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Two relatively large-scale couple relationship education initiatives have been funded and evaluated by the federal government. Building Strong Families Wood et al. The couples were not identified as having specific relationship difficulties. The results for Building Strong Families appear to be limited, although there is some evidence for a possible impact on conflict in low-income families.

Self-report and observational measures suggest that the Supporting Healthy Marriage Program changed the way participants viewed their marriage, as well as the extent to which they were able to implement the skills taught by the program curricula Cowan and Cowan, A number of smaller programs have shown evidence of success Cowan and Cowan, ; Faircloth et al. One of these programs Supporting Father Involvement works with parents about to have a child.

A consistent body of. This program provides a week group course to either the couple or just the father.

Beyond the health care system, the most widely used approaches to strengthening and supporting parenting are home visiting programs; programs focused on helping parents provide cognitive stimulation in the home through educational activities involving reading, language, and math; efforts at providing parenting education in the context of classroom-based ECE programs; and efforts to increase parent engagement in school settings and school-related activities prekindergarten through grade 3.

The programs vary in their core features e. Because these programs may cost several thousand dollars per participant per year, they often are targeted to those families considered to be in greatest need of additional support. Some programs, such as Head Start, require that families meet income requirements e.

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In addition, as described in Chapter 3 , the actual numbers of families enrolled in these programs represent only a fraction of those who are eligible for them. Prenatal, infant, and early childhood home visiting is a relationship-based mode of service delivery in which a professional or paraprofessional. Home visiting programs have specific goals and range from truly universal programs for new parents in the community in which it is offered to targeted programs that select families based on important descriptive characteristics e.

Visits usually last 60 to 90 minutes and occur regularly over the course of 6 months to 2 years, with some long-term models serving families prenatally through age 5. These relatively intensive services usually are targeted to families with children at the highest risk for poor outcomes and those who are unlikely to enter kindergarten with the preacademic skills needed to make the most of formal schooling. Home visiting services generally are voluntary, although in some cases they may be court mandated for example, in cases of child abuse and neglect.

Although many home visiting programs target pregnant women and mothers, some include fathers in visits, and others provide separate visits for mothers and fathers Sandstrom et al. The roots of home visiting in the United States trace back to nurse and teacher home visiting in 19th-century England Wasik and Bryant, The more than home visiting programs implemented and studied at the state and local levels in the United States during the late 20th and early 21st centuries reflected those public health and education roots as well as an emphasis on prevention of child maltreatment Boller et al.

Programs focused on pregnant women and newborns often were run by public health departments and child welfare agencies, and those focused on ECE or on special education services often were run by a human service or education agency Boller et al. In fiscal year , the federal home visiting program served about , parents and children in all 50 states, the District of Columbia, and 5 territories Health Resources and Services Administration, There are also a number of state-based home visiting programs.

In , the most recent year for which the committee could find data, 40 states reported that they had state-based home visiting programs. Most states supported one or two models Johnson, , with 5 states reporting that they supported three or more, for a total of 70 state-based home visiting programs across the 40 states Johnson, Over the past 20 years, the development of national home visiting programs with national offices and a support infra-. States, counties, and municipalities around the country have implemented different models, some that are branded and have some evidence of effectiveness and some that are home grown and have not been evaluated Johnson, As depicted by the prenatal and early childhood home visiting logic model in Figure , some of the problems home visiting is designed to address include poor birth outcomes low birth weight , child maltreatment, and lack of school readiness.

Historically, funding agencies and communities that developed home visiting programs or selected from existing programs chose models that best suited the needs of the families they served and the particular outcomes they were trying to improve. Regardless of the specific mode, the underlying assumption of these programs is that the home is a comfortable, convenient setting for expectant parents and parents of young children to receive supports and services.

As described below, a growing body of research points to the importance of high-quality implementation such as collaboration among local public and private partners, program developers, and funders and oversight of service provision [training, quality assurance] in achieving impacts on targeted knowledge, attitudes, and practices and child outcomes. Assuming an implementation system that brings families into services and provides high-quality visits as intended, targeted short-term outcomes include decreased parenting stress, depression, and isolation and improved parenting knowledge, attitudes, and practices.

As depicted in Figure , home visiting programs aim to support several evidence-based parenting knowledge, attitudes, and practices identified in Chapter 2. Some programs target household and vehicular safety. Throughout this section, three home visiting models are profiled to illustrate how model activities are linked to outcomes and to highlight examples of the evidence for their impacts on parenting knowledge, attitudes, and practices and child outcomes. Finally, Durham Connects, described in Box , is one of the newer models, focused on universal strategies for ensuring that families receive the services they need, for which two studies were included in the U.

In addition, the legislation identified the specific outcome areas that had to be impacted by the selected programs and the performance measures on which the states would have to report each year, which included positive parenting practices and three child outcome areas—child health, child development and school readiness, and reductions in child maltreatment. Based on a systematic review of the evidence and the application of strict criteria for what counted as evidence adapted in part from the U.

Thus, HHS allowed grantees to choose from existing models but required them to conduct an evaluation. In , 40 models were re-. In either case, impacts must be found for either the full sample or, if found for subgroups only, be replicated in the same domain in at least two studies using nonoverlapping participant samples. For models meeting these criteria based on randomized trials only, significant impacts must be sustained for at least 1 year after participants were enrolled and must be reported in a peer-reviewed journal.

Department of Health and Human Services, Table shows the number of favorable primary positive parent and child outcomes compared with the total number of outcomes reviewed for all of the models reviewed in , , , and It is important to note that the logic of home visiting programs and their evaluations may not always align. As depicted in the generic home visiting logic model in Figure , for example, parenting knowledge, attitudes, and practices are among the hypothesized short-term outcomes en route to the longer-term outcome of child well-being. As seen in Table , positive parenting practices were not measured in the evaluations of some programs; however, this does not necessarily mean that parenting was not part of the program logic model.

