Evaluation of a preventive intervention for bereaved children

One hundred eighty four families completed a twelve month parent-guidance (experimental) or a parent telephone-monitoring (comparison) intervention initiated during one parent's terminal cancer illness and continued until six months after the death. Children in the parent-guidance intervention reported greater reduction in trait anxiety and greater improvement in their perceptions of the surviving parent's competence and communication, a primary goal of the intervention. Identified problems in implementing evaluations of experimental interventions with bereaved children include the following: (1) Available and commonly used standardized psychopathology measures do not adequately capture changes in non-psychopathological but bereaved distressed, grieving children and adolescents. (2) Experimental and control samples usually have very few children with psychopathology (scores). Relatively small changes in scores within the normal range may be insufficient to allow measurement of meaningful differences between interventions. (3) Both experimental and control interventions must provide sufficient help to retain families for later evaluation. The level of general support and referral for other treatments, if adequately done, may be sufficient to blur differences in standardized psychopathology measure scores between any two interventions. It may only be in the specifically targeted intervention area that differences can be expected to be significant in adequately resourced families.     

Child Well‐Being Scales (CWBS) in the assessment of families and children in home‐care intervention: an empirical study

This paper reports research carried out in Italy designed to investigate the usability of Child Well‐Being Scale (CWBS) for the outcome evaluation of home‐care interventions for vulnerable families and children in need. Using a pre‐ and post‐test design, the study traces the changes in 18 vulnerable families and 23 children in need included in a programme of home‐care intervention over a period of 11 months. All the families and children were assessed twice: at intake and at the end of the intervention (after 6 months). Furthermore, 10 families and 11 children had a longer intervention and were assessed three times. Moreover, two focus groups involving 13 home‐care workers and 11 face‐to‐face interviews were used to collect practitioners' points of views on CWBS. The results generally support the idea that families' and children's situation improved over time, as shown by an improvement in almost all of the considered dimensions after 6 months and after 11 months. Specifically, the families improved more on household adequacy in the long term while children on the child performance dimension improved in the short term. Practitioners reported that CWBS was an aid to multi‐professional decision‐making, as the systematic evaluation of the subscales was a practical base upon which to activate shared decision‐making during the casework.     

Building a Tailored,Multilevel Prevention Strategy to Support Children and Families Affected by Parental Incarceration

ABSTRACT

During the past several decades, a wave of incarceration engulfed the United States. In the wake of this “mass incarceration” are children and families who continue to struggle from its impact. Although findings are now emerging on the impacts of incarceration, there are few studies that have examined how to best intervene to promote positive development for those children who have had a parent incarcerated. While there are common risks and challenges faced by children and their families, the significant variation between and among these individuals and their relationships highlights the challenges in finding solutions. Given the number of issues at play, it is clear that a “one-size-fits-all” approach to addressing child needs is not sufficient. This article examines some of the common challenges faced by families impacted by parental incarceration as well as existing interventions designed to help support children and families overcome these challenges. It then offers some potential directions for the field to move, to develop a prevention strategy that meets the needs within the population and leads to better outcomes for the children of incarcerated parents, their families, and their communities.     

Indirect effects of the Family Check‐Up on youth extracurricular involvement at school‐age through improvements in maternal positive behavior support in early childhood

Extracurricular involvement in the school‐age years has widespread potential benefits for children's subsequent socioemotional development, especially for low‐income youth. However, there is a dearth of research on interventions aimed at increasing school‐age extracurricular involvement in low‐income youth. Thus, the present study aimed to test the collateral effect of a brief, family‐focused intervention for low‐income families, the Family Check‐Up, on children's school‐age extracurricular involvement via improvements in maternal positive behavior support (PBS) in early childhood. The sample (n = 630, 50% female, 50% White, 28% Black/African American) represented a subsample of families from the Early Steps Multisite Study. At the age of two, families were randomly assigned to the Family Check‐Up or Women, Infants, and Children Nutritional Supplement Services as usual. Mother‐child dyads participated in observed interaction tasks at child ages 2 and 3 that were subsequently coded to assess PBS. Primary caregivers reported on children's school‐age extracurricular involvement at ages 7.5, 8.5, and 9.5. Results indicated that although there was not a direct path between intervention status and children's school‐age extracurricular involvement, a significant indirect path emerged from intervention group to changes in PBS between ages 2 to 3 to children's school‐age extracurricular involvement. The results are discussed in terms of implications for designing preventive interventions in early childhood that promote extracurricular involvement at school‐age, particularly for children at risk for maladaptive outcomes.     

