Family Coaching Clinics: A New Model of Preventive Mental Health Care
This entry has been selected as a finalist in the
Disruptive Innovations in Health and Health Care: Solutions People Want competition.
The Family Coaching Clinics offer a new model of preventive mental health care for children and families: targeted, action-oriented education and coaching to help families with children from infancy to adolescence address common childhood issues for which little support is currently available. Clearly defined services are offered in an accessible retail environment to make mental health care readily available to families before simple problems become more serious.
Families face predictable challenges in raising healthy children. Children pass through many developmental transitions as they grow to adulthood, and need appropriate parental support to make those transitions successfully. They are also affected by a range of environmental pressures from their culture and community.
Evidence-based research has many answers about how to address such issues, but this rarely gets to parents in ways that are easy to use. Psychotherapy, consultation with teachers and pediatricians, or self-help books are the primary ways families seek help. All have limitations.
Our evidence-based model provides targeted coaching modules based on cognitive-behavioral strategies that help families achieve well-being. Modules are delivered in 4-6 coaching sessions by experts trained to help families create a plan, identify support, and integrate behavior change into sustainable family lifestyles. Modules include individual coaching sessions, group sessions, and self-directed materials. We also offer broad community education on the same topics.
Our model makes mental health care more accessible, affordable and easier to use. By locating clinics in shopping malls, help is easier to find and reaches families who might not utilize psychotherapy. Focused short-term coaching by trained, supervised experts is more affordable than open-ended therapy. We de-mystify mental health care by providing a menu of services that identifies common family challenges and simple strategies to address them.
About You
Location
Project Street Address
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Your idea
Focus of activity
Service/process
Year the initiative began (yyyy)
2006
Positioning of your initiative on the mosaic diagram
Which of these barriers is the primary focus of your work?
Complex, expensive medicine
Which of the principles is the primary focus of your work?
Center consumers in business model
If you believe some other barrier or principle should be included in the mosaic, please describe it and how it would affect the positioning of your initiative in the mosaic:
This field has not been completed
Name Your Project
Family Coaching Clinics: A New Model of Preventive Mental Health Care
Describe Your Idea
The Family Coaching Clinics offer a new model of preventive mental health care for children and families: targeted, action-oriented education and coaching to help families with children from infancy to adolescence address common childhood issues for which little support is currently available. Clearly defined services are offered in an accessible retail environment to make mental health care readily available to families before simple problems become more serious.
Families face predictable challenges in raising healthy children. Children pass through many developmental transitions as they grow to adulthood, and need appropriate parental support to make those transitions successfully. They are also affected by a range of environmental pressures from their culture and community.
Evidence-based research has many answers about how to address such issues, but this rarely gets to parents in ways that are easy to use. Psychotherapy, consultation with teachers and pediatricians, or self-help books are the primary ways families seek help. All have limitations.
Our evidence-based model provides targeted coaching modules based on cognitive-behavioral strategies that help families achieve well-being. Modules are delivered in 4-6 coaching sessions by experts trained to help families create a plan, identify support, and integrate behavior change into sustainable family lifestyles. Modules include individual coaching sessions, group sessions, and self-directed materials. We also offer broad community education on the same topics.
Our model makes mental health care more accessible, affordable and easier to use. By locating clinics in shopping malls, help is easier to find and reaches families who might not utilize psychotherapy. Focused short-term coaching by trained, supervised experts is more affordable than open-ended therapy. We de-mystify mental health care by providing a menu of services that identifies common family challenges and simple strategies to address them.
Innovation
Define the innovation
The Family Coaching Clinics offer a new model of preventive mental health care for children and families: targeted, action-oriented education and coaching to help families with children from infancy to adolescence address common childhood issues for which little support is currently available. Clearly defined services are offered in an accessible retail environment to make mental health care readily available to families before simple problems become more serious.
Families face predictable challenges in raising healthy children. Children pass through many developmental transitions as they grow to adulthood, and need appropriate parental support to make those transitions successfully. They are also affected by a range of environmental pressures from their culture and community.