In addition to findings from the HomVEE review, this section draws on findings from a paper commissioned by the committee on evidence for investing in parenting programs at scale, which includes six programs that were not included in the HomVEE review. NOTE: The table shows the number of favorable outcomes relative to the total number of outcomes.

Footnotes indicate when the total number of outcomes includes an unfavorable or ambiguous outcome s.

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In accordance with www. While some outcomes are clearly unfavorable, for other outcomes it is not as clear which direction is desirable. HHS has determined that home visiting is not the primary service delivery strategy and the model does not meet current requirements for MIECHV program implementation. Across two studies, the HomVEE evidence review found 11 favorable impacts of PALS Infant on parenting behaviors such as contingent responsiveness and maintaining child foci, although it also found a negative impact on redirecting child foci Landry et al.

The HomVEE review identified favorable impacts of NFP on a number of parenting beliefs and practices, including cognitive stimulation in the home, reductions in dangerous exposures in the home, beliefs, worry, mother-infant interaction, and sensitive interaction across a number of studies Kitzman et al. Among other models with impacts on parenting practices, the specific parenting outcomes affected within and across models vary, even for those programs that share a similar theoretical grounding or logic model. In addition, as can be seen in Table for several programs, the number of outcomes for which no impacts were found is high, exceeding the number of outcomes for which significant impacts were found; moreover, impacts may have been found at one point of measurement but not another.

For example, EHS-HV participants were no more likely than controls to report reading to their children every day at the end of the program. Two years after the program ended, however, participants were significantly more likely than controls to say that they read to their children daily Jones Harden et al. The effect of Getting Ready on child outcomes was not assessed. Overall, while many individual evaluations of home visiting programs have shown impacts on parenting practices tied to positive developmental outcomes, the average impacts of home visiting on parenting practices are not large.

Nor is there a strong pattern of effects on parenting practices across evaluation studies and home visiting models.

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Family economic self-sufficiency Relatively few home visiting programs target or measure effects of home visits on family economic self-sufficiency. Taking into account secondary outcomes i. Department of Health and Human Services et al. Effects for measures of infant health, such as fewer hospitalizations and emergency room visits, were found for both EIP and Durham Connects Dodge et al.

Participation in HANDS was associated with reductions in preterm births and low birth weight across studies Williams et al. Rest Routine, which focuses on reducing infant irritability or colic, a hypothesized precursor to child maltreatment, was found to reduce the number of hours of child crying and some aspects of parenting stress Keefe et al. The MOM Program provides up to 11 home visits to encourage care for the health and development of the baby and use of well-child care and early intervention services if needed Schwarz et al.

The program had an impact on use of early intervention services, but no differences were seen in rates of developmental delays or cognitive outcomes. Parenting knowledge, attitudes, and practices were not assessed. Three programs showed clear evidence of effectiveness: Child FIRST effects on externalizing problems and language problems [ Lowell et al. In the commissioned paper, the University of California at Los Angeles Family Development Project is identified as improving child behavior but not cognitive skills Heinicke et al.

Minding the Baby Sadler et al. Both trials of Family Spirit showed mixed findings across parent-reported behavioral outcomes, including significant reductions in externalizing problems but not in many other similar behaviors Barlow et al. Effects of Healthy Steps on children were not evaluated during the intervention, and no effects were found 2 years after the intervention Minkovitz et al. The program had effects on hospitalizations for accidents and injuries and involvement in child protective services CPS in some sites and follow-ups, but not consistently across sites and studies Administration for Children and Families, b.

The review found improvements in measures of child maltreatment for other programs as well e. HV CoIIN aims to achieve improvement in outcomes in four areas targeted by home visiting programs: breastfeeding, maternal depression, family engagement, and child development. This model is designed to close the gap between what is known from science about what works and what is happening on the ground to achieve results and facilitate the implementation of improved programs Arbour, Faculty are recruited to develop a framework and set of changes expected to improve service quality and outcomes, and teams are then formed to participate in the collaborative including leadership, front-line workers, and end-users.

These teams test changes and adapt them to specific contexts, collect data on a number of indicators over time to demonstrate improvement, and share experiences to facilitate learning Arbour, HV CoIIN is using this approach to build a culture of inquiry and improvement and enhance the implementation of improvements across a number of the home visiting models included in the MIECHV Program and across the participating states.

HV CoIIN is the first national initiative to apply continuous quality improvement CQI methods to evidence-based home visiting programs to improve critical outcomes for vulnerable families with young children ages Participating home visiting teams receive training and coaching in the basic quality improvement skills of rapid-cycle hypothesis testing and data use based on the Model for Improvement.

At the second and third Learning Sessions, teams learned from one another as they reported on successes, barriers, and lessons learned in formal presentations, workshops, and informal dialogue and exchange. Every month, data are displayed on run charts and shared transparently across the collaborative and with state. Its mission also includes developing the means to diffuse the learning and improvements resulting from its efforts more widely within participating organizations and to other MIECHV grantees and home visiting agencies.

During its first phase May August , the collaborative enrolled 12 states and tribes and 33 home visiting agencies using five evidence-based home visiting models serving 3, families. HV CoIIN integrates CQI methodologies into existing evidence-based home visiting programs with the goal of disseminating practices known to work, innovating, achieving results more rapidly, building leaders in quality improvement and sustainability in home visiting, and demonstrating the effectiveness of home visiting in large-scale implementation.

Initial data indicate that the learning and improvements resulting from the HV CoIIN efforts have enabled agencies and staff to change their practices so as to affect behaviors in ways that are associated with quality improvements that support outcomes targeted by the collaborative Arbour, In PALS and My Baby and Me, parents of infants are coached during minute in-home sessions on contingent responsiveness, joint engagement, interactive communication, and emotional support for their children. It is worth noting, however, that while My Baby and Me produced gains for mothers and children when administered from 4 to 30 months of age, PALS administered during the toddler years produced more positive outcomes for children than it did during infancy alone or across both infancy and toddlerhood.

