tool for relationship building and reflective practice, which can be used regardless of the model of home visiting used and has been demonstrated to reduce burnout and increase reflective capacity in home visitors. The theory of change underlying the FAN approach is attunement, defined as engaging with a person so they feel connected and understood which opens the space for change. FAN teaches providers to be as adept at reading adult cues as they are at reading baby cues. Providers learn to observe parents, match interactions to what the parents are most able to use in the moment and respond flexibly to meet them where they are.
The first process of FAN is “Calming or Mindful Self-Regulation is unique in that it focuses on the provider’s self-awareness. Providers learn to notice, track and regulate their own reactions to stay present for the family. Providers accomplish this by learning to use Mindful Self-Regulation strategies, such as breathing, grounding, or self-talk so they can see more clearly what is needed in the interaction. The four remaining processes include:
- Feeling or Empathic Inquiry, which entails providing emotional support when parents are expressing feelings.
- Thinking or Collaborative Exploration, which is used when parents want to think together to understand the concern or make a plan.
- Doing or Capacity Building when parents are ready to learn or build skills
- Reflecting or Integration, which validates parents’ insights about their child, their parenting, or their concerns.
Target Population
Anyone working with families.
Evidence-Based Ratings
Title IV-E Clearinghouse
Unrated
The California Evidence-Based Clearinghouse
Unrated
Use in Alaska
The Family Services Training Center (FSTC) is contracted with the state of Alaska, Division of Behavioral Health to provide training to professionals that bill Medicaid for behavioral health services. Interested professionals that bill Medicaid for behavioral health services, can follow up at https://www.uaa.alaska.edu/academics/college-of-health/departments/center-for-human-development/family-services-training-center/index.cshtml.
The Office of Children’s Services is implementing FAN training for its staff.
Information Sources
https://amchp.org/2020/02/15/facilitating-attuned-interactions-fan/
Family Spirit
About
Family Spirit® is a culturally tailored home visiting program designed for young American Indian mothers (ages 14-24) who enroll during the second trimester of pregnancy. The goal of Family Spirit® is to address intergenerational behavioral health problems and promote positive behavioral and emotional outcomes among mothers and children. The program uses a culturally informed, strengths-based approach for helping mothers develop positive parenting practices, strengthen their coping skills, and learn how to avoid coercive parenting behaviors and substance abuse. Community health paraprofessional home visitors deliver program lessons to participating mothers through six modules: (1) Prenatal Care, (2) Infant Care, (3) Your Growing Child, (4) Toddler Care, (5) My Family and Me, and (6) Healthy Living. The program encourages other family members to participate in the lessons alongside mothers. Home visitors also provide case management and help families access services, as needed.
Target Population
Any at-risk or young adult mother (under age 25 years) who is pregnant (ideally 28 weeks gestation or sooner) and/or has a child younger than 3 years old and lives in a Native American community; however, can be used with any pregnant woman and/or woman with a child younger than 3 years old, regardless of ethnicity/race. For parents/caregivers of children/adolescents ages: 0 – 3, 13 – 24
Evidence-Based Ratings
Title IV-E Clearinghouse
In-home Parent Skill-based Programs and Services – Promising
The California Evidence-Based Clearinghouse
Home Visiting Programs for Child Well-Being – Promising Research Evidence
Use in Alaska
South Central Foundation is beginning the process of implementing the model. If you are interested in learning more about their program, contact Cassie Stenehjem or Marisa Wang.
Information Sources
https://preventionservices.acf.hhs.gov/programs/277/show
https://www.cebc4cw.org/program/family-spirit/
https://cih.jhu.edu/programs/family-spirit-home-visiting-program/
Fetal Alcohol Spectrum Disorder
About
Babies whose mothers drank alcohol during their pregnancy can be born with birth defects and developmental disabilities. The problems that can happen when babies are exposed to alcohol are grouped together and called fetal alcohol spectrum disorders (FASDs). These include a wide range of physical, behavioral, and learning problems. The most severe type of FASD is fetal alcohol syndrome (FAS).
Children with fetal alcohol syndrome have facial features such as small eyes, a thin upper lip, and a smooth philtrum (the groove between nose and upper lip).
