Family Check-Up

1. Introduction

Version followed: the standard in-person Family Check-Up (FCU) as described by the University of Oregon Prevention Science Institute (UO PSI) and the developers (Thomas Dishion, deceased, and Elizabeth Stormshak): Phase 1 is a three-session check-up (initial interview, ecological assessment, motivational feedback), and Phase 2 is tailored follow-up, usually the Everyday Parenting curriculum. Two editions of Everyday Parenting exist. The 1st edition (Dishion, Stormshak & Kavanagh) has 12 sessions in 3 modules, and the training literature and Blueprints use it. The 2nd edition (Stormshak, Mauricio & Gill, Research Press) has 11 sessions and adds separate emotion-coaching and mindful-parenting sessions. Where the two differ, both are named below. The early-childhood Early Steps procedures (Shaw and colleagues) and FCU Online are covered as named variants. [source: UO PSI Intervention Process; Blueprints; Research Press contents; CPC Pitt]

The FCU is a brief, strengths-based, family-centred check-up for families with children aged 2–17, especially children at risk of behaviour problems. It is a framework more than a fixed course of therapy. A short assessment-and-feedback routine, modelled on the Drinker's Check-Up, decides whether a family needs follow-up and what kind. The follow-up comes from a menu that runs from monthly check-ins to parent training, family therapy, school work and community referral. [source: Blueprints; Gill et al. case study]

Core idea of change: the target is coercion theory, the idea that child problem behaviour grows out of escalating aversive parent–child exchanges. Change in parenting (positive behaviour support, limit setting and monitoring, relationship building) is the route to change in the child. Motivation for that change is built from the family's own multi-informant assessment data, which are fed back with motivational interviewing (MI). Contact is repeated at least yearly across developmental transitions, like a well-child visit, so a family that is not ready one year can become motivated the next. [source: Blueprints; UO PSI; Gill et al.; Stormshak et al. 2018 protocol]

2. Framework

Phase 1: the check-up (three sessions, about 1 hour each, 1–2 weeks apart) [source: Blueprints; CEBC; National Register webinar slides]

Session 1, initial interview. Goals: build rapport, explore strengths, concerns and motivation, explain the FCU and its rationale, answer questions, then link the interview to the assessment and book it. The parent leaves feeling understood, with goals and motivation clarified. [source: UO PSI; webinar slides]
Session 2, ecological assessment. Multi-method and multi-context. It uses parent questionnaires (about self and family, and about the child, in age-banded versions for 2–5, 6–10 and 11–17), a youth self-report for ages 11–17, teacher ratings, and 3–5 videotaped Family Interaction Tasks of about 3–5 minutes each, coded by the therapist on a FIT coding form. It also measures context such as parental depression and couple conflict. It is often done in the home. [source: UO PSI; webinar slides; Foundations]
Session 3, feedback. Goals: give the integrated results using the FCU Feedback Form and MI, set goals in the parent's words, and choose follow-up from a Menu of Options. [source: UO PSI; webinar slides]
Order variant. In Early Steps (toddlers), the in-home assessment came first, then a Get-to-Know-You (GTKY) visit, then feedback. [source: Gill et al.] Adaptations: community mental health sites have combined intake and assessment into one session before a separate feedback session. For wide-scale dissemination, videotaping and video feedback have been dropped. Online delivery has been used for rural families. [source: Stormshak 2019 slides]

Phase 2: follow-up (tailored, flexible)

Options include monthly follow-up support, individual parent training or family management therapy (Everyday Parenting), school consultation, family or child therapy, and community referral. [source: UO PSI; webinar slides]
Dose: CEBC recommends at least four 1-hour Everyday Parenting sessions every two weeks. As brief prevention the FCU can run 2–3 sessions; as treatment, 3–15 contact hours over about 1–4 months. [source: CEBC] In Early Steps, families averaged about 3.4–3.7 follow-up sessions a year. The case family used about 10 in year 1, then 3–4 a year. [source: Blueprints; Gill et al.] Foundations reports 3–15 weekly sessions of 50–60 minutes. [source: Foundations] The figures differ by site and version [uncertain].
Repeat check-ups: the FCU is offered again at least yearly across key transitions (toddlerhood, school entry, middle school). [source: Gill et al.; Stormshak 2019 slides]

Criteria for moving on

Interview to assessment: the parent understands the process, has had questions answered, and has agreed and booked the assessment. [source: webinar slides]
Assessment to feedback: questionnaires are scored against norms, interaction tasks are coded, and the Feedback Form is prepared using the THINK principles (Section 3). [source: webinar slides; UO PSI]
Feedback to follow-up: the parent has named goals and chosen a menu option. Choosing no follow-up is legitimate, and the family is then seen at the next annual check-up. [source: webinar slides; Gill et al.]
Order inside follow-up: safety and security first, then behaviour management, then parenting skills, then relationship building. [source: Gill et al.]
Ending follow-up: the sources give no formal discharge criteria. A practical rule is to end when the parent's own goals are met, or the chosen menu item is done, and to re-offer the check-up at the next transition or annual point. [synthesis]

Format and staffing: individual family sessions, delivered at home, clinic, school, primary care or community centre. Everyday Parenting can also be run as parent groups. Master's-level providers are recommended. Bachelor's-level staff or paraprofessionals can deliver it with more supervision. MI training is recommended. [source: Blueprints; CEBC; CPC Pitt; Foundations]

Training, certification and fidelity (before delivering under the name)

CEBC: 16–32 hours of training (in-person, online or hybrid), then about 5–10 hours of consultation with review of uploaded session videos to reach certification. Certification is described as optional, but ongoing fidelity consultation is strongly recommended. Implementation support comes from the REACH Institute, Arizona State University. [source: CEBC]
Blueprints: e-learning, a skills training session, and 6–12 group consultations. Supervisor-trainer certification runs in months 5–11 of an 11-month start-up, with recertification every 2 years on recorded sessions and annual quality-assurance check-ins. Contact: NW Prevention Science. [source: Blueprints]
Foundations (UK): 35 hours of training plus a supervisor trained in the model; licensing not required. [source: Foundations]
Fidelity is measured with the COACH rating system (Section 4, item 35). [source: CEBC; Smith 2013 slides]
The sources give different training figures and different purveyor organisations. Check current requirements with the purveyor before you call your service "Family Check-Up" [uncertain].

