Family Connections
Fostering positive interactions for
families facing adversity in Early Head Start
& Head Start Centers
Catherine Ayoub, William Beardslee, Caroline Watts, P.I.’s
Mary Watson Avery, Director
Why Address Depression & Adversity
in Early Head Start & Head Start
Families?

Almost half of mothers eligible for Early Head
Start were depressed
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Women who were depressed were much more
likely to remain depressed
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Early relationship between maternal depression
& lack of positive child self-regulation is strong

Early Head Start programs are effective with
depressed mothers & buffer negative outcomes
for their children
(Ayoub, et. al., 2004; Chazen-Cohen, 2006)
Family Connections
Children’s Hospital Boston
Theory of Change:
Using a prevention/ intervention approach
to build the capacity of Early Head
Start/Head Start staff & programs to better
understand & respond to the needs of
parents (& their children) suffering from
adversity, particularly those experiencing
depression.
Figure 1: The Family Connections Pyramid
Clinical
Intervention &
Identification of
depression & parenting
difficulties/
disconnections; extended
outreach & crisis services
Targeted Prevention
(At Risk Parents/Children)
Enriched prevention programming, mental health
outreach, social & academic skill building, networks
to specialized services in mental health, substance
abuse, marital counseling
Universal Prevention (All Children & Families)
Education on depression; support in accessing resources; communication &
relationship-building in families; classroom-based enrichment activities to support
social and academic development; community networks to connect families to
supportive prevention services
Community & Systems Development (All Head Start Staff)
Education on depression, mental health, & factors of resiliency; classroom consultation; professional skill
development including self-reflection and parent engagement; community connections to enrichment and family
nurturing programs
Family Connections
Children’s Hospital Boston
Major Implementation Activities

Educational program series for all staff on depression, mental health,
&relationship building, & fostering resilience to adversity.

Professional skill development including reflective practice with emphasis on
child & parenting skill support.

Classroom consultation to build staff knowledge, understanding skills to
effectively engage parents and children, particularly those affected by depression
& emotional difficulties.

Training & educational programs for parents on the topics of communication
and relationship-building in families including depression & mental health.
Family Connections
Children’s Hospital Boston
Major Implementation Activities
(cont.)

Classroom-based enrichment activities to enhance children’s social
& academic functioning.

Community networks to connect staff & families to support prevention
services.

Referrals to treatment & support programs for related difficulties
(substance abuse, domestic violence) as well as for depression and
parenting concerns.

Enriched prevention & treatment services tailored to meet the needs
of the individual HS partner sites.
Family Connections
Children’s Hospital Boston
A new way of consultation:
Engagement Process
Readiness first
Full staff focus & engagement
Useful assessment & feedback
Classroom consult & support
Classroom interventions – social skill groups
& Tell Me a Story curriculum
Child on site interventions - pair play therapy
& social skill/conflict resolution
Family Connections
Children’s Hospital Boston
A new way of consultation:
Parent engagement
Drop-in times
Social support groups
Educational workshops
Parent night consultation
Drop-off/pick up connections
Community Connections
Community group participation
Service exchange
Crisis community response
Family Connections
Children’s Hospital Boston
A new way of consultation:
Institutional connections
Engage middle & upper management
Build center-wide/institution wide plans
& policies (ex: Mental Health First Aid)
Jointly plan for sustainability
National Replication Strategies
Family Connections
Children’s Hospital Boston
Lessons Learned:
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Assess readiness & resources first
Start with an engageable task & build supports
Use crisis as opportunity
Lead with the message of effective parent engagement
Present full cycle of activity from knowledge to skill
Speak from strength & vulnerability perspectives
Focus on staff transformation over time
Spend time in the classroom
Know that adult mental health is for all – staff & parents
Build assessment processes that are relevant & practical
Develop system wide plans for mental health first aid
National Replication Strategies
Family Connections
Children’s Hospital Boston
Developing “off-the-shelf” products
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A self-assessment for program readiness to engage in
mental health-related consultation and staff development.
A set of guidelines in the form of short 3 to 4 page
resource papers on the core components of the Family
Connections intervention.
“Modularize” the Family Connections intervention model
to create stand-alone training materials which HS
programs can choose to implement based on their unique
needs, assets, & program readiness.
A program manual & training guidelines, with the
expectation that HS programs will implement Family
Connection with their own support systems.
Materials in hard copy & web-based (ECKLC) formats.
National Replication Strategies
Family Connections
Children’s Hospital Boston
Future Directions: Train-the-Trainer Approach
Through separate funding, develop capacity to train consultants
to support comprehensive implementation of Family
Connections methods and tools in HS/EHS sites nationally.
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Create cadre of Master Trainers for Family Connections.
Master Trainers serve as trainers & expert consultants to
HS programs nationwide seeking to implement
comprehensive model.
Convene annual conferences to support network of Master
Trainers and provider booster trainings and expand network
of certified Master Trainers.
Provide technical assistance and support to HS programs
implementing Family Connections.