IPT visual tools in a preventive multifamily program for children and families living with a depressed parent

Abstract

Introduction: Several preventive interventions targeted at children living with a parent with a mental disorder and their families exist and are recognized as effective (Reupert et al., 2013). The majority of preventative interventions include goals related to improving social skills, communication in the family, and community involvement. A commonly used approach targeting depressed parents, IPT, is also focused on improving interpersonal relationships. Its effectiveness in samples of pre-teens, adolescents and depressed adults was highlighted in the last years. However, to our knowledge, the usefulness and appreciation of the visual tools proposed in this approach have never been evaluated. This project aimed to verify the satisfaction of participants with respect to 3 tools inspired by the IPT approach and 3 innovative tools, adapted to the cognitive and socioemotional capacities of 7 to 11 years-old children.
Methods: A mixed-methods study was conducted, using both quantitative and qualitative methods to support a child-centered research process (Crivello et al., 2009). Three parents and five children were recruited to participate in a multifamily group prevention program. To assess child satisfaction with the visual tools, a short questionnaire adapted to school-aged children’s cognitive level (5-7 questions using Likert scales expressed in emoticons) was completed by child participants after each meeting, as well as before and at the end of the program. Parents and facilitators also gave their perception of the tools through a questionnaire at the end of the program. In addition, an individual interview was held with each participant, as well as with the facilitators.
Results: Preliminary results show that the tools were well accepted and appreciated by both parents and children. The storybook was also highly valued by the participants. The children found the main characters attractive and funny. However, children identified several words from the workbook and storybook as being too difficult to understand. The material will thus be reviewed accordingly.
Discussion: The proposed methods are well accepted and appreciated by children between the ages of 7 and 11, and overall allow for agood knowledge integration.
Recommendations:This initial testing is interesting since it raised areas for improvement in our program. Yet, above all this project underlines the utility of using IPT visual tools, to ensure children's understanding and appreciation.

