Parents In Intervention Group Research Articles

Preventing anxiety in the children of anxious parents - feasibility of a brief, online, group intervention for parents of one- to three-year-olds.

The evidence suggests an increased risk of developing anxiety problems in children of anxious parents. The current study explored the feasibility and acceptability of an intervention with anxious parents of young children, to inform the possibility of further trials. Participants were recruited through primary and secondary care psychological services and social media. Participants who had a current or recent anxiety disorder and a child aged 12-47 months were included. Assessments of parental and child outcomes occurred at baseline, after the intervention (week-2) and follow-up (week-8). The intervention was delivered in a small group format, in two sessions, one week apart, using videoconferencing. Out of 32 participants, 30 (94%) attended the full intervention. All found the intervention acceptable and reported it as useful and relevant. There was a reduction in parental depression (MD = 2.63, 95%CI 1.01-4.26), anxiety (MD = 3.93, 95%CI 2.49-5.37) and stress (MD = 4.60, 95% CI 3.02-6.18) and increases in parenting confidence. The online group intervention was feasible and acceptable. There were moderate to large effects on parental mental health and no adverse effects on children (decline on outcome measures). This indicates that intervening early in parenting with anxious parents is possible and warrants further investigation to establish prevention efficacy with a larger, controlled trial.

A Brief Cognitive Behavioural Intervention for Parents of Anxious Children: Feasibility and Acceptability Study

BackgroundParent-only psychological interventions can be effective treatments for child anxiety. Involving parents in treatment may be beneficial for children, ensuring that interventions are delivered effectively in a supportive environment. Few studies have investigated the feasibility and acceptability of parent-only interventions for child anxiety.ObjectiveIn this study, we report on feasibility, acceptability and preliminary clinical outcomes of a brief cognitive behavioural group intervention for parents of children (4- to 10-years-olds) experiencing anxiety in the absence of a diagnosed anxiety disorder.MethodParent participants attended a three-session group intervention delivered online. We collected feasibility information (recruitment and retention rates); parents and children (when appropriate) completed acceptability and clinical outcome measures after each session. Participants were also interviewed about the acceptability of the intervention and study processes.ResultsNineteen parents consented to take part (child mean age 6.47, SD 1.23). Participant retention rates (68.4%) and intervention satisfaction (total mean CSQ score 28.52) were high​. Calculated effect sizes were moderate to large for parent-rated outcomes, small for child self-reported anxiety, and small to moderate for parent confidence/efficacy. Thematic analysis of interview data identified benefits, such as connecting with parents and learning strategies, as well as challenges associated with the intervention.ConclusionsAttendance appeared to be associated with positive changes for parents and children. Overall, participants found this to be an acceptable and useful intervention. These findings demonstrated the potential benefit of a brief intervention for parents of anxious children. A larger trial is required to further investigate these preliminary findings.

Emotionally focused therapy group intervention for parents of primary school students with parenting stress: an evaluation study in Hong Kong

ABSTRACT The ‘Hold Me Tight, Let Me Go’ relationship education and enhancement programme for families with teens was indigenised to help parents with preteens to lower their parenting pressure and to enhance parent–child communication. The evaluation of the intervention adopted a mixed method approach. 45 parents and 64 children were invited to fill out pre-test (T0), post-test (T1), and 2-month follow-up (T2) questionnaire. A total of 16 parent participants were involved in two focus groups. The findings indicated that participants’ parenting stress was lowered after the group intervention, and improvement in family relationships was observed in the aspects of communication, mutuality, and parental control. Children respondents were aware of the positive change in parents in terms of communication and statistically significant differences were found in the pre-test and 2-month follow-up. Parent participants highlighted that the prerequisites to become an accessible, responsive, and emotionally engaging parent was self-care and self-regulation.

Perinatal support for couples during COVID-19: A descriptive qualitative study.

