Family Intervention Programs Research Articles

The Cultural Factors in Moderate to Severe Depression and Relevant Interventions

Depression is resulted from a mixture of hereditary and environmental variables. This article mainly considered biological, genetic, and psychological influences on depression. For environmental aspects, this paper aims to identify the impact of different cultures on depression. The most relevant previous studies were reviewed. The findings suggest that culture does play a role in the development of depression. This review mainly examined studies that compared the effects of individualistic and collectivistic cultures on depression. Traditional filial piety culture and thin culture showed different effects on depression. In addition to the traditional gender roles of certain cultures, caste and other cultural differences can also have an impact on the development of depression. Similarly, prenatal depression is more common in immigrants and poor countries than in non-immigrants and industrialized countries. Resilience and social support are two protective factors for mental health, and these two factors have different degrees of influence depending on the culture. There is still limited amount of research investigated the effects of different cultures on depression. More research on the characteristics of different cultures and their association with depression is needed in the future. This review can provide some guidance for furture research and practice. Prevention and intervention programs for children and families should incorporate cultural factors.

The Relationship between Fathers Parenting Behavior and Adult Attachment

Parenting behaviors are based on the Internal Working Model (IWM), which people acquire through attachment experiences in childhood. Bowlby and Ainsworth developed the fundamental model of childhood attachment. Later, researchers extended the original attachment theory and measures of adult attachment to study adult attachment bonds. The attachment styles of adults and their parenting behaviors are closely related. There is a connection between a parents adult attachment style and parenting style, as they have varying levels of demandingness in their IWM. Nonetheless, when fathers and mothers experience marital conflict or maltreatment, there is a difference between them. As most previous research concentrated on mothers, it is important to investigate and gain a deeper understanding of the relationship between the fathers adult attachment and fathers parenting style, considering various marital factors. Father with an insecure adult attachment tend to adopt approaches of withdrawal or authoritarian control in parenting, especially in the case of conflict. A secure adult attachment of father is essential for the child to develop a secure attachment. A better understanding of the fathers parenting style can help improve family intervention programs. This review can provide some insights for future research regarding the role of father in a family.

Addressing the Overprotected Past of Dependent Personality Disorder

Studies and research relevant to Dependent Personality Disorder (DPD) recently have shown controversy regarding whether genetic or external factors contributed more to the development of DPD. This review aims to investigate the relationship between parental overprotection and DPD from the perspectives of the specific effect of overprotective parenting styles on DPD, factors regarding overprotection in DPD, and relevant interventions for DPD. It was found that there was an association between overprotective parenting styles and the development of DPD symptoms. Factors related to overprotection, such as distress intolerance and sensitivity to falsehoods detected from facial expressions, have a relationship with DPD traits. Different psychotherapies have demonstrated their effectiveness. Cognitive behavioral therapy (CBT), clarification-oriented psychotherapy (COP), existential group therapy, and cognitive analytic therapy (CAT) are effective to treat clients' DPD, targeting different symptoms. It is concluded that CBT can aid decision-making, self-confidence, and proper self-cognition. Furthermore, COP and existential group therapy can facilitate emotional and social adjustment. Lastly, CAT can improve identity recognition and reassurance-seeking. Regardless of these effectual treatments, the small sample sizes of previous studies may lower the generalizability. More efforts should be devoted to this field of personality disorder and expand the number of empirical research. The present paper may offer some guidelines for the later development of family intervention studies and programs.

3-day intervention program for family members of hikikomori sufferers: A pilot randomized controlled trial.

