Independent Study Directions

1
Independent Study Directions

• Please read the following Power Point
  Presentation and answer the questions at the end.
• View the LCLC Tools and Skills for Couples
  Intimacy video. (Your agency will provide you
  with this DVD)
• View the Mock Group video. (Your agency will
  provide you with this DVD)
• View Shadow of Hate video after slide 53 of
  the Power Point Presentation. (Your agency will
  provide you with this DVD)
• Please email your answers to the test to
  bev_at_scaninc.org and to your direct supervisor.

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Healthy Couples Healthy Families Training
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Training

• The purpose of this tutorial is to assist you,
  the reader, in understanding the framework behind
  the curriculum used for the Healthy
  Couples/Healthy Families groups. This is also
  sometimes referred to as the Building Strong
  Families Project.
• The information presented derives from the
  lecture notes of Drs. John and Julie Gottman.

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• The purpose of this training is not to train you
  as a group facilitator but to assist your
  understanding of how this program started.
• This is a required training for all staff who may
  potentially serve a couple who are participating
  in group.
• If you have any questions regarding groups please
  direct those to your group facilitators.
• Thank you

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What is Building Strong Families?

• National demonstration and evaluation project,
  sponsored by the U.S. Department of Health and
  Human Services.
• Partnership between HHS (through the
  Administration of Children Families),
  Mathematica Policy Research 7 sites (Florida,
  Indiana are Healthy Families Programs).
• Multi-site, multi-year study of marriage and
  relationship education for unwed new parents.
• Based on Fragile Families study which says that
  children have better outcomes when they come from
  a home where there is a stable marriage.

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FRAGILE FAMILIES CHILD WELL-BEING STUDY,
CARLSON 2002 SAYS

• Most Unwed Parents are Romantically Involved at
  Childs Birth
• 1. 18 Not romantic
• 2. 5 Romantic but
• not living together
• 3. 47 Cohabitating

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BUT.

• Most dont marry and many break up.
• Interventions to help couples improve
  relationships have been shown to be effective.
• Unwed, low-income parents have generally not had
  access to such services.
• SO

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• HFI is working with BSF to implement a program
  focused on couples that builds on the Healthy
  Families model.
• It is called Healthy Couples/Healthy Families.
• Because we believe that helping couples develop
  skills needed for a healthy relationship will
  improve parent and child well-being.

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CRITERIA FOR HC/HF ELIGIBILITY

• Couples who are eligible for Healthy Families.
• Expecting child or have had child in last 3
  months.
• Age 18 .
• Allege to be biological parents of mutual child.
• Not married (unless wed each other during
  pregnancy).
• No domestic violence.
• Both parents say they are romantically involved.
• Both parents voluntarily agree to be in the study.

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How Do Couples Become Involved ?

• The FRS/FAW assess couples for Healthy Families.
• Fathers are encouraged to be present at the
  assessment.
• The FRS/FAW screens for BSF eligibility.
• For those who are eligible
• Introduce HC/HF to couples
• Assess both mom and dad facilitator may help
  locate dad
• Explain HC/HF study and obtain consent
• Collect baseline information
• Enter in HVTIS
• Mathematica determines who goes to control group
  and who goes to served group. Random assignment
  is 50/50

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WHY RANDOM ASSIGNMENT?

• Creates two similar groups.
• Its only way to tell if changes are due to
  HC/HF.
• Objective and fair all eligible couples get
  equal chance.
• Non-program (control) group gets Healthy Families
  assessment and referrals.
• Goal is 720 couples over 2 years. Allen County,
  Lake County, Marion County and Miami County
  (meaningful sample size)
• Half of couples will receive home visits because
  the project added money to Healthy Families for
  services.

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What Do Services Look Like?

• Regular HF visits
• May go on outreach while in HC/HF group
• Weekly outreach by HC/HF coordinator while
  waiting on group.
• Weekly groups, focused on relationship skills,
  run by facilitators and coordinators.
• Groups are based on Loving Couples/Loving
  Children curriculum developed at the Gottman
  Institute.
• Support for the relationship outside group.
• Transportation, childcare and incentives
  provided.

