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Summary
of ReCAPP Forum:
Parent-Child
Connectedness On February 2, 2004, ETR's Lori Rolleri was joined by fellow moderators Steve Bean, Nicole Lezin, and Julie Taylor for ReCAPP's forum on parent-child connectedness (PCC). All four moderators were authors of a comprehensive literature review of PCC as part of a year-long study of PCC funded by the Annie E. Casey Foundation. Ninety-nine participants from across the United States, representing a variety of organizations and viewpoints, joined the forum and shared information, resources and common concerns and questions regarding how to define, identify and develop PCC within families. Co-moderator Lori Rolleri began by welcoming everyone and inviting them to look at the information about PCC that was published on ReCAPP in January/February 2004. The forum defined PCC and described ETR's PCC project. There were also many queries and suggestions regarding the recruitment of youth and parents into programs designed to enhance PCC among families. Issues of when and how to intervene were also discussed. The four moderators fielded questions, responded to suggestions and offered advice on the following topics:
Defining PCC and its Roots One participant, noting that she has read a lot of parenting resources but had not encountered the term "connectedness" until the forum discussion, asked about the origin and significance of the term. Ms. Rolleri responded that parent-child connectedness clearly has roots in Attachment Theory, which was originally written by John Bowlby in the late 1960s. She explained that Attachment Theory says that an infant's first attachment (initially to his/her mother) profoundly shapes the social, cognitive and emotional developments that follow. Ms. Rolleri noted that she was first exposed to the term "parent-child connectedness" in several papers authored by Robert Blum, MD, PhD, MPH at the University of Minnesota, Center for Adolescent Health on ADD Health Data. Ms. Rolleri added that the participant's query tapped into a concern she has about how well "parent-child connectedness" resonates with practitioners. She pointed out that an ETR online survey with ReCAPP users (conducted last May with 599 respondents) made it clear that many people seem to confuse parent-child connectedness with parent-child communication. She noted that communication is definitely part of connectedness, but it alone does not determine connectedness. Ms. Rolleri asked the forum's participants for their thoughts on the term "parent-child connectedness," and suggested that the nomenclature might have to change so that the construct is better understood. Co-moderator Nicole Lezin added that she, too, first became aware of the PCC term from Dr. Blum's work with the Adolescent Health data and seconded Ms. Rolleri's request for feedback and suggestions on a better way to describe this important but complicated concept. Another participant, who is a childbirth educator, suggested checking Brazelton or Kendall and Klaus, researchers focusing on maternal (parental) bonding, for the origin of the term. Ms. Rolleri noted that PCC appears to be a strong protective factor against adolescent pregnancy. ETR's PCC study found that PCC was mentioned as a protective factor to 33 different adolescent health outcomes, including mental health, drug abuse prevention, academic achievement, and violence prevention. ETR's PCC Project Both co-moderators Steve Bean and Nicole Lezin mentioned their work on ETR's year-long PCC project in their introductory comments. Mr. Bean explained that his primary role in the first year of the project was the design and facilitation of its think tank meeting. The meeting brought together more than a dozen practitioners and researchers to critique ETR's literature review on PCC, to analyze the ReCAPP survey of practitioners and to suggest the next steps for developing pilot interventions for increasing PCC for families with teens. Mr. Bean encouraged forum participants to read and critique the project's
proposed model for how PCC develops in families, which is found in the
literature review. How PCC Develops Mr. Bean explained that ETR's model for how PCC develops between parent and child is based on what he and the other researchers learned during the literature review. He provided the following abbreviated summary of the PCC process as modeled. (See Parent-Child Connectedness under "Authored Papers" in Current Research for the full diagram and description of the model.)
In requesting critiques of the model from forum participants, Mr. Bean asked the following questions:
The forum grappled with some of these questions, but the discussion made clear that there are as yet no definitive answers.
