Multiple Family Group Research Articles

Quality of Life, Treatment Adherence, and Locus of Control: Multiple Family Groups for Chronic Medical Illnesses

The Multiple Family Groups (MFGs) approach for patients with a chronic medical illness and their families is a structured psychoeducational program that unfolds in six weekly 90-minute sessions. In the MFGs, patients and family members explore new ways to balance illness and nonillness priorities in family life (Steinglass, 1998; Steinglass, 2000 Cuadernos de Terapia Familiar, 44-45, 11; Steinglass, Ostroff, & Steinglass, 2011 Family Process, 50, 393).

The Moderating Role of Developmental Microsystems in Selective Preventive Intervention Effects on Aggression and Victimization of Aggressive and Socially-Influential Students

Although ecology is often cited as an important factor in prevention, it is infrequently incorporated to the evaluation of intervention effects. This study tests the moderating role of three developmental microsystems (family, peer, and school) on a family-focused intervention to prevent violence. The family intervention was part of the Multisite Violence Prevention Project, a trial involving random assignment of 37 schools to four conditions: 1) a universal intervention composed of a student social-cognitive curriculum and teacher training, 2) a selective multiple family group intervention, 3) these two interventions combined, and 4) a no-intervention control condition. The present study focused on 1,113 eligible families from two cohorts. Students attending schools that were randomly assigned to the selective family intervention were compared with students in other conditions. Composite indicators of risk were formulated for each microsystem and entered as moderators of intervention effects on violence and aggression perpetration and overt and relational victimization. Results of intent-to-treat and dose-weighted analyses indicated that peer risk moderated outcomes, but family and school risk did not. Intervention effects were limited to youth with elevated peer risk at the outset of intervention. This pattern points to the importance of peer groups in the effects of family-focused interventions, particularly with high-risk early adolescent youth. More generally, the results illustrate the importance of mesosystems for understanding prevention effects.

Experiencing multiple family groups in a Chinese context: the clients' perception of its helpful and unhelpful impact

In Hong Kong, the knowledge of multiple family groups (MFGs) among social workers has been limited, in particular, in adapting MFG activities to a Chinese context. In this paper, we describe our experience of employing this group approach to assist Chinese parents who are taking care of children with special needs; state the challenges of implementing it and report the families' perception of helpful and unhelpful aspects of the MFG experience. In the perspective of the parents, two activities, namely preparing a joint meal and surrogate parenting have proven efficacious for parents to understand their child's strengths and explore alternate ways of parenting.

Multiple Family Groups for Adult Cancer Survivors and Their Families: A 1-Day Workshop Model

With marked advances in early detection and aggressive multimodality treatment, many adult cancers are now associated with good prognoses for disease-free survival. A burgeoning literature examining posttreatment quality-of-life issues has highlighted the numerous challenges experienced by patients and families in the aftermath of cancer treatment, further underscoring a need for new family-based psychosocial support interventions for cancer survivors and their families. This paper describes the clinical protocol for one such intervention, a 1-day "workshop" version of a multiple family group (MFG) for head and neck cancer survivors and their families. Data are reported from our experiences in running five 1-day workshops. Families uniformly reported that they were highly satisfied with their MFG participation, leading us to conclude that the abbreviated 1-day MFG model we are advocating is a promising family-focused support intervention for cancer survivors and their families.

A Collaboratively Designed Child Mental Health Service Model

This paper presents preliminary outcomes associated with an experimental, longitudinal study of a Multiple Family Group (MFG) service delivery approach set within thirteen urban outpatient clinics serving children and their families living in inner-city, primarily African American and Latino communities. Specifically, this paper focuses on parent reports of child oppositional behavior and parenting stress over time. MFG is a flexible, protocol-driven approach designed to address the most common reason for referral to outpatient child mental health clinics, childhood behavioral difficulties. The MFG also aims to enhance family-level engagement and retention in ongoing care. Further, the service delivery model was collaboratively developed with intensive input from parents rearing children with conduct difficulties, parent advocates, community-based child mental health providers and services research staff in order to ultimately expand the number of effective service models that can be situated within "real world," urban child mental health settings.

