Family Intervention Research Articles

Homicide-suicide cases during the COVID-19 lockdown in Pakistan: content analysis of newspaper reports

Homicide-suicide is a tragic event characterized by multiple fatalities within the intimate relationships, familial bonds, and community networks. Our aim was to explore the extent of coverage of homicide-suicide cases in the newspaper reports delivered in Pakistan during the COVID-19 lockdown (March–August 2020). We conducted a quantitative content analysis of news- reports obtained from eight Pakistani newspapers published in English and Urdu languages and daily reviewed by the authors. A total of 50 news-reports have been selected and analyzed, documenting 107 deaths due to homicide-suicide incidents. The majority of these cases involved male perpetrators within family settings, such as parent-child and spousal/married couples, often attributed to factors such us familial discordance and poverty. Negligibly, reasons for homicide-suicides included mental health issues of the perpetrators. Gunshot wounds emerged as the most prevalent method of homicide-suicide. Given the familial backgrounds in most of cases, it is likely that they occurred within the domestic environments. These findings may suggest the need of specific family interventions across the country in order to prevent family discordances or cope with relevant issues within the families, as both may contribute to homicidal and suicidal incidents, either independently or concurrently.

Reopening schools safely and educating youth (ROSSEY) study: Protocol for a community-based, cluster randomized controlled trial

IntroductionROSSEY is a community–academic partnership aiming to develop and test a COVID-19 risk communication intervention for elementary school students and families in Yakima County, Washington. We describe the ROSSEY study protocol that will be implemented in the Yakima School District. MethodsAim 1 is to identify the community's social, ethical, and behavioral needs and resources for students to return to school and maintain onsite learning. We will conduct semi-structured interviews with students and school employees and focus groups with parents. Aim 2 is to evaluate the effectiveness of risk communication on students' school attendance. We will conduct a cluster randomized control trial. We will enroll 14 Yakima School District elementary schools with 900 student participants and randomize the schools into the COVID-19 risk communication intervention or control group. Aim 3 will assess implementation of the risk communication intervention and schools' COVID-19 mitigation strategies. We will use the RE-AIM framework to guide this work, which will entail conducting semi-structured interviews with students and school employees and focus groups with parents. DiscussionImplementation of science-based risk communication can educate the community on the benefits and safety of COVID-19 testing and vaccination. Risk communication may also inform families about the role of COVID-19 testing and vaccines as part of mitigation strategies to allow for safe in-person learning. Schools have extraordinary influence to promote children's health through policy and practice change. Study findings will provide evidence to facilitate policy decisions and best practices at schools that facilitate adoption of COVID-19 risk communication. Trial registrationClinicalTrials.govNCT04859699. Registered on April 26, 2021.

Effects of multi-disciplinary family interventions versus isolated interventions in psychosocial and behavioral pairs of overweight adolescents: a pragmatic trial

Effects of multi-disciplinary family interventions versus isolated interventions in psychosocial and behavioral pairs of overweight adolescents: a pragmatic trial

Translation and validation of a simplified Chinese version of the psychosocial assessment tool

BackgroundThe Psychosocial Assessment Tool (PAT2.0) is widely used to assess psychosocial risk in families of children with cancer. Our study aims to apply PAT2.0 to Chinese patients and assess the reliability, content validity, and construct validity of the Chinese version.MethodsA total of 161 participants completed the study, each with only one child diagnosed with cancer. Psychometric evaluations, including internal consistency, score distribution, test-retest reliability, and construct validity, were conducted.ResultsCronbach’s alpha values ranged from 0.732 to 0.843, indicating good internal consistency. Additionally, intraclass correlation coefficient values ranged from 0.869 to 0.984, indicating excellent test-retest reliability. The Simplified Chinese version of PAT2.0 demonstrated high construct validity in factor analyses and correlations with the General Functioning Subscale of the Family Assessment Device.ConclusionThe translation process of the Chinese version of PAT2.0 was successful, proving its applicability for psychosocial evaluation and interventions in families of children with cancer in China.

Please help me, I am drowning! The cry of parents of adolescents with a substance use disorder.