To explore the perspectives of parents during the perinatal period amid the COVID-19 pandemic and explore the experiences of Singaporean parents receiving perinatal support via the Supportive Parenting App (SPA). The stressors accompanying parenting responsibilities often affect the overall well-being of the family unit. With the emergence of the COVID-19 pandemic, Singaporean parents are forced to shoulder childcare responsibilities with minimal support due to safety restrictions. The Supportive Parenting Application (SPA) was introduced to parents during the start of the pandemic to offer timely additional support. It is a mobile health application-based educational support for parents across the perinatal period, consisting of features such as peer support, expert advice and discussion forums. Descriptive qualitative study. Semi-structured one-to-one interviews were conducted with 33 parents (16 from the control group, 17 from the intervention group) in an ongoing randomised controlled trial between June 2021 and February 2022. The COREQ checklist was used to guide the reporting of the data. Four themes with 10 subthemes describing the perinatal experiences of parents were identified. The themes include 'Ups and downs' of parenting experiences; Perinatal care from 'best care' to 'flying blind'; What kept couples going and Use of technology-a way forward. Although COVID-19 negatively affected parents' availability of care and support, most could still access other support sources to help them. Additionally, the SPA was found to be a dependable information source for the intervention group parents. Future research could work on improving technology-based support based on the feedback given to offer better quality perinatal care for parents. Technology-based support provided by healthcare professionals helps provide reliable perinatal information and support for parents. More efforts should be directed towards developing quality informational resources and support to improve perinatal care. Patients/members of the public contributed to the data collected and were involved in member checking to ensure the rigour of the study. NHG DSRB: 2019/00875.

QOL-09. SyMon-SAYS: A symptom monitoring and reporting program for children with cancer

Unrelieved symptom burden due to cancer treatments can lead to poor psychosocial functioning and decreased health-related quality of life (HRQOL) for patients and their families. Barriers at the patient, healthcare provider and system levels can contribute to poor symptom management. Funded by the US National Cancer Institute, we have developed the Symptom Monitoring & Systematic Assessment and Reporting System in Young Survivors (SyMon-SAYS) program. SyMon-SAYS is a technology-based program with the potential to minimize symptom management barriers by routinely collecting and interpreting patient-reported outcomes in pediatric oncology ambulatory settings in a manner that is efficient, actionable by clinicians, supports engagement of patients and families with their health and care, and improves clinical processes and outcomes. This is a single institution modified waitlist control 16-week randomized trial of 200 children (ages 8-17) with cancer and their parents/guardians. Participants in the intervention phase will complete a symptom checklist weekly via the electronic health record patient portal. Scores exceeding a pre-defined threshold will trigger an alert to the treatment team, which will review the report and take appropriate actions. Participants will complete a separate battery of questionnaires assessing HRQOL at baseline and weeks 8 and 16. The recruitment is in progress. As of today, we have recruited 57 patients/parents. 29 completed 16-week study (15 intervention & 14 wait-list). Preliminary results showed SyMon-SAYS system was easy (92%) and convenient (85%) to use. Parents were satisfied (74.1%) with the SyMon-SAYS program. Comparing to the waitlist control, intervention group parents reported significantly less concerns on not having enough time to discuss their child’s symptoms with treating clinicians (p=0.0022), and disagreed that it is not necessary to treat their child’s symptoms as they will go away (p=0.04). We anticipate completing the recruitment by the end of 2023.

