Table of Contents | Previous | Next |
Chapter II: Implementation Approaches
Identifying a service delivery organization that is likely to attract low-income couples and engage them in the program is a particular challenge for many healthy marriage initiatives. Although state and local government agencies may be interested in sponsoring such initiatives, few are equipped with the appropriate background, staff, or facilities necessary to deliver marriage or relationship skills education themselves. Thus, one of the first questions that planners of healthy marriage initiatives typically face is who or what organization will carry out the direct services to clients. In making this decision, planners often must consider a range of tradeoffs that may affect the success of service delivery. For example, counseling centers that provide marriage or relationship skills education may work well for middle-class families, but may have little experience in attracting or serving a lower-income population. On the other hand, social services organizations that serve the poor typically have little or no experience talking with clients about their personal relationships, or about marriage, and may not even recognize that their single parents are in viable relationships.
This chapter focuses on what the BSF project has learned about the kinds of local entities that succeeded in implementing the program model, including organizational and staffing successes and the challenges encountered in developing a service delivery system. Some of the decisions that organizations made, and the challenges they faced, would be similar for any new programming effort, while others are unique to healthy marriage initiatives, particularly those focused on unmarried couples. In future reports, when the sites will have had more experience, we will be able to comment more thoroughly on the strategies that were used to overcome obstacles; however, based on the experiences from pilot BSF operations, we can begin now to identify some of those unique decisions and challenges and to describe how sites responded. This chapter begins with an overview of three broad approaches to implementation taken by BSF pilot sites. For each type of approach, we discuss the relative advantages and disadvantages relating to initial start-up, how the approach was implemented, and what challenges arose during initial implementation. The chapter concludes with a discussion of staffing and training issues that were common to all pilot programs.
A. OVERVIEW OF BSF PILOT PROGRAM SETTINGS
The pilot sites were free to implement the BSF model in any way they wished within the general constraints of the BSF model guidelines, which called for three major components: group instruction in marriage/relationship skills, family coordinators, and access to a range of family support services. This strategy permitted sites to think creatively and find innovative implementation approaches that fit their local resources and circumstances while still following a common model. Obviously, the ideal setting for a BSF program would be an organization with either prior experience or existing infrastructure analogous to the three BSF components. Such organizations did not appear to exist, so pilot sites either located BSF services in organizations that had some structure analogous to at least one of the components, or built the entire program from the ground up.
As it turned out, the service delivery approaches taken by the seven BSF pilot sites can be grouped into three general categories, as shown in Table II.1. The sites within each group had similar advantages at initial start-up, although these advantages varied across groups. In the first group, sites sought to “graft” BSF onto the procedures, practices, and service delivery system of an existing host organization that already had been providing other direct services to low-income families. Three BSF pilot sites took this integrative approach, building onto Healthy Families, a home-visiting program for new at-risk parents. In the second group, which includes two community-based organizations offering multiple center-based programs, such as employment services, parenting education, and fatherhood programs, sites chose to offer BSF as an independent program along with their array of other existing services for low-income families. The remaining two BSF pilot sites, the third group, were similar in the sense that they both chose to develop and implement the BSF model outside of the context of any existing center or program that provides direct services. Instead, they built the necessary infrastructure as they went along.
Below we discuss the benefits and challenges these site groups experienced in implementing the program model. It is important to bear in mind that, although sites can be grouped by general approach, the advantages and challenges were not always a function of the setting or implementation approach; some challenges were an inherent function of the specific host program or sponsoring organization. For example, the Maryland and Louisiana sites had experience in engaging the participation of men in their fatherhood programs, but this would not necessarily be true of all multi-program agencies.