Many of the forum's participants asked about the best ways to recruit youth and their parents for programs and workshops designed to develop and maximize PCC. Several participants joined the moderators in suggesting effective recruitment strategies. Recruiting Youth In response to a general query from a Canadian participant about recruiting and retaining youth, co-moderator Steve Bean noted that it is important to first clarify the types of programs (i.e., clinic-based, after school activity groups, peer education groups) for which the youth are being recruited. Participant Heather Samel, a Sexuality Health Educator for Planned Parenthood of Nassau County, stated that the key to recruiting and maintaining teens is incentive. The obvious answer to what they will gain from their participation — learning useful information and developing life skills — is often not enough for them. Ms. Samel suggested other incentives such as training them to be peer educators, providing them with free t-shirts, business cards, and food. Several participants stressed the importance of offering incentives that are immediately meaningful to the youth (such as payment or free childcare) that encouraged them to be involved and stay involved and that making youth feel more professional helps attract and retain them. Another participant suggested finding a student who is interested in the topic or program for which you are trying to recruit youth and brainstorming with him or her about how best to bring in peers. In addition to the incentives already mentioned, which she noted are costly but are worth the expense, she also recommended posting flyers around school. Mr. Bean added that there are lots of resources available for helping with start-up and recruitment for peer education programs (listed under Resources). The evaluations of peer education programs often show strong outcomes for the peer educators and weak or no outcome for the other youth who participate. When it comes to youth development, the key to recruiting and retaining youth is threefold:
Mr. Bean suggested those seeking more information should read Preventing Teen Pregnancy: Youth Development and After School Programs by Kirby, Lezin, Afriye & Gallucci (2003). Recruiting Parents A participant planning a parent youth conference designed to get parents and youth to better communicate with each other noted that the idea came from the youth. Co-moderator Lori Rolleri strongly encouraged him to include parents on the planning team as well and to think about ways to talk about parent-child connectedness at the conference. Communication of important messages is more likely to take hold when parents and children feel close. She noted that parents and teens spending time together at the conference may in itself be a way to develop/strengthen connectedness. Co-moderator Julie Taylor seconded Ms. Rolleri's suggestion to include parents, noting that if PCC is going to be effective, health educators, community-based organizations (CBOs) and schools will need access to parents as well as teens. She stated that most of the schools and CBOs with which she has worked have found it difficult to bring groups of parents together for educational purposes. She suggested enhancing parent-teen connectedness by having parent-teen nights or offering a 2-3 session workshop where parents and teens could spend time together as well as talk about sexuality. A participant commented that she has had a lot of success recruiting parents using the tupperware approach to recruitment (home workshops, recruiting by peers, small thank you gifts for hostess and participants, recruiting more workshops from participants), which she also refers to as the "peer-to-peer" approach. Another participant asked about the efficacy of holding private workshops in people's homes since the schools are hesitant to include some of the programming in question. Co-moderator Julie Taylor suggested working with the local PTA, whose members can help identify appropriate goals and activities for the meeting as well as help with recruiting parents. She added that the tupperware approach is a grassroots approach and relies heavily on word of mouth. Other ways to get a program off the ground include getting a few committed parents to sponsor one or two meetings and working with groups like Boys and Girls Clubs who have access to a neighborhood facility and to youth. Another participant added that she is often faced with parents who miss the workshops and want to hold their own or are from other communities. She tells them that they can set up their own, and she will provide invitations if they want to send them out. She also recommended Boy Scouts and Girl Scouts as a great resource for recruiting parents. One participant noted that she has had success offering programs to parents of preschoolers in parent participation preschools that have a parent education component (such as HeadStart). Another successful idea she proposed was to present to parents during the middle school dance nights. Parents drop their kids off for the school dance, then go to another room for a bit of sex education during which youth present. She noted that she has had up to 90 parents attend (and as little as 5), with the average being 25-35. Co-moderator Bean added that offering free transportation to and from meetings and workshops also works wonders. He concluded, however, that another route to parents is through an intrinsic incentive, which CARTA (Center for Applied Research and Technical Assistance) calls an "engagement" — supporting and educating parents to become advocates in the issues that affect their children. He recommended looking at CARTA's web site (www.cartainc.org) for more information on the good work that they have done on parent engagement. Youth Promoting PCC to their Own Families In response to a participant's query about the role of the youth in PCC, co-moderator Bean stated that ETR's review of the literature suggests that PCC is and must be bi-directional. Teens could take an active role in promoting it and suggested that this could especially be the case when there are structural or contextual obstacles getting in the way of family connectedness, like parents working long hours at multiple jobs to combat poverty. In such a case, a teen empowered to do the scheduling of shared activities, or cooking dinner for the family to eat together might take a load off parents, and, at the same time, promote connectedness. On the other hand, in order for PCC to produce positive outcomes for youth, other aspects of connectedness MUST come from the parent including monitoring, supervision, boundary-setting, etc. If a parent is not taking this authoritative role, a teen stepping into that role is unlikely to benefit.
