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U.S. Department of Justice

Office of Justice Programs

Office of Juvenile Justice and Delinquency Prevention

Shay Bilchik, Administrator

Fam

ilyStrengthening Series From the Administrator

Youth at risk of adolescent delin-quency often come from stressedand socially isolated families. Thesechildren also frequently fail in schooland may eventually drop out. ThisBulletin profiles a program, Familiesand Schools Together (FAST), thatbrings at-risk children and theirfamilies together in multifamily groupsto strengthen families and increasethe likelihood that children willsucceed at home, at school, andin the community.

Based on research and family therapy,FAST builds protective factors forchildren and increases parent involve-ment with the family, other parents, theschool, and the community. In a typicalcase, the entire family of an 8-year-oldmale who exhibits problem behaviorsat home and at school participates inthe 8-week FAST program. After“graduating,” families move on to 2years of monthly meetings of a school-based group of FAST families, whichprovide a strong social network to fallback on in times of crisis.

Evaluations have shown that FAST hasa statistically significant positive impacton children and families. Withoutintervention, the boy in the casedescribed above would be a strongcandidate for teenage delinquency andviolence. Communities in search of aschool-based approach to interveningwith at-risk children and their familieswill find this Bulletin of great interest.

Shay BilchikAdministrator

November 1999

groups to increase parent involvementwith at-risk youth. Developed in 1987 byDr. Lynn McDonald of Family Service, anonprofit family counseling agency inMadison, WI, FAST helps at-risk youth(ages 3 to 14) build relationships througha research- and family therapy-based, mul-tifamily group approach to preventing ju-venile delinquency (McDonald, 1993, 1997;1998; McDonald and Billingham, 1998;McDonald et al., 1991). FAST has beenespecially successful at involving low-income, stressed, and isolated parents.

For several years, the founder of FASTconducted court-ordered, in-home, familytherapy with drug- and alcohol-involvedand violent youth who had been signifi-cantly involved in the court system. Sheapplied family therapy techniques fordelinquents that were developed, re-searched, and published by JamesAlexander, Ph.D. (1973; Alexander andParsons, 1973, 1982) and SalvadorMinuchin, M.D. (1979). Using these ap-proaches, 75 percent of delinquent youthcould alter their circumstances in 3 monthsof two to three family sessions per week,with 24-hour backup coverage (McDonald,1993). This therapeutic work developedinto the FAST program for early inter-vention. The FAST program works withschool teachers to identify elementaryschool children about whom they havedevelopmental or behavioral concerns.

Families and SchoolsTogether: BuildingRelationshipsLynn McDonald, ACSW, Ph.D., and Heather E. Frey

The Office of Juvenile Justice and Delin-quency Prevention (OJJDP) is dedicated topreventing and reversing trends of increaseddelinquency and violence among adoles-cents. These trends have alarmed the pub-lic during the past decade and challengedthe juvenile justice system. It is widely ac-cepted that increases in delinquency andviolence over the past decade are rooted ina number of interrelated social problems—child abuse and neglect, alcohol and drugabuse, youth conflict and aggression, andearly sexual involvement—that may origi-nate within the family structure. The focusof OJJDP’s Family Strengthening Series is toprovide assistance to ongoing efforts acrossthe country to strengthen the family unit bydiscussing the effectiveness of family inter-vention programs and providing resourcesto families and communities.

Overview of theProgram

Both affluent and low-income familiesstruggle with the same issues concerninghow to raise a child successfully. Manyparents feel alone, too busy to connectwith their children, and lacking in sup-port from other adults. Using parent-professional collaborative teams, theFamilies and Schools Together (FAST)program systematically reaches out toentire families and organizes multifamily

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tions for admission into the program. TheFAST process begins with home visits, fol-lowed by a weekly series of school-basedevening activities for 12 families (for 8–10weeks), followed by 2 years of monthlymultifamily FASTWORKS meetings. Thesemeetings are run by paid FAST parentgraduates (and supported by FAST teammembers) to consolidate and maintaininterpersonal relationships developedduring the weekly sessions.

The team structure ensures that par-ents are included as partners. The certifica-tion of each new program site includes apublic interview with several parent gradu-ates in front of their FAST team to give feed-back on their experience in the program.

FAST successfully increases parent in-volvement with their at-risk youth, otherfamily members, other parents, the school,and the community. Of the thousands offamilies who have attended one multifam-ily FAST meeting, more than 80 percenthave graduated from the 8- to 10-weekprogram. The percentage is consistentacross hundreds of different settings withdifferent types of families from varied cul-tural backgrounds. Two to four years afterparticipating in FAST, 75 percent of theparents who graduated were still very in-volved with schools and 86 percent werestill seeing friends they made at FAST(McDonald et al., 1997).

The overall goal of the FAST program isto intervene early to help at-risk youth suc-ceed in the community, at home, and inschool and thus avoid problems includingadolescent delinquency, violence, addic-tion, and dropping out of school. The FASTprocess utilizes the existing strengths offamilies, schools, and communities increative partnerships. FAST offers youthstructured opportunities for involvementin repeated, relationship-building interac-tions with the primary caretaking parent,other family members, other families, peers,school representatives, and communityrepresentatives. The program builds andenhances long-term relationships to pro-vide youth a “social safety net” of protec-tive factors for getting through difficulttimes. Specific aspects of the FAST pro-gram reduce common forms of delinquentbehavior because:

◆ Increasing multiple levels of social bond-ing reduces juvenile violence/crime.

◆ Increasing connections, rituals, and resil-ience reduces alcohol and drug abuse.

◆ Reducing isolation and promoting familystrength reduce child abuse and neglect.

◆ Promoting parent involvement forschool success reduces school failure.

FAST works with every kind of family.Because the program respects how eachfamily defines itself, there are no restric-

FAST increases parent involvementby actively reaching out and engagingstressed and isolated families. Parentslearn to monitor their children’s behavior,interact through play, and communicatewith their children. They also becomemore involved with social networks ofother parents, schools, and communities.Rural, suburban, and inner-city schoolsdevelop ownership of their FAST pro-grams. The cost per family is approxi-mately $1,200 for 86 hours of services(30 sessions, including FASTWORKS) over2 years. The cost for each school that of-fers 2 FAST cycles per year to serve 30families is $30,000 (not including evalua-tion or FASTWORKS). For more informa-tion, see table 1.

Ten years after the first multifamilygroups were implemented, FAST:

◆ Is being implemented in more than 450schools in 31 States and 5 countries.

◆ Has won numerous national awards asa research-based, family-strengthening,family-supporting, collaborative,prevention/early intervention program.

◆ Has been evaluated continuously ateach new site with the FAST Processand Outcome Evaluation Package(McDonald and Billingham, 1998).

◆ Is being systematically replicated withcertified FAST team trainers by fourStates and two national organizations.

The FAST CurriculumFollowing an elementary school or

middle school teacher’s recommendation,the family of an at-risk child is invited toparticipate in the program by a FAST par-ent graduate who conducts home out-reach visits. Some schools offer FAST toall children who are enrolled. Theseschools encourage families to attend acluster meeting with other families fromthat school. “Family” is redefined to in-clude all variations of adults raising chil-dren. Ten to fifteen families meet for 8 to10 weekly sessions that include a familymeal, singing, and other highly interactivefamily activities that are enjoyable forboth children and parents.

Each weekly FAST session follows astandard 21/2-hour agenda:

◆ Opening tradition (15 minutes). Sessionbegins with FAST hello and FAST song.

◆ Family tables (45 minutes). Teamssupport parental authority by puttingparents in charge of activities at theirfamily tables.

Families and Schools Together (FAST) Program Goals

Enhance family functioning.

◆ Strengthen the parent-childrelationship in specific, focusedways.

◆ Empower the parents to be theprimary prevention agents fortheir children.

Prevent the child from experienc-ing school failure.

◆ Improve the child’s short- andlong-term behavior and perfor-mance in school.

◆ Empower the parents to bepartners in the educationalprocess.

◆ Increase the child’s and family’sfeelings of affiliation with theirschool.

Prevent substance abuse by thechild and family.

◆ Increase the family’s knowledgeand awareness of substanceabuse and the impact of substanceabuse on child development.

◆ Link the family to appropriateassessment and treatmentservices, as needed.

Reduce the stress that parentsand children experience fromdaily life situations.

◆ Develop an ongoing supportgroup for parents of at-riskchildren.

◆ Link the family to appropriatecommunity resources andservices, as needed.

◆ Build the self-esteem of eachfamily member.

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❖ Families eat meals at their familytables.

❖ Structured family table communica-tion activities (e.g., for elementaryschool, “draw and talk about it”game and “act out a feeling andguess it” game; for middle school, afamily communication board game).

◆ Mutual peer support time (1 hour).Parents gather for discussion, and chil-dren gather for age-appropriate activi-ties to build connections to each other.

◆ One-to-one FAST parent-child commu-nication time (15 minutes). The FASTteam coaches parents to provide playtherapy for elementary school children.In the middle school curriculum, theFAST team coaches parents to discusstopics with their youth, selected by theyouth group.

◆ Closing tradition (15 minutes). Activi-ties (e.g., celebrating winners, thankinghosts, announcing and sharing, and asilent circle) build multifamily commu-nity and FAST team cohesion.