B. INTEGRATING BSF INTO AN EXISTING PROGRAM
The three pilot sites that chose to integrate BSF into an existing home-visiting program—Florida, Indiana, and Texas—had several distinct advantages from the start. First, they had an existing staff infrastructure that included intake and direct services staff, management and supervisory personnel, and sometimes administrative and support staff, including information technology professionals connected with a broader statewide system of service delivery. Second, as part of their home-visiting services, staff already had developed procedures for assessing clients for various service needs and connecting them to available resources in the community. Third, they had well-developed connections with birthing hospitals that allowed them to access expectant and new parents directly for their home-visiting service. Fourth, they were already known and had well-established reputations in the community as organizations that serve vulnerable families. Finally, they had strong orientations toward providing instruction in parenting and child development, since that was the main focus of their home visits.
| FL, IN, TX BSF Embedded Within an Existing Home-Visiting Program |
LA, MD BSF Added to Services Offered by Multi-Program Agency |
GA, OK BSF Created As Organization’s First Direct Service |
|
|---|---|---|---|
| Existing intake and service delivery staff |  |
|
|
| Existing facilities and experience providing group services1 | |
||
| Family support services available on site or via existing referral system | |
|
|
| Established presence in the community | |
|
|
| Ready access to and experience working with low-income parents | |
|
|
| Experience in engaging the participation of fathers1 | |
||
| Strong emphasis on parenting and child development (host program) | |
||
| No potentially competing program goals, policies, or procedures | |
|
| Note: Unlike the other home-visiting programs, one of the Texas sub-sites, San Angelo, had existing facilities and experience in providing group services and engaging the participation of fathers. |
1. How BSF Was Embedded in the Existing Infrastructure
The three sites that integrated BSF into their home-visiting programs took several steps: they used their existing staff and procedures in new ways, they hired additional staff to fill positions for which they had no suitable personnel, and they developed or secured facilities for conducting the group sessions. To recruit BSF-eligible couples, these sites trained their existing staff to incorporate an assessment for BSF eligibility into their intake assessments for the home-visiting service. To fulfill the role of the BSF family coordinators, the sites used existing home visitor staff, who already were accustomed to referring families to other needed support services. To develop the instructional component in marriage and relationship skills, the sites either provided curriculum training for existing program managers or assistant program managers designated to conduct the group sessions, or hired or contracted with staff with appropriate background.
Early in the planning stages, these sites realized the importance of employing male staff. Most home-visiting programs are run almost entirely by female staff, and there was concern that, if BSF lacked staff who could relate to them, the male members of BSF couples would feel out of place. Therefore, the programs made an effort to hire new male staff to conduct outreach to men and to co-facilitate the couples’ group sessions.
In addition to assigning new roles and functions to existing staff, the need for retraining also was apparent from the beginning. For example, the home visitors had to learn how to incorporate BSF-related functions into their home visits, including encouraging ongoing attendance at group sessions and reinforcing the skills that participants were learning at group. These staff were accustomed to working mostly with mothers and babies, rather than with couples, so they had to learn new ways of relating to a two-parent family and forging relationships with the mothers’ male partners. To help address this need, home visitors and intake workers in most sites participated in at least one or two days of the group leaders’ curriculum training, as well as a one-day training in “how to work with couples.”
2. Challenges Encountered With the Embedded Approach
Although the approach of embedding a healthy marriage program into an existing service delivery system has some obvious advantages, pilot sites that used this implementation strategy experienced several challenges.
Distinguishing Multiple Missions Within Agencies. Many challenges stemmed from the fact that, while the mission of the host agencies (to reduce child abuse) and BSF’s mission (to support healthy relationships and marriage) certainly were compatible, they were not the same, and these differences often were reflected in existing procedures and policies. Consequently, these sites were challenged by the need to revise or develop program approaches that could meet the objectives of both the host and the BSF programs.
Sometimes these compromises were difficult. Choices had to be made regarding the amount of time staff would spend to meet the objectives of each of the two programs for assessment, enrollment, and service delivery. For example, a primary goal of the home-visiting programs is to assess every mother giving birth for her risk of child maltreatment. However, only a small fraction of those giving birth are likely to meet the very specific BSF eligibility criteria. This meant that staff were spending a significant amount of time assessing many parents who were unlikely to be eligible for BSF. Another example of competing program goals was seen in the work of the home visitors, who traditionally use the Growing Great Kids curriculum to teach parenting and child development. When the BSF family coordinator functions were added to the home visitor’s duties, staff often struggled to find an appropriate balance between the amount of time they would spend on the couple’s relationship and the time they would spend teaching the parenting curriculum.