3. Guiding principles

Strengths-based. Open the feedback with strengths, and use video clips of the parent's own good moments. [source: UO PSI; Stormshak 2019 slides; webinar slides]
Family-centred. The parent is the agent of change. Use the parent's motivation at transitions such as school entry. [source: Stormshak 2019 slides]
Ecological. Assess and address context (parent depression, stress, substance use, couple or co-parenting conflict, school, neighbourhood, social support), not only the child. [source: UO PSI; Blueprints]
Developmental. Match tasks, measures and goals to the child's age and to the current transition. [source: Stormshak 2019 slides; webinar slides]
Motivational (MI spirit and strategies). Express empathy, develop discrepancy, avoid arguing, roll with resistance and support self-efficacy, at every stage. Show the parent you understand they have been trying. [source: webinar slides; Gill et al.]
Tailored and adaptive. No fixed dose. The family chooses from a menu, and intensity follows need and readiness. [source: UO PSI; Gill et al.]
Health-maintenance model. Treat the FCU like a routine preventive check-up, at least yearly, rather than crisis-driven care. [source: Gill et al.]
THINK when preparing feedback. Tailor the feedback to this client; Harm reduction is the top priority (address safety first); Integrate all the data into a parenting frame; Notice and build on parenting strengths; Know and consider functional family dynamics. [source: webinar slides]
Data-driven. Base the feedback on normed, multi-informant data and observation, not impressions. Re-show the data over the years to reveal persistent problems. [source: UO PSI; Gill et al.]
Parenting frame. Translate every concern, including adult problems, into what it means for parenting, and set goals from a parenting perspective. [source: webinar slides]
Safety first, then skills. Put safety and security ahead of behaviour management, skills and relationships. [source: Gill et al.]
Collaborative, parent's own words. Check in often during the feedback, and write goals in the parent's language. [source: Gill et al.; webinar slides]
Coercion focus. Look for escalating aversive exchanges, and replace them with proactive structure and positive reinforcement. [source: Blueprints]
COACH as the stance standard. Be conceptually accurate to the model, observant and responsive to the family, actively structure the session, carefully teach with corrective feedback, and instil hope and motivation. [source: CEBC; Smith 2013 slides]
Brief and efficient. Make the most of few contacts, and support parents by phone or online between sessions where appropriate. [synthesis, informed by Stormshak et al. 2018 protocol]

4. Intervention inventory

Part A covers the check-up phase, Part B the Everyday Parenting follow-up, and Part C the ecological, school, online and fidelity components. Instruments are named but none of their items are reproduced. The FCU questionnaires, Feedback Form and FIT coding form are distributed through training. All example language is illustrative unless quoted.

Part A. The check-up

1. Engagement contact and introducing the FCU

Purpose: Get the family to a first meeting, and frame the FCU as a routine check-up rather than a judgement on their parenting. [source: Gill et al.; Stormshak 2019 slides]
When: First contact after referral or recruitment (e.g., through WIC, primary care or a school).
Steps:
1. Phone the parent to set up the meeting, usually at home or wherever is convenient. [source: Gill et al.]
2. Describe the three steps (talk, assessment, feedback), how long each takes, and that the family decides afterwards whether to do anything further. [source: UO PSI; webinar slides]
3. Say plainly that you look at strengths as well as worries. [source: UO PSI]
Example language (illustrative): "It's a bit like a check-up at the doctor's, but for how family life is going. We meet three times, you get a picture of what's going well and what could be easier, and then you decide what, if anything, you'd like to do next."
Watch for: Shame or fear of child-protection involvement. Answer these questions directly, including the limits of confidentiality. [synthesis] It is working if the family agrees to the interview and keeps the booking.

2. Initial interview (parent)

Purpose: Build rapport, map strengths, concerns and current coping, clarify motivation, and lay the ground for the assessment. [source: UO PSI; webinar slides]
When: Session 1. In Early Steps this is the GTKY visit, after the assessment. [source: Gill et al.]
Steps:
1. Explain the FCU process and its rationale, and invite questions. [source: webinar slides]
2. Ask who lives in the home, and what the parent's 2–3 main concerns are. [source: webinar slides]
3. Ask about the family's strengths and how they cope now. [source: webinar slides]
4. Do a functional sequence for the main concern: what happens just before the problem behaviour, what the child does, how the parent responds, and what happens next. [source: webinar slides]
5. Explore supports and liabilities (extended family, housing stability, safety) and the gap between how the parent wants family life to be and how it is now. [source: Gill et al.]
6. Use open questions, reflective listening and encouragement throughout. [source: UO PSI]
7. Link the interview to the assessment, explain what will happen, including the video tasks, and book it. [source: webinar slides]
Example language (illustrative): "Take me through the last time bedtime went badly. What happened just before? What did you do? And then?" / "What would you most like to be different six months from now?"
Watch for: A parent who lists only the child's faults. Reflect the effort and stress behind this, and keep asking about strengths. [synthesis] It is working if the parent feels understood and has said what they want. [source: UO PSI]