After graduating from FAST, each groupof families joins an ongoing school-basedcollective of interdependent FAST familiesthat meets monthly for 2 years in meetingscalled FASTWORKS. FASTWORKS sessionsare more flexible than FAST sessions,enabling families in each community totailor agendas to their own needs. Eachmonthly meeting includes the FAST open-ing and closing traditions and 15 minutesof one-on-one special play or discussionbetween one family member and one child.The rest of each meeting is planned bythe families with support from a collabo-rative team that includes parents who havegraduated from the FAST program. Insteadof rewarding each family for attendance,FASTWORKS rewards small groups offamilies by allowing them to plan how thebudget ($100) for the next month’s meet-ing will be used. By emphasizing connec-tions between entire families, FASTWORKSmeetings sustain the relationships thatdeveloped during the 8- to 10-week FASTsessions. These relationships act as protec-tive factors for at-risk youth and their fami-lies against the stresses of daily living.

Risk and ProtectiveFactors

The FAST program assumes that partici-pants are at risk—that families are understress and need social support—yet neverdirectly focuses on risk. Six research-basedstrategies are used to build protective

Table 1: FAST Implementation Expenditure (estimates per new program)*

Cost

National Training Center Contract for Team Training byCertified FAST Trainer

Process and outcome evaluation site certification(not including travel and lodging of the trainers) $3,900

2-Day Collaborative Team Training (costs for site)4–8 team members (released to attend) 02 parent partners (16 hours @ $15/hour) 480Casual relief teacher (2 days @ $180/day) 360Hire of venue and lunches 250Subtotal 1,090

Program Implementation Costs (without repositioning)Salaries (for one cycle)

3 professional team members @ $1,000 each 3,0001 parent partner (100 hours @ $15/hour) 1,5001 supervisor/lead facilitator (including 12.5% fringe) 5,200

Subtotal 9,700

Program ExpensesProgram supplies (startup materials, etc.) 400Telephone, stationary, postage, travel 700Subtotal 1,100

Weekly Program CostsHost family food (8 weeks @ $50/week) 400Door prizes (10 @ $40) 400Dinner supplies (plates, napkins, cups, etc.) 200Film (video, Polaroid, and processing) 100Craft materials 50Graduation ceremony 50Subtotal 1,200

1-Day FAST Training (review/debriefing/certification)2 parent partners (8 hours @ $15/hour) 2404–8 team members (released to attend) 0Casual relief teacher (1 day @ $180/day) 1803 parent graduate panelists (2 hours @ $15/hour) 90Subtotal 510

FASTWORKS (2-year monthly followup program for multiple FAST cycles)Parent support group budget (12 months @ $100/month) 1,200Staff support costs for 12 months (10 hours/month @ $22/hour) 2,640Parent partner support costs for 12 months

(10 hours/month @ $15/hour) 1,800Travel 500Supplies (12 months @ $30/month) 360Subtotal 6,500

Total $24,000

* Estimates for one new pilot cycle, including training and evaluation.

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factors (e.g., relationships) for youth inthe FAST program. These strategiesaddress:

◆ Each child’s interpersonal bonds.

◆ The family system.

◆ Parent-to-parent support (bonds betweenspouses or two other supportive adults).

◆ Parent self-help support group (peersocial network).

◆ Parent empowerment training (puttingparents in charge of children).

◆ School-community affiliation (involve-ment in the school and community byparents and youth).

Positive bonds and relationships on mul-tiple levels counteract many youth risk fac-tors and reduce behavior problems corre-lated with later violence, delinquency,substance abuse, and school failure. Eachof the six strategies discussed below ap-plies tested approaches published by vari-ous researchers in refereed journals andfunded by multiyear Federal grants fromthe National Institute of Mental Health(NIMH). The FAST program integrates childpsychiatry, child psychology, play therapy,family therapy, family stress theory andfamily support, self-help group dynamics,parent empowerment, and communityorganization into an appealing, replicable,multicomponent approach to prevention.

Each Child’s InterpersonalBonds

Research on delinquency shows thatinterpersonal bonds inhibit aggression andviolence. In FAST, each child receives 15minutes a day of one-to-one quality play ordiscussion time with his or her parent withthe team’s support. The team coaches par-ents to follow the child’s lead in play andnot to boss, teach, or correct the child.Parents practice this process at the weeklymeetings and then are requested to playwith their children one-to-one at home ona daily basis. Research shows this nondi-rective, nonjudgmental playtime reduces achild’s problem behaviors at home and atschool while building self-esteem. In 2-yearfollowup interviews, children report “spe-cial play” as their favorite part of FAST.Sixty-two percent of parents still do specialplay once a week 2 years after completingthe program. Parents learn that regularone-to-one playtime with their children isvaluable and powerful, and often parentsreport that their children confide in themmore and have a more positive relationshipwith them.

help each other assist their children tosucceed in school and at home. No didac-tic presentation on parenting is allowed.The parents determine the content oftheir discussion. During the 8- to 10-weekprogram, the parent group bonds andserves as a source of ongoing informalsupport for parents who are stressed andsocially isolated. Followup studies onFAST indicate that 86 percent of partici-pating parents make new friends at FASTand that the parent group is their favoritepart because it shows them that they arenot alone and because they feel that theiradvice is valued by other parents.

Parent EmpowermentTraining

When parents are in charge of theirchildren and connected to other parentsand the community, they can both in-crease the safety of their neighborhoodsand better monitor youth behavior. FASTactivities are structured to increase thepower of each parent systematically,within the separate sets of relationshipsdetailed below, through frequent re-hearsals of behavior and experiencesof success:

◆ Family. Controlling one’s children with-out coercion (i.e., becoming empoweredwithin the immediate family).

◆ School. Collaborating as a partner inthe FAST team and as a cofacilitator ofongoing, 2-year, multifamily group meet-ings. Interdependent school-based FASTparent networks begin to actively par-ticipate in their children’s education.For example, parents begin to volunteerin the school, act as advocates for theirchildren, and see themselves as part-ners in their children’s education.

◆ Community. Acting as leaders in thecommunity. Parents who know otherparents and professionals in localcommunity agencies are more likelyto assume leadership roles.

Successful implementation of the FASTparent empowerment program acrossnew settings in many parts of the UnitedStates requires values-based team train-ing. Each new FAST team reviews anddiscusses 10 beliefs underlying the FASTprevention program: for example, thatevery parent loves his or her child andthat, with informal and formal social sup-port, every parent can be the primarydelinquency prevention agent for his orher child. The FAST Team ReplicationTraining developed by McDonald in

The Family SystemResearch on treatment of delinquent

youth shows that altering the patterns offamily involvement reduces recidivismrates (Alexander and Parsons, 1973, 1982).The family unit of the FAST child is system-atically strengthened with hour-longweekly sessions at their FAST family tablebased on family therapy principles of help-ing the parents to be both firmly in chargeof and lovingly connected to their chil-dren. For each family activity, the teamputs the parents in charge by giving infor-mation and support only to the parents.The family activities include having par-ents delegate a child to serve their food,constructing a family flag, drawing andtalking about drawing, play-acting feelings,and guessing each other’s feelings. Par-ents oversee the family communicationgames at their own family table. Parentsallow each person in the family to speakand be heard, which is a basic communi-cation skill for conflict resolution. Theseexercises develop parental skills in re-questing compliant behavior and in moni-toring children’s behavior. Team membersactively support the parents to ensure thesuccess of the family exercises.

Parent-to-Parent SupportResearch shows that regular, daily,

intimate support from other parents isa protective factor that keeps stressedand depressed mothers from abusingand neglecting their children. Child abuseis correlated with later delinquency. FASTincorporates support for parents by havingthe spouses, partners, or two single par-ents who are put together by team mem-bers spend 15 minutes at each weeklymeeting listening to each other speakabout issues of concern. The only restric-tion is that no advice should be given.This conversation time provides the op-portunity for growth of reciprocal, per-sonal support for the primary caretaker.

Parent Self-Help SupportGroup

Research shows that parents who havebeen highly trained in behavior modifica-tion parenting skills have stopped usingthose skills 6 months later if they are so-cially isolated (i.e., they have no one toturn to under stress) (Wahler, 1983). Re-search also finds that when a family isunder stress, social isolation can result inchild abuse and neglect (Pianta, Egeland,and Stroufe, 1988). Parents in FAST meetfor 45 minutes in each weekly session to

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1990 (revised 1998) for new site teams in-cludes behavioral rehearsals (role-plays)designed to help the team learn how toempower, respect, and support parentsrather than undercut parental power. Theteam partners, as part of their training,act out five scenarios twice—the wrongway and then the right way—and lead adiscussion of issues that are relevant toeach scenario. Each role-play covers agiven aspect of parenting: orienting chil-dren, asking for support, celebratingchildren’s success, helping children whenthey are hurt, and disciplining childrenwithout abuse. Each team member experi-ences disempowerment and then empow-erment by acting out the scenarios twicein role-plays.

