Effectiveness Of Family-based Interventions Research Articles

The Effects of Family-Based Interventions on Oxidative Stress and Social Skills in Adolescents with Down Syndrome

The Effects of Family-Based Interventions on Oxidative Stress and Social Skills in Adolescents with Down Syndrome

Effects of family-based treatment on adolescent outpatients treated for anorexia nervosa in the Eating Disorder Unit of Helsinki University Hospital

BackgroundFamily therapy for adolescent anorexia nervosa (AN) has stronger evidence of efficacy in comparison with individual therapy, and family-based treatment (FBT) is the most evaluated in numerous randomized clinical trials. However, few studies have focused on how FBT performs outside of research settings. The current study is the first to assess clinical outcomes of FBT for adolescent AN in Finland, in a specialized outpatient clinic.AimThe naturalistic outcome of outpatient FBT for adolescent AN was investigated.MethodsFifty-two female patients and their families who received FBT at a tertiary eating disorders unit participated in the study. Data on their pre-treatment parameters, treatment details, and condition at the end of treatment (EOT) was collected from their medical records.ResultsAt EOT, a majority (61.5%) had achieved a full weight restoration [percentage of expected body weight (%EBW) ≥ 95%]. Participants with an %EBW ≥ 95 at EOT had a significantly higher pre-treatment %EBW than those with an EBW < 95% at EOT. Participants with an EBW ≥ 95% at EOT showed significantly higher total weight gain during the treatment period, a higher rate of regular menstrual periods at EOT, significantly lower rates of dietary restrictions, and less cognitive or behavioral symptoms of the eating disorder overall, compared to participants who did not achieve a normal body weight. In 22 cases (42.3%), there was no need for further treatment at the end of FBT. Participants who needed further treatment after FBT, compared to those who did not, showed significantly higher rates of psychiatric comorbidity, history of mental health treatment, and need for psychopharmacological treatment.ConclusionsIn this naturalistic study, and in line with previous studies, FBT for AN appeared to be an effective and sometimes sufficient intervention, especially for patients with milder weight deficit and less severe psychiatric comorbidities. The results show that FBT can be successfully implemented in Finland and suggest that training more ED clinicians in FBT would be beneficial.Trial registration: The study was retrospectively registered on February 8th, 2023, in ClinicalTrials.gov Protocol Registration and Results System, identifier: NCT05734573.

Addressing Comorbid Anxiety in Family-Based Treatment for Adolescent Anorexia Nervosa: User Experiences and Perspectives

Purpose: This study examines three families ́ experiences of the influence of comorbid anxiety on the effectiveness of family-based treatment (FBT) for anorexia nervosa (AN) and the effect of an add-in module addressing comorbid anxiety, and how this might interact with the families’ work on AN and the young person ́s (YP ́s) sense of self-efficacy. Method: Qualitative interviews were carried out with three families, who had been offered an add-in module at The Child and Adolescent Mental Health Centre of the Capital Region of Denmark. All interviews were analysed using thematic analysis.

2.40 Is Virtual Therapy Effective for Pediatric Eating Disorder Patients? An Exploratory Study

As a result of the COVID-19 pandemic, in-person pediatric eating disorder treatment was moved to a virtual format. The study explored the early treatment response and effectiveness of family-based treatment (FBT) delivered virtually.

Effects of Family-Based Interventions Using Mobile Apps on Youth's Physical Activity: A Systematic Review.

Objective. This review synthesized the currently available literature on the effects of family-based interventions using smartphone apps on youth physical activity. Design. Systematic review. Data Sources. 1037 studies from eight databases were retrieved. Eligibility Criteria for Selecting Studies. The seven articles included in this review met the following inclusion criteria: (1) experimental studies, (2) using smartphone apps, and (3) involving families with healthy children/adolescents. Results. Studies were stratified according to whether they used smartphone apps only or the combination of sports wearables and their associated companion app. The smartphone app interventions showed significant improvements in youth’s PA levels. All but one of the studies reported no significant improvement in PA levels after the intervention. However, positive PA-related outcomes were found, and the combination of sports wearables and their associated companion app showed inconclusive results due to the small number of studies. A trend of the relevance of families in improving the PA levels of youths was found. Conclusions. The findings of this review indicate that more research is needed on the effects of family-based interventions using mobile apps on youth’s physical activity. Mixed results were found for variables related to the PA of the youth involved in these programs. Although strong evidence was found that youth’s physical activity levels do not always improve with the implementation of these programs, promising results were found for a positive impact on different variables related to physical activity. Therefore, more experimental studies using only a mobile app to promote PA as the main outcome are needed to understand the real effect of mobile apps on youth’s PA levels. Future studies need to further explore this topic by developing programs based on designs of high methodological quality.