3. Child interview component

Purpose: Hear the child's view of home and school, and build rapport with the child. [source: webinar slides]
When: Session 1 or 2, at an age-appropriate level.
Steps: Ask about favourite and least favourite activities. Ask the child to draw the family doing something together. Ask a "three wishes" question about home. Ask what they like and dislike about school. [source: webinar slides]
Example language (illustrative): "If you had three wishes that would make things better at home, what would they be?"
Watch for: Disclosures of harm, which you handle under your safeguarding procedures. Keep these tasks playful for young children. [synthesis]

4. Questionnaire and multi-informant ecological assessment

Purpose: Get normed, multi-informant data on the family context, family management and relationships, and child adjustment. [source: UO PSI; Blueprints]
When: Session 2. Some sites send digital questionnaires in advance. [source: webinar slides]
Steps:
1. Give the parent a questionnaire about self and family, and an age-banded questionnaire about the child (2–5, 6–10 or 11–17). [source: webinar slides]
2. Give a self-report questionnaire to youth aged 11–17. [source: webinar slides]
3. With consent, get teacher ratings of behaviour at school. [source: UO PSI]
4. Include contextual stressors (parental depression, couple conflict) in the measures. [source: UO PSI] Early Steps also assessed sociocultural context and resources, and child behaviour in other care settings. [source: Gill et al.]
5. Score against norms or comparison samples, to prepare the profile and Feedback Form. [source: Gill et al.]
Watch for: Literacy and language barriers. Read items aloud or use translated versions; one cultural adaptation used culturally relevant measures. [source: Stormshak 2019 slides] The exact instrument set varies by version, and the sources do not list the current battery [uncertain].

5. Family Interaction Tasks (videotaped observation)

Purpose: Observe real parent–child interaction (cooperation, limit setting, proactive structure, warmth, problem solving), both for coding and to find video clips of the parent's strengths. [source: webinar slides; Gill et al.]
When: Session 2. Run 3–5 scripted tasks of about 3–5 minutes each. [source: webinar slides]
Steps (younger children): [source: webinar slides]
1. Child-led play: the parent follows the child's play.
2. Clean-up: the parent directs the child to tidy the toys without moving them themselves. The clinician leaves the room for three minutes, and the timer starts as they leave.
3. Teaching task: the parent helps the child with a task slightly above the child's ability.
4. Parent-busy task: the parent is occupied with something else while the child plays freely.
5. Family drawing task.
- Early Steps also used a semi-structured meal-preparation task. [source: Gill et al.] The kindergarten version adds reading together and doing maths homework together. [source: Stormshak 2019 slides]
Steps (older children and teens): guided family discussions on school expectations and goals; monitoring (talking about a time the young person was with peers without an adult); limit setting; solving a family problem; and planning a family activity. [source: webinar slides]
Materials: age-appropriate toys for ages 2–5 and 6–8/9, a basket, puzzles, blocks, paper and coloured pens or crayons, and a recording device. [source: Blueprints]
Coding: The therapist scores the video on the FIT coding form. Early Steps coded child compliance, positive play and aggression, and parental limit setting and proactivity. [source: webinar slides; Gill et al.]
Example language (illustrative): "For this one, please ask your child to put all the toys in the basket. You can use words but please don't pick them up yourself. I'll step out for a few minutes."
Watch for: Parents who feel tested. Normalise this ("most kids don't tidy up on request"). Get written consent for recording and explain how the video is stored. [synthesis] Some large-scale implementations drop the video. [source: Stormshak 2019 slides]

6. Preparing the feedback (case conceptualisation)

Purpose: Turn the data into a short, tailored, parenting-framed message. [source: webinar slides]
When: Between sessions 2 and 3.
Steps:
1. Fill in the FCU Feedback Form across its three domains: family context, family management and relationships, and child adjustment. FCU Online uses a green/yellow/red colour code against normative ranges (strength / needs attention / serious concern), and the in-person form follows the same logic. [source: UO PSI; Stormshak et al. 2018 protocol; the colour-coding of the in-person form is inferred, uncertain]
2. Apply THINK. Tailor to this family. Decide what must come first for harm reduction and safety. Integrate everything into a parenting frame. Choose the strengths to lead with. Formulate the functional family dynamics, such as a coercive cycle. [source: webinar slides]
3. Choose 1–3 short video clips that show parenting strengths. [source: webinar slides]
4. Prepare one or two research points in plain language that link the family's patterns to outcomes. [source: webinar slides; Gill et al.]
5. Draft the follow-up options the family could realistically use. [source: UO PSI]
Watch for: Too many "red" areas. Prioritise; do not list everything. [synthesis]

7. Feedback session (core sequence)

Purpose: Build motivation by sharing the assessment in an MI style, and agree goals and next steps. Its model is the Drinker's Check-Up. [source: Gill et al.; UO PSI]
When: Session 3, at home, clinic, school or community centre. [source: UO PSI; Stormshak et al. 2018 protocol]
Steps (published sequence): [source: webinar slides]
1. Explain the process of the session.
2. Invite the parent's self-assessment (item 8).
3. Explain the Feedback Form.
4. Give feedback domain by domain using the form, starting with strengths and checking in often. [source: webinar slides; Gill et al.]
5. Show video clips of the parent's strengths (item 9).
6. Summarise the relevant research in parent-friendly language (item 10).
7. Set goals and choose from the Menu of Options (item 11).
Example language (illustrative): "Before I show you anything, what stood out for you from the questionnaires and the video tasks?"
Watch for: The parent's reactions after each domain, especially defensiveness, tears or minimising. Slow down, reflect, and let the parent move on when ready. [source: Gill et al.] It is working if you hear change talk and the parent commits to specific goals. [source: Gill et al.] In published FCU fidelity studies, this is the session that was COACH-rated, and coders rated it more reliably when they also saw the family's assessment data. Links to later outcomes are reported, but they were not read here [uncertain]. [source: Smith 2013 slides]

