Family Intervention Programs Research Articles

The Role of Dosage and Family Profiles in a Child Welfare Home Visiting Program

Abstract Background Among the different modalities of family support, home visiting programs have proved to be one of the most effective secondary prevention models for families involved in child welfare services. Despite the promising outcomes and the extensive available literature, further research is needed to investigate target population characteristics and implementation factors that may explain the heterogeneity in the outcomes of these programs for families receiving child welfare services. Objective This longitudinal study explored the role of dosage and family characteristics related to the effectiveness of the Family Intervention Program (FIP), which is a home-based Spanish child welfare service for supporting families at psychosocial risk. Method To this end, a quasi-experimental design was followed, including a time-series evaluation of the 289 families receiving the FIP. In order to examine the impact of the FIP, the evolution of child well-being (CWB) was evaluated with Child Well-Being Scales every 6 months. Results The results showed that the highest average CWB score was observed after 39 months of intervention, observing no improvements in CWB from that point. Similarly, the results showed that the FIP was more effective for single parent families at higher socioeconomic levels. Conclusions This article provides new knowledge for the understanding of home visiting programs success, concluding that the programs are not equally effective for all family profiles, and that it is necessary to adjust each program to the specific characteristics of the target population.

An Archival Study of the Relationship Between Treatment Duration, Functioning, and Out-of-Home Placement for Youth with Serious Emotional Disturbance in a State-Wide Intensive In-Home Family Treatment Program

AbstractThe main aim of this study was to evaluate the effectiveness of Pennsylvania’s state-wide intensive in-home treatment for youth with serious emotional disturbance (SED), EcoSystemic Structural Family Therapy-Family Based Mental Health Services (ESFT-FBMHS). Despite its long history of implementation, the program remains empirically under-evaluated. In this archival study, out-of-home placement and youth functioning outcomes were compared across four tiers of length of stay. Given the high-risk population treated in ESFT-FBMHS, it was hypothesized that the families and youth who completed the full duration of treatment (169–224 days) would have better outcomes than those who stopped treatment after 168 days or less. We utilized an ex post facto quantitative research design analyzing archived medical claims data of 2251 youth treated between 2018 and 2022 to assess out-of-home placement rates and analyzed archived data from six domains of the Child and Adolescent Needs and Strengths (CANS; Problem Presentation, Risk Behaviors, Functioning, Child Safety, Caregiver Needs, and Child Strengths) to assess changes in youth functioning post-discharge (90 and 180 days). An analysis using generalized estimating equations (GEE), controlling for potential confounding variables such as demographics and clinical features, suggest that length of stay in ESFT-FBMHS was significantly associated with out-of-home placement and youth improvement on the CANS at both 90- and 180-days post-discharge. As a group, youth with SED who did not complete the full duration of the program had 2–3 times the odds of out-of-home placement at 90 days post-discharge and 1–3 times the odds at 180 days post-discharge as compared to program completers. CANS scores showed improvement in 40.1% of youth who completed the program as compared to only 11.7%–18.2% for those who did not. The results of this study suggest that ESFT-FBMHS is effective for youth with SED as a group and can improve youth functioning and reduce out-of-home placement.

Calibrating families: Data behaviourism and the new algorithmic logic

Abstract Family intervention is a long-established mechanism of state control, but recent technological developments are facilitating new regulatory capacities and objectives. This paper will explore how contemporary welfare policy interventions in the UK are converging around a technological solutionist ideology that centres family relationships as core instruments of social management. The last decade has seen a marked techno-administrative turn, with family/state relationships increasingly mediated through online portals and dashboards. Over the last few years this data-centric model has accelerated towards an algorithmic approach to governance through the incorporation of big data surveillance, predictive analytics and behavioural interventions to monitor and socially engineer populations. In this paper we draw on policy analysis and freedom of information requests to trace the embedding of data collection frameworks into apparently conventional family intervention programmes in the UK, and show how this “datification” was made into a core delivery tool. We also highlight how secrecy, or at the very least strategic silence, has restricted public knowledge of how and why data is being collected and used in the UK. We show how parents and children are being quantified and translated into datapoints to support new logics of choice manipulation, ceding unprecedented power to financiers, data analytic and social marketing companies, platform developers and big tech industries. The resulting financialization of family welfare services tracks the contours of longstanding social divisions, reconfiguring and in many cases compounding the injustices of race, class and gender. This algorithmic calibration of children and parents is extending the regulatory powers of the state far beyond previous efforts to govern and control poor families, with under-explored consequences for the principles of democracy and justice.