An Alternative Way of Helping Chinese Parents With Parenting Difficulties: Learning From the Participants' Feedback on the Multiple Family Groups in Hong Kong

Children with special needs have posed a great challenge to parenting. The multiple family groups developed in the 1960s in Western societies have become an increasingly acceptable intervention approach to help families with special needs, but its application in Hong Kong has been limited. The authors launched a one-year project in March 2008 to examine the applicability of this model in resolving parenting difficulties in a Chinese context and, through the use of in-depth posttreatment interviews, to assess if the participants viewed this approach as beneficial. Parents who were interviewed reported positive changes at intra- and interfamilial levels. The implications of the study are discussed.

Posttraumatic Psychological Distress and Resettlement: The Need for a Different Practice in Assisting Refugee Families

Social work practitioners are increasingly confronted with couples and families who have come from war-torn countries. Refugees may have experienced genocide, organized violence, ethnic wars, displacement, and losses of various kinds. Such experiences will often be carried through the post-migratory period and obscure legitimate individual and family processes that are often evaluated through a psychopathology lens. In this context, there is a pressing need to be attentive to refugee situations around the world and to issues related to forced migration and its impact on families. In an attempt to fill the gap in the literature on intervention with refugee families, this article presents two of the most compelling aspects of the refugee experience that can have a lasting impact on families and couples: premigration traumatic events and their potential impact on the refugee resettlement experience, and postmigration social and psychological experiences. The concept of “trauma” is presented within the context of resettlement of asylum seekers and refugees. Key stressors documented as having an impact on the long-term well-being of individuals, families, and communities who have been touched by war and conflict are outlined. Multiple-family group intervention is discussed as one of the promising approaches for helping families cope with pre- and postmigration trauma.

Implementing Evidence-Based Multiple-Family Groups with Adolescent Substance Abusers

Agencies that provide adolescent drug treatment services have reported increased demand to treat multiple families in groups. However, little attention has been paid to the challenges associated with implementing multiple-family group interventions for adolescent substance abusers. To address this gap in the literature, the authors discuss the implementation of multiple-family groups embedded within a promising multimodal intervention called Strengths-Oriented Family Therapy (SOFT). We provide a brief description of the system of care within which the SOFT multiple-family groups were developed and outline the process of implementation. The authors discuss challenges they faced implementing multiple-family groups in their partnership with a not-for-profit agency using Gotham's (2006) conceptual framework for the transfer of evidence-based models into community practice. The challenges included meeting state licensure standards, providing services in rural areas, supervising the multiple-family groups, and addressing therapist's concerns and assumptions about the model. The authors conclude with practical recommendations for others that are developing or implementing multifamily groups as adolescent substance abuse treatment models.

Predictors of family participation in a multiple family group intervention for aggressive middle school students

AbstractThe authors examine predictors of family participation in the G.R.E.A.T. Families Program of the Multisite Violence Prevention Project (MVPP), a four‐site collaboration examining student, teacher, and family interventions for middle school students. Teachers recruited two cohorts of sixth grade students, recognized as being aggressive and influential with their peers, and their families into a voluntary, 15‐session weekly program. Among the 643 families that consented (66%), the mean number of sessions attended was 8.13, with almost half (48.3%) attending 11 or more sessions. Linear mixed models (LMMs) were developed to predict the number of sessions attended based on a cluster of demographic variables and scales designed to measure aggression, problem behaviors, family factors, and other psychosocial constructs. Three of the nine clusters held significance when associated with attendance: level of aggression as rated by the child (negative association), parent–child bond (negative association), and level of child victimization (positive association). Somewhat surprisingly, the variance component due to interventionist turned out to be small and to constitute a nonsignificant component of the overall variability in attendance. Results suggest that family recruitment for multiple family group programs can be achieved with substantial effort and that resources available for recruitment might be differentially applied across families based on predictors of attendance. © 2010 Wiley Periodicals, Inc.

Multifamily Group Treatment for Schizophrenia

Multifamily Group Treatment for Schizophrenia

Partnering with families: multiple family group psychoeducation for schizophrenia

Family psychoeducation (FPE) is one of six evidence-based practices endorsed by the Center for Mental Health Services for individuals suffering from chronic mental illnesses. Multiple family group psychoeducation (MFG) has been shown to be an effective component of FPE in reducing symptom relapses and rehospitalizations for individuals with schizophrenia. It is especially effective when family members participate on a consistent basis, which allows them to increase their understanding of the biology of the disorder, learn ways to be supportive, reduce stress in the environment and in their own lives, and develop a broader social network. When used in conjunction with medication, MFG can help an individual with schizophrenia progress towards the rehabilitation phase of recovery. A case illustration describes the engagement of a chronically ill, mid-thirties male in MFG and how his family's participation for 2 years benefits all members, in spite of the longevity of his illness.

