At the end of 2001, Hendrick succeeded Regier as cabinet secretary for Health and Human Services and used his agency to continue leadership and support for the initiative, guiding its evolution and eventually its full-scale implementation. Hendrick strongly believed that marriage education services had great potential as a vehicle for the kind of change sought by the initiative. With funding secure and a clear direction for implementation, the OMI embarked on an intensive set of activities, aimed primarily at defining the services that would be provided and developing a system for delivering them. The initiative took its first steps toward implementation of services in 2001.
Curriculum selection: PREP®. In January 2001, Oklahoma selected the Prevention and Relationship Enhancement Program (PREP®) as its core curriculum, after a search of the literature and research on curriculum effectiveness. PREP®s developers, Drs. Markman and Stanley, were known to many academics and professionals in the marriage, relationship, and counseling fields, so OMI leaders thought their involvement would enhance acceptance of the initiatives marriage education strategy among those groups. OMI leaders also expected that using a single curriculum would simplify the adaptation of materials for alternative settings and audiences, and that it might promote coherence and uniformity in the initiatives activities and messages.
PREP® is a research-based 10 to12 hour educational curriculum that teaches skills and principles associated with healthy relationships and marriage. The curriculum takes an educational rather than a therapeutic approach. It aims to help couples:
- Develop and use constructive communication and conflict management skills
- Clarify and modify unrealistic beliefs and expectations about relationships and marriage
- Maintain and enhance fun, friendship, and spiritual connection in intimate relationships
- Develop ground rules for handling disagreements and conflict
- Develop skills to enhance and maintain commitment
A key feature of PREP® is the speaker-listener technique a structured way of communicating akin to active listening, taught to help couples avoid such negative behaviors as escalation and withdrawal. Skills are taught and demonstrated in a classroom format, and couples are expected to practice them in situational role-playing, with coaching by instructors or aides. More recently, some experiential activities have been added to enhance the curriculum and address different learning styles.
The research on which PREP® was based included empirical studies that identified the behaviors and skills associated with healthy and long-lasting marriage. The curriculums effectiveness has been tested in multiple studies, typically with engaged or married white, middle-class couples who participated in small groups with other couples (Markman et al. 1988; Markman et al. 1993). At the time the OMI was formed, no marriage education program had been rigorously evaluated for effectiveness with low-income, diverse populations, with youth, or with singles attending alone (including PREP®) and few had been experimentally evaluated in controlled research designs even with white, middle-class couples.
PREP® was designed for delivery to couples, with both partners attending together. Attending together allows the two partners to learn and practice the skills with each other. In some sessions, communication coaches or co-leaders circulate around the workshop room to ensure that couples understand how to apply the skills during their practice exercises. PREP® has been delivered in a variety of formats, ranging from a single intensive weekend to classes that meet for two hours each week for six weeks.
Initial approach to curriculum deployment. To realize OMIs goals, the initiatives leaders recognized that they needed to continue building public support, develop capacity for providing services throughout the state, stimulate demand, and build awareness of available services. In 2001, they began doing so by arranging for the PREP® developers and others to present the curriculum to large groups of potential partners members of organizations, agencies, and private individuals.
To build the states capacity to deliver services, the initiative began to offer free training to anyone who was interested in providing workshops in their community. This included local professionals such as therapists, pastors, marriage counselors, and social workers, as well as less experienced individuals. These individuals were acting on their own in seeking OMI training, and they were expected to offer the workshops on a volunteer basis during their personal time.
Building on existing infrastructure. At this early stage of development, the OMI also established a guiding principle: it would build on existing infrastructure and systems to deliver marriage education services wherever possible. This approach seemed efficient, allowing the initiative to capitalize on the employees, facilities, and clients of various agencies. Building on existing infrastructure was also a strategic decision to increase the likelihood that the initiative would be sustained over the long term. By partnering with agencies and programs that had their own resources and funding streams, the delivery of relationship education workshops might take on a life of its own independent of the OMIs promotion efforts.
Between 2000 and 2001, in keeping with this principle, OMI leadership first approached three agencies that operated local programs to serve families throughout the state: the Oklahoma State University Cooperative Extension Services, the Child Guidance Program within Oklahomas Department of Health, and the TANF program within DHS. They explored the possibility of training agency staff either to provide the PREP® program to interested couples and individuals, or to refer clients to PREP® workshops. The OMI simultaneously began to develop a system for introducing the initiative to the leaders of these and other agencies, and for training agency staff.
A three-tiered training approach. The OMI developed and began to implement a three-tiered system to train agency managers and leaders, potential referral sources, and workshop leaders. This approach was designed to help develop the buy-in of organizations and agencies and train individuals to lead the curriculum workshops, including staff at the three agencies named above, as well as interested individuals from the community. In 2001, the OMIs Tier I training targeted community leaders and upper-level managers within public and private agencies, such as DHS, to introduce the initiative and build support. Instead of merely describing the initiative and its goals, as is often the case when organizations strive to develop partnerships, the curriculum developers presented select lessons from the material to management staff as they would to a group of couples, so they could experience it for themselves. Additionally, national experts were brought in to share information about the research foundations of the OMIs approach. While practical in the early days, the Tier I training method is no longer in use. OMI leadership have come to favor a more tailored and individualized approach to engaging the interest of high-level agency directors and managers although if circumstances warrant it, the strategy could be revived.
Tier II training was intended to build a network of sources that could refer prospective participants to OMI workshops. These training sessions, which occurred mostly prior to 2002, targeted public agency frontline workers, such as TANF caseworkers, as well as representatives from potential referral sources, such as faith and community-based organizations. According to one report, 483 people representing 65 counties participated in five Tier II training sessions between August 2001 and June 2002 (Orth 2002).
A concern was identified in the Tier II training that ultimately led to the development of a revised approach. In contrast to frontline workers from other agencies, TANF workers were particularly reluctant to talk with their clients about marriage. These staff often had personal concerns about the topic; many were single parents themselves, and these concerns had to be addressed before they could become effective referral sources. As a result, the Tier II training was devoted in large part to building comfort among workers and addressing the role of frontline staff in discussing marriage. Because TANF workers had different needs and concerns than staff from other organizations, the OMI discontinued its large, diverse-group style of Tier II training in 2002 and began instead to respond to agencies interests by meeting with them individually or in smaller groups where issues could be more effectively discussed and worked out.
Tier III training was designed for individuals who were interested in becoming PREP® workshop leaders. The three-day training was provided by the original curriculum developers and continues to be offered on a regular basis. This training covers both the research background of the curriculum and the curriculum material itself. Trainees are provided with detailed leaders manuals and other teaching materials. Although the curriculum is highly structured, leaders are given considerable room for discretion in delivery. They are encouraged to personalize the curriculum, such as including their own stories to illustrate a problem or concept. PREP® workshop trainees have varying backgrounds and levels of education, from highly trained Ph.D-level clinicians to individuals with no more than a high school diploma.
While no longer referred to as Tier III, the OMIs curriculum training continues to evolve to meet the needs of participants and to find ways to encourage productivity. Most recently, a fourth day of training was added. This optional Teachback Day, held approximately three weeks after the initial training, gives new leaders the opportunity to refine their presentation skills and workshop content through peer presentations and critiques.