Post‐separation parental conflict and father–child physical contact: A bidirectional study

AbstractThe first goal of this longitudinal study was to examine the strength and direction of the relations between post‐separation parental conflict (PSPC) and father–child physical contact, as reported by the mother, at the time of separation (Time 1) and in the following 2 years (Time 2). A cross‐lagged panel model was conducted with a sample of 198 parents of children from 3 to 8 years old at the time of separation. The results indicated that PSPC at Time 1 predicted a lower frequency of father–child physical contact at Time 2, whereas the inverse relationship was not found. The strength and direction of the relations did not vary as a function of the level of the moderators. The results help us to identify priority targets in the development of policies and treatment programs for separated families.

Eating Behavior, Sleep Disorders and Digital Game Addiction in Children and Determination of Associated Factors by CHAID Analysis

Background: Healthy nutrition and good quality sleep are one of the most important factors for growth and development in a child. Digital game addiction may cause some problematic behaviors and affect children's nutrition and sleep. We aimed to investigate the relationship between digital game addiction, eating behavior, and sleep disorders in children. Methods: The study was conducted with 252 mothers with children between the ages of 4-7 years, selected by convenient sampling methods. The Digital Game Addiction Scale, Children's Eating Behavior Questionnaire and The Sleep Disturbance Scale for Children (SDSC) were used to collect data. The correlation coefficient and the decision tree CHAID algorithm were used in the data analysis. Results: Digital game addiction negatively affects children's eating behavior and sleep patterns. It was found that there was a mostly positive but weakly significant relationship between digital game addiction and children's eating behaviors (P<.01; P<.05) and a highly significant relationship was found between the sleep disorder scale sleep hyperhidrosis sub-dimension (P<.05). While digital game addiction is affected by gender, the mother's education level, and eating behavior are affected by the mother's age, the parent's education level, and the child's gender (P<.05). The child's age is the variable that affects the children's sleep disorder (P<.05). Conclusion: Intervention programs for children and families can be created for the causes of digital game addiction, its effects on child development and the correct use of the digital world.

The Effectiveness of Brain Injury Family Intervention in Improving the Psychological Well-Being of Caregivers of Patients With Traumatic Brain Injury: Protocol for a Randomized Controlled Trial.

Globally, traumatic brain injury (TBI) is recognized as one of the most significant contributors to mortality and disability. Most of the patients who have experienced TBI will be discharged home and reunited with their families or primary caregivers. The degree of severity of their reliance on caregivers varies. Therefore, the task of delivering essential care to the patients becomes demanding for the caregivers. A significant proportion of caregivers expressed considerable burden, distress, and discontentment with their lives. Therefore, it is critical to comprehend the dynamic of TBI and caregivers to optimize patient care, rehabilitation, and administration. The effectiveness of the Brain Injury Family Intervention (BIFI) program tailored for caregivers of patients with TBI has been widely proven in Western countries. However, the impact is less clear among caregivers of patients with TBI in Malaysia. This study aims to assess the effectiveness of BIFI in reducing emotional distress and burden of care, fulfilling the needs, and increasing the life satisfaction of caregivers of patients with TBI at government hospitals in Malaysia. This is a 2-arm, single-blinded, randomized controlled trial. It will be conducted at Hospital Rehabilitasi Cheras and Hospital Sungai Buloh. In total, 100 caregivers of patients with TBI attending the neurorehabilitation unit will be randomized equally to the intervention and control groups. The intervention group will undergo the BIFI program, whereas the control group will receive standard treatment. Caregivers aged ≥18 years, caring for patients who have completed >3 months after the injury, are eligible to participate. The BIFI program will be scheduled for 5 sessions as recommended by the developer of the module. Each session will take approximately 90 to 120 minutes. The participants are required to attend all 5 sessions. A total of 5 weeks is needed for each group to complete the program. Self-reported questionnaires (ie, Beck Depression Inventory, Positive and Negative Affect Schedule, Caregiver Strain Index, Satisfaction With Life Scale, and Family Needs Questionnaire) will be collected at baseline, immediately after the intervention program, at 3-month follow-up, and at 6-month follow-up. The primary end point is the caregivers' emotional distress. The participant recruitment process began in January 2019 and was completed in December 2020. In total, 100 participants were enrolled in this study, of whom 70 (70%) caregivers are women and 30 (30%) are men. We are currently at the final stage of data analysis. The results of this study are expected to be published in 2024. Ethics approval has been obtained. It is expected that the psychological well-being of the intervention group will be better compared with that of the control group after the intervention at 3-month follow-up and at 6-month follow-up. Iranian Registry of Clinical Trials IRCT20180809040746N1; https://irct.behdasht.gov.ir/trial/33286. RR1-10.2196/53692.

