The Family Talk Intervention When a Parent With Dependent Children or a Child is Severely Ill

The Family Talk Intervention (FTI), also called Beardslee's Family Intervention is a manual-based complex intervention and involves families who have children aged 6-18 years. The core elements are to support the families in talking about illness-related subjects, support the parents in understanding the needs of their children and how to support them, and support the families in identifying their strengths and how best to use them.

The overall aim of this trial is to evaluate the effects and the implementation process of FTI in clinical practice when a parent or a child has a life-threatening/life-limiting illness (cancer, neurological diseases, etc.). More specifically, to examine the effects of FTI regarding family communication and psychosocial health among family members (Aim 1) and describe facilitating factors and barriers for implementing FTI in everyday clinical practice (Aim 2).

The FTI has previously been pilot-tested in the context of specialized palliative home care with promising results. In pilot-tests, an assigned interventionist was used for intervention delivery, while in this continued trial, social workers will deliver the intervention as a part of their clinical work.

This trial has a pre-post effectiveness-implementation hybrid design using mixed method. It will be placed at a children's hospital and at a university hospital in Sweden and conducted by all social workers working there (n=25). Education of social workers in working with FTI will take place during 2021 and families will be invited to the project from April 2022 and until power has been reached. Data will be collected using web-based questionnaires and interviews with families and social workers, and observations will be performed throughout the study.

• Changed resilience for adults measured by the Resilience Scale (RS-14) [Time frame: At baseline (before FTI starts), after the end of FTI/three months later (follow-up 1), and six months after that (follow-up 2).]
• Changed resilience in children measured by the Resilience Scale for Children (RS-10), [Time frame: At baseline (before FTI starts), after the end of FTI/three months later (follow-up 1), and six months after that (follow-up 2).]
• Changed symptoms of pathologic grief measured by Prolonged Grief Disorder (PG-12) [Time frame: At baseline (before FTI starts), after the end of FTI/three months later (follow-up 1), and six months after that (follow-up 2).]
• Generalized Anxiety Disorder (GAD) [Time frame: At baseline (before FTI starts), after the end of FTI/three months later (follow-up 1), and six months after that (follow-up 2).]
• Changed feelings of strength and weaknesses in children measured by The Strengths and Difficulties Questionnaire (SDQ) [Time frame: At baseline (before FTI starts), after the end of FTI/three months later (follow-up 1), and six months after that (follow-up 2).]
• Changed feelings of parental skill measured by the Parental Skill Questionnaire (SDQ) [Time frame: At baseline (before FTI starts), after the end of FTI/three months later (follow-up 1), and six months after that (follow-up 2).]
• Changed key mechanisms to promote and inhibit implementation measured by The Swedish Normalization Process Theory Measure (S-NoMAD) [Time frame: At baseline (after FTI education), four months later (follow-up 1) and 12 months later (follow-up 2).]
• Changed organizational context measured by Alberta Context Tool (ACT) [Time frame: At baseline (after FTI education), four months later (follow-up 1) and 12 months later (follow-up 2).]