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Keys to Success

• Being open-minded.
• Commitment in involving both parents in services.
• Focus on healthy relationship skills along with
  parenting.
• Good communication between assessment workers and
  facilitators/coordinators.
• Good communication between home visitors,
  supervisors, and facilitators/coordinators.

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Your Important Role
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• You are the key to success of this important
  initiative.
• The communication between you and the group
  facilitators is vital for the success of the
  family.

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Meat and Potatoes of Group

• Rules There are some general group rules i.e.
  confidentiality, respect, no violence. The group
  also states their own specific rules.
• 6 months Group curriculum is for 6 months,
  however, groups generally run one or two months
  longer due to group outings and other issues that
  may require longer group time on a specific topic.

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• Educational/skill building The curriculum is
  designed to educate the parents on how to
  effectively communicate and helps build skills to
  resolve conflict and enhance the relationship.
• Strength based The curriculum and groups are
  strength based.
• Voluntary No couple is required to attend.
• Perks Free childcare/transportation/
  incentives/community building/support.

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Theoretical Framework

• What predicts relationship breakup?

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Two Patterns

• Emotional Disengagement

• Escalating Conflict

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Early Breakup Pattern

• There is a 5-to-1 positive to negative ratio
  during conflict in relationships that work.
• A ratio of about 20-to-1 positive to negative in
  relationships that work when couples are not in
  conflict.

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Early Break-up Patterns
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The Four Horseman and their antidotes

• Criticism- Complaining as if there is something
  defective in your partners personality.
• Antidote Complain about what is frustrating,
  dont criticize.

• Defensiveness- Self-protection and warding off an
  attack. Can be righteous indignation or innocent
  victimhood.
• Antidote- Accept responsibility for the role that
  you play.

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• Contempt- Speaking from a superior plane.
• Antidote- Create a culture of appreciation.

• Stonewalling- Listener withdrawal from
  interaction.
• Antidote- Self soothing. Take breaks.

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Sound Relationship House Theory

• Has three parts Conflict, Meaning and Friendship

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Friendship Circle

• Knowing ones partner.
• Having a fondness and admiration system in the
  relationship.
• Turning toward each other vs. turning away.

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Conflict Circle

• Many conflicts occur because of personality and
  other differences between partners that dont get
  resolved.

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Meaning Circle

• Looking for the dreams within the conflict for
  the couple.
• Looking for the levels of connection within the
  couples stories, dreams, and metaphors.

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The Real Cradle That Holds The Baby

• The real cradle that holds the baby is the
  emotional relationship between parents.
• How parents relate to each other in the 6th month
  of pregnancy will strongly predict the babys
  neurological development, ability to self soothe,
  focus attention, and connect emotionally with the
  parents.

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Transition to Parenthood

• Couples undergo major changes in the transition
  to parenthood.
• It is important for couples to stay in touch with
  each other during these times of transition.
• Many times, the father is pushed out and is more
  than happy to withdrawal and work more.

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Transition to Parenthood (Contd)

• The withdrawal of the father is neither good for
  the baby or the relationship.
• Fathers make unique contributions to their
  children, particularly through play.
• Relationship conflict increases the first year
  after the baby arrives.
• Sex declines dramatically.
• Conversation declines dramatically.

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Transition to Parenthood (Contd)

• Symptoms of post-partum depression increase
  significantly for both mom and dad.
• Hostility increases between parents.
• When conflict increases, fathers withdrawal from
  their partners and their children.
• Babies withdraw from unhappily married fathers.

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• Couples need to become more of a WE than two
  MEs. This change is about becoming a better team!

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What Every Baby Needs

• Children have the ability to be totally in the
  moment.
• Everything happens much more slowly for them.
• Being able to turn off the television, phone,
  etc. and just play with your baby will greatly
  enrich your life.

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What Every Baby Needs (Contd)

• Face to face play with parents is extremely
  important to babies.
• Babies learn that their world will respond to
  them and not ignore them.
• Babies also need for the parent to respect their
  need to self-soothe when they become over
  stimulated.
• Babies who are not given this opportunity will
  learn that the world does not respect their
  needs and the baby will withdraw.