Full text

Moods, emotions and needs tools
« I like closing my
eyes and trying to
find the emotion I
am feeling.»
Juliet, 8 years old.
TOOLS INSPIRED BY IPT INNOVATIVE TOOLS
The proximity circle
Drawing activities
My life with my parent Fun times with my parent
Pirate storybook
« The story is
cool! » Sam,
11 years.
• Several interventions targeted at children and families
living with a depressed parent have been recognized
as effective (Reupert et al., 2013). The majority of
them include goals related to improving interpersonal
relationships.
•While positive results have been found, results show
modest effect sizes (Van Doesum et al., 2019),
similarly to results from CBT or IPT programs for
depressed children (Garber et al., 2016; Dietz et al.,
2015).
•Children aged 7-11 years have difficulties sharing their
emotions, solving social conflicts, and understanding
complex concepts, underlining the need to better
adapt the tools and activities proposed to their
developmental capacities (Garber et al., 2016).
•IPT is also focused on interpersonal relationships. Its
effectiveness in samples of pre-teens, adolescents and
depressed adults was highlighted in the last years.
•The IPT approach uses several visual tools, (e.g.,
moods thermometer, closeness circle), which are
thought to be fundamental to its efficacy.
•Our research lab has developed a preventive
intervention for children and families living with a
parent with a depressive disorder (FAMILLE+), based
on Family Talk (Beardslee, et al., 2007) and IPT tools.
•A pilot study conducted in 2019 showed positive
preliminary results (Piché et al., accepted).
•Yet, the usefulness and appreciation of the visual
tools have never been evaluated.
Objective :
Part of a larger project, this study aimed to verify
the satisfaction of participants with respect to tools
and activities proposed in the context of a
preventive multifamily group for children and
families living with a depressed parent (FAMILLE+,
Piché et al., accepted).
Methods:
• Mixed methods: quantitative and qualitative
methods (child-centered research process; Crivello
et al., 2009).
•Sample: 8 participants + 3 facilitators
• 3 parents (2 mothers, 1 father)
•5 children aged 7-11 years (3 boys, 2 girls)
•3 facilitators: 2 in child group / 1 in parent group
•Child satisfaction towards the tools and
activities proposed :
• a short questionnaire adapted to school-aged
children’s cognitive level (5-7 questions using
Likert scales expressed in emoticons) was
completed by child participants after each
meeting, as well as before and at the end of the
program.
•Parents satisfaction towards the tools and
activities proposed: a questionnaire after each
meeting and at the end of the program.
•In addition, an individual interview was held with
each participant, as well as with the facilitators.
INTRODUCTION METHODS
• Garber, J., Frankel, S. A., et Herrington, C. G. (2016). Developmental demands of
cognitive behavioral therapy for depression in children and adolescents: cognitive,
social, and emotional processes. Annual review of clinical psychology, 12, 181-216.
• Mendel, M.R., Harris, J., & Carson, N. (2016). Bringing bibliotherapy for children to
clinical practice. Journal of the American Academy of Child and Adolescent Psychiatry,
55 (7), 535-537.
• Emotions and needs tools from the Institute of Social Emotional Education
(http://www.me-you-us.org/).
•Piché, G, A Villatte, K Vetri, R Habib, W Beardslee. (accepted) FAMILLE+, a
multifamily group program developed to meet the cognitive and socioemotional abilities
of school-aged children living with a depressed parent. Journal of Parent and Family
Mental Health.
•Reupert, A. E., Cuff, R., Drost, L., Foster, K., van Doesum, K. T. et van Santvoort, F.
(2013). Intervention programs for children whose parents have a mental illness: a
review. Medical Journal of Australia, 199(3 Suppl), S18-22.doi: 10.5694/mja11.11145
• Doesum, K. V., Maia, T., Pereira, C., Loureiro, M., Marau, J., Toscano, L., ... & Reedtz,
C. (2019). The impact of the ‘Semente’program on the family focused practice of
mental health professionals in Portugal. Frontiers in psychiatry, 10, 305.
Limits and discussion
REFERENCES
Geneviève Piché, Ph.D.1,2,3,4 & Aude Villatte, Ph.D.1,3,4
1. Department of psychoeducation and psychology, Université du Québec en Outaouais
2. Quebec Population Health Research Network
3. University Research Center on You th and Families
4. Laboratory of research and actions for people with mental health problems and their families (https://lapproche.uqo.ca/)
ISIPT, November 2019
Contact: Genevieve.piche@uqo.ca
• Results show that the tools and activities were well accepted and appreciated by both
parents (mean: 4,6/5) and children aged 7 to 11 years (mean: 4,3/5).
• The content and activities proposed did not elicit negative emotions (as assessed with
the mood thermometer), except the role-playing activities and family meeting.
• This project thus underlines the utility of using IPT visual tools, to ensure children's
understanding and appreciation.
•Four innovative tools and activities were particularly enjoyed by participants: emotions
and needs posters and cards; pirate storybook (bibliotherapy); body percussion and
drawing activities.
•Getting direct feedback from families is important as it raises areas for
improvement in our interventions:
• Example 1- The storybook was highly valued by the participants. Children found the
main characters attractive and funny. However, through direct investigation of
children thoughts, results inform us to that several words from the workbook and
storybook were too difficult to understand.
• Example 2- While the role-plays and family meeting was the most enjoyed activity by
parents and accepted by older children (9-11 years), 2 younger children (7-8 years)
informed us that they felt uncomfortable. Also, the use of our moods and emotion
tools before and after these activities confirmed this difficulty.
RESULTS AND DISCUSSION
Multifamily preventive intervention for children and
families living with aparent with adepressive disorder.
•Goal:to prevent the onset of mental disorders in children
and foster the resilience of the family.
•Objectives.That parents and children :
• Increase their knowledge on depression
• Recognize/use their personal strenghts
•Strengthen the parent-child relationship and family ties
• Improve their support network
•Plan the future
Learning tools: several visual tools and activities, to:
1. illustrate complex concepts (depression, emotions);
2. facilitate discussion of sensitive and emotional content;
3. normalize and make connections with their experiences &
4. stimulate interest (see below).
•Used in every meeting with children (except for proximity
circle/only in meetings 3-7), but also reinvested in parental
meetings, as well as in at-home proposed family activities.
FAMILLE+ (Piché & Villatte)
Body percussion activities
«Pick a photo » activity
(life with a depressed parent)
Most popular
activities (according
to children)!
Children and parents
completed the
proximity circle in
parallel.
The parents all
underlined the
relevance of this
activity
«We improved communication, I would say that. The keys to communicating better together as
a family, better identification of emotions, the best way to express them too” Patrick, father.