Breaking Cycles: How Education Lifts Families

In the previous article associated with this series, I discussed Healthy Relationships Utah at length. However, this organization does not have a monopoly on excellent community-based relationship education programs funded by public dollars. Over the years, I have visited several other programs and listened to many other presentations about them at national conferences. I’ll highlight here just two programs that I admire. They both serve individuals and couples in the time around the birth of their babies but in different ways.  

MotherWise Denver

 Just over the Front Range to the east is a unique program under the label of MotherWise that serves mostly low-income pregnant women and new mothers in the Denver area. MotherWise is the flagship program of Thriving Families and the on-ramp for a set of other valued services for these lower-income moms. A class in English or Spanish begins almost every week, so moms can start the program right away. Teen moms have their own separate classes, using a different curriculum, Love Notes (which is also used in Healthy Relationships Utah). The curriculum is designed for individuals rather than couples, although many of these moms are in romantic relationships, married, and all have children. MotherWise is a 6-week, 12-hour educational program focused on gaining knowledge and skills for healthy relationships using the well-researched Within My Reach curriculum. It also includes information on mothers caring for and connecting with their babies. Many of the participants have experienced trauma in their lives growing up and/or within their romantic relationships. For some, the class alerts them to the reality that they are in a dangerous relationship which can help them make decisions and plans for exiting the relationship safely, if they choose. The Within My Reach curriculum used in the program was designed with sensitivity to how trauma can impede learning and change. In-person classes resumed summer of 2022 (after the pandemic disruption), but program administrators learned a lot about online delivery of their classes and continue to offer that popular delivery option as well. The opportunity for online classes provides fewer logistical challenges for moms and is more economical for MotherWise. 

I had the opportunity to observe an in-person class last October. The class was held in Thriving Families’ downtown Denver office in a nondescript office building next to the state courthouse. The building also houses offices for the local Family Justice Center that serves survivors of domestic violence. Moms arrived with babies, older kids (free childcare provided), strollers, and diaper bags in tow. Many took advantage of free Uber rides to classes that Thriving Families pays for. This was deemed an important expense for the program because transportation issues are a big challenge for moms to attend weekly classes. What seemed like a large classroom quickly becomes tight with about 8 moms, 5 babies in carriers, and all the accompanying baby gear. One mom is missing (she gave birth two days ago), and breastfeeding war stories are the informal topic of conversations as participants get settled before class begins.

Collette, a mom and grandmother herself and a veteran human services worker, begins the class by highlighting last week’s lesson on communication danger signs and then launches into a lesson on communication skills that can de-escalate conflict. Such tactics include taking time outs (a very structured way to say “I’m losing it” in an escalating conversation and leave to calm down), XYZ statements that “own” emotions about a problem rather than blame and attack a partner (X = “I felt frustrated” Y = “when the dishes were still piled in the sink” Z = “when I got home last night.”), and the speaker-listener technique (a way to slow down a potentially heated discussion by structuring who talks when, who listens when, and building understanding of a problem before misunderstandings derail the conversation). There is plenty of chaos in these women’s lives in which misunderstandings and hard feelings can come easily. Hence, good communication skills are important for these women to manage their day-to-day challenges. There was no shortage of group participation; this was real life for them. Additionally, in research on relationship education programs, participants consistently do not find that one of their primary reasons for taking these kinds of classes is they want to learn how to stop fighting with their partner. I was surprised by how well moms could juggle fussy babies and still stay intellectually engaged with the curriculum throughout the class. For moms with older children, an onsite daycare center allows them to more fully concentrate on the class. A break for a healthy lunch buffet helped to keep blood sugar levels up.

I was also impressed with how Collette fielded comments and questions and sometimes skillfully steered conversations back to the lesson. Despite the large amount of group participation, she was able to cover the scheduled curriculum for the class that day. She taught without notes, keeping constant eye contact with the moms, and even occasionally bouncing a participant’s baby on her hip. There was clearly a positive group dynamic among the participants, something many relationship education experts believe is crucial to good outcomes of these kinds of classes. The class ends with a list of infant care resources in the Denver area from which moms could benefit. The participants enjoyed being with each other and listening to other women’s stories and comments. One participant offered a ride home to another one at the end of class instead of her calling an Uber. 