Substance use disorders (SUDs) are on the rise among adolescents worldwide, including in South Africa, causing a significant challenge to parents. Regardless of the difficulties associated with SUDs in adolescents and their impact on parents, current studies on substance addiction have focused on diverse fraternities, excluding social work services for parents of adolescents with SUDs. To develop an in-depth understanding of social work services provided to parents of adolescents with SUDs. The study was conducted in two districts, Capricorn and Waterberg, in Limpopo province, South Africa. A qualitative research method using exploratory and descriptive designs was employed. The scheduled interview guides facilitated semi-structured interviews with 11 social workers and 8 parents. For data analysis, Tesch's eight steps were used. Six themes emerged from the study: (1) social work interventions for parents, (2) family and community-related obstacles, (3) organisation-related obstacles, (4) substance use intervention strategies received by parents, (5) parents' coping mechanisms in dealing with adolescents with SUDs and (6) factors hindering access to social services. The findings show that the government, particularly the Department of Social Development as the custodian of social services, is obliged to develop and design standard guidelines for services to parents of adolescents with SUDs and to provide uniform services to social workers. The study benefits the social work profession, particularly in the field of substance abuse because it generates effective parameters for services for parents of adolescents with SUDs.

A randomized controlled trial of a family-based community health worker delivered intervention for urban adolescents with uncontrolled asthma

ABSTRACT Black adolescents with asthma are at elevated risk for health disparities. This study used mixed methods to test an evidence-based, family intervention adapted for home-based delivery by community health workers (CHWs). Fifty-nine families were randomly assigned to receive the adapted intervention, Reach for Control (RFC), or home-based case management. Paired t-tests showed adolescents in both groups had significant decreases in asthma-related emergency department visits. Families in RFC also had significant improvements in asthma management. Qualitative interviews suggested high satisfaction with CHW delivery, but treatment dose was low. Additional studies are needed to develop effective interventions for this population.

First episode psychosis caregiver perspectives on motivational interviewing for loved ones training: A qualitative study.

Past research has found that family involvement in psychosis treatment leads to better patient outcomes. Thus, caregiver communication skills training can be a viable approach to reducing caregiver stress and increasing self-efficacy and communication. The purpose of this qualitative study was to describe family caregivers' perceptions of changes in themselves and their family member with psychosis following their participation in Motivational Interviewing in Loved Ones (MILO), a brief four to five-hour psychoeducational intervention for caregivers. Sixty-three participants in the MILO trials provided written qualitative responses to the prompt, "Since learning the ideas and techniques in this course, what is the most significant change you noticed in yourself, your family, or your relationships?" Responses were collected immediately following MILO participation and 12 weeks later. Qualitative themes were identified through an iterative consensus process. Most participants reported positive changes in multiple domains of their lives. Major themes included: (1) Changes in Self, (2) Changes in Relationships, (3) Changes in Mindset, (4) Use of MILO Skills, and (5) Challenges. Qualitative results support and add context to the previously reported quantitative results from this study. MILO is a promising family intervention that positively influenced family environment and communication in pilot trials. Adaptations of MILO for families outside of a highly educated North American context should be considered.

‘Family first’ – feasibility and pilot outcomes of a community intervention for families of children in recovery following brain injury

ABSTRACT Purpose Feasibility and pilot outcomes of a new community-based program for families of children with acquired brain injury (ABI) are presented. Interventions, delivered by home-visiting and teletherapy, were underpinned by problem-solving therapy, narrative meaning making, goal-directed interventions and community system psychoeducation. Methods Eighty-three families of children, who had sustained an ABI before 12 years of age, had an average of 13 sessions of the ‘Family First’ (FF) intervention. A mixed-methods prospective design was employed. Feasibility was evaluated through measures of accessibility and acceptability. Goal attainment scaling and pre-post changes on standardized questionnaires assessed changes in psychosocial adjustment and quality of life. Results Feasibility analyses suggested engagement and retention of often hard to reach families and children with high psychosocial needs. Qualitative analyses suggested themes related to the accessibility of a unique service (‘Nothing else like this out there’ and ‘Accessible and flexible’) which facilitated ‘Empowerment’ within a family context (‘A family affair’). Promising changes on standardized scales of behavior problems, competencies and child and family quality of life were discerned. Increased goal attainment scores were observed. Conclusion The FF program showed feasibility and promise. It impacted positively on the lives of children and families and improved capacity in supporting systems.

