Family Coaching Clinics: A New Model of Preventive Mental Health Care
Location
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
Project City
Project Province/State
Project Postal/Zip Code
Project Country
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)
- Login to post new content in this forum.
Comments
Dear Dr. Flanery:
We see the potential of Family Coaching Clinics of becoming the Minute Clinic of mental health. Has any market testing been conducted to see what the potential demand would be for such a service? Is there a tangible demand outside the middle income market? The idea of turning mental health around to preventive care rather than treating crises is indeed transformative. Also, due to the stigma that mental health holds in so many communities throughout the country, how will these clinics be marketed?
Thank you in advance for your response!
Changemakers Team
GO BRUINS!
Thank you so much for your interest in our Family Coaching Clinics. Please see below for our reply to your good questions about market demand and marketing strategies.
1) Has any market testing been conducted to see what the potential demand would be for such a service?
Our initial market testing has consisted of general market research into current trends centered on wellness, prevention, and parental spending. We see that a wellness boom is sweeping the United States. Prevention—best thought of as a holistic, integrated approach that encompasses mental, physical and spiritual well-being—is being integrated into many aspects of health care delivery and personal lifestyle choices. Americans spend over $200 billion a year on wellness and sustainable living, exemplified by a broad array of services, products, and centers spanning traditional and alternative medicine, spirituality, fitness and nutrition, as well as “green” living and sustainable lifestyles.
U.S. parents spend upward of $40 billion a year on their children between the ages of four and twelve, and parental spending has increased by 400 percent in the past 20 years. While the marketplace offers few choices for products and services genuinely designed to increase children’s well-being, there is some evidence that the wellness trend is beginning to expand to include children. In Los Angeles, for instance, a newly opened day spa called The Treehouse Social Club has hit a nerve in the family marketplace. Combining standard beauty and relaxation treatments for adults with mini-treatments for children, along with a child-friendly gourmet café and an array of imaginative and enriching children’s classes and play opportunities, the center is thriving and rapidly expanding. The success of this venture, along with family oriented “destination” malls, suggests that families are hungry for experiences that give them a feeling of well-being and connection.
The Family Coaching Clinics are designed to help families achieve a strong foundation for well-being by learning to identify their strengths and stressors and develop effective strategies to cope with developmental and cultural challenges. We believe that family wellness is a fundamental value that matters to all parents, and that there is a significant market for substantive tools, like family coaching, that helps parents and children solve problems and build the kind of lives they desire.
As we move from the pilot into the start-up stage, we will increase market testing of each of our specific services, coaching modules and delivery options, to ensure that we have assessed these markets correctly. We plan to launch a web-based “real time data collection system,” which will inform our development of evidence-based coaching interventions as well as serve as a method of continual quality improvement. We will continually refine our services to maintain alignment with what families need and want to address common childrearing problems.
2) Is there a tangible demand outside the middle income market?
Our experience is that parents everywhere want the best for their children. We know that there is a significant unmet need for mental health services among low-income families. An estimated 80% of children who need mental health care do not receive it, and a disproportionate number of those are poor or uninsured (e.g., approximately 31% of low income children do not receive needed care, versus 23% of middle class children). We also know that the kinds of childrearing problems family coaching will address – e.g. bullying in schools, key school transitions, healthy eating and exercise, and emerging sexuality – are issues that face families across the socio-economic spectrum.
In addition to keeping fees for family coaching as affordable as possible, we are establishing a sliding scale and scholarship structure to offer coaching to all families who need it, regardless of their ability to pay. As the Family Coaching Clinics make family coaching easily accessible in shopping malls and reduce the stigma often associated with mental health care (see answer to 3 below), we believe that families in the lower income market segments will be eager to participate in these relatively simple family coaching strategies that help them build a better future for their children.
3) Due to the stigma that mental health holds in so many communities throughout the country, how will these clinics be marketed?
