Strengthening Family Coping Resources (SFCR)

About This Program

Target Population: Families living in traumatic contexts who are vulnerable

For children/adolescents ages: 0 – 17

For parents/caregivers of children ages: 0 – 17

Program Overview

SFCR is designed for families living in traumatic contexts with the dual goals of reducing the symptoms of trauma-related disorders in any family member and increasing coping resources in children, caregivers, and in the family system. Consistent with these two primary objectives, SFCR is guided by theories related to the ways families adapt to traumatic stress and a blending of ritual and routine theories with family stress and coping theories. SFCR provides trauma treatment within a family format. SFCR is designed to build the skills necessary to help families boost their sense of safety; function with stability; co-regulate their stress reactions, emotions, and behaviors; and make use of support resources. Although SFCR can be implemented using a variety of formats, it is typically delivered as a 10- or 15-week multifamily group (MFG).

Program Goals

The goals of Strengthening Family Coping Resources (SFCR) are:

  • Reduce symptoms of traumatic stress and other trauma-related disorders in any family member
  • Increase coping resources in children, caregivers, and in the family system to help families:
    • Boost their sense of safety
    • Function with stability
    • Regulate their stress reactions, emotions, and behaviors
    • Make use of supports

Logic Model

The program representative did not provide information about a Logic Model for Strengthening Family Coping Resources (SFCR).

Essential Components

The essential components of Strengthening Family Coping Resources (SFCR) include:

  • SFCR is typically delivered as a 10- or 15-week multifamily group (MFG) that meets for two hours weekly.
    • High-Risk (HR): The high-risk model is a 10-week group that is more appropriate for families at risk for exposure to trauma or for families who have experienced trauma but have minimal symptoms of traumatic stress. This is also a closed enrollment model.
    • Trauma Treatment (TT): The trauma treatment model is a 15-week group with closed enrollment. The treatment model is most appropriate for families who have a family member with a stress or trauma-related disorder.
  • SFCR provides trauma treatment within a family format.
    • Core components include the following among others:
      • Psychoeducation
      • Stress reduction training and practice
      • Mindfulness
      • Relationship repair
      • Constructing a trauma time line
    • The model includes work on family storytelling, which builds to a family trauma narrative.
  • SFCR fosters skills and competencies across six protective family coping resources:
    • Deliberateness which includes skill-building and practice in:
      • Planning
      • Problem-solving
      • Follow through
    • Structure and a sense of safety which includes:
      • A Safety Mapping activity
      • Developing safety routines
      • Designing multiple daily routines
      • Clarifying limits
    • Connectedness involves family activities designed to:
      • Increase attunement
      • Increase co-regulation
      • Increase meaning making including family discussion of values and spiritual practices (sharing a family meal together at the start of group is an important group routine)
    • Resource seeking comprises activities such as:
      • Completing sociograms
      • Completing family sculptures
      • Participating in Community building within the MFG through:
      • Sharing
      • Jointly practiced opening and closing rituals
    • Co-regulation and crisis management is achieved through:
      • Check-ins at the beginning of each group
      • In-the-moment coaching of emotion/behavior regulation techniques
      • Encouragement of parents/caregivers to be in charge and help their children with regulation
    • Positive affect, memories and meaning are emphasized as families:
      • Participate in fun activities such as telling a story that envisions a positive future.
      • Laugh together
      • Plan and carry out a celebration

Program Delivery

Child/Adolescent Services

Strengthening Family Coping Resources (SFCR) directly provides services to children/adolescents and addresses the following:

  • Symptoms of traumatic stress and other trauma‐related disorders
Services Involve Family/Support Structures:

This program involves the family or other support systems in the individual's treatment: SFCR includes the whole family in treatment. The whole family is defined by the family, and can include anyone involved in the daily life of the family. The model of family treatment used includes developmentally appropriate skill building activities that are reinforced with family practice and this model provides a novel approach to addressing co-occurring traumatic reactions in multiple family members.

Parent/Caregiver Services

Strengthening Family Coping Resources (SFCR) directly provides services to parents/caregivers and addresses the following:

  • Symptoms of traumatic stress and other trauma‐related disorders

Recommended Intensity:

Weekly 2-hour sessions

Recommended Duration:

10 weeks or 15 weeks

Delivery Settings

This program is typically conducted in a(n):

  • Hospital
  • Outpatient Clinic
  • Community-based Agency / Organization / Provider
  • Group or Residential Care
  • School Setting (Including: Day Care, Day Treatment Programs, etc.)
  • Virtual (Online, Telephone, Video, Zoom, etc.)

Homework

Strengthening Family Coping Resources (SFCR) includes a homework component:

Families are asked to practice or prepare to learn new skills during the week between group sessions by completing various activities. All materials needed for the homework are available to trained facilitators on the SFCR website.

Languages

Strengthening Family Coping Resources (SFCR) has materials available in a language other than English:

Spanish

For information on which materials are available in this language, please check on the program's website or contact the program representative (contact information is listed at the bottom of this page).

Resources Needed to Run Program

The typical resources for implementing the program are:

A space large enough to accommodate 5-6 families with additional space available for break-out groups, the manual, ability to provide a family meal

Manuals and Training

Prerequisite/Minimum Provider Qualifications

SFCR MFG groups are conducted using facilitator teams. SFCR facilitator teams usually comprise experienced clinicians along with support staff. Other staff can include case workers, educators, direct care workers, trainees, family advocates, and legacy family members. Any additional facilitators can be members of the organization or community in which the group is taking place and bring an understanding of that community's culture and value system.