Evidence-based research has many answers about how to address such issues, but this rarely gets to parents in ways that are easy to use. Psychotherapy, consultation with teachers and pediatricians, or self-help books are the primary ways families seek help. All have limitations.
Our evidence-based model provides targeted coaching modules based on cognitive-behavioral strategies that help families achieve well-being. Modules are delivered in 4-6 coaching sessions by experts trained to help families create a plan, identify support, and integrate behavior change into sustainable family lifestyles. Modules include individual coaching sessions, group sessions, and self-directed materials. We also offer broad community education on the same topics.
Our model makes mental health care more accessible, affordable and easier to use. By locating clinics in shopping malls, help is easier to find and reaches families who might not utilize psychotherapy. Focused short-term coaching by trained, supervised experts is more affordable than open-ended therapy. We de-mystify mental health care by providing a menu of services that identifies common family challenges and simple strategies to address them.
Context for Disruption:
The Family Coaching Clinics are transforming treatment and delivery models for common childhood problems, filling a large gap in currently available options. Psychotherapy is expensive, difficult to access, stigmatized, and based on a family dysfunction view of problems. Pediatricians and teachers have neither the time nor the expertise in behavioral health, family dynamics, and cognitive-behavioral strategies to give families the help they need. Self-help books are rarely enough to create sustained change.
We bridge this gap with an evidence-based coaching model specifically tailored to common family problems. Our model is based on the view that most child-rearing problems families encounter are normal, predictable, and relatively easy to handle—if addressed early. Research shows that small behavior changes have great power to increase family well-being over the long run.
Preventive physical health care is assumed to be a basic need, yet the need for preventive mental health care is largely unrecognized. We bring a prevention mentality to mental health for children and families, demonstrating that larger problems can be avoided through early intervention focused on simple lifestyle changes, support and education. We teach families to “self-treat” early, preventing the development of later dysfunction with much higher costs to individuals, families, and society.
Family Coaching Clinics are designed to do for family mental health what Minute Clinics do for basic physical health. By locating the clinics in shopping malls, we bring a new level of accessibility to mental health care. We design the setting to be normalizing and make it easy for families to find support. Our model has the potential to transform cultural perceptions and practices regarding common child-rearing problems: what they are, who has them, and how to solve them.
Delivery Model
The Family Coaching Clinics’ consumer-oriented delivery model is a key aspect of our innovation. By locating the clinics in retail centers and organizing services around a menu of specific child-rearing issues, we reach families who might never seek out traditional psychotherapy or might not do so until problems had become much more serious. The psychotherapy delivery model is not consumer-oriented; even families who want therapy often have difficulty finding a therapist willing to work with them on identified issues in a way that makes sense for their family. Coaching is designed to give families the tools they need to resolve common problems by changing their behaviors in ways that have been proven effective.
Rule-based assessment is central to our delivery model. Coaches are trained to screen for serious childhood disorders that require specialized treatment, such as mood, anxiety, conduct, learning or attention deficit disorders, autism, and Asperger’s syndrome. Although such families might benefit from coaching, they also need specialized medical, psychiatric or educational treatment. We refer them to a carefully screened network of qualified professionals.
We reach our target population in part through the structural integration of the Family Coaching Clinics into more broadly focused Family Centers. Each Coaching Clinic is part of a Family Center that is built on creative educational programming and the highest quality scientific research, offering an array of educational programs, cultural events, peer support, web-based resources, and global citizenship opportunities. The Family Centers’ resources and programs help attract a wide cross-section of families, as do the Family Coaching Clinics’ broad-based educational programs.
During the pilot phase we have reached families largely through word-of-mouth. As we move into the start-up phase, we will utilize referring providers, school presentations, online marketing, free press coverage, and paid advertising.
