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Families affected by another's substance use, including methamphetamine, experience harms to their mental and physical health. Yet, research has paid little attention to support and service needs of this population. This pilot study examines the feasibility and outcomes of SMART Family and Friends, a video-conference-delivered mutual-support group targeting families affected by another's methamphetamine use. Recruitment for this study occurred between March–October 2021 via the SMART Recovery Australia website. Participants were English-speaking Australian residents, ≥18 years, affected by another's methamphetamine use, interested in participating in a manualised eight-module group delivered via video-conferencing. Feasibility was evaluated by attendance rates, participant satisfaction, fidelity ratings, and semi-structured interviews. Measures of distress, quality of life, and family functioning assessed outcomes at baseline and one-month post-treatment conclusion. Forty-three participants commenced SMART Family and Friends groups. 84 % (n = 36) completed ≥4 modules, 67 % (n = 29) completed ≥6, and 42 % (n = 18) completed all 8 modules. Participant satisfaction (M = 4.32, SD = 0.66, out of 5) and facilitator fidelity (>94 % for all modules) were high. A within-group analysis, without comparison condition demonstrated significant improvements in psychological distress (d = 0.38), family impact (d = 0.64), family strain symptoms (d = 0.48), and total family burden (d = 0.69) post-treatment. Qualitative findings illustrated the benefits and challenges of the video-conference-delivered group, as well as recommendations for improvement. Results provide initial support for the feasibility and positive outcomes of the SMART Family and Friends program. These findings demonstrate the successful provision of a mutual-support group for affected families delivered via video-conferencing, and merit further sufficiently powered randomised-control-trials to evaluate efficacy. • Limited evidence-based treatments exist for families affected by methamphetamine. • Families report high satisfaction with the program and video-conference delivery. • The mutual-support component reduces feelings of isolation among families. • One-way design analyses show positive outcomes following SMART Family and Friends. [ABSTRACT FROM AUTHOR]

Background: Adolescents with bipolar disorder (BD) report lower quality of life (QoL) than adolescents with other psychiatric disorders. This study compared the efficacy of family-focused therapy for adolescents (FFT-A) plus pharmacotherapy to brief psychoeducation (enhanced care, or EC) plus pharmacotherapy on self-rated QoL in adolescents with BD over 2 years.Methods: Participants were 141 adolescents (mean age: 15.6±1.4yr) with BD I or II who had a mood episode in the previous 3 months. Adolescents and parents were randomly assigned to (1) FFT-A, given in 21 sessions in 9 months of psychoeducation, communication enhancement training, and problem-solving skills training, or (2) EC, given in 3 family psychoeducation sessions. Study psychiatrists provided patient participants with protocol-based pharmacotherapy for the duration of the study. QoL was assessed with The KINDLRQuestionnaire (Ravens-Sieberer and Bullinger, 1998) during active treatment (baseline to 9 months) and during a post-treatment follow-up (9-24 months).Results: The two treatment groups did not differ in overall QoL scores over 24 months. However, adolescents in FFT-A had greater improvements in quality of family relationships and physical well-being than participants in EC. For quality of friendships, the trajectory during active treatment favored EC, whereas the trajectory during post-treatment favored FFT-A.Limitations: We were unable to standardize medication use or adherence over time. Quality of life was based on self-report rather than on observable functioning.Conclusions: A short course of family psychoeducation and skills training may enhance relational functioning and health in adolescents with BD. The effects of different psychosocial interventions on peer relationships deserves further study. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the association between history of suicide attempts (SA) and family functioning in bipolar disorder (BD) patients.Methods: Thirty-one BD type I patients with lifetime history of SA, 31 BD type I with no lifetime history of SA, participating in the Outpatient Clinic of the Bipolar Disorder Program at the Institute of Psychiatry of the University of São Paulo Medical School were recruited for this study. We used the Family Assessment Device (FAD) to evaluate family functioning. We compared these two groups on demographic and clinical variables to identify which variables were associated with family functioning impairment. Fifty-one relatives of the same patients were also asked to complete a FAD.Results: BD patients with SA presented more psychiatric hospitalizations, higher frequency of psychotic symptoms, and higher scores on depressive, manic, and suicidal ideation than BD patients without SA. BD patients with SA presented significantly higher scores in several subscales of the FAD, including Problem Solving (p=0.042), Communication (p=0.009), Roles (p=0.006), and General Functioning (p=0.025), when compared with BD patients without SA. Relatives of BD patients with SA presented significantly higher scores in Communication, Roles, Affective Responsiveness, and General Functioning than relatives of BD patients without SA.Limitations: Cross-sectional study and long time elapsed since last SA.Conclusion: History of SA in BD is associated with worse family functioning in several domains of FAD, including Problem Solving, Communication, Roles, and General Functioning. As suicide attempts are routinely assessed in clinical practice, these findings may help to identify patients with poorer family functioning and may suggest a role for environmental risk factors in suicidal behavior among BD patients. [ABSTRACT FROM AUTHOR]

