BackgroundChildren of substance-abusing parents are at risk for developing psychosocial development problems. In Germany it is estimated that approx. 2.65 million children are affected by parental substance abuse or dependence. Only ten percent of them receive treatment when parents are treated. To date, no evaluated programme for children from substance-affected families exists in Germany. The study described in this protocol is designed to test the effectiveness of the group programme TRAMPOLINE for children aged 8-12 years with at least one substance-abusing or -dependent caregiver. The intervention is specifically geared to issues and needs of children from substance-affected families.Methods/DesignThe effectiveness of the manualised nine-session group programme TRAMPOLINE is tested among N = 218 children from substance-affected families in a multicentre randomised controlled trial. Outpatient counselling facilities across the nation from different settings (rural/urban, Northern/Southern/Eastern/Western regions of the country) will deliver the interventions, as they hold the primary access to the target group in Germany. The control condition is a group programme with the same duration that is not addiction-specific. We expect that participants in the intervention condition will show a significant improvement in the use of adaptive coping strategies (in general and within the family) compared to the control condition as a direct result of the intervention. Data is collected shortly before and after as well as six months after the intervention.DiscussionIn Germany, the study presented here is the first to develop and evaluate a programme for children of substance-abusing parents. Limitations and strengths are discussed with a special focus on recruitment challenges as they appear to be the most potent threat to feasibility in the difficult-to-access target group at hand (Trial registration: ISRCTN81470784).
Children of substance-abusing parents (COS) are at risk for developing psychosocial problems. We evaluated the effectiveness of the manualized, 9-session psychoeducational preventive intervention "TRAMPOLINE" (PE) for 8-12-year-old COS compared with a non-educational "fun and play" group (NE) of equal length delivered by social workers in 27 German counselling centres. A randomized controlled trial was conducted to compare PE (n = 130) and NE (n = 88) outcomes at baseline, post intervention, and 6-month follow-up. Primary outcomes were related to stress and coping; secondary were also examined. Analyses were conducted using baseline-adjusted repeated measures linear mixed models. Five outcomes revealed improvements both in PE and NE, four of which were more pronounced in PE, and one more pronounced in NE. Small but significant group differences in favour of PE were found in "social isolation" and "addiction-related knowledge." Children from both groups reported reduced mental distress, reduced avoidance in coping with family stress, improved self-perceived autonomy, and a better parent-child relationship. No changes were observed in self-efficacy, physical stress symptoms, and in other health-related quality of life aspects. TRAMPOLINE can instill positive changes in COS by reducing mental distress and social isolation.
Zusammenfassung Zielsetzung: Das Gruppenangebot ?Trampolin? richtet sich an Kinder aus suchtbelasteten Familien und wurde im Rahmen des Bundesmodell?projekts ?Modularisierte Hilfen f?r Kinder aus suchtbelasteten Familien? wissenschaftlich evaluiert. Als qualit?tssichernde Ma?nahme erfolgte im Verlauf der wissenschaftlichen Begleitforschung neben der Ergebnisevaluation auch eine systematische Untersuchung des Implementierungsprozesses. Methoden: Dokumentierend und prozessbegleitend wurden die Manualtreue, Merkmale der Programmausf?hrung und die Zufriedenheit der teilnehmenden Kinder, Eltern und Kursleiter in 27 Einrichtungen erfasst. Ergebnisse: Die Sitzungen wurden hoch adh?rent (84,1%) ausgef?hrt. Kinder, Kursleiter und Eltern zeigten insgesamt hohe Akzeptanz und Zufriedenheit bez?glich des ?Trampolin?-Programms. Die Qualit?t des Evaluationsprozesses ist somit als hoch zu bewerten. Fazit: Aufgrund der hohen Prozessqualit?t ist mit gro?er Sicherheit davon auszugehen, dass die Wirksamkeitsnachweise des Programms ?Trampolin? auf die Interventionsma?nahme zur?ckzuf?hren sind. Das ?Trampolin?-Manual wurde auf Grundlage der Prozessevaluation ?berarbeitet und optimiert.
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