Manual Information

There is a manual that describes how to deliver this program.

Training Information

There is training available for this program.

Training Contact:
Training Type/Location:

Arrangements are made to fit needs of agencies.

Number of days/hours:

Training duration depends on the version being implemented: For the MFG version, training consists of a 2- to 2½-day training. A 1-day booster training is offered for teams experienced in running SFCR. Consultation calls occur weekly through the initial implementation and then bi-weekly during a second round. Videos of SFCR concepts and strategies are also available on the website.

Relevant Published, Peer-Reviewed Research

Kiser, L. J., Donohue, A., Hodgkinson, S., Medoff, D., & Black, M. M. (2010). Strengthening Family Coping Resources: The feasibility of a multi-family group intervention for families exposed to trauma. Journal of Traumatic Stress, 23, 802-806. doi:10.1002/jts.20587

Type of Study: One group pretest-posttest study
Number of Participants: 19

Population:

  • Age — Children: 1-12 years; Adults: Not specified
  • Race/Ethnicity — Children: 96% Hispanic, Adults: Not specified
  • Gender — Children: 51% Female and 49% Male, Adults: Not specified
  • Status — Participants were 6th to 8th grade students who have been exposed to traumatic events.

Location/Institution: Urban outpatient clinics

Summary: (To include basic study design, measures, results, and notable limitations)
This study tested the efficacy of the Strengthening Family Coping Resources (SFCR) program on families living in traumatic contexts to determine whether SFCR reduced symptoms of posttraumatic stress disorder (PTSD) and other trauma-related disorders in children and caregivers. Measures utilized include the Schedule for Affective Disorders and Schizophrenia for School Age Children-Present (K-SADS P/L), the Trauma Symptom Checklist for Young Children (TSCYC), the UCLA PTSD Index, and the Child Behavior Checklist (CBCL). Results demonstrate improvements in children’s functioning including decreases in PTSD symptoms and other behavioral and emotional concerns. Limitations include small sample size, lack of randomization of participants, lack of control group, and length of follow-up.

Length of controlled postintervention follow-up: 3 and 6 months.

Kiser L. J., Backer, P., Winkles, J., & Medoff, D. (2015). Strengthening Family Coping Resources (SFCR): Practice-based evidence for a promising trauma intervention. Journal of Couple and Family Psychology: Research and Practice, 4, 49-59. doi:10.1037/cfp0000034

Type of Study: One group pretest-posttest study
Number of Participants: 103

Population:

  • Age — Children:6-17 years, Parents: Not specified
  • Race/Ethnicity — Children: 73% African American, and 22% Hispanic; Parents: Not specified
  • Gender — Children: 51% Female, Parents: 88% Female
  • Status — Participants were either families with at least one child who met full or partial criteria for posttraumatic stress disorder (PTSD) or families with a trauma-exposed child who did not meet partial or full PTSD criteria.

Location/Institution: 13 National Child Traumatic Stress Network (NCTSN) sites in the United States

Summary: (To include basic study design, measures, results, and notable limitations)
This study tested the efficacy of the Strengthening Family Coping Resources (SFCR) program on families living in traumatic contexts to determine whether inclusion in the SFCR program would be associated with decreased distress at both the child and family levels. Two SFCR models were tested across multiple sites in the current study. About 85% of the families (158) attended SFCR trauma treatment (TT) model groups and about 15% of the families (27) attended SFCR high risk (HR) model groups. The TT model is designed for families with at least one child who meets full or partial criteria for posttraumatic stress disorder (PTSD), whereas the HR model is for families with a trauma-exposed child who does not meet partial or full PTSD criteria. Measures utilized include the UCLA PTSD Reaction Index for the DSM–IV, the Child Behavior Checklist (CBCL), the Family Assessment Device-12 (FAD-12), and the Parenting Stress Index-Short Form (PSISF). Results showed that the strength of SFCR's effect on trauma-related symptomatology and family functioning did not significantly differ by gender, age, or treatment group type. Improvement in family functioning was also moderated by group type, reflecting greater improvement among HR families. Limitations include lack of randomization, lack of control group, high attrition rate, and length of follow-up.

Length of controlled postintervention follow-up: 1 month.

Additional References

Kiser L. J. (2006). Protecting children from the dangers of urban poverty. Clinical Psychology Review, 27, 211-225.

Kiser, L. J. (2015). Strengthening Family Coping Resources: Intervention for families impacted by trauma. New York: Routledge.

Kiser, LJ, Miller, AB, Mooney, MA, Vivrette, R, Davis, S. (2020). Integrating parents into child trauma treatment: Reviewing evidence and establishing core components. Practice Innovations, 5, 65-80. doi: http://dx.doi.org/10.1037/pri0000109

Contact Information

Laurel Kiser
Agency/Affiliation: University of Maryland School of Medicine
Website: www.sfcresources.org
Email:
Phone: (410) 706-2490

Date Research Evidence Last Reviewed by CEBC: March 2016

Date Program Content Last Reviewed by Program Staff: July 2020

Date Program Originally Loaded onto CEBC: June 2016