They also can have:
- Poor growth. Newborns may have low birth weights and small heads. They may not grow or gain weight as well as other children.
- Birth defects. FAS can cause heart, bone, and kidney problems. Vision problems and hearing loss are common.
- Seizures and other neurologic problems, such as learning disabilities, and poor balance and coordination.
- Delayed development. Kids may not reach milestones at the expected time.
- Behavioral problems. Babies may be fussy or jittery and have trouble sleeping. Older children and teens may have:
- a lack of coordination and poor fine-motor skills
- trouble getting along with friends and relating to others
- learning problems (especially in math), poor memory, and poor problem-solving skills
- behavior problems such as hyperactivity, poor attention and concentration, and impulsiveness
Children with other FASDs have many of the same problems, but usually to a lesser degree.
There is no cure for fetal alcohol syndrome or other FASDs. But many things can help children reach their full potential, especially if the problem is found early.
Kids can benefit from:
- early intervention services and special education in school
- speech-language therapy, occupational therapy, and physical therapy
- classes that teach kids social skills
- counseling with a mental health professional
Doctors may prescribe medicines to help with related problems, such as attention deficit hyperactivity disorder (ADHD), depression, aggressive behavior, sleep problems, and anxiety.
Parent training can help caregivers learn how to best care for a child with FAS and handle any problem behaviors.
Target Population
Parents/Caregivers of and children with FASD.
Evidence-Based Ratings
Title IV-E Clearinghouse
Unrated
The California Evidence-Based Clearinghouse
Unrated
Treatment and Training in Alaska
The Family Services Training Center (FSTC) is contracted with the state of Alaska, Division of Behavioral Health to provide training to professionals that bill Medicaid for behavioral health services. Interested professionals that bill Medicaid for behavioral health services, can follow up at https://www.uaa.alaska.edu/academics/college-of-health/departments/center-for-human-development/family-services-training-center/index.cshtml.
The State of Alaska provides education and training resources at https://health.alaska.gov/osmap/Pages/fasd-training.aspx.
Information Sources
Motivational Interviewing
About
Motivational Interviewing (MI) is a method of counseling clients designed to promote behavior change and improve physiological, psychological, and lifestyle outcomes. MI aims to identify ambivalence for change and increase motivation by helping clients progress through five stages of change: pre-contemplation, contemplation, preparation, action, and maintenance. It aims to do this by encouraging clients to consider their personal goals and how their current behaviors may compete with attainment of those goals. MI uses clinical strategies to help clients identify reasons to change their behavior and reinforce that behavior change is possible. These clinical strategies include the use of open-ended questions and reflective listening. MI can be used to promote behavior change with a range of target populations and for a variety of problem areas. The Prevention Services Clearinghouse reviewed studies of MI focused on illicit substance and alcohol use or abuse among youth and adults, and nicotine or tobacco use among youth under the age of 18. MI is typically delivered over one to three sessions with each session lasting about 30 to 50 minutes. Sessions are often used prior to or in conjunction with other therapies or programs. They are usually conducted in community agencies, clinical office settings, care facilities, or hospitals. While there are no required qualifications for individuals to deliver MI, training can be provided by MINT (Motivational Interviewing Network of Trainers) certified trainers.
Target Population
Caregivers of children referred to the child welfare system, it has been used with adolescents. MI can be used to promote behavior change with a range of target populations and for a variety of problem areas.
Evidence-Based Ratings
Title IV-E Clearinghouse
Substance Abuse Programs and Services – Well Supported
The California Evidence-Based Clearinghouse
Motivation and Engagement Programs – Well Supported by Research Evidence
Substance Abuse Treatment (Adults) – Well Supported by Research Evidence
Use in Alaska
The Family Services Training Center (FSTC) is contracted with the state of Alaska, Division of Behavioral Health to provide training to professionals that bill Medicaid for behavioral health services. Interested professionals that bill Medicaid for behavioral health services, can follow up at https://www.uaa.alaska.edu/academics/college-of-health/departments/center-for-human-development/family-services-training-center/index.cshtml.