Evaluation of the Treatment Programme for Families with Children in Andalusia: An analysis of the impact on the children

AbstractThe Treatment Programme for Families with Children in Andalusia is fundamentally aimed at promoting the integral development of children and adolescents through the strengthening of parental competences and family preservation strategies. In the last 20 years, this programme has been applied to over 75 000 families, involving about 150 000 children and adolescents. The aim of this study was to analyse the effects of this family intervention programme on the quality of life and behaviour problems of the children. This quasi‐experimental and longitudinal study had two non‐randomized groups (intervention group and comparison group) and two evaluation measures (pre‐treatment and post‐treatment). The intervention group was constituted by 297 families (540 children) who had participated in the programme. The comparison group consisted of 95 families (138 children) at a similar risk level, although these families had not participated in the programme. The results showed a significant improvement in the quality of life of the children of the families that belonged to the intervention group, which was significantly greater than the evolution detected in the children of the families that belonged to the comparison group. The results of efficacy and efficiency of this type of practice constitute a quality criterion of evidence‐based programmes and a requirement to maintain public investment.

The flexibility of family co-ordinators in complex family interventions: building relations over time with families living in sustained poverty

ABSTRACT Complex family interventions represent innovative yet contested policy approaches to child poverty and their follow-up with families with complex needs laid down in several national policies. Across welfare state regime contexts, the role of the family co-ordinator is central to these approaches. This role and the work of co-ordinators in interaction with families, family members, and other services deserve further exploration to increase knowledge of the contribution of such interventions. In this article, we explore the role of the family co-ordinator in the Norwegian family intervention programme, New Patterns – Safe Upbringing. The research builds upon fieldwork conducted over several intervals (2019–2021). Family co-ordinators were followed in their everyday work practices, and they were interviewed over several rounds. In our analysis, we look at how the family co-ordinator role and relations with families evolve over time as knowledge increases and the family situation changes. Our research findings demonstrate the importance of flexibility and temporality in complex family interventions, including their role for instigating trust in the relationships between family co-ordinators and families, their role as cultural and system interpreters, and as such providing means for successful targeted support.

Gender Based Violence: A Silent Epidemic, Knowledge and Patterns in Ibadan, Oyo State

Gender Based Violence (GBV) is a crucial social, health issues which is a great concern to human rights abuse globally. There could be increase in their presentations and patterns. The study aims to determine knowledge and patterns of GBV among residents of Idi-Arere in Ibadan South-East Local Government Area; Oyo State. Descriptive quantitative cross-sectional design was used among 220 residents of Idi-Arere in Ibadan South-East Local Government Area, Oyo State were randomly selected. Data was collected by a self-developed questionnaire with the aid of research assistants. Theory of reasoned action was used for the study. Majority 124 (56.4%) of the respondents were females and in 10-59 years range. Most of the respondents had poor knowledge 111 (50.5%) More than half 138 (62.7%) of the total case of the GBV had been sexually abuse one time or the other. Also, majority of the respondents 195 (88.6%) had been physically abused. It is therefore concluded that majority of the victims were 195 (88.6%) females were physically abused and recommended among other things that, Community Health Nurses should assist in preventing gender based violence through family and community intervention programmes.

How to Become an Efficient Family Caregiver for a Loved One with Schizophrenia?