School-CommunityAffiliation

The FAST program increases the at-riskyouth’s and family’s feelings of affiliationwith the school. Positive, repeated, per-sonal, low-key interactions with school per-sonnel outside the regular school day buildrelationships that are not based on the at-risk child’s problem behaviors atschool. Informal interaction during FASTsessions enables parents to establish re-spectful relationships with addiction coun-selors, family therapists, and counselors ofvictims of domestic violence. Over time,this results in an increase in the appro-priate use of school opportunities andservices by parents. Two to four yearsafter graduating from FAST, parents re-main involved: 75 percent of the parentsreported increased involvement in theschools. Parents report that they self-referto family counseling (26 percent) andsubstance abuse treatment (8 percent).Self-motivated parents are more likely touse appropriate services fully, one of theimportant outcomes of FAST (McDonaldet al., 1997).

Ninety-one percent of FAST parentgraduates report an increased involve-ment in community activities, eventhough one-third of this sample neverattended FASTWORKS. Parent activities2–4 years after the FAST program includepursuing further education for them-selves (44 percent), attending church(35 percent), and obtaining employment(55 percent). Some parents reportedgreater involvement in more than oneactivity. After participating in FAST, mostfamilies no longer feel socially isolatedand both youth and parents report theavailability of stronger formal and infor-

mal social networks available to assistthem in stressful circumstances(McDonald, 1997).

Identifying Candidatesfor FAST

The school principal, teachers, andpupil services teams screen students forindicators of mental health problems toidentify children who could greatly benefitfrom FAST. Many schools also ask teachersto survey their classrooms for trouble-makers, bullies, or others who are hard toteach. Typical FAST children are at least1 year behind their expected grade level.In addition, the children tend to be apa-thetic, hypersensitive, depressed, underhigh stress, and subject to family trauma.Based on data on youth who entered theprogram in 53 schools in 13 States, thetypical FAST child is male (65 percent),8 years old, and shows significant problembehaviors in the classroom and at home(85 percent), as rated by teachers andparents. The average FAST child exhibitsa tendency toward bullying and aggressivebehavior, is very anxious and withdrawn,has a very short attention span, and showsuneven classroom performance. Theseattributes in an 8-year-old predict teenagedelinquency and violence (Ensminger,Kellam, and Rubin, 1983; Kellam et al.,1991; Starfield et al., 1993). Longitudinalstudies have shown that 8-year-old childrenwho are socially isolated but aggressiveare more likely to end up in detention asteenagers for violent and delinquent acts.Other studies show that classroom aggres-siveness in first grade predicts aggressive-ness in seventh grade, unless there is an

intervention (Kellam et al., 1998). FASTapplies this research by intervening earlywith students who have been identified asat risk by teachers. Research shows thatteachers can spot 8-year-olds who, withoutintervention, are 10 times more likely thantheir peers to spend time in jail later in life(Gullotta, Adams, and Montemayor, 1998).

Next, families of the identified stu-dents are invited to voluntarily partici-pate in the multifamily group process.Many schools that serve primarily low-income populations offer universal invi-tations to all school children and fami-lies, to avoid singling out some childrenas “at risk.” Because of local control, eachschool makes a decision about whichgroups of youth and families it invites toany particular multifamily 8- to 10-weekcycle. For example, a school may targetstudents who are bullies; truants; lowachievers; low-income children whoqualify for free or reduced-price lunchesat school (Title I children); highly mo-bile, new residents of poverty-strickenareas; or recent immigrants to the UnitedStates. Families can also ask to partici-pate in the program; some schools de-cide to take only self-referrals.

FAST in DiverseSettings

FAST children and their families comefrom many ethnic, cultural, racial, andsocial class backgrounds, depending on thegeographic setting and who the schooldecides to invite to FAST. Nationally, 51 per-cent of FAST participants have been Cau-casian, 25 percent Latino, 23 percentAfrican American, and 2 percent Asian and

A family graduating from FAST in Washington, DC.

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American Indian; 70 percent of the childrenhave been low income and eligible for freeor reduced-price lunches at school. FASThas had similar levels of impact acrossdiverse groups of families; the programmaterials have been translated into French,German, Japanese, Spanish, and Vietnam-ese, and they have been used with multi-lingual, English as a Second Language(ESL) family groups. FAST has been foundeffective in rural, suburban, and inner-cityschools in Australia, Austria, Canada,Germany, and 34 States and 3 Indiannations in the United States.

FAST mandates cultural comparabilityin both the program content and the rulesof implementation; for example, teamshave to “look” like the families they serve.FAST program certification requires thatthe team that facilitates the program andthe families being served be similar intheir ethnic and cultural backgrounds.

In addition, one-half of the activity-based program takes place at a familytable, which means the parents “deliverservices” to their own children. Thus, thereis perfect cultural and language compe-tency at each family table. FAST has nowritten or spoken curriculum, so literacyis not a requirement and language barri-ers do not restrict access to the program.Because learning about relationships andparenting occurs through a set of interac-tions, no translator is needed. FAST hasbeen particularly successful at involvinghard-to-reach, low-income families fromdiverse ethnic groups. Eighty percent ofinner-city parents and American Indianparents on reservations who were willingto attend one FAST session have gone onto complete the program.

Since the FAST program began, teamshave taken responsibility for carrying outand refining the recruitment and retentionstrategies for “hard to reach” parents. Forexample, a FAST team member (preferablythe FAST parent graduate on the team) re-peatedly visits or meets with the parentbeing recruited at nontraditional hours—not 9 a.m. to 3 p.m., but in the evenings oron weekends—on his or her terms. Theteam member explains FAST and invites theparent to attend just one session. The pro-gram also actively recruits participants byproviding transportation, infant care, meals,and respect. Team members are trainedto listen as parents discuss their children,to reflect their concerns using their ownwords, and to help parents understand thatwhat their child is doing at home is similarto what the teacher says he or she is doingat school. Then the team members explain

that FAST helps build the relationships fromwhich children will benefit. They tell eachparent that one time during the FAST pro-gram his or her family will win a large lot-tery and that the “winning” family in eachsession receives money to shop and cookfor all of the participants the followingweek. The conversation with a team mem-ber teaches each parent that, by participat-ing in the FAST program, he or she can bothgive and receive support in raising children.

The Research-BasedProcess

The FAST program incorporates ele-ments from studies that combined scien-tific rigor with straightforward commonsense (see table 2). Research and evalua-tion are vital parts of the FAST process:

◆ In the FAST team training, all FAST teammembers (not family participants inthe program) are required to read

Ten years ago, the first multifamily groupgraduated from an 8-week FAST cycleat Lowell Elementary School in Madi-son, WI. One of the mothers at thatgraduation ceremony and her two chil-dren had received a framed commenda-tion from the principal for her family’sinvolvement. She seemed proud that herachievement was being recognized.

Before participating in FAST, thiswoman was living on a low fixed income,had no car and no phone, had not com-pleted high school, and was raising hertwo children alone. In addition, she hadno friends, and she had never partici-pated in a school event. Her own motherhad passed away 8 months before, andwhen the parent advocate made the out-reach home visit to invite the womanand her children to a multifamily groupevent at the school, the house appeareddark and without hope. She heard aboutthe weekly family meal, the free trans-portation, and the family prize being of-fered, and because of the enthusiasticparent advocate who encouraged her toattend once to see if she liked it, sheagreed to attend one FAST session (seetable 2). She arrived at the first sessionwith her children an hour late.

The second week, her children beggedher to take them again to the multifamilyactivities because they were so much

fun. The parent advocate returned to thehouse and drove the family to the schoolevent in her own car. The woman andher children won the family prizes thesecond week, and the children werevery excited about winning. Because the“winning family” is always asked to cookfor everyone the week after having won,the mother was given money to plan,cook, and host the next meal for all ofthe families and the team. She told teammembers that the children asked her tocook a macaroni and cheese dish thatwas her own mother’s family recipe. Themeal was delicious, and the childrenwere proud when everyone clapped andthanked their mother for her wonderfulcooking.

The family attended each of the weeklymeetings and participated fully to theend of the program. Just 8 weeks later,the woman laughed with her children,interacted comfortably with school per-sonnel, and had befriended parents ofother children at the school.

Over the next 4 years, this womancontinued to participate actively inschool-promoted activities. Two of thefriendships she made in those first 8weeks continued over time. The out-reach and multifamily engagement pro-cess had a long-term positive effect onthis family.

One Family’s FAST Experience

through a summary of the researchstudies that underlie each FAST activityand then to discuss the studies as ateam. By doing so, team members learnexactly how the FAST intervention isbased on research. This helps them torespect, rather than try to alter, theactivities of the program.

◆ Each certified FAST team trainer mustbe able to present the original studiesand to read current research journalarticles, discuss them, and relate themto the FAST process.

◆ Each new FAST site is evaluated withthe McDonald and Billingham Processand Outcome FAST Evaluation Package(for more information, see “Role of theTeam Trainer” on page 10) (McDonaldand Billingham, 1998). Team Trainers,who make three onsite observation vis-its and complete assessment formsfor each multifamily program, con-duct the process evaluation. The FAST

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National Training and Evaluation Cen-ter collects and analyzes the data. TheCenter submits a final report based onstatistical tests on standardized instru-ments that describes the program’simpact on children’s mental healthand family functioning in each newFAST community.