Early childhood services and support for vulnerable families: lessons from the Benevolent Society's Partnerships in Early Childhood program

Access to early childhood services is widely considered to be an important means of supporting vulnerable children and families. Yet the evidence that access to such services automatically makes a difference for vulnerable families is mixed at best. The growing presence of for‐profit early childhood services may have an impact on the sector's capacity to provide the enhanced education and care to those most likely to benefit. What are the current and future possibilities for early childhood services to benefit vulnerable children and families? What resources are required to build the capacity of early childhood settings in supporting vulnerable families, and are these likely to differ between for‐profit and not‐for‐profit settings? This paper will explore these questions using a Benevolent Society project, Partnerships in Early Childhood, funded through the Commonwealth's Stronger Families and Communities Strategy, Invest to Grow, as an illustrative case study. Researchers from the Social Policy Research Centre evaluated the first three years of the project, which involves a number of not‐for‐profit early education and care providers. The paper describes the implementation of PIEC as an attempt to improve the quality of early education and care services to vulnerable children, and lessons that can be drawn for the future of similar interventions. We conclude that time, support for staff and partnerships between different organisations appear to be critical for the success of these interventions, and that the capacity of for‐profit services to provide these resources deserves attention.     

Storytelling as a tool: A family-based intervention for newly resettled Syrian refugee children

The conflict in Syria has resulted in a humanitarian emergency and one of the largest refugee crises in history. The Canadian government has welcomed over 40,000 Syrian refugees. Stressors caused by instability, conflict, and the resettlement process put refugee children at high risk for mental health problems. Anxiety is a common problem experienced by refugee children. Thus, early intervention is crucial to promote their adequate adaptation and development. This study explores the impact and value of a culturally specific family-based storybook intervention for newly resettled Syrian refugee children. Six refugee families participated. Anxiety symptoms were measured before and after the intervention, and families shared their experiences, thoughts, and feedback regarding the intervention. The results showed a significant decrease in children's anxiety symptoms. Furthermore, qualitative analyses demonstrated that the intervention was culturally relevant to Syrian refugee families and that it was effective in promoting children's overall well-being, agency, and family connectedness.     

Paternal Risk Factors for Child Maltreatment and Father's Participation in a Primary Prevention Program in Germany

ABSTRACT

Across the globe, the research into the influence of paternal risk and protective factors on the family, as well as on the involvement of fathers in family-related interventions, is lacking. This study utilized 506 families and examined the characteristics of fathers in psychosocially stressed families and associations between paternal risk factors (PRFs: mental health disorder, physical health disorder, young paternity, unemployment, absence of father) and family risk factors (FRFs: problematic financial situation, problematic housing situation, social isolation) for child maltreatment. The identification of PRFs and FRFs was carried out using information from consultations with social education workers and from a risk inventory completed by the mothers. The data analysis revealed an increased incidence of economic problems found in families with fathers having mental health issues, fathers under the age of 22, and unemployed fathers or single mothers. Other factors such as social isolation occurred more often in families with a single mother. The present study underlines the importance of a father's involvement for young families. Future research and program recommendations should always systematically include the father's role in family-related interventions.     

