Commentary: Family-Centered Treatment in Hispanic Communities
According to a report released this summer by The Partnership at Drugfree.org (23rd annual Partnership Attitude Tracking Study, 2012), Hispanic teens are more likely to abuse illegal and legal drugs than their black or white peers (54 percent compared with 45 percent of black teens and 43 percent of white teens). Earlier studies comparing non-Hispanics and Hispanic males found higher rates of alcohol-related problems, intimate partner violence and cirrhosis mortality for Hispanics. Unfortunately, substance abuse serves a purposeful function for many Hispanics as a means of escape from the problems related to social, environmental and political structures (Gallardo and Curry, 2009).
Celebrating Families!™ (CF!) is a family-based program for parents in early recovery with their children. CF! was created to help families deal with substance use disorders, to prevent children’s future use and to help unify families involved in Dependency Drug Court. ¡Celebrando Familias! (¡CF!) was developed specifically for Spanish-speaking families affected by substance use disorders, based on Celebrating Families!™, which is listed on the Substance Abuse Mental Health Services Administration’s National Registry of Evidence-Based Programs & Practices. Both CF! and ¡CF! have been replicated in multiple settings including schools, community-based sites, dependency drug courts, child welfare organizations and treatment facilities. The programs use a multi-family, skill building model, engaging every member of the family with the goal of breaking the cycle of chemical dependency. Curriculums and training are available from the National Association for Children of Alcoholics (NACoA) and its specialty site www.celebratingfamilies.net.
Research by the Celebrating Families!™ development team found that programs involving the entire Hispanic family are virtually non-existent. As part of evaluating the effectiveness of the programs, two prospective studies tested the hypothesis that family-centered intervention is as effective with Hispanic families as with non-Hispanic families and that a family-centered treatment model can be an effective treatment intervention for Hispanic clients (Sparks, Tisch and Gardner, 2013).
In the first study (Coleman, 2006), the program was presented in English to both non-Hispanics and Hispanics together and compared changes within the families for parenting skills, family strength/resilience, parent observation of their children’s behavior, parent cognitive awareness and parents’ level of alcohol use. In the second study (Sparks, Tisch, Gardner, & Sparks, 2010), the program had been culturally and linguistically adapted for Hispanic populations. It was presented in Spanish to monolingual and limited English- and Spanish-speaking adults and in English to the bi-lingual children of the adults. Results from participants and group leaders were compared to a previous study of the English version of the program, which had been presented to English-speaking participants. Several areas of effectiveness were measured: parenting skills, family strengths/resilience, parent observations of their children’s behavior, and level of cognitive understanding of substance abuse (LutraGroup, 2007).
In Coleman’s study, using Celebrating Families!™, all participants (Hispanics, Whites and other minorities) showed improvement in each of the five measures with no evidence of problems with cultural competency indicated in this study. This study also revealed especially promising results in regards to Hispanics’ participation in CF!, with Hispanics showing more change in CF! when compared to non-Hispanics. Coleman suggests that a family-centered model, such as CF! may be an excellent resource for Hispanic clients dealing with substance abuse.
In Study 2 (Sparks, Tisch, Gardner, & Sparks, 2010), ¡Celebrando Familias! results were consistent with findings of Coleman and LutraGroup (2007), indicating significant impact on family organization, cohesion, communication, conflict solving, strengths and resilience, positive parenting, parent involvement, improvement in parenting skills, and alcohol and drug use reduction. Group leaders for youth observed very significant positive changes with 96 – 99 percent confidence levels. The availability of childcare was noted as being very important in parents’ willingness to attend.
In addition to quantitative evaluation, qualitative evaluation provides additional data and insight. Responses to open-ended questions by the parents and group leaders about the impact of the program included:
• If there is an alcoholic in the family, all the family suffers.
• It is important that the manner in which I respond to and attempt to help a person is important – not be oppositional.
• My children told me “We need to eat together. If not, we’re not family!”
• The importance of self-control.
• A single mom of a third-grade student with behavior and social issues told her story of drug use while pregnant and as a young mother. Tearfully, she said “If I’d known then what I have learned through ¡Celebrando Familias!, things would have been different!”
• The amazing turnout of fathers and their commitment! “Never have I had so many dads in my class!”
• A Mom asking, “What is an alcoholic?” After the explanation, her response of “My dad is an alcoholic!”
• A Mom saying, “I hug my kids and tell them I love them now. I don’t know why I didn’t do it before…perhaps I was embarrassed, but not anymore!”
These studies strongly suggest that family-centered program models, such as Celebrating Families!™ and ¡Celebrando Familias! can be an effective intervention for substance use disorders with Hispanic clients (Sparks, et al., 2013). Results of both studies indicate that the model is as effective for Hispanic families as non-Hispanic families, and in many instances, even more effective for Hispanic families. Both programs were enthusiastically received by both English and Spanish speaking participants, as indicated by satisfaction scores in both studies.
Rosemary Tisch and Sis Wenger
National Association for Children of Alcoholics
Coleman, K. (2006). The success rate of Hispanic vs. non-Hispanic participants in Celebrating Families!™. www.celebratingfamilies.net/evaluation_reports.htm.
Gallardo, M.E., & Curry, S. (2009). Shifting perspectives: Culturally responsive interventions with Latino substance abuse. Journal of Ethnicity in Substance Abuse, 8(3), 314-329.
LutraGroup. (2007). Final outcome evaluation report for Lucile Packard Foundation for Children’s Health.
Sparks, S., Tisch, R., Gardner, M., and Sparks, J. (2011). ¡Celebrando Familias! An innovative approach for Spanish speaking families at high risk for substance abuse disorders.
Sparks, S., Tisch, R., & Gardner, M., (2013). Family-centered interventions for substance abuse in Hispanic Communities. Journal of Ethnicity in Substance Abuse,12:68-81
Tisch, R. and Sibley, L. (2004) Celebrating Families! Family Resources International. www.celebratingfamilies.net.
Tisch, R., Sibley, L., and Ramirez, M. (2009). ¡Celebrando Familias! Prevention Partners International. www.Preventionpartnerships.US.