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The 4 Rs and 2 Ss for Strengthening Families Program

Program Description

The 4 Rs and 2 Ss for Strengthening Families is a manualized, multiple family group therapy program designed for families who have a child between 7–11 years old diagnosed with a disruptive behavior disorder. The goals of the program are to 1) provide family time to develop and practice communication and togetherness, 2) reduce stigma of mental health issues by normalizing the family’s experience within a group, and 3) promote continued learning outside the group.


The multiple family group intervention is a 16-week series of meetings guided by a protocol that was developed by a collaborative group of parent advocates, providers, and the research staff. Groups are held on a weekly basis. A multidisciplinary team of one clinician and one parent advocate delivers the training to groups of six to eight families during weekly, 1-hour sessions. Adaptations that allow for a clinician to work with an individual family, and over a more condensed 8-week time frame, are also available.


The program focuses on helping families to strengthen four aspects of family functioning that have been empirically linked to childhood behavioral disorders. Specifically, four broad conceptual categories related to parenting skills and family processes form the targets for the 4 Rs and 2 Ss multiple family group service delivery approach. These include Rules, Responsibility, Relationships, and Respectful communication (4 Rs). Stress and Social Support (2 Ss) were added as the targets of the program to describe the impacts of child service engagement and outcome.

Program Snapshot
Evidence Ratings
Disruptive Behavior Disorders and Symptoms
Social Competence
Physical Health Conditions and Symptoms
Program Contact
Mary M. McKay, PhD


Dissemination/Implementation Contact
Lydia Franco, LMSW

Program Type
Mental health promotion
Mental health treatment


6-12 (Childhood)

Geographic Locations

Outpatient Facility

American Indian or Alaska Native
Asian or Pacific Islander
Black or African American
Hispanic or Latino

Implementation materials available
Dissemination materials available