This paper reports on the 6-month follow-up outcomes of an effectiveness study testing a multiple family group (MFG) intervention for clinic-referred youth (aged 7–11) with disruptive behavior disorders (DBDs) and their families in socioeconomically disadvantaged families compared to services-as-usual (SAU) using a block comparison design. The settings were urban community-based outpatient mental health agencies. Clinic-based providers and family partner advocates facilitated the MFG intervention. Parent-report measures targeting child behavior, social skills, and impairment across functional domains (i.e., relationships with peers, parents, siblings, and academic progress) were assessed across four timepoints (baseline, mid-test, post-test, and 6-month follow-up) using mixed effects regression modeling. Compared to SAU participants, MFG participants reported significant improvement at 6-month follow-up in child behavior, impact of behavior on relationship with peers, and overall impairment/need for services. Findings indicate that MFG may provide longer-term benefits for youth with DBDs and their families in community-based settings. Implications within the context of a transforming healthcare system are discussed.
Problem drinking is of great concern for mothers, especially those who are HIV-infected. We compared background characteristics, co-occurring drug use, and physical and mental health functioning of urban HIV-infected and uninfected mothers with problem drinking who were raising adolescents. Mothers in both groups reported similarly high levels of lifetime and current alcohol and drug use and poor physical and mental health. Health outcomes for mothers with problem drinking do not appear to be exacerbated by HIV status. Implications for intervention efforts with mothers and their adolescent children are discussed.
In this qualitative study the authors examine factors associated with the
successful implementation and plans for continued use of an evidence-informed
intervention, the 4Rs and 2Ss Program for Strengthening Families, in a sample of
29 New York State, Office of Mental Health licensed child mental health clinics.
A learning collaborative (LC) approach was used as a vehicle for supporting
training and implementation of the program. The PRISM theoretical framework
(Feldstein & Glasgow, 2008)
was used to guide the data analysis. Data were analyzed using a multi-phase
iterative process, identifying influences on implementation at multiple levels:
the program (intervention), the external environment, implementation and
sustainability infrastructure, and recipient characteristics. Clinics that were
more proactive evidenced staff with advanced organizational skills were able to
take advantage of the trainings and supports offered by the LC and fared better
in their ability to adopt the intervention. The ability to adapt the
intervention to the specific constraints of the clinics was a strong influence
on continued use following the end of the LC. These preliminary results suggest
that the supports provided by the LC are useful in consolidating information
about the process of implementing evidence-informed interventions in community
mental health settings. The impact of these supports is also based on their
interactions with specific clinic contextual factors.
The abuse of alcohol and other substances by mothers raising adolescent children has serious adverse effects on family functioning and youth outcomes, and on mothers' own health and adaptation. Mothers who are also HIV-infected face additional challenges. In the present report, we describe a multi-session intervention conducted in individual sessions for mothers with alcohol and other substance use problems who are raising adolescent children. We outline the primary components of the intervention and include case studies and examples of exercises and tools. We found that engagement with the intervention and high rates of attendance were facilitated by tapping into mothers' desires to improve their relationships with their adolescent children, the use of a harm reduction approach toward substance use, and intensive outreach. We also discuss lessons learned in the course of implementing and evaluating the intervention.
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