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What Every Baby Needs (Contd)

• Babies, through this interaction and respect
  shown by parents, begin to trust in the
  fundamental love and nurturance of their parents.
  
• This is called an attachment to its mother and
  father.
• Three month old babies of non-depressed parents
  will try to engage an adult if they look at them
  with a still face and become upset if there is no
  facial reaction to them.

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What Every Baby Needs (Contd)

• All babies need touch. It is essential to the
  emotional and physical development of a baby. It
  is impossible to spoil a baby by responding to
  their needs.
• Children that feel secure with their parents
  become more independent and do so at a younger
  age. They deal better with stress, have a higher
  self-esteem, are less aggressive, less anxious
  and have better relationships with other children.

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We Need Fathers

• More than half of all childrens books that
  include a reference of a parent have mom as the
  only parent.
• In TV sitcoms, fathers are selfish, cold,
  uncaring, immature, fools and primarily depicted
  as idiots.

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We Need Fathers (Contd)

• Fathers are stereotyped as coming home from work
  and sitting on the couch watching TV while the
  mother, who also worked a full day, works a
  second shift at home.

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We Need Fathers (Contd)

• Do fathers really matter? What do fathers do
  differently than moms, and does it make any
  difference to children?
• The answer, based on research, is a resounding
  YES to both questions.

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We Need Fathers (Contd)

• Fathers tend to give children more freedom to
  explore, with mothers being more cautious.
• Fathers encourage childrens independence by
  encouraging exploration.
• The greatest difference between mothers and
  fathers is in play.

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We Need Fathers (Contd)

• Dads are more tactile and physical with babies.
• Father-infant play also shifts rapidly from peaks
  of high attention and excitement to valleys of
  minimal attention.
• 2/3 of 2 ½ year olds chose dads as play partners
  over moms.

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We Need Fathers (Contd)

• Do these differences really matter?
• The answer is YES.
• Rough and tumble play predicts self-control
  abilities.
• The high energy positive affect play of dads with
  young children predicted how they were viewed by
  other children and how accepted the children were.

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We Need Fathers (Contd)

• In the Gottmans research, they have observed
  three times the variability in how fathers relate
  to their kids than is seen in moms. Basically,
  this means that some dads are terrific for their
  kids and some dads are awful for them. It is not
  just the mere presence and availability of
  fathers that matters, but exactly HOW they are
  present.

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Emotion Coaching

• Raising an emotionally intelligent child

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Emotion Coaching (Contd)

• How does conflict between parents affect kids?
• The attentional (Mirskys theory) system.
• Attention is the shuttle between emotion and
  cognition. It mediates how well a child can
  mobilize their IQ.
• Physical health. Children of divorce lived an
  average of 4 years less. These children lived 8
  years less if they divorced also.
• Affected childrens aggression, then peer
  rejection, then internalizing disorders.

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Emotion Coaching (Contd)

• How can kids be buffered from an ailing marriage?
• Through working with one s meta-emotion.
• This is how we feel about our feelings and our
  philosophy about emotional expression.

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Emotion Coaching (Contd)Two types of parents

• Emotion Dismissing

• Emotion Coaching

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Emotion Coaching (Contd)Emotion Dismissing

• See negative emotions as toxic, prefer a cheerful
  child.
• Are impatient with childs negativity. May
  punish the child for just being angry even if
  there is no misbehavior.
• They see themselves as offering constructive
  criticism.
• The child increases the number of mistakes as
  they are pointed out.
• Parents escalate their criticism to insults.
• Parent takes over, becomes intrusive.

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Emotion Coaching (Contd)Emotion Coaching

• See emotions as an opportunity for growth and
  teaching.
• Communicate understanding and empathy.
• Help child verbally label all emotions they may
  be feeling.
• Specific praise and add a little more
  information.
• Communicate the familys values.

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Emotion Coaching (Contd)

• There are several goals to emotion coaching.
• Think for themselves.
• Be compassionate human beings.
• Moral people.
• Treat people well.
• Have good relationships with others.
• Select an appropriate mate.