Hikikomori, pathological social withdrawal, is becoming a crucial mental health issue in Japan and worldwide. We have developed a 3-day family intervention program for hikikomori sufferers based on Mental Health First Aid (MHFA) and Community Reinforcement and Family Training (CRAFT). This study aims to confirm the effectiveness of the 3-day program by a randomized controlled trial. This study was registered on the UMIN Clinical Trials Registry (UMIN000037289). Fifteen parents were assigned to the treat as usual (TAU) group (TAU only; Age Mean, 65.6; SD, 7.8), and 14 to the Program group (program + TAU; Age Mean, 67.9; SD, 8.6). This study was discontinued due to the COVID-19 pandemic; the recruitment rate was 36.3% of our target sample size of 80. Perceived skills improved temporally and stigma temporally worsened in the TAU group. Confidence decreased and attitude showed no change in both groups. Aggressive behaviors of hikikomori sufferers were significantly worsened in the Program group; however, no serious domestic violence was reported. In the TAU group, Avoidance and irregular life patterns were improved. Activity levels were worsened in both groups. Two participants (16.7%) in the Program group and one participant (7.7%) in the TAU group reported actual behavioral changes (e.g., utilizing support). We could not draw general conclusions on the effectiveness of the program due to the study discontinuation. Nevertheless, this study indicates the necessity for revision of the program to improve family members' confidence in engaging with hikikomori sufferers, with safer approaching by families.

Family intervention for expressed emotion in schizophrenia: Indian context.

Expressed emotion (EE) being a part of the family environment could adversely affect the course and prognosis of schizophrenia. This study aimed to assess the effects of family intervention among the caregivers of persons with schizophrenia. The experimental research design was used for 80 caregivers of persons with schizophrenia. Sociodemographic interview schedule of caregivers, family emotional involvement and criticism scale, and mini international neuropsychiatric interview (MINI 6.0) were used for data collection. A standardized family intervention program involving 10 sessions was provided to caregivers. The intervention included six sessions of family psychoeducation, two sessions of communication training, one session of stress management, and one session on recap and referral services over a period of 2-3 months. The intervention used methods of social case and group work, social work principles, and therapeutic activities. The methodologies adopted a brainstorming technique, case vignettes, role plays, and video clippings concerning the topics of the day. Brief handout on intervention was given. The RMANOVA score (F = 35.892; P =0.001) revealed that there was a significant reduction in EE of the caregivers of the intervention group who underwent the family intervention program in comparison with the control group. Family-based intervention was found to be effective for reducing EE in schizophrenia.

Quality of life and associated factors among family caregivers of individuals with psychiatric illness at DRH, South Wollo, Ethiopia, 2020

Mental illness results in an enormous social and economic burden not only on patients, but also on their families and communities. Many caregivers of patients with mental illnesses suffer from an extremely poor quality of life. In Sub-Saharan Africa, approximately 71% caregivers suffer from economic burden of severe mental illness. To our knowledge, no study has been conducted on quality of life of caregivers in Ethiopia. Therefore, this study aimed to assess the quality of life of family caregivers of patients with mental illness at Dessie Referral Hospital. The institution-based cross-sectional study was conducted among 398 caregivers selected using a consecutive sampling technique. The World Health Organization Quality of Life BREF was used to assess the quality of life. Logistic regression was performed and statistical significance was declared at a p-value < 0.05. 189 (47.5%) of family caregivers had poor quality of life. Being divorced, unable to read and write, primary education, being spouse, sibling and children of the patient, poor social support and high perceived stigma were significantly associated with the outcome variable. Because the magnitude of poor quality of life among family caregivers was high, family intervention programs are highly recommended to improve quality of life among caregivers.

Family Intervention in the Treatment of Female Juvenile Delinquency: A Qualitative Study in the Collectivist Society of Malaysia

Aims: The current study explores the benefits of a family intervention program on families and their adolescent children who were convicted as juveniles. Adolescents and their families shared their experiences in joining the program, especially the improvement they made while in the program. Demographics: Research participants included eight adolescents, six mothers, and two fathers. Settings: The program took place in Malaysia's adolescents’ rehabilitation center. Methodology: Data were collected through an in-depth interview with participants. Analysis: Thematic analysis was used to analyze the data. Findings: Findings revealed five main themes: (1) awareness and insight; (2) Understanding risk and protective factors of delinquency; (3) the opportunity to learn roles in the family; (4) Learning to improve communication skills; and (5) Learning to forgive. Implications: The study provides insight into the importance of family involvement in delinquent adolescents’ rehabilitation and the need to consider the family system approach in counseling delinquent adolescents.

The co-occurrence of substance misuse, domestic abuse, and child maltreatment: Can Family Drug and Alcohol Courts play a part?