Teen Pregnancy Prevention In a slight deviation from the topic, several participants discussed the need for pregnancy prevention programs and lamented the fact that few alternatives to abstinence-only programs are being offered due to widespread budget cuts. One participant noted that even abstinence education has been cut in his district because the community is divided with respect to its value, and no one is taking the initiative to seek funding for it. A participant with over 25 years of experience in the health education field lamented the lack of required education for the teachers in the school teaching anything to do with sex education. She stated that they are as uncomfortable as the rest of the population and often do not have the correct information themselves — thus it is so easy to "not have time" to educate students in comprehensive sex education. She applauded the efforts of a religious-based school in her area that has taken the initiative of hiring a trained family life educator who will offer a totally comprehensive course on sex education. She noted that an important component of the sex ed curriculum for students are two parent presentations which she hopes will serve as a prototype for future interventions. Parent-Child Communication Programs One participant stated that even though the bulk of her work is with youth, she also focuses on parent education because she thinks one of the best ways to increase PCC is to educate the parents about the struggles of our youth today. She noted that it is unrealistic to expect them to be comfortable talking to their children about sex and related topics when no one modeled such behavior with them when they were little. Co-moderator Lori Rolleri responded that ETR's research indicates that the evidence is actually quite mixed about the effectiveness of parent-child communication programs. Some programs may be effective at actually changing parents' behavior to increase communication while others are not. There is also mixed evidence about whether or not a parent who talks to his/her teen actually changes the teen's sexual behaviors (i.e., abstain from sexual intercourse, use contraception). Ms. Rolleri recommended reading a great summary published by SIECUS about parent-child communication and its effectiveness titled: "Innovative Approaches to Increase Parent-Child Communication about Sexuality: Their Impact and Examples from the Field." What seems to be a key factor in whether or not parent-child communication efforts work is whether or not parent-child connectedness exists. If parents and teens feel connected, respect each other and trust each other, then communication/education about sexuality (and other topics) is more likely to stick. Co-moderator Steve Bean referred again to CARTA (Center for Applied Research and Technical Assistance) and their work on parent engagement and a Annie E. Casey parent-child intervention focused on communication called Plain Talk. Plain Talk trains community members to be "walkers & talkers" or in Spanish "promotoras" who go door-to-door to recruit participants for home health parties — much like the "tupperware" approach mentioned earlier. These home health parties are meant to offer a model for parent-child communication. Mr. Bean added that the model could be used to address other factors and that it develops long-term human resources in the community. Even though it is not likely to yield a lot in the short term, over time it provides an intervention with strong effects. Mr. Bean encouraged those who want to learn more about the Plain Talk model to visit the Casey web site at www.aecf.org. A participant suggested other Can We Talk programs, including the former California "It's Up To Me" campaign Talk Early, Talk Often Activity Kit and one from Kaiser that has drama presentations like "Nightmare on Puberty Street." A strategy she uses as a parent and practitioner is to keep a pack of "playing" cards in the car glove compartment for long trips or other opportune times. The cards ask things like, "If you were a chair, what kind of chair would you be and why?" and "Do you believe in love at first sight? Why or why not?" These cards stimulate great conversation but, more importantly, provide the opportunity for people to get to know each other better. As an educator, she uses such questions as ice breakers or as homework or, if she can finance it, as gifts for families. She also recommends having students anonymously write down questions they would ask their parents if they could ask them anything and visa versa. The questions are presented by a youth leader to the whole group, and the anonymity makes it safe for everyone to discuss them. In response to a participant's request for effective strategies and goals for parent-child meetings, co-moderator Julie Taylor suggested seeking input directly from the parents since they know first hand the issues and dilemmas they face with their children. She also recommended asking a group of teens what they would like their parents to know about them. The answers to these questions could help form the basis for the goals and the activities that get built into the subsequent parent-teen meetings. Ms. Rolleri, drawing from SIECUS' Innovative Approaches book, recommended assigning homework. Since it is difficult to sometimes get parents and teens together in one room, homework assignments can encourage parents and teens to talk at home. These types of assignments may involve many more parents than any other program. According to Doug Kirby (author of the first half of the publication), research indicates that a substantial percentage of students complete these assignments and that some parents commented that these assignments provided justification for them to talk about sex or other difficult issues and made them feel more comfortable. Two studies in particular were mentioned in Kirby's review: Managing Pressures before Marriage and The Youth AIDS Prevention Project. Both sets of evaluation data showed that homework assignments do increase parent-child communication and might increase connectedness since teens and parents are put in a situation where they have to spend time together, communicate and share values. Crossing Disciplines and Health Topics Several participants suggested tapping into programs that have already been developed to address other issues, such as substance abuse, that have activities designed to foster and enhance PCC built into them. As one participant put it, "Why reinvent the wheel if you can learn something valuable from another arena?" She recommended a substance abuse prevention program Families that Care: Guiding Good Choices curriculum because it teaches parents of preteens and adolescents the skills they need to improve family communication and family bonding. She noted that parents learn effective parenting techniques, family management