Although changes in parenting behaviors were not examined following treatment, significant child-level effects included improved vocabulary, literacy, numeracy, and general academic skills, as well as inhibitory control and social-behavioral skills. The intervention improved the richness of parent-child conversations and interactive reading activities.

When the children entered kindergarten, significant differences between treatment and control groups included better self-directed learning, literacy skills, and academic performance for those whose parents had received the trainings Bierman et al. Although generally less intensive than the other in-home and workshop trainings discussed above, several dialogic reading interventions Arnold et al.

Experimental evaluations of these interventions have shown them to be effective for improving literacy or language outcomes e. There are several other programs with some evidence of impact. In one randomized controlled study, interactions between high-risk parents and their children over developmentally stimulating, age-appropriate learning material e. In another experimental study, children of mothers who watched a series of short films on talking to children, using praise, using bath time to learn, and looking at books and puzzles, among other topics, followed by discussion with community health workers to encourage mothers to practice the activities with their children, showed significant benefits on measures of cognitive development predictive of academic achievement compared with controls Chang et al.

Language interventions for parents of children with developmental disabilities and delays also have shown an impact. An study meta-analysis found that language interventions implemented by parents had a significant and positive effect on the development of receptive and expressive language skills in children ages months with and without intellectual disabilities Roberts and Kaiser, In another randomized controlled study, Parent-Child Interaction Therapy, which targets child behavior problems. In the Getting Ready for School intervention Noble et al.

The complementary workshops, led by a trained facilitator, focused on teaching parents how to engage with their children at home in activities focused on literacy e. Although parenting behaviors were not measured, compared with children in comparison classrooms, children of parents in the intervention evidenced improved language and literacy as well as applied problem and math concept scores.

There is also some evidence that aligning home learning contexts for literacy with early elementary school literacy learning is valuable, at least for increasing the frequency of literacy activities in the home of socially disadvantaged children. The Family Literacy Program Morrow and Young, , for example, encouraged parents to create home centers for parent-child literacy activities that paralleled 1st- to 3rd-grade classroom centers, while also encouraging reading daily, sharing stories, and writing journals together.

Parents were guided through monthly group meetings and one-on-one mentorship. In an experimental study, according to parents and children, in-home literacy activities increased in the intervention group relative to controls, and teacher-rated literacy ability and interest improved, although no improvements were evident on a standardized reading assessment. There is also evidence that transmedia interventions—focused on media content delivered across multiple platforms e.

From to , the U. In addition, the study report indicates that children participating in the intervention exhibited statistically significant improvements in the mathematics skill areas of ordinal numbers, spatial relationships, and 3-D shapes compared with children in the nontreatment group. Important study limitations, however, included reliance on parent self-reports, selection bias, and inadequate assessments targeted by the study experience. Findings indicated large increases in usage of a reading app after the 6-week intervention with increases due to the behavioral tools rather than the increased information.

ECE programs provide full- or part-time classroom-based services center or family child care for children from birth to age 5. ECE programming that involves parents can be structured in several different ways, including 1 comprehensive two-generation programs with components that include multipronged, intensive classroom-based services for children, parenting education, and parent self-sufficiency support as in Head Start, Early Head Start, and Educare ; 2 primarily classroom-based services for children with some parenting education services; and 3 primarily classroom-based services for children with some parent self-sufficiency services.

The logic behind ECE programming that involves parents is the potential for additive effects for the child and family. However, coupling ECE programs with parenting com-. Thus, it is important to identify two-generation models likely to generate benefits that justify their added expense and administrative complications.

This section summarizes findings from studies evaluating how ECE programs support parenting and healthy child development. The committee was unable to identify clearinghouses or reviews of classroom-based ECE programs that included parenting supports and thus drew on rigorous studies published in the peer-reviewed literature.

Head Start and Early Head Start are rigorously evaluated two-generation programs. A brief description of both programs and numbers of families served can be found in Chapter 3. Parent policy councils and center committees also provide opportunities for parents to participate in program leadership. Services are intended to be responsive to the needs and cultural and linguistic heritage of families in the communities served Administration for Children and Families, Parental engagement and service take-up, which have become a focus of attention because of the cost of nonparticipation and the potential impact of nonengagement on school readiness outcomes, are far from percent Administration for Children and Families, d.

Attendance at goal-setting classes also was significantly higher for Head Start than for non-Head Start parents,. Head Start impacts on knowledge, attitudes, and practices and child outcomes Puma and colleagues provide a random-assignment evaluation of parenting impacts in the National Head Start Impact Study. Parenting-related measures included disciplinary practices, educational supports, parenting styles, parent participation in and communication with the school, and parent and child time together.

Two cohorts of children those entering Head Start for the first time at ages 3 and 4 were analyzed separately. Looking first at impacts at the end of the Head Start year, in no case did any of the parenting measures differ significantly for the two cohorts of children. Practices for which significant impacts were found for only one cohort included an unexpected negative impact on the amount of time parents reported reading to their children for the 3-year-old cohort and beneficial impacts on spanking, reading, and cultural enrichment for the 4-year-old cohort.

None of the beneficial impacts found at the end of the Head Start year persisted across the kindergarten, 1st-, and 3rd-grade follow-ups, and in no case did safety practices differ significantly between the Head Start and control groups. For the 4-year-old cohort, only 1 of 28 parenting impacts emerged as statistically significant time spent with child in 3rd grade.

For the 3-year-old cohort, there was some indication that parenting styles were more authoritative characterized by high warmth and control and less authoritarian for the Head Start group, although these patterns were seen in less than one-half of the tests conducted. By the end of 3rd grade, the only favorable impact was on reading, and this was only for the 4-year-old cohort. Results in the social-emotional domain differed by both cohort and source of information.