Longitudinal ResearchSupporting FAST

Professionals who routinely work withdelinquent youth need to understand thatwhat happens early in a child’s life couldpredict the tough, violent, drug-abusing,antisocial behaviors displayed by youth inthe juvenile justice system. However, longi-tudinal research studies that follow indi-viduals for 15 to 30 years support the im-portance of childhood experiences and ofparent involvement in helping predict adultbehavior. Knowledge about this researchinto the sources of delinquent behavior en-ables practitioners to address risk factorsbefore problem behavior begins. Twokey studies are summarized below.

Werner and Smith (1992) studied allthe babies (about 600) on an island ofHawaii and followed them from birth toage 30 to determine who was incarceratedas an adult. The researchers collecteddata about the children, their psychology,their education, and their families. Theylearned that 23 percent of the youth wereidentified at age 10 as “troublemakers”by teachers and parents, 13 percent wereadjudicated delinquent by age 18, and4 percent were jailed as adult criminalsby age 30. After determining who was in-carcerated by age 30, Werner and Smithperformed many statistical analyses ofthe 30 years of data they had collected.Because they knew the outcomes for par-ticular members of the original popula-tion, they were able to identify whichsignificant factors were correlated withviolence, delinquency, and criminality.Early childhood experiences of trauma,child abuse, and poverty were risk factorsfor adolescent and adult criminal behav-ior. Having just one positive, long-termrelationship with a parent, family mem-ber, or community member (e.g., a friend,neighbor, minister, teacher, or mentor) towhom one could talk about stress couldoverride the risk factors. Werner andSmith identified feeling loved by parentsand being able to communicate with andconfide in an adult about difficult topicsas protective factors that can outweighrisk factors and help at-risk youth. Theyfound that strong relationships with an

adult had the potential to help at-riskyouth avoid incarceration as adults. Theirfindings have extremely important impli-cations for treatment, intervention, andprevention.

Schedler and Block, at the Universityof California-Berkeley, studied and followeda group of youth ages 3 to 18 (1990). Theynoted which 18-year-olds abused alcoholand drugs and which did not. Schedlerand Block then went back to look at earlydata they had collected, which includedvideotapes of mothers playing with their7-year-olds. They reported many early fac-tors that predicted outcome, includingthe mothers’ styles of play with their chil-dren. Warm and supportive mother’s playwas a protective factor, and hostile, criti-cal, and bossy mother’s play was a riskfactor significantly correlated with latersubstance abuse by youth. Positive parentinvolvement with the child predictedlong-term positive outcomes. On the basisof their research, Schedler and Blockrecommend early relationship-buildinginterventions with families as a system,rather than in programs only for youth,to increase the likelihood that youngchildren will avoid undesirable outcomesof substance abuse.

Cross-Sectional ResearchSupporting FAST

In a recent article on adolescents,Michael Resnick and colleagues (1997)reported on a study of more than 12,000high school youth. They interviewed youthabout their violent behavior, delinquency,substance abuse, and school failure. Theresearchers’ analysis determined that twocrucial factors were significantly associ-

ated with a youth staying out of trouble:connections between parents and youthand positive associations with school.

David Hawkins studies the relationshipof risk and protective factors for thou-sands of middle school children (Pollard,Hawkins, and Arthur, in press) and notesthat if a youth had more than five risk fac-tors, there was a strong likelihood that heor she had, at most, one protective factor.Hawkins reported that these high-riskyouth never had two or more protectivefactors and they often lacked even one.He encouraged interventionists to developprograms that offer opportunities for in-teractive, personal, positive relationshipbuilding to increase protective factors forat-risk youth and reduce negative outcomesin youth. Two examples of the interventionresearch applied by the FAST program aredescribed below.

Intervention ResearchApplied in FAST

Dr. James Alexander of the Departmentof Psychology at the University of Utahdeveloped a research-based interventioncalled Functional Family Therapy for usewith delinquent youth (Alexander andParsons, 1982). Alexander’s family therapyresearch worked closely with the courtsand randomly assigned first-time courtoffenders to his approach and contrastedit with several other approaches. His fam-ily therapy interventions with families ofdelinquent youth involved changing howthe families interacted with one another(e.g., using communication training, includ-ing problem solving, listening, and takingturns speaking). When Alexander and Par-sons did 3-year followups with court data,

A family graduating from the first FAST implementation in Australia.

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Table 2: FAST Program Activities Apply Mental Health Research To Build Community

Activities Description Mental Health Research Building Community

Flag Each family unit creates a Alexander and Parsons, Each family makes a flagfamily flag to set on their 1982; Minuchin, 1979. within a community contextfamily table for 8 weeks. of approximately 60 people;Parents are in charge of the the flag becomes an identityprocess in which each family for the family within themember adds to the flag. FAST community.

Music Participants sing the FAST Pianta, Egeland, and Stroufe, Everyone sings the FASTsong. Families are invited 1988. song together; sharingto bring songs to teach music builds community.others; school songs canbe shared.

Meal A host family, who won the Dunst, Trivette, and Deal, Each family hosts a meal.lottery the week before, 1988; Minuchin,1979. This builds feelings ofreceives money to buy food, mutual and sharedplans a menu, and prepares responsibilities.a meal for 12 families andthe FAST team. The familyis thanked. Staff membershelp children show respectfor parents by serving dinner.

Scribbles This drawing and talking Alexander and Parsons, Each family plays at its tablegame is played with one’s 1982; Lewis et al., 1976; within the context of a largerown family. Parents are in Pianta, Egeland, and Stroufe, community. Play and fun arecharge of taking turns and 1988; Minuchin, 1979; emphasized. Support fromasking positive questions. Schedler and Block, 1990. the FAST team is offered as

needed.

Feelings Charades Participants play-act, guess, Alexander and Parsons, Sharing feelings in one’s ownand talk about feelings with 1982; Lewis et al., 1976; family and sharing withtheir families. The parents Pianta, Egeland, and Stroufe, other FAST families buildsare in charge of taking turns. 1988; Schedler and Block, community. Support from

1990; Werner and Smith, 1992. the FAST team is offeredas needed.

Kid’s Play These developmentally Bronfenbrenner, 1979; Time for hanging out together,appropriate organized Minuchin, 1979; Rutter, 1983. having fun, and developing aactivities offer children peer network emphasizespositive peer group friendship in a community.experiences. No televisionis allowed.

Parents’ Talk in Buddy Time One-to-one adult time for Alexander and Parsons, 1982; Parents make friends and findand Self-Help Group private communications is Belle, 1980; Cochran, 1992; their peers to be supportive

followed by a self-help parent Dunst, Trivette, and Deal, and wise. Parents build agroup. Parents share their 1988; Gilligan, 1982; Gottlieb, local association ofown successes and help 1985; Hill, 1958; Lewis et al., interdependent families.one another help their 1976; McCubbin and Patterson, FAST professionals servechildren succeed in school. 1983; Minuchin, 1979; Pianta, as backup support.Informal social-support Egeland, and Stroufe, 1988;networks emerge. Solomon, 1985; Wahler, 1983;

Werner and Smith, 1992.

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Table 2: FAST Program Activities Apply Mental Health Research To Build Community (continued)

Activities Description Mental Health Research Building Community

Parent-Child Time: Special Play is child-initiated Barkeley, 1987; Garbarino, Parent-child pairs playSpecial Play play whereby the parent 1987; Guerney, 1977; Kogan, together within a context

is coached to follow the 1980; Minuchin, 1979; of a community of other pairs.child’s lead and not to teach, Schedler and Block, 1990,direct, or judge the child. Webster-Stratton, 1991.Play materials are provided.

Lottery (fixed) Each family wins once. Dunst, Trivette, and Deal, Parents know that winningThe winning family is 1988; Hill, 1958; McCubbin is universal and fair.showcased, and members and Patterson, 1983; Cooking the following week’sreceive various prizes. Minuchin, 1979. meal models reciprocity.The winner cooks the nextweek’s meal.

Closing Circle All participants gather into Bronfenbrenner, 1979; This builds community bya large circle for special Epstein, 1995; Hill, 1958; sharing local information,announcements, clapping, Minuchin, 1979. celebrating special events,singing for birthdays, etc. and having traditions with allA final ritual of nonverbal ages and families, neighbors,movements is passed around schools, and professionalsthe circle in silence, making joining together in a circle.sounds of rain followed bya sun emerging in the group.

Daily Homework for Parents are expected to do Barkeley, 1987; Guerney, 1977; This maintains a FAST com-Parents’ Special Play Special Play every day at Kogan, 1980; Patterson, munity of caring for the next

home as “homework.” A 1975; Schedler and Block, generation and helps parentsbehavior chart and stickers 1990; Webster-Stratton, 1991. and children support eachare given to each parent. other.

Graduation The ceremony is held at Bronfenbrenner, 1979; The ceremony is a community(eighth session) school to graduate 10–12 Epstein, 1995. celebration of family achieve-

entire families. Guests are ments with informal andinvited by the families, and formal supports together.the school principal gives The graduation party bringseach family a framed the larger community togethercertificate of completion. with shared experiences toGraduation hats and a remember.recording of “Pomp andCircumstance” add to thiscelebration, foreshadowinghigh school graduation.