Dr. Saïd Fattah, Chairman of the Scientific WASP Section on Family Intervention Program, wished to share with readers the touching and incredible story of Mr. Jean-Michel Piat, a family caregiver whose mother, brother, and daughter suffered from schizophrenia. Despite the significant stress of living around unstable loved ones, and the heavy burden of caring for those with chronic psychiatric disorders, this family caregiver managed to overcome all these obstacles due to a family psychoeducation program, called Profamille and due to his exemplary resilience and empowerment.

Impact of a Family Educational Program on Moroccan and French Caregivers of Patients with Schizophrenia: A Comparative Analysis of Prevalence and Severity of Depressive Symptoms

Background/Objectives: Caring for individuals with psychosis is an emotionally demanding task as caregivers often face significant psychological challenges. The experience and intensity of these challenges might differ across cultural contexts. This study sought to analyze and compare the prevalence and severity of depressive symptoms among caregivers of patients with schizophrenia in Morocco and France. Methods: Our retrospective observational study included 130 caregivers from Morocco and 5057 from France. We used the Center for Epidemiological Studies Depression Scale to screen for depressive symptoms and evaluated variations in symptom manifestation using the four-factor model. Furthermore, we evaluated the impact of a family intervention program called Profamille on alleviating these symptoms by examining improvements in caregivers’ mood and patients’ social functioning, using the life skill profile 20. Results: Moroccan caregivers displayed a higher prevalence (72%) and severity of depressive symptoms compared to French caregivers (51%). While Moroccan caregivers scored higher in the interpersonal problems subscale, they did not notably differ in the somatic subscale, challenging some preconceived cultural notions. Postpsychoeducational intervention, a significant reduction in depression rates was observed in both Moroccan and French groups. Conclusions: Moroccan caregivers, despite the nation’s collectivist culture emphasizing strong familial bonds, exhibited heightened depressive symptoms, hinting at potential culture-specific challenges. Psychoeducational interventions were effective across both cultural groups, indicating their universal therapeutic potential. The findings emphasize the importance of recognizing and addressing cultural variations in caregiving experiences and mental health symptomatology.

Acceptability and feasibility of delivering family intervention for caregivers of patients with schizophrenia in Egypt

Background: In Egypt as elsewhere, patients with schizophrenia and their families confront unique obstacles. This study examined the views of important stakeholders’ on the feasibility, approval, and obstacles of family intervention programs for schizophrenia in Egypt to address these issues. Objective: The aim of the study was to investigate the perspectives of stakeholders regarding the feasibility, acceptability, and obstacles associated with providing family intervention for schizophrenia in Egypt. Methods: The research took place at El-Maamoura Hospital in Alexandria and included a total of 37 participants. These participants were divided into seven focus groups, with 25 individuals being health professionals and the remaining 12 individuals being caregivers. Concurrently, data collection and analysis were carried out using the qualitative research method, employing the framework analysis to process the transcripts. Results: The participants highlighted the importance of families feeling accepted and well-informed regarding the nature of the illness. In conclusion, the participants suggested making changes to the intervention’s content by incorporating details about the illness, providing emotional support, and including culturally appropriate coping mechanisms. Conclusion: In conclusion, it is determined by the study that before implementing family intervention for schizophrenia, it is crucial to make cultural adjustments to ensure its acceptability. The findings of the study offer valuable insights for the development and execution of family intervention programs for schizophrenia in Egypt. Implication for Clinical Practice: It is crucial to culturally adapt a modified family interventions to cater to the cultural requirements of families and healthcare professionals in Egypt, as this could potentially result in improved outcomes for patients diagnosed with schizophrenia and their families.

The Father's Part: A Pilot Evaluation of a Father-Centered Family Intervention Group in Child and Adolescent Psychiatry.