Family factors have continually been identified as potential risk and protective factors for youth at risk for suicide. This paper reviews family processes that not only are associated with suicide risk, but also might be malleable enough to target in treatment. We also review family intervention components that have been incorporated into most youth suicide treatments. Unfortunately, research on if and how these family processes moderate, mediate or change as a result of treatment is limited. Recommendations for future research are offered. [ABSTRACT FROM AUTHOR]

The aims of the present study were, first, to establish the effect of brief, in-home intensive family preservation programs on prevention of out-of-home placement, family functioning, child behavior problems and social support and, second, to study moderators of these effects. The results of this meta-analytic study, consisting of 20 studies (31,369 participants), show that intensive family preservation programs had a medium and positive effect on family functioning (d =.486), but were generally not effective in preventing out-of-home placement. Intensive family preservation programs were effective in preventing placement for multi-problem families, but not for families experiencing abuse and neglect. Moreover, the effect on out-of-home placement proved to be moderated by client characteristics (sex and age of the child, parent age, number of children in the family, single-parenthood, non-white ethnicity), program characteristics (caseload), study characteristics (study design and study quality), and publication characteristics (publication type, publication year and journal impact factor). The discussion addresses implications for evaluation and practice. [Copyright &y& Elsevier]

Mental health problems contribute significantly to the global burden of disease. Driven in part by family stressors and insufficient sleep, mental health disproportionately affects low SES urban adolescents. In the United States, American Indian/Alaska Native (AI/AN) youth exhibit excessively high rates of mental health problems. Family functioning is strongly associated with adolescent mental health, and sleep problems may serve as a pathway between family functioning and mental health. Using mixed methods we examine the associations among family functioning, subjective- and actigraphy-measured sleep, mental health (depressive and anxiety symptoms), and cultural identity in a sample of urban AI/AN youth. All participants (N = 142) completed surveys; a random subsample (n = 26) completed qualitative interviews to assess family and cultural dynamics related to sleep, which informed hypothesized direct and indirect effects that were tested using survey data. Narratives identified mechanisms of family cohesion (e.g., daily interactions that build perceived family togetherness and family-centered traditional activities) and the role that family cohesion plays in sleep (e.g., ensuring stability of sleep environments). Path analysis showed direct effects of improved family functioning on fewer depressive and anxiety symptoms, and indirect effects through lower self-reported sleep disturbance (but not through greater actigraphy-measured sleep duration or efficiency). Cultural identity did not moderate effects in quantitative tests. Our findings illustrate the complex associations among family functioning, sleep, and mental health in AI/AN youth. Family-based interventions to improve adolescent mental health should address modifiable intervention targets such as sleep, and address sources of both risk and resilience relevant to urban AI/AN families, including extended family and cultural practices. • Narratives show family cohesion through family traditional practice. • Narratives show role family cohesion plays in sleep, e.g., stable sleep environment. • Better family functioning had direct effect on less depression and anxiety. • Better family functioning had indirect effects through lower sleep disturbance. • Cultural identity was not a significant moderator in the tested pathways. [ABSTRACT FROM AUTHOR]

