1. Family Connections Fostering positive interactions for families facing adversity in Early Head Start & Head Start Centers families facing adversity in Early Head Start & Head Start Centers Catherine Ayoub, William Beardslee, Caroline Watts, P.I.’s Mary Watson Avery, Director

2. Why Address Depression & Adversity in Early Head Start & Head Start Families? Almost half of mothers eligible for Early Head Start were depressed Women who were depressed were much more likely to remain depressed Early relationship between maternal depression & lack of positive child self-regulation is strong Early Head Start programs are effective with depressed mothers & buffer negative outcomes for their children (Ayoub, et. al., 2004; Chazen-Cohen, 2006)

3. Family Connections Children’s Hospital Boston Theory of Change: Using a prevention/ intervention approach to build the capacity of Early Head Start/Head Start staff & programs to better understand & respond to the needs of parents (& their children) suffering from adversity, particularly those experiencing depression.

4. Figure 1: The Family Connections Pyramid Community & Systems Development (All Head Start Staff) Education on depression, mental health, & factors of resiliency; classroom consultation; professional skill development including self-reflection and parent engagement; community connections to enrichment and family nurturing programs Universal Prevention (All Children & Families) Education on depression; support in accessing resources; communication & relationship-building in families; classroom-based enrichment activities to support social and academic development; community networks to connect families to supportive prevention services Targeted Prevention (At Risk Parents/Children) Clinical Intervention & Identification of depression & parenting difficulties/ disconnections; extended outreach & crisis services Enriched prevention programming, mental health outreach, social & academic skill building, networks to specialized services in mental health, substance abuse, marital counseling

5. Family Connections Children’s Hospital Boston Major Implementation Activities Educational program series for all staff on depression, mental health, &relationship building, & fostering resilience to adversity. Professional skill development including reflective practice with emphasis on child & parenting skill support. Classroom consultation to build staff knowledge, understanding skills to effectively engage parents and children, particularly those affected by depression & emotional difficulties. Training & educational programs for parents on the topics of communication and relationship-building in families including depression & mental health.

6. Family Connections Children’s Hospital Boston Major Implementation Activities (cont.) Classroom-based enrichment activities to enhance children’s social & academic functioning. Community networks to connect staff & families to support prevention services. Referrals to treatment & support programs for related difficulties (substance abuse, domestic violence) as well as for depression and parenting concerns. Enriched prevention & treatment services tailored to meet the needs of the individual HS partner sites.

7. Family Connections Children’s Hospital Boston A new way of consultation: Engagement Process Readiness first Full staff focus & engagement Useful assessment & feedback Classroom consult & support Classroom interventions – social skill groups & Tell Me a Story curriculum Child on site interventions - pair play therapy & social skill/conflict resolution

8. Family Connections Children’s Hospital Boston A new way of consultation: Parent engagement Drop-in times Social support groups Educational workshops Parent night consultation Drop-off/pick up connections Community Connections Community group participation Service exchange Crisis community response

9. Family Connections Children’s Hospital Boston A new way of consultation: Institutional connections Engage middle & upper management Build center-wide/institution wide plans & policies (ex: Mental Health First Aid) Jointly plan for sustainability

10. National Replication Strategies Family Connections Children’s Hospital Boston Lessons Learned: o Assess readiness & resources first o Start with an engageable task & build supports o Use crisis as opportunity o Lead with the message of effective parent engagement o Present full cycle of activity from knowledge to skill o Speak from strength & vulnerability perspectives o Focus on staff transformation over time o Spend time in the classroom o Know that adult mental health is for all – staff & parents o Build assessment processes that are relevant & practical o Develop system wide plans for mental health first aid

11. National Replication Strategies Family Connections Children’s Hospital Boston Developing “off-the-shelf” products  A self-assessment for program readiness to engage in mental health-related consultation and staff development.  A set of guidelines in the form of short 3 to 4 page resource papers on the core components of the Family Connections intervention.  “Modularize” the Family Connections intervention model to create stand-alone training materials which HS programs can choose to implement based on their unique needs, assets, & program readiness.  A program manual & training guidelines, with the expectation that HS programs will implement Family Connection with their own support systems.  Materials in hard copy & web-based (ECKLC) formats.

12. National Replication Strategies Family Connections Children’s Hospital Boston Future Directions: Train-the-Trainer Approach Through separate funding, develop capacity to train consultants to support comprehensive implementation of Family Connections methods and tools in HS/EHS sites nationally. Create cadre of Master Trainers for Family Connections. Master Trainers serve as trainers & expert consultants to HS programs nationwide seeking to implement comprehensive model. Convene annual conferences to support network of Master Trainers and provider booster trainings and expand network of certified Master Trainers. Provide technical assistance and support to HS programs implementing Family Connections.