FASTWORKS (2 Years) FASTWORKS holds monthly Alinsky, 1971; Freire, 1995; An association of parentsmeetings for 2 years in which Hill, 1958; Horton, 1990; begins to express its ownparents determine the agendas, McKnight, 1995; Solomon, unique agenda with thereceive a small budget, and 1976; Wahler, 1983. school and community, withget support from the school. a positive unified voice andParents may choose more informal social support.training or outings.

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they found that the recidivism rates of thefamily therapy youth were half those ofyouth who received the routine array ofavailable services (Alexander and Parsons,1982). In addition, after the intervention,the siblings of the delinquents in thestudy’s treatment group were also followed;they were half as likely as siblings of con-trol group youth to get involved in thecourt system as delinquents. Some findingsof Alexander’s study are integrated intoFAST family communication activities.

Kate Kogan’s work at the Departmentof Child Psychiatry, University of Washing-ton (1978, 1980; Vann and Kogan, 1979),included intervention with behaviorallyand psychiatrically disturbed childrenages 2 to 8 in which she supervised astructured play activity of one-on-onetime between parent and child. Koganplaced the parent and child alone to-gether in a room with toys and put asmall listening device in the parent’s ear.She then coached the parent-child inter-actions through a microphone while ob-serving from the other side of a one-waymirror. She watched for parental behav-iors that were too bossy or too critical,urging parents to show interest in thechild’s play and to let the child lead theplay. Kogan found that children’s well-beingand anxiety or behavior problems dra-matically improved when they had non-judgmental, nondirective, repeated play-time with a parent. In addition, suchplaytime strengthened the relationshipbetween parent and child. Applying bothKogan’s and Alexander’s research, FASTworks to intervene early in a child’s life byoffering opportunities for families to com-municate and play together in positive ways.

Replication TeamTraining

FAST has been widely replicated. Thefirst 10 FAST trainers were certified in1989. Currently, there are more than 250certified FAST trainers in the UnitedStates, Canada, and Australia. Trainersprepare collaborative teams to facilitatethe multifamily program. McDonald’straining and replication process has sixdistinct elements:

◆ Standard FAST team trainer structure.It takes 1 year to become a certifiedFAST team trainer. Requirements in-clude observing a multifamily session,completing a week of classes at the FASTNational Training and Evaluation Centerat Edgewood College in Madison, WI,and training a team under supervision.

The founder of the program directlysupervises the team trainer qualifica-tion process, which includes makingthree site visits to a new FAST site.

◆ Restricted access to FAST programtraining materials. FAST programtraining is available only to local col-laborative teams (rather than to indi-viduals) that will implement FAST atsites with operational funds. Each teammust include a parent partner, a schoolpartner, and two mental health andsubstance abuse prevention partnersfrom the community.

◆ Program adaptability. FAST teamtrainers lead team exercises, includingdiscussions about values, to build teamcohesion. They also work with the teamto adapt the FAST program to incorpo-rate local challenges and unique contex-tual factors (e.g., cultural or geographi-cal issues).

◆ Uniform manuals and process check-lists. Consistent documents enable teamtrainers to monitor the process andintegrity of the team’s implementation.

◆ Technical assistance on three sitevisits. Certified team trainers visit eachnew site three times to observe theprogram directly and help the teamadapt FAST to the needs of the site.

◆ Required evaluation package. Newsites must submit data before and afterimplementation and an outcome evalu-ation report using the FAST EvaluationPackage of six standardized instruments.

Role of the Team TrainerThe certified FAST team trainer solves

problems on location with the team thatis facilitating the program and adapts theprogram to unique local needs and issues.As a result, the FAST program is respon-sive to local schools, communities, andcultural differences. Certified team train-ers maintain a delicate balance betweenaccommodating to local initiative andcontrol and maintaining fidelity to thecore FAST process to preserve the highpredictability of the program’s impact.Adaptation of the standard program tounique local site requirements is criticalto successful replication and transport-ability of the program. Without a certifiedFAST trainer, sites cannot start a program.

Training MaterialsFAST program workbook manuals for

elementary schools, written in 1990 byMcDonald and Billingham, were revised in

1991, 1992, and 1998. In 1997, with fundingfrom the Center for Substance Abuse Pre-vention (CSAP), two new program manu-als for training and implementation werecompleted: one for the preschool programand one for the middle school program.A training videotape on the long-term im-pact of the FAST program was completedin 1997 based on the CSAP evaluation data.In these training materials, each step ofthe process is outlined and feedback isincluded from FAST teams in a variety ofsettings. The program curriculum has beenrefined since its development in 1990. Op-tional graduate credit is available throughthe FAST National Training and EvaluationCenter Master’s Program in Marriage andFamily Therapy at Edgewood College un-der McDonald’s direction. The work re-quired for qualification as a Certified TeamTrainer is being integrated as best prac-tices into Edgewood’s undergraduate andgraduate curriculums.

Training CostsThe complete FAST team (a minimum

of 4 and a maximum of 10 partners)spends a total of 4 full workdays togetherin FAST training over a 4-month period.The trainer makes three direct observa-tions of the team’s implementation of themultifamily program. The cost of the FASToutcome evaluation and team trainingwith three site visits by certified teamtrainers is $3,900, not including travel.Travel and lodging costs are assumed bythe local site. The complex replication,training, and evaluation structure makespositive outcomes predictable for families,schools, communities, and funders.

State and NationalReplication

Since its implementation in 1988, FASThas been funded by both the public andprivate sectors and has been recognizednationally for using an exemplary approachto building protective factors for at-riskyouth. Federal funding has supportedprogram development and research.

Two Statewide FASTInitiatives

Two State governments have fundedand replicated FAST successfully. In 1990,Wisconsin passed State legislation to fundFAST for $1 million annually under an an-tidrug bill (AB 122) through the WisconsinDepartment of Public Instruction (DPI).Each year, school districts can apply fora FAST grant ranging from $20,000 to

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$70,000 a year. Schools must subcontractwith community agencies. Wisconsin’sFAST grants are renewable for 2 years,with an 80/20, and then 40/60, ratio ofState/district funds. DPI studies of pro-gram sustainability show that 91 percentof the State-funded pilot sites reportedplans to maintain the program with localbudget money after the 3-year Stategrants ended. FAST trainings and evalua-tions were voluntarily purchased byschool districts, and the trained sitesshowed statistically significant (p<0.01)improvements of a magnitude of changeof 20 percent (reported by teachers) to25 percent (reported by parents) on stan-dardized instruments in child functioning,family cohesion, and lessening of socialisolation (see tables 3 and 4).

In 1995, the State of California Depart-ment of Social Services, Office of ChildAbuse and Neglect awarded $40 millionover 5 years to 12 counties under a Juve-nile Crime Prevention Initiative for a 5-part, family-based program to reduce ju-venile violence and crime. FAST was oneof the five mandated components of thestatewide initiative in each California lo-cation. FAST training and evaluation werealso included by the State government toensure the quality of the program replica-tion. Each of the 12 participating Califor-nia counties spends a minimum of $70,000annually on FAST. The results of the FASTtraining and evaluations using six sepa-rate, repeated measures, pretests andposttests, and instruments with estab-lished reliability and validity show a sta-tistically significant (p<0.01) positiveimpact on participating children and fami-lies (see tables 5 and 6). As a result of theprogram’s success, many of the California

sites have used other funding sources toincrease the number of FAST schools.

Corporate and FoundationSupport

Corporate and private sector fundinghas contributed greatly to the wide dissem-ination and replication process of FAST:

◆ United Way of America has identifiedFAST as one of 20 exemplary childrenand family programs nationally. DaneCounty, WI, United Way was the firstfunder of FAST, providing support forprogram development and implemen-tation costs. United Way helps to fundmany of the implementation costs ofFAST programs nationally through theirmember community-based agencies.

◆ The DeWitt-Wallace Reader’s DigestFoundation has substantially funded($2.4 million) the infrastructure for

the national dissemination of FAST toincrease parent involvement in schools.The foundation grant funds the training,evaluation, and technical assistance ser-vices, but not program implementations.

◆ Kraft Corporation funded the develop-ment of a strategy for expanding FASTto many schools in the Madison, WI,Metropolitan School District (thehome of FAST), citing it as an exem-plary parent-involvement-in-schoolsprogram. This included training, evalu-ation, and implementation costs. Inaddition, Kraft is currently funding astatewide FAST initiative in Missourithrough Caring Communities/FamilyInvestment Trust. The grant enablescollaborating State agencies to havecertified FAST trainers. Eight pilot sites,strategically placed across the State,are receiving seed money for imple-mentation and are being trained andevaluated through the FAST NationalTraining Center.

National OrganizationsIn 1993, Family Service America (FSA),

an international nonprofit association ofchild- and family-serving agencies, initi-ated a 5-year project to disseminate FASTthroughout its membership structure withthe support of a DeWitt-Wallace Reader’sDigest Foundation grant. FSA membershipcomprised about 240 family counselors,who were usually funded by United Wayto provide psychotherapy, support groups,and other mental health services. FSA,which became the Alliance for Childrenand Families in fall 1998, recommendedFAST to its member agencies as the bestparent involvement program in theUnited States and encouraged their

Table 3: Results of the Wisconsin Statewide Implementation of FAST,by Parent Report

Scale Pre-FAST Mean S.D. Post-FAST Mean S.D.

