Abstract
BackgroundMulti-problem families face problems in several domains that are often found to be chronic and intergenerational. Effective mental health care for youth from these families is currently lacking, urging research on new methods. The InConnection approach is an integrated care program to improve resilience in multi-problem families by connecting the professional expertise from multiple disciplines with the informal social network of the youth. Specifically, youth are asked to nominate a youth initiated mentor (YIM) from among the supportive adults in their network. The aim of this protocol is to describe the design of a mixed-methods study to examine the effectiveness and working mechanisms of the InConnection approach.Method/designThe effectiveness of the InConnection approach is studied in a quasi-experimental questionnaire study using propensity score matching, with N = 300 families with youth aged 10–23 years receiving treatment in either the intervention group (InConnection approach) or the control group (care as usual). The main outcome variables include youth resilience (primary), youth mental health, parental functioning, and the number, duration and types of out-of-home placements. Mediators, moderators, and predictors of effectiveness are examined. Assessments take place at the start of the care program and after three, nine and 15 months. Additionally, semi-structured interviews are conducted with families who have and have not nominated a YIM to understand why some families successfully nominate a YIM, whereas others do not.DiscussionEffective care for youth in multi-problem families is urgently needed. Given its flexibility and accessibility to suit all youth aged 10–23 years from multi-problem families, and its low costs compared to out-of-home placements, the InConnection approach seems an appealing approach to support these families. The current study will provide information on the effectiveness of the InConnection approach. Strengths of this study include its robust design, the ecological validity, and the inclusion of possible mediators, predictors, and moderators of treatment effects.Trial registrationNetherlands Trial Register NL7565. Retrospectively registered on March 5, 2019.
Highlights
Multi-problem families face problems in several domains that are often found to be chronic and intergenerational
In this article we have presented the protocol of the Growth in Personal environment (GRIP) study designed to investigate the effectiveness of the InConnection approach, an individualized treatment program for multi-problem families with specific focus on collaboration with the social network
By conducting a prospective quasi-experimental study with propensity score matching, the GRIP study aims to examine the effectiveness of the InConnection approach as well as mediators, moderators and predictors of this effectiveness among multi-problem families
Summary
Giving the lack of convincing evidence for an effective treatment for children of multi-problem families [4, 5], evidence-based approaches are urgently needed. This study compares two different active treatment conditions that are similar in most aspects, such as the systemic and individualized approach and the intensity and duration of the treatment This makes it possible to disentangle the effects of the unique components of the InConnection approach, that is, the integrated care offered by a multidisciplinary team and the YIM. This study will contribute to our knowledge on the effects of multidisciplinary care and YIM in this complex target group of multi-problem families, and on factors that mediate, moderate and predict treatment effects. This knowledge could help to improve the care for multi-problem families and care targeted at improving resilience
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