Abstract
BackgroundSupport groups for children in troubled families are available in a majority of Swedish municipalities. They are used as a preventive effort for children in families with different parental problems such as addiction to alcohol/other drugs, mental illness, domestic violence, divorce situations, or even imprisonment. Children from families with these problems are a well-known at-risk group for various mental health and social problems. Support groups aim at strengthening children’s coping behaviour, to improve their mental health and to prevent a negative psycho-social development. To date, evaluations using a control-group study design are scarce. The aim of the current study is to evaluate the effects of support groups. This paper describes the design of an effectiveness study, initially intended as a randomized controlled trial, but instead is pursued as a quasi-experimental study using a non-randomized control group.Methods/designThe aim is to include 116 children, aged 7–13 years and one parent/another closely related adult, in the study. Participants are recruited via existing support groups in the Stockholm county district and are allocated either into an intervention group or a waiting list control group, representing care as usual. The assessment consists of questionnaires that are to be filled in at baseline and at four months following the baseline. Additionally, the intervention group completes a 12-month follow-up. The outcomes include the Strength and Difficulties Questionnaire (SDQ S11-16), the Kids Coping Scale, the “Ladder of life” which measures overall life satisfaction, and “Jag tycker jag är” (I think I am) which measures self-perception and self-esteem. The parents complete the SDQ P4-16 (parent-report version) and the Swedish scale “Familjeklimat” (Family Climate), which measures the emotional climate in the family.DiscussionThere is a need for evaluating the effects of support groups targeted to children from troubled families. This quasi-experimental study therefore makes an important contribution to this novel field of research. In the article various problems related to pursuing a study with children at risk are discussed.Trial registrationISRCTN52310507
Highlights
Support groups for children in troubled families are available in a majority of Swedish municipalities
International estimates indicate that 12-39% of all children have parents with mental health problems [7,8,9,10]; 10-40% are affected by domestic violence [11,12,13]; 8-30% grow up with at least one problem drinking parent [14,15,16,17]; about 2% of US children have a parent in prison [18]
Objective and research questions The objective of this study is to evaluate the effectiveness of support groups provided to children who grow up in families with parental problems
Summary
This paper describes a quasi-experimental study of support group interventions for children who grow up in families with parental psycho-social problems. The effectiveness of the groups will be evaluated using a controlled study design with two conditions: one group having access to the interventions and another group consisting of a waiting list control group. Many support group therapists expressed doubts about the RCT-design as they thought it was unethical to randomize children into the control condition. Once parents had made the decision to let their children participate in a group, many did not want their children to be allocated to a waiting list. This led us to conclude that if we retain the randomization protocol we run an imminent risk of not being able to pursue this study. At an early stage we abandoned the randomization protocol and instead use a more pragmatic approach, where the waiting list control group consists of a “natural” waiting list on hold for entering a support group
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