FAIR (Families Actively Improving Relationships)

FAIR (Families Actively Improving Relationships) was designed to address the needs of parents referred to child welfare services for substance use, parenting deficits, mental health symptoms, and ancillary support.

FAIR is an intensive community-based treatment model that integrates components of evidence-based behavioral interventions including Parent Management Training (PMT; Patterson & Forgatch, 2010) developed at the Oregon Social Learning Center (OSLC) and Reinforcement Based Therapy (RBT; Jones et al., 2005), a community reinforcement approach of contingency management to address substance use. Behavioral principles from these evidence-based interventions are integrated across four treatment targets. The FAIR team meets clients in the environments in which they exist and provide hands on support to parents to help them gain healthy skills. FAIR has been rigorously evaluated in clinical trials with positive clinical outcomes.

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 help navigating 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, coaches, a resource builder, and a clinical supervisor. An overview of implementation support for FAIR and approximate annual costs is available here.

In 2019, OSLC was awarded funding to expand the Families Actively Improving Relationships (FAIR) treatment model for the prevention of opioid and methamphetamine use disorders among young parents with public system involvement. This study is part of National Institutes of Health (NIH)’s Helping to End Addiction Long-term (HEAL) Initiative. Currently, this preventive PRE-FAIR model is being implemented in five counties in Oregon and being evaluated for effectiveness. Read the project announcement here.

FAIR References

Cruden, G., Crawford, S., & Saldana, L*. (2021).  Prevention adaptation of an evidence-based treatment for parents involved with child welfare who use substances. Frontiers in Psychology. https://doi.org/10.3389/fpsyg.2021.689432

Cruden, G., Campbell, M., & Saldana, L.* (2021). The impact of COVID-19 on service delivery for an evidence-based behavioral treatment for families in the child welfare system. Journal of Substance Abuse Treatment, 129, 108388. https://doi.org/10.1016/j.jsat.2021.108388 

Saldana, L., Chapman, J. E., Campbell, M., Alley, Z., Schaper, H., & Padgett, C. (2021). Meeting the needs of families involved in the child welfare system for parental substance abuse: Outcomes from an effectiveness trial of the Families Actively Improving Relationships program. Frontiers in Psychology, 12, 2592. https://doi.org/10.3389/FPSYG.2021.689483

Saldana, L. (2015). An integrated intervention to address the comorbid needs of families referred to child welfare for substance use disorders and child neglect: FAIR pilot outcomes. Child Welfare Journal, 94(5), 167-168.

Saldana, L., Smith, D.K., & Weber, E. (2013). Adolescent onset of maternal substance abuse: Descriptive findings from a feasibility trial. Journal of Child and Adolescent Substance Abuse, 22, 407-420.

Formerly Affiliated Principal Investigator:

• Lisa Saldana, Ph.D.