Risk of Overburdening Couples with Two Programs. The main objective of the child-abuse prevention programs was to provide intensive home-visiting services aimed at improving parenting and knowledge of child development. Understandably, the host program’s sponsors did not want to miss any opportunities to provide home-visiting services to families that were deemed in need; for this reason, they required all eligible families who accepted the weekly BSF program also to accept the often weekly home-visiting service. In some cases, couples who enrolled in BSF later changed their minds when they learned that they also would have to participate in the regular home visits. Sites learned to avoid this problem by presenting the participation requirements for both programs at the same time. Still, it is not known what proportion of eligible families might have been discouraged from agreeing to BSF in light of the intensive dual participation requirements.
Making the Group Sessions the Centerpiece of the Program. Most home-visiting programs have had little experience providing group-oriented services, relying primarily on individual in-home contact instead. Yet the core component of the BSF program is group-based instruction in relationship skills and marriage. Because of their strong belief in the home-visiting approach, some programs at first thought that it was necessary to “stabilize” families through a prolonged period of individual home visiting prior to inviting them to participate in group sessions. These sites found, however, that by the time they invited families to the group sessions, some couples had lost interest. It is possible that these couples interpreted the focus on parenting during home visits as the primary intervention, with the relationship skills education as only a secondary, and perhaps optional, focus.
Serving Low-Income Men. Integrating a focus on the couple during home visits was a new experience for most home visitors. Prior to integrating BSF, staff typically welcomed, but did not particularly encourage or require, the participation of fathers during home visits. For BSF, scheduling visits when both parents would be home was in itself a major challenge. In addition, home visitors had to learn how to become father-friendly and think of the couple as the unit of service, rather than just the mother and baby. As the pilot progressed, home-visiting staff witnessed the attendance of couples at group sessions and came to realize how important the couples’ relationships were to them. This helped home visitors to understand the importance of serving both parents, and some found the new approach refreshing. As one home visitor in Florida put it, “Serving both the mother and the father is twice the work, but it’s also twice the reward.”
Shifting from Serving Single Mothers to Serving Couples. Other issues arose in the shift from focusing primarily on the mother and her new baby to focusing on the couple and baby. Sometimes this shift challenged sites to reconsider carefully their traditional approach, as in the case of domestic violence. Being a victim of domestic violence traditionally was a reason to screen a woman into the home-visiting program, so that staff could help her leave a dangerous situation. In contrast, BSF seeks to serve couples through an intervention that requires the participation of both partners, which might endanger victims in cases of serious domestic violence. For BSF, the presence of serious intimate partner violence is a reason to exclude couples from the program, while providing the victim with appropriate services to ensure safety. Although the home-visiting sites always had screened women for domestic violence, they were not accustomed to assessing whether mothers would be endangered by participating in a couples program. Consequently, the home-visiting sites had to work closely with their state’s domestic violence coalitions and other experts to find a solution to these competing goals, and to develop methods to effectively identify those couples who would be inappropriate for BSF.
Changing Long-Established Procedural Approaches. The host organizations also found it challenging to change long-established procedures that they previously had found effective for their home-visiting service, so as to accommodate BSF. For instance, the standard practice for identifying eligible parents for the home-visiting program involves a lengthy informal conversational procedure. Sites were reluctant to alter this assessment approach. Adding BSF’s structured eligibility questionnaire to this more informal intake approach required both flexibility and creative thinking.
C. ADDING BSF SERVICES TO A MULTI-PROGRAM AGENCY
Two BSF pilot sites—Louisiana and Maryland—were developed by community-based organizations that chose to offer the BSF program independently, along with an array of other existing services for low-income families or expectant parents. Both of these organizations offered numerous advantages for the initial start-up of BSF operations (see Table II.1). First, they had existing intake and service delivery staff associated with the various direct services they provided, as well as administrative staff that managed the centers’ daily operations. Second, they had experience in providing group-oriented family services at locations that were well known, accessible, and convenient for low-income parents. Third, families were accustomed to coming to the centers, not only to participate in various group-oriented activities or programs, but also to access the on-site array of other family support services such as job placement or parenting education, or to obtain linkages to such services available in the community. Fourth, both organizations were highly regarded in their communities as serving the needs of young vulnerable families. Fifth, as one of their services, both operated programs to encourage responsible fatherhood. This meant that they already employed a number of male staff and had developed significant experience in conducting outreach to low-income men and engaging them in center-based activities—a skill that is essential to involving couples in BSF. Sixth, the organizations had direct access to low-income expectant or new parents through their range of programs, or through their connections with the larger community.