In the 3-year-old cohort, early favorable impacts on social-emotional measures problem behaviors, social skills were sustained through 3rd grade based on parent-reported measures, but data reported by teachers suggested. No social-emotional impacts were observed in the 4-year-old cohort through kindergarten, while favorable impacts were reported by parents and unfavorable impacts by teachers at the end of the 1st and 3rd grades. There was strong evidence of improved receipt of dental care at the end of the Head Start year in both cohorts Puma et al.

One of the challenges of programs that include both direct and indirect pathways to child outcomes is the inability to assess the extent to which observed impacts are the result of any one component of the intervention. It is impossible to know in this case whether the parenting impacts noted scattered as they were had any role in the observed impacts on child outcomes. Nonexperimental analyses could provide exploratory answers to these types of questions. Early Head Start center-based impacts on knowledge, attitudes, and practices and child outcomes Evidence of the impact of Early Head Start on parenting comes from the Early Head Start Research and Evaluation Project, a large-scale randomized evaluation following 3, children and families in 17 community sites.

A random-assignment evaluation of Early Head Start in four center-based programs found one positive impact of the program on the quality of parent-child play when the children were age 3 and one negative impact on parent knowledge of how to use a car seat correctly U. Mothers in the Early Head Start group reported lower levels of severe depression and were more likely than controls to be employed or in an education or training program.

Overall, none of the other many parenting, parent well-being, home, and self-sufficiency outcomes studied was affected by Early Head Start among the families in the center-based sites. With regard to child outcomes at age 3, children in the Early Head Start group were less likely to show negativity toward their parent during a parent-child play task. There were no other impacts on child outcomes for the Early Head Start center-based group. At age 3 and beyond, analysis indicated that among the three service delivery approaches, sites employing the mixed approach tended to have the greatest concentration of impacts with respect to both parenting and child outcomes.

These findings may have implications for the need for increased flexibility in programming that allows families to shift from one mode of service delivery to another as their needs change.

Other classroom-based ECE programs that include parenting supports also have some evidence of effectiveness and provide insights into ways to reach parents. In some cases, these targets are complemented by attempts to improve alignment between home and classroom learning contexts.

The Kids in Transition to School KITS Program is a short-term, targeted, evidence-based intervention aimed at increasing early literacy, social skills, and self-regulatory skills among children who are at high risk for school difficulties. This program provides a session readiness group for children that promotes social-emotional skills and early literacy as well as a session parent workshop focused on promoting parent involvement in early literacy and the use of positive parenting practices.

In a pilot efficacy trial with 39 families, Pears and colleagues found that children in families who received the KITS intervention demonstrated early literacy and social skill improvements as compared with their peers who did not receive the intervention Pears et al. In randomized controlled studies, foster children who received the intervention exhibited improvements in social competence, self-regulation skills, and early literacy skills Pears et al.

One class of early intervention programs uses a two-generation approach with an explicit focus on human capital skill building. As described by Chase-Lansdale and Brooks-Gunn , p. Early versions of these kinds of two-generation programs focused on adolescent mothers, providing them with a host of education- and job-related services. Developed during a time when the nation was focusing on welfare reform and had not begun to appreciate the potential of high-quality early childhood education programs with respect to skill building for children, these programs typically viewed child care services as a means of supporting the self-sufficiency efforts of mothers rather than promoting the school readiness of their children.

Project Redirection was the earliest. It offered education and training programs for low-income adolescent mothers combined with intensive support services that included individual counseling, training in parenting and employability skills, and referrals to community services. Evaluations of the other three programs were based on random assignment and showed a less positive set of impacts Granger and Cyrton, In terms of parenting knowledge, attitudes, and practices, the New Chance Demonstration provided parenting education designed to promote positive parenting practices and better mother-child relationships and to reduce the stresses associated with parenthood.

The Teen Parent Demonstration also included parenting workshops. Maternal mental health was assessed in evaluations of New Chance and the Teen Parent Demonstration, but in neither case did the program improve scores on the mental health measures employed. Moreover, mothers in the New Chance Demonstration experimental group reported significantly more parenting stress relative to their control counterparts. In fact, New Chance mothers reported higher rates of child behavioral problems relative to their control group counterparts.

Pierre et al. Services were intended to extend from birth through kindergarten or 1st grade but, in contrast to Head Start and some Early Head Start programs, were not built on a high-quality classroom-based program for children. CCDP service delivery relied heavily on case managers and appeared to be implemented effectively St.

Most sites offered biweekly home visits by a case manager or early childhood specialist between birth and age 3 in which training was provided to parents on infant and child development and, in some cases, modeling of ways to interact with children. Nor did consistent impacts emerge for any demographic subgroups or among the families that participated in the program for most of the service period.

In contrast to CCDP, the Child-Parent Center CPC Program in Chicago is a center-based early intervention program that offers comprehensive educational and family support services designed to increase academic success among low-income children ages residing in disadvantaged Chicago neighborhoods University of Minnesota, CPC employs a number of components directed at children and parents to meet the program objec-. In effect, these programs view ECE as an important and independent source of human capital training for children rather than merely a means of providing child care in order to promote the careers of mothers.

ECE is coupled with postsecondary workforce skill development for parents, with training taking place in community colleges, job training programs, or workplaces. The theory of change behind these models is focused on the education benefits to children of high-quality ECE programs and higher parental levels of education and labor force motivation. Parenting knowledge, attitudes, and practices may be improved, but the improvement comes indirectly through higher parental job skills and education and reduced household stress rather than explicit programming directed at parenting skills.

To date, implementation studies have shown promise for the program in addressing the quality gap of service delivery and parent engagement. A randomized controlled trial currently under way is comparing children at age 3 who are cared for at home or in other settings with. No strong evidence on program impacts is available, however, so it is impossible to determine whether this new generation of programs will change parenting knowledge, attitudes, and practices or improve child well-being.