MotherWise is just the gateway to other valuable supports. Thriving Families, the non-profit that runs MotherWise, also offers individual, couple, and family therapy for the moms who go through MotherWise. These voluntary therapeutic opportunities allow these women to work on problems that can go beyond what a group class can help with. Trauma-informed therapists offer 30-40 sessions a week on-site and virtually for participants. Additionally, Thriving Families offers postpartum depression prevention groups because these low-income moms are at especially high risk for postpartum depression. Some participants want more help with parenting, so there are regular parenting classes as well. Once a month, there is also a group session with a certified doula to answer questions about pregnancy and childbirth. About a third of MotherWise moms will participate in these additional support services. Overall, MotherWise enrolls 400-500 moms a year. 

Of course, navigating this array of internal services can be a challenge for overwhelmed moms. Therefore, the classroom instructors can do double duty as their “family support coordinators” by working one-on-one with participants outside of class to connect them with additional internal and community resources as needed and wanted. This may be one of the key ingredients of the program’s success that other programs might want to follow. Another key ingredient may be the drive for continuous improvement of existing services to meet the needs of their clients. However, the ‘secret sauce’ in all this, according to multiple MotherWise program administrators, is their ability to hire deeply caring and professional staff with low turnover rates. Dr. Galena Rhoades, an internationally known scholar of relationship education and a research professor at the University of Denver, provides overall leadership. She writes the grants to fund these programs and gives strategic vision to the operation and, additionally, is one of the most impressive practitioner-scholars I’ve ever known. While her role is essential, she relies on the Director of Programs and Community Outreach, Jessica Purcel, as the COO of Thriving Families, and other dedicated staff, to make the program dream an operational reality. Purcel came to MotherWise with a client services background in business, not the typical social services career history.

A researcher at heart, Rhoades insists that MotherWise be subjected to rigorous evaluation. Early studies have already found some encouraging results, including improved relationship skills, lower rates of unintended pregnancies, and a significant reduction in low-weight and pre-term births, especially for Hispanic women. Longer-term results found improved relationship skills and fewer relationship transitions. These outcomes have the potential to save money for moms, healthcare systems, and government public assistance programs.

Sometimes, when I observe these kinds of classes, I find myself wondering whether they really have sufficient ‘oomph’ to lift participants’ relationships and family lives above their challenging circumstances. In this case, however, I could sense how this kind of class—along with the additional services—would be a powerful support system for moms going through stressful times and provide a real lifeline for some. Program administrators told me that for some of the moms, MotherWise was really their only support system. As more research evaluating this program emerges over the next few years, I expect it to prove its merits and cost-effectiveness. 

Family Expectations and True Dads—Oklahoma City

Further east is a program in Oklahoma City. On an unusually balmy December 2022 evening, I sat in on Family Expectations and True Dads classes in Oklahoma City. This program is offered through Public Strategies Inc. (PSI), a private human services company that delivers relationship education, fatherhood and co-parenting education, and workforce development services to lower-income individuals and couples in Oklahoma City. PSI is one of the premier providers of these kinds of educational services in the country. Kathy Edin, Princeton University professor and one of the most important social policy scholars in the country, believes that PSI’s work is one of the most important local social policy laboratories in the country right now. She argues that what they do is a beacon for other social policy efforts nationwide to improve the lives of disadvantaged families. Given their programming experience, skill, and innovation, the federal government’s Office of Family Assistance also contracts with PSI to consult with other similar federally funded programs.

Along with Edin, I have served on the National Research Advisory Group for this organization since 2010. We meet annually in December to review PSI work and accomplishments and to discuss improvements. Not many would claim that wind-blown, brown-drab Oklahoma City in December is their favorite holiday destination, but Christmas comes early for me each year when I get to hang out for two days with a gaggle of skilled practitioners, dedicated policy administrators, and nerdy researchers.

