The Family Check-Up Online: A Telehealth Model for Delivery of Parenting Skills to High-Risk Families with Opioid Use Histories
Elizabeth A. Stormshak, Ph.D., Jordan M. Matulis, M.S., Whitney Nash. M.A., and Yijun Cheng, M.A.

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Introduction 

Parents who experience substance misuse also have a great need for support to care for their children. Opioid misuse has risen over the past decade in the U.S., with over 10 million people having misused opioids. Subsequently, more children are living with substance misuse in the home as more parents are caring for their children while using substances. Parents who struggle with opioid misuse often also struggle with mental health concerns and parenting responsibilities, increasing the risk of child abuse and neglect. Additionally, children living with a parent with opioid misuse are more likely to grow up in a chaotic environment, including low monitoring and low parental support, which may negatively affect a child’s development and create later risk for engaging in risky behaviors. Parenting interventions that have been specifically developed for parents with opioid use histories aim to address their unique needs by helping to support both parenting and substance use treatment. However, most parents with opioid use histories don’t receive treatment due to many barriers, including the stigma associated with seeking treatment, fear of judgment by neighbors and peers, and fear of their children being removed from their care. This brief reports on a recent journal article which outlines an adaptation of the Family Check-Up, an evidence-based parenting intervention to reduce risk behavior and enhance parenting skills, to address the specific needs of parents with a history of substance use through an eHealth model.

KEY FINDINGS

• Parents cited lack of access to resources, stigma, and judgment as barriers to accessing mental health and substance use treatments
• The FCU Online delivers its intervention through an eHealth model to address the needs of parents with opioid misuse 
• New content addressing parent wellness and substance use was added to tailor the information for families with substance use histories

FINDING HIGHLIGHTS
The FCU Online is grounded in the original FCU model and includes an assessment, feedback, and content designed to help parents of young children improve their relationship with their children and build parenting skills to help their child’s long-term development. The FCU Online includes five different content modules: parent wellness, substance use and parenting, positive parenting, proactive parenting, and monitoring and limit setting. The content of these modules was adapted from the Everyday Parenting curriculum and includes additional support for parent wellness and substance use prevention. This added content addresses challenges often associated with parents with a history of substance misuse.

IMPLICATIONS FOR POLICY RESEARCH AND PRACTICE
Our eHealth intervention focuses on supporting parents by increasing their confidence in their skills, teaching tools to manage stress, and encouraging parents to focus on their own mental health and routines, which is hypothesized to lead to the prevention of opioid misuse as well as increase parenting skills to build stronger bonds with their children. This intervention targets parents of young children as a prevention effort to disrupt the cycle of addiction and prevent substance misuse in future generations. It is important to concurrently provide parenting support and skill-building opportunities alongside substance use treatment for families, to better serve the needs of the family system, as opioid misuse in young adults and parents is rising at alarming rates. Without support, poor parenting practice can contribute to a range of child problems that begin in early childhood. To reduce risk factors within parenting, it is critical to provide that support.

REFERENCE
Stormshak EA, Matulis JM, Nash W, Cheng Y. The Family Check-Up Online: A telehealth model for delivery of parenting skills to high-risk families with opioid use histories. Hypothesis and theory. Frontiers in Psychology. 2021;12. doi:10.3389/fpsyg.2021.695967

SUGGESTED CITATION
Stormshak, EA, Matulis, JM, Nash, W, & Cheng, Y. The Family Check-Up Online: A telehealth model for delivery of parenting skills to high-risk families with opioid use Histories. CPO Research Brief. 2021. doi:10.3389/fpsyg.2021.695967

ABOUT THE AUTHORS
Elizabeth A. Stormshak, Ph.D., is a researcher and faculty member in the Counseling Psychology program and Prevention Science Institute at the University of Oregon.
Jordan M. Matulis, M.S., and Yijun Cheng, M.S. are doctoral students in the Counseling Psychology program at the university of Oregon.
Whitney Nash, M.A., is a research coordinator and graduate student at the University of Oregon Prevention Science Institute.

ACKNOWLEDGEMENTS
The authors would like to thank all the families who have participated in this research over the past 20 years. The authors also acknowledge the contributions of many research assistants and faculty at the University of Oregon who have contributed to this work.