A brief summary of two ECE programs developed in the latter half of the 20th century, in which children assigned to comparison groups faced different and often worse conditions than they do today, is provided in Box These practices may include participation in school functions e. Theory on parent engagement is built largely on ecological systems frameworks, particularly those focused on how aligning child, family, school, and community assets can help promote positive development in.

For a review, see Dearing and Tang As noted in a recent review of parent engagement programs, policies, and practices Sheridan et al. Studies have found that specific parent involvement behaviors, such as participation in school activities and direct communication with teachers, are linked to higher academic achievement in both reading and mathematics El Nokali et al.

Furthermore, parent involvement in the home, such as monitoring assigned homework and participating in learning activities, as well as having conversations with their children about school, is linked to higher reading and writing scores and report card grades. Many attempts have been made to improve parent engagement through interventions in the home and through home-school connections.

About Silvereye Services Contact. Advanced Search Alphabetic Publishers. Goali Saedi Bocci Description. Related Titles Transforming Stress for Teens. Adalyn's Clare. Worries Are Like Clouds. The Worry Workbook for Kids. In the book's three major parts, Bradshaw distinguishes healthy from unhealthy secrets, proffers a tool for self-ascertainment of family secrets, and counsels those who unearth dark secrets on what to do with their discoveries.

In an appendix, he distinguishes the much-publicized phenomenon of repressed memory from false memory syndrome. The latter, he says, though vociferously advocated by those victimized by family members claiming to recall incest and other enormities, has not been clearly defined by clinicians. He does not, however, clearly indicate what clinicians like him mean when they say, as he does in "A Final Word of Caution," "The traumatic abuse of children by their guardians and relatives occurs with great frequency.

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It is organized into daily twenty-minute exercises initiated by each spouse on alternating days. Because this tragic situation is not easily resolved, this workbook is a must to get couples on the road to healing and oneness. In Torn Asunder, Dave Carder provides an overall recovery process from sexual and non-sexual affairs. Infidelity is at crisis level even within the church.

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With innovative new research and experiential, reflective materials, this practical workbook will serve as an excellent tool both for the general public and therapists. Patrick Carnes offers a way for addicts to deal with their sexual compulsions and become whole human beings. This is the landmark book introducing and legitimizing sexual behaviors and sexual fantasies as an addictive disease. Carnes proposes three levels of sexual addiction, describes the addiction cycle and its progression, and presents the faulty core beliefs of the addict and the coaddict and their healthy counterparts.

Divorce, employee relations, litigation of any type, incest and child abuse, family and marital systems, domestic violence, hostage negotiations, kidnapping, professional exploitation and religious abuse are all areas of trauma bonding. All these relationships share one thing: they are situations of incredible intensity or importance where there is an exploitation of trust or power.

Patrick Carnes presents an in-depth study of these relationships: why they form, who is most susceptible, and how they become so powerful. He shows readers how to recognize when traumatic bonding has occurred and gives them a checklist for examining their own relationships. He then provides steps readers can take to safely extricate themselves or their loved ones from these relationships. Readers will return to this book again and again for inspiration and insight, while professionals will find it an invaluable reference work.

Clinical Management of Sex Addiction Oct. Collecting the work of 28 leaders in this emerging field, the editors provide a long-needed primary text about how to approach treatment with these challenging patients. The book serves as an excellent introduction for professionals new to the field as well as serving as a useful reference tool.

The contributors are literally the pioneers of one of the last frontiers of addiction medicine and sex therapy. With a growing awareness of sex addiction as a problem, plus the advent of cybersex compulsion, professional clinicians are being confronted with sexual compulsion with little clinical or academic preparation. This is the first book distilling the experience of the leaders in this emerging field. With a focus on special populations, it also becomes a handy problem-solving tool. Readable, concise, and filled with useful interventions, it is a key text illustrating a problem clinicians must be able to identify.

It is destined to be a classic reference. Destroyed marriages, damaged relationships, career loss and financial ruin are common outcomes. Equips us with specific recovery strategies for recognizing and handling addictive behavior. Readers addicted to cybersex will know they're not alone -- and know that recovery is possible -- by the personal stories in this groundbreaking book.

Author Patrick Carnes is a well-known, widely respected expert in sexual addiction treatment. Patrick Carnes' extensive field research. Now, along with Debra and Mark Laaser of the National Council for Couple and Family Recovery, Carnes distills that data into a compelling, compassionate and ultimately joyful guide to supportive intimacy.

Packed with practical ideas, anecedotes and dialogue-sparking exercises, this book is written with Carnes' trademark warmth, personal honesty and inspiring insight. It is a workbook for those struggling with communication, parenting, finances or sex teaches relationship skills drawn from the lives of couples shattered by the ultimate betrayals of sex addiction; offers a hopeful path to any couple seeking healthy and fulfilling intimacy. Learn how to: overcome 'coupleshame,' fight fair, understand your family 'epics,' set healthy boundaries, break free from the same old battles, form a spiritual bond and renew your early passion -- through revealing exercises, honest insight and personal stories of others in recovery.

Author Dr. Patrick Carnes begins by defining sexual anorexia and demonstrating how it and its parallel disorder, sexual addiction and compulsivity, often arise from a background of childhood sexual trauma, neglect, and other forms of abuse. Carnes explores the numerous dimensions of sexual health, examining key issues which must be addressed and resolved for recovery to proceed. Utilizing extensive research and elucidating case studies, Carnes develops concrete tasks and plans for restoring nurturing and sensuality, building fulfilling relationships, exploring intimacy, and creating healthy sexuality.

Woven throughout the book are stories of recovery which illustrate sexual healing principles, model new behavior, and support motivation for change. Drawing on numerous interviews and real-life scenarios, and written with humor, insight, and wisdom, this book offers guidance for all of us who want genuine, sustained intimacy with our romantic partners.

