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Evidence Base

The initial Fathers for Change outpatient program (Stover, 2013) was developed and piloted in an outpatient substance abuse clinic within a department of psychiatry. First, a sample of 10 fathers and their partners participated in an open trial of initial feasibility. Completion rates were 80% in the pre-pilot phase. This 20% drop out rate was significantly lower than other studies of IPV interventions with dropout rates ranging from 40-60% (Stover, Meadows, & Kaufman, 2009). All fathers who completed the program remained non-violent during treatment and reduced their substance use, with 80% being abstinent during treatment. There were very high rates of satisfaction from participants. All men reported liking all three components of the model (individual, co-parent and child focused sessions) and stated they thought the program was either just right or too short in length.

Subsequently, a small randomized pilot was conducted with 18 fathers randomized to Fathers for Change or Individual Drug Counseling (IDC). Those randomized to Fathers for Change were more likely to complete treatment (67% vs. 33%, p=.10). Additionally, men in the Fathers for Change intervention showed a trend toward greater reduction in violence that continued following treatment. Not only did men reduce their violence, but they reported less violence by their partners as well on the Conflict Tactics Scale-Revised. There were comparable reductions in substance abuse for the Fathers for Change and IDC groups (Stover, 2015). Men in the Fathers for Change intervention showed gains in their video-taped interactions with their children. Fathers’ interactions were coded using the Child Interactive Behavior Rating Scales. These were coded by blind, reliable coders. Men who received Fathers for Change showed less intrusiveness during free-play interactions and more consistency of style post intervention than men who received IDC. Fathers in the IDC condition did not improve in these areas and got worse.

Residential Substance Abuse Treatment Application

The intervention was modified and implemented with a residential treatment program of substance abusing men. Forty-four fathers participated in the pilot program. Interviews were conducted at baseline and follow-up to assess the impact of the intervention on anger, hostile thinking and emotion regulation problems. Focus groups were also conducted with the participants to gain further insight into their needs as fathers and their recommendations for interventions that they would find helpful. Results indicated a high prevalence of anger related thoughts at baseline that significantly decreased at follow up; there were also significant reductions in affect regulation problems. Impressively, 84.1% of participants completed the program in its entirety and were highly satisfied with the content (Stover, Carlson, Patel, 2017). F4C was compared to a parenting education program (PE) in a randomized trial. Sixty fathers were randomized to F4C or PE. Fathers in F4C had greater reductions in emotion dysregulation and less substance use following discharge than men in the PE group (Stover, Moore and McMahon, 2019).

Statewide Implementation in CT

Clinicians from 6 community mental health agencies were trained to offer FFC to child protection involved families through a statewide initiative in CT. In this initiative, FFC is implemented as part of a larger Intimate Partner Violence Family Assessment Intervention Response (IPV-FAIR) funded by the CT Department of Children and Families. This program includes assessment of all members of the family, safety planning, treatment for mothers and fathers and case management services. Each family is assigned a clinician and family navigator team. The clinician provides Fathers for Change or other clinical treatment needed by the mother and father and the family navigator assists with case management, connection with other services, and advocacy. Based on an ongoing program evaluation by the Injury Prevention Center, in the initial 2.5 years of implementation, 207 fathers were referred for Fathers for Change program with a 70% completion rate. Pre-post assessments revealed significant reductions in IPV and children’s exposure to conflict based on both fathers and mothers’ reports. Fathers reported significant reductions in affect dysregulation and hostility from pre to post intervention. These changes were associated with reductions in IPV post-intervention. Importantly, fathers also reported significant reductions in PTSD, depression and anxiety symptoms. Mothers who were co-parents of fathers who participated also reported improved mental health symptoms in their children (Stover, Beebe, Clough, DiVietro, Madigan & Grasso, submitted).