Conduct Disorder 17.01 9.70 13.37*** 9.10Socialized Aggression 2.85 3.40 2.11*** 2.90Attention Span Problems 11.22 6.90 9.05*** 6.30Anxiety/Withdrawal 7.65 4.60 6.11*** 3.80Psychotic Behavior 1.89 2.10 1.60*** 1.90Motor Excess 3.55 3.30 2.77 2.40

Notes: These scales are measured by a well-known children’s mental health screening instrument,the Quay-Peterson Revised Behavior Problem Checklist (RBPC), with established norms for normal6- to 12-year-old children, at-risk children, and problem children (1987); n=358. S.D.=standarddeviation.

*** Significant at the 0.001 level.

Table 4: Results of the Wisconsin Statewide Implementation of FAST,by Teacher Report

Scale Pre-FAST Mean S.D. Post-FAST Mean S.D.

Conduct Disorder 11.73 11.00 10.45*** 10.60Socialized Aggression 1.84 3.80 1.71 2.80Attention Span Problems 11.93 8.30 10.08*** 7.40Anxiety/Withdrawal 5.94 4.80 5.02*** 4.50Psychotic Behavior 1.33 2.20 1.25 2.10Motor Excess 3.10 2.90 2.65*** 2.60

Notes: These scales are measured by a well-known children’s mental health screening instrument,the Quay-Peterson Revised Behavior Problem Checklist (RBPC), with established norms for normal6- to 12-year-old children, at-risk children, and problem children (1987); n=408. S.D.=standarddeviation.

*** Significant at the 0.001 level.

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Table 6: Results of the California Juvenile Crime Prevention Project,by Teacher Report

Scale Pre-FAST Mean S.D. Post-FAST Mean S.D.

Conduct Disorder 9.63 10.55 7.89* 10.31Socialized Aggression 1.25 1.92 .92 2.11Attention Span Problems 10.20 8.51 8.47** 7.86Anxiety/Withdrawal 6.07 4.94 4.96*** 4.65Psychotic Behavior .77 1.27 .70 1.50Motor Excess 2.73 2.91 1.98*** 2.35

Notes: These scales are measured by a well-known children’s mental health screening instrument,the Quay-Peterson Revised Behavior Problem Checklist (RBPC), with established norms for normal6- to 12-year-old children, at-risk children, and problem children (1987); n=83. S.D.=standarddeviation.

* Significant at the 0.05 level.

** Significant at the 0.01 level.

*** Significant at the 0.001 level.

participation. Family counseling agenciesthat are Alliance members and have aninterest in prevention have initiatedschool collaborations and received train-ing and evaluation through the Allianceto implement FAST in many parts of theUnited States. From 1993 to 1998, a totalof 51 FSA/Alliance member agencies be-gan replicating FAST. The Alliance forChildren and Families replication wasa positive experience for all concerned:the Alliance’s provision of training andevaluation technical assistance throughthe FAST program’s leader enhanced thelocal agency director’s willingness to trysomething new. The local member agen-cies also benefited from the program bybroadening their community-based out-reach activities and increasing the rangeof funding sources for their programs.The Alliance/FAST initiative continues toprovide training and evaluation technicalassistance to Alliance members through-out the United States and Canada.

In 1998, Communities In Schools, Inc.(CIS), a national, nonprofit organizationencompassing a network of State and lo-cal community-based CIS initiatives, em-barked on a national replication of theFAST process. For more than 25 years, CIShas helped communities build local colla-boratives that engage government, busi-ness, local and county agencies, schooldistricts, nonprofit organizations, and fami-lies. CIS helps local communities developa process that relocates existing servicesand resources into schools to help studentsand families succeed. The CIS collabora-tive brings together major stakeholdersto create their own nonprofit agency that

supports communitywide integrated plan-ning and school-linked services to benefitchildren, youth, and families and to usecommunity assets more effectively. Thereare 18 State CIS offices and more than150 local CIS organizations in 30 States,Canada, and Ireland. CIS supports childrenin more than 1,000 schools in the UnitedStates. CIS considers FAST a major re-source for family involvement and familystrengthening that creates a school-based collaborative team and buildsa long-term process that involves, em-powers, and strengthens families. The CIS/FAST initiative enhances the CIS processwith predictable and accountable out-comes. The CIS/FAST initiative is buildinga network of trainers who can use the CIS

collaborative to build teams that bringFAST to local CIS school sites and thatcan engage school districts using FAST toexplore the CIS process.

Evaluation ResultsFrom the outset, the FAST program has

been evaluated for quantitative outcomes,and its ongoing processes have been moni-tored with each new implementation. In1990, McDonald and Billingham developeda FAST Evaluation Package to measure theoutcome of the program for children andfamilies at each new replication site of theWisconsin statewide initiative. Evaluatingthe local impact of each site and monitoringthe processes of the local program adapta-tion and implementation are ongoing FASTcommitments. The data not only show theprogram’s impact on children and families,but allow the team to assess the uniquelocal fit and facilitate site improvements.

McDonald and Billingham’s FAST Evalua-tion Package (1998) includes only standard-ized questionnaires with established valid-ity and reliability and published norms forchildren and families. Teachers and parentscomplete these measures to evaluate thechild’s mental health functioning at homeand at school before and after FAST.

Pretreatment, posttreatment, andfollowup assessments are performed forthe following indicators:

◆ Child mental health functioning atschool (assessment by a teacher usingthe Quay-Peterson 1987 Revised Be-havior Problem Checklist (RBPC)).

Table 5: Results of the California Juvenile Crime Prevention Project, byParent Report

Scale Pre-FAST Mean S.D. Post-FAST Mean S.D.

Conduct Disorder 13.85 9.14 10.34*** 8.54Socialized Aggression 2.62 3.34 1.96* 2.60Attention Span Problems 10.39 6.81 7.07*** 6.47Anxiety/Withdrawal 6.82 4.83 4.98*** 3.97Psychotic Behavior 1.50 1.98 1.30 1.91Motor Excess 3.45 2.73 2.31*** 2.26

Notes: These scales are measured by a well-known children’s mental health screening instrument,the Quay-Peterson Revised Behavior Problem Checklist (RBPC), with established norms for normal6- to 12-year-old children, at-risk children, and problem children (1987); n=105. S.D.=standarddeviation.

* Significant at the 0.05 level.

*** Significant at the 0.001 level.

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◆ Child mental health functioning athome (assessment by a parent usingthe above instruments).

◆ Family functioning (using Moos’ FamilyEnvironment Scale (FES) (Moos, Insel,and Humphrey, 1974) and/or Olson’sFamily Adaptability and CohesionEvaluation Scales (FACES III (Olson,Portner, and Lavee, 1987)).

◆ Family social isolation (using Abidin’ssubscale of the Parenting Stress Inven-tory (Abidin, 1986)).

◆ Parent involvement in schools (usingEpstein’s Parent Involvement Scale(Epstein, 1995)).

◆ Consumer feedback and satisfaction(McDonald and Billingham, 1998).

Across hundreds of school FAST pro-grams, assessments show high statistical sig-nificance in pretreatment-to-posttreatmentimprovements on the conduct disorderscale, the anxiety-withdrawal scale, and theattention span problem scale of the RBPC.The improvements on these scales havebeen correlated in several studies with re-duced violence and substance abuse in ado-lescents. The FAST Evaluation Package hasbeen used in more than 300 schools andcommunities, and the improvements arepredictable and consistent.

Replication Evaluation Datain Two Statewide FASTInitiatives

Outcome evaluation data were collec-ted from statewide FAST replications byMcDonald and Billingham at 30 Wisconsinschools using antidrug funds (Billingham,1993; McDonald, 1993) (see tables 3 and 4)and by the State of California at 12 Califor-nia schools using Office of Child AbusePrevention funds (see tables 5 and 6).Data from both statewide implementa-tions showed high statistical significance(p<0.01) in improvements on the five mea-sures described above using paired, two-tailed t-tests (these tests indicate whetherthe improvements are due to chance or tothe program). Parents reported 25-percentimprovement at home, and teachers re-ported 20-percent improvement at schoolafter only 8 weeks. Reductions occurredin several categories of problems:

◆ Behavior problems, such as bullying,hitting, stealing, and lying.

◆ Withdrawal and anxiety, such as inse-curity and social isolation.

◆ Attention span problems, such as lackof focus and distraction.

FAST Evaluation AcrossTime in Madison, WI, WithComparison Groups

CSAP funded evaluations of the long-term impact of FAST in Madison, WI, withoutside evaluator Thomas Sayger, Ph.D.,of the University of Memphis, TN. The CSAPevaluations used several measures, includ-ing Achenbach’s CBC and Moos’ FamilyEnvironment Scales. These measuresshowed statistically significant pretest-to-posttreatment improvements, and gainswere maintained at the 6-month followupevaluation (Sayger, 1996; McDonald andSayger, 1998).

In addition, a complete followup studyof all FAST families in Madison surveyedthe improvement in child functioning;parents reported that gains were main-tained 2 to 4 years later. Using compari-son groups of other Title I children in theMadison Schools, the followup study deter-mined that participating in FAST helpedchildren improve their third-grade read-ing scores. Based on a 2-year followup of250 FAST families in Madison, the improvedfunctioning of the child, the improvedfamily cohesiveness, and the increasedsocial involvement of FAST parents in theirchildren’s schools and in the communityseem to be long-term impacts of the FASTprogram.

