Lessons Learned from Scaling Up the Ecological Approach to Family Interventions and Treatment Program in Middle Schools

  • Gregory M. Fosco
  • John R. Seeley
  • Thomas J. Dishion
  • Keith Smolkowski
  • Elizabeth A. Stormshak
  • Rosemarie Downey-McCarthy
  • Corrina A. Falkenstein
  • Kevin J. Moore
  • Lisa A. Strycker
Part of the Issues in Clinical Child Psychology book series (ICCP)


The gap between efficacy trials and real-world implementation is often wider than we realize, and is bridged most effectively when careful consideration is given to the (a) qualities of the intervention that facilitate implementation, (b) external environmental influences on implementation success, (c) characteristics of intervention infrastructure that allow for sustainable implementation, and (d) qualities of the recipients that influence the degree and fidelity of implementation (Feldstein & Glasgow, 2008). We discuss the lessons learned while adapting the Ecological Approach to Family Intervention and Treatment (Dishion & Stormshak, 2007), a family-centered preventive intervention model delivered in public middle schools, for large-scale implementation in an effectiveness trial. We also share our experiences related to the challenges that arise when adapting an intervention model for large-scale dissemination and to share insights we have gained through this first-hand experience.


Middle School Family Support School Staff Family Management Parent Consultant 


  1. Caruthers, A. S., Van Ryzin, M. J., & Dishion, T. J. (2012). Preventing high-risk sexual behavior in early adulthood with family interventions in adolescence: Outcomes and developmental processes. Prevention Science. Google Scholar
  2. Collins, L., Murphy, S., & Bierman, K. (2004). A conceptual framework for adaptive preventive interventions. Prevention Science, 5, 185–196.PubMedCrossRefGoogle Scholar
  3. Connell, A., & Dishion, T. J. (2008). Reducing depression among at-risk early adolescents: Three-year effects of a family-centered intervention embedded within schools. Journal of Family Psychology, 22, 574–585.PubMedCrossRefGoogle Scholar
  4. Connell, A. M., Dishion, T. J., & Klostermann, S. (2012). Family check-up effects on adolescent arrest trajectories: Variation by developmental subtype. Journal of Research on Adolescence, 22, 367–380.PubMedCrossRefGoogle Scholar
  5. Connell, A., Dishion, T. J., Yasui, M., & Kavanagh, K. (2007). An adaptive approach to family intervention: Linking engagement in family-centered intervention to reductions in adolescent problem behavior. Journal of Consulting and Clinical Psychology, 75, 568–579.PubMedCrossRefGoogle Scholar
  6. Crone, D. A., Hawken, L. S., & Horner, R. H. (2010). Responding to problem behavior in schools: The behavior education program (2nd ed.). New York: Guilford Press.Google Scholar
  7. Crone, D. A., & Horner, R. H. (2003). Building positive behavior support systems in schools: Functional behavioral assessment. New York: Guilford Press.Google Scholar
  8. Dishion, T. J. (2011). Promoting academic competence and behavioral health in public schools: A strategy of systemic concatenation of empirically based intervention principles. School Psychology Review, 40, 590–597.Google Scholar
  9. Dishion, T. J., & Andrews, D. W. (1995). Preventing escalation in problem behaviors with high-risk young adolescents: Immediate and 1-year outcomes. Journal of Consulting and Clinical Psychology, 63, 538–548.PubMedCrossRefGoogle Scholar
  10. Dishion, T. J., Ha, T., & Véronneau, M.-H. (2012). An ecological analysis of the effects of deviant peer clustering on sexual promiscuity, problem behavior, and childbearing from early adolescence to adulthood: An enhancement of the life history framework. Developmental Psychology, 48, 703–717.PubMedCrossRefGoogle Scholar
  11. Dishion, T. J., & Kavanagh, K. (2003). Intervening in adolescent problem behavior: A family-centered approach. New York: Guilford Press.Google Scholar
  12. Dishion, T. J., Kavanagh, K., Schneiger, A., Nelson, S., & Kaufman, N. (2002). Preventing early adolescent substance use: A family-centered strategy for public middle school. In R. L. Spoth, K. Kavanagh., & T. J. Dishion (Eds.), Universal family-centered prevention strategies: Current findings and critical issues for public health impact [Special Issue]. Prevention Science, 3, 191–201.Google Scholar