Facilitating health-enabling social contexts for youth: qualitative evaluation of a family-based HIV-prevention pilot programme

This paper reports on a post-intervention qualitative evaluation of the pilot intervention of the AmaQhawe Family Project, in South Africa, which is a cartoon-based, manualised intervention delivered to multiple family groups over 10 sessions, aimed at preventing HIV in adolescents through strengthening the adult protective shield. Semi-structured interviews with nine women who had participated in the pilot intervention were used to understand participants' perceptions of how the family-based HIV-prevention programme had assisted in addressing the issues identified in a pre-intervention exploratory study. Analysis of the data was informed by community health psychology and social capital theory. The findings indicate that at an individual level, the women interviewed had experienced an improved sense of empowerment, both as parents and as women. They also reported increased social support for effective parenting. At a collective level, the women reported that the programme had helped them to exert better informal social controls within the community, as well as to increase their social leverage and participation in community organisations. The findings suggest that HIV interventions involving families can strengthen the adult protective shield to facilitate health-enabling social contexts for youth.

Multiple Family Group Therapy in a Drug and Alcohol Rehabilitation Centre: Residents' Experiences

This study documents how residents experience Multiple Family Group (MFG) treatment in an 18‐week residential therapeutic program for people with a severe substance disorder. Individual in‐depth interviews with nine residents and three ex‐residents of European descent were undertaken, and analysed using a descriptive thematic analysis. Results indicate that, prior to taking part in the program, their relationships with their families were seriously damaged and their situations often appeared complex and hopeless. After attending the MFGs all of the participants of this study experienced a number of positive changes in their relationships with their family members and partners. All interviewees said that they had gained more awareness about their interactions, better communications skills and were able to integrate these skills into their relationships with their families and partners.

Multi-Familientherapie bei Kindern mit Teilleistungsfertigkeiten

Multifamily therapy is an evidence-based method used in the treatment and prevention of severe psychiatric disorders, behavioral problems and physical illnesses in children, adolescents and adults. For preventive family-oriented work with children with learning disorders there is a lack of therapeutic models. This article presents results from an innovative pilot project--multiple family groups for families with a learning disabled child of primary school age (six to eleven years old). Based on a systemic approach, this resource-oriented program integrates creative, activity-based interventions and group therapy techniques and conveys a comprehensive understanding of the challenges associated with learning disorders. Because of the pilot character of the study and the small sample size, the results have to be interpreted with care. The results do however clearly support the wider implementation and evaluation of the program in child guidance clinics, social-pediatric centers, as well as child and adolescent clinics and schools.

Evaluating A Multiple‐Family Group Access Intervention for Refugees with PTSD

The purpose of this study was to analyze the effects of a multiple-family group in increasing access to mental health services for refugees with posttraumatic stress disorder (PTSD). This study investigated a nine-session multiple-family group called Coffee and Families Education and Support with refugee families from Bosnia-Herzegovina in Chicago. Adults with PTSD (n = 197) and their families were randomly assigned to receive either the intervention or a control condition. The results indicated that a multiple-family group was effective in increasing access to mental health services and that depression and family comfort with discussing trauma mediated the intervention effect. Further well-designed studies of family interventions are needed for developing evidence-based interventions for refugee families.

How are the Experiences and Needs of Families of Individuals with Mental Illness Reflected in Medical Education Guidelines?