1. How BSF Was Added to the Organizations’ Other Family Services
Perhaps the most important advantage of this implementation approach is that it allowed sites to be free of potentially competing program philosophies or goals while still taking advantage of the organizations’ experience in operating structured center-based group sessions for low-income families. In contrast to the approach taken by the home-visiting programs, these two community organizations chose not to embed BSF within the intake procedures or delivery of one of their other family services. Instead, they hired and trained new staff and developed procedures and policies specifically for BSF, while simultaneously working to develop the support of existing programs and staff. They drew on their reputations in the community and existing connections with other service providers to identify the best source for recruiting eligible couples and used their existing community-based facilities as locations for services.
The institutional experience of providing group-oriented activities for low-income families, such as classes or meetings focused on parenting or job search skills, meant that these sites had already developed warm and friendly environments that were welcoming to parents, and had learned the importance of providing supports to facilitate group participation, such as child care and transportation assistance. For instance, to encourage participation in group activities, one of the sites had already created a bright and cheerful “store” with items such as new baby clothes, car seats, and infant toys, where participants could cash in “baby bucks” they earned for participation in the various programs for parents offered at the center.
2. Challenges Involved in Adding BSF to the Services of a Multi-Program Organization
In general, sites that added BSF to the services of an existing multi-program social services organization had some initial advantages not present in other sites, as summarized in Table II.1. They also faced two particular challenges.
Creating the BSF Family Coordinator Function. Although the community organizations operated programs that involved a case-management element relatively similar to the BSF family coordinator function, they chose not to integrate the two, usually because the programs focused on somewhat different population groups. To develop the BSF family coordinator function, the organizations hired new staff and developed procedures and policies that differed in some degree from those of the home-visiting sites. First, although the community organizations also conceived of the family coordinator function as one that required regular contact with participating families, they did not necessarily define that contact as a home visit, per se. The procedures specified that family coordinators could meet with families at the center, by telephone, before or after group sessions, in the community, or wherever families felt most comfortable. Second, these sites also chose a level of contact frequency that generally was less intense than that required by the home-visiting programs. Third, family coordinators in these sites did not teach a structured parenting or child development curriculum, as in the home-visiting programs, although families were encouraged to participate in parenting education classes available at the center or in the community. In these sites, the family coordinator role was more targeted toward fulfilling the functions specified in the BSF model guidelines: to support and encourage participation and ongoing attendance at group sessions, to assess and link family members to needed support services, and to reinforce the relationship skills that the couples were learning.
Shifting from Recruiting Men to Recruiting Couples. As part of their experience in operating fatherhood programs, these organizations had learned how to go into the community to recruit and engage the participation of low-income men. Understanding how to approach low-income men in a way that is most likely to elicit their interest is an essential skill for BSF recruitment. Although experience with men was clearly an advantage, it did not mean that the organization automatically would be successful in recruiting couples. Because couples rarely participate in social services together, creative new strategies still were needed to identify at least one likely eligible partner and determine the interest and eligibility of both.
D. CREATING BSF PROGRAMS FROM THE GROUND UP
The two remaining BSF pilot sites—Georgia and Oklahoma—chose to implement the program model by developing a completely new program infrastructure devoted solely to BSF. Although neither sponsoring entity previously had ever implemented a direct services program prior to BSF, they hired staff who had this experience to lead the program development. Although a great deal of effort was needed to develop and implement BSF in the absence of any program infrastructure, there were still important advantages to this approach.
1. How the BSF Program Was Created from the Ground Up
The two sites that chose this implementation approach found creative ways to build the program from the ground up, by securing facilities for administration and service delivery and hiring an entire set of staff to run the operation. These sites hired program managers, supervisors, and outreach staff, full- or part-time family coordinators, and contracted with experienced individuals to facilitate the groups sessions. Clearly, this implementation strategy required significant investment and resources, but it also provided freedom from any potentially competing program philosophies and constraining management or program policies from a host program. For instance, site developers were free to seek out and employ only individuals who from the outset were accepting of the BSF mission and its strong focus on the couple relationship and marriage. Consequently, staff needed less retraining, compared with other sites. Sites were also free to develop policies that were maximally efficient for recruiting and serving the BSF target population without distraction from competing objectives.