Key Operational Partnerships
Key partners are as follows:
UCLA –
The Family Coaching Clinics are a project of UCLA’s Global Center for Children and Families, and the resources and reputation of University of California Los Angeles are vital to successful implementation of this innovation. We receive both financial and scientific support from the Semel Institute for Neuroscience & Human Behavior and the Departments of Child Psychiatry and Public Health. The UCLA name is helping us to build the Family Center brand and instill public confidence in our family coaching model and related products and programs.
Pompeii, A.D. and BEAM, Inc. –
Pompeii and Beam are leaders in the development of transformational environments and experts in socially conscious branding, marketing and retail development. They are working with us on the design and marketing of the Family Coaching Clinics’ retail-based delivery model.
Utu Social Ventures –
Utu, which incubates social programs for the purpose of promoting well-being among children and families worldwide, is a third partner. Utu is a key provider of programming for the Family Center, such as a global networking program that inspires families and children to see themselves as global citizens and take action on worldwide issues confronting the environment and humanity.
Impact
Financial Model
The Family Coaching Clinics are a social enterprise run by the Global Center for Children and Families. The business model is as important as the innovative coaching model. By packaging the coaching technology in a transparent, accessible way, locating the clinics in shopping centers, and incorporating them into family centers that attract a broad cross-section of families, we are building a sustainable business model that will enable us to develop multiple centers and disseminate the model for replication around the country. The Family Coaching Clinics and Family Centers are designed as financially viable enterprises that will attract a strong consumer base and are scalable for expansion to multiple sites.
We project that 70 percent of each Family Center’s revenue will come from earned income, once the model is fully operational: fees for coaching sessions, educational programs, and products that support healthy family lifestyles. Families will pay out of pocket for coaching fees in the model’s early stages of development. As the disruptive innovation becomes more widely recognized and accepted, insurance coverage for such sessions is likely to become available.
In order to build a sustainable financial model, we are initially targeting middle and upper-income families with the ability to pay moderate coaching fees. Since 61 percent of U.S. families are middle- or upper-income, this is the largest market segment. Once the business is self-sustaining, we will work to extend services to families across the socio-economic spectrum.
We also plan to secure corporate underwriting for educational programs and events, to mitigate the cost to families.
Thirty percent of revenue will come from retail center rent subsidies, in recognition of the Family Center’s role as an anchor attracting customers to the shopping center. We are currently in negotiations with five developers who recognize this value, and expect to secure three such agreements within the next three years.
What is your annual operating budget?
$420K (2007-08)
What are your current sources of revenue? (please list any sources that are foundation grants)
We have been funding the project’s pilot stage through the Global Center for Children and Families’ general operating budget. As we move into the start-up phase in 2007-08, we have identified the following sources of revenue:
UCLA Semel Institute: $100,000
Major Donors: 5,000
Earned Income: 115,000
TOTAL: $220,000
Funding from the Semel Institute represents a commitment of $300,000 over three years, allocated at $100,000 per year.
Effectiveness
During the project’s pilot phase, we have collected anecdotal evidence which strongly suggests that family child-rearing practices and mental health have improved as a result of participation in our programs. We can see the program’s impact in the stories families tell us of how they have adjusted their family lifestyles and are sustaining these changes over time.
We also have evidence of customer satisfaction and impact in the number of referrals we are getting from other families. Despite having done no advertising, we are receiving numerous phone calls from families who heard about our programs through those who participated in the pilot phase.
Our positive assessment of this initial evidence has informed our decision to move into start-up mode and begin the process of opening our first full-scale Family Coaching Clinic and Family Center. As we move further into the start-up phase, we will carry out randomized control trials to determine the scientific evidence in support of the Family Coaching Clinic’s effectiveness.
Which element of the program proved itself most effective?
The Family Coaching Clinic’s effectiveness lies in its ability to provide evidence-based services that offer a cognitive-behavioral approach to help families deal with common, mid-level problems encountered in child-rearing. People typically need more than information alone, and more than self-help books can provide, to create and sustain changes in their family behaviors. At the same time, they often do not need full-scale psychotherapy. The opportunity to work with an expert coach, who is trained in methods that have been proven effective to help families address specific problems, appears to provide exactly the level of support and education families need to navigate successfully the environmental pressures and developmental transitions that are a normal part of childhood.