8. Parent self-assessment

Purpose: Let the parent name their concerns and strengths first. This reduces defensiveness and shows you what they are ready to hear. [source: webinar slides]
Steps: Ask open questions about what stood out from the assessment, and how the parent would rate their family in each area before seeing the form. Reflect what they say, and link it to the data as you go. [source: Gill et al.; webinar slides]
Example language (illustrative): "If you were scoring your family on getting through the morning routine, where would you put it?"
Watch for: A big gap between the parent's view and the data. This is material for developing discrepancy, not for arguing. [source: webinar slides]

9. Strength-focused video feedback

Purpose: Build self-efficacy by showing the parent doing something effective on their own video. [source: webinar slides]
Steps: Play a short clip, ask what the parent notices, and name the specific skill shown (a clear request, praise, following the child's lead). Link the skill to the goal. [source: webinar slides; synthesis for the step detail]
Example language (illustrative): "Watch what happens right here after you give that short, calm instruction... What did you notice?"
Watch for: Shame at watching themselves. Keep clips short and positive. The sources do not describe using clips of problem moments [uncertain].

10. Research summary in parent-friendly language

Purpose: Connect the family's pattern to known outcomes so the stakes are clear without blaming. [source: webinar slides; Gill et al.]
Steps: Give one or two plain statements, such as how coercive cycles escalate, how parental depression affects parenting, or why monitoring matters in adolescence. Then ask what the parent makes of it. [source: Gill et al.]
Example language (illustrative): "Research with lots of families shows that when tantrums and arguing feed each other, they tend to grow. The good news is that small changes in how requests and limits are handled can turn that around. How does that fit with what you see at home?"
Watch for: Fear or fatalism. Pair every risk statement with hope and a strength. [source: Gill et al.; COACH "hope and motivation"]

11. Goal setting and the Menu of Options

Purpose: Turn motivation into a concrete plan the family chooses. [source: webinar slides; UO PSI]
Steps:
1. Help the parent set a small number of goals in their own words, framed as parenting goals. In the Early Steps case three goals were set. [source: webinar slides; Gill et al.]
2. Present the menu: monthly check-ins, Everyday Parenting (individual or group), family therapy, child therapy, school interventions, community referrals, or no further service until the next check-up. [source: UO PSI; webinar slides]
3. Link each goal to a menu item, agree the first step, and book it. [source: webinar slides]
Example language (illustrative): "You said you want mornings to be calmer and you want to get some help for yourself with feeling low. Here are some ways we could work on those. Which feels most useful to start with?"
Watch for: Goals that are the therapist's, not the parent's. It is working if the parent picks an option and sets a date. [synthesis]

12. Motivational interviewing strategies (cross-cutting)

Purpose: Build engagement and commitment at every stage. [source: webinar slides]
Steps: Express empathy (reflect stress and effort). Develop discrepancy (between goals and current patterns). Avoid arguing. Roll with resistance: agree with part of the parent's view, then explore what happens if it is not so. Support self-efficacy (affirm past efforts and strengths). [source: webinar slides; Gill et al.]
Example language: In the Early Steps case, a mother said her child would "outgrow" aggression. The consultant agreed this was possible, then asked what would happen if she did not. [source: Gill et al., paraphrased] Illustrative: "She may well grow out of it. And if she didn't, what would worry you most?"
Watch for: Change talk (desire, ability, reasons, need, commitment) as the sign it is working. The change-talk categories are standard MI, not FCU-specific [synthesis].

Part B. Everyday Parenting follow-up

Session topics follow the 1st-edition 12-session structure (CPC Pitt; Stormshak 2019 slides). The 2nd-edition equivalents (Research Press contents) are given in brackets. Both editions are modular: deliver only the sessions that fit the family's goals, in the order that suits them. The sources give topics but little step detail. Steps not given in the sources are marked [synthesis] and follow standard behavioural parent training. They should not be read as the manual's wording or sequence.

13. Follow-up session format

Purpose: A predictable structure for skill teaching. [synthesis]
Steps:
1. Check in on goals and the past week.
2. Review home practice.
3. Introduce one skill with its rationale, linked to the parent's feedback goals.
4. Model it.
5. Role-play it, and where possible practise it live with the child. Role-play and in-vivo practice are documented in the Early Steps case. [source: Gill et al.]
6. Troubleshoot barriers.
7. Agree a specific home-practice task, with a handout. The 2nd edition has handouts for home practice. [source: Research Press product page]
- Steps 1–4, 6 and the ordering are [synthesis]; the manual's own session template is not drawn on [uncertain].
Example language (illustrative): "Let's try it here first. I'll be your son refusing to turn off the game, and you try the short, calm request we talked about."
Watch for: Practice that never happens between sessions (see Section 5).

14. Making requests that invite cooperation (Session 1: parent requests and child cooperation) [2nd ed. Session 1: Effective Directions and Praise]

Purpose: Make it more likely the child cooperates, and break the cycle of repeated, escalating commands. [source: CPC Pitt; Stormshak et al. 2018 protocol (clear directions with follow-through)]
Steps: [synthesis] Get close and get the child's attention. Give one clear, specific, positively worded instruction (say what to do, not what to stop). Use a calm, neutral tone. Wait a few seconds. Follow through every time: praise if the child complies, apply the planned limit if not (item 21).
Example language (illustrative): "Maya, shoes on now, please." (pause) "Thank you, you did that straight away."
Watch for: Question-form requests ("Can you...?"), strings of instructions, or repeating the request without follow-through. Compliance rising on the parent's tracking chart shows it is working. [synthesis]

