Reducing parental anxiety using a family based intervention for youth mental health : a randomized controlled trial

This paper presents findings on parent anxiety and attachment relationship style from the Deakin Family Options (DFO) pilot study, a randomized controlled pilot study comparing a family-based treatment (BEST Plus), versus a youth only treatment (CBT) versus a group who received both of these treatments (COMBINED). Eligible participants were families with a young person (aged 12 - 25 years) with a high prevalence mental health problem. Youth from participating families scored in the clinical or subclinical range for depression, anxiety and/or substance misuse symptoms on standardized measures during the initial assessment. The collected sample was drawn from regional and urban centers in Victoria, Australia and allocated to treatment condition using a simple randomization procedure (parallel design). It was hypothesized that families receiving the BEST Plus would experience greater reductions in youth and parent mental health symptoms, and improved parent-child relationships, compared with those in the CBT condition. This paper describes and discusses changes in parent anxiety and parent attachment, according to whether the parent participated in a treatment (BEST Plus) or did not (NONBEST Plus). Participants were blind to the study hypotheses. In total 71 parent participants returned pre data and were allocated to a treatment group. In this paper, data from parent participants who completed pre and post measures (n = 48) and pre, post, and 6-month follow-up measures (n = 28) on anxiety and attachment were analyzed by group (BEST Plus versus NONBEST Plus). The results of this study suggest that parent anxiety decreased significantly more following parent involvement in a group treatment, than for parents that did not receive treatment. Unexpectedly, avoidant attachment increased in the no treatment group, but remained relatively stable following the BEST Plus group. There were no significant findings in relation to compulsive traits and anxious attachment. These findings are discussed in light of the study limitations.<br /

Accounting for the association of family conflict and heavy alcohol use among adolescent girls: the role of depressed mood

Objective: Heavy alcohol use increases dramatically at age 14, and there is emerging cross-sectional evidence that when girls experience family conflict at younger ages (11-13 years) the risk of alcohol use and misuse is high. This study evaluated the role of family conflict and subsequent depressed mood in predicting heavy alcohol use among adolescent girls. Method: This was a three-wave longitudinal study with annual assessments (modal ages 12, 13, and 14 years). The participants (N = 886, 57% female) were from 12 metropolitan schools in Victoria, Australia, and participants completed questionnaires during school class time. The key measures were based on the Communities That Care Youth Survey and included family conflict (Wave 1), depressed mood (Wave 2), and heavy alcohol use (Wave 3). Control variables included school commitment, number of peers who consumed alcohol, whether parents were living together, and ethnic background. Results: With all controls in the model, depressed mood at Wave 2 was predicted by family conflict at Wave 1. The interaction of family conflict with gender was significant, with girls showing a stronger association of family conflict and depressed mood. Depressed mood at Wave 2 predicted heavy alcohol use at Wave 3. Conclusions: Girls may be especially vulnerable to family conflict, and subsequent depressed mood increases the risk of heavy alcohol use. The results support the need for gender-sensitive family-oriented prevention programs delivered in late childhood and early adolescence. (J. Stud. Alcohol Drugs, 74, 396-405, 2013

Consumer feedback following participation in a family-based intervention for youth mental health

Background. This paper presents findings derived from consumer feedback, following a multicentre randomised controlled trial for adolescent mental health problems and substance misuse. The paper focuses on the implementation of a family-based intervention, including fidelity of delivery, family members&rsquo; experiences, and their suggestions for program improvements. Methods. Qualitative and quantitative data

Associations between early childhood temperament clusters and later pychosocial adjustment

The study adopted a person-centered approach to examine whether clusters of children could be identified on the basis of temperament profiles assessed on four occasions from infancy to early childhood, and if so whether differing temperament clusters were associated with subsequent differences in behavior problems, social skills, and school adjustment in middle and late childhood. Parent, teacher, and self-report data were obtained from a large community-based cohort sample of Australian children, followed prospectively from infancy to late childhood. Four temperament clusters were identified. Children in the clusters labeled as reactive/inhibited and poor attention regulation tended to have higher levels of later behavior problems than children in clusters labeled nonreactive/outgoing and high attention regulation. Results suggested that a person-oriented clustering approach can identify children on the basis of early temperament who are at greater risk for behavioral, academic, and social difficulties four to eight years later.<br /

A review of alcohol and drug education and early intervention programs in Australian government schools

In recent decades, reductions have been observed in Australian school student alcohol and drug use. A range of effective alcohol and drug use programs and policies have contributed to the decline in youth alcohol and drug use. The changing context of youth alcohol and drug use introduces the need to review future prevention and early intervention targets against school programs and policies to establish new direction. This report reviews alcohol and drug use prevention and early interventionapproaches used in Australian government schools. First, a literature review is presented summarising the evidence for effective programs and the theoretical mechanisms that underpin successful behaviour change. Second, the report assesses to what extent the current alcohol and drug use prevention and early intervention approaches used in Australian government schools accord with projected needs and theevidence for effective programs. The literature review completed for this report identified that there are an increasing number of evidence-based alcohol and drug use prevention and early intervention approaches available to Australian schools. However, our examination of state government websites and surveys of school staff suggest that the majority of schools do not use evidence-based programs and guide their school practices instead on general frameworks and principles. The report makes five recommendations:(1) set ambitious behaviour change targets for continued reduction of alcohol and drug use amongst Australian school students;(2) evaluate school practices that are based on frameworks and principles to ensure they are safe and not contributing to harm;(3) offer incentives to schools that use evidence-based alcohol and drug programs;(4) place a priority on the evaluation of school alcohol and drug education programs, within Australian government research funding schemes; and(5) examine positive youth development outcomes in the evaluation of school alcohol and drug education programs

Adolescent depressive disorders and family based interventions in the family options multicenter evaluation: study protocol for a randomized controlled trial

BackgroundThere is increasing community and government recognition of the magnitude and impact of adolescent depression. Family based interventions have significant potential to address known risk factors for adolescent depression and could be an effective way of engaging adolescents in treatment. The evidence for family based treatments of adolescent depression is not well developed. The objective of this clinical trial is to determine whether a family based intervention can reduce rates of unipolar depressive disorders in adolescents, improve family functioning and engage adolescents who are reluctant to access mental health services.Methods/DesignThe Family Options study will determine whether a manualized family based intervention designed to target both individual and family based factors in adolescent depression (BEST MOOD) will be more effective in reducing unipolar depressive disorders than an active (standard practice) control condition consisting of a parenting group using supportive techniques (PAST). The study is a multicenter effectiveness randomized controlled trial. Both interventions are delivered in group format over eight weekly sessions, of two hours per session. We will recruit 160 adolescents (12 to 18 years old) and their families, randomized equally to each treatment condition. Participants will be assessed at baseline, eight weeks and 20 weeks. Assessment of eligibility and primary outcome will be conducted using the KID-SCID structured clinical interview via adolescent and parent self-report. Assessments of family mental health, functioning and therapeutic processes will also be conducted. Data will be analyzed using Multilevel Mixed Modeling accounting for time x treatment effects and random effects for group and family characteristics. This trial is currently recruiting. Challenges in design and implementation to-date are discussed. These include diagnosis and differential diagnosis of mental disorders in the context of adolescent development, non-compliance of adolescents with requirements of assessment, questionnaire completion and treatment attendance, breaking randomization, and measuring the complexity of change in the context of a family-based intervention