  13. Dishion, T. J., & Loeber, R. (1985). Adolescent marijuana and alcohol use: The role of parents and peers revisited. The American Journal of Drug and Alcohol Abuse, 11, 11–25.PubMedCrossRefGoogle Scholar
  14. Dishion, T. J., McCord, J., & Poulin, F. (1999). When interventions harm: Peer groups and problem behavior. American Psychologist, 54, 755–764.PubMedCrossRefGoogle Scholar
  15. Dishion, T. J., & Patterson, G. R. (1993). Antisocial behavior: Using a multiple-gating strategy. In M. I. Singer, L. T. Singer, & T. M. Anglin (Eds.), Handbook for screening adolescents at psychosocial risk (pp. 375–399). New York: Lexington.Google Scholar
  16. Dishion, T. J., & Patterson, S. G. (1996). Preventive parenting with love, encouragement, and limits: The preschool years. Eugene, OR: Castalia.Google Scholar
  17. Dishion, T. J., & Patterson, G. R. (2006). The development and ecology of antisocial behavior in children and adolescents. In D. Cicchetti & D. J. Cohen (Eds.), Developmental psychopathology (Risk, disorder, and adaptation, Vol. 3, pp. 503–541). New York: Wiley.Google Scholar
  18. Dishion, T. J., Reid, J. B., & Patterson, G. R. (1988). Empirical guidelines for the development of a treatment for early adolescent substance use. In R. E. Coombs (Ed.), The family context of adolescent drug use (pp. 189–224). New York: Haworth.Google Scholar
  19. Dishion, T. J., & Stormshak, E. (2007). Intervening in children’s lives: An ecological, family-centered approach to mental health care. Washington, DC: American Psychological Association.CrossRefGoogle Scholar
  20. Dishion, T. J., Stormshak, E. A., & Kavanagh, K. (2011). Everyday parenting: A professional’s guide to building family management skills. Champaign, IL: Research Press.Google Scholar
  21. Eccles, J. S., Midgley, C., Wigfield, A., Flanagan, C., Buchanan, C. M., Reuman, D., et al. (1993). Development during adolescence: The impact of stage/environment fit. American Psychologist, 48, 90–101.PubMedCrossRefGoogle Scholar
  22. Feldstein, A. C., & Glasgow, R. E. (2008). A practical, robust implementation and sustainability model (PRISM) for integrating research findings into practice. Joint Commission Journal on Quality and Patient Safety, 34, 228–243.PubMedGoogle Scholar
  23. Fixsen, D., Blase, K., & Van Dyke, M. (2011). Mobilizing communities for implementing evidence-based youth violence prevention programming: A commentary. American Journal of Community Psychology, 48(1–2), 133–137.PubMedCrossRefGoogle Scholar
  24. Fosco, G. M., Dishion, T. J., & Stormshak, E. A. (2012). A public health approach to family-centered prevention of alcohol and drug addiction: A middle school strategy. In H. J. Shaffer, D. A. LaPlante, & S. E. Nelson (Eds.), The American Psychological Association addiction syndrome handbook (pp. 225–245). Washington, DC: American Psychological Association.Google Scholar
  25. Glasgow, R. E. (2002). Evaluation of theory-based interventions: The RE-AIM model. In K. Glanz, F. M. Lewis, & B. K. Rimer (Eds.), Health behavior and health education (3rd ed., pp. 531–544). San Francisco, CA: Jossey-Bass.Google Scholar
  26. Glasgow, R. E., Nelson, C. C., Strycker, L. A., & King, D. K. (2006). Using RE-AIM metrics to evaluate diabetes self-management support interventions. American Journal of Preventive Medicine, 30, 67–73.PubMedCrossRefGoogle Scholar
  27. Gottfredson, G. D., Gottfredson, D. C., Czeh, E. R., Cantor, D., Crosse, S. B., & Hantman, I. (2000). National study of delinquency prevention in schools. Ellicott City, MD: Gottfredson Associates.CrossRefGoogle Scholar
  28. Green, L. W., & Glasgow, R. (2006). Evaluating the relevance, generalization, and applicability of research: Issues in external validation and translation methodology. Evaluation & the Health Professions, 29, 1–28.CrossRefGoogle Scholar
  29. Griner, D., & Smith, T. B. (2006). Culturally adapted mental health interventions: A meta- analytic review. Psychotherapy: Theory, Research, Practice, Training, 43, 531–548.CrossRefGoogle Scholar
  30. Handler, M. W., Rey, J., Connell, J., Their, K., Feinberg, A., & Putnam, R. (2007). Practical considerations in creating school-wide positive behavior support in public schools. Psychology in the Schools, 44, 29–39.CrossRefGoogle Scholar