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Emotion Coaching (Contd)

• Enjoy their talents and abilities.
• Be proud of themselves, but not boastful.
• Have purpose and meaning in life.
• Have interests and self-esteem.
• Live for something beyond themselves and not be
  materialistic.
• Care about the welfare of the world.

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Emotion Coaching (Contd)

• Only five steps in emotion coaching
• Notice emotion.
• See it as an opportunity for teaching or
  intimacy.
• Validate.
• Provide verbal labels for the emotions that the
  child is feeling.
• Set limits or problem solve (children get
  aggressive if this is not done).

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Bringing Home Baby Project

• These were two randomized trials for couples
  undergoing the transition to parenthood.
• These trials measured the effectiveness of
  preventive intervention on these relationships.
• Data obtained confirmed that these were helpful
  and that a support group added to their
  effectiveness.

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Barriers and Diversity

• Please view the DVD Legacy of Hate at this
  time.
• The legacy of slavery, as well as poverty, has
  created a state in which respect and honor is
  essential to all interventions designed.
• Other problems such as inequality of education
  and employment opportunities, inequalities in the
  criminal justice system, domestic violence,
  infidelity, children by multiple partners,
  addiction, and post incarceration syndrome which
  are created by the history of slavery and poverty
  are addressed in our modules, with respect and
  honor being of central importance.

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Overview of the Loving Couples/Loving Children
Curriculum

• The curriculum is highly structured and didactic.
• It teaches people the curriculum and critical
  skills needed for success as a couple and a
  family, but is spontaneous and group driven.

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Overview of the Loving Couples/Loving Children
Curriculum (Contd)

• This curriculum uses a module concept.
• Every module gives something useful in a short
  time that leaves participants feeling empowered.
• Multi-media presentations start each module with
  real couples discussing the topic for that group.

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Suicide and Inter-Partner Violence
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Suicidality

• Check with your agency concerning protocol you
  should follow.
• Ex. In Allen county we follow a No-Harm Protocol
  and use a No-Harm Agreement if necessary.
• If home visitor or group leaders have concerns
  there needs to be communication between all
  parties.

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Inter-Partner (Domestic) Violence

• The following is protocol for HC/HF not HF
• IPV includes physical, emotional, psychological
  or sexual abuse. IPV is about one person in a
  relationship using a pattern of behaviors to
  control the other person. It can happen in
  marital and non-marital relationships.

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Signs of Abuse

• Pushing, hitting, slapping, choking, kicking,
  biting.
• Threats to victim, children, family members,
  friends, pets.
• Threats of suicide to get the victim to do
  something.
• Using or threatening with a weapon.
• Intimidation.

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• Forced financial dependence.
• Verbal put downs.
• Forcing sex (of any kind).
• Isolating the victim.

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Starting Point

• Use the Kempe Family Stress Checklist

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• During the initial Kempe assessment issues of IPV
  may be determined.
• If IPV is determined the couple is not eligible
  for Healthy Couples/Healthy Families. They are,
  however, eligible for Healthy Families and
  appropriate referrals should be made.

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Lethality

• This is one of the issues considered when
  determining IPV.
• If injuries were sustained, by either partner,
  that had them seek medical care or the police
  were contacted, or if weapons were used, they are
  not eligible for HC/HF.

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Emotional Abuse

• If either partner reports threats and controlling
  behaviors that they identify as abusive or that
  could lead to physical abuse, the couple is not
  referred to HC/HF.

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Threats of Harm

• If either partner has threatened to kill the
  other or their child(ren) they are not referred
  to HC/HF.

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Threats of Taking the Children

• If this is used as a control technique by either
  partner they are not eligible for HC/HF.

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Threats of Suicide/Public Violence

• If the couple uses threats of self harm/suicide
  as a way to control their partners behavior or
  if there has been any public violence between
  them, they are not eligible for HC/HF.

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Isolation/Fear

• If either partner describes isolation due to
  abuse or manipulation, the couple is not eligible
  for HC/HF.
• If either partner reports being afraid of the
  other partner, they are not eligible for HC/HF.