strategies, and how to communicate peer pressure refusal skills to their children. (See Resources for more information.) Participant Mary Rosenthal, Project Director for an Office of Adolescent Pregnancy Prevention Adolescent Family Life Demonstration Project in Las Vegas, Nevada, noted that she has successfully taught (to a largely Hispanic audience) a two-hour workshop using the Positive Choices, Positive Futures curriculum modified from a Center for Continuing Education on Adolescent Healthcare provider curriculum. She has also recently proposed a three-level intervention that focused on awareness and knowledge (PCPF workshop), a four-week curriculum for skills building and asset building clubs for on-going parent support based on a logic model that includes increasing both parent-child connectedness and communication and increasing parent-parent connectedness and communication (social support). Ms. Rosenthal is also using the program Parenting Wisely on the assumption that if she can increase use of effective parenting skills, she will increase parent-child connectedness. Co-moderator Lori Rolleri applauded Ms. Rosenthal's efforts and added that Parenting Wisely has had several positive results including a 25% improvement in overall family functioning. She also liked Ms. Rosenthal's idea of increasing "parent-parent" connectedness and communication (social support), noting that ETR's literature review found "parental support" to be one of the possible 98 determinants of parent-child connectedness. Ms. Rolleri pointed out that social support networks available to parents — regardless of whether or not they draw upon these resources — have been linked to family functioning and child well-being. In one study, parent support was linked to school involvement. The average size of the parent network was relatively small (2 other people). The study recommended intervening with isolated parents to connect them with others. A participant from Seattle, Washington who works with expectant and parenting teens stated that she incorporates information from the University of Washington's School of Nursing's program: NCAST — "Keys to Caregiving." This program promotes parent-child attachment through the use of infant cues and appropriate parental responses. Another participant chimed in that she, too, uses the NCAST program extensively and has found it to be very effective. Co-moderator Nicole Lezin noted that the NCAST program sounded similar to some that were characterized in the literature review as "Family In-Home Support." They include nurse home visitation and a doula (birth attendant) visiting program. Ms. Lezin agreed that reaching young parents and creating PCC "afresh" when it was not modeled in one's own family life is clearly an approach with a lot of potential — for more than one generation. As was stated by another participant, "Recognizing each other's cues is vital to connection and relationships — why not start at the beginning?" Role of Religious Communities One participant asked how constructs outside of religious communities are dealing with PCC since his own experience in PCC thus far is strictly ecclesiastical. Co-moderator Steve Bean responded that faith-based organizations are in a strong position to play a role in building/strengthening parent-child connectedness by sponsoring events (both religious and non-religious) in which parents and children can share/spend time together. They can also sponsor programs such as workshop series where parents and children can learn skills such as active listening that can lead to connectedness. The participant stated that he is uncomfortable mixing methods from non-religious and religious communities because, while he values what happens in clinics and community centers, successes in his faith group do not stem from programs that easily translate to non-religious settings. He would like to take the power of faith connection into the secular realm, but the added "magic" seems to disappear in the move. He suggested that his successes stem from the integration of certain attitudes about things like child-rearing, the role of fathers and mothers, and the importance of home life over all other influences. He questioned the efficacy of translating what are essentially religious doctrines that have been very effective in preventing teen pregnancy into practices that can be used by secular organizations. Mr. Bean surmised that the aspects of successful faith-based work that do not integrate well with the educational and skill development approaches of secular programs result from counseling and intervention between clergy and church member — or between church members and church member — with a foundation in shared values and mores. However, ETR's PCC project discovered that shared values and activities
are an essential aspect of the development of connectedness, so a shared
faith would certainly be conducive of parent-child connectedness —
as long as the parent used an "authoritative" and not an "authoritarian"
parenting style. (See "Parenting Styles and Practices" in the literature
review Co-moderator Lori Rolleri added that religion is certainly a powerful force for "indoctrinating" values, but that it is not the only force that can indoctrinate good values. Culture, history, and laws also play important roles in teaching "good" values in our society. Parents play a crucial role in teaching their children about values; some of this occurs through communication and conversation and some is taught through modeling and being a good example. She noted, however, that not all parents are in the situation to be positive role models for their children (for a variety of reasons), nor will they all choose to follow religious doctrine. Also, Ms. Rolleri continued, children will be exposed to a variety of values as they grow from being with friends, media, co-workers, etc. Schools and other community based organizations (including communities of faith) can play an important role in supporting parents and children in learning about facts, skills and services related to health, career, parenting and other factors that are important to a healthy life. She also cautioned against assuming that all religions take the same positions on issues related to sexuality and added that it is important to respect the tenets of all religions. Another participant who has many years' experience presenting in both the secular and faith communities and has been received with very open arms in both venues suggested that everyone, regardless of their religious affiliation, desires parent-child connectedness. She steers away from doctrine or individual family values and concentrates instead on honest, open communication and the protective factor that has on teen pregnancy/STD prevention. She added that her PCC presentation is the most demanded of her programs in both the secular and the faith communities.