2. Challenges in Creating a BSF Program From the Ground Up
The sites that developed BSF programs without an existing program infrastructure faced a different set of challenges, including the need to hire all staff and secure facilities. In addition they needed to identify the family support services in their communities, create linkages to them, and define the roles and duties of the family coordinators.
Identifying and Creating Linkages to Family Support Services. Unlike the home-visiting programs or the multi-services agency programs, sites that started from the ground up had to identify the range of family support services that were available in the community to which BSF families could be referred, and create linkages and connections that did not previously exist. As part of the program planning effort, one of the two sites engaged in a systematic and in-depth effort to identify and survey such services in its metro area to determine the capacity and willingness of each program to accept BSF referrals. Another strategy used by both sponsoring organizations was to develop and gain the support of a coalition of interested public and private agencies who were interested in seeing the BSF program succeed. These agencies could be instrumental in providing information or helping to create the needed connections between BSF and available family support services.
Defining the Family Coordinator Function. As with the multi-services agency sites, the component that required significant development was the BSF family coordinator function. While sites were successful in hiring social workers with a background in serving low-income families, and although the BSF program guidelines specify the general role the family coordinators are to perform, there was little foundation upon which to build a systematic effort (e.g., how often to visit families, where to visit them, how to assess them for family needs, what topics should be discussed). Thus, policies, procedures, and processes had to be developed to support this important program component.
E. EXPERIENCES WITH STAFFING AND TRAINING
Regardless of the implementation approach or program setting, all BSF pilot sites had to confront issues related to hiring and training program staff. Some sites reassigned existing staff and trained them to perform one or more of the BSF staff roles, while others hired new staff or made use of contractors. Most sites employed some combination of these strategies, although the home-visiting programs were more likely to use existing staff to perform BSF functions.
1. Staffing Strategies
Identifying the most appropriate background and qualifications for the staff that would carry out each of the BSF functions was not immediately obvious, since BSF is one of the first programs of its type. Each site used its best judgment, and typically experienced and learned from some period of staffing trial-and-error. In the end, most sites generally came to similar conclusions about the qualifications and background that would be needed for each position.
Curriculum Group Facilitators. All seven of the BSF sites arranged for curriculum groups to be facilitated by a male-female team of at least two people. The presence of both men and women as group leaders was considered to be essential in putting participants of both genders at ease and providing each with a role model and someone to relate to during discussions of relationships and marriage. Within each group leader team, one person generally was considered more senior and usually had a master’s degree in counseling, social work, mental health, family therapy, or a similar discipline. Ideally, this person also had experience in facilitating group interventions and working with low-income families. In reality, it was not always possible to find individuals with this mix of experience, so sites often had to employ master’s-level personnel who had either group or low-income experience, and train them in the area in which they lacked experience. Two of the sites chose to operate groups with a larger number of couples compared to other sites; these two employed coaches who circulated around the room to provide more individualized attention as couples practiced communication skills. Both the coaches in these sites and group co-facilitators in the other sites typically had less formal education (sometimes only a high school diploma), but often had experience in working with low-income families or with men.
One site had two group leader teams who were married couples, had been together many years, and had children of their own. Being older and of the same racial/ethnic background as the couples they served meant that these facilitator teams could serve as real role models for healthy marriage, and could refer to their own experiences as they taught the curriculum-based skills and information.
At several pilot sites, contractor staff were used to lead the curriculum groups, a strategy that was particularly useful while sites gradually were building their service capacity. Groups often were held at night or on the weekends so these staff could usually hold other jobs until the program became large enough to sustain them on a full-time basis.
Family Coordinators. At many sites, the family coordinator position was filled by mostly female staff who had either a bachelor’s degree in social work or a similar area, or who had a high school education and relevant experience. Sites looked for past experience in case management and providing services to low-income families, as well as knowledge of available family support services. Family coordinator staff often were women, but depending on the family’s needs, could be accompanied by male BSF staff. At the sites that built onto a home-visiting program, the family coordinator role was added to the other responsibilities of the home visitors associated with the host program. At those sites, the family coordinator often developed a very close bond with the family because of the frequent in-person visits to the home. This put them in an excellent position to encourage participation and ongoing attendance at the curriculum groups.
