FAIR (Families Actively Improving Relationships)

Based on Research Conducted at OSLC

FAIR is an intensive treatment for parents referred to child welfare services for neglect and substance use. The treatment aims to build parents’ skills in parenting and address their substance use, while promoting stability through housing, employment, and other supports.

Project Overview

FAIR (Families Actively Improving Relationships) 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. Previous research 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 NIDA-funded Career Development Award. FAIR was also evaluated as part of an efficacy trial funded by the Administration on Children, Youth, and Families.

FAIR Efficacy Trial Final Report

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. 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. Read the project announcement here.

Principal Investigator

Lisa Saldana, Ph.D.

Senior Research Scientist
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 (EBP). She has been active in the development, evaluation, and implementation of EBPs, with a particular emphasis in services for child welfare populations.

Lisa currently is the PI of a number of federally funded projects related to implementation in child serving systems. Building on her previous work with the Stages of Implementation Completion (SIC), she and the SIC team are extending the SIC into the Sustainment Phase of the implementation process. Moreover, they are conducting a randomized trial of the SIC-Coaching strategy as a method for integrating implementation fidelity with intervention fidelity to increase rates of successful implementation among adolescent substance use treatment EBPs. Lisa and the SIC team have collaborated with a number of EBP developers in different service sectors, serving different populations to operationalize and monitor real-world implementation efforts. Similarly, the SIC team has developed the Cost of Implementing New Strategies (COINS) tool for assessing implementation costs across the three phases of implementation. Lisa also is the PI of a real-world evaluation of the implementation of the R3 Supervisor Strategy in four regions in the Tennessee child welfare system. R3 is a workforce practice model aimed at improving family-system relationships and subsequent family and system-level outcomes.

Lisa is the developer of the Families Actively Improving Relationships (FAIR) model, an integrative intervention for families referred to the child welfare system for parental substance abuse. She currently is conducting an efficacy trial of FAIR when delivered under a Medicaid billable environment. FAIR integrates evidence-based techniques targeting four key treatment components including parental substance use, maladaptive parenting, 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 related to healthy households for meeting individualized treatment goals. Lisa oversees FAIR services provided to Lane County residents through the ODI Clinic; for more information, visit odiclinic.org/fair.

Lisa also was a Co-Investigator on the NIDA-funded Translational Drug Abuse Prevention Center at OSLC, as well as a number of other non-OSLC led projects.