Academic journal article Family Relations

Impact of Home-Based Family Therapy on Maternal and Child Outcomes in Disadvantaged Adolescent Mothers

Academic journal article Family Relations

Impact of Home-Based Family Therapy on Maternal and Child Outcomes in Disadvantaged Adolescent Mothers

Article excerpt

This study evaluated home-based family therapy. The clients-116 high-risk, urban, disadvantaged teenage mothers and their children--received case management and supportive counseling or these services plus family therapy. At the 12-month followup, the family therapy clients were less dependent on welfare and had improved more on all 3 parenting dimensions, but at 24 months there were no significant differences between the groups.

Over one million adolescents become pregnant in the United States each year, and nearly half end up giving birth (Ketterhuis, Lamb, & Nitz, 1991). The direct costs of adolescent pregnancy and childbirth, based on government expenditures for AFDC, food stamps, and Medicaid, were over $25 billion in 1995. The human costs are of even more concern than the economic ones. Teenage births often have an adverse effect on infants' health outcomes, and they also often have a negative impact on the teen mothers' developmental, educational, and occupational outcomes (Bureau of Vital Statistics, 1990; Hayes, 1987; Trussell & Menken, 1978). Children of teenage parents are more likely than children of older parents to experience developmental difficulties during their early years and, when they enter school, their educational achievement tends to be lower (Brooks-Gunn & Furstenberg, 1986; Hofferth, 1987).

Although teen pregnancy and parenting is, in general, associated with poor outcomes for the teen mother and child, there is still great variability in outcomes within the population of adolescent parents. Some teen parents, usually those with substantial family support, finish high school, delay future pregnancies, meet the basic needs of their infants, and become financially independent adults (Furstenberg, Brooks-Gunn, & Morgan, 1987). At the other extreme, however, are the adolescent parents who encounter all the worst outcomes (e.g., school failure, dependence on welfare, repeat pregnancies in rapid succession, and failure to care adequately for their children).

The most salient characteristics of the least successful teen parents include very low levels of family and social support, poor school performance, and depression (Colletta, 1983; Troutman & Cutrona, 1990; Turner, Grindstaff, & Phillips, 1990). Depressed young parents are less likely to finish school (Linares, Leadbeater, Kato, & Jaffe, 1991) and are less likely to have nurturant relationships with their babies (Colletta, 1983; Field, 1984). Indeed, maternal depression may be related to the high incidence of developmental and behavioral problems experienced by many children of adolescent parents. Depression, school performance, and social support are clearly interrelated variables (Turner, 1981; Turner et al., 1990). Adolescent parents who feel supported and aided by their families are much less likely to be depressed, much more likely to finish school and, with their family's help, more likely to meet the needs of their infants.

It is important, therefore, when devising intervention strategies for teen parents, to identify the different levels of need. Whereas a teen parenting and support group might be sufficient for higher functioning adolescents, more intensive individual and family-focused treatments will be required for depressed teens from unsupportive and dysfunctional families. The intervention programs for teen parents and their children that have been established and evaluated during the past decade (Barnard et al., 1988; Burt, Kimmich, Goldmuntz, & Sonenstein, 1984; Kuziel-Perri & Snarey, 1991; Landy, Grey, & Walker, 1988; Miller & Dyk, 1991; Musick, 1993; Polit, 1989; Polit & Kahn, 1985) have been open to all teen parents and have had mixed results. One reason for these mixed results may be that these programs have failed to address the different levels of need within their population. Another reason might be that they have focused on the teenage mother and her baby and have not targeted other members of her family or social support system. …

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