FSTC has provided training to staff at https://searhc.org/, https://ninestar.org/, https://setfreealaska.org/, https://northstarbehavioral.com/, https://www.kenaitze.org/, https://www.apiai.org/, https://citci.org/, https://www.choices-ak.org/, https://aarsrecovery.org/, https://voaak.org/, https://cookinletcounseling.org/, https://www.sitkacounseling.org/, https://www.rycalaska.com/, https://www.fairbanksnative.org/.
Information Sources
Nurse Family Partnership (NFP)
About
Nurse-Family Partnership® (NFP) is an intensive, strengths-based, trauma- and violence-informed community health program whose goals are to improve the health and lives of individuals expecting their first baby and their children living in poverty. Specially trained registered nurses regularly visit individuals expecting their first baby (adolescents and adults), starting early in pregnancy and continuing through the children’s second birthday. NFP nurses aim to leverage their clinical expertise in applying behavior change and human ecology theories to deliver this client-centered program. Ideally, NFP participants develop close relationships with their nurse. It is hoped that the nurse becomes a trusted resource for advice on everything from safely caring for their child to taking steps to provide a stable, secure future for their family. In addition to living in poverty, NFP participants also often are experiencing, or at risk of experiencing, homelessness; addiction or substance misuse; involvement with child welfare or juvenile or criminal justice systems; intimate partner violence; severe developmental disabilities; behavioral or mental health needs; or a high-risk pregnancy.
In Alaska, NFP is now available to multiparous families, meaning that the child is not their first baby.
Target Population
NFP is intended to serve young, first-time, low-income participants expecting their first baby from early pregnancy through their child’s first two years. Though the program primarily focuses on mothers and children, NFP also encourages the participation of fathers and other family members.
Evidence-Based Ratings
Title IV-E Clearinghouse
In-home Parent Skill-based Programs and Services – Well Supported
The California Evidence-Based Clearinghouse
Home Visiting Programs for Child Well-Being – Well Supported by Research Evidence
Home Visiting Programs for Prevention of Child Abuse and Neglect – Well Supported by Research Evidence
Prevention of Child Abuse and Neglect (Primary) Programs – Well Supported by Research Evidence
Teen Pregnancy Services – Well Supported by Research Evidence
Use in Alaska
Providence Nurse Family Partnership (Anchorage and Mat-Su) – Contact Pamela Conrad Michaels
907-212-6543 [email protected].
Southcentral Foundation NUTAQSIIVIK – NFP (Anchorage and Mat-Su) – Contact (907) 729-2490 [email protected] or [email protected].
Information Sources
https://preventionservices.acf.hhs.gov/programs/385/show
https://www.cebc4cw.org/program/nurse-family-partnership/
https://www.nursefamilypartnership.org
https://www.southcentralfoundation.com/services/home-based-services/#toggle-id-2
Parents As Teachers (PAT)
About
Parents as Teachers (PAT) is a home visiting program designed to promote the early development, learning, and health of children and their families through an evidenced-based home visiting model. Families and caregivers are a child’s first and most influential teachers. We welcome expectant families and those with children up to five years old. We work to equip them with knowledge and resources to prepare their child for a stronger start in life and greater success in school. The eight Alaskan PAT program affiliates operate in various settings, including in homes, virtual visits, schools, tribal organizations, and housing communities providing the four dynamic components of the PAT model: personal visits, group connections, providing resource referrals, and child and caregiver screenings. Our services are delivered by Parent Educators who focus on understanding each family’s specific strengths. An additional, larger network of Alaskan organizations use the PAT curriculum in their parental support. For more information, check out the fact sheets on PAT’s evidence-based model. Contact Heather Foxworthy to be connected to a PAT affiliate nearest you.
Target Population
Families with an expectant mother or parents of children up to kindergarten entry (usually 5 years)
Evidence-Based Ratings
Title IV-E Clearinghouse
In-home Parent Skill-based Programs and Services – Well Supported
The California Evidence-Based Clearinghouse
Home Visiting Programs for Child Well-Being – Promising Research Evidence
Prevention of Child Abuse and Neglect (Primary) Programs – Promising Research Evidence
Use in Alaska
State of Alaska Parents as Teachers Affiliate Grantees
RurAL CAP Parents as Teachers – prenatal through age 5, this affiliate covers Haines, Kodiak, Anchorage, and Toksook Bay https://ruralcap.org/client-services/education/parents-as-teachers/.