Noting that she is eagerly awaiting the next phase of ETR's PCC materials
on practical applications, a participant asked the forum for suggestions
of evaluated interventions which they have used to successfully build
PCC (or any of its proximal influences). Co-moderator Steve Bean recommended
looking at the interventions chapter in ETR's literature
review Mr. Bean specifically recommended those interventions that look directly at "connectedness" in some form. Some of the projects PCC BRIDGE will focus on in Year Two are:
When is the optimal time to intervene? In response to a participant's statement that it is crucial to educate children about the responsibilities of parenting before they become parents or take any actions that can lead to becoming parents, co-moderator Lori Rolleri agreed that some people might argue that trying to implement a PCC intervention with teens and parents is too late and that the best time to intervene with parents is during pregnancy. Ms. Rolleri also agreed, on a personal and professional level, with the participant's suggestion that all potential parents (adolescents) get information and skills in schools and elsewhere, but the school day needs to be extended by about 2 hours to accommodate everything we should be giving adolescents. She noted that ETR and the Annie E. Casey Foundation have decided to focus on intervening with parents and early teens (11-15) largely because so much more research and programs are available (relatively speaking) around parent-child bonding and young children. Co-moderator Nicole Lezin agreed with the notion that many parents have alarmingly little preparation and guidance before they actually become parents. She noted that in ETR's review of PCC, several aspects of parenting style (particularly the combination of warmth and control known as "authoritative parenting") came up as strongly associated with PCC. She added that many researchers agree that some kind of universal parenting education through the school system would go a long way toward promoting many other positive outcomes for parents and children alike. The participant responded by saying that he was actually advocating for parenting education/preparation starting in elementary school because adolescence is already too late. He noted that the children are able to relate to the issues presented by considering their own relationships (or lack of them) with their parents. Another participant also felt that work on PCC needed to start sooner than with teens. She prefers to address the issue of PCC with parents of preschoolers because they have the opportunity to connect from the beginning. Participant Barbara White, from the Florida State University Center for Prevention and Early Intervention Policy, agreed, stating that her organization provides leadership and training at a state level on infant mental health. She advocates the use of key principals of infant mental health be infused in all aspects of programs serving young parents. In response to co-moderator Steve Bean's question about what kinds of programs, activities or interventions would be vehicles for translating her work with infants to teen outreach, Ms. White stated that she and her colleagues encourage the use of a multi-level infant mental health approach that includes prevention, intervention, and treatment. She noted that many teen parents do very well in connecting with their child by offering parenting education, guided interactive play experiences, and basic support services to direct them to appropriate resources. Other teen parents need a more intensive level of intervention to address the multiple risk factors that they bring to the parenting experience. Multi-disciplinary services focus on supporting the parent-child relationship and nurturing the young parent so they can begin to nurture their child. For teen parents with specific mental health issues or who have experienced extensive abuse, neglect or violence, infant mental health treatment is sometimes needed. Ms. White added that some communities in Florida are beginning to sponsor training programs for licensed professionals in the field of infant mental health. She concluded by observing that many programs operate with a standard set of services and are not careful observers of the unique needs of each young parent and child. Her experience has been that many young parents, when armed with training and support, are interested in providing relationship-based interventions and different levels of support. Young parents thrive on these experiences and are often willing to look at new ways of doing things for the sake of their child. Co-moderator Julie Taylor concluded the discussion by stating that she supports both approaches. She agreed that we need to educate our young people with the knowledge and skills to become good parents of tomorrow's children, but we also need to continue to work to improve the skills of today's parents. Acknowledging that she is an optimist, Ms. Taylor feels it is never too late. Most parents want strong bonds with their children, and the research shows that teens also need those bonds even at a time when they are pushing their parents away. Creating opportunities for parents and teens to enhance those bonds can strengthen parent-child relations during the adolescent years. Who is the targeted audience? In response to a participant's comment that she focuses on the emotional trauma and anxiety caused from a lack of early bonding in infancy, co-moderator Lori Rolleri admitted that the ETR team struggled with determining the best audience for their PCC interventions. She noted that they asked the following questions in making their determination:
The team ultimately decided to design interventions for low-income families who are not in crisis, but they are still unclear about which system they will target and who will be the provider. Ms. Rolleri added that those issues should be resolved at the team progresses with the focus group study this year. Implementation Ideas In response to requests from many participants for PCC interventions
and activities, co-moderator Lori Rolleri noted that the PCC Project will
conduct 12 focus groups with parents and teens and will interview service
providers over the next year. She encouraged the participants to stay
tuned because this additional data will allow the PCC project team to
develop targeted and purposeful activities. In the interim, she suggested
picking activities that focus on strengthening the factors that comprise
parent-child connectedness. These factors are diagrammed in the operational
definition of PCC in the literature