This descriptive study explored the extent that medical education curriculum guidelines contained content about the experiences and needs of family members of people with serious mental illness. Key family-focused-literature themes about the experiences and needs of families of individuals with mental illness were drawn from a review of over 6,000 sources in the mental health practice literature that were identified within a systematic search and thematic development process. The study identified the extent and nature of family-focused key literature themes as reflected in medical education curriculum guidelines for psychiatry and primary care practice specialties of family practice, internal medicine, and pediatrics. An iterative process was used to retrieve and analyze text data drawn from the curriculum guidelines of national accrediting organizations for undergraduate, graduate, and continuing medical education. The key family-focused themes, as drawn from the mental health practice research literature, were: mental illness stigma; family caregiver burden; information exchange and referral; family stress, coping, and adaptation; family support; crisis response; and family psychoeducation. Two of these seven themes appeared in medical education curriculum guidelines: information exchange and caregiver burden. The most frequently appearing family-focused key literature theme was information exchange. Psychiatry and undergraduate medical education reflected the most family content. It appears that medical education curriculum guidelines have insufficient content about families of people with mental illness. The educational experiences of psychiatrists and primary care physicians may not adequately prepare them for working with family members of their patients. It is recommended that medical education curriculum guidelines incorporate information about family stigma; family/caregiver burden; information exchange; family stress, coping, and adaptation; family support; crisis response; and multiple family group psychoeducation.

Multiple Family Group Therapy in a Drug and Alcohol Rehabilitation Centre

In the last decade there has been increasing interest in working systemically with groups of families. Multiple family groups (MFGs) have been used in mental health settings with schizophrenia, eating disorders and drug and substance abuse. This article describes the MFG program used in Higher Ground Alcohol and Drug Rehabilitation Trust, a rehabilitation centre in Auckland, (New Zealand). Higher Ground provides an 18‐week residential therapeutic program for people with a severe substance abuse disorder. The MFG in Higher Ground focuses on developing better communication patterns and better boundaries between family members, fostering mutual support, and promoting self‐responsibility.

The Family Forum: Directions for the Implementation of Family Psychoeducation for Severe Mental Illness

The Family Forum: Directions for the Implementation of Family Psychoeducation for Severe Mental Illness

Adapting Multiple-Family Group Treatment for Brain and Spinal Cord Injury Intervention Development and Preliminary Outcomes

There is a need for interventions that assist in managing the multiple adjustments of persons with spinal cord and brain injuries and their families. The purpose of the present field-initiated development project was to adapt a family psychoeducation model, multiple-family group treatment (MFGT), for persons with brain and spinal cord injury and their families. The experiences of survivors and caregivers in MFGT were evaluated using quantitative and qualitative methods. Twenty-seven survivors and 28 caregivers participated in MFGT for 12-18 mos. Reliable and valid quantitative measures were used to assess a variety of target outcomes. Additionally, semistructured interviews and focus groups were conducted with participants. Survivors reported a decrease in depressive symptoms and anger expression toward others as well as an increase in life satisfaction. Caregivers reported a significant reduction in burden. The themes derived from the qualitative analysis addressed the normalization of the caregiving experience, importance of socialization, improvement in a variety of coping skills, and education about the injuries. The findings support the adaptation of MFGT for brain and spinal cord injuries.

Clinician Integrity in Multiple Family Groups: Psychometric Properties and Relationship with Schizophrenia Client and Caregiver Outcomes

Multiple family group treatment (MFGT) is an evidence-based cognitive behavioral psycho-education and problem-solving intervention for the management of schizophrenia. Despite empirical support for the efficacy of MFGT, there is no psychometric tool for measuring treatment integrity in MFGT. In addition, research has not examined the impact of treatment integrity on client and family outcomes. The psychometric properties of a clinician integrity measure and its relationship to client and family outcomes was investigated among 7 clinician dyads who provided treatment to 53 persons with schizophrenia and their families over 2 years. The treatment integrity measure was found to have adequate psychometric properties and was able to differentiate clinicians with low, moderate, and high treatment integrity. To investigate the association of integrity with outcomes, dyads were split into low/moderate and high MFGT integrity groups. It was hypothesized that participants who received high integrity MFGT would experience a greater reduction in client psychiatric symptoms and more positive psychological health in family caregivers, relative to persons who received low/moderate integrity MFGT. Accounting for pre-intervention levels of psychiatric symptoms and session attendance, clients who were provided high integrity MFGT demonstrated significantly lower post-randomization scores on two measures of psychiatric symptoms, relative to those who received low/moderate integrity MFGT. There was no effect of treatment integrity on family caregiver outcomes. Discussion focuses on the issues associated with measuring and assuring treatment integrity in clinical research and practice.