Kids’ Corps Inc. Parents as Teachers – prenatal through age 5, this affiliate covers the greater Anchorage area https://www.kcialaska.org/programs/home-visiting/.
Kodiak Area Native Association Parents as Teachers – prenatal through age 5, this affiliate covers Kodiak. Contact Arwen Botz at [email protected].
The Association for the Education of Young Children Southeast Parents at Teachers – prenatal through age 5. This affiliate covers the Juneau area. http://www.aeyc-sea.org/parents-as-teachers.html.
Other Affiliate PAT Programs
Cook Inlet Tribal Council Parents as Teachers – prenatal through age 5. Their contact information is 907-793-3134 or [email protected] for Alaska Native families in the greater Anchorage area.
Fairbanks Native Association Parents as Teachers – prenatal through age 5. https://www.fairbanksnative.org/our-services/tribal-home-visiting-thv/ for Alaska Native families in the Fairbanks region.
Alaska Family Services Parents as Teachers – prenatal through age 5. This afficiliate, covers the Mat-Su area https://akafs.org/programs/family-support-services/.
Information Sources
https://www.cebc4cw.org/program/parents-as-teachers/
Parenting with Love and Limits (PLL)
About
Parenting with Love and Limits® (PLL) is a family-focused intervention for teenagers (ages 10-18) with severe emotional and behavioral problems (e.g., conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder). The program is designed to help families re-establish adult authority through setting consistent limits and reclaiming loving relationships. PLL consists of both multifamily group therapy sessions and individual family therapy coaching sessions.
Multifamily group sessions are led by two facilitators, including one PLL Coach and one co-facilitator. Group session topics include reasons for teenager misbehavior, button-pushing, behavior contracts, positive feedback, and approaches for restoring nurturing relationships. Each group session is conducted in two parts. During the first half of each session, all parents and teenagers meet in one group to learn skills related to addressing behavioral problems. The second half of each session is split into one group of parents and one group of teenagers. During these breakout groups, the group facilitator validates concerns and leads solution-focused discussions.
Families also attend individual family therapy coaching sessions with PLL Coaches. These sessions are intended to complement the group sessions and follow four phases of treatment. The first phase sets the terms of the therapy. The second and third phases focus on developing a behavioral contract and role-playing skills learned in group sessions. The fourth and final phase focuses on evaluating and maintaining progress and preventing relapse. After initial work to stabilize the family system, PLL Coaches also address trauma in the family system, as needed.
Target Population
PLL targets families with teenagers (ages 10 to 18) who have severe emotional and behavioral problems (e.g., conduct disorder, oppositional defiant disorder, attention-deficit/hyperactivity disorder). Teenagers frequently have co-occurring issues (e.g., depression, substance use, chronic truancy, destruction of property, domestic violence, suicidal ideation) and/or involvement with the juvenile justice, mental and behavioral health, and child welfare systems.
Evidence-Based Ratings
Title IV-E Clearinghouse
Mental Health Programs and Services – Supported
In-home Parent Skill-based Programs and Services – Supported
The California Evidence-Based Clearinghouse
Disruptive Behavior Treatment (Child & Adolescent) – Supported by Research Evidence
Use in Alaska
Kodiak Area Native Association offers PLL http://dev.kodiakhealthcare.org/community-services/cs-families-children/parenting-love-limits-pll/.
Sitka Counseling offers PLL https://www.sitkacounseling.org/child-family-services.
Information Sources
https://www.cebc4cw.org/program/parenting-with-love-and-limits/
https://preventionservices.acf.hhs.gov/programs/322/show
https://www.nafi.com/innovations/parenting-with-love-and-limits/
Strengthening Families
Strengthening FamiliesTrauma-Focused Cognitive Behavioral Therapy (TF-CBT)
About
Strengthening Families™ is a research-informed, strength-based approach to helping families reduce stress, address risk factors, and promote healthy development. The overarching goal is the promotion of child and family well-being. It is based on engaging families, programs and communities in building five protective factors that help families succeed and thrive, even in the face of risk and challenges. Alaska was selected in 2005 by the Center for the Study of Social Policy to pilot this approach and continues to work with programs and communities in implementing this framework.