review Participant Sue Simonson, with the California State Office of Family Planning, noted that her 25 years of experience in the area of parent/child connectedness, especially in the area of teen pregnancy/STD prevention, has led her to conclude that the most effective programming in this area is youth-driven. She particularly advocated using youth as presenters at workshops because they are very powerful educators not only for other youth but for parents in particular because parents want to hear from youth and listen intently. At the end of speaking engagements, the line of parents wanting to talk one-on-one to the youth is often longer than the line wanting to talk to her. Another participant suggested serving meals in a classy and/or fun way — not simply cafeteria style — with a theme that changed each month and that would be something to look forward to. She also recommended having something that the families could "invest" in (not monetarily), such as the having the kids prepare the meal for the parents and then eating it together, or sharing different cultural foods, or cooking over an open fire or different ways of eating (such as eating spaghetti without utensils).
Several participants lamented how funding — or a lack thereof — is an obstacle to presenting the kind of recruitment and programming they would like. One participant recommended tapping into local businesses, such as getting stores to donate food for events (noting that such requests need to be made early) and stores for gift certificates and other incentives. She also recommended partnering with groups like Junior League, National Charity League, Soroptimist or Rotary clubs. Another suggestion was to utilize limousines to solve transportation problems (obtained at a discounted price or donated) because the limo ride itself can serve as a great motivation for participants to attend. The overall idea is to create positive experiences and memories and treat each other as VIPs. Perhaps local limousine companies could be offered free advertising if they donated their services for transporting participants to and from workshops and meetings. Another participant noted that his group wants to affect families but its "frontier" county is extremely limited in funds and energy. He asked what programs or curriculum would afford a small county (under 10,000) the maximum "bang for the buck." In response, co-moderator Steve Bean first summarized the intervention and recruitment ideas that were suggested during the forum, ranging from the "intensive," such as the SAMHSA programs, to the "contextual," like helping organize family dinners, to the "extensive," such as homework assignments that bring parents and children together to complete them. Something like the latter seems very doable, even in a "frontier" county. A homework assignment could raise topics specific to connectedness, or it could just be a way to bring parents and children together to get it done. The strong network of communities of faith that the participant has could be a vehicle for delivery, such as a Sunday school homework assignment with a small incentive attached to motivate kids to bring it home. Perhaps completion of the homework assignments could be the families' ticket to a fun event, which in and of itself could promote connectedness, and that families could be prepped for these assignments through church networks.
A participant in the South Bronx in New York City, where over 60% of the households are headed by a single mom and there are the highest teen pregnancy rates in the nation — and some of the highest drug usage as well — asked how PCC applies outside the context of a traditional, two-parent family. How, she asked, can PCC be promoted when parents are not present or when the single parent may be a drug addict who prostitutes for a hit or where children are in foster homes being raised by foster parents or reside in group homes? Co-moderator Nicole Lezin said that there are so many reasons why parents may be unable or unwilling to connect with their children, including those mentioned and others (such as the parent's mental health, abuse, grief, long or inconsistent work hours, etc.) ETR's study of PCC so far has focused on parents or those in parenting roles, but an important research question is how other caring adults (whether or not they are in an official parenting role) can provide some of the same protective benefits to children and adolescents who do not receive warmth and guidance from their own parents, for whatever reason. Another issue she raised is how some positive aspects of connection can be maintained or nurtured even in the most dysfunctional situations, and how positive PCC can be promoted and practiced by people who did not experience it in their own childhoods. Single Parents or No Parents Co-moderator Steve Bean reiterated Ms. Lezin's points, noting that the issue of the non-traditional family came up prominently in the think tank discussion of PCC and that many of the think tank researchers and practitioners shared the participant's concerns about our most vulnerable families. He summarized their discussion as follows:
Mr. Bean asked the forum to share their thoughts on these important questions. To what extent can youth relationships with other significant adults, particularly those outside their family, compensate for the absence of PCC? Is it appropriate for these adults to "bond" with youth in ways that are similar to a parent? Co-moderator Julie Taylor quoted Hillary Clinton, "It takes a village to raise a child." ETR's literature review looked at only one component of that village — "parents." Exploring the role of other significant adults in a child's life and how they impact risk taking behavior is a possible future project. Mr. Bean learned the role other significant adults can play when he oversaw an ETR violence prevention pilot program for at-risk youth. One of the service learning projects they did with alternative school youth was intergenerational and involved taking the youth to residential care facilities for the elderly and having them interview residents about their life story and create books to give them. The connection that was created to the community with these youth in a very short period of time (two visits) was incredible. Co-moderator Nicole Lezin noted that it's hard to tease out the effects of single parenthood and PCC because single parenthood so often coincides with many other stressors, such as poverty, working more than one job, living in a dangerous neighborhood, having few social supports, etc. As with non-custodial parents, some researchers have found that it is the parenting behavior that matters most, especially if the