Project SUPPORT - Detailed Report

Project SUPPORT is a home-based intervention that includes two primary components:

• Providing instrumental and emotional support to the mother during her transition from the women's shelter.
• Teaching the mother to implement a set of child management and nurturing skills that have been shown to be effective in the treatment of clinical levels of conduct problems.

Project SUPPORT delivery method:

• Therapists visit families weekly to conduct the sessions.
• The therapists are accompanied by child mentors who interact with the children in the home and model pro-social behavior. The child mentors are advanced undergraduate or post-baccalaureate students who receive specialized training.
• The child mentors actively work to build positive, supportive relationships with the children in their charge. This goal is accomplished by the mentor's generous and appropriate use of praise and positive attention. Child mentors are also proficient in using all of the child management skills taught in the Project SUPPORT intervention.

Child Management and Nurturing Skills Component

• Directly target child problems by teaching mothers to use child management and nurturing skills effectively.
• Through direct instruction and practice (via demonstration, role-plays, exercises, and homework assignments), mothers are taught skills with which to communicate more effectively with their children, facilitate a warm and supportive relationship with their children, increase pro-social and appropriate child behavior, and decrease inappropriate or problematic child behavior.
• Adapts to the needs of each family by systematically assessing each mother's beliefs, practices, and knowledge about parenting, each child's behavior patterns, and the relationships among family members.
• Meets the family's specific needs, with a focus on using the child management and nurturing skills to address those needs.
• Covers topics and teaches skills such as: developing realistic and age-appropriate expectations about children's behavior, playing with and listening to children, delivering contingent praise and positive attention, giving appropriate instructions and commands, delivering contingent negative consequences for noncompliance and aggressive behavior (teaching alternatives to yelling and hitting), setting limits, being consistent, providing good supervision, influencing children's beliefs and behavior, teaching by example, and understanding the effects of seeing violence (both in person and through the media).
• Based on programs of other researchers and reviews of best practices, with our own augmentations to address the circumstances of children in violent, low-income families.

Social and Instrumental Support Component

• Provides emotional support to the women during their transition from the shelter.
• Helps mothers build support networks by linking them to community agencies and organizations.
• Helps mothers obtain physical resources (e.g., financial help, furniture, household appliances) and social supports central to their efforts to become self-supporting.
• Addresses safety concerns.
• Trains mothers decision-making and problem-solving skills.

Project SUPPORT is rated a "2 - Supported by Research Evidence" on the Scientific Rating Scale based on the published, peer-reviewed research available. The practice must have at least one rigorous randomized controlled trial with a sustained effect of at least 6 months. For more information on the rating of a "2 - Supported by Research Evidence," please see the Scientific Rating Scale.

Jouriles, E. N., McDonald, R., Spiller, L., Norwood, W. D., Swank, P. R., Stephens, N., et al. (2001). Reducing conduct problems among children of battered women. Journal of Consulting and Clinical Psychology, 69(5), 774-785.

Type of Study: Randomized controlled triall
Number of participants: 36 families
Population:

Age Range: Children between 4 and 9 years
Race/Ethnicity: Mothers: 12 Latino, 11 African American, 10 Caucasian, 1 Asian American, and 2 Other.
Status (e.g., foster care, CW): Women and children recruited from shelters.

Location/Institution: Texas
Summary: (To include comparison groups, outcomes, measures, notable limitations) Women and their children were recruited from shelter programs. To meet study requirements, children had to have a diagnosis of oppositional defiant disorder (ODD) or conduct disorder (CD) based on Diagnostic and Statistics Manual of Mental Disorders, 4th edition (DSM-IV) criteria. Women and children in the intervention condition were provided with support services and parent training. Families in the comparison condition were encouraged to use existing community and shelter services. Mothers were assessed for history of violence during the previous 12 months using the Conflict Tactics Scale (CTS). Follow-up measures included the Child Behavior Checklist (CBCL) and the Symptom Checklist-90 to assess mothers’ psychological distress, as well as video-taped observation of child management skills. Compared with families receiving services as usual, children in the intervention condition improved at a faster rate, the proportion of conduct problems was diminished, and mothers displayed greater improvement in child management skills. The authors note that although children’s behavior improved, CBCL externalizing scores remained at clinical levels.
Length of post-intervention follow-up: 16 months.

McDonald, R., Jouriles, E. N., & Skopp, N. A. (2006). Reducing conduct problems among children brought to women’s shelters: Effects 24 months following termination of services. Journal of Family Psychology, 20(1), 127-136.

Type of Study: Randomized controlled trial
Number of participants: 30 families
Population:

Age Range: 4 to 9 years at intervention
Race/Ethnicity: Mothers: 11 African American, 9 Caucasian, 8 Latino, 1 Asian American, and 1 Other
Status (e.g., foster care, CW): Women and children recruited from shelters.

Location/Institution: Texas
Summary: (To include comparison groups, outcomes, measures, notable limitations) Note: This study uses the same sample as Jouriles, et al., 2001. Mothers in the Project Support condition received parent training targeted at child conduct problems. Follow-up assessments were conducted during home visits. Mothers reported on children’s disruptive behavior during an interview which included the Child Behavior Checklist (CBCL). Mothers also responded to items from the Health Resources Inventory to assess children’s happiness and social relationships and to items from the Conflict Tactics Scale (CTS) to assess their own aggression towards their children. Finally, they reported on contact with their partner and any recurrence of physical violence. Children in the Project Support condition were less likely to be having conduct problems, and had higher happiness scores. Mothers in the treatment condition reported les aggression and were less likely to have returned to an abusive partner. There were no group differences in recurrence of physical violence. The authors note that the study’s measures of children’s adjustment and of family functioning were limited.
Length of post-intervention follow-up: 24 months.

Ezell, E., McDonald, R., & Jouriles, E. N. (2000). Helping children of battered women: A review of research, sampling of programs, and presentation of Project Support. In J. Vincent & E. Jouriles (Eds.), Domestic violence: Guidelines for research-informed practice (pp.144-170). London: Kingsley Publishers.

Jouriles, E. N., McDonald, R., Stephens, N., Norwood, W., Spiller, L. C., & Ware, H. S. (1998). Breaking the cycle of violence: Helping families departing from battered women's shelters. In G. Holden, R. Geffner, & Jouriles, E. N. (Eds.), Children exposed to marital violence: Theory, research, and applied issues (pp. 185-221). Washington, DC: American Psychological Association.