This review article focuses on the inter-relationship between substance misuse, domestic abuse, and child maltreatment, especially in the context of care (child protection) proceedings. It reviews what is known about the prevalence and impact of co-occurring domestic abuse and substance misuse on adult and child victims, and the response of criminal and family law and intervention programmes in supporting families to address these problems holistically. Special attention is paid to the role of Family Drug and Alcohol Courts (FDACs), a radical problem-solving approach to care proceedings, which provide integrated interventions to the range of co-occurring problems that trigger the proceedings. Despite clear evidence of the greater harm to children when exposed to these two parental difficulties, the review has found a lack of systematic information on the prevalence of co-occurrence and a lack of effective integrated interventions, including within care proceedings. It argues that the FDAC approach is well suited to respond to co-occurring substance misuse and domestic abuse in care proceedings and it has the potential to break down silos across sectors. However, in the absence of empirical evidence, this premise would need testing. A particular focus of the review has been on efforts to overcome silos in practice, law and policy. Promising initiatives are described in criminal and family law to improve the response to domestic abuse that build on the Domestic Abuse Act 2021, the first dedicated domestic abuse legislation in England and Wales. All of them are based on problem-solving approaches used in other jurisdictions. Despite these initiatives, the review concludes that there remain significant barriers to effectively align law, policy and practice to ensure that domestic abuse strategy recognizes and responds to the overlaps with substance misuse.

Factors That Impact Caseload and Case Acuity in Outpatient Mental Health and Family Maltreatment

Abstract Providing high-quality and cost-effective services in family and mental health treatment programs is difficult. There is an elusive balance between (a) maximizing patients served and positive patient outcomes and (b) minimizing provider burnout and turnover. Agencies often implicitly assume that all cases require equivalent provider time and effort and thus assign cases solely to balance each provider’s caseload numbers. However, this assumption ignores factors that can lead to substandard treatment and provider burnout. This study identifies factors that contribute to case complexity and difficulty as part of a program of research to develop a weighted case-demandingness model in outpatient mental health and family maltreatment services in the U.S. Air Force. Focus groups with providers revealed distinct themes related to caseload and effective time management. The generalizability of the findings was tested quantitatively among a larger sample of providers. Results indicate the need to consider environmental, structural, and individual patient factors when determining patient acuity and caseload.

Child internalizing and externalizing behaviors: Interplay between maternal depressive symptoms and child inhibitory control.

Maternal depression is a risk factor for child internalizing and externalizing behaviors. Aiming to investigate the moderating role of child inhibitory control on this relationship, we invited a sub-sample of dyads from the Norwegian Mother, Father, and Child Cohort study (MoBa) for a lab-based assessment (N=92, M age=68months, Range=59-80, 50% girls). Maternal depression was assessed using the Beck Depression Inventory (BDI-II), while child behaviors were measured using the Child Behavior Check List, and inhibitory control using a child friendly version of the Flanker-task. As expected, higher levels of concurrent maternal depressive symptoms predicted higher levels of child internalizing and externalizing behaviors. Importantly, and in line with our predictions, child inhibitory control moderated the association. Lower levels of inhibitory control predicted a stronger association between concurrent maternal depressive symptoms and child behavioral outcomes. The results support prior research suggesting that concurrent maternal depression poses a risk for child development, and highlight that children with lower levels of inhibitory control are more vulnerable to negative environmental influences. These findings contribute to our understanding of the complexity of parental mental health issues on child development and suggest avenues for personalized treatment programs for families and children at risk.

Supporting families to achieve a healthy weight development for their child with overweight/obesity using the STARKIDS intervention: study protocol for a cluster-randomized controlled trial

