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Involving families in programs for pregnant teens

Hanson, S.L. (1992, May). Involving families in programs for pregnant teens: Practices and obstacles. Families In Society, pp. 274-281. (1992, July). Involving families in programs for pregnant teens: Consequences for teens and their families. Family Relations, 41, 303-311.


The Adolescent Family Life (AFL) is a government funded program for pregnant and parenting teenagers. In 1981 legislation was passed which revised Title XX of P.L. 97-35 to introduce a family approach to providing services. In addition to the teenager herself, family members are now "eligible persons to receive services." Between 65% and 85% of both pregnant teens and teen parents live with their families (Burt, Kimmich, Goldmuntz, & Sonenstein, 1984; Furstenburg, 1976; Polit-O’Hara, Kahn & Stevens, 1984). Significantly more negative consequences occur when mother and child live separate from their families (Baldwin & Cain, 180; Hofferth, 1987). The teenager’s mother has been shown to play a particularly important role, giving advice on a number of concerns such as nutrition, child care, whether to continue education or seek employment, etc. Significant re-adjustments on how family functions must often be made and often leads to conflict. Hence, services supporting the entire family are much needed. Unfortunately, these services are limited. Programs both historically and currently tend to see the teen as the client as opposed to the family. If the life chances of pregnant and parenting teens and their babies are to be improved, much more needs to be done in this area.


The purpose of these studies is to inquire into the strategies used by AFL to involve families in the support of pregnant teens and to assess the relationship between family involvement and outcomes.


Questionnaires were mailed to program directors (76), supervisors and line workers (104), and evaluators (53) in more than 50 AFL programs funded through 1986. The following categories of information were collected:

  • General program perspectives.
  • Intake practices (Participants in the initial interview—the teen by herself? Other family members?).
  • Program practices (Are families and fathers counted as separate clients?).
  • Follow-up practices.
  • Family involvement attitudes (Staffs’ opinion on effectiveness of family involvement).

Three care programs which rated the highest in regards to practices and outcomes were Teenage Pregnancy and Parenting Project (TAPP), Pathways, and Caring Network. These programs were targeted to measure family involvement and outcome. TAPP is located in San Francisco and emphasizes including male partners as clients in their program. Pathways is located in Hyattsville, MD. It includes an out-patient component and a mixed-race clientele. It strongly encourages family involvement, inclusion of a male partner, and adoption counseling. Caring Network has sites in Philadelphia, PA, Bridgeport, CT, and Patterson, NJ. It has a strong family involvement and adoption orientation. Given the small sample size and the incompleteness of the data, these studies only serve to provide preliminary analyses which hopefully will generate future studies with more refined data.


The following are the results of the review of the 50 AFL programs:

  • General program perspectives.
    • 32% Preferred counseling the teen only.
    • 30% Preferred counseling the teen and families separately.
    • 23% Preferred counseling the teen and families together.
  • Intake practices.
    • 50% Never asked the teen to bring someone along to the intake interview.
    • 51% Only rarely interviewed the accompanying person when there was one.
    • Only 8% of the programs require parental involvement.
  • Program practices.
    • Only 17% specifically request family members to be present during home visits.
    • 37% Counted family members as separate clients.
    • 49% Counted fathers as separate clients.
  • Discharge and follow-up.
    • 20% Of family members are part of discharge process.
    • 61% Of programs rarely or never contact families after discharge.
  • Family-involvement attitudes.
    • Four outcomes of family involvement are: infant health in first year, positive parenting practices, teen-parent relations, and continuation of teen’s education.
    • Least likely outcomes of family involvement are: repeat pregnancy, employment prospects and sibling pregnancy.

The following are the result of the research conducted on the three specific federally-funded agencies:

  • Teenage Pregnancy and Parenting Project (TAPP).
    • 24% Of the teens graduated when the father was a formal client, 9% when the father was an informal client, and only 5% when the father was not a client.
    • 35%, 44%, And 68% of the teens were on welfare when the father was a formal client, an informal client and not a client, respectively.
    • Over 90% of the teens used contraceptives after delivery when the father was a client. Only 68% used them when the father was not a client.
  • Pathways.
    • 56% Of those with family counseling were enrolled in school as compared to 22% of those without family counseling. Those with family involvement were also more likely to be working.
    • Family involvement was not found to have an impact on the infant’s health and feelings about an abortion decision after discharge.
    • 77% Of those who used 3 or 4 family services reported an improvement in family interaction as compared to 35% who had no services.
    • When the father had been involved in counseling, 75% contributed financially to the child’s support as compared to 39% when no counseling was given.
    • When the father was involved, the teen was less likely to be on welfare.
  • Caring Network.
    • Family involvement is shown to improve the teen’s relationship with the infant’s father.
    • Family involvement decreases significantly the likelihood of the teen needing public assistance.
    • Counseling of father and family significantly increased the likelihood of teen using birth control in the future.


Given the small sample size, these findings should be only considered exploratory. Much more research is needed. But, regardless of the small sample size and incomplete data, there appears to be a significant correlation between family involvement and positive outcomes for the teen and her child. In some cases parental involvement is not best for the teen. However, because many teens are forced to return to their families for support, a service is needed to strengthen the family system so that when they do go home, the positive effects of the original support are not diluted. Also, the definition of "family" needs to be broadened to include the infant’s father; this can only enhance the outcomes.


  1. What kind of impact can involvement of family members have on the life of the pregnant teen?
  2. Why would it still make sense for members of a dysfunctional family to be involved?
  3. What results can occur if the infant’s father is involved in the process?
  4. What improvements can be made by the agencies currently supporting pregnant teens?


  1. It is essential for the teenager to have ongoing familial support, given her limited resources.
  2. The involvement of the father increases the likelihood of the father taking responsibility and, as a result, enhances the likelihood of positive outcomes for the mother and child.
  3. When no family member is available, a close substitute must be found.
  4. Agencies providing services to the teen should also focus on family members and fathers.
  5. Agencies should attempt to strengthen the family system in order to increase the likelihood of positive outcomes for the teen and her child.

Dean Borgman cCYS