Parent-implemented interventions in Chinese families of children with autism spectrum disorder

This study aims to test the effects of the parent-implemented interventions (PIIs) on children with autism spectrum disorder (ASD) in China and to explore the effects of PIIs on the family quality of life of families of children with ASD in China. This study adopted a randomized controlled trial (RCT) design based on PIIs. Participants is divided into intervention group (N(parents) = 35, Age(M ± SD) = 35.69 ± 3.45; N(children) = 35, Age(M ± SD) = 5.49 ± 2.74) and control group (N(parents) = 35, Age(M ± SD) = 36.06 ± 4.28; N(children) = 35, Age(M ± SD) = 5.71 ± 3.25); parents in intervention group were trained with PIIs and required to implement family interventions for their children with ASD as they learned. This study will provide data to support the development and improvement of PIIs, and will also benefit the well-being and sustainability of children with ASD and their families. Compared to control group, the children in intervention group had a significant improvement in social communication ability (p < 0.05), and the families in intervention group had a significant enhancing in family quality of life (satisfaction) (p < 0.001). This study found that PIIs are effective in enhancing the social communication ability of children with ASD in China and the family quality of life (satisfaction) of their families. PIIs is a good and cost-effective complement to rehabilitation training in professional institutions, and have positive significance for the well-being and sustainability of children with ASD and their families.

Prospective evaluation of parent and child outcomes following admission to a ‘virtual’ early parenting residential programme

ObjectivesAustralian early parenting residential services provide interventions for families experiencing complex early parenting issues. Many services have recently shifted to virtual care models but the clinical effectiveness of such programmes...

Family Empowerment to Fullfillment Nutrition in Stunted Children

Background: This research aims to analyze family empowerment in efforts to fulfill nutritional requirements for children aged 6-24 months who are stunted. Method: The method used was a quasi-experiment with a pre-post test control group design approach to 72 mothers in each group. Result: The results of the research show that there is a difference in mothers' ability to fulfill nutrition in terms of complementary feeding and responsive feeding after being given family empowerment interventions in families with stunted children aged 6-24 months, namely food preparation and processing (p=0.000), complementary feeding (p= 0.000), responsive feeding (p=0.000). Conclusion: So it is hoped that family empowerment is an effort to strengthen its role in handling and accelerating the reduction in stunting incidents.

Neighbourhood deprivation and access to early intervention and support for families of children with intellectual and developmental disabilities

AbstractEnsuring families of children with intellectual and/or developmental disabilities (e.g., developmental delay, intellectual disability, autism) can access early intervention and support is important. Current research indicates there are family‐level socioeconomic disparities of access to early intervention and support, however, there is limited evidence on the relationship between neighbourhood‐level socioeconomic deprivation and access to support. Therefore, the aim of this study was to examine the relationship between neighbourhood deprivation and families' access to and unmet need for early intervention and support. We collected cross‐sectional data using a survey of 673 parental caregivers of young children with suspected or diagnosed intellectual and/or developmental disabilities in the UK. Multiple regression models were fitted for three early intervention and support outcome variables: access to early intervention; access to services across education, health, social care, and other sectors; and unmet need for services. Each regression model included a neighbourhood deprivation variable based on the index of multiple deprivation and five control variables: family‐level economic deprivation, country, caregivers' educational level, developmental disability diagnosis, and informal support sources. Neighbourhood deprivation was a significant independent predictor of access to services, but neighbourhood deprivation was not a significant predictor of access to early intervention or unmet need for services. Families living in the most deprived neighbourhoods accessed fewer services than other families. Socioeconomic disparities of access to early intervention and support, at both a neighbourhood and family level, exist for families of young children with suspected or diagnosed intellectual and/or developmental disabilities in the UK. Future research should focus on policy and other interventions aimed at addressing socioeconomic disparities at the neighbourhood and family level, to ensure equitable access to early intervention and support.

Dyadic effects of stigma on quality of life in people with schizophrenia and their family caregivers: Mediating role of patients' perception of caregivers' expressed emotion.