Mediation pathways for reduced substance use among parents in South Africa: a randomized controlled trial

BackgroundSubstance use is a major public health concern worldwide. Alcohol and drug use have increased during recent decades in many low- and middle-income countries, with South Africa, where this study was conducted, having among the highest rates in the world. Despite existing evidence on the effectiveness of family-based interventions in reducing substance use among parents and caregivers in low- and middle-income countries, little is known about the mechanism of change that contributes to the reduction. This study investigated mediators of change in a parenting programme (Parenting for Lifelong Health [PLH]) on reducing substance use among parents and caregivers of adolescents through three potential mediators: parental depression, parenting stress and family poverty.MethodsThe current study used a pragmatic cluster randomized controlled trial design. The total sample comprised 552 parent and caregiver of adolescents M = 49.37(SD = 14.69) who were recruited from 40 communities in South Africa’s Eastern Cape. Participants completed a structured confidential self-report questionnaire at baseline and a follow-up test 5 to 9 months after the intervention. Structural equation modeling was conducted to investigate direct and indirect effects.ResultsAnalyses indicated that the effect of the PLH intervention on reducing parental substance use was mediated in one indirect pathway: improvement in parental mental health (reduction in parental depression levels). No mediation pathways from the PLH intervention on parental substance use could be associated with parenting stress or family poverty.ConclusionsThe findings of the study suggest that intervention approaches targeting mental health among parents and caregivers have promise for reducing parental substance use. These findings emphasize the need to create supportive environments and systems for parents who suffer from emotional strain and mental health problems, particularly within families experiencing adversity.Trial registrationPan-African Clinical Trials Registry PACTR201507001119966. Registered on 27 April 2015. The trial can be found by searching for the key word ‘Sinovuyo’ on the Pan-African Clinical Trials Registry website or via the following link: http://www.pactr.org/ATMWeb/appmanager/atm/atmregistry?_nfpb=true&_windowLabel=BasicSearchUpdateController_1&BasicSearchUpdateController_1_actionOverride=%2Fpageflows%2Ftrial%2FbasicSearchUpdate%2FviewTrail&BasicSearchUpdateController_1id=1119

The Effect of Family-based Intervention on Overweight/ Obesity in Children: Meta Analysis

The Effect of Family-based Intervention on Overweight/ Obesity in Children: Meta Analysis

The Effectiveness of Family-Based Treatment on Attitude towards Substance Use in Female Students with Substance Use Disorder

The Effectiveness of Family-Based Treatment on Attitude towards Substance Use in Female Students with Substance Use Disorder

A Protocol for Integrating Neuroscience Into Studies of Family-Based Treatment for Anorexia Nervosa: An Approach to Research and Potential Benefits for Clinical Care

Anorexia nervosa (AN) is a life-threatening disorder with peak onset during adolescence. Prior research supports the effectiveness of family-based treatment (FBT) for AN in adolescents, but studies do not regularly include neuroimaging to investigate the effects of FBT on the brain. This is important because we know that malnutrition has a detrimental impact on brain volume, cortical thickness, and function, which often recover with weight restoration. Additionally, early weight gain in FBT has emerged as a robust predictor of treatment outcome, yet it is unclear whether it is associated with neural change. Understanding neural change during treatment, particularly in the early weeks, has the potential to improve outcome by enhancing motivation for rapid behavior change, while also highlighting mechanisms by which early treatment response leads to improved outcome. This manuscript describes a study protocol and discusses both challenges and implications for this type of integrative research.