The Working Mechanisms of Parental Involvement in Interventions for Children with Chronic Illness

Children with chronic illness (CI) are at risk for internalizing problems, which reduce their quality of life, hamper treatment, and increase family stress. Accordingly, behavioral interventions are provided at the family level. However, the effects of parental involvement on child outcomes are not consistently beneficial. Therefore, it is relevant to study the working mechanisms. In the present study, we tested child coping and parenting stress as underlying mechanisms of the effect of an intervention for children and an additional group intervention for parents. Data were analyzed from a randomized controlled trial. Families of children with chronic illness (N = 120, child M age = 12.11 years, range 7.98–18.07) participated in a cognitive-behavioral-based group intervention and were randomized in the child-only intervention or parent–child intervention. Primary outcomes were parent- and child-reported internalizing problems, whereas the mediators were the use of child active coping skills and parenting stress. The causal model was tested with multilevel mediation analysis. Active coping skills and parenting stress stood out as significant mediators of the effect of the intervention on parent- and child-reported internalizing behavior (Cohen’s d effect size range 0.29–1.57). When parents were involved in the intervention, children increased their use of active coping skills and parents decreased in parenting stress, which in turn improved child internalizing problems. Knowing that coping skills and parenting stress underlie the benefit of involving parents can be used for optimizing interventions for children with CI and addressing the risk of internalizing problems.

Group Intervention for Parents of People with Psychotic and Substance Use Disorders: a Qualitative Evaluation of Appropriateness

Group Intervention for Parents of People with Psychotic and Substance Use Disorders: a Qualitative Evaluation of Appropriateness

Mindful parenting intervention for parents of children with skin conditions: a single group experimental cases series.

Parents of children with eczema or psoriasis experience high levels of parenting stress, which can negatively impact their child's mental and physical health. We aimed to investigate the effectiveness, feasibility and acceptability of a mindful parenting intervention for parents of children with eczema or psoriasis. Seven parents of children (4-12 years old) with eczema or psoriasis took part in an 8-week mindful parenting group intervention. A single-case experimental design was adopted, whereby parents completed daily idiographic measures of parenting stress related to their child's skin condition. Parents also completed standardised questionnaires measuring their parenting stress, depression, anxiety and quality of life, and children completed a quality of life measure, at four time points: baseline, pre-intervention, post-intervention and 6-week follow-up. Parents provided qualitative feedback after the intervention. All parents completed the intervention and showed improvements in idiographic measures of parenting stress from baseline to follow-up. Improvements in parenting stress were larger at follow-up than post-intervention, suggesting the benefits of intervention continue beyond the intervention. Six of seven parent-child dyads showed improvement in at least one of the wellbeing measures, from pre-intervention to post-intervention or follow-up. Feasibility was demonstrated through good participant retention, adherence to home practice, and treatment fidelity. Acceptability was demonstrated through positive parent evaluations of the intervention. Mindful parenting can be an effective, feasible and acceptable intervention for parents of children with eczema or psoriasis. Future studies should attempt to replicate the findings through randomised controlled trials.

Cost-Benefit Analysis of an Intervention in Divorced Parents: Implications for Society, Public Administrations and Family Visitation Centers.

Families going through conflictive divorce processes are at increased risk of developing mental health problems. The Egokitzen program is a group intervention for parents who have undergone a divorce process, funded by the public administration. Budgetary constraints cause funding institutions to be interested in the effectiveness and economic efficiency of these programs. Therefore, the objective of this research is to carry out an efficiency analysis of the Egokitzen program, implemented by family visitation centers in Spain, through a cost-benefit analysis, to determine whether the positive impact on symptomatology (measured using CBCL and SCL-90 instruments) is translated into a positive economic impact for society. A sample of 382 parents participated. Costs will be first identified and valued; secondly, benefits achieved with the program will be identified through a prevalence analysis and, finally, the cost-benefit comparative analysis will be carried out. Additionally, a sensitivity analysis will be performed. The results obtained in the analysis indicate that for every euro spent on this program, the public administration and society save 3.10 euros in future interventions through medical costs and productivity losses. The study has practical implications for public administration, organizations, and the family visitation centers that implement the program.