Intake and Outreach Staff. The role of intake staff was to identify and assess the eligibility of potential BSF participants. Male outreach staff often were used to locate and assess the eligibility of the male partners of women who already were known to be eligible and interested in the program (at some sites, these male staff doubled as group co-facilitators). Most intake and outreach staff were paraprofessionals with at least a high school education. According to program managers, the ability of intake/outreach staff to connect quickly with people was the most important attribute or skill. Most sites knew that some clients might be reluctant or even suspicious of the motives of any staff member whose aim was to offer information about programs, let alone a program about personal relationships and marriage. Therefore, they felt it was essential that intake and outreach staff be individuals that could readily relate to the target population and have good rapport-building skills. Sites believed that it was helpful for workers to have characteristics that were similar to those of participants, such as cultural background, gender, age, or experience. One particularly successful intake team was a young African American couple expecting their first child, who met with interested African American couples in their homes to assess eligibility.
Program Managers and Supervisors. In general, BSF sites employed program managers who had background and experience in administering direct services to low-income families. Those managers who had to split their time between BSF and management of other programs reported feeling challenged, because the up-front effort to bring staff online and develop and refine procedures was greater than was first envisioned. The supervisory function was one that also had to be developed for BSF. Although home visitors already had supervisors who monitored the frequency and quality of home visits, these supervisors often struggled at first to understand what aspects of performance they should monitor for the BSF part of their duties. This was especially true for the supervisors of group facilitators, who had themselves never before led a couples group in the marriage/relationship skills curriculum. Consulting with the curriculum developers, and sitting in on regular meetings between group facilitators and developers, was useful in helping the supervisors to define more clearly what to look for.
2. Staff Training
Training is always a central element of any new program implementation. Yet in the case of healthy marriage initiatives, training often must go beyond functional information such as how to complete intake paperwork or how to follow a curriculum lesson plan. BSF sites found that it was essential to provide opportunities for staff at all levels to buy in to the program goals and intervention. Staff entered the program with varying levels of understanding and commitment to the program message, but through training and ongoing observation of their clients’ interest in and positive reactions to the program, attitudes tended to evolve.
Orientation. At each BSF pilot site, all program staff with an active role in operating or supporting BSF at the local level participated in an orientation session that described the need for a BSF program, its goal and objectives, the intervention components, and the implementation and operational design. Depending on their particular role or function, staff then were trained in the responsibilities and expectations for their position. Some sites took a cross-training approach, encouraging a core set of staff to be trained in all the major positions so that back-up staff always would be available.
Curriculum Training and Follow-Up Supervision. All group facilitators, co-facilitators, coaches, program managers, and supervisors participated in a training conducted by the developers of the curriculum. The developers traveled at least once to each BSF pilot site to conduct the training so that they could better understand the context in which the curriculum would be delivered. The curriculum training lasted four to six full days, depending on the specific curriculum. The training usually involved a combination of brief lecture and hands-on practice in presenting material, explaining exercises, facilitating group discussion, and coaching to ensure that skills were properly understood. It included troubleshooting and covered significant portions of the content. In most sites, the family coordinators and intake/outreach workers also participated in at least a part of the curriculum training so they could become familiar with the intervention, understand what couples would experience, and be able to speak knowledgeably about it with families.
After the main curriculum training, group facilitators continued to learn and develop their skills for an extended period by receiving regular feedback on their performance directly from the curriculum developers. Group facilitators in five of the seven sites videotaped their group sessions (after obtaining written consent from participants), and shipped the videos to the curriculum developer. After systematically reviewing each tape, the developer provided detailed comments to group leaders during weekly or biweekly conference calls throughout the site’s first series of curriculum sessions. Staff in the remaining two pilot sites held regular calls with their developers to discuss progress and receive feedback, but did not videotape their sessions.