Abstract: The parents consulting on behalf of their teenager, without himself being present, are revealing a zone of indifferienciation, a personal and couple fragility. With the parents, the therapist accomplishes a kind of heterocentred treatment. The recall, the rewriting of the parents history with the grand-parents and the original families are displacing them at a psychical and relational level. This repositionning, through the play of reciprocal projections and a transformation of the relationship causes a removal of the symptoms of the teenager and a restart of the adolescent process. [Copyright &y& Elsevier]

Abstract: Family intervention has a long-standing and robust evidence base and the importance of practitioners working with families has been recognized. Yet the approach has either been neglected or not incorporated into general service provision. Many practitioners are unclear about who to engage with, which assessment strategies to use and when to intervene. By providing a brief synopsis of psychosocial family intervention and defining its components, this contribution identifies how to undertake this role and introduces a triage approach to address how the intervention may be equitably incorporated into routine clinical practice. [Copyright &y& Elsevier]

This paper describes a technology transfer initiative in which Network Therapy (NT), a substance abuse treatment that utilizes peer and family support, was disseminated to a cohort of addictions counselors located in an outpatient community-based addictions treatment center. Training methods included a didactic seminar, role-playing, use of videotaped illustrations, and clinical supervision, and are described in detail. Counselors then implemented the NT approach with a sample of cocaine-abusing patients (N = 10) who were being treated concurrently with the standard program provided by the treatment setting. NT patients were compared by chart review with a cohort of cocaine abusers who received community treatment--as-usual (TAU) (N = 20). The groups did not differ on demographic variables or the amount of TAU received at the community program. However, NT patients had significantly less positive urinalyses than TAU patients, though they were not significantly different in terms of treatment retention. Implications for technology transfer are discussed. [ABSTRACT FROM AUTHOR]

Objective: To establish whether an intervention given by child psychiatric social workers to the families of children and adolescents who had attempted suicide by taking an overdose reduced the patients' suicidal feelings and improved family functioning.Method: One hundred sixty-two patients, aged 16 or younger, who had deliberately poisoned themselves were randomly allocated to routine care (n = 77) or routine care plus the intervention (n = 85). The intervention consisted of an assessment session and four home visits by the social workers to conduct family problem-solving sessions. The control group received no visits. Both groups were assessed at the time of recruitment and 2 and 6 months later. The primary outcome measures were the Suicidal Ideation Questionnaire, the Hopelessness Scale, and the Family Assessment Device.Results: There were no significant differences in the primary outcomes between the intervention and control groups at either of the outcome assessments. Parents in the intervention group were more satisfied with treatment (mean difference 1.4 [95% confidence interval 0.6 to 2.1]). A subgroup without major depression had much less suicidal ideation at both outcome assessments (analysis of covariance p < .01) compared with controls.Conclusions: The home-based family intervention resulted in reduced suicidal ideation only for patients without major depression. [ABSTRACT FROM AUTHOR]

• There are some links in the research between ADHD and insecure attachment styles. • Including attachment-based interventions in family therapy for child ADHD are suggested. • An example module and clinical recommendations are suggested. Attention-Deficit Hyperactivity Disorder (ADHD), a common presenting problem in the mental health profession, occurs in about five percent of children and has a high heritability factor. It is, therefore, common for clients with ADHD to have another family member also diagnosed with ADHD and/or display typical ADHD behaviors. ADHD is often correlated with emotion regulation difficulties and problematic family functioning. One way to address emotion regulation problems and problematic family functioning is through attachment-based interventions. Among research supported therapeutic interventions for children with ADHD, few, if any, treatment practices include overtly addressing attachment in treatment. Treating child ADHD through attachment in family therapy may be beneficial in reducing common behavioral problems that accompany ADHD (i.e., hyperactivity, inattentiveness, impulsivity, etc.). We suggest a Family Therapy Attachment Based (FTAB) therapeutic module (this module has yet to be empirically supported) to implement alongside common evidence-based treatment for treating child ADHD. [ABSTRACT FROM AUTHOR]