Acceptance and Commitment Therapy Group Intervention for Parents of Children with Disabilities (Navigator ACT): An Open Feasibility Trial

Parents of children with autism spectrum disorder and other disabilities report high levels of distress, but systematically evaluated interventions are few. This study aimed to evaluate the feasibility of a novel, manualized Acceptance and Commitment Therapy group intervention (Navigator ACT) in a sample of 94 parents of children with disabilities. Feasibility was measured by treatment completion, credibility, and satisfaction, and preliminary outcomes by using self-rating scales administered at the baseline, post-intervention, and follow-up. The results imply the intervention is feasible in the context of Swedish outpatient habilitation services. A preliminary analysis of the outcome measures suggests that parents experienced significant improvements in well-being. The results indicate that the treatment is feasible and should be evaluated in a randomized controlled trial.

Subjective experiences of participating in the Supporting Transitions, Attachment and Relationships (STAR Mums) program, a psychological group intervention for high-risk pregnant women

The Supporting Transitions and Relationships (STAR Mums) program is a five-session psychoanalytic and attachment-based group intervention for first-time parents with risk factors in the transition to parenthood. The primary aim of this study was to explore the subjective experiences and acceptability of participating in the STAR Mums program both for first-time expectant mothers with risk factors and the facilitators delivering the program. Sixteen women across four groups completed the Baseline measures and commenced the group program, with 12 participants completing at least 3/5 sessions and the follow-up interviews. Participants’ and facilitators completed interviews over time to provide feedback regarding the program and to inform manual revisions and future directions. Participants and facilitators reported high acceptability with high levels of engagement and participation. The group helped them to feel less isolated and also provided a model for reflecting on the baby and the significant changes required to adapt to the parenthood role. Participants spoke about subjective reductions in their anxiety levels and finding the mindfulness exercises helpful in connecting with their babies and managing their anxieties in the longer-term once the group finished. Overall, the findings suggest the program appears acceptable and facilitates reflection for participants.

A Mindful Parenting Program for Parents Concerned About Child Internalizing Problems: a Randomized Controlled Feasibility Study

ObjectivesThis study sought to establish four aspects of feasibility for a mindful parenting program: demand for the program from parents with concerns regarding their child’s internalizing problems, acceptability of the program to those parents, preliminary efficacy, and the likelihood of successful expansion of the program to the intended population.MethodsThe study was a pilot, randomized controlled trial comparing a mindful parenting program to waitlist. Participants were parents (N = 25) of children aged 3–18 years, with self-reported concerns regarding their child’s internalizing problems, recruited from the community. Demand was assessed using recruitment and adherence rates. Acceptability was assessed using parent-reported usefulness. Preliminary efficacy was assessed using parent reports of child internalizing problems, mindful parenting, parenting stress, cognitive emotion regulation, parental experiential avoidance, and parent beliefs about child anxiety. Intervention group parents also provided weekly in-session data on coping in stressful parenting situations. The likelihood of successful expansion was assessed using qualitative feedback on whether and how the program had helped parents manage child internalizing problems, particularly anxiety.ResultsFeasibility was established for the four aspects assessed. The program was well-attended and acceptable to parents. Moderate to large effects were found in favor of the intervention group for most parent and child outcomes. Weekly data showed improved coping in difficult parenting situations. Qualitative feedback suggested that parents believed that increased acceptance and empathy had helped them cope with child internalizing problems.ConclusionsMindful parenting programs may assist parents of children with internalizing problems to manage parenting stress and emotionally regulate themselves, even in difficult parenting moments. They may also reduce child internalizing problems, through improved parental emotion regulation, and greater acceptance of and empathy for their child.Trial RegistrationAustralian Clinical Trials Registry, registration number ACTRN12620000690954

A systematic review and meta-analytic evaluation of psychosocial interventions in parents of children with cancer with an exploratory focus on minority outcomes.