Participation, completion, and eventualleadership in the ongoing FASTWORKS

programs are characteristic of low-incomefamily participants. In the CSAP long-term impact study, McDonald and col-leagues (1997) talked to 10 FAST parents inopen-ended interviews and transcribedthe interviews for qualitative analysis tobetter understand the process of change.Parents were asked to discuss and ratetheir experiences in FAST using theMcDonald/Billingham followup question-naire. Qualitative reports by parents andchildren were enthusiastic. Teachers,administrators, and school social workers/counselors were also positive in theirevaluation of FAST’s impact on increasedparent involvement and bonding betweenfamilies and schools.

Experimental Studieson FAST

In an experimental study by Billingham(1993), outcomes were statistically signifi-cant: FAST youth improved more thancontrols (p<0.05). Five experimental stud-ies of FAST with special populations thatuse randomized trials are being funded byFederal research institutes. Three of thesestudies have McDonald as the coprincipalinvestigator in collaboration with ThomasKratochwill, Ph.D., and Joel Levin, Ph.D.,of the University of Wisconsin-MadisonSchool of Education; Paul Moberg, Ph.D.,Director, University of Wisconsin-MadisonSchool of Medicine, Center for HealthPolicy and Program Evaluation; and HollyYoungbear-Tibbits, Ph.D., College of theMenominee Nation. The first study isfunded by the U.S. Department of Educa-tion, Office of Education Research andImprovement (OERI), through the Insti-tute of At-Risk Students, to study FASTwith three Indian nations. The secondstudy is funded by the U.S. Department ofEducation, Office of Special Educationand Rehabilitation Services (OSERS), tostudy FAST as a strategy to reduce refer-rals to special education for emotionaldisabilities. The third study, funded bythe National Institute on Drug Abuse(NIDA) and supplemented by the Office ofNational Drug Control Policy (ONDCP),studies cultural adaptations of FAST atinner-city schools with predominantlyAfrican American and Hispanic popula-tions. In addition, Phil Leaf, Ph.D., ofJohns Hopkins University School of PublicHealth, Center for Prevention Research, isconducting research on the BaltimoreHead Start FAST program in Baltimore,MD. The Baltimore study is funded by theU.S. Department of Health and HumanServices (HHS), Substance Abuse and

A Cambodian family, in ceremonial attire,graduating from FAST in Wisconsin.

14

Mental Health Services Administration(SAMHSA). Jean Layzer of Abt Associates,Inc., and Lynn Kagan of Yale Universityare conducting research in 10 schools inNew Orleans, LA, funded by HHS, Admin-istration for Children, Youth, and Families,to determine the impact of FAST as a theo-retically grounded family support program.OERI is also funding a study which includesthe FAST program and its impact on thedevelopment of social capital in threeinner-city schools in Chicago, IL. Dr. TonyBryck, University of Chicago, and Metro-politan Family Services are involved.

Thirteen-State SiteEvaluation of Children’sMental Health in FASTSchools

FAST has been implemented in manynew settings with team training by certi-fied trainers. The FAST Outcome Evalua-tion Package is used with each new imple-mentation. The mental health scores ofchildren ages 6 to 12 on scales related toconduct disorder, anxiety/withdrawal, andattention span problems are of particularinterest to juvenile justice professionals

(see figures 1 and 2). High scores on “con-duct disorder” correlate with delinquencyand incarceration; high scores on “anxi-ety/withdrawal” correlate with alcoholand drug addiction; and a combined highscore on “conduct disorder” and “anxiety/withdrawal” correlates with violence.High scores for “attention span problems”correlate with dropping out of school(high scores also indicate the problemsare severe).

Pre- and post-FAST data were collectedon children’s mental health (using RBPC’s)for the first 53 trained FAST sites of theAlliance National Dissemination Initiative.1

The data assessed the impact of FAST onmore than 420 FAST children at 53 sitesin 13 States (1 site did not collect teacherdata). Outcomes are summarized in figures1 and 2 (McDonald, Pugh, and Alexander,1996). Of the children evaluated, 50 per-cent were European American, 23 percentwere African American, 25 percent wereHispanic, 1 percent were Asian American,and 1 percent were American Indian. Thirty-

four percent were female and 66 percentwere male. The age range of 70 percentwas from 6 to 8 years. As these figuresshow, the average child being referred toFAST in these schools was not just at risk,he or she was already in serious trouble.2

These data also indicate that most of thechildren referred to FAST across 13 Statesbegan with severe problems, as measuredby both teachers and parents using astandardized scale. In only 8–10 weeks ofmultifamily programming, the averageseverity of conduct disorders, anxiety/withdrawal, and attention span problemsdropped significantly, from the clinicallysevere to the at-risk level. In other words,parents and teachers observed an im-provement of 20 to 25 percent in the be-havior of FAST children at home and atschool in just 8–10 weeks, shifting theaverage score closer to normal functioningfor that age.

National RecognitionSince 1990, FAST has won many awards

in several areas of national competition andit has been included in numerous “shortlists” of research-based model programs.Most recently, these honors include thefollowing:

◆ FAST was one of four effective ap-proaches recognized and highlightedby the White House Conference onSchool Safety on October 15, 1998.

◆ FAST was identified as a culturallycompetent model in education by theAmerican Institute of Research for theU.S. Department of Education (1998)(for more information, see www.air.org/cecp/cultural/Q_integrated.htm).

◆ FAST was recognized for being among27 research-based models for schoolreform. The National Institute on theEducation of At-Risk Students pub-lished a booklet describing effectivemodels, including FAST, and dissemi-nated it to all Title I schools (i.e., thoseserving low-income children) in theUnited States (U.S. Department ofEducation, Office of Educational Re-search and Improvement, 1998).

◆ FAST was identified as 1 of 12 research-based model family approaches to

8581 83

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Figure 1: Schools With Clinically Severe Mental Health Scores Beforeand After FAST, Parent Ratings*

* These data represent 420 children in 53 schools in 13 States. These three scales aremeasured by a well-known children’s mental health screening instrument, the Quay-PetersonRevised Behavior Problem Checklist (RBPC), with established norms for normal 6- to 12-year-old children, at-risk children, and problem children (1987). These scales correlate with delinquency.

** These data represent the average of the whole group of FAST children at each school andthe percentage of the 53 schools in which the group average was above the problem levelsestablished by the RBPC norms.

2 These data were collected by the Alliance for Chil-dren and Families with McDonald’s consultation (1993–98). The Alliance used the McDonald-Billingham FASTEvaluation Package with Alliance-member family coun-seling agencies that were initiating FAST programs andwhose training was funded by DeWitt-Wallace Reader’sDigest Foundation.

1 Between 1993 and 1995.

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delinquency prevention and dissemi-nated nationally by OJJDP in 1993and 1997.

◆ FAST was invited to present its research-based model for a safe school climateat a Research into Practice Conferencesponsored by the U.S. Department ofEducation’s Safe and Drug-Free SchoolsProgram (June 1997).

◆ FAST was named an effective programfor safe schools and safe students in abooklet describing 26 research-basedmodels, which was published by theNational Education Goals Panel andthe National Alliance of Pupil ServicesOrganizations (McDonald, 1996).

◆ FAST was cited as one of four effectiveschool-based substance abuse pre-vention program models in a brochuredistributed by the U.S. Department ofHealth and Human Services, SubstanceAbuse and Mental Health ServicesAdministration, Center for SubstanceAbuse Prevention (1996).

◆ FAST was included as one of six exem-plary family support program modelsfor further study by Abt Associates/Yale University for the U.S. Departmentof Health and Human Services (1996).

◆ FAST was included as 1 of 20 effectiveprograms for children and families ina booklet published by United Way ofAmerica (1996).

◆ FAST’s statewide replication in Wiscon-sin was recognized as 1 of 25 nationalfinalists (out of an initial pool of 1,600applicants) in 1994 in the Ford Founda-tion/Harvard University awards pro-gram for Innovations in State and LocalGovernment (Fifteen, 1994).

◆ FAST was included as one of fivefamily-based programs in the CSAPpublication Signs of Effectiveness II:Preventing Alcohol, Tobacco, and OtherDrug Use: A Risk Factor/Resilience-Based Approach (Gardner, Green, andMarcus, 1994).

Policy ImplicationsFAST is unusual in three ways: it is sys-

temic rather than categorical, it respectsthe parent as a partner in prevention, andit is replicated, evaluated, and found to besuccessful in diverse communities. Thereare many short lists of exemplary research-based model programs being developed,published, and distributed. However,each list is focused on a specific socialproblem reflecting a separate funding

stream and a distinct Federal Governmentagency. The focus on research-based bestpractices arises from a commitment toeffective early interventions. However, thethinking of policymakers remains categori-cal rather than holistic and systemic. Onecommunity that chose to implement ex-emplary, research-based, recommendedapproaches to reduce delinquency,school violence, drug addiction, schooltruancy, and school failure could requirefive different programs for the same chil-dren. In contrast, the community couldaccomplish the same multiple categoricaloutcomes by putting significant resourcesinto the FAST program, a single, positiveintervention that builds stronger relation-ships with whole families and with theexisting social structures of schools andcommunities.