BackgroundChildhood and adolescent overweight and obesity are among the most serious health challenges today. Structured weight reduction programs can be helpful to reduce severe health consequences but evidence is partly scarce. The STARKIDS program aims to improve on some of these limitations and is designed to be a structured, stepwise, digitally supported intervention program for the whole family. It is divided into two intervention steps spanning over 1.5 years and aims at promoting a healthy weight development of children/adolescents with overweight/obesity and an increase in quality of life.MethodsThe STARKIDS intervention is evaluated in a cluster-randomized study design by comparing it with a control group receiving a one-time structured counselling in the pediatric practice. The study aims to include 1000 families with children/adolescents with overweight/obesity from 100 pediatric practices. The main outcomes are reduction in body mass index percentiles and improvements in children’s/adolescent’s quality of life, secondary outcomes refer to the contents of the intervention such as diet, physical activity, stress, and media habits. All outcomes are measured on three measurement time points: (T0) at baseline/inclusion in the study, (T1) baseline + 12 months which is the end of step 1 of the STARKIDS intervention, and (T2) baseline + 18 months which is the end of step 2 of the STARKIDS intervention.DiscussionThe stepwise, e-health-supported STARKIDS program is a low-threshold intervention program for families with children/adolescents with overweight/obesity. With the proof of concept, STARKIDS provides the potential to be implemented as a standard care tool for the prevention and intervention of childhood/adolescence obesity in the German health system.Trial registrationGerman Clinical Trials Register (DRKS) DRKS00022813 (acknowledged primary register of the World Health Organization). Registered on 27 November 2020 (Universal Trial Number U1111-1254-9536).

Sociocultural Adjustment and Well-being Among Third Culture Kids and Their Families: Protocol for a Longitudinal Study.

BackgroundIncreasing globalization has led to more families with children being relocated each year, highlighting the importance of issues, such as adjustment and psychological well-being, in this population. These children, commonly known as third culture kids, often spend a significant part of their developmental years in countries and cultures foreign to them.ObjectiveOur longitudinal study aims to examine the roles of cognitive, psychological, sociocultural, and family factors in the longitudinal trajectories of the well-being and sociocultural adjustment of third culture kids and their families over time.MethodsThis study adopts both quantitative and qualitative procedures. Data from both procedures will be collected at baseline and at a 1-year follow-up. We aim to recruit 150 to 200 participants between 7 and 17 years old and one of their primary caregivers. After providing informed consent, participants will complete an online survey. Outcome measures include validated questionnaires on well-being and sociocultural adjustment. Predictor measures include validated questionnaires on negative self-thoughts, emotion regulation, resilience, psychological attributes, self-esteem, stress, acculturative stress, cultural intelligence, couple satisfaction, and family functioning. A multiple regression model will be used to analyze quantitative data. In addition, 15 to 20 families who participate in the online survey will be randomly selected to take part in a family interview focusing on questions related to well-being, relocation experiences, cultural issues, and challenges. A concurrent triangulation mixed methods design will be used to analyze and interpret data from both quantitative and qualitative methods.ResultsAs of March 15, 2022, a total of 138 children and 126 parents have completed the baseline online survey. In addition, 44 children and 48 parents have completed the 1-year follow-up online survey. A total of 8 families have completed the baseline family interview, while 4 families have completed the 1-year follow-up interview. Data analyses, transcription of the interview, and preparation for publication are on-going.ConclusionsFindings from this study would enable us to understand the adjustment processes, and risk and protective factors associated with the well-being and sociocultural adjustment of third culture kids and their families in Switzerland, which could have implications on the development of intervention programs for individuals and families to address acculturation and adjustment issues.International Registered Report Identifier (IRRID)RR1-10.2196/30088

Assessing Family Functioning Before and After an Integrated Multidisciplinary Family Treatment for Adolescents With Restrictive Eating Disorders

IntroductionPrevious studies applying the Lausanne Trilogue Play (LTPc), a semi-structured method for observing family dynamics, highlighted dysfunctional interaction patterns in the families of individuals affected by restrictive eating disorders (REDs). Family-centered approaches are considered the first-line treatment for severe cases of REDs in adolescence.ObjectivesTo investigate family functioning in the families of adolescents with severe REDs assessed before and 6 months after a multidisciplinary family treatment program that combined psychodynamic psychotherapy, parental role intervention and triadic or family-centered intervention.MethodsSixty-seven families of adolescent patients diagnosed with REDs were assessed for eligibility between July 2017 and October 2020. Family functioning was assessed using the clinical version of LTPc. Nutritional counseling and neuropsychiatric monitoring were also provided.ResultsWe observed a significant change in the family functioning score for the LTPc phase 2, in which the father interacts with his daughter while the mother acts as a silent observer. This suggests that the fathers, when playing an active role, could improve dyadic family functioning. The treatment was not found to change triadic functioning: a 6-month treatment may not be long enough to modify interactions at the triadic level.ConclusionsA brief multidisciplinary treatment program may significantly improve family functioning in the families of patients diagnosed with severe REDs. Although appropriate clinical trials are needed to further test the efficacy of this treatment, our study reinforce the concept that treatment programs targeting the individual patient and both the parents should be a first-line approach in adolescents with severe REDs.DisclosureThe authors declare that they do not have a significant financial interest, consultancy or other relationship with products, manufacturer(s) of products or providers of services related to this abstrac.

