Since 2000, APA's ACT Raising Safe Kids program has been teaching research-based, positive parenting skills to prevent childhood abuse and neglect and to help parents learn better parenting approaches. The program has been so successful it's now being implemented in schools, health centers, mental health clinics, churches and other community venues in 18 U.S. states and the District of Columbia, as well as in Brazil, Colombia, Ecuador, Guatemala, Greece, Japan, Peru and Puerto Rico. This year, APA also is establishing ACT programs in Bosnia, Croatia and Turkey.
One powerful setting for ACT in the United States is prisons. Inmates are a particularly important population to reach because many are parents of minor children and the number of children with parents in prison is continuing to rise, according to the Bureau of Justice Statistics. It's tough on kids and parents when a parent is incarcerated, so positive interventions can make a big difference. Research also suggests that many inmates had difficult or violent childhoods themselves, so they need guidance on learning and adopting different ways of parenting, says Sharon Souza, a nurse at St. Luke's Hospital in New Bedford, Massachusetts, who oversees and facilitates ACT parenting classes at the Bristol County House of Correction in Dartmouth, Massachusetts.
"The stories of abuse they tell me they experienced — it's amazing some of them survived," she says.
The program uses hands-on, user-friendly role play and exercises based on psychoeducation principles to teach the inmates parenting skills. Inmates learn to understand and control their anger, deal with conflicts, practice more effective ways of disciplining their children and connect with relevant community resources. The goal is to help them build safer, healthier families emotionally and psychologically once they are back in the community, says Donna Dickman, ACT Great Lakes Region director, who oversees three ACT prison programs in Ohio.
"It's breaking that intergenerational cycle of, ‘This is how you raise kids,'" Dickman explains. "We try to give the message that you don't have to raise kids that way and you can still get good results."
Childhood development is a key topic in ACT programs. Parents learn what to expect from their children at different ages; for example, that temper tantrums are part of normal development for young children, who are not yet able to control their emotions. That lesson gives them the intellectual tools to avoid harsh punishment and opt instead for alternatives, such as ignoring a child until he or she calms down, says Michelle Breitigan, who teaches ACT workshops at the Allen/Oakwood Correctional Institution in Lima, Ohio, and the Ohio Reformatory for Women in Marysville, Ohio.
Besides the Ohio programs, ACT is established in prisons in Massachusetts and in Albany, New York. Like other ACT programs, those based in prisons are hosted by community-based organizations. The ACT programs in the Ohio prisons, for instance, are run through the Partnership for Violence Free Families, a regional coalition of 50 groups that works to support healthy communities through public awareness, education and prevention.
Like other ACT program sites, ACT in prisons focuses its information on children from infancy to age 8. While parents often understand the physical developmental stages of childhood, many are unfamiliar with the psychological stages of development — for example, when children are first able to distinguish between real and pretend information or empathize with others' feelings.
Facilitators work with prison staff to make sure that ACT classes complement existing prison programs and schedules. Inmates can take the classes any time during their prison stay, and programs are offered several times a year.
Over the years, ACT programs have reached more than 1,500 inmates, a number that APA ACT National Director Julia da Silva would like to increase because of the clear need for the program.
"Doing this program while they are still in prison gives inmates an urgency in terms of, ‘I need to be better, I want to get out of this, I don't want to come back to this,'" she says.
The program's interactive, hands-on activities work well in engaging the parents, even if they don't outwardly show it, Dickman adds. "Sometimes you get inmates who act like they couldn't care less, and you wonder why they're sitting in there," she says.
One man, the father of a young son, showed little interest in an exercise that asked inmates to shape pipe cleaners in ways that expressed their hopes and dreams for their children. Despite his seeming apathy, he proceeded with the project anyway, braiding together red, yellow and green pipe cleaners.
When the facilitator asked about the design, the depth of his answer surprised her.
"I want my child to know when it's OK to go ahead with what they're doing," he said, pointing to the green pipe cleaner — "when they need to slow down and think about what they're doing," pointing to the yellow pipe cleaner — "and when they need to stop what they're doing" — pointing to the red pipe cleaner.
Other exercises have prisoners play the parts of family members; inflate balloons and then pop them to demonstrate the way anger can get out of hand; and reflect on the ways they were parented themselves and how those experiences influenced their beliefs and actions. Classes include plenty of laughter, as in role-play scenarios in which an adult inmate may agree to play the part of a small child.
To date, there have been no randomized controlled trials of ACT in the prison setting. But a 2011 randomized trial described in the Journal of Primary Prevention shows that ACT programs in general have significant benefits, including a reduction in harsh discipline and greater social support for parents who completed the programs, versus controls. Similarly, a randomized controlled trial in press at the Journal of Community Psychology finds that parents who took part in ACT were more likely to use nurturing and other positive parenting behaviors and less likely to use psychological and physical aggression than controls.
Pre- and post-tests at the prisons show similar outcomes, facilitators say. Some inmates, including young fathers, have even gained custody of their children upon release. To increase the likelihood they'll succeed as parents over the long term, da Silva is applying for a grant that would allow facilitators to follow up with this group when they return home.
For facilitators, rewards come in a variety of forms, adds Souza, who works in a hospital unit for pre-term and drug-addicted babies.
During a recent shift at the hospital, she saw a former inmate visiting his newborn twins with the babies' mother.
"He was spouting off word for word to his companion things he'd learned in the class," Souza says. "Hearing that made me feel like even on bad days when nobody wants to listen, that it's somehow worth it."
Tori DeAngelis is a journalist in Syracuse, New York.