FAST’s approach to prevention uses ashared governance model in which eachteam includes a consumer parent, whosevoice is a highly respected part of the solu-tion. FAST is a parent-youth-professionalpartnership that builds positive protectivefactors for youth by strengthening ongoing,preexisting, informal, social relationships.

The procedure is determined by the partici-pants at a grassroots level, in their own lan-guage, style, preferences, and cultural forms.The power of the parent’s voice extends toprogram planning and budget decisions;these crucial decisions shift gradually fromthe parent-professional partnership to thecommunity of parents. FAST is popular withparticipants, who support increased pro-gramming available to all youth and families.

Finally, FAST is unusual in its 10-yearhistory of commitment to the developmentof a living, rigorous, and hands-on struc-ture for quality control of the replicationand dissemination process. There is a re-spectful awareness that each communitymust adapt FAST to fit its own priorities,and this adaptation is accomplished dur-ing the three site visits by a certified FASTtrainer. Evaluation of each new pilot sitewith process tools and quantitative out-comes allows routine review of what worksand what does not work. Regular revisionof FAST program manuals incorporatesnew lessons and new research to improvethe program and the replication processover time. The decision to house the FASTNational Training and Evaluation Center at

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54 54 56

After 8-Week FAST Program**

* These data represent 399 children in 52 schools (at 1 school, teachers did not submitratings) in 13 States. These three scales are measured by a well-known children’s mentalhealth screening instrument, the Quay-Peterson Revised Behavior Problem Checklist (RBPC),with established norms for normal 6- to 12-year-old children, at-risk children, and problemchildren (1987). These scales correlate with delinquency.

** These data represent the average of the whole group of FAST children at each school andthe percentage of the 52 schools in which the group average was above the problem levelsestablished by the RBPC norms.

Figure 2: Schools With Clinically Severe Mental Health Scores Beforeand After FAST, Teacher Ratings*

16

a graduate school of family therapy in anacademic institution reflects the program’songoing commitment to what works now,rather than to what worked 10 years ago.

If FAST were available to every youthidentified as at risk by each elementaryschool, it could act as a funnel or filter forstabilizing the immediate context—thefamily and the community—of youth whoare at risk for violence and delinquency.After the 8- to 10-week program, more in-tensive interventions can be facilitated foryouth who need family therapy, probationmonitoring, intensive individual treatment,medication, or other services. The 8–10weeks of FAST are shorter than either thewaiting period to enter most treatmentfacilities or the trial period to determinethe levels and effects of medication inreducing violent episodes.

Two statewide initiatives funding FASTdissemination and replication have takenplace in Wisconsin (1990) and California(1995) and two more are beginning inMissouri and South Carolina. Each Stateinitiative arose from a different type ofpolicy: The Wisconsin initiative was legis-lative through one State agency (SubstanceAbuse Prevention in Education), the Cali-fornia initiative was administrative throughone State agency (Office of Child AbusePrevention in Human Services), the SouthCarolina initiative is offered as a technicalassistance program for local schools byCIS with the State Department of MentalHealth, and the Missouri initiative has afoundation grant to build statewide capac-ity to certify FAST trainers. Missouri hascreated a prevention system that assistscommunities and families to achieve bet-ter results for themselves. The FamilyInvestment Trust, created by executiveorder of the Governor, is a unique partner-ship of seven State agency directors andeight private-sector business and civicleaders. The Family Investment Trust allo-cates $40 million annually to communitiesto improve child and family outcomes.

Effective research-based programsthat can be shown to work across manydiverse settings with low-income families,including parent partners, and that use afamily therapy-based approach to earlyintervention with at-risk children are themost likely to achieve cross-categoricalresults. Together, the multilevel relationship-building components of FAST create anassets-based, comprehensive family,school, and community approach to help-ing youth avoid undesirable outcomes.

The costs for offering FAST to all fami-lies should not be borne by one groupalone; they should be shared across edu-cation, child welfare, substance abuseprevention, mental health, public health,and community development agencies;asset building initiatives; and juvenilejustice systems. Systemic approacheswork and have impacts across fundingcategories. Until these approaches be-come policy realities rather than policygoals, professionals will struggle withpiecemeal solutions for at-risk youth.

ConclusionEveryone knows that relationships are

key ingredients for healthy families and safecommunities and that they help peopleget things done. Yale child psychiatristJames Comer says: “Relationships are tochild development what location is toreal estate” (Comer, 1998). There is a newterm in education called “social capital,”which correlates with children’s suc-ceeding in school. The original definitionof social capital was that at a school, onaverage, each parent knows four or fiveother parents of children at that school.As a result, if one youth is caught drink-ing, stealing, fighting, or carrying a gun atschool, some parents will find out about itand tell other parents about the incident;the word will get around. This informalnetwork of parents—based both on car-ing about youth and on enforcing rules—monitors youth behavior. Parent net-works are powerful allies to theenforcement corps of police and juvenilejustice officials. However, busy workingparents are increasingly socially isolatedfrom one another and suffer from a lack ofsupport from social institutions (Hewlettand West, 1998). In dangerous inner-cityneighborhoods, the social isolation offamilies from one another and youth fromadults has dramatically increased overthe past 10 years (National ResearchCouncil, 1993). In poverty-stricken ruralareas, social isolation can be hazardousto the well-being of youth and their fami-lies. These societal factors have increasedthe risk of inadequate monitoring of at-risk youth by parents, neighbors, andother caring adults who have historicallyhad long-term relationships with thoseyouth. FAST actively facilitates, supports,and builds these relationships, contribut-ing to the safety and welfare of youth,their families, and communities.

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For Further InformationFor further information on FAST,

contact:

Lynn McDonald, ACSW, Ph.D.FAST Program FounderThe FAST Research ProjectWisconsin Center for Education ResearchUniversity of Wisconsin-Madison1025 West JohnsonMadison, WI 53706608–263–9476608–263–6448 (fax)E-mail: mrmcdona@facstaff.wisc.eduInternet: www.wcer.wisc.edu/fast

For more information about the Commu-nities In Schools-FAST Initiative, contact:

Carole LevineCommunities In Schools, Inc.North Central Regions815 West Van Buren, Suite 319Chicago, IL 60607312–226–1076888–371–3606312–226–7566 (fax)E-mail: carole@cisnet.org

For more information on the Wisconsinstatewide FAST initiative, contact:

Doug WhiteDirectorStudent ServicesPrevention and Wellness TeamDepartment of Public InstructionState of WisconsinP.O. Box 7841Madison, WI 53707608–266–8960608–267–3746 (fax)E-mail: douglas.white@dpi.state.wi.us

For more information on the Californiastatewide FAST initiative, contact:

Frank IngramDirectorOffice of Child Abuse PreventionState of California744 P StreetSacramento, CA 95814916–445–2852

For more information on the South Caro-lina statewide FAST initiative, contact:

Elizabeth FreemanChair, FAST State CommitteeDepartment of Mental Health2414 Bull StreetColumbia, SC 29202803–898–8350803–898–8355 (fax)E-mail: EVF88@dmh.state.sc.us

19

For more information on the Missouristatewide FAST initiative, contact:

Kate LeeFamily Investment Trust3915 West Pine BoulevardSt. Louis, MO 63108800–838–3388314–531–2285

For more information about FAST pro-grams and Indian nations, contact:

Holly Youngbear-Tibbits, Ph.D.College of Menominee NationP.O. Box 1179Keshena, WI 54135715–799–4921715–799–1336 (fax)E-mail: Hyoungbear@menominee.com

Acknowledgments

Dr. Lynn McDonald is a Senior Scientist at the University of Wisconsin-Madison,Center for Education Research, and a faculty member of the Edgewood CollegeGraduate School of Family Therapy. She is a former faculty member, School ofSocial Work, University of Wisconsin-Madison (1975–87); former president of theNational Association of Social Work Wisconsin Chapter; and a clinical supervisorfor the American Association of Marriage and Family Therapists.

Heather E. Frey is a Senior Writer/Editor with OJJDP’s Juvenile Justice Clearinghouse.

All photographs in this Bulletin were provided by Dr. McDonald.

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For more information about FAST repli-cation by family counseling agencies,contact:

Linda WheelerNational FAST DirectorAlliance for Children and Families11700 West Lake Park DriveMilwaukee, WI 53224–3099800–221–3726414–359–1074 (fax)E-mail: lwheeler.alliance1.org

For more information about FAST teamtraining, site evaluation information, thequality control process, and certificationof team trainers, contact:

FAST National Training and EvaluationCenter

Graduate School of Family TherapyEdgewood College855 Woodrow StreetMadison, WI 53711608–663–2382608–663–2336 (fax)Internet: www.wcer.wisc.edu/fast

Points of view or opinions expressed in thisdocument are those of the authors and do notnecessarily represent the official position orpolicies of OJJDP or the U.S. Department ofJustice.

The Office of Juvenile Justice and Delin-quency Prevention is a component of the Of-fice of Justice Programs, which also includesthe Bureau of Justice Assistance, the Bureauof Justice Statistics, the National Institute ofJustice, and the Office for Victims of Crime.

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