Family Education and Support Programme: Implementation and Cultural Adaptation in Cape Verde

This article describes some preliminary data on the implementation of the Family Education and Support Programme (FAF) on psychosocially at-risk families of Boavista Island, Cape Verde, specifically in relation to its effectiveness in parenting competences. The FAF is a family intervention programme designed to be integrated into preventive and formative actions and it has the purpose of promoting positive parenting and preventing child abuse. This study aims to (a) describe the participants’ psychosocial profile regarding sociodemographic characteristics and negative or risky life events, (b) analyse the effectiveness of the FAF on improving parenting competences, and (c) address the main procedural topics related to the implementation of the FAF in Cape Verde. An experiential and participatory methodology was used with 66 parents, who participated in 12 group sessions, with a weekly periodicity, for four months. The evaluation was performed, in the pre-test and post-test, with the control group and the intervention group. Results show the effectiveness of the FAF in an African context, including its impact. The intervention group improved their post-intervention scores on perceived efficacy and satisfaction with a moderate and high effect size, respectively. We present some recommendations to be considered in future programs to promote positive parenting, since improvements in parents’ competences, are key to reducing neglectful or abusive situations.

Spanish Adaptation of the Parenting Practices Interview (PPI-25) for Families with Substantiated Reports or at Risk for Child Maltreatment

Parenting practices are a central focus of many family preventive and treatment programs due to their influence on children’s well-being. Reliable measures of parenting practices are relevant not only for research purposes, but also for assessment, selection of intervention goals, and evaluation of expected changes in clinical practice. However, measurement of parenting practices has been a challenge for researchers and practitioners. The Parenting Practice Interview (PPI) has been developed to assess both positive and negative parenting dimensions and has been used in clinical contexts. The present study aimed to develop a Spanish adaptation of the PPI and to analyze its main psychometric properties. The sample consisted of 213 parents with substantiated reports or at risk for child maltreatment with significant problems in coping with their children’s behavioral problems, recruited from Child Welfare and Child Protection Services. Confirmatory factor analysis (CFA), measurement invariance (MI), convergent validity, and differences based on parents’ and children’s age and gender were analyzed. A four-factor model with 25 items (Appropriate Discipline, Verbal Praise and Incentives, Inconsistent Discipline, and Physical Punishment) met statistical requirements (RMSEA = 0.06, CFI = 0.92, TLI = 0.91) and showed adequate internal consistency and convergent validity. MI analyses allowed comparison across time and groups. Although more research is needed, the PPI-25’s psychometric properties are encouraging for its use with families with substantiated reports or at risk for child maltreatment in Spain.

A Protective Factor for Emotional and Behavioral Problems in Children: The Parental Humor.

In order to prevent the development of emotional and behavioral problems, risk and protective factors must be identified. This study aims to establish a link between perceived parental humor and children mental health. The sample comprises 762 pupils aged 10 to 15 (M = 12.23; SD = 1.12), who completed self-reports evaluating perceived parental humor (EEE-H) and their own emotional and behavioral strengths and difficulties (SDQ). The results indicate that parental humor is negatively associated with internalizing problems in children; no association with externalizing problems is observed. According to the study, girls who perceive low parental humor are the most likely to display internalizing problems, while girls perceiving high parental humor are the least likely to do so. Parental humor, characterized by calmness, cheerfulness, and optimism, is a protective factor against internalizing problems in children, especially girls. We recommend training for parents and training and intervention programs for families to encourage activities that boost parental humor.

Preferences for WeChat-Based and Hospital-Based Family Intervention Among Caregivers of People Living with Schizophrenia.