parent maintains what is known as an authoritative parenting style (a combination of high warmth and moderate control, as well as granting psychological autonomy as the child matures). She pointed to a study by Baumrind comparing two-parent and single-parent families which found no differences between the children whose parents adopted this style, whether it was one parent or two. And there's also some research on step-parents as part of a two-parent home, with some studies finding no difference between single-parent and two-parent (one biological, one step) households and others finding actual harm. Dysfunctional Parents A participant suggested that having a teen initiate the PCC with a dysfunctional parent could backfire if the newly connected parents encourage dysfunctional behavior, such as early and unprotected sex. He asked whether the key ingredient of PCC is really the connection between parents and children or the fact that "good" parents are typically connected to their children. Co-moderator Steve Bean said that the topic of "bad connectedness," and whether there is such a thing, was a source of much discussion at their think tank meeting. The research suggests that it is crucial to separate out connectedness, or the social/emotional bond, from modeling, or demonstrating and reinforcing attitudes and behaviors. The consensus among the think tank participants, especially some researchers, is that any connection is a good connection, but that modeling, whether of healthy or unhealthy behaviors, is more likely to "stick" if parent and child share a strong bond. In response to a query from a participant asking about the value of a connection between a child and a parent who is a pedophile (which was actually asked by the participant's daughter), Mr. Bean stated that the bond with the father, even if he is a pedophile, is likely to have some positive outcomes, but at the same time, if he is modeling values and behaviors that promote pedophilia, then there is a risk that this connection could transfer some of these values and behaviors to the child. He concluded that if the father is actually molesting his daughter, he would expect such dysfunctional behavior to interfere with their connectedness. One way it does this is by pushing the control dimension of parenting way off the scale. Fathers Versus Mothers A participant who deals primarily with initiatives focused on men and on helping fathers be actively involved with their children, whether or not they live with them, asked if any distinctions have been made between father-child connectedness compared to mother-child connectedness. She also wondered if the impact of PCC is different for boys and for girls. Co-moderator Steve Bean responded that ETR's initial draft of the literature review turned up scant information on fathers, but the think tank participants steered them towards lots of good work (see Resources). The following conclusions can be drawn from the literature:
Co-moderator Nicole Lezin noted that Amato and Gilbreth looked at 63 different studies on non-resident fathers and child well-being and found that measures like support and closeness did not depend on the frequency of contact. They acknowledge that because of time limitations, it may be tempting for non-custodial fathers to use their scarce time with children for fun activities instead of helping with homework, talking about problems, and setting limits, but that the key to PCC (and child well-being resulting from it) lies in the parenting behaviors rather than frequency of contact. Similar findings from studies by Lamb and by Pruett suggest that parental behaviors (warmth and support, school involvement, setting limits, monitoring) are more important than gender (influences of mothers vs. fathers). Sexual Minority Parents/Youth Co-moderator Nicole Lezin noted that the issue of PCC among children and gay parents is a controversial topic, and the research reflects that controversy, with strong and conflicting views on all sides. Overall, studies have not found significant differences in terms of social adjustment, gender identity, gender role, and sexual orientation among children of gay parents as opposed to children of heterosexual parents. (She recommends reading Golombok et al., and Stacy & Biblarz, for example, or Cameron and Cameron for an opposing view — see PCC bibliography). Brubaker (also cited in the literature
review
Noting that PCC has shown to be a protective factor in adolescent sexual and reproductive health, a participant asked if there are specific tools that identify important indicators that suggest the quality and level of parent-child connectedness that might exist within the parent-child relationship. Co-moderator Lori Rolleri responded that co-moderator Nicole Lezin, the
principal literature review writer, identified 13 scales that measure
constructs closely associated or part of parent-child connectedness. These
13 scales are found in Appendix C of the literature
review Co-moderator Steve Bean added that not only is there a need for a scale that is usable by researchers and evaluators for measuring PCC, but that the PCC think tank participants stressed the need for a ground-level assessment that could be used by practitioners, including public health workers, school counselors, therapists, clergy, probation officers, etc. to determine the level of PCC in individual families with whom they are working. It was felt in the think tank meeting that this would be a tremendously useful tool in "the field." Mr. Bean encouraged forum participants who work directly with youth and families to contribute their thoughts on what such a tool would look like by answering the question: What do you look for when working with youth and families to determine whether parents and children have connectedness, i.e. a positive social/emotional bond? One of the activities that was central to the think tank was to take a list of 98 determinants of PCC (factors that potentially increase or decrease it) and try to identify the 25 that our expert participants thought would both have the most significant impact on PCC in families AND be determinants that could be affected by programs or interventions. The final list can be found in Major Findings. The top 24 were (a "+" is a protective factor and a "-" is a risk factor):
Mr. Bean asked forum participants whether they concurred with what was listed based on what they are hearing from families and whether the list matched their own internal sense of what creates or hinders PCC. One participant responded that the list seems to have much in common with the Search Institute work, located at www.search-institute.org/.