PSI’s founder and president, Mary Myrick, has been leading this work for 25 years now. She is a home-grown resident who speaks in a slow Oklahoma drawl that belies a keen mind that is equally adept at managing the minute details of providing high-quality services to lower income families and executing the rigors of social policy evaluation studies. Additionally, she more than holds her own in esoteric ruminations about how to build a better social welfare system. PSI’s work in this field started in the late 1990s as a unique state policy initiative to strengthen marriage and reduce divorce rates. During this time, Oklahoma’s divorce rate was outranked only by Nevada, and then-Governor Frank Keating wanted to do something about it. Myrick’s public relations firm was tasked by the governor to build a statewide infrastructure for providing marriage education services to Oklahomans. She built an impressive operation in the early 2000s before the Great Recession, and big budget cuts forced her to focus resources on a more limited area. From that point, federal grants supported continuing services in Oklahoma City. During the Obama administration, program providers were also urged to offer employment services to program participants, and Myrick embraced this opportunity to help couples financially as well as relationally. Both fathers and mothers have the opportunity to improve their employability and find work. Employment challenges and financial stresses are a big factor in why lower income families may struggle to stay together. With another grant, PSI eventually added a fatherhood and coparenting program to their portfolio, enabling them to serve low-income families better regardless of the status of the parents’ relationship. Each of these services—couple, father/co-parenting, and employment—is integrated with the others, and program participants often use multiple services. PSI is a valued partner with the Oklahoma Department of Human Services in an effective private-public partnership to serve disadvantaged families in Oklahoma City. 

At the end of one Research Advisory Group meeting, I stayed an extra evening to observe the Family Expectations and True Dads classes being taught in their renovated facility on the edge of the trendy redeveloped Bricktown downtown area of Oklahoma City. Couples slowly gathered in their respective classrooms, bringing in a modest meal of pasta and salad, which was provided to the couples due to the late start time of 6 pm. Onsite childcare is provided as well when needed, so couples don’t have that added expense and can concentrate on the curriculum and activities. Eventually, about 5 couples settled into the Family Expectations classroom’s comfortable chairs, each well representing the racial and ethnic diversity of Oklahoma City.

Keesha, Marlon, and Brittany were their instructors that night. Keesha, a short African American woman in jeans and a colorful Christmas sweater that jingled as she swished around the room, actually was a participant in a Family Expectations class about 10 years ago. She is an engaging presenter and skilled facilitator. While most of the 10-week, 30-hour curriculum is focused on principles and skills to help couples understand each other better, communicate more effectively, and regulate their emotions, tonight, the primary focus is on infant care. One of the moms in the room was a “veteran”—this was her second child, but the first for her male partner. Marlon is a tall, married, African-American grandfather who jokingly mentioned that his last child is about to leave home, and he is trying to convince his wife to adopt another child because he doesn’t want to be an empty-nester. He, too, is a dynamic presenter. The third facilitator, Brittany, is a tiny, young, vivacious White, pregnant woman also dressed in a colorful Christmas outfit accessorized with teal high heels. Despite her startling, high-pitched, childlike voice that you would more expect to hear in a preschool center than in an adult development class, she exudes confidence and makes the participants feel completely at ease.

After a PowerPoint lesson on building babies’ brains, I follow the men upstairs to another room for “baby boot camp,” where they practice on life-like infant dolls. Marlon dials down his strong voice to a softer, earnest mode to help the men understand that they need to be out ahead of their female partners in childcare. “Before you come home from work, you call her and ask if you need to pick up anything for the baby or dinner on your way home,” he commands more than suggests. “And those dishes in the sink when you get home are your responsibility. Later, when she is nursing the baby, you are there rubbing her feet or talking to her. She is not alone in this; she has a full partner. This is father-of-the-year stuff, men,” he preaches. Then, he patiently teaches them how to swaddle and hold an infant, practicing it with them three times. He doesn’t leave out the high-pitched baby talk so essential to infant linguistic, cognitive, and emotional development. His father-in-waiting trainees are fully engaged now. I can’t help but smile at the scene of five wide-eyed young men—probably equal parts excitement and terror as they anticipate their coming baby—gooing and smiling at their infant dolls as they carefully wrap and tuck them in their upside-down triangle baby blankets and gently slip their hand under the doll’s neck and head to lift and cradle them.

After enjoying this optimistic scene, I slip out of this classroom and into the room next door, where a session of True Dads is going on. Again, a tall African-American man with a large fedora hat is facilitating, regularly calling on the men and their partners by name as he circumnavigates the room, asking them to respond to a question or say what’s on their mind. They are talking about “Amy” and “Flo,” animated characters in a video they just watched that represent the different parts of the brain that are involved in emotion regulation and our “fight or flight or freeze” response. I recognize this material from the PREP relationship-strengthening curriculum out of the University of Denver, from which the True Dads program draws a healthy sample of its content. The 5 or 6 couples and a few “stag” men in the room are trying to learn how to harness their emotions and avoid destructive communication patterns that break apart coparenting relationships and make it hard for men to stay engaged in their children’s lives. A second facilitator, a grandmotherly African-American woman with a constant smile and encouraging demeanor, leads a discussion on depression and getting past the stigma of asking for professional help. I get a sense that these True Dads participants are not quite as engaged and upbeat as the expectant couples in the Family Expectations class downstairs. Probably most of them are no longer in romantic relationships but are trying to hold together a workable relationship as co-parents of a shared treasure.