Differences in Problems Faced by Families with a Child Coping with a Serious Emotional Disorder or an Adult Member Coping with Mental Illness

Abstract

Examination of similarities and differences in the issues families face can help determine whether models for families with a child coping with serious emotional disorder (SED/behavioral disorder (BD)) warrant inclusion in, or adaptation of, interventions for families with an adult member coping with a mental disorder. Families attending psycho-education workshops identified problems faced in managing their family member's illness. Composite lists of problems generated by 175 participants were categorized and sorted, using previously established methods for determining reliability and validity. Fourteen categories were identified for children and fifteen for adults, with ten overlapping. Family members attending the child-focused workshops more often listed mood symptoms and problem behaviors. Family members attending the adult-focused workshops more often listed family issues, denial and noncompliance, and positive symptoms of psychosis. Problems identified by families with a child coping with SED/BD may be sufficiently distinct from those of families with an adult coping with mental illness to warrant separate and distinct interventions.     

Clinical Home Visitation for Children With Externalizing Disorders: A Randomized Study

ABSTRACT

Clinical home visitation (CHV) was empirically tested in a randomized study to determine if it could reduce a child's externalizing behaviors while alleviating parental stress. Clinic-referred waitlisted young children (n = 33) with symptoms suggesting an externalizing disorder were randomly offered a CHV intervention composed of a developmentally guided dyadic-centered syllabus. Families were recruited to participate in an experimental (n = 21) or control group (n = 12). Mothers completed the Parenting Stress Index (PSI) and the Child Behavior Checklist. Results of paired-samples t-tests indicated that postintervention aggression scores were significantly different from the pretest scores for the entire sample. The Difficult Child domain was the only significant PSI subscale. The results did not support definitive conclusions about CHV as an effective intervention to reduce an externalizing disorder or to alleviate parenting stress. Future research should include larger numbers of children with externalizing disorders pooled from the clinic-referred and community samples. To address the complexities involved in treating externalizing disorders, CHV could be offered as part of a multimodal intervention (e.g., CHV combined with parent and family education).     

Noncompletion of Evidence-Based Parent Training: An Empirical Examination Among Families of Children in Foster Care

Child welfare have historically experienced high dropout rates. As evidence-based interventions (EBIs) spread to the child welfare field, treatment noncompletion could interfere with successful outcomes. Using a mixed methods approach, this study investigated the differences between completers and noncompleters, and reasons for treatment noncompletion of an EBI for families of children in foster care. The sample comprised 315 families randomized to receive Parent Management Training, Oregon Model (PMTO). Researchers examined clinicians' discharge notes to explore reasons for noncompletion. Using data collected from a battery of assessments, bivariate logistic regression compared completers and noncompleters on demographics, socioeconomic factors, children's social-emotional functioning, and parents' functioning. About one third of families were noncompleters. Single fathers and parents with lower socioeconomic status were more likely to drop out. By contrast, parents with lower functioning on child behavior and parenting trended toward higher completion rates. Formidable challenges were parental substance abuse and mental illness. Results suggest parent training may require tailoring for specific subgroups and pairing with strategies for enhancing early engagement and reducing treatment barriers. Future research is needed to include parents' views on noncompletion and to more closely examine the influence of specific factors, such as severity of parental mental illness and substance abuse.     

Possibilities for Intervention in Domestic Violence: Frame Analysis of Health Care Professionals’ Attitudes

ABSTRACT. Violence is a serious problem, and social and health care providers are in a key position for implementing successful interventions. This qualitative study of 6 focus groups with professionals (n = 30) examines the health care professionals’ ways of framing a domestic violence intervention. Of special interest here is how professionals see their own roles in the process of recognizing and helping victims of domestic violence. By using Erving Goffman's frame analysis, this study identifies several frames that either: a) emphasize the obstacles to intervention and justify nonintervention, or on the contrary, b) question these obstacles and find justifications for intervention. The possibilities for intervention are further explored by analyzing the ways in which the dynamics between the different frames allow redefinition of domestic violence interventions. Despite the challenges involved in a domestic violence intervention, there seems to be potential for change in personal attitudes and reform of professional practices. The research findings underline the role of social and health care professionals as members of a larger chain of service providers working collaboratively against domestic violence. Implications for practice and directions in policy and future research are suggested.     