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• This protocol only applies to HC/HF families. A
  separate protocol is used for HF. This is an
  ongoing process and group facilitators are alert
  to any potential IPV behaviors and will meet with
  couples to assess any concerns. Sometimes this
  may mean the couple must be asked to leave the
  group.

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Cobra
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Cobra Violence

• This is a particularly frightening form of
  violent behavior.
• The Gottmans identified two forms of violent
  behavior to be of most concern and that are not
  good candidates for group partner work. The
  Cobra and the Pit Bull.

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Cobra

• Tend to be explosive/ out of control.
• Violence is extreme.
• Lack insight into own behavior.
• Blame the victim.
• Frightening yet captivating.

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Pit Bull
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Pit Bull

• Control driven by fear of abandonment.
• Control means turning the partner into a puppet,
  stifling independence.
• Pit Bulls deny their partners experience of
  reality.
• Demand change in their partner while resisting
  their partners efforts to change them.

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Cobra/Pit Bull

• Cobra violence more severe. 38 Cobra violence
  had threatened with a weapon compared with 4 Pit
  Bulls.
• 9 of Cobras in the study actually shot or
  stabbed their wives as compared to none from the
  Pit Bull sample.

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• Cobras are more emotionally abusive. They are
  generally contemptuous of others and maintain
  control even in the heat of an argument. Pit
  Bulls will start out in control and become
  increasingly heated and begin to lose control.
• Cobras tend to come from more traumatic
  childhoods.

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• Women in relationships with Cobras tend to have
  more depression and fear. They showed less anger
  than women with Pit Bulls.
• Cobras and their partners are less likely to
  divorce or separate.
• Cobras are more likely to have violence outside
  of the marriage as well.
• Cobras had more mental illness specifically
  antisocial personality disorder.

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Intervention

• Victims, children and staff safety are priority!

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EMPOWER

• Educate victims
• Safety plans
• Use resources

82

• Victims are educated to risks and empowered to
  make own decisions.
• Victims are educated concerning the effects on
  children.
• Parents are educated in non-threatening way about
  CPS reporting requirements related to abuse or
  witnessing abuse.
• Staff NEVER interfere when violence occurs. Leave
  and call 911.

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What to do if.

• Family is in group when DV occurs
• Assess lethality
• Meet with couple
• Allow to stay based on info from HV and
  assessment/remove from group
• Contact home visitor ASAP

84
Cont.

• Fight in group
• Diffuse
• Normalize
• Take couple aside
• If high or using, need to leave that group
  session. Group leaders will set time to meet with
  the couple

85
Teamwork
86
Documentation
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Perpetual Problems, Gridlock and the Existential
Solution
88
The Concept of Perpetual Problems and Gridlock

• We use the Dreams within the conflict method of
  dealing with gridlock.
• This puts people in touch with their feelings and
  makes them think it is okay to have these
  complaints rather than adjusting the relationship
  and ignoring ones complaints.

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Perpetual Problem

• Problem that is not solvable.
• It causes continuous fighting (gridlock).
• Feelings are often hurt, partners dont feel
  understood, feel like giving up.

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Perpetual Problems

• Can be about anything.
• Examples finances, in-laws, sex, house keeping,
  recreation.
• Its the topic that always comes up and always
  causes a fight.
• Compromise does not work.
• What is the cause?

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• These problems never seem to get solved.
• Even when we give up on arguing about them, they
  are still there.

92
Dreams

• When a problem seems impossible to solve, there
  is likely a hidden dream.
• A hidden dream is the underlying feeling or value
  behind the persons position.

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DREAMS

• We have core values/beliefs that we dont want to
  and shouldnt have to give up.
• These can interfere with problem-solving because
  we fear giving up who we are.
• Often we dont even realize that these dreams
  are motivating our behavior.

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Dreams

• In the disagreement we only see our partners
  position, not the underlying dream.
• We cant understand why the person wont budge.

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Gridlock

• Couples wait an average of six years from the
  time they realize there is a serious problem, to
  get help.
• By then the problem transforms, changes and
  grows.
• Becomes difficult to see underlying dream/meaning.