One participant took issue with the notion that conditions like poverty are acceptable "excuses" for poor parenting. Co-moderator Steve Bean disagreed, noting that there are very valid obstacles to parenting in ways that do not maximize connection. For example, research suggests that parents who live in violent neighborhoods are often prone to more authoritarian styles of parenting out of concern for their children's basic safety. While authoritative styles of parenting are likely to promote more connectedness and better outcomes for their teens in other areas, using an authoritarian style seems like an understandable reaction to an external situation. Mr. Bean suspects that for many parents, the problem may not be that they lack the knowledge or skills needed to create a connection, but that they face other obstacles — such as unemployment, underemployment, poverty, poor public transit and crime in their neighborhoods — that prevent them from employing effective parenting styles. These parents need structural interventions that provide relief from some of these problems, or at least a time and place where they can connect with their children. He proposed interventions that provided the transportation, childcare and food for families to come together and share a meal at a local site like a church or community center. This is a simple but powerful kind of intervention, because, he stated, we know that things like shared meals go a long way in fostering connection, but the reality is that they have disappeared from many families. A participant responded that they have had success with such projects in their community but the problem lies in getting or keeping the funding or keeping the funding for such efforts. Co-moderator Lori Rolleri added that poverty is contextual. The poverty experienced by those in the 1930s is different in some ways than poverty today, and different opportunities and pressures exist today. Also, the combined effects of racism and poverty cannot be ignored. The effects of racism on health have been well documented from heart disease, diabetes, substance abuse, maternal mortality, infant mortality, and AIDS. In conclusion, Ms. Rolleri said she is not interested in looking for excuses for people who are having a hard time parenting, but rather for ways to effectively, efficiently and compassionately support them — for their sake and the sake of their children. In response to a participant's request for teaching children to think positively and take responsibility for their actions, Mr. Bean referred participants to the Positive Action program. This program teaches children that they have resources for making decisions in their lives. It also teaches that if they do positive actions, they will have both positive thoughts and positive feelings. The curriculum offers 80 - 150 short (15-20 min lessons) lessons for grades K-12 as well as a parent kit, school climate kit, drug prevention supplement kits, and a community kit. It has shown very significant positive effects across a range of outcomes.
In closing, co-moderator Lori Rolleri thanked the forum's participants and moderators for a surprisingly lively and informative debate and discussion. She assured the participants that they provided plenty of fodder for future PCC team discussions. Co-moderator Steve Bean also thanked everyone for sharing their experiences and perspectives on PCC and encouraged them to continue to do so (and to tell their colleagues to do the same) via ReCAPP because the project has truly been strengthened by all those who have reviewed the materials and offered their perspectives. He also directed forum participants to the Take Away Messages that were written as a part of the Topic in Brief column for January/February 2004 ReCAPP edition devoted to PCC at Major Findings:
ETR's PCC Project
Youth Recruitment
Parent-Child Communication Programs
Crossing Disciplines/Health Topics
PCC Interventions
PCC for Non-Traditional Families Fathers vs. Mothers
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Ms. Rolleri noted that one of the major reasons why ETR decided to study
PCC is because it appears in the research quite often as an important
condition and protective factor, but there was little to be said on how
that connection between parent and child is created.
of PCC. 