15. Praise and encouragement for cooperation (Session 2) [2nd ed. part of Session 1]

Purpose: Reinforce cooperation and positive behaviour, and shift the household ratio away from criticism. [source: CPC Pitt; Stormshak et al. 2018 protocol; Gill et al.]
Steps: [synthesis] Catch the child doing the target behaviour. Praise straight away, specifically (name the behaviour), and warmly. Set a daily praise target, and log praise on a simple tally.
Example language (illustrative): "You put your plate in the sink without me asking. That's really helpful."
Watch for: Praise followed by a sting ("...why can't you always do that?"). Parents with depression may struggle to notice positives, so link this to item 29. [synthesis]

16. Behaviour-change plans and incentives (Session 3) [2nd ed. Session 2: Developing and Using Behavior Change Plans]

Purpose: Build new routines or behaviours with structured rewards. [source: CPC Pitt; Research Press contents; Gill et al. (incentives)]
Steps: [synthesis] Choose one or two specific, observable target behaviours, stated positively. Agree small, frequent, inexpensive rewards with the child. Make a chart (stickers or points). Reward immediately and consistently, alongside praise. Review the plan weekly, and thin rewards out as the behaviour becomes established.
Example language (illustrative): "Let's pick one thing to start with. Getting dressed before breakfast? Each time he does it, he gets a star, and five stars means he picks the Saturday park."
Watch for: Targets that are too big, rewards that are too delayed, or charts that are used as punishment (taking stars away). It is working when the target behaviour rises within one to two weeks. [synthesis]

17. Barriers to behaviour-change plans (Session 4)

Purpose: Troubleshoot plans that are not working. [source: CPC Pitt; Gill et al. (troubleshooting)]
Steps: [synthesis] Review the chart data. Check that the target is specific, the reward is valued and immediate, the parent is consistent, and every caregiver is on board. Adjust one element at a time. Explore what in the parent's life (stress, a co-parent, schedules) gets in the way.
Example language (illustrative): "Let's look at the days it worked and the days it didn't. What was different?"
Watch for: Discouragement. Affirm the effort and shrink the step. [synthesis]

18. Emotion coaching [2nd ed. Session 3]

Purpose: Help the child name and manage emotions, and help the parent respond to the child's feelings rather than only to the behaviour. [source: Research Press contents; Research Press product page lists emotion coaching and emotion regulation among its skills]
Steps: [synthesis; procedure not given in the sources, uncertain] Notice the child's emotion, especially at low intensity. Treat it as a chance to connect. Name and validate the feeling. Set limits on behaviour, not on feelings. Help the child problem-solve once they are calm.
Example language (illustrative): "You look really frustrated that the tower fell. That's annoying. Do you want to try again together, or take a break first?"
Watch for: Parents who believe that validating means giving in. Make clear that limits still apply. [synthesis]

19. Mindful parenting: managing the parent's emotions in everyday interactions [2nd ed. Session 4]

Purpose: Help parents regulate their own reactions so they can respond calmly rather than coercively. UO PSI describes proactive monitoring and proactive parenting as the basis of mindful parenting across domains. [source: UO PSI; Research Press contents]
Steps: [synthesis] Identify the parent's personal triggers and early body cues. Agree a pause routine (breathe, step back, use a calming phrase) before responding. Practise it in role-play of a typical trigger. Review real episodes the next week.
Example language (illustrative): "When you feel your jaw tighten as he starts arguing, that's your cue to take one slow breath before you say anything."
Watch for: Parental depression, anxiety or trauma that needs its own referral (item 29).

20. Monitoring daily activities, supervision and listening (Session 5) [2nd ed. Session 5: Supervision, Listening, and Monitoring Activities]

Purpose: Know where the child is, who they are with and what they are doing, and keep communication open, especially in adolescence when time without adults carries risk. [source: CPC Pitt; Research Press contents; Stormshak et al. 2018 protocol]
Steps: [partly synthesis] Map the child's week, including after school, weekends and online time. Agree check-in routines with the young person (where, who with, when home). Monitor school attendance and homework; FCU Online includes a school on-time calculator. [source: Stormshak et al. 2018 protocol] Listen without lecturing when the young person shares, so that they keep sharing. [synthesis]
Example language (illustrative): "What would be a reasonable way for you to let me know where you are after school, that doesn't feel like I'm spying?"
Watch for: Monitoring that turns into interrogation. It is working when the parent's knowledge of the young person's activities goes up without more conflict. [synthesis]

21. Setting limits: effective rules (Session 6: SANE guidelines) [2nd ed. Session 6: Setting Limits: Effective Rules]

Purpose: Set a small number of clear house rules with planned consequences. [source: CPC Pitt; Research Press contents; NIDA Family Checkup]
Steps:
1. Write a few rules that are clear, simple and specific. Check that the child understands them. Prepare a list of consequences in advance, and be ready to follow through. [source: NIDA Family Checkup]
2. Choose consequences by the SANE guidelines: Small; Avoid ones that punish the parent too; Non-abusive; Effective (within the parent's control and not rewarding to the child). [source: NIDA Family Checkup] The CPC Pitt page names "SANE guidelines for limit setting" as an Everyday Parenting session but does not expand the acronym. The expansion here comes from the NIDA Family Checkup page, and its link to the FCU developers is not confirmed in the sources [uncertain].
3. Give praise or encouragement when rules are kept. [source: NIDA Family Checkup]
Example language (illustrative): "House rule: phones go in the kitchen basket at 9. If the phone isn't there at 9, it stays in the basket until after school tomorrow."
Watch for: Huge or long consequences ("grounded for a month") that the parent cannot sustain. These breach the S and A guidelines. [source: NIDA Family Checkup; application synthesis]