The Effect of Father–Toddler and Mother– Toddler Role Reversal on the Development of Behavior Problems in Kindergarten

Role reversal is a relationship disturbance in which a parent looks to a child to meet a parent's need for comfort, parenting, intimacy or play, and the child attempts to meet these needs. The current study examined, within a developmental psychopathology framework, the effect of father and mother role reversal with toddlers on the development of attention problems, externalizing symptoms, internalizing symptoms, and social problems in kindergarten. In a normative sample, N=57, role reversal was assessed in an observational paradigm, and teachers rated behavior problems. Father role reversal predicted attention problems and externalizing symptoms, whereas mother role reversal predicted social problems. Gender was an important moderator such that father role reversal predicted social problems for boys and mother role reversal predicted social problems for girls. The importance of a developmental psychopathology perspective, the role of fathers, and implications for the development of diagnosable disorders and for preventive interventions are discussed.     

Examining the impact of family services on homeless children

This study examined the impact on children of services delivered through a collaborative initiative designed to provide supports to working poor families who are homeless or at immediate risk of becoming homeless. Overall, a number of positive findings can serve to inform the development of promising intervention strategies for children in homeless families and highlight areas for further research. Along with improved housing status, there was a statistically significant improvement in the economic self‐sufficiency of the families served, regardless of whether they completed the full programme cycle. In addition, youth self‐report data indicated significant improvements in externalizing and internalizing behaviour. The ability to combine programme data with school data for participating children also made it possible to explore school performance outcomes. Although these results did not indicate a change in participants’ levels of attendance or reading performance, there was a statistically significant improvement in students’ math scores. Moreover, when participating children were compared with a group of students matched on their level of academic performance at baseline who had not received housing or homeless services, no significant differences were detected between groups post‐intervention, indicating that services may help reduce the risk of homeless students’ falling further behind their peers academically.     

The Moderating Effect of Living with a Child Before Incarceration on Postrelease Outcomes Related to a Prison-Based Parent Management Training Program

ABSTRACT

With the rapid growth in incarceration in the United States over the past few decades came dramatic growth in the number of the incarcerated parents with at least one minor child. Parental incarceration places extra stresses and strains on families and children. Almost all of those incarcerated will eventually be released. However, the majority of those released from prison will be rearrested within a year. Finding interventions that can decrease the likelihood of returning to crime and to incarceration are of utmost importance. Using a social bond theory framework, the authors examine the moderating effect of living with a child before incarceration on program outcomes related to a prison-based parent management training program. A significant effect was found. Implications for these findings are discussed for future research and practice.     

Stages of change and engagement in a family intervention

Prochaska and DiClemente's stages of change model facilitate understanding of engagement difficulties in psychosocial intervention processes. We assessed the link between stages of family change and intervention dropout in a sample of 141 families with relational conflicts between parents and adolescent children. Each family member's stage of change was defined according to three criteria: seeing the conflict as a relational problem, assuming part of the responsibility for the dysfunctional relationship, and understanding one's own mental and emotional states and those of the other family members involved in the conflict (mentalization). Our dropout rate for the sample was 41.8% and was higher for immigrant families. We found a strong association between engagement and the contemplation stage of change, particularly the mother's. In family conflict interventions, participation of all the family members is essential so as raise awareness of the relational aspects of the conflict and the shared responsibility for the conflict and its resolution.     

Can Psychosocial Intervention Improve Peer and Sibling Relations Among War‐affected Children? Impact and Mediating Analyses in a Randomized Controlled Trial