Intake and Outreach Training. Because BSF is a demonstration and evaluation, the pilot period offered a valuable opportunity to train staff in research-required intake procedures, including obtaining informed consent, contact information for followup, administering a brief baseline survey, and submitting eligible cases for random assignment. During training, intake staff also practiced describing the BSF program in their own words to prospective participants. Followup involved direct observation of intake procedures to ensure that staff understood and could perform the procedures adequately.
Working with Couples. Sites found that most staff experienced in working with low-income groups tended to think about families primarily as mothers and their children. This issue was particularly relevant to family coordinators and intake/outreach workers, who were not actively involved with the marriage/relationship skills curriculum. These staff had little experience in discussing marriage or issues related to couple relationships with their clients, and at first some were resistant to the concept that mothers and their children would benefit from the involvement of fathers, or that addressing the couple’s relationship and potential marriage was a valuable strategy that could strengthen the family. To help address this issue, staff at most sites participated in a brief training session called “Working With Couples.” This experiential training was designed to elicit participants’ potentially hidden biases about couples, and low-income men in particular, and help them begin to think about ways that they could support healthy couple relationships and marriage.1
F. LESSONS AND IMPLICATIONS
The experiences of the BSF pilot sites imply that there are relative advantages and disadvantages to integrating a healthy marriage program into an existing program, adding it to an array of other services, or building it from the ground up. All three of the general strategies appear to have succeeded, at least in the initial start-up and operations, but they varied as to what was required to achieve that success and what challenges they encountered. Starting a new program from the ground up obviously requires a greater level of effort and resources, but offers the most freedom to develop an intervention that is targeted specifically to the new program’s goals. Integrating group-centered healthy marriage initiatives into home-visiting programs has many advantages because of existing intake and case management staff, but requires significant flexibility and creativity to accommodate potentially competing program goals and procedures. Finally, offering a healthy marriage program at community-based centers that serve low-income families, along with an array of other family support services, offers many advantages yet requires good organizational management.
The general program setting for healthy marriage initiatives like BSF may matter less than the details of how it is implemented. Simply offering a marriage program like BSF at a community-based center for low-income parents is not likely to succeed unless implementers focus specifically on identifying and recruiting couples rather than single parents. Also, embedding a healthy marriage program into a home-based service is not likely to be effective unless the staff recognize and support the importance of the group component. Successfully implementing a healthy marriage program depends on understanding the structural and cultural context of the organization or program that will host it, filling in the gaps, and moving staff toward an understanding of the role of healthy relationships and marriage in family development.
The BSF pilot experience has demonstrated that there are many ways to develop and implement a healthy marriage program in which education in marriage skills for low-income couples is offered in groups. The pilot experience also suggests that certain key characteristics of host agencies, staff, or organizations may be particularly helpful. These include:
A strong commitment to the concept that couple relationships and marriage matter, and that low-income couples can learn relationship skills. This element was a focal point in BSF programs and, combined with sites’ understanding of low-income families, was likely a key factor in their initial operational success. Traditional social services programs that want to implement healthy marriage initiatives should take steps to provide their staff with opportunities to allow this commitment to evolve and grow stronger over time.
Organizational experience in delivering group services to low-income families. Having experience with low-income families was perhaps as important as the commitment to healthy relationships and marriage. Agencies that already had earned a reputation in the community for helping vulnerable families or new parents probably had an initial advantage, particularly if they offered group services at a location that was warm and welcoming.
Male and female staff, particularly male-female teams in working with couples. Every BSF site found it was important to use male-female teams to facilitate the curriculum sessions. Men also were central in outreach activities and in engaging fathers in program activities. Including men transformed programs from organizations focused on single parents to programs that serve couples and their children.
Technical assistance from curriculum developer. BSF sites realized that the multiple-day curriculum training was really only the beginning of learning how to support couple relationships and marriage among fragile families. Regular ongoing consultation and assistance from highly experienced developers helped group facilitators to process their experiences with the curricula and gain valuable feedback on their performance.
Staff who resemble the target population in characteristics or backgrounds. Employing staff of the same cultural background as participants, especially those who were in healthy marriages, provided powerful role models. As BSF staff gained operational experience and experienced turnover, programs became more adept at identifying the characteristics most essential to each BSF function.
| Table of Contents | Previous | Next |