Schizophrenia, as a stressful diagnosis, profoundly impacts the whole family, especially people with schizophrenia and their caregivers. This study tested the potential mediating role of expressed emotion in the association between mental health stigma and quality of life in caregiver-patient dyads. Using a 2-wave longitudinal design with a 6-month interval between assessments, 161 dyads of patients with schizophrenia and their family caregivers (one patient and one caregiver) completed measures of mental health stigma, expressed emotion, and quality of life. The results showed that patients' self-stigma had no significant actor or partner effect on expressed emotion or quality of life. In contrast, caregivers' stigmatizing attitudes toward patients had a significant partner effect on patients' perception of caregivers' expressed emotion and quality of life. The mediating effect of patients' perception of caregivers' expressed emotion in the association between caregivers' stigmatizing ideas toward patients and patients' quality of life was significant. By focusing on the interdependence of patients and their caregivers, this study highlights the role of caregivers' stigmatizing attitudes toward patients and patients' perception of caregivers' expressed emotion on patients' quality of life. Psychoeducation and interventions should not only aim to reduce the self-stigma of people with schizophrenia but also their caregivers' stigmatizing ideas toward patients. Family interventions targeted at reducing the EE level of caregivers and patients' perception of caregivers' EE would also benefit the adaptation and quality of life of people with schizophrenia and their caregivers.

Supporting adolescents' leisure time physical activity in low‐income areas: A qualitative systematic review of participant, parent and stakeholder perspectives on family and community interventions

AbstractIn low‐income communities, there is often a lack of resources and facilities for adolescents to engage in organized sports and leisure time physical activity. Therefore, different intervention strategies have been applied to promote physical activity. Yet, a systematic overview of the experiences of those involved in the interventions is lacking. Thus, the purpose of this qualitative systematic review was to synthesize participating adolescents', their parents' and other stakeholders' perspectives on family and/or community interventions that seek to support adolescents' leisure time physical activity in low‐income areas. Five databases were searched using PIICo (P [population], I [intervention], I [phenomena of interest], and Co [context]) to operationalize the review question. Sixteen studies met the inclusion criteria. Through a thematic synthesis inspired by Thomas and Harden, six themes were constructed: (1) developing relationships with a trustworthy adult coach, (2) meeting an inclusive approach: ‘A place for everyone’, (3) forming new friendships through fun sports activities, (4) receiving support through free services, (5) experiencing the neighbourhood as unsafe and (6) challenging life circumstances for adolescents' participation. The findings showed that coaches and other programme staff are significant for adolescents' positive experiences of the intervention and continuous participation. Furthermore, mutual trust, respect and coaches utilizing inclusive approaches were significant to the development of social bonds between peers and their coaches. However, life circumstances and the experience of an unsafe neighbourhood impacted the adolescents' attendance negatively. Please refer to the Supplementary Material section to find this article's Community and Social Impact Statement.

The Logic of Generalization From Systematic Reviews and Meta-Analyses of Impact Evaluations.

Systematic reviews and meta-analyses are viewed as potent tools for generalized causal inference. These reviews are routinely used to inform decision makers about expected effects of interventions. However, the logic of generalization from research reviews to diverse policy and practice contexts is not well developed. Building on sampling theory, concerns about epistemic uncertainty, and principles of generalized causal inference, this article presents a pragmatic approach to generalizability assessment for use with systematic reviews and meta-analyses. This approach is applied to two systematic reviews and meta-analyses of effects of "evidence-based" psychosocial interventions for youth and families. Evaluations included in systematic reviews are not necessarily representative of populations and treatments of interest. Generalizability of results is limited by high risks of bias, uncertain estimates, and insufficient descriptive data from impact evaluations. Systematic reviews and meta-analyses can be used to test generalizability claims, explore heterogeneity, and identify potential moderators of effects. These reviews can also produce pooled estimates that are not representative of any larger sets of studies, programs, or people. Further work is needed to improve the conduct and reporting of impact evaluations and systematic reviews, and to develop practical approaches to generalizability assessment and guide applications of interventions in diverse policy and practice contexts.

Stakeholder perspectives of family interventions for schizophrenia in Indonesia: a qualitative study.