The Family Coaching Clinics will be marketed within the context of holistic Family Centers designed from a perspective of family wellness rather than family dysfunction. These centers will appeal to a broad range of families, offering a multi-dimensional framework for preventive mental health care characterized by three features:
• Innovative and inspiring techniques for helping families adopt and sustain healthier life styles, incorporating action-oriented family coaching; exciting, interactive education; and accessible, engaging self-directed products;
• Consumer-oriented delivery model, with clearly defined services offered in accessible retail environments that make it easy for families to find and engage with the help they need; and
• Evidence-based programs for family well-being, derived from top quality scientific research within the UCLA community and around the world.
A fundamental goal of the UCLA Family Centers is to de-stigmatize mental health care for families, changing the way that preventive mental health and family wellness are perceived in society. In addition to family coaching, the Family Centers will offer a dynamic mix of interactive educational and cultural programming that attracts a variety of parents and children. We expect families to be eager to attend events at the Family Centers. Innovative classes and workshops designed to inspire and engage; bold and exciting cultural events tied to critical family issues; high quality, appealingly packaged products to support family well-being—all will create a powerful atmosphere of creative expression and community engagement that galvanizes parents and children to take responsibility for their family’s wellness.
By providing multiple avenues for families to engage with the same childrearing topics they might explore through coaching, we will help to normalize these issues and attract families who might be reluctant to seek out psychotherapy. In addition, the Family Coaching Clinics will offer a very clearly defined menu of services, organizing coaching modules around simple and straightforward childrearing problems that any family might struggle with. Our model is based on the view that all parents need help with childrearing at one time or another. Just as athletes need coaches to realize their full potential, so do families. The Family Centers will also include docents or concierges, who are parents trained to orient visitors to the Family Center, welcome them, and guide them to the resources and support available for specific issues they may be experiencing.
By developing a transparent, straightforward coaching model and by marketing the Family Coaching Clinics within the context of Family Centers with broad appeal and interest, we will help to de-stigmatize mental health care for families. This will make it much more likely that families will get the help they need early, while common problems are relatively easy to resolve, rather than waiting until problems are larger and their consequences more serious.
We all need this--yes I'm sane. Marketing to remove the stigma will definitely help!
This is the most concise summary of our proposal we could imagine. Kudos.
This is the most concise summary of our proposal we could imagine. Kudos.
This project is an excellent way to take critically needed mental health services to where the consumers are. As banks are moving their service delivery into shopping malls and supermarkets, to where their consumers are, mental health service providers might also benefit from the same. This project has the potential to engage consumers in a way that is less stigmatized and user-friendly than the traditional mental health service delivery venues. I look forward to the arrival of the Family Coaching Clinic in my neighborhood soon!
We agree, it is time to take our interventions to where the consumers are. For too long, evidence-based mental health programs have languished in academic and public health circles. This is our opportunity to engage consumers with the same vigor as Coca-Cola and McDonald's, but with health and well-being as the target of consumer’s dollars.
Families already have so much on their plates, juggling the stresses of working, raising children, and leading busy lives, and we want to make it easier for them to get the support they need when and where they need it.
Designing the clinics from the perspective of family wellness is critical and an innovative approach to gaining acceptance. Locating the clinics where pressured families are already spending time serves to make it easier for families to make use of services and followthrough with the consistency needed over time to achieve the benefits of coaching. MArketing to all families is so important from both the income generating aspect and the notion that all families have the need for parenting skills- not just low income families who are often targeted for special programs tending to stigmatize program users. This program has the potential of making a tremendous difference for large numbers of families.
We absolutely agree with you. In order to reduce the stigma that is attached to preventive mental health, we think engaging families of all income levels, not just targeted low-income families, is crucial. Every family has times of stress when a little coaching today would go a long way toward well being in the future.
A fully functional Family Coaching Clinic would work on a sliding scale (or even with insurance co-payments), where those in financial need would be provided with the assistance they require to access services, while families from affluent backgrounds would provide the self-sustaining financial backbone.
Coaching will be available to everyone for the benefit of all!
Voting for UCLA family Coaching Clinics