Parents of children with cancer are prone to psychosocial distress, yet little is known about intervention response among diverse parents. Our systematic review and meta-analysis evaluated the efficacy of psychosocial interventions on anxiety and depression among parents of children with cancer and explored race and/or ethnicity differences in the efficacy of these interventions. Twenty articles met inclusion. The aggregate effect size on anxiety (-0.01, 95% CI: -0.95, 0.93, p=.97) and depression (-0.56, 95% CI: -1.65, 0.54, p=.32) showed micro to medium effects, with larger negative effect sizes indicating that anxiety and depression scores after treatment were lower for parents in intervention group as compared to control group. Neither aggregate effect size was statistically significantly different from zero. Due to underrepresentation of minorities, we could not perform subgroup or moderator analyses. Several efficacious psychosocial interventions were found to reduce parental anxiety. Future studies to examine psychosocial interventions in minority parents are warranted.

Mental health effects on adolescent parents of young children: reflections on outcomes of an adolescent parenting programme in South Africa

ABSTRACT At-risk families and caregivers from low-and middle-income countries have been shown to benefit from parenting interventions. But there is limited evidence on the impact of interventions on adolescent parents. This paper considers the effects of a parenting programme targeting adolescent parents in South Africa, emphasising parenting and adolescent well-being outcomes. Secondly, it explores whether such an intervention can influence adolescent depression and parenting behaviours. Using a quasi-experimental, longitudinal design, data was collected over 2015–2017 from 113 adolescent parents (aged 12–22 years) who attended three secondary schools in Cape Town. Adolescents (biological and non-biological parents) were assigned to intervention (parenting programme participation) and control groups. They completed assessments on parenting, adolescent well-being, and social context at three time-points. Inter-group, and time-period differences were examined, and analyses on whether depression moderates programme effects on outcomes were conducted. At the ten-month follow-up, positive parenting and resilience improved for biological and non-biological parents and in both study groups. For the non-biological intervention group parents, depression rates increased over time. Intervention adolescents with high depression risk showed smaller improvements in supportive parenting than their control group counterparts. Although adolescents increased in positive parenting and resilience, it is unclear whether and how the intervention contributed to these results. As the intervention group included more adolescents at high risk of depression at follow-up, this study highlights the importance of including mental health support in interventions targeting adolescents in LMIC contexts. The study is limited by a small sample size and reliance on self-reported data.

A cognitive-behavioral group intervention for parents of youth with chronic pain: Development, feasibility, and preliminary effectiveness.

A cognitive-behavioral group intervention for parents of youth with chronic pain: Development, feasibility, and preliminary effectiveness.

Going online: Reflections from a therapeutic parenting group

An exploration of the experience of moving a therapeutic parenting group intervention online, necessitated by the Covid-19 pandemic. Two online formats are described, and reflections by participants are offered, from which the benefits for such an approach became evident.

A clinical and cost-effectiveness trial of a parent group intervention to manage challenging restricted and repetitive behaviours in young children with autism spectrum disorder: study protocol for a randomised controlled trial

BackgroundRestricted and repetitive behaviours vary greatly across the autism spectrum, and although not all are problematic some can cause distress and interfere with learning and social opportunities. We have, alongside parents, developed a parent group based intervention for families of young children with autism, which aims to offer support to parents and carers; helping them to recognise, understand and learn how to respond to their child’s challenging restricted repetitive behaviours.MethodsThe study is a clinical and cost-effectiveness, multi-site randomised controlled trial of the Managing Repetitive Behaviours (MRB) parent group intervention versus a psychoeducation parent group Learning About Autism (LAA) (n = 250; 125 intervention/125 psychoeducation; ~ 83/site) for parents of young children aged 3–9 years 11 months with a diagnosis of autism.All analyses will be done under intention-to-treat principle. The primary outcome at 24 weeks will use generalised estimating equation (GEE) to compare proportion of children with improved RRB between the MRB group and the LAA group. The GEE model will account for the clustering of children by parent groups using exchangeable working correlation. All secondary outcomes will be analysed in a similar way using appropriate distribution and link function.The economic evaluation will be conducted from the perspective of both NHS costs and family access to local community services. A ‘within trial’ cost-effectiveness analysis with results reported as the incremental cost per additional child achieving at least the target improvement in CGI-I scale at 24 weeks.DiscussionThis is an efficacy trial to investigate the clinical and cost-effectiveness of a parent group based intervention designed to help parents understand and manage their child’s challenging RRB. If found to be effective, this intervention has the potential to improve the well-being of children and their families, reduce parental stress, greatly enhance community participation and potential for learning, and improve longer-term outcomes.Trial registrationTrial ID: ISRCTN15550611 Date registered: 07/08/2018. Sponsor and Monitor: Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust R&D Manager Lyndsey Dixon, Address: St Nicholas Hospital, Jubliee Road, Gosforth, Newcastle upon Tyne NE3 3XT, lyndsey.dixon@cntw.nhs.uk, Tel: 0191 246 7222