Key to the Family Coaching Clinic’s success is the fact that the coaching model is built on powerful, evidence-based programs for behavior change – programs that have, by and large, been sitting on the shelf, unused, since they were developed and tested. (Statistics show that once clinical trials are over, evidence-based programs reach less than one percent of those they’re intended to help.) Extracting the elements of these programs on which their effectiveness depends, and transforming them into formats and delivery vehicles that fit the real-world circumstances of families and providers, offers a robust method for developing an effective model for family coaching.
Number of clients in the last year?
We developed our model through pilot work with approximately thirty families. Once the Family Coaching Clinics and Family Centers are fully operational, we expect thousands of families per year to visit each center.
What is the potential demand?
Initial responses to the Family Coaching Clinic and Family Center’s pilot programs have shown that we have tapped into a large need that is not met by anything currently available in this market. On the strength of word-of-mouth alone, without advertising or formal outreach, we already have a waiting list of 50 families interested in our services and programs. We receive daily phone calls from parents seeking advice and support around mid-level childrearing issues, and we see a marked shift in cultural interests and priorities toward prevention and wellness in body, mind and spirit.
Preliminary evidence suggests that a wide range of families will be interested in the type of coaching services we offer: the estimated 25 percent of families whose children have mid-level problems; the 50-80 percent of children and adolescents who need mental health care but are not currently receiving it; and the overwhelming majority of families who may not have “problems,” but are simply experiencing stress and confusion about how to address normal childrearing issues.
The Family Coaching Clinic will address a wide range of issues: for example, bullying in school; setting boundaries on Internet, video games, and other technology; helping teens make sound choices about sexual activity and drug use; and finding balance in a culture where having “too much” is as real a problem as having too little. An overview of the coaching modules currently in development shows how the model could be of use to almost any family, at some point in its experience:
Life Span Development:
• Key school transitions (entering first grade, middle school, high school, college)
• Parenting stages (toddlers, tweens, adolescents)
• Emerging sexuality
• Sibling rivalry
• Healthy family schedules
Prevention:
• Aggression, bullying, mean girl syndrome
• Divorce
• Drug use
• Digital technology
• Hyper-parenting
• Childhood stress
• Mindfulness
• Physical health (diet & exercise)
• Global perspective and balance
Scaling up Strategy
Scaling up our initiative is essential to demonstrating the model’s potential for regional impact and national replicability. Locating the clinics in retail outlets is key to realizing the model’s potential for disruptive innovation. Hence, over the next three years, we plan to open our first three Family Coaching Clinics in existing retail outlets in different neighborhoods throughout the Los Angeles area. (During the pilot phase, we have been operating the coaching clinic in a semi-retail area of Los Angeles’ Westwood neighborhood.) We are currently in negotiations with five developers.
In addition to moving forward with plans to open centers, we will continue to develop, test and refine the coaching model that lies at the heart of the Family Coaching Clinic. In order to make our programs engaging, effective, cost-efficient and transparent, we deliver coaching services by means of discrete modules that address common family issues. Over the next three years we will be developing a number of these modules, which will include coaching protocols, educational programs, and self-directed materials and products.
Stage of the initiative:
0
Expansion plan:
For the first seven years, we will concentrate on opening Family Coaching Clinics throughout the Los Angeles area. Once we get these initial clinics up and running, prove their effectiveness, and refine our model, we will develop a full-scale expansion plan. Our long-range goal is to replicate the Family Coaching Clinics widely, expanding the model throughout California and the rest of the U.S. We will explore various options, such as opening additional centers ourselves or licensing or franchising the model, to determine the best way to achieve maximum market penetration on a national scale.