When a snack was delivered to the rooms to keep participants’ blood sugar levels elevated for the remaining hour of the evening’s instruction, I slipped out and made my way back downstairs to the Family Expectations classroom, where the mothers were talking about labor and delivery expectations. Feeling a little out of place as the only man in the room, I roam the halls and chat with a few of the support staff who are there. PSI is regularly rated as one of the best places to work in Oklahoma. As president, Myrick gives serious attention to building strong relationships among coworkers too. You can not help but feel that whatever their particular job, these workers believe deeply in what these programs are trying to accomplish—is accomplishing.

 Where other programs artfully dodge the close-up lens of evaluation research, PSI has enlisted in three federally funded, rigorous evaluation studies. Family Expectations was evaluated twice, once focusing on unmarried couples and a second one looking at married couples. In the first study with unmarried couples, Oklahoma City was one of eight couple-relationship-strengthening programs evaluated across the United States. This multi-year study, labeled Building Strong Families, was the first to assess the effectiveness of these new programs serving disadvantaged couples. It studied them right at the beginning while the program administrators were still on a steep learning curve. In most sites, many participants who signed up for the program never showed up, and only a small percentage had a substantial dosage of the intervention, but this was not the case in Oklahoma City. Building on several years of experience, Myrick and her team had already figured out how to recruit and retain these stressed couples. Most of their recruited couples received a strong dosage of the intervention. Maybe this is why the Oklahoma City site was the only one to see some positive results at the end of the study, finding a statistically significant difference in the percentage of Family Expectations couples who were still together three years after beginning the program (49%) compared to control-group couples who did not receive the intervention (41%). However, no programs in the study found a difference in the percentage of couples who decided to marry during the course of the study.

A second rigorous study of Family Expectations concentrated on the married-couple participants. Again, Oklahoma City was one of eight program sites across the country testing the effectiveness of these marriage-strengthening programs. This time, most sites, including Oklahoma City, found a reliable pattern of positive but relatively small effects on couple relationships. However, there was no difference between the treatment and control groups in the percentage of married couples who were still together at the end of the 30-month study.

I think it is worthwhile to note that the Family Expectations program has survived two rigorous tests now showing positive effects. This is especially impressive because the ‘norm’ of these kinds of social policy evaluation studies is finding “no effects,” particularly when they are done at the early stages of program development like these studies were. From these results, a confident PSI launched another rigorous study to test the effectiveness of its new fatherhood/co-parenting program. Serious evaluation of these kinds of fatherhood programs was lagging behind the couple programs. For a third time, a PSI program demonstrated its skill with results that noted a decrease in fathers’ psychological distress, improvement within their coparenting relationships and parenting practices, and, perhaps most impressively, improving children’s psychological well-being. Showing the positive effects of these adult education programs on children’s well-being has been the holy grail of this work because their ultimate purpose is to improve disadvantaged children’s lives.

My University of Wisconsin colleague, Dr. Sarah Halpern-Meekin, has gone beyond the numbers and conducted in-depth interviews with these program participants. They talk about their hopes for and experience with the programs in more personal terms. “Tiana knows life will spill many more ‘glasses of milk,’” Halpern-Meekin writes in her book, Social Poverty, “and so [Tiana is] banking on Family Expectations to provide them with some tools so such mishaps are not ‘catastrophic.’ And it’s essential to her that [her partner] Stefan is by her side through all this.” Additionally, Halpern-Meekin further explains the primary motivation she found for why parents enroll in these classes: 

“Parents often explained that one of the life experiences they most wanted to give their children was that of growing up with both their parents in a loving and healthy household —they saw this as a social resource. An investment in their own relationship, therefore, was a guard against their children’s social poverty.” 

Or as one mother put it, “I still want my son now to see that it’s us, and we’ve got a strong bond, and we can communicate . . . so that they have some kind of grasp of, you know what, people can make relationships work. That not every relationship fails.” 

Backed by scientific inquiry as well as through these personal testimonials, the programs I have highlighted here possess the ability to change the landscape of interpersonal relationships for some low-income families. From either a conservative or progressive perspective, there is much to be gained from public investment in these types of programs.