22. Delivering consequences, including time-out (Session 7: proactive limit setting) [2nd ed. Session 7: Limit Setting: Effective Consequences]

Purpose: Follow through calmly and consistently, so the child learns that limits are reliable and the coercive escalation stops. [source: Research Press contents; NIDA Family Checkup; Blueprints (coercion)]
Steps:
1. Label the problem behaviour in terms of the rule. State the consequence clearly. Avoid arguing. Ignore trivia. Expect protest, which is normal. Use a firm, calm tone, and follow through every time the limit is tested. [source: NIDA Family Checkup]
2. For young children, teach correct use of time-out. [source: Gill et al.] The time-out procedure (where, how long, what if the child leaves) is not given in the sources. Use a standard brief, calm, non-humiliating time-out with a clear end, and avoid physical restraint [synthesis].
3. For older children, use privilege removal or a small extra job of short duration [synthesis; consistent with SANE].
Example language (illustrative): "The rule is no hitting. That's time-out for three minutes." (then no further discussion until it is over)
Watch for: Harsh, physical or humiliating discipline. Treat it as a safety issue, not a skill gap (Section 5). It is working when episodes get shorter and less frequent. [synthesis]

23. Proactive parenting and planning ahead [1st ed. within Session 7 and the relationship module; 2nd ed. Session 10]

Purpose: Prevent problems by structuring high-risk situations in advance. [source: Research Press contents; UO PSI; Gill et al. (psychoeducation on proactive parenting)]
Steps: [synthesis] Identify predictable trouble spots (shopping, transitions, bedtime). Plan in advance: prepare the child, set the expectation and the incentive, bring an activity, and decide the backup consequence. Debrief afterwards.
Example language (illustrative): "Before the supermarket, let's agree on three things: you hold the trolley, you choose one fruit, and if we get round without fuss, you pick the song in the car."
Watch for: Parents who plan only after problems happen. Use the parent-busy task video, where relevant, as a reference point. [synthesis]

24. Challenges in limit setting and self-regulation (Session 8)

Purpose: Handle escalation, testing of limits, and the parent's own anger. [source: CPC Pitt]
Steps: [synthesis] Anticipate the burst of testing when limits first become consistent. Rehearse staying calm (item 19). Agree with the co-parent on a shared response. Plan what to do if the parent feels they may lose control: step away, and hand over to another adult where safe.
Example language (illustrative): "It often gets louder before it gets better. If you hold steady through that, kids learn the rule is real."
Watch for: Risk of harm when the parent is overwhelmed. Assess this and safety-plan it. [synthesis]

25. Negotiating conflict: problem solving and communication (Session 9) [2nd ed. Session 8: Improving Family Relationships With Effective Problem Solving and Communication]

Purpose: Replace coercive arguing with structured negotiation, especially with older children. [source: CPC Pitt; Research Press contents; Stormshak et al. 2018 protocol (listening, asking questions, problem solving)]
Steps: [synthesis] Pick a calm time. Each person states the problem without blame, and the other summarises it. Brainstorm options without judging them. Agree a trial solution. Review it later.
Example language (illustrative): "Let's each say what the problem is for us in one sentence, and the other person says it back before replying."
Watch for: Problem solving started in the heat of a conflict. It is working when the family can reach and try an agreed solution. [synthesis]

26. Choosing solutions to family problems (Session 10) [2nd ed. Session 9]

Purpose: Evaluate the brainstormed options and commit to one. [source: CPC Pitt; Research Press contents]
Steps: [synthesis] Weigh each option for its pros and cons for each person. Choose one everyone can live with. Specify who does what by when. Put it in writing. Set a review date.
Example language (illustrative): "Which of these could you both live with for one week as an experiment?"
Watch for: The parent overriding the young person, or vice versa. [synthesis]

27. Proactive positive routines and shared family routines and activities (Sessions 11–12) [2nd ed. Session 11: Practices That Promote Communication and Connection: Shared Family Routines]

Purpose: Strengthen the relationship and predictability through regular positive time and routines. [source: CPC Pitt; Research Press contents; Stormshak 2019 slides]
Steps: [synthesis] Identify the current daily routines (morning, homework, meals, bedtime). Make one routine more predictable. Schedule short, regular, child-chosen positive time. Plan a shared family activity. In the older-child FIT, planning a family activity is an assessment task, and its video can guide this work. [source: webinar slides for the FIT task]
Example language (illustrative): "What's one thing you all enjoy together that could happen every week, even for twenty minutes?"
Watch for: Activities dropped when busy. Keep them small and fixed in the calendar. [synthesis]

28. The Good Behavior Game at home

Purpose: Used in the Early Steps case as one of the strategies for a toddler's aggression and noncompliance. [source: Gill et al.]
Steps: The source names it but gives no procedure [uncertain]. Do not run it as an FCU procedure without the relevant training materials. Item 16 covers the comparable incentive-based approach. [synthesis]

Part C. Ecological, school, online and fidelity components

29. Addressing contextual risks: referral, advocacy and case management

Purpose: Reduce the context-level barriers to parenting: parental stress, depression, anxiety, substance use, limited social support, co-parenting conflict, unsafe housing or harassment. [source: UO PSI; Gill et al.]
When: When the feedback shows a red-flag context. Do this first if safety is involved (THINK: harm reduction first). [source: webinar slides; Gill et al.]
Steps:
1. Give psychoeducation linking the stressor to parenting and to the child's behaviour. In Early Steps, for example, the consultant explained how depression affects parenting. [source: Gill et al.]
2. Make an active referral and advocate, for example by connecting the parent with a psychiatrist. [source: Gill et al.]
3. Problem-solve practical safety steps with the family. In the Early Steps case the family moved away from a harassing ex-partner within three months. [source: Gill et al.]
4. Come back to the parenting goals once things are stable. [source: Gill et al.]
Example language (illustrative): "You've told me how low you've been feeling. Many parents find that when they get help with that, the parenting stuff gets easier too. Would you be open to me helping set up an appointment?"
Watch for: Referrals the parent does not take up. Follow up at the next contact. [synthesis]