Origin of the Initiative
The Global Center for Children and Families was founded by Co-directors Dr. Mary Jane Rotheram-Borus and Dr. Diane Flannery to bridge the gap between research and those who need its findings most. We had seen the benefits that evidence-based programs could offer families, but were concerned that those programs were reaching only a small percentage of those they were intended to help.
We were also becoming increasingly aware of the stresses families experience in today’s world, and how difficult it is for families to find answers to their questions about childrearing. The Family Coaching Clinics represent our vision for a new mental health prevention strategy that connects families to scientifically proven information, programs and services that can help them make changes in their family lifestyles to raise healthier children.
This Entry is about (Issues)
Sustainability
What are your two main challenges to finance the growth of your initiative
The largest challenges to financing the growth of our initiative are securing both the research and development funding and the capital costs for getting each Family Coaching Clinic and Family Center started. Once operational, the centers will be financially self-sustaining, but we will need to raise start-up costs of approximately $500,000 per center from outside sources.
Standard sources of funding for scientific research cover the costs of running randomized control trials and writing up the results in papers published in academic journals. Highly effective evidence-based programs are developed, implemented in clinical trials, and described in lengthy manuals, but rarely get implemented again in real-life settings once the trials are over.
We are trying to create a new paradigm for science-based programs, in which funding is readily available for translating science into programs and products that are accessible, engaging and affordable for many people.
In order to reach our goal of scaling up to three Family Coaching Clinics in the next three years, we would require $1.5 million, with an additional $500,000 to open each subsequent center.
How did you hear about this contest and what is your main incentive to participate?
We heard about the contest through the Robert Wood Johnson Foundation’s email news. We hope to attract funding for our work, receive honest feedback, and participate in dialogue with other social entrepreneurs engaged in developing new and innovative visions for transforming health care delivery.
The Story
Do you have an annual financial statement?
Yes.
Do you currently have an annual financial statement that tracks profit/loss?
Yes.
Please describe the amount (and/or type) of funding you need to implement your initiative, at year 1 and at year 5.
Year One: $420,000 (Operational costs)
Year Five: $3,000,000 (Operational costs for three centers); $500,000 (Start-up costs for one new center)
 | 262 weeks ago Danny Nobles said: Changemakers' homepage asserts. "Our evidence-based model provides targeted coaching modules based on cognitive-behavioral strategies ... about this Competition Entry. - read more > |
| 262 weeks ago Danny Nobles said: Changemakers' homepage asserts. "Our evidence-based model provides targeted coaching modules based on cognitive-behavioral strategies ... about this Competition Entry. - read more > |
| 294 weeks ago Diane Flannery said: These are great questions, thanks for raising them. You are absolutely right that we are aiming for simple, straightforward treatments ... about this Competition Entry. - read more > |
| 296 weeks ago ipp isl said: this seems like a great idea.since you've mentioned that coaches would have MA or PHD degree , what would be the cost of a coaching ... about this Competition Entry. - read more > |
| 298 weeks ago Bunchoay Nasoongnern said: I think this is a wonderful program about this Competition Entry. - read more > |
| 298 weeks ago Ratana Viliyakul said: I agree, it is time to take our interventions to where the consumers are. For too long, evidence-based mental health programs have ... about this Competition Entry. - read more > |
| 298 weeks ago Family Coaching Clinics: A New Model of Preventive Mental Health Care has been chosen as a winner in Disruptive Innovations in Health and Health Care: Solutions People Want. |
| 298 weeks ago Diane Flannery said: Thank you for thinking so carefully about the viability of retail spaces in urban areas. We will have to chose our shopping malls ... about this Competition Entry. - read more > |
| 298 weeks ago Diane Flannery said: We appreciate your enthusiasm for our Family Coaching Clinic name. There is clearly a difference in opinion emerging about the merit of ... about this Competition Entry. - read more > |
| 298 weeks ago Stuart Rhoden said: As someone who has taught in South LA for four years, I am curious to know how this program would be implemented in urban retail ... about this Competition Entry. - read more > |