Changes in parental roles have renewed the focus on a father's involvement in an offspring's psychological development. However, fathers are still under-represented in family research. There are only a few structured father-centered intervention programs in child and adolescent psychiatry. In a German population sample, a pilot father-centered family intervention program with n = 16 participants, conducted in person (n = 8) and online (n = 8), in a child and adolescent psychiatry inpatient/day clinic setting was evaluated by comparing paternal stress, PSE, and child-rated paternal competence in a pre-post design. Participating fathers showed significant decreases in child-related parenting stress (presence: p = 0.042, online: p = 0.047) and significant increases in PSE (p = 0.006/0.012). Parent-related stress and child-rated paternal competence were unaffected (p = 0.108/0.171; p = 0.167/0.101), while small-to-medium effect size measures pointed in the direction of our hypothesis (d = 0.48/0.36; d = 0.37/0.50). Participant satisfaction was higher in person than online (p = 0.008). As social and biological fathers have important influences on child and adolescent well-being and development, they should be included more frequently in prevention and intervention programs. Fathers seem to benefit from gender-specific intervention programs with regard to stress reduction, as well as experiencing competence- and PSE-increasing effects.

Psychometric Properties of the North Carolina Family Assessment Scale (NCFAS) for Vulnerable Preschoolers from Ecuador

Positive parenting and appropriate interaction with children are globally recognized as pivotal in enhancing children’s quality of life. Evaluating family intervention programs is therefore vital, particularly in regions that lack reliable tools for assessment. This manuscript details a study conducted in Ecuador, a country noted for its scarcity of validated instruments to assess the impact of such interventions, especially for vulnerable preschool children. We focused on the application of the North Carolina Family Assessment Scale (NCFAS), a well-established measure to evaluate family functioning internationally, to Ecuadorian families with preschool children who are deemed vulnerable. The Spanish translation of the original scale was administered by trained evaluators to 470 preschool children in Machala, Ecuador. Our examination of the psychometric properties of the NCFAS in this context demonstrated high internal consistency. Additionally, factor analysis corroborated the reliability and validity of this adapted version of the NCFAS, albeit with a reduced item count. This research supports the effectiveness of the NCFAS in the Ecuadorian setting and underscores its potential utility in further studies involving varied demographic groups within the country. The results of this study have substantial implications for the enhancement of children’s quality of life in Ecuador through family intervention programs.

The dyadic effects of individual resilience on family resilience among Chinese parents and children during COVID-19.

Previous studies have mainly focused on examining families' struggles during the adaptive process of adversity, while the strength of family and how it arises were neglected. This study aims to explore the relationships between individual and family resilience among parents and children in families during COVID-19. Guided by the longitudinal actor-partner interdependence model, one parent and a child in 136 Chinese families completed assessments of pandemic media exposure and individual resilience in mid-February 2020 and family resilience in early March. Results showed that the child's individual resilience was positively associated with their own and their parents' family resilience, while parents' resilience was only positively associated with their own. The evidence indicated that a child's individual resilience was critical for all core family members' perceived family resilience and provided implications for family intervention programs.

The Significance of Psychoanalysis on Remitting the Effect of COVID-19 on Peoples Mental Health

The COVID-19 pandemic has had a profound impact on mental health, highlighting the need for effective approaches to address the psychological distress experienced by individuals. This article explored the potential role of psychoanalysis in supporting individuals' mental well-being during the pandemic. Drawing on insights from previous studies investigating the challenges and future prospects of psychoanalysis, as well as an examination of dream experiences during the pandemic, this article emphasized the importance of integrating experiential and conceptual research to strengthen the scientific foundation of psychoanalysis. It also highlights the need for interdisciplinary collaboration, dialogue among analysts of different orientations, and inclusive publishing practices to enhance the field. The study further underscores the significance of adequate funding for empirical research and the promotion of inclusivity within the field. The article concluded with emphasizing the potential of psychoanalysis in providing a safe space for individuals to explore and process their emotions, understand their experiences, and promote healing and adaptation in the face of challenges after the pandemic. Overall, this article highlights the relevance of psychoanalysis in addressing the mental health repercussions of the COVID-19 pandemic and offers valuable insights for mental health professionals and researchers in the field. It also can provide some guidance to the design of family and community intervention programs.

Trends and Meta-Analysis of Research on the Operation of Programs for Bereaved Families in South Korea.