30. School interventions and home–school coordination

Purpose: Improve behaviour and success at school, and strengthen home–school communication. [source: UO PSI; Stormshak 2019 slides]
Steps:
1. Consult with the school, with consent. [source: UO PSI]
2. Set up a home–school behaviour plan, for example a daily report that home rewards. [source: UO PSI; daily-report detail is synthesis]
3. Structure school routines such as homework schedules. [source: UO PSI]
4. Set up a home-to-school communication routine. [source: Stormshak 2019 slides]
5. In school-partnership models, coordinate with the school's own behaviour programmes, often with on-site therapists. [source: Stormshak 2019 slides]
Example language (illustrative): "Would it help if you, the teacher and I agreed on one behaviour to track every day, with a quick note home?"
Watch for: Staff turnover, which the developers note as a weakness of school partnerships. [source: Stormshak 2019 slides]

31. Reading support (kindergarten version)

Purpose: Help parents support early reading and school adjustment. [source: Stormshak 2019 slides]
Steps: Set a regular reading routine. Keep it enjoyable and at the child's level. Ask questions about the story. Encourage the child, follow their lead, and don't force reading. Link books to real life. Ask the teacher which strategies to use at home. [source: Stormshak 2019 slides, paraphrased]
Example language (illustrative): "What do you think will happen next? Has that ever happened to you?"
Watch for: Reading turning into a battle. Shorten it and follow the child's interest. [source: Stormshak 2019 slides]

32. Monthly follow-up support and brief check-ins

Purpose: A low-intensity option for families who want light-touch support. [source: UO PSI]
Steps: [synthesis] Make a short monthly call or visit. Review the goals from feedback. Problem-solve one current issue. Offer a step up to Everyday Parenting if needed.
Example language (illustrative): "How have mornings been since we last spoke? Anything you'd like to tweak?"
Watch for: Problems that are getting worse. Offer more intensive options. [synthesis]

33. Annual re-check (health-maintenance check-up)

Purpose: Track progress, catch persistent problems, and re-engage families who were not ready earlier. [source: Gill et al.]
Steps:
1. Repeat the interview, assessment and feedback at least yearly, or at key transitions. [source: Gill et al.; Stormshak 2019 slides]
2. Compare the new data with earlier years in the feedback. A problem that has persisted or worsened is often what motivates a family that minimised it before. [source: Gill et al.]
3. Update the goals and the menu choice. [source: Gill et al.]
Example language (illustrative): "Last year you said you'd wait and see about the tantrums. Here's how this year's picture compares. What do you make of it?"
Watch for: Families lost to follow-up. Keep up contact between check-ups. [synthesis]

34. FCU Online with coach support (named variant)

Purpose: Remote or self-directed delivery, for example for rural families and parents of middle-school students. [source: Stormshak et al. 2018 protocol; Stormshak 2019 slides]
Steps: [source: Stormshak et al. 2018 protocol]
1. The parent completes an online assessment based on Strengths and Difficulties Questionnaire items plus additional items from the Oregon group.
2. They receive colour-coded feedback (green strength, yellow needs attention, red serious concern) in an MI style, highlighting strengths and offering choices.
3. They work through four skill sessions: positive parenting (encouragement, praise, clear directions, rewards); setting limits (reasonable rules, predefined consequences, consistent follow-through); monitoring; and open communication (listening, asking questions, problem solving).
4. The site has role-play and interactive activities, behaviour and mood tracking, model videos showing effective and ineffective ways, text and email prompts, and a library.
5. In the coach condition, the coach makes at least two brief calls (typically under 30 minutes) to set goals, review results, support and motivate. The design follows a supportive-accountability model, and coaching is not designed to require advanced clinical training.
Example language (illustrative): "I saw you finished the limits module. How did trying the new phone rule go this week?"
Watch for: Low engagement with the website. Use coach calls and prompts. FCU Online was a trial protocol, so check that it is currently available [uncertain].

35. COACH fidelity self-monitoring (therapist tool)

Purpose: Keep delivery competent and prevent drift. [source: CEBC; Smith 2013 slides]
Steps:
1. Record sessions, especially the feedback session, with consent. [source: CEBC; Smith 2013 slides]
2. Rate the session on the COACH dimensions: Conceptually accurate to the model; Observant and responsive to the family's context and reactions; Actively structures the session; Carefully teaches and gives corrective feedback; Hope and motivation instilled. Caregiver engagement is rated separately. [source: CEBC; Smith 2013 slides]
3. Each dimension uses a 9-point scale: 1–3 needs work, 4–6 acceptable, 7–9 good. [source: Smith 2013 slides]
4. Review ratings in consultation, and have certified supervisors double-rate sessions. [source: CEBC]
Watch for: Ratings in the "needs work" band on a dimension. Target that dimension in supervision. The full COACH manual and anchors are not drawn on [uncertain].

5. Handling problems

Parent minimises the problem or is not ready. Roll with resistance: agree that the problem may resolve, then explore what would happen if it did not. Develop discrepancy against the parent's own goals, and avoid arguing. [source: Gill et al.; webinar slides] Accept a "no follow-up for now" choice and rely on the annual re-check. Families who minimise in year one often engage once the next year's data show the problem has continued. [source: Gill et al.]