Investigating the effectiveness of parent-implemented shared book reading intervention for preschoolers with ASD

Children diagnosed with autism spectrum disorder (ASD) are at increased risk of persistent language and literacy difficulties. This study investigated the effectiveness of an 8-week parent-implemented shared book reading intervention designed to change parent and child book reading behaviours. Sixteen parents and their preschoolers on the autism spectrum participated. Nine parents were randomly allocated to receive the shared book reading intervention first. The intervention used a coaching model and comprised a training session, four home visits, and four follow-up phone calls. Parents completed a shared book reading video with their child prior to the intervention, immediately post-intervention and eight weeks after the intervention was completed. Following intervention, there was a significant increase in the intervention group parents’ use of book-related vocabulary and their explicit teaching of story structure, compared to the waitlist control group. Compared to the control group, there was a significant increase in children’s verbal participation (number of utterances and number of different words). However, these effects disappeared when the significant increase in reading duration following the intervention was taken into account. All improvements were maintained over time. Our results highlight the feasibility of a parent-implemented shared book reading intervention for encouraging early language skills in children on the spectrum in a naturalistic setting that is part of many family routines.

Uptake and impact of journaling program on wellbeing of NICU parents.

This pilot study evaluated a brief parent journaling program in the neonatal intensive care unit (NICU). Hundred NICU parents were randomized to a control group (no journal) or an intervention group (journal provided). Parents reported pre- and post-intervention anxiety and depression symptoms using the hospital anxiety and depression scale (HADS) and qualitative journal use data. The analysis included Student's paired two-tailed t-test and two-way ANOVA. This study was registered with clinicaltrials.gov on April 1, 2020, NCT04331925. At baseline, clinically significant anxiety was more prevalent than depression (66% vs. 23%). Post-intervention scores were best predicted by baseline scores. Relative to controls, intervention group parents experienced a decrease in anxiety from baseline (t = -1.983, p = 0.056). The same effect was not seen for depression. Most intervention group parents used the journal and provided positive feedback. Journal use rates and positive feedback support the acceptability of a NICU journaling program.

Mentalization-based Families First Group Intervention for First-Time Parents: Parents’ Perspective

ABSTRACT The study investigated, first, the benefits reported by first-time parents after attending a Families First mentalization-based group intervention and, second, looked for indicators of mentalization. A total of 367 mothers and 183 fathers completed a web-based questionnaire. Data analysis concentrated on parents’ responses to seven open questions that were subsequently processed by qualitative thematic analysis. Also a chi-square test was performed to study the differences between mothers and fathers on the benefits reported. Four main benefits were reported by the parents: peer support, understanding of the baby, insights into oneself as parent and parent-child interaction, and family involvement. Indicators of mentalization and differences between mothers and fathers in the number of experienced benefits within the four main categories of benefits were found. The results indicate that the Families First intervention succeeded in benefiting first-time mothers and fathers in various ways. Also, the findings suggest that a mentalization-based group intervention supports parents during a significant transition phase in their lives. The findings highlight the value of preventive support for first-time parents and the application of a mentalization-based approach in parenting programs.