Family Options for Parents with Mental Illnesses: A Developmental, Mixed Methods Pilot Study

University of Massachusetts Medical School, MA, USA.
Psychiatric Rehabilitation Journal (Impact Factor: 1.16). 09/2009; 33(2):106-14. DOI: 10.2975/33.2.2009.106.114
Source: PubMed


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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Available from: Kathleen Biebel, Apr 08, 2015
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    • "In Finland studies evaluating the effectiveness of these family-based interventions found that they successfully decreased children " s maladaptive behaviors and symptoms of anxiety and hyperactivity; they also improved social behavior in the children of parents with mental illness (Solantaus, Paavonene, Toikka & Punamaki, 2010). In studies conducted in the United States family based interventions were associated with significant improvements in family social support and a decline in the need for services (Nicholson et al., 2009; Tolan et al., 2007). "
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    ABSTRACT: Research substantiates children of parents with mental disorders including substance abuse face increased risk for emotional and behavioral problems, mental illness, substance abuse, learning problems, social difficulties and stigma by association with parental conditions. These children may also experience family violence and require child protection services. Children of parents with mental illness tend to negotiate their circumstances with limited supports and information. Although evidence suggests that family-focused psycho-education and support programs for children or families enhance resiliency, recruiting children and families to these groups remains problematic. This study identifies successful recruitment strategies for prevention programs for children of parental mental illness, substance abuse and co-occurring disorders. Method: The participants were recruited from an international network of researchers working with parental mental illness and substance abuse. E-mail invitations requested that researchers forward a web-based questionnaire to five colleagues with recruitment experience for this population. Forty-five individuals from nine countries practicing in adult mental health and child mental health responded. Descriptive statistics and qualitative content analysis techniques were used within the analysis Inter-rater reliability was established with a senior qualitative researcher and two doctoral students using constant comparison to guide analysis. Results: Schools, adult mental health and youth mental health services were recruitment sources found through connections with practitioners and teachers. Nine main themes were identified: Direct relationships, diversified information output, logistics, program consistency, family involvement, recruitment through adults, stigma, recruiting locations and social media. Recruitment barriers were: stigma, inadequate knowledge about parental mental illness and limited time in family schedules. Transportation to programming was an essential component of successful recruitment. Significance: This study identifies successful recruitment strategies from an international perspective and provides evidence informed direction for best practice recruitment strategies to support groups for children and families living with parental mental illness and substance abuse. Key words: children, parental mental illness, parental substance abuse, co-occurring disorders, recruitment, support groups, psycho education, families
    Full-text · Article · Oct 2015 · Child & Youth Services
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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. "
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    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).
    Full-text · Article · Mar 2015 · Families Systems & Health
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    • "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). "
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    ABSTRACT: Objective: This study examined the effectiveness of an Internet parenting education and support intervention among mothers with a serious mental illness (SMI). Methods: 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. Results: 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. Conclusion: 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.
    Full-text · Article · Jun 2014 · Psychiatric Rehabilitation Journal
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