Program Content

The Nurturing Parenting Programs have been field tested with families at risk for abuse and neglect, families identified by local social services as abusive or neglectful, families in recovery for alcohol and other drug abuse, families at risk for delinquency, parents incarcerated for crimes against society, and adults seeking to become adoptive or foster parents. As such, a primary use of the Nurturing Parenting Programs is to treat child and adolescent maltreatment, prevent its recurrence, and build nurturing parenting skills in at-risk populations.

There are 13 separate Nurturing Parenting Programs currently being implemented across the United States, Canada, Mexico, Europe, South America, and Israel:

• Prenatal Families.

• Parents and Children, Birth to 5 Years.

• Parents and Children, 5 to 11 Years.

• Parents and Adolescents.

• Teenage Parents and Their Families.

• Foster and Adoptive Parents and Their Children.

• Parents With Special Learning Needs and Their Children.

• Families in Substance Abuse Treatment and Recovery.

• Hmong Parents and Their Adolescents.

• African American Families.

• Crianza con Cariño Programa Para Padres y Niños (Hispanic Parents and Children, Birth to 5 Years).

• Crianza con Cariño Programa Para Padres e Hijos (Hispanic Parents and Children, 4 to 12 Years).

• The ABC's Parenting Program for Parents and Children.

Adaptations for Special Populations

Hmong families. The Nurturing Parenting Program for Hmong Parents and Their Adolescents was designed in cooperation with the staff at the Department of Social Services in Fresno, CA—location of the largest population of Hmong refugees in the United States—where delinquency rates have escalated more than 3,000 percent during the past 8 years. Because Hmong refugee families have had little to no formal support in acculturating from Laos to the United States and because many traditional Southeast Asian parenting practices are inappropriate for American society, frustrated Hmong parents have had little control over their teenage children. Rates of gang membership, delinquency, school dropouts, and drug use continue to increase among Hmong youth (H. Himes, Fresno County, CA, Social Services Department, personal communication, 1995). The program uses an instructional parenting video and a handbook for parents in the Hmong language, and the program activities take traditional Hmong values and modify them to fit Hmong life in American society. The program is active in Hmong communities throughout the United States.

Hispanic families. The Crianza con Cariño Nurturing Parenting Programs for Hispanic Parents and Children, Birth to 5 Years, and Hispanic Parents and Children, 4 to 12 Years, were developed and evaluated for Spanish-speaking families in Arizona, Colorado, Texas, Wisconsin, Mexico, and Venezuela. Agencies serving Hispanic families of Mexican, Central and South American, and Puerto Rican descent participated in the field testing. Program concepts and language were carefully edited and reviewed by Hispanic human services professionals to ensure that the nurturing parenting concepts are culturally sensitive and appropriate and accurately presented. These programs are now implemented nationwide and throughout Mexico and Central and South America.

African American families. The Nurturing Parenting Program for African American Families is designed to teach nurturing parenting within the context of African American history, traditions, practices, and beliefs. The program's information and activities provide helping organizations with a grounded perspective for teaching nurturing parenting skills to African American parents and children.

Families in treatment and recovery. The Nurturing Parenting Program for Families in Substance Abuse Treatment and Recovery is a new psychoeducational group-based program that assists parents in strengthening their own recovery, facil-itating recovery within their families, and building a nurturing family lifestyle. A core goal of this program is to nurture parents, thereby enhancing their ability to nurture their children. To enhance the richness of the experiences of nurturing and recovery, the program focuses on parenting as a relationship characterized by mutuality (building attachments with their children), authenticity (being worthy of their children's trust), and empathy. Parents develop self-awareness and build nurturing skills by using a variety of techniques and activities that accommodate different learning styles. Parents explore their childhood experiences, their fears and their strengths, and the effects of substance abuse on them and on their families. They build skills that strengthen their recovery, explore their own development as adults in recovery, and examine similarities and differences in the development of their children. This program is also useful for partners of parenting adults in treatment and recovery and for extended family members who may be parenting children of substance-abusing adults.

Program Formats

The frequency and length of Nurturing Parenting Program sessions vary according to the type of program. Generally, group-based sessions run from 2½ to 3 hours once a week. Home-based sessions run 1½ hours once a week. The number of group-based sessions varies from 12 (Parents and Adolescents) to 23 (Parents and Children, Birth to 5 Years). Home-based sessions for Birth to 5 Years programs total no more than 45. In addition:

• Group sessions are held in sites ranging from church basements to prison classrooms, but conference rooms at State, county, or private nonprofit agencies are the most common sites.

• Parents and children meet in separate groups that run concurrently.

• A total of 12 to 15 adults attend the group programs (single parents or intact couples).

• Two professionals or paraprofessionals facilitate the parent group; at least two staff (more when necessary) facilitate the children's program.

• For many families, attending a Nurturing Parenting Program has been either mandated by the court or required by social services as a stipulation of the family's treatment plan to learn new, nonabusive parenting skills. Normal (nonabusive) families who are not involved in abuse or neglect but who want to attend Nurturing Parenting Programs may register voluntarily. The programs are promoted through the media and fliers.

Home-based programs. For the first hour of a 1½-hour session, the Nurturing Parenting Program home visitor meets one-on-one with the parents. Noninfant children who do not require close supervision are free to be present as they wish, but the focus is primarily on the parents and the home visitor. Each home session follows a consistent format:

• Icebreaker and Home Practice Check-In (10 minutes). This is a time for parents to increase their self-awareness, for the home visitor to introduce the concept for the session, and for parents to review their success in completing their home practice exercise.