Current State of Family-Based Prevention and Therapy of Substance-Use Disorders in Children and Adolescents: A Review

Current State of Family-Based Prevention and Therapy of Substance-Use Disorders in Children and Adolescents: A Review Adolescence is a vulnerable period for substance use disorders (SUD) as indicated by epidemiological studies. Research demonstrates the family's role for the etiology of SUD and provides a rationale for interventions based on family-associated risk and resilience factors. In this article, we summarize published results for family-based interventions from 2008-2018. Taken together, prevention programs can be effective when they focus on the promotion of broader developmental competencies and familial resources, rather than narrowly addressing substance use. Moreover, programs could benefit from targeting youth and parents as done in the "Strengthening Families Program 10-14"; most existing programs however target parents and do not include the adolescents. Family-based treatment programs with an evidence base are Multisystemic Therapy, Functional Family Therapy, Multidimensional Family Therapy and Brief Strategic Family Therapy. Overall, the effects of family-based interventions are small-to-middle sized but vary significantly across populations. Across the field of family-based interventions, there is a need for more knowledge on effective components and differential effects. The results could be improved by translational research such as on the emerging concept of mindfulness. Moreover, there is a need for implementation research and the effectiveness of service delivery programs on the community level in Germany.

Effectiveness of family-based treatment for pediatric eating disorders in a tertiary care setting.

Effectiveness of family-based treatment for pediatric eating disorders in a tertiary care setting.

Supplemental Material for Effectiveness of Family-Based Treatment for Pediatric Eating Disorders in a Tertiary Care Setting

Supplemental Material for Effectiveness of Family-Based Treatment for Pediatric Eating Disorders in a Tertiary Care Setting

The Effectiveness of Family-Based Intervention on Symptom Severity, Expressed Emotion and Coping Styles of Bipolar Patients

Background: There is a growing body of literature on the effectiveness of family-based interventions in bipolar disorder (BD). Objectives: The present study aimed to determine the effectiveness of a family-based intervention on expressed emotion, coping styles of family and symptoms severity of bipolar patients. Methods: An experimental design using pretest, posttest, and a three-month follow-up was used. The population comprised family members of patients with one type of bipolar disorder spectrum who were hospitalized in a referral Psychiatric Hospital in Tehran, Iran, during the second half of 2017. Sixty-two patients were selected randomly and assigned randomlyinto two groups of experimental and control. Then, the main caregiver of their family was invited for participation in the research. They had no diagnosis in axis I and they were eager to participate in the study. 12 sessions of family-focused therapy (FFT) based on the Micklowitz protocol with some adaptation for Iranian families were used for the experimental group. The control group was on the waiting list and received no intervention. The following measurement tools were used: the Young Mania Rating Scale (YMRS), Coping Inventory for Stressful Situations (CISS), and Emotional Expressiveness Questionnaire (EEQ). Data were analyzed via repeated measures analysis of variance test. Results: The results showed that there was a significant difference between the two groups in coping styles and expressed emotion (P = 0.023). The symptoms severity was 46.4 ± 5.9 in patients and 54.5 ± 6.9 in controls (P = 0.038). The results remained at follow-up (P = 0.041). The effect size of 0.8 indicated a high promotion after treatment. Conclusions: The family-focused therapy was effective in decreasing emotion expression in families and improving coping styles of family members. It led to an improvement in symptoms severity in patients. Therefore, it is recommended as supplementary to pharmacotherapy in patients with bipolar disorder and their families.

Effectiveness of family-based weight management interventions in childhood obesity: an umbrella review protocol.

The main objective of this umbrella review is to identify the effectiveness of family-based interventions that target overweight or obesity in children aged 18 years and under. The umbrella review intends to compare and summarize existing systematic reviews of experimental studies that address a range of family-based interventions for overweight children. Family-based is defined as the involvement of first- or second-degree relatives or carers who are cohabiting under one roof. The second objective of this umbrella review is to identify strategies that are effective in improving children's body weight or body mass index (primary outcomes) and, where applicable, changes in child/family behavior, including dietary intake or physical activity.The review questions are as follows: What is the effectiveness of family-based behavioral or lifestyle weight management interventions for overweight children? What are the strategies or characteristics of effective interventions in combating child obesity?