This study aimed to analyze interventions for bereaved families and evaluate their effectiveness, with the ultimate goal of supporting evidence-based nursing for bereaved families. Research trends were identified based on a search of domestic databases from January 2000 to December 2022, and a meta-analysis was conducted on interventions for bereaved families. Forty-five papers were selected, and information was extracted on participants, research design, and interventions. A meta-analysis of seven papers was performed, and the effect size was calculated. Fourteen papers dealt with interventions for middle-aged women who had lost their spouses, 20 used qualitative research methods, and 20 were on art therapy programs. Thirty studies had fewer than 10 participants, and most interventions had 60~120 minutes per session and 9~16 sessions in total. There were seven randomized controlled trials, and all studies included in the quality evaluation showed a low risk of bias. Four papers measured grief as an outcome, and the effect size was -1.9577 (95% CI -2.9206 to -0.9947), indicating that the treatment significantly decreased grief (P<0.001). Six papers measured depression as an outcome, and the effect size was -1.6775 (95% CI -2.1835 to -1.1716), showing that the treatment significantly decreased depression (P<0.001). Intervention programs for bereaved families were shown to be effective in relieving grief and depression. However, programs should be developed that target middle-aged men who have lost their spouses and children who have lost their parents. Randomized controlled trials should also be conducted on interventions to reduce grief and depression.

The Influence of Perceived Security in Childhood on Adult Self-Concept: The Mediating Role of Resilience and Self-Esteem.

Secure attachment, developed through consistent relationships with attachment figures in childhood, is a crucial factor in fostering healthy interpersonal relationships and a positive self-perception. Part of the positive parenting approach and the theory of affect is taken as a basis to assess how perceived security, as an indicator of secure attachment, predicts adult self-concept through the mediating effects of resilience and positive self-esteem. A quantitative, cross-sectional, and nonprobabilistic study was conducted with 383 participants. We unveiled significant positive associations between perceived security, self-concept, resilience, and positive self-esteem. Path analysis demonstrated that resilience and positive self-esteem sequentially mediate the relationship between perceived security during childhood and adult self-concept. Findings suggest that the ability to cope with adversity and personal acceptance underlie the impact of perceived security on self-concept. It is recommended to promote family intervention programs framed within positive parenting that focus on fostering secure attachment given its influence on adult life. It is also deemed essential to incorporate the promotion of resilience and self-esteem into programs aimed at youths, and adult role models can enhance their self-perception and resilience in the face of potential effects stemming from insecure parenting practices.

Parent–child contact problems and family intensive interventions: The crisis of adolescent suicidality and the role of social media

AbstractAlthough clinicians, educators and parents have been alarmed by the decline in the mental health of children and adolescents commensurate with the Covid‐19 pandemic, statistics indicate there has been a downward spiral over the last decade. This has been evident in the overall increase in suicide rates for young people. For legal and mental health professionals working in the Family Court system, this has provided unique challenges. Most vulnerable has been those children and adolescents embroiled in high conflict divorces, especially those exhibiting parent child contact problems. This article focuses upon that population exhibiting parent child contact problems, and their treatment, specifically Family Intensive Intervention. Building Family Resilience is an Intensive family treatment program that has had to address this deterioration in child and adolescent mental health and increase in suicidality. The role of social media in both exacerbating and/or ameliorating mental health issues is explored.

Young people on the ‘edge of care’: perspectives regarding a residential family intervention programme using social pedagogic and systemic approaches- striving for ‘humane practice’

ABSTRACT Support approaches and interventions to keep families together are major goals in family welfare services. Different service models are used including some targeted at families where the assessment is part of family court pre-proceedings. Although outcomes of family interventions have been extensively researched, there is limited recent research regarding the subjective experiences of young people, their parents/carers and professionals who experience an intervention where they all live together for a short period and where mutually agreed goals and a family programme are co-created. This article presents findings from an exploratory qualitative study into a residential family learning project where families from an English inner-city local authority and professionals reside together for up to a week with engagement in intensive family work. Findings revealed mixed experiences of the intervention with a key theme being that a sense of time and space allowed the families to reflect and listen to each other’s perspectives leading to relationships improving and shifting. However, despite positive changes being made during the intervention sustaining these changes when returning home was often challenging. Findings, which are linked to the systemic idea of punctuation where families saw professionals differently and vice versa, had particular significance for families experiencing social and economic deprivation.