Social resources are considered important protectors in traumatic conditions, but few studies have analyzed their role in psychosocial interventions among war‐affected children. We examined (1) whether a psychosocial intervention (teaching recovery techniques, TRT) is effective in improving peer and sibling relations, and (2) whether these potentially improved relations mediate the intervention's impacts on children's mental health. Participants were 428 Palestinian children [10–13 (mean = 11.29, standard deviation SD = .68)‐year‐old girls (49.4 percent) and boys (50.6 percent)], who were cluster‐randomized into the TRT and wait‐list control groups. They reported the quality of peer (friendship and loneliness) and sibling (intimacy, warmth, conflict, and rivalry) relations, and posttraumatic stress, depressive and psychological distress symptoms, as well as psychosocial well‐being at baseline (T1), postintervention (T2), and six month follow‐up (T3). Results showed gender‐specific TRT intervention effects: Loneliness in peer relations reduced among boys and sibling rivalry reduced among girls. The TRT prevented the increase in sibling conflict that happened in the control group. The mediating hypothesis was partially substantiated for improved peer relations, and beneficial changes in sibling relations were generally associated with improved mental health.     

Lessons Learned From the Supporting Father Involvement Study: A Cross-Cultural Preventive Intervention for Low-Income Families With Young Children

ABSTRACT

Despite the proliferation of fatherhood programs designed to promote paternal involvement and positive family outcomes, evaluations of these programs are scarce. The Supporting Father Involvement (SFI) study is a randomized clinical trial comprised of 289 low-income Spanish- and English-speaking families living in California. The evaluation design reflects a partnership stance that promotes empowerment of staff and social service agencies. This article examines lessons learned from the program's first 3 years (2002–2004) from the perspectives of both evaluators and program staff. The lessons cover a broad range of areas, including communication procedures, training, staffing, recruitment/retention, clinical needs, intervention content and process, and maintaining cultural sensitivity.     

Predictors of behavioural and emotional problems of children placed in children's homes in Croatia

Since children's homes in Croatia and elsewhere nowadays deal with children who have more problems than in the past, there is a need to identify predictors of the children's behavioural and emotional problems in order to provide adequate interventions and an appropriate developmental environment. This research was carried out in all children's homes in Croatia. The sample consisted of 263 children aged 10–14. Standardized instruments (Youth Self‐Report and Child Behaviour Check‐List) were used as outcome measures of children's psychosocial functioning. The results showed significantly more behavioural and emotional problems in children in children's homes than in the comparison group of children living with their families. Child care‐workers assessed fewer behavioural and emotional problems than did the children themselves. Multiple regression analyses were used to determine predictors for well‐being scores. The level of everyday stress in children's homes, coping strategies, perception of social support and school achievements proved to be the most significant predictors. Since those variables belong to mediating variables within the suggested model of research, it is argued that positive changes in these areas can facilitate a better psychosocial functioning of the children in children's homes.     

Supporting families living with parental substance misuse: the M‐PACT (Moving Parents and Children Together) programme

The Moving Parents and Children Together (M‐PACT) programme is one of the growing number of interventions tailored to meet the multiple and complex needs of children and families affected by parental substance misuse. This paper pulls together the qualitative findings from 13 evaluated M‐PACT programmes in England. Sixty‐four families attended an M‐PACT programme, including 82 children and 75 adults. Qualitative data were collected from 37 children, 36 adults and over 30 group facilitators. Six themes are discussed: engaging with M‐PACT, shared experiences, understanding addiction, changes in communication, healthier and united families, and ending M‐PACT. The majority of families benefitted in a range of ways from the programme: meeting others who were experiencing similar problems, greater understanding about addiction and its impact on children and families improving communication within the family. In many families there was more openness and honesty, stronger relationships and more time as families, and a reduction in arguments and conflict. The key findings are discussed in terms of the potential for interventions of this kind to reduce family‐related harm from parental substance misuse.     

Breaking the cycle: an asset-based family intervention for poverty alleviation in China

ABSTRACT

Limited attention is given to how the poverty alleviation benefits children’s development and breaking the transmission of intergenerational poverty in China. Based on two pilot programmes, Chunyu and Qianshou, in Shan’xi province, this study presents the potential effects of an asset-based family intervention that incorporates Child Development Accounts (CDAs) and parental support services on children and families. This study finds that the implementation of the programmes has positive financial and nonfinancial benefits for children and their families. The CDAs may serve as a key mechanism to integrate and strengthen the effect of asset building and parental involvement.