Defensiveness or shame during feedback. Start with strengths, and use the parent's self-assessment before your data. Show strength video clips. Normalise the struggle, and affirm that they have been trying. [source: webinar slides; Gill et al.] Present concerns as a parenting frame and a shared puzzle, not as a verdict. Offer fewer messages rather than more. [synthesis]

Overwhelm: parent distressed, depressed or in crisis. Slow down and reflect. Let the parent move on when ready. [source: Gill et al.] Put harm reduction and safety first (THINK). Pause skill training, and use referral and advocacy (item 29) until things are stable, then return to the parenting goals. [source: webinar slides; Gill et al.] Assess parental suicidality using your service's standard risk assessment if depression is significant. [synthesis]

Child-safety concerns (harsh or physical discipline, domestic abuse, neglect). Harm reduction takes priority over the parenting curriculum. Follow your mandated-reporting and safeguarding duties. Tell the parent, where safe, what you must do and why, and keep offering support. [source: webinar slides (harm reduction priority); procedure is synthesis]

Stuck: a behaviour plan is not working. Use the barriers session (item 17). Check the chart data, the target size, how much the reward is valued, how quickly it comes, and consistency across caregivers. Then change one variable. [source: CPC Pitt (session topic); steps synthesis] Re-check for an unaddressed context problem such as couple conflict or depression. [source: UO PSI]

Non-adherence to home practice. [synthesis] Make tasks smaller and specific to one situation. Rehearse them in session. Plan when and where they will happen. Use text or email reminders, which FCU Online uses. [source: Stormshak et al. 2018 protocol] Explore the parent's ambivalence with MI rather than lecturing.

Missed sessions and drop-out. Bring the work to the family: home visits, flexible times, phone or online contact. Keep a light-touch monthly option open. [source: UO PSI; Stormshak et al. 2018 protocol; synthesis for application]

Rupture with the parent (feels judged, disagrees with feedback). Acknowledge the rupture openly and reflect the parent's view. Re-anchor on their own goals and words. Re-offer choice from the menu. [synthesis informed by MI strategies in webinar slides] Review the session's COACH rating, especially "observant and responsive", in supervision. [source: CEBC]

Co-parents disagree, or only one caregiver engages. Invite both caregivers to the feedback session where safe. Frame goals around the child. Use problem-solving skills (items 25–26) between the adults. Where there is harassment or abuse, safety comes first and joint sessions are not appropriate. [source: Gill et al. (ex-partner harassment handled as a safety priority); remainder synthesis]

Adolescent refuses to take part. [synthesis] Proceed with the parent alone. The FCU targets parenting, so the adolescent's participation is not essential to progress. Offer the young person a brief, separate, respectful conversation. Focus on monitoring and communication skills that do not depend on the teen joining sessions.

Video recording refused. [synthesis] Proceed with questionnaires and interview, and observe the tasks live with notes, or drop the observation. The developers report dropping video for large-scale dissemination. [source: Stormshak 2019 slides]

Cultural fit. Tailor the feedback to the family's culture, socioeconomic situation and structure. Use culturally relevant measures and feedback processes where available. [source: Gill et al.; Stormshak 2019 slides] Check whether norms used on the Feedback Form apply to this family, and explain any limitations. [synthesis]

Modality-specific difficulty: misreading "red" scores. [synthesis] Normative colour codes can feel like labels. Present them as information about where support could help most, and always pair them with green areas.

Modality-specific difficulty: delivering outside fidelity. Practitioners who are not certified, or who drop the assessment or feedback structure, are not delivering the FCU as tested. Seek consultation and COACH review. [source: CEBC; Blueprints]

Sources

Sources

Family Check-Up: Intervention Process (UO PSI). Cited as "UO PSI".
Family Check-Up, Blueprints for Healthy Youth Development. Cited as "Blueprints".
Family Check-Up webinar slides, National Register of Health Service Psychologists. Cited as "webinar slides".
Gill, Hyde, Shaw et al., The Family Check-Up in early childhood: a case study (Early Steps). Cited as "Gill et al."
Stormshak, FCU at school entry, slides (Jan 2019). Cited as "Stormshak 2019 slides".
Stormshak et al. (2018), The Family Check-Up Online program for parents of middle school students: protocol for an RCT, JMIR Research Protocols. Cited as "Stormshak et al. 2018 protocol".
Smith, J. D. (2013), Assessing fidelity (COACH), SIRC conference slides. Cited as "Smith 2013 slides".
Family Check-Up (FCU), CEBC implementation page. Cited as "CEBC".
Everyday Parenting, Center for Parents & Children, University of Pittsburgh. Cited as "CPC Pitt".
Everyday Parenting, 2nd ed., contents (Research Press). Cited as "Research Press contents".
Everyday Parenting, 2nd ed., product page (Research Press). Cited as "Research Press product page".
NIDA Family Checkup: Setting limits. Cited as "NIDA Family Checkup"; its relationship to the FCU developers was not confirmed [uncertain].
Family Check-Up for Children, Foundations Guidebook (UK). Cited as "Foundations".

Further reading (not drawn on)

Dishion, T. J., Stormshak, E. A., & Kavanagh, K. (2011/2012). Everyday Parenting: A Professional's Guide to Building Family Management Skills (1st ed.). Research Press.
Stormshak, E. A., Mauricio, A. M., & Gill, A. M. (2nd ed., about 2024). Everyday Parenting: A Professional's Guide to Building Family Management Skills. Research Press. Only the table of contents and product description are drawn on.
Dishion, T. J., & Stormshak, E. A. (2007). Intervening in Children's Lives: An Ecological, Family-Centered Approach to Mental Health Care. American Psychological Association. [uncertain].

Further reading (not drawn on): the Research Press sample pages, the full COACH manual, the FCU Feedback Form, the FIT coding form, and the current FCU questionnaire battery. Step-level detail for Everyday Parenting sessions is therefore marked [synthesis] or [uncertain] throughout.

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