Redefine your personal goals away from "image fixes" such as money, expense accounts, power and glamour and an outdated mythology of winners, players, limitless credit cards and Horatio Alger. This book can help you: 1 Recognize early warning signs of the commitmentphobic man; 2 Determine the extent of his fears -- and his willingness to change; 3 Analyze your own role in the situation; and 4 Avoid unnecessary stress and heartache. This book is for those in recovery who seek to enjoy the miracle each day brings.

Exploring intimate, coupled relationships among men, especially among gay men, the author celebrates embodied, sensual, sexual goodness of men's sexual relationships, while adamantly rejecting an "anything goes" approach to gay male sexuality or to sexuality in general. The author proposes an ethics of sexual accountability in-relation as a middle ground between those who espouse anonymous multi-partnered sex as the crux of gay identity and those whose current sex panic resounds with sex-negativity. The author clearly leads the student, day-by-day, using Biblical examples and amazing personal testimonies from previous students, to habitual freedom from sexual immorality.

This text is based on an interactive web-based course of the same name, Pure Freedom, which can be found at SettingCaptivesFree. The principles in this book can break the secret addiction that has ruined so many lives. The book isn't about snapping your wrist with a rubber band or going back to your childhood to find out why it's someone else's fault; it's about Jesus Christ and how to practically apply His truth to your life!

You don't have to be a "recovering addict" the rest of your life; reading and studying this book will show you how to be free forever from Satan's trap. Often the source of this pain lies buried in patterns of behavior that we learned as children and continue to practice today. Because or poor parenting or childhood trauma, our growth toward maturity slows or stops entirely. To become mature image-bearers of God, says Dr.

Henry Cloud, we most learn to do four things: bond to others; separate from others boundaries ; accept both the good and bad in life; and take charge of our lives. All of us must accomplish these things to heal our inner pain and to enable us to function and grow emotionally and spiritually. In "Changes That Heal," Dr.


Cloud explains each of these needs. Then he identifies problems that arise when they are not met, and shows what changes to make to bring healing. With solid scriptural insights, Changes That Heal helps listeners form healthy relationships with themselves, others, and God -- relationships that will bring new richness and purpose to life. Cloud's groundbreaking book, plus give you practical suggestions for discovering the answer to the following questions and more.

What are the four basic tasks of becoming mature image bearers and more? How do I accomplish these tasks? What problems result because of failure to accomplish these tasks? What changes do I need to make in my life In order to bring about healing? Once you've learned and accomplished the four basic tasks that are absolute necessary for emotional and relational stability, you'll have learned to: bond to others; separate from others; sort out good and bad in yourself and others; and become an adult. Henry Cloud and Dr. John Townsend don't think so.

They maintain that avoiding dating isn't the way to cure the problems encountered in dating. The cure is the same as the Bible's cure for all of life's problems: as we grow spiritually, we will mature. The way to a better dating relationship is by learning how to love another person, learning how to follow God, how to be honest and responsible, how to treat others as you would want to be treated, and how to develop self-control.

We've been abandoned or taken advantage of, and left with little to show for what we've given. We've lost our sense of security and personal value in the process. And what's worse, we tend to either repeat the same mistakes of judgment over and over Or else lock the doors of our hearts entirely and throw away the key. Why do we choose the wrong people to get involved with?

Is it possible to change? And if so, where does one begin? Henry Cloud and John Townsend offer solid guidance for making safe choices in relationships, from friendships to romance. They help identify the nurturing people we all need in our lives, as well as ones we need to learn to avoid. Safe People will help you to recognize 20 traits of relationally untrustworthy people.

Discover what makes some people relationally safe, and how to avoid unhealthy entanglements. You'll learn about things within yourself that jeopardize your relational security. And you'll find out what to do and what not to do to develop a balanced, healthy approach to relationships. It's filled with pointed assessments, insights, questions for thought and discussion, and principles for you to put into practice in your relationships with others. Your longing for a marriage marked by lifelong love, intimacy, and growth can be yours if you set wise boundaries.

By the time you've completed this workbook, you will know yourself and your mate better than ever before. You'll also understand and practice the ten laws of boundaries in ways that can make a real difference in your relationship. Step by step, the Boundaries in Marriage Workbook helps you apply the biblical principles discussed in the book Boundaries in Marriage so you can Set and maintain your personal boundaries and respect those of your spouse -- Establish values that form a godly structure and architecture for your marriage -- Protect your marriage from different kinds of "intruders" -- Work with a spouse who understands and values boundaries, or work with one who doesn't.

Filled with self-tests, questions, and applications, the Boundaries in Marriage Workbook helps you deal effectively with the friction points and serious hurts in your marriage -- and move beyond them to the mutual care, respect, affirmation, and intimacy you both long for. A boundary is a personal property line that marks those things for which we are responsible. In other words, boundaries define who we are and who we are not. Boundaries impact all areas of our lives: Physical boundaries help us determine who may touch us and under what circumstances.

Mental boundaries give us the freedom to have our own thoughts and opinions. Emotional boundaries help us to deal with our own emotions and disengage from the harmful, manipulative emotions of others. Spiritual boundaries help us to distinguish God's will from our own and give us renewed awe for our Creator.

Cloud and Townsend, this is a psychological survival manual that will give you biblically based answers to questions you have about setting and maintaining boundaries. Used with its companion book, Boundaries, this workbook will provide practical, non-theoretical exercises that will help you set healthy boundaries with parents, spouses, children, friends, co-workers, and even yourself Being a loving and unselfish Christian does not mean never telling anyone no.