  31. Irvine, A. B., Biglan, A., Smolkowski, K., Metzler, C. W., & Ary, D. V. (1999). The effectiveness of a parenting skills program for the parents of middle school students in small communities. Journal of Consulting and Clinical Psychology, 67, 811–825.PubMedCrossRefGoogle Scholar
  32. Loeber, R., Dishion, T. J., & Patterson, G. R. (1984). Multiple gating: A multistage assessment procedure for identifying youths at risk for delinquency. Journal of Research in Crime and Delinquency, 21, 7–32.CrossRefGoogle Scholar
  33. McDougal, J. L., Clonan, S. M., & Martens, B. K. (2000). Using organizational change procedures to promote the acceptability of prereferral intervention services: The School-Based Intervention Team Project. School Psychology Quarterly, 15, 149–171.CrossRefGoogle Scholar
  34. Miller, T. R. (2004). The social costs of adolescent problem behavior. In A. Biglan, P. A. Brennan, S. L. Foster, & H. D. Holder (Eds.), Helping adolescents at risk: Prevention of multiple problem behaviors. New York: Guilford.Google Scholar
  35. Miller, W. R., & Rollnick, S. (2002). Motivational interviewing: Preparing people for change (2nd ed.). New York: Guilford.Google Scholar
  36. O’Connell, M. E., Boat, T., & Warner, K. E. (2009). Preventing mental, emotional, and behavioral disorders among young people: Progress and possibilities. Washington, DC: The National Academies Press. Committee on the Prevention of Mental Disorders and Substance Abuse Among Children, Youth and Young Adults: Research Advances and Promising Interventions; Institute of Medicine; National Research Council.Google Scholar
  37. Patterson, G. R., & Dishion, T. J. (1985). Contributions of families and peers to delinquency. Criminology, 23, 63–77.CrossRefGoogle Scholar
  38. Patterson, G. R., Reid, J. B., & Dishion, T. J. (1992). Antisocial boys. Eugene, OR: Castalia.Google Scholar
  39. Poulin, F., Dishion, T. J., & Burraston, B. (2001). 3-year iatrogenic effects associated with aggregating high-risk adolescents in preventive interventions. Applied Developmental Science, 5, 214–224.CrossRefGoogle Scholar
  40. Stormshak, E. A., Connell, A., & Dishion, T. J. (2009). An adaptive approach to family-centered intervention in schools: Linking intervention engagement to academic outcomes in middle and high school. Prevention Science, 10, 221–235.PubMedCrossRefGoogle Scholar
  41. Stormshak, E. A., Connell, A. M., Véronneau, M.-H., Myers, M. W., Dishion, T. J., Kavanagh, K., et al. (2011). An ecological approach to promoting early adolescent mental health and social adaptation: Family-centered intervention in public middle schools. Child Development, 82, 209–225.PubMedCrossRefGoogle Scholar
  42. Stormshak, E. A., Dishion, T. J., Light, J., & Yasui, M. (2005). Implementing family-centered interventions within the public middle school: Linking service delivery to change in student problem behavior. Journal of Abnormal Child Psychology, 33, 723–733.PubMedCrossRefGoogle Scholar
  43. Sugai, G., Horner, R. H., Dunlap, G., Hieneman, M., Lewis, T. J., Nelson, C. M., et al. (2000). Applying positive behavioral support and functional assessment in schools. Journal of Positive Behavior Interventions, 2, 135–141.Google Scholar
  44. Sugai, G., Lewis-Palmer, T., Todd, A., & Horner, R. (2001). School-wide evaluation tool. Eugene, OR: University of Oregon.Google Scholar
  45. Van Ryzin, M. J., Stormshak, E. A., & Dishion, T. J. (2012). Engaging parents in the family check-up in middle schools: Longitudinal effects through the transition to high school. Journal of Adolescent Health , 50, 627–633.Google Scholar
  46. Walker, H. M., Colvin, G., & Ramsey, E. (1995). Antisocial behavior in school: Strategies and best practices. Pacific Grove, CA: Brooks/Cole.Google Scholar

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Gregory M. Fosco
    • 1
  • John R. Seeley
    • 2
  • Thomas J. Dishion
    • 3
  • Keith Smolkowski
    • 2
  • Elizabeth A. Stormshak
    • 3
  • Rosemarie Downey-McCarthy
    • 3
  • Corrina A. Falkenstein
    • 3
  • Kevin J. Moore
    • 3
  • Lisa A. Strycker
    • 2
  1. 1.Department of Human Development and Family StudiesPennsylvania State UniversityUniversity ParkUSA
  2. 2.Oregon Research InstituteEugeneUSA
  3. 3.University of OregonEugeneUSA

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