• Trusting relationships are key to change in family preservation interventions. • Holistic, on-site programmes facilitate engagement for parenting change. • Developing psychological resources occurs over time, needed for behaviour change. Placement in out-of-home care is associated with a number of devastating outcomes for mothers and for their children in the short and long term. The aim of this study was to examine factors and processes of change that occurred through participation in a residential family preservation/reunification programme from the perspectives of service users and staff. We conducted in-depth interviews and a focus group with 12 service users and staff from one programme in Aotearoa/New Zealand. Three overarching themes common to the narratives of service users and staff were identified: (1) relationships, (2) programme structure, and (3) psychological resources. We describe eight sub-themes discussed by service users (emotional support, reciprocal learning, trust in staff, programme and therapy, daily routines, insight through trust, self-confidence, love for children) and six sub-themes discussed by staff (love and change, social learning, holistic, self-confidence, attunement, insight through trust). In addition, service users noted the importance of change occurring over time and staff identified the importance of an all-embracing nurturing environment (awhi). We discuss the place of culture as raised by one participant. Overall, the narratives offered hope that family preservation and reunification may be a potential alternative to parent/child separation for some families. [ABSTRACT FROM AUTHOR]

Functional Family Therapy (FFT) is an evidence-based treatment intervention targeted toward justice-involved adolescents and their families. Prior research suggests that FFT is effective in treating delinquent tendencies, and may also be effective in improving family members' inner strengths, self-efficacy, and psycho-social functioning. While FFT has been demonstrated to reduce youth recidivism, less is known about the role parents may play throughout therapy and how parental problems (i.e., poor knowledge of the child's needs, or inadequate supervision of their child) impede successful treatment. Furthermore, the role of missed therapy sessions is often a neglected area of research, despite having a critical impact on treatment outcomes. Using structural equation modeling, this study explores the effect parental problems have on missed therapy appointments and treatment outcomes using a sample of 117 justice involved youth and their families who participated in FFT. Findings demonstrate that missed therapy sessions act as an important intervening variable between parental problems and therapy incompletion, where parental problems are directly related to missed sessions and missed sessions are directly related to the unsuccessful termination of treatment. Implications for FFT specialists are discussed. • Parental problems are directly related to missed FFT sessions. • Missed sessions are directly related to unsuccessful treatment termination. • Missed sessions acts as an important intervening variable. • School problems are significantly related to missed sessions and FFT termination. [ABSTRACT FROM AUTHOR]

Objective: Although evidence-based treatments for pediatric obsessive-compulsive disorder (OCD) exist, many youth fail to respond, and interventions tailored to the needs of specific subsets of patients are lacking. This study examines the efficacy of a family intervention module designed for cases of OCD complicated by poor family functioning.Method: Participants were 62 youngsters aged 8 to 17 years (mean age = 12.71 years; 57% male; 65% white) with a primary diagnosis of OCD and at least 2 indicators of poor family functioning. They were randomized to receive 12 sessions of individual child cognitive-behavioral therapy (CBT) plus weekly parent psychoeducation and session review (standard treatment [ST]) or the same 12 child sessions plus 6 sessions of family therapy aimed at improving OCD-related emotion regulation and problem solving (positive family interaction therapy [PFIT]). Blinded raters evaluated outcomes and tracked responders to 3-month follow-up.Results: Compared to ST, PFIT demonstrated better overall response rates on the Clinician Global Impression-Improvement scale (CGI-I; 68% versus 40%, p = .03, φ = 0.28) and rates of remission (58% PFIT versus 27% ST, p = .01, φ = 0.32). PFIT also produced significantly greater reductions in functional impairment, symptom accommodation, and family conflict, and improvements in family cohesion. As expected, these shifts in family functioning constitute an important treatment mechanism, with changes in accommodation mediating treatment response.Conclusion: PFIT is efficacious for reducing OCD symptom severity and impairment and for improving family functioning. Findings are discussed in terms of personalized medicine and mechanisms of change in pediatric OCD treatment. Clinical trial registration information-Family Focused Treatment of Pediatric Obsessive Compulsive Disorder; http://clinicaltrials.gov/; NCT01409642. [ABSTRACT FROM AUTHOR]