Disseminating FBT to a private practice setting: practicalities and pitfalls

The use of effective treatments for eating disorders has been emphasised, given their well-known risks. Despite this, the research-practice gap persists. The Redleaf Practice recently undertook an evaluation to explore the effectiveness of family-based treatment (FBT) for adolescent anorexia nervosa in a private practice setting. The study, while supporting the use of FBT in private practice, raised questions about barriers to the uptake of this treatment in this setting. This paper will therefore present an exploration of these challenges, and will offer practical recommendations to those considering the use of FBT in alternate treatment settings.

Psychosocial Well-Being of Adolescents Before and After a 1-Year Telephone-Based Adiposity Prevention Study for Families

PurposeBody image and psychosocial well-being play an important role in influencing health behavior of obese adolescents. Effects of family-based interventions on self-image and mental well-being are poorly understood. The effects of a parent-delivered intervention on psychosocial well-being in obese adolescents were investigated. MethodsA subset of secondary variables from the randomized-controlled Telephone-based Adiposity prevention study For Families (T.A.F.F. study) was analyzed. Multivariate analysis of variance and Pearson correlations were used to examine intervention effects on measures of body image, body dissatisfaction, self-efficacy, self-worth, and resilience and changes of standard deviation score of body mass index (BMI-SDS). ResultsA total of 154 randomized adolescents participated in this study (10–17 years). Body dissatisfaction decreased between baseline and follow-up (p = .013, confidence interval [CI], .03–.29), whereas self-efficacy increased (p = .022; CI, −1.73 to −0.14). Both were independent of the randomization arm. Initial body image was a negative predictor of self-efficacy after the intervention. Changes in body dissatisfaction and self-efficacy were positively correlated with changes in self-worth and resilience but were not related to changes in weight status. ConclusionsOverweight/obese adolescents have a high level of body dissatisfaction, more pronounced in girls than in boys. Interactions within families during overweight and obesity interventions need to be investigated in relation to adolescent body self-concept.

Case study: successful recovery from anorexia nervosa in a 19yr old patient using manualised FBT

At the Regional Eating Disorders Service (REDS) in Auckland Family Based Treatment (FBT) is the first line treatment offered to adolescents and their families - and with great success. At REDS we are also offering a choice to individuals over 18 and their families between FBT and individual treatment in an adult part of the service. This presentation describes a successful example of a client case study where FBT was provided with a 19yr old Japanese woman and her family. The case presented with some initial challenges like beginning treatment with a BMI of 14.9, parents needing interpreters and the family living 40km away. There is no evidence for the effectiveness of FBT for young adults; however in a case series published by Chen., LeGrange et al. (2010) they describe how FBT was used with 4 older clients with 3/4 at follow up being in the normal weight range. The presenter raises the question about whether services should offer FBT as a choice to those over 18 years and living at home and willing to have their family involved. This presentation will also discuss the question about whether there is a need to consider modifications to FBT with this older age group. A summary of data of FBT cases with young adults at REDS will be provided. This abstract was presented in the Treatment in Community and Inpatient Settings stream of the 2014 ANZAED Conference.

Family-based interventions for substance misuse: a systematic review of systematic reviews--protocol.

BackgroundWorldwide, there are an estimated 15 million individuals with drug use disorders and over five times as many with alcohol use disorders (WHO 1:2, 2005). Most individuals with substance misuse have families who are affected. Initial scoping searches identified an expanse of broad and disparate studies and reviews on the family interventions for substance misuse. This systematic review of systematic reviews aims to bring together the expanse of research on the effectiveness of family-based interventions in substance misuse.Initial scoping searches identified an expanse of broad and disparate studies and reviews on the family interventions for substance misuse. This systematic review of systematic reviews aims to bring together the expanse of research on the effectiveness of family-based interventions in substance misuse.MethodsExtensive electronic and manual searches will be undertaken. Screening, data extraction and quality assessment will be undertaken by two reviewers with disagreements resolved through discussion.The inclusion criteria will be that the study is a systematically undertaken review, the population is individuals with substance misuse problems and the interventions include a family-focused component. Reviews that focus on prevention rather than treatment will be excluded.The reviews will be assessed for quality and relevance. The evidence from included systematic reviews will be mapped by focus of intervention (promoting engagement of user into treatment/joint involvement in treatment of user/treating family member in own right) for both adults and adolescents for drug and/or alcohol misusers to allow assessment of the density of available evidence. The higher-quality, up-to-date evidence for each domain will be identified and described, and conclusions will be drawn with limitations of the evidence highlighted.DiscussionThis systematic review of systematic reviews will be an efficient and robust way of looking at the current state of the evidence in the field of family-based interventions for substance misuse.It will evaluate all the available systematic-review-level literature to report on the effectiveness of family-based psychological interventions in improving substance-related outcomes and improving health and wellbeing of substance misusers and/or their families. This will inform future treatment policies and commissioning decisions.In addition, it will identify areas of poor quality, inconsistency and gaps in the evidence base for family-based psychological interventions in substance misuse with respect to secondary evidence in order to inform future research.Systematic review registrationPROSPERO CRD42014006834

