Implementing Family Check-Up^® For Children

Family Check-Up is a strength-based, family-centered intervention designed to support parents’ efforts to promote children’s behavioral and mental health and prevent behavior problems. The model is tailored to address the specific needs of each family. It can be integrated into a variety of service settings, including home visiting. The model can be delivered by telehealth with virtual sessions for parents and/or through a web-based application that allows asynchronous family engagement.

The University of Oregon and Northwest Prevention Science Inc. offer training and resources to Family Check-Up providers.

When needed, implementation support is provided by the University of Oregon on an hourly basis to help providers and site administrators address uptake barriers, establish or tailor implementation benchmarks, or identify an optimal implementation plan.

The intended population for this model is families with children who are at risk for conduct problems and academic failure and face familial adversity including socioeconomic disadvantages and maternal depression.

Families with children ages 2 through 17 years old are eligible for Family Check-Up. The HomVEE review only included studies that used home visiting as the primary service delivery method, incorporated the Everyday Parenting curriculum, and focused on families with children ages 2 through 5 years old. Thus, for the purpose of the HomVEE review, HomVEE uses the name Family Check-Up for Children to describe Family Check-Up that incorporates the Everyday Parenting curriculum and is delivered in the home to families with children ages 2 through 5 years old.* There are few differences between the implementation of Family Check-Up and Family Check-Up for Children, so the information in this profile applies to Family Check-Up broadly, unless specified otherwise.

*Family Check-Up is a flexible model that can be delivered to children and adolescents in the home or in other settings. Family Check-Up for Children is HomVEE’s designation for the group of studies on Family Check-Up that HomVEE reviewed. Family Check-Up for Children does not appear as a version of Family Check-Up on the developer’s website because the requirements for implementing Family Check-Up for Children do not differ from those for Family Check-Up.

Family Check-Up is designed to reduce children’s behavioral problems, academic difficulties, and emotional problems, and to improve maternal depression, parental involvement, and positive parenting.

Family Check-Up has two phases. Phase 1 includes three sessions: an interview, an assessment, and a feedback session. During the feedback session, the provider and the family collaboratively decide which follow-up services, if any, would be beneficial. In Phase 2, the provider can refer the family to additional community services as needed and/or may deliver the Everyday Parenting family management training curriculum to the family.* The Everyday Parenting curriculum provides a basis for more intensive parenting support and is designed to enhance parent skills in reinforcing positive behavior, setting healthy limits, and building relationships. Phase 2 services, which the provider tailors to the family’s needs, may also include support for the child’s school success or services to address the parent’s behavioral or mental health needs.

When used as a health maintenance model, Family Check-Up involves yearly behavioral and mental health check-ups in which families complete Phase 1 and participate in Phase 2 as needed. This annual contact enables providers to track family and child behavior over time and continue to motivate families to change persistent areas of difficulty.

The Family Check-Up curriculum details objectives for the initial interview, assessment, and feedback sessions and the process skills needed to accomplish these objectives. It also provides tips and strategies to deliver the model.

The Everyday Parenting curriculum manual presents session outlines and materials organized into three skill areas: (1) supporting positive behavior, (2) setting healthy limits, and (3) building family relationships.

*Family Check-Up may be delivered without the Everyday Parenting curriculum, but the effectiveness of the model has only been evaluated when offered in conjunction with the Everyday Parenting curriculum.

Phase 1 of Family Check-Up consists of three initial one-hour sessions (interview, assessment, and feedback), which are scheduled no more than one month apart. In Phase 2, parents may choose to engage in follow-up services, which may include Everyday Parenting sessions that are at least 30 minutes long. As a health promotion and prevention strategy, Phase 2 of Family Check-Up can be limited to 1 to 3 Everyday Parenting sessions. As a treatment approach, Phase 2 can range from 3 to 15 Everyday Parenting sessions. (The average family participates in 3 to 6 sessions.)

When used as a health maintenance model, Family Check-Up involves annual behavioral and mental health check-ups (Phase 1, and Phase 2 as needed) through age 17 years.

Phase 1 of Family Check-Up has been delivered in two, rather than three, sessions: (1) an extended interview and assessment session, and (2) a feedback session.

Additionally during pre-service staff training, a Family Check-Up consultant certified by the University of Oregon discusses with providers the adaptations that are allowable, without compromising model fidelity, to meet the needs and service delivery of local implementing programs.

Family Check-Up for Children is typically implemented by community mental or behavioral health agencies.

The model requires providers to meet a set of ongoing fidelity guidelines. Please contact the model developer for additional information about these guidelines.

A Family Check-Up provider meets with families to conduct the interview, assessment, and feedback sessions. They may also deliver the Everyday Parenting curriculum. If additional services are required, the provider refers families to community resources. To promote model sustainability, sites are encouraged to have at least one provider trained as a Family Check-Up trainer/supervisor to train and supervise other providers at the program.

Family Check-Up providers must have experience delivering family-based interventions. It is also recommended that providers have experience with behavior-based parent training programs and motivational interviewing. There are no education requirements for Family Check-Up providers. While not required, it is recommended that Family Check-Up providers have a master’s degree in counseling, social work, education, or a related field. Trainers/supervisors must have a minimum of a master’s degree (or equivalent) in education, social work, psychology, or a related field.

The University of Oregon strongly recommends, but does not require, that the Family Check-Up trainer/supervisor offer providers weekly individual and monthly group supervision during the first year of implementation. Supervision is encouraged to promote implementation quality and fidelity and to provide the opportunity to address barriers to implementation and discuss adaptations to support model sustainability.

The University of Oregon requires providers to participate in 10 hours of training on Family Check-Up and 5 hours of training on the Everyday Parenting curriculum before they start delivering services. Training as a Family Check-Up trainer/supervisor requires demonstrating competence in using the Family Check-Up fidelity assessment tool, delivering training, and supervising staff. On average, training to become a Family Check-Up trainer/supervisor requires 15 to 18 hours of consultation. Please contact the model developer for additional information about the pre-service training requirement.

After the initial training is complete, monthly one-hour group or individual consultation is recommended but not required for the first six months of implementation. Please contact the model developer for additional information about the ongoing professional development requirement.