This workbook helps you discover what boundaries you need and how to avoid feeling guilty about setting them. It will give you biblically based answers to questions you have about boundaries. Because two lives becoming one is easier said than done. How do you work out conflict, establish healthy communication, solve problems, and deal with the struggle of differing needs? In the process of knitting two souls together, it's easy to tear the fabric. You long for a marriage marked by lifelong love, intimacy, and growth.

And it can be yours - if you set wise boundaries. Boundaries are the "property lines" that define and protect each of you as individuals. Get them in place and you can make a good marriage better and possibly even save a less-than-satisfying one. Chemical Dependency and Intimacy Dysfunction A comprehensive text on the topic, it demonstrates how chemical dependency, sexual dysfunctions, and inappropriate touching are symptoms of intimacy problems.

The reader is taught the relationship between the symptoms and the core issues; issues that must be resolved if recovery is to be complete. Experts in the fields of chemical dependency and human sexuality provide answers to pressing questions regarding the relationship between chemical dependency and intimacy dysfunction and treatment for individuals and families. Because many chemical dependency professionals are unaware of intimacy problems, are unwilling to discuss them, or have not received sufficient training to evaluate and treat the problems, this book provides professionals with information and skills to deal with these issues with the hope of improving treatment and rehabilitation of addicted individuals and their families.

Emotional Unavailabity takes an upbeat, inspiring look at why people form such painful associations and empowers them to find authentic emotional connections. Through real-life examples, quizzes, and easy-to-understand text, readers will learn how to identify the 10 types of emotionally unavailable people to avoid -- the Romeos and Romiettes, the Indiana Joneses, the Tens, the Emotional Einsteins, and the Eels, among others Intimacy, Control and Manipulation, Interpersonal Relations Collins, Bryn C How to Recognize Emotional Unavailability and Make Healthy Relationship Choices In this groundbreaking book based on her extensive clinical experience, psychologist Bryn Collins discusses life with an emotionally unavailable person.

She uses case studies, quizzes, and down-to-earth awareness to profile the most common types of emotionally unavailable partners, and offers the skills you need to change these painful associations. Collins explores the common problem of emotional unavailability from a fresh, practical, and non-judgmental viewpoint. She explores why we enter painful, frustrating relationships, and how we can make positive changes without blaming ourselves. The book covers: types of emotion unavailability; how and why people are unavailable; patterns of thought and how they control events by controlling expectations; tell-tale signs; understanding why you get drawn in; and how to change and grow beyond emotional unavailability.

Cybersex: The Dark Side of the Force: A Special Issue of the Journal Sexual Addiction and Compulsivity X Presents an empirical foundation for discussing cybersex compulsivity, online pornography and the affects on the mental health of individuals, couples, teens and young children. A crucial resource for sex therapists, who until now had no rigorous study of the effect of online pornography on the patients they treat.

Sex and the Internet: A Guidebook for Clinicians Sex and the Internet is the first ever professional book on the fascinating and revolutionary area of internet sexuality. With many disturbing questions raised by sex and the internet, here is a clinician's guide that addresses these concerns by both informing and providing practical and concrete suggestions and directions. Contributions by international compilation of experts in the field of sexuality keeps on course with pertinent and relevant material.

Unable to make connections in your daily life that could anchor you in love and friendship? Learn to take stock of your strengths, create the right kind of change, and develop a circle of support that can sustain you through difficult times. Alone time can relieve stress, build character, and serve the necessary function of providing a time-out from this hectic worlk. But too much time alone can make our lives unduly hard, and lead us to feel unloved and unwanted. In this comprehensive guide to relieving loneliness, distinguished writer and lecturer Mary Ellen Copeland creates a practical program for assessing personal strengths and using them to bring connection into our lives.

Based on an extensive study of former loneliness sufferers, The Loneliness Workbook helps us learn to identify our assets as well as our relationship inhibitors, develop relationship skills, practice loneliness-relieving excercises, reach out for support, join with others, and create intimacy. Through the inspiring testimony of those who hwave overcome loneliness, we are encouraged to implement our very own plan of action and bring about the kinds of lasting changes that will fill our lives with love and support. Christine Courtois is a gifted and highly brilliant writer and speaker.

Her books are highly truthful and revealing about sexual abuse and exploitation of children and adolescents. She also writes about the resulting psychiatric illnesses, particularly, in the worst possible of all cases, Multiple Personality Disorder, with extreme compassion, knowledge and sensitivity. She writes about incest with intelligence, good taste and limitless compassion. Traditional time management suggests that working harder, smarter, and faster will help you gain control over your life, and that increased control will bring peace and fulfillment.

The authors of First Things First disagree. In the first real breakthrough in time management in years, Stephen R. Covey, A. Roger Merrill, and Rebecca R. Merrill apply the insights of The 7 Habits of Highly Effective People to the daily problems of people who must struggle with the ever-increasing demands of work and home life. Rather than focusing on time and things, First Things First emphasizes relationships and results.

And instead of efficiency, this new approach emphasizes effectiveness. Covington, coauthor of Leaving the Enchanted Forest: The Path from Relationship to Intimacy HarperCollins, , offers this guide for women recovering from abuse, addiction, or dysfunctional relationships. She uses case histories mixed with practical suggestions on how to change past behavior and work toward healing. Particularly helpful are her appendixes, which discuss the sexual response cycle and women and AIDS. Bibliographies and resources are also included.

Although titles on recovery proliferate, this book fills an important niche. Advice, step-by-step guidelines, and a clear, practical guide to recovery for those who want to understand the nature of addictive relationships and are ready to embrace genuine intimacy, the gift of recovery.

It is full of insight and the testimonials of gay men in recovery make it easy and enjoyable to read. Many gay men are making remarkable journeys as they recover from addiction, whether it be to alcohol, drugs, food, sex, work or unhealthy relationships. The stories and opinions of hundreds of gay men provide the core of this book about the ascent out of compulsive behavior and the discovery of a fulfilling life. The author examines the struggles and successes of gay men overcoming addiction and compulsive behaviour.