Family-based interventions for substance misuse: a systematic review of reviews

BackgroundWorldwide, there are an estimated 15 million individuals with drug use disorders and over five times as many with alcohol use disorders. Most individuals with substance misuse have family who are affected, regardless of whether they remain close and provide caring roles or have become estranged. Initial scoping searches identified an expanse of broad and disparate studies and reviews on the topic. We did a systematic review of reviews to bring together the expanse of research on the effectiveness of family-based interventions in substance misuse. Evidence from the highest quality systematic reviews was synthesised to inform future research and evidence-based commissioning. MethodsExtensive electronic (inception to April, 2012) and manual (April, 2012) citation searches were undertaken. Medline, Embase, CINAHL, Cochrane Library, PsycINFO, IBSS, Campbell Collaboration, and CPSI-S were searched via two parallel searches: one alcohol and one drug specific. Screening, data extraction, and quality appraisal were undertaken by two reviewers, with disagreements resolved through discussion. The inclusion criteria were that the study be a systematically undertaken review, the population be individuals with substance misuse problems, and the interventions include a family-focused component. Studies that focused on prevention rather than treatment were excluded. Quality assessment of the identified reviews was undertaken using the AMSTAR framework, and those fulfilling at least half the quality criteria were deemed to be of sufficiently high quality to draw evidence from. The level of evidence available supporting the interventions was categorised into three areas: (1) working with family members to promote user entry into treatment; (2) joint involvement of user and family members; and (3) interventions for family members in their own right. Evidence was classed as sufficient if the effectiveness was consistently supported across reviews, tentative if the evidence was consistent across less robust studies, and no evidence if no results were available in that area. Because there was substantial heterogeneity between systematic reviews, a meta-analysis was inappropriate. FindingsThe search identified 1065 alcohol-related and 2977 drug-related reviews. After removal of duplicates and title and abstract screening, 83 alcohol-related and 214 drug-related full text articles were reviewed. After removal of overlap between both searches, 25 reviews were quality assessed. Evidence was drawn from the eight systematic reviews judged to be of sufficiently high quality. Robust evidence for effectiveness of joint involvement was found for family-based interventions for adult alcohol misusers for both substance-related and relationship outcomes (three reviews) and tentative evidence for behavioural couples therapy in adults who misused drugs (two reviews). However, no review-level evidence supported or refuted the effectiveness of family interventions to promote engagement into treatment of adolescents who misuse substances or adults who misuse drugs. Responding to the needs of the family members of substance misusers in their own right was found in only one review. No review-level evidence for joint involvement of family in the treatment of adolescents who misuse substances was found, despite six reviews in this area. However, positive evidence was found in support of family interventions for engagement of users in treatment for adults who misuse alcohol and for multidimensional family therapy for improvement of substance-use-related outcomes for adolescents. InterpretationEvidence exists for family-based interventions in improvement of substance-use-related outcomes and some relationship-based outcomes. However, the conclusions that can be drawn from the existing research are limited owing to gaps in the evidence base. An absence of evidence does not mean an absence of effect. Weaker study types identified during the research do show encouraging results for family interventions across all areas; however, more high-quality reviews are needed to quantify these results with certainty. FundingNone.

Long-term effects of family-based treatment of childhood obesity.

Long-term effects of family-based treatment of childhood obesity.