Family-Based Treatment Research: A 10-Year Update

Department of Psychiatry, University of Pennsylvania School of Medicine, and The Center for Family Intervention Science, The Children's Hospital of Philadelphia, PA 19104, USA.
Journal of the American Academy of Child & Adolescent Psychiatry (Impact Factor: 7.26). 10/2005; 44(9):872-87. DOI: 10.1097/01.chi.0000169010.96783.4e
Source: PubMed


To provide an update on the state of the art of family-based treatment research.
Randomized clinical trials conducted in the past 10 years that included parents as a primary participant in treatment of child and adolescent psychiatric problems were reviewed. Studies were identified from major literature search engines (e.g., PsycINFO, Medline). Current significant pilot work was identified in the National Institute of Mental Health Computer Retrieval of Information on Scientific Projects (CRISP) Web page or from the authors themselves.
Family treatments have proven effective with externalizing disorders, particularly conduct and substance abuse disorders, and in reducing the comorbid family and school behavior problems associated with attention-deficit/hyperactivity disorder. Several new studies suggest that family treatments or treatment augmented by family treatments are effective for depression and anxiety.
For many disorders, family treatments can be an effective stand-alone intervention or an augmentation to other treatments. Engaging parents in the treatment process and reducing the toxicity of a negative family environment can contribute to better treatment engagement, retention, compliance, effectiveness, and maintenance of gains. Recommendations for the next decade of research and some implications of family-based treatment for child and adolescent psychiatry are explored.

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    • "Interventions have been developed to provide families with such information and support (Lock & Le Grange, 2005; Lucksted, McFarlane, Downing, Dixon, & Adams, 2012) and research has found these, along with a diverse range of other family interventions to be helpful for people with mental illness, particularly in reducing symptoms and relapse. However, the critical components of family treatments and the mechanisms through which they work are unclear (Diamond & Josephson, 2005; Kazdin & Nock, 2003). Understanding the things parents do to try to assist young people with mental illness and how these strategies affect young people, is one way to begin to unravel the link between family interventions and outcomes. "
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    ABSTRACT: Parents of young people with mental illness use a variety of strategies to try to positively influence young people’s mental health-related behaviours. Evidence suggests that these parents can influence young people’s well-being and mental health trajectories. However little is known about how young people perceive and are affected by the strategies parents use. In-depth qualitative interviews focussing on parental involvement in mental health were conducted with 26 young people with mental illness. The data were analysed using constant comparative analysis. Young people described parents as directly influencing their mental health-related behaviour through facilitative, persuasive and controlling practices. Young people’s behavioural and emotional responses to these practices were influenced by when the incident occurred; what they believed about the attitudes and motives behind their parents’ actions; whether they agreed in principle with the practices; the degree to which they accepted their parents’ authority and anticipated their own increasing autonomy; and whether other support was provided alongside the behavioural practices. Understanding how young people view their parents’ influence on their mental health-related behaviour under different circumstances is a vital step towards promoting the best possible parental support for these young people.
    No preview · Article · Dec 2014
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    • "One of the critiques about the family-based-intervention is that the amount and kind of interaction between the child and its parents’ behaviour outside the experiment setting is one of the main problems considered. This explains the reasons why the effectiveness of a family weight loss program is difficult to determine [26]. "
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    ABSTRACT: The prevalence of childhood obesity, which has seen a rapid increase over the last decade, is now considered a major public health problem. Current treatment options are based on the two important frameworks of school- and family-based interventions; however, most research has yet to compare the two frameworks in the treatment of childhood obesity.The objective of this review is to compare the effectiveness of school-based intervention with family-based intervention in the treatment of childhood obesity. Databases such as Medline, Pub med, CINAHL, and Science Direct were used to execute the search for primary research papers according to inclusion criteria. The review included a randomised controlled trial and quasi-randomised controlled trials based on family- and school-based intervention frameworks on the treatment of childhood obesity. The review identified 1231 articles of which 13 met the criteria. Out of the thirteen studies, eight were family-based interventions (n = 8) and five were school-based interventions (n = 5) with total participants (n = 2067). The participants were aged between 6 and 17 with the study duration ranging between one month and three years. Family-based interventions demonstrated effectiveness for children under the age of twelve and school-based intervention was most effective for those aged between 12 and 17 with differences for both long-term and short-term results. The evidence shows that family- and school-based interventions have a considerable effect on treating childhood obesity. However, the effectiveness of the interventional frameworks depends on factors such as age, short- or long-term outcome, and methodological quality of the trials. Further research studies are required to determine the effectiveness of family- and school-based interventions using primary outcomes such as weight, BMI, percentage overweight and waist circumference in addition to the aforementioned factors.
    Full-text · Article · Jan 2014 · Archives of Public Health
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    • "Positive family influence is an important dimension that should be better documented since it has been identified as a " best practice " (Health Canada 2001) and a key element in adolescent rehabilitation (Dowel & Ogles 2010; Gauthier, Bertrand & Nolin 2010; Carr 2009; Diamond & Josephson 2005; Kumpfer & Alvarado 2003; Frensch & Cameron 2002). The relationship between the role of family involvement on changes in adolescent rehabilitation trajectories is still poorly understood (Dowel & Ogles 2010; Diamond & Josephson 2005). In a meta-analysis of this topic, Dowel and Ogles (2010) determined that duration of family therapy did not influence the rehabilitation processes of youths undergoing treatment. "
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    ABSTRACT: Parental involvement in adolescents' substance abuse treatment is highly recommended, even though the mechanisms explaining how this favors youths' recovery are not well understood. The present study examines the association between (1) changes in adolescents' substance use and parenting practices, as measured by adolescent self-disclosure and parental warmth; (2) changes in mothers' mental health and their parenting practices, and (3) parental use of services offered by substance abuse treatment centres, parenting practices and adolescent substance use. In total, 147 adolescents and 69 mothers participated in this study. Participants were assessed upon adolescent admission into treatment, as well as at three- and six-month follow-up. Results show an association between improved maternal mental health and greater parental warmth, as perceived by adolescents. In addition, greater parental use of treatment services was found to be associated with greater adolescent self-disclosure and greater reduction of adolescent substance use. Finally, greater adolescent self-disclosure and parental warmth were both associated with lower adolescent substance use. These findings underscore the need to facilitate parents' access to and involvement in treatment of adolescents. The parent-adolescent relationship and the mental health of parents are essential aspects to consider for interventions.
    Full-text · Article · May 2013 · Journal of psychoactive drugs
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