Direct and honest, Kettelhack provides a sense of what it's like for gay men to overcome crippling self-hatred as he examines the challenges, triumphs, and setbacks they face in dealing with compulsive behaviour and addiction. Writing from his own experiences as a recovering alcoholic, the author provides guidance for the road to recovery. This is one of the good ones. They are silent sins. And therefore some of the most difficult to conquer. Facing those sexual temptations daily, sometimes unfaithful in thought or deed, persistently assaulted by world, flesh, and the Devil, can men today possibly win the war for sexual purity?

This courageous book offers a resounding "yes! This no-nonsense book -- complete with discussion questions -- will take you to a new level of purity, as well as encourage you that in this terribly private struggle, you are never alone. Not a day goes by without our being called upon to help one another-at home, at work, on the street, on the phone Great for someone needing to know about child sexual abuse but is not prepared to read a huge book.

The workbook is a combination of checklists, open-ended questions, writing exercises, art projects, and activities. Often this wound lies hidden in the silent chambers of our hearts for years and undermines our ability to have nurturing, comfortable relationships. In this book, you will find a way out of the pain toward a place where you can heal and form confident, mature relationships. Heartwounds is an experiential guide for exploring this minefield of painful memories and emerging beyond them with new energy for resolution and growth. Noted clinical psychologist Dr. Tian Dayton clearly outlines the impact of unresolved trauma and grief on both the personality and on relationships.

Through vivid case studies and probing exercises, this book opens our hearts and minds to a deeper meaning and purpose in life and allows us to connect with others in real rather than superficial ways. Heartwounds is about turning wounds into wisdom so that the lessons learned from painful circumstances can lead to a more satisfying life and healthier, more peaceful and joyful relationships.

Since trauma responses are stored in the body, a method of therapy that engages the body through role play can be more effective in accessing the full complement of trauma-related memories. This latest book identifies the interconnection of trauma and addictive behavior, and shows why they can become an unending cycle. Emotional and psychological pain so often lead to self-medicating, which leads to more pain, and inevitably more self-medicating, and so on -- ad infinitum.

This groundbreaking book offers readers effective ways to work through their traumas in order to heal their addictions and their predilection toward what clinicians call self-medicating the abuse of substances [alcohol, drugs, food], activities [work, sex, gambling, etc. Readers caught up in the endless cycle of trauma and addiction will permanently transform their lives by reading this book. Therapists treating patients for whom no other avenue of therapy has proved effective will find that this book offers practical, lasting solutions. Case studies and examples of this behavioral phenomenon will illustrate the connection, helping readers understand its dynamics, recognize their own situations and realize that they are not alone in experiencing this syndrome.

The author deftly combines the longstanding trauma theories of Van der Kolk, Herman, Bowlby, Krystal and others with her own experiential methods using psychodrama, sociometry and group therapy in the treatment of addiction and posttraumatic stress disorder. While designed to be useful to therapists, this book will also be accessible to trade readers. It includes comprehensive references, as well as a complete index. Quizzes, lists, and anecdotes render De Angelis's sensible material in easy-to-swallow morsels.

Early on, readers are asked to make lists of past lovers' worst qualities and then to write a want ad for a partner, highlighting the common themes "WANTED: Self- absorbed, damaged loser who has lots of potential and is doing nothing with it Readers count off "the seven wrong reasons to be in a relationship" from "sexual hunger" to "emotional or spiritual emptiness" ; "nine fatal flaws to watch out for in a partner" addiction, control-freak tendencies, sexual dysfunction ; seven compatibility time-bombs, etc.

Although the majority of the text deals with negatives, going on the theory that recognizing self-destructive habits is the major step toward overcoming them, De Angelis comments briefly on the attitudes and flexibility necessary for change. Those unsure of whether to commit may value the elaborate self-test offered here, leading to a numerical assessment of compatibility.

Given a tolerance for lists and comfort with an approach that precludes subtlety, readers with histories of unhappy relationships may gain insight from this solid, well-organized advice. But the use of sex on the Internet is skyrocketing, and anyone caught up in the spell of Internet sex knows its intense and seemingly irresistible power to undermine careers, upend relationships, and create emotional chaos.

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This frank, compassionate, and practical workbook offers a hope-filled plan for breaking free of compulsive cybersex, one that enables those entrapped to regain control of their relationships and their lives. Easy to follow exercises serve as a guide for confronting and understanding cybersex behavior and lead the way to change, personal growth, and a life free of cybersex's intoxicating and destructive spell.

No matter how mild or severe the problem, this book can be a guide back to the real world of relationships. A must read both for those with concerns about their own Internet usage for sex and for family and friends trying to support them. Looking for Love gives excellent descriptions of Love addiction and provides direction for those people who are in relationships with Love addicts. Diamond describes some characteristics of a Love Addict, and most important offers solutions for healing and help. Diamond also offers understanding of this addiction yet urges the reader that this addiction does not go away on its own.

He emphasizes that seeking awareness and help is the only way to recover. The book provides a very good description of Healthy Love and Addictive Love by putting them in a contrasting format. In this groundbreaking and much-lauded book, author Jed Diamond shows that male menopause involves dramatic chemical and physiological changes that affect everything from a man's view on life to his ability to attain and maintain an erection. As featured in public television specials by the same name, Male Menopause surveys the most current medical data and listens to men and women as they struggle to arrive healthy and happy in the second half of life.

In his earlier book Male Menopause, Jed Diamond exposed the worldwide reality that the often-joked-about phenomenon of "male menopause" is indeed a medical, psychological and emotional fact of life for millions of men. Diamond's new book offers guidance to and tells the stories of those perhaps as affected by male menopause as men -- women.

Surviving Male Menopause examines the most current medical happenings, then focuses more strongly on the emotional, personal side of this life passage. Its effect on relationships and on the individuals involved is unmistakable.