FAIR was designed to address the needs of parents referred to child welfare services for neglect and substance use, including their co-occurring parenting and substance use needs. Previousresearch suggests many families referred to child welfare for neglect and substance use experience co-occurring risk factors; accordingly, the FAIR program aims to address these risk factors. FAIR achieved positive outcomes in a small, randomized pilot trial conducted as part of Dr. Saldana’s recently completed NIDA-funded Career Development Award. FAIR is currently being evaluated as part of an efficacy trial funded by the Administration on Children, Youth, and Families.
FAIR is an intensive community-based treatment model that integrates components of two evidence-based behavioral interventions: 1) Parent Management Training (PMT; Patterson & Forgatch, 2010) developed at the Oregon Social Learning Center (OSLC) to increase parenting skills, teach and support positive family interactions, and address mental health problems; and 2) Reinforcement Based Therapy a community reinforcement approach of contingency management (RBT; Jones et al., 2005) to address adult substance use. Behavioral principles from these evidence-based interventions are integrated to address parenting, parental substance use, and any ancillary needs presented by the family (e.g., mental health, housing, employment). Ongoing engagement efforts are utilized throughout the 8 month treatment. Outcomes from the pilot suggest that these efforts were successful with 94% of participants randomized to FAIR engaging in treatment and 87% completing the full course of treatment.
The community-based, outpatient, intensive behavioral treatment involves five major components: 1) Teaching and supporting parenting skills including nurturing and attachment, reinforcement, emotion regulation, supervision, non-harsh discipline, and nutrition; 2) Delivering substance abuse treatment including contingency management, relationship building, day planning, healthy environments and peer choices, and refusal skills; 3) Resource building and provision of ancillary supports including housing, employment, support with court and child welfare attendance; 4) Use of incentives (FAIR bucks to spend in the FAIR store) for success with all treatment components; and 5) Ongoing engagement strategies. To implement and integrate these 5 components into one model, the FAIR team includes counselors, skills coaches, a resource builder, and a clinical supervisor.
Lisa Saldana, Ph.D.
Oregon Social Learning Center
Active Research Projects
Primary Research and Clinical Interests
Lisa joined OSLC in 2007. She received her doctorate in clinical psychology from the University of Missouri-Columbia in 2003 with a research and clinical emphasis in child maltreatment and evidence-based practice. She has been active in the development, evaluation, and implementation of evidence-based practices, with a particular emphasis in services for child welfare populations.
Lisa is currently the PI on the Stages of Implementation Completion for Evidence-Based Practice, an NIMH-funded R01 that examines the successful implementation of interventions in community settings. She is also working on NIH-funded research grants focusing on the economic evaluation of EBPs and is a Co-Investigator on the NIDA-funded Translational Drug Abuse Prevention Center at OSLC. Lisa is a Co-Investigator on a large real-world implementation of two linked EBPs in a large multi-site child welfare system. She is the developer of the Stages of Implementation Completion (SIC) and Cost of Implementing New Strategies (COINS) implementation tools. Recently, in collaboration with OSLC colleague Patti Chamberlain, Lisa has helped to develop the R3 practice model focused on maximizing the quality of positive relationships between caseworkers and families involved in the child welfare system.
She received funding from ACYF to conduct an efficacy evaluation of the FAIR model, an integrative treatment for maternal substance abuse and child neglect which she developed using a NIDA-funded Career Development award. The Families Actively Improving Relationships (FAIR) model integrates evidence-based techniques targeting three key components: treatment of parenting deficits, substance use, and mental health symptoms as well as their correlated contextual problems such as housing and employment. Families referred to FAIR receive services in their natural environments (e.g., home, school, court) and receive incentives that are related to healthy households for meeting individualized treatment goals. A dynamic wait-list design is being utilized to evaluate services being delivered in a Medicaid environment to families referred through the child welfare system.
Previously, Lisa was a Co-Investigator on a large-scale trial evaluating “what it takes” to implement an evidence-based practice (TFCO) for youth in foster care in communities with barriers to implementation. Lisa also collaborated on a trial evaluating the dissemination of the KEEP foster parent training group to prevent placement disruptions in foster children.