• Parenting Skills and Self-Nurturing Activities (45 minutes). Parents and the home visitor engage in role-playing, discuss new ideas, view videos, and express themselves through art activities using paints, markers, and clay. The focus of home sessions alternates between nurturing parenting skills and nurturing self skills.

• Home Practice Exercise (5 minutes). Parental activities conclude with the assignment of a home practice exercise for parents to complete for the next session.

• Family Nurturing Time (25 minutes). Parents and children learn new skills and ways to have fun.
  • Infant Activities (birth to 15 months). These include telling stories using fingers ("Mr. Pointer Finger says 'Good morning'"), systematic use of infant massage as a daily parent-child interaction, and interactive play.

  • Toddler Activities (15 months to 3 years). These include finger plays, hand-eye motor coordination skills, large muscle movement, sensory discovery, language development, and child massage.

  • Preschooler Activities (3 to 5 years). These include Hello Time, a chance for everyone to talk, sing, and have fun; Big Motor Time, activities to promote movement and large muscle exercise; Circle Time, a time for family members to talk about a topic (puppets and games are used to facilitate learning); and Art Time, a time for family members to work together and individually on creative projects.

• Family Hug (5 minutes). At the end of each home visit, the home visitor, parents, and children engage in a group hug.

Group-based programs—parent format. Each session follows a consistent format:

• Icebreaker and Home Practice Check-In (20 minutes). Parents share their thoughts and feelings, and the group facilitator introduces the concept for the session. Home practice check-in allows parents the opportunity to share their successes in trying out new concepts and skills.

• Parenting Skills Activities (40 minutes). Parenting skills, nurturing routines, and behavior encouragement techniques are presented through videos, discussion, art activities, and role-playing.

• Family Nurturing Time (30 minutes). Parents, children, and group facilitators engage in activities, including games, songs, and infant massage, and enjoy snacks and beverages. Facilitators model and teach new skills and supervise parents in practicing them.

• Self-Nurturing Activities (50 minutes). Parents increase their self-awareness and self-growth and learn ways to nurture themselves through group discussion, videos, role-playing, and art activities.

• Home Practice Exercise (5 minutes). Parents are given a brief exercise related to the session concept to practice at home before the next session.

• Group Hug (5 minutes). Sessions conclude with a group hug. The intent of the hug is to increase group cohesion, offer praise, and experience positive touch.

• Infant Activities (2 hours). During the times the parents are in their groups, facilitators engage infants in age-appropriate activities, including infant stimulation, reading stories, holding, smiling, and talking to the infants.

• Toddler Activities (2 hours). Children participate in songs, games, and large-muscle motor activities.

• Preschooler Activities (2 hours). Children ages 3 to 5 participate in scheduled activities that include Hello Time, Big Motor Time, Circle Time, Art Time, and closing Group Hug.

Professionals in parent education, social work, psychology, education, public health, and the general helping fields (medicine, mental health, parent aide programs, and home visitor programs) and paraprofessionals in helping fields facilitate the parent, adolescent, and children's programs. Generally, two staff are required to facilitate the parent groups, and two or more staff are required to facilitate the children's and adolescents' groups. Professionals who have previously facilitated groups and taught parenting education and who subscribe to teaching nonviolent, nurturing parenting values and practices can successfully facilitate the Nurturing Parenting Programs.

Session Content

The Nurturing Parenting Programs teach age-specific parenting skills. The program also addresses the need to nurture oneself. These two elements are considered equally important. Each program session is divided into parenting instruction and self-improvement instruction.

Parenting instruction. Program topics related to parenting skills include:

• Discipline—philosophy of discipline, alternatives to spanking, rewards and punishment, family rules, timeout, loss of privilege, restitution, being grounded.

• Nurturing—needs and self-esteem; developing empathy; ways to nurture others; praise; nurturing routines at mealtime, bath time, bedtime, dressing time; communicating with your child through touch.

• Communication—redirecting, ignoring, communicating age-appropriate expectations, recognizing and understanding feelings, "I" statements.

• Spoiling children.

• Toilet training.

• Baby-proofing a home.

• Establishing morals, values, and rules.

• Relationship between anger, alcohol, and abuse.

All concepts taught in the program are discussed in the context of the participant's personal history (e.g., what experience the person has with a concept such as timeout, being hit, or feeling loved). Establishing a personal connection with the concept reinforces the likelihood that the individual will integrate it into his or her behavior, because understanding personal history plays an important role in changing old, unwanted, abusive parenting patterns.

Teaching aids. The program uses the following teaching aids to engage parents and children on both cognitive and affective levels:

• Training manuals (activities manuals) for parents, children, and adolescents. These manuals are program specific and constitute the curriculum for each of the 13 Nurturing Parenting Programs.

• Parenting handbooks for parents and adolescents. These handbooks are written at a fifth-grade reading level.

• Implementation manual that describes the how-to's of implementing the programs, facilitating groups, gathering pretest and posttest data, recruiting families, and working with children.

• Instructional videos in which actors demonstrate examples of abusive parenting with inappropriate behaviors such as hitting and yelling. Parents discuss the interactions dramatized in the video and alternatives to the abusive behavior.

• Games for parents and children that help build their nurturing skills and provide an opportunity for them to interact and have fun together. The games reinforce the concepts that are being presented.

• Instructional aids that include card games, pictures, and questionnaires.