Target Population
- Benefits ALL families and communities
- Builds on family strengths, buffers risk, and promotes better outcomes
- Can be implemented through small but significant changes in everyday actions
- Builds on and can become a part of existing programs, strategies, systems and community opportunities
- Is grounded in research, practice and implementation knowledge
Communities, providers, and families can embed five protective factors seamlessly into their ongoing work to the benefit of families and children. Five Protective Factors are the foundation of the Strengthening Families Approach: parental resilience, social connections, concrete support in times of need, knowledge of parenting and child development, and social and emotional competence of children. Research studies support the common-sense notion that when these Protective Factors are well established in a family, the likelihood of child abuse and neglect diminishes. Research shows that these Protective Factors are also “promotive” factors that build family strengths and a family environment that promotes optimal child and youth development.
Evidence-Based Ratings
Title IV-E Clearinghouse
Not rated
The California Evidence-Based Clearinghouse
Not rated
Use in Alaska
Many organizations utilize the Strengthening Families Framework in Alaska.
UAA’s Child Welfare Academy offers Strengthening Families training https://www.uaa.alaska.edu/academics/college-of-health/departments/school-of-social-work/child-welfare-academy/index.cshtml.
The Family Services Training Center (FSTC) is contracted with the state of Alaska, Division of Behavioral Health to provide training to professionals that bill Medicaid for behavioral health services. Interested professionals that bill Medicaid for behavioral health services, can follow up at https://www.uaa.alaska.edu/academics/college-of-health/departments/center-for-human-development/family-services-training-center/index.cshtml.
Information Sources
Trust-Based Relational Interviewing (TBRI)
About
Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a program for children and adolescents who have symptoms associated with trauma exposure. TF-CBT is intended to treat children/adolescents who have post-traumatic stress disorder (PTSD) symptoms, dysfunctional feelings or thoughts, or behavioral problems. The intervention also supports caregivers in overcoming their personal distress, implementing effective parenting skills, and fostering positive interactions with their child/adolescent. After ensuring safety of the child/adolescent, TF-CBT is structured into three phases that include: 1) skill building for the child/adolescent’s self-regulation and the caregiver’s behavior management and supportive care abilities, 2) addressing the traumatic experience, and 3) joint therapy sessions between caregiver and child/adolescent. TF-CBT is usually administered in clinical office settings over 12 to 16 weekly sessions for about one hour, though this can range. During these sessions the therapist may meet with the caregiver and child/adolescent separately or jointly. This program is administered by licensed mental health professionals who have received TF-CBT training and certification.
Target Population
Children ages 3-18 with a known trauma history who are experiencing significant posttraumatic stress disorder (PTSD) symptoms, whether or not they meet full diagnostic criteria. In addition, children with depression, anxiety, and/or shame related to their traumatic exposure. Children experiencing childhood traumatic grief can also benefit from the treatment.
Evidence-Based Ratings
Title IV-E Clearinghouse
Mental Health Programs and Services – Promising
The California Evidence-Based Clearinghouse
Trauma Treatment – Client-Level Interventions (Child & Adolescent) – Well Supported by Research Evidence
Sexual Behavior Problems Treatment (Children) – Supported by Research Evidence
Use in Alaska
The Family Services Training Center (FSTC) is contracted with the state of Alaska, Division of Behavioral Health to provide training to professionals that bill Medicaid for behavioral health services. Interested professionals that bill Medicaid for behavioral health services, can follow up at https://www.uaa.alaska.edu/academics/college-of-health/departments/center-for-human-development/family-services-training-center/index.cshtml.
FSTC has provided training to staff at https://alaskabehavioralhealth.org/, https://www.akchild.org/, https://www.providence.org/lp/ak/alaska-cares, https://comconnections.org/, http://www.denalifs.org/, https://www.fairbanksnative.org/, https://www.pchsak.org/, https://www.matsuregional.com/, https://www.providence.org/locations/ak/kodiak-island-medical-center/counseling-center, https://www.reach907ak.org/, https://www.rycalaska.com/, https://www.sitkacounseling.org/, https://www.spbhs.org/, https://voaak.org/.
Information Sources
https://www.cebc4cw.org/program/trauma-focused-cognitive-behavioral-therapy/