Mental illnesses comprise the single largest source of health-related economic burden globally and low-and middle-income countries (LMICs) are disproportionately affected. Many individuals with schizophrenia do not receive evidence-based, psychosocial interventions as these are largely unavailable, undeveloped, and under-researched in LMICs. Involving service-users and carers in the design of interventions is crucial to ensure stakeholder needs are adequately addressed by the intervention and to aid successful implementation. We aimed to explore the views and perspectives of different stakeholder groups about the delivery, format, and content of family interventions for people living with schizophrenia in Indonesia as a first step towards developing evidence-based, acceptable family interventions. This study used a qualitative design comprising single stakeholder focus groups. Data were analysed separately using the framework approach incorporating deductive and inductive coding within an existing heuristic framework. 51 participants consented to take part in this study comprising six stakeholder consultation groups including service-users (n = 15), caregivers (n = 15) and healthcare professionals (n = 21). Service users were diagnosed with schizophrenia. Caregivers comprised parents (n = 10, 67%), brothers (n = 2, 13%), sister (n = 1, 7%) and husbands (n = 2, 13%). Healthcare professionals were working as nurses (n = 6, 29%), doctors (n = 5, 23%) or cadre's (n = 10, 48%). Caregiver and service-user respondents had limited knowledge or experience of structured family interventions. There was strong support for such interventions, however, for effective delivery a number of challenges exist in terms of widespread stigmatised views, low expectations for involvement in sharing decisions about care and treatment, views that healthcare professionals are expert and have the authority to delegate tasks to families such as responsibility for ensuring medication adherence and understanding the need to balance the needs of both service-users and families when there are conflicting agendas for treatment. These findings can support the development of evidence-based family interventions for families of those with schizophrenia in Indonesia, as user-informed interventions enhance engagement, satisfaction, and adherence to family interventions.

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.

LEGAL PROTECTION AND RESTORATIVE APPROACH IN HANDLING CHILDREN INVOLVED IN TERRORISM CRIMES IN INDONESIA

This study examines the implementation of restorative justice in handling children involved in terrorism crimes in Indonesia. Restorative justice, which focuses on rehabilitating and reintegrating individuals into society, is a relevant approach to rehabilitating children involved in criminal acts of terrorism. The concept also allows community and victim participation in the settlement process. The study uses normative legal and analytic philosophical approaches. Although restorative justice has the potential to handle terrorism cases involving children, its implementation still faces challenges and requires cooperation from various parties. The research emphasizes that restorative justice should be part of a broader strategy in protecting children from involvement in terrorism, involving effective education, early intervention, and support for families and communities vulnerable to extremist influences. This study also emphasizes that implementing restorative justice in the context of criminal acts of terrorism involving children poses significant challenges and requires cooperation between various parties, including the legal system, educational institutions, families, and communities. The research argues that restorative justice should be an integral part of a broader strategy that involves effective education about the values of peace and tolerance, early intervention to detect and prevent radicalization, and support for families and communities vulnerable to extremist influences.

The relationship between family communication and family resilience in Chinese parents of depressed adolescents: a serial multiple mediation of social support and psychological resilience

BackgroundFamily resilience plays a crucial role in helping depressed adolescents overcome challenges. However, studies examining family resilience in depressed adolescents are currently scarce. This study, guided by the family resilience framework, aimed to investigate the serial-multiple mediation of social support and psychological resilience between family communication and family resilience in Chinese families of depressed adolescents.MethodsIn 229 parents of adolescents with major depressive disorder, 20.1% comprises of fathers, while 79.9% comprises of mothers. The mean age of depressed adolescents was 14.84 (±1.76) years, and the mean age of parents of these depressed adolescents was 43.24 (±4.67) years. The Family Resilience Assessment Scale (FRAS), the Psychological Resilience of Parents of Special Children Questionnaire, and the Social Support Rating Scale, Family Assessment Device (FAD) were used to collected data. Descriptive, univariate, and Pearson correlation analyses were used in preliminary analyses. To explore mediation, we employed a serial-multiple mediation model (PROCESS model 6).ResultsFamily communication was positively correlated with family resilience, social support, and psychological resilience. Mediation analysis revealed indirect effects of family communication on family resilience, which were mediated solely by either social support or psychological resilience, or through multiple mediation pathways involving both social support and psychological resilience.ConclusionsFamily communication positively and directly affects the family resilience of depressed adolescents, and a higher level of social support and psychological resilience can help improve family resilience. These findings not only provide empirical evidence supporting the family resilience framework but also have practical implications for future family interventions targeting depressed adolescents.

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.