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Evidence-Based Programs

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Project TALC (Teens and Adults Learning to Communicate)

Overview of the Curriculum

Curriculum Objectives

Project TALC is designed to provide coping skills to parents living with HIV and their adolescent children.

For the parents, the goal is to reduce emotional distress and problem behaviors, such as substance use.

For the youth, the goal is to reduce emotional distress, problem behaviors, and teenage parenthood.

Curriculum Sessions

The intervention includes 24 sessions spaced out over a period of 12 Saturdays. The intervention is delivered in small, facilitated groups on Saturdays in local community centers. It can be offered over a period of four to six years.

Component 1: Parent Sessions
The first eight sessions of the program are targeted only to parents. In these sessions, parents meet in small groups with program facilitators to learn how to adapt to their HIV status, maintain healthy lifestyles, deal with emotional reactions to AIDS and the stigma associated with it, and how to disclose their HIV status to their adolescent children.

Component 2: Sessions for Parents and Adolescents
During the second component of the intervention (16 sessions), both parents and their adolescent children participate in the program. The sessions address reducing emotional distress, maintaining positive family relationships, and avoiding risky behaviors such as sexual activity and teenage pregnancy. In the session focused on teenage pregnancy, parents and adolescents discuss their beliefs concerning having a baby as a teen, think of problem-solving strategies, and engage in role-play and small-group activities. Refusal skills and condom-use skills are taught. These sessions also address issues such as making custody plans, expressing love and affection, and maintaining positive family routines with a very ill parent. Each of the sessions involves some activities for which parents and children are separated and some activities for which parents and children meet together. All sessions include goal-setting and problem-solving activities.

Component 3: Sessions for Adolescents and New Caregivers
Additional sessions are available for adolescents whose parents die from the disease. These additional sessions involve participation from both the adolescents and their new guardians or caregivers and focus on dealing with loss and grief, adjusting to their new relationships, and preventing risky behaviors and teen pregnancy. Refusal skills for risky sexual activity and condom-use skills are taught.

Unique Features of the Curriculum

This program features sessions for adolescents alone, HIV-positive parents alone, and sessions with youth and parents together. This is a long-term intervention which can be delivered over four to six years. The extensive curriculum addresses a broad range of issues and provides knowledge and coping skills for parents and their children living in stressful circumstances.

Theoretical Framework

Project TALC is based on Social Learning Theory, which states that learning occurs within a social context. It considers that people learn from one another, including such concepts as observational learning, imitation, and modeling.

Ordering and Training Information

Ordering: Curriculum materials are available online at chipts.ucla.edu/interventions/manuals/intervhra1.html

Training: The original implementation of Project TALC was delivered by social workers and psychology graduate students who completed a five-day training program.

Evaluation Fact Sheet

Intervention

Project TALC (Teens and Adults Learning to Communicate) is designed to provide coping skills to parents living with HIV and their adolescent children. For the parents, the goal is to reduce emotional distress and problem behaviors, such as substance use. For the youth, the goal is to reduce emotional distress, problem behaviors, and teenage parenthood. The intervention is delivered in small, facilitated groups over a period of four to six years, on Saturdays in local community centers.

Behavioral Findings

During the first 15 months after baseline, adolescents assigned to the treatment group experienced a reduction in emotional distress that was significantly greater than that experienced by adolescents assigned to the control group. Treatment adolescents also experienced a significantly greater decrease in anxiety. Reductions in emotional distress and anxiety did not differ significantly between groups after the 15-month follow-up, however.

Over the two-year follow-up period, adolescents assigned to the treatment group decreased their problem behaviors and conduct problems to a greater extent than did adolescents assigned to the control group. Specifically, adolescents in the treatment group had four times fewer behavior problems and 2.4 fewer conduct problems. Treatment adolescents also experienced significantly fewer family life stressors and experienced significant gains in self-esteem.

Parents also benefited from Project TALC. Compared with control parents, treatment parents reported lower levels of emotional distress and problem behaviors. Three-quarters of parents had disclosed their health status to their children before the program; however, the intervention did not have an impact on parents' willingness to disclose their HIV-positive status to their children or on their formation of custody plans for their children.

At the four-year follow-up (from program start): adolescents participating in the intervention were significantly less likely to report being a teenage parent.

Research Design

The target population was youth between the ages of 11 and 18 living with a parent with HIV. Three hundred seven financially-needy, AIDS-infected parents and 412 adolescent children constituted the study sample for this investigation. The majority (80%) of the parents were mothers.

Adolescent children of parents with HIV, who received services and were recruited from the New York City Division of AIDS Services. The mean age of youth was 14.6 years. They identified as 35% African American, 50% Latino, 4% white, and 11% other race or ethnicity.

All study participants were interviewed at baseline. Interviews assessed emotional well-being, problem behaviors, and self-esteem. Follow-up interviews occurred every three months for a period of two years.

Over the course of the two-year follow-up period, 134 of the AIDS-infected parents died - 62 from the intervention group and 52 from the control group.

References

Borus-Rotheram, M.J., Lee, M., Leonard, N., Lin, Y.Y., Franzke, L., Turner, E., Lightfoot, M., & Gwadz, M. (2003). Four-year behavioral outcomes of an intervention for parents living with HIV and their adolescent children. AIDS, 17(8), 1217-1225.

Borus-Rotheram, M. J., Lee, M. B., Gwadz, M., & Draiman, B. (2001). An intervention for parents with AIDS and their adolescent children. American Journal of Public Health, 91(8), 1294-1302.