Child Guidance Services, operated by the Oklahoma State Department of Health, is a county-based program designed to promote the health and well-being of families and children in Oklahoma. The program is staffed by trained psychologists, social workers, speech-language pathologists, and child development specialists, most with graduate degrees. Taking both preventive and treatment approaches, the program offers a variety of services for families with emotional or behavioral problems or in need of guidance services. It emphasizes family-focused parent education and support. Staff offices are organizationally located at county health departments throughout the state. Clients frequently self-refer to the program, but offices also receive referrals from schools, Head Start, Even Start, and other health departments. Services are typically provided in the office; home visiting is rare.
With its broad infrastructure and family focus, OMI and State Department of Health leaders hoped that the Child Guidance program could add PREP® workshops to its menu of services. To that end, a contract was formed in 2000 between the OMI and Child Guidance, which covered free training and materials and part of an administrators position. Behavioral health staff received PREP® training and materials, and were encouraged to organize and lead workshops as a complement to their other supports and services, by recruiting participants from their existing client base or through their connections with other community based services.
Engagement of high-level staff. The management at Child Guidance had become interested in focusing on relationships and marriage even before the official marriage initiative began. The deputy commissioner at that time was involved in planning meetings with PSI and state leaders as the OMI was being developed. Management at Child Guidance saw the OMI as an opportunity to expand services to families and as a potential new funding source.
Staff and participant reactions. Most Child Guidance staff were favorably impressed with PREP®. According to management staff who reviewed evaluations submitted by workshop participants, most people had positive experiences. Participants said they learned to listen, liked the communication techniques, learned to appreciate their partner more, and felt hopeful about doing something different for [their] relationship. Staff reported that participants did not complain about the length of the program, but were more likely to say they wanted the workshops to last longer.
Nevertheless, workshop activity led by Child Guidance staff peaked and then dwindled. Staff led a total of 213 workshops from 2001 to 2004, reaching 2,344 participants. As with the Cooperative Extension Services, the level of implementation declined over time, and the contract between OMI and Child Guidance ended in 2004. In 2007, the number of workshops led by Child Guidance staff had dropped to 16.
Buy-in of local offices. County administrators, who supervised local Child Guidance staff, were generally not as supportive of the effort to integrate OMI services as was state-level management, and the interest of local staff varied. One of the obstacles was that staff and county administrators were accustomed to designing their own programs rather than following state-level requirements. Furthermore, the counties had no financial incentives to participate because although program materials and training were free, the workshops had to be provided without charge to the participants. The decentralized structure of the Child Guidance program thus made widespread implementation of OMI services challenging.
Fit of the curriculum for single parents. Child Guidance staff liked the PREP® curriculum and were aware of the research supporting its effectiveness. In particular, they knew that PREP®s effectiveness was based on research involving couples in committed engaged or married relationships. However, in order to meet workshop activity targets suggested, they felt that they needed to offer the program to others, such as single mothers. Most staff were uncomfortable trying the program with a population for whom effectiveness had not been scientifically established.
Recruitment issues and changing expectations. As with the Cooperative Extension Services experience, the implementation of OMI services at Child Guidance suffered from a lack of guidance and resources for recruiting participant couples. Recruitment was described by management as very stressful for staff, and not an area in which they had much experience. Despite much advertising, including flyers, church newsletters, and newspapers, some staff ended up giving the workshops to only one or two couples at a time. Child Guidance also thought that their highly trained experts should have been spending their time as clinicians, not arranging the logistics of a workshop, such as searching for locations to hold workshops and arranging for food, child care, and other workshop supports. However, they did not have the budget to hire support staff. Institution of the four-workshop commitment after many staff had already been trained exacerbated these recruitment issues, partly because of different standards for those trained before and after the rule was issued.
Change in agency leadership. Over time, with natural changes in leadership and priorities, the impetus for the program was lost and implementation challenges could not be overcome. The deputy commissioner who had been the initial advocate for OMI involvement retired. Shifting priorities and funding limitations at the state level, which resulted from factors unrelated to the OMI, also interfered with the agencys ability to address implementation barriers and sustain workshop delivery efforts. With these uncertainties, staff got the message, whether accurate or not, that the agency was no longer committed to providing marriage education services, and thus that they did not need to focus on providing workshops.
Current status. Since the three-year contract between the OMI and Child Guidance ended, several program staff have continued to support the OMIs goal of helping couples improve their relationships. Some have continued to participate in the OMI in other venues for example, as OMI workshop presenters for adoptive couples, a program of DHS. One staff member working in Oklahoma City has been conducting Within My Reach workshops for women at a community corrections facility.