PurposeThis study examines the preferences for WeChat-based and hospital-based family intervention among caregivers of people living with schizophrenia (PLS) and identify correlates associated with these preferences.Patients and MethodsA cross-sectional study was conducted with 449 family caregivers of PLS. Face-to-face interviews were conducted to collect information on socio-demographics, preferences for WeChat-based and hospital-based family intervention, social support, and coping.ResultsOver 72.16% of participants endorsed hospital-based family intervention, while 50.11% endorsed WeChat-based family intervention. Endorsement of WeChat-based family intervention was associated with younger age (OR=0.42, 95% CI: 0.22, 0.79), WeChat use (OR=12.90, 95% CI: 7.48, 22.23), and higher social support (OR=1.03, 95% CI: 1.01, 1.04). Endorsement of hospital-based family intervention was associated with lower education (OR=0.19–0.37, 95% CI: 0.07, 0.66) and WeChat use (OR=3.27, 95% CI: 1.91, 5.59).ConclusionThe studies showed a higher endorsement rate for hospital-based family intervention than WeChat-based family intervention and provide implications for developing targeted family intervention programs based on participants’ own unique characteristics.

Experiences with Childhood Cancer among Latinx Families: Identification of Informational and Support Needs

Latinx children with cancer generally have poorer health outcomes than their non-Latinx White counterparts. The purpose of this study was to examine the experience of Latinx mothers whose children have been diagnosed with cancer at the onset of symptoms, the barriers surrounding the diagnostic process, and the resources families identify are needed post-diagnosis. The researchers conducted two focus groups (one in Spanish, one in English) with Latina mothers of children who have or experienced pediatric cancer in the United States. Two researchers conducted constant comparative analysis of the transcribed focus group audio recordings to identify themes. Themes included a sense of community support at the onset of symptoms, feelings of disbelief, helplessness, overload of information, and a need for advocacy in medical settings. Needs included more palatable and simplified information, financial assistance and resources, increased parental social support, accessible Spanish-speaking providers, and culturally informed care. Latina mothers indicated a range of challenges pertaining to childhood cancer diagnosis and treatment that may impact child and family outcomes. Implications for social work practitioners to reduce disparities and develop intervention programs for Latinx families of children with cancer are discussed.

Family intervention program for autism

Interventions can minimize the impact of developmental barriers on autism. Inconsistent interventions result in behavioral deterioration. Parents have a big role to provide consistent intervention to children. This study aims to review home intervention programs that family can do at home. The research method used is a literature review. The data collection method used is the literature related to home-based autism interventions and family intervention. The results of the study show several programs that can be applied by families at home. The results showed the intervention models that can be done by family are ABA, PLAY, dan TEACCH. Through this study, it can be concluded that ABA is the most effective technique that can be used as a basis for implementing family interventions. Comprehensive interventions are also highly recommended for home interventions, such as modifying the environment and providing preschool life skills.

Assessing Family Functioning Before and After an Integrated Multidisciplinary Family Treatment for Adolescents With Restrictive Eating Disorders.

The present study presents an investigation of family functioning in the families of adolescents with severe restrictive eating disorders (REDs) assessed before and 6 months after a multidisciplinary family treatment program that combined psychodynamic psychotherapy, parental role intervention, and triadic or family-centered interventions. Nutritional counseling and neuropsychiatric monitoring of the overall treatment and care process were also provided. Family functioning was assessed using the clinical version of the Lausanne Trilogue Play (LTPc), a semi-structured procedure for observing family dynamics, previously validated for this patient population. The LTPc is divided into four phases. In phase 1, the mother interacts with the patient while the father assumes the role of observer. In phase 2, the father plans an activity with the patient while the mother observes. In phase 3, all the family members interact. Finally, in phase 4, the parents talk while the adolescent observes. A significant change emerged in family functioning after the treatment, but only for the interactive phase 2, when the father is required to interact with the daughter while the mother silently observes. The results of this study suggest that a relatively brief multidisciplinary treatment program may significantly improve family functioning in the families of patients diagnosed with severe REDs. Although appropriate clinical trials are needed to further test the efficacy of this treatment, the results also reinforce the concept that treatment programs targeting the individual patient and both the parents should be a first-line approach in adolescents with severe REDs.