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5 Stages

• Dreams in Opposition
• Entrenchment of Position
• Fear Accepting Influence
• Vilification
• Emotional Disengagement

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Reversing the Process

• We need to take the time to understand our
  partners and our underlying dream.
• Why is this issue so important?
• What am I afraid of?

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Reversing the Process

• The relationship must feel safe in order for
  dreams to emerge.
• You have to feel like you can talk to your
  partner about your history and vision of the
  future without judgment.

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Reverse the Process

• Dialogue must occur.
• Use open-ended questions to find out more.
• Use empathy to understand the others point of
  view.
• Really listen to what your partner has to say.
• Both share dreams.

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Reverse the Process

• Dreams must be supported.
• What does this dream mean to you?
• How does your dream relate to the problem?
• How can we solve this problem without giving up
  our dreams?

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Reverse the Process

• Remember why we got into this relationship in the
  first place.
• We are a team, not competitors.

102
Physiological Arousal in Combat, Deadly Force,
Police Encounters, and Relationship Arguments
that Escalate
103
Physiological arousal in combat, deadly force,
police encounters, and relationship arguments
that escalate

• We are living in a suspicion-filled, fearful,
  anti-terrorist world, where we are hyper-vigilant
  to dangers.
• When we sense danger, our empathy for others is
  gone. This leaves us unable to feel or sense our
  partners pain in many cases.

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Domestic Violence is everyones fault it
is no surprise that our society has become more
violent.
105
Leads to

• NO EMPATHY
• Which leaves us vulnerable to not being able to
  feel or see our partners pain. a dangerous
  place to be.

106
Diffuse Physiological Arousal

• DPA

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Chronic DPA Leads To

• Heart rate increases, nervous system shuts off
  ability to clam self
• Tunnel vision, compromised hearing, inability to
  focus on anything except the danger
• Cognitive distortions

• Not capable of empathy
• You may become psychologically abusive
• You may become physically violent

108
Chronic DPA in Relationships

• Post Traumatic Stress
• Confused thinking
• Hopelessness
• Weight gain or loss
• Fatigue
• Depression
• Anxiety
• Obsessive thoughts (extreme jealousy)

109
Many people descend in DPA without even knowing
it. When people are in this state of mind they
become flypaper for any emotion. They can easily
become more angry and escalate.
110
The major culprit, other than violence, in a
relationship that leads people to be afraid of
their partner is contempt. The communication of
disrespect.
111
When there is a sense of danger, slow things
down. It that fails, leave. The best time to
stop things from getting out of hand is before
they really get started.
112
Shirley Glass and Infidelity

• The way that affairs happen is that people give
  themselves permission to cross small or large
  boundaries.
• Sometimes you may have a conversation with
  someone and you may think that you should tell
  your partner about that conversation. Once you
  dont share that, you and this person have a
  secret.

113
There is a wall that is created between you and
your partner. If you become unhappy in your
relationship and talk to someone else about it,
then that person has a window into your
relationship.
114
Walls and windows have been reversed. In a
close relationship there are walls keeping it
safe from the outside, and you and your partner
have a window through which you both look at the
world together.
115
The End

• Please complete the post test and send one to BSF
  Administrative Assistant at SCAN and one to your
  supervisor for your training book.
• Thank you for all of your hard work and
  dedication to helping this program thrive!

116
Post Test

• 1. Name 5 criteria for couples to be eligible for
  Healthy Couples/Healthy Families.

117

• 2. How do couples become involved in Healthy
  Couples/Healthy Families?

118

• 3. Once a couple is enrolled in HC/HF, what do
  their services look like?

119

• 4. What is Cobra violence?

120

• 5. What is a perpetual problem, and name one way
  we can begin to reverse the process of staying in
  the problem and moving toward solutions.

121

• 6. If Domestic Violence occurs after a couple is
  in group what are the steps taken?

122

• 7. what are two positive roles Fathers play in
  their childs life?

123

• 8. If a couple is not eligible for Healthy
  Couples can they receive Healthy Families?
• Yes or No

124

• 9. What is the purpose of random assignment?

125

• 10. What are the keys to success for Healthy
  Couples/Healthy Families?