The objective of this paper is to provide a description of Family Options, a rehabilitation intervention for parents with serious mental illnesses and their children focusing on recovery and resilience, and to report the findings from a pilot study at 6-months post-enrollment for participating mothers.
A developmental design, and mixed quantitative and qualitative methods facilitate an in-depth understanding of Family Options and its impact on parents early in the implementation process.
Participating families faced significant challenges, including long-term mental health conditions in adults, and emotional and behavioral difficulties in children. Data from mothers (n = 22) demonstrate significant improvements in well-being, functioning, and supports and resources at 6 months post-enrollment in Family Options. Mothers report help from Family Options staff consistent with the intervention as conceptualized, and high levels of satisfaction with the intervention as delivered.
Innovative study design and analytic strategies are required to build the evidence base and promote rapid dissemination of effective interventions. Findings from this study will assist purveyors in refining the intervention, and will lay the groundwork for further replication and testing to build the evidence base for parents with serious mental illnesses and their families.
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"Which factors are most effective have to yet to be studied. The results of this study may give support to integrating a family-focused approach in psychiatric services (Falkov, 2012; Nicholson et al., 2009) with a community-based youth services approach for multiproblem families. "
[Show abstract][Hide abstract] ABSTRACT: Children of parents with a mental illness (COPMI) are at increased risk for developing psychiatric disorders, especially when parenting is compromised by multiple risk factors. Due to fragmented services, these families often do not get the support they need. Can coordination between services, as developed in the Preventive Basic Care Management (PBCM) program, improve parenting and prevent child behavioral problems? This randomized controlled clinical trial (RCT) compared the effectiveness of PBCM with a control condition. Ninety-nine outpatients of a community mental health center were randomized to intervention or control. Primary outcomes included parenting quality (assessed by the HOME instrument), parenting skills (parenting skills subscale of FFQ), and parenting stress (PDH). Secondary outcomes are child behavioral problems (SDQ). Outcomes were assessed at baseline and after 9 and 18 months. Effects were analyzed by Repeated Measures Analysis of Variance. Most families were single-parent families belonging to ethnic minorities. The results of the first RCT on effects of PBCM suggest that this intervention is feasible and has a positive effect on parenting skills. There was no evidence for effects on the quality of parenting and parenting stress, nor preventive effects on child behavioral problems. Replication studies in other sites, with more power, including monitoring of the implementation quality and studying a broader palette of child outcomes are needed to confirm the positive effects of PBCM. Long-term prospective studies are needed to investigate if improved parenting skills lead to positive effects in the children in the long run. (PsycINFO Database Record (c) 2015 APA, all rights reserved).
Families Systems & Health 03/2015; 33(2). DOI:10.1037/fsh0000105 · 1.13 Impact Factor
"The barriers they face are numerous, and the consequences can be devastating. The limited programming that does exist for parents with a mental illness has shown positive outcomes (Hinden, Biebel, Nicholson, & Mehnert, 2002; Nicholson, Albert, Gershenson, Williams, & Biebel, 2009). "
[Show abstract][Hide abstract] ABSTRACT: Objective:
This study examined the effectiveness of an Internet parenting education and support intervention among mothers with a serious mental illness (SMI).
Sixty mothers diagnosed with a schizophrenia spectrum or mood disorder who had primary/shared custody for a child 18 or younger were enrolled in a randomized controlled trial (RCT) with two conditions. The experimental condition involved participation in the online parental education course and a listserv co-moderated by a parent with a mental illness and a mental health professional. The control condition involved participation in online education healthy lifestyle course. Standardized measures were used at baseline and 3 months to assess outcomes. Using an intent-to-treat approach, group differences over time were assessed using a two-tailed independent sample t test on all dependent variables, including parental efficacy, skills, coping, support, and stress.
Participation in an online parenting intervention for mothers with a SMI enhanced parenting and coping skills, and decreased parental stress. No support was found for improved efficacy or support.
This RCT establishes that mothers with a SMI are interested in and capable of receiving online parenting education and support. Findings demonstrate that an online parenting intervention can improve parenting and coping skills and decrease parental stress.
"Several pilot reflective functioning groups of this sort are currently underway at community-based programs in Connecticut. On the other hand, if mothers with SMI feel that they need help setting boundaries with their children, getting their children to school on time, or remembering their children's school bus schedule, then assistance can be developed to target these more instrumental domains (see Nicholson et al., 2009). Mothers with SMI may also need help with childcare so that they can return to productive work outside the home. "
[Show abstract][Hide abstract] ABSTRACT: Women with serious mental illness often parent without adequate support from psychiatric and behavioral health providers. The lack of such services is significant, given that women with SMI have children at the same or higher rates as women without psychiatric disabilities. In this call to action, we argue that the need to develop supported parenting initiatives for women with SMI is necessary and long overdue. First, we describe numerous social and systemic barriers in the U.S. that have hindered the development of parenting supports for women with SMI over the last century. We next describe recent qualitative and quantitative findings regarding the parenting needs and strengths of these mothers. Finally, we conclude with suggestions for future research, program development, and systems-level policy changes to support mothers with SMI in parenting most effectively.
American Journal of Psychiatric Rehabilitation 04/2011; 14(2):137-153. DOI:10.1080/15487768.2011.569668