A Program Evaluation of the Brief Family Therapy Program in the York University Psychology Clinic

Обзор

Background. Children are vulnerable to mental health challenges during development. Given that youth are reliant on their parents for support, understanding the child's symptoms within the family context is critical for promoting positive change. This proposal focuses on "systemic therapy", or family-based therapy, which seeks to enhance children's mental health by improving the relationships and communication between family members (1). Most family-based therapies for treating child mental health problems are intense in duration and frequency (2), which is a barrier to access for many families. Shorter-term family therapies or what will be referred to hereafter as brief family-based therapies are effective in treating a variety of child symptoms, while also minimizing participant burden and therapy dropout (3). One type of brief family-based therapy model is the Lausanne Family Play - Brief (LFP-B), a three-session service that utilizes a play-based family observational assessment with video feedback to draw attention to and catalyze change in challenging family interactions. The LFP has been widely researched as a clinical assessment tool and has been implemented as a brief family-based therapy program (4). The current project represents the implementation and evaluation of the program in the York University Psychology Clinic (YUPC), which services children, adults, couples, and families in the Greater Toronto Area (and Ontario, broadly). The current study will be the first to evaluate the implementation, acceptability, and effectiveness of the LFP-B as a clinic service. Objectives. The aim of this project is to evaluate the LFP-B as a brief family-based clinical service offered in the YUPC. The first objective is to explore program acceptability for both clients and therapists. The investigators are interested in whether clients and therapists are satisfied with this clinical service and its processes. The second objective is to assess program effectiveness, specifically whether coparenting, family functioning, and child mental health problems improve across the course of the program and in the months following. Importance. Brief therapies with a systemic lens can increase cost-effectiveness, accessibility, and treatment retention. They also have potential to fill an apparent gap in service needs as up to three-quarters of youth with psychological concerns never receive treatment (5). Thus, brief services can provide more timely access to mental health care in Canada which have potential for reducing wait times, preventing further deterioration in mental health, and avoiding more intensive and expensive higher levels of care (e.g., acute inpatient mental health services; (6)). The LFP-B has potential to be widely used as a brief family-based therapy program with Canadian families to support child and family functioning in a timely and non-intensive manner.

Вмешательства

• Поведенческое Brief Family Therapy Program
  The Lausanne Family Play - Brief is a video-feedback intervention adapted for families seeking support for a child two to nine years old with a mental health challenge. Feedback focuses on engagement, teamwork, conflict, and child-focused issues.

Первичные конечные точки

• Referral Sources [Срок оценки: Week 0]
• Participants Enrolled Per month [Срок оценки: Week 0]
• Service Enrollment Rate [Срок оценки: Week 0]
• Reasons for Non-Enrollment [Срок оценки: Week 0]
• Waitlist Duration [Срок оценки: Week 0]
• Participant Education [Срок оценки: Week 1]
• Geographic Reach [Срок оценки: Week 0]
• Retention [Срок оценки: Week 8]
• Service Uptake [Срок оценки: Week 8]
• Client Acceptability [Срок оценки: Week 8]

Вторичные конечные точки (5)

• Pre-Post Change in Parenting Stress [Срок оценки: Pre-post change from week 1 to week 8]
• Pre-Post Change in Child Reported Coparenting Relationship [Срок оценки: Pre-post change from week 2 to week 8]
• Pre-Post Change in Parent and Child Family Adjustment [Срок оценки: Pre-post change from week 1 to week 8]
• Pre-Post Change in Child Emotional Distress (i.e., Anger, Anxiety, and Depressive Symptoms) [Срок оценки: Pre-post change from week 0 to week 8]
• Pre-Post Change in Child Externalizing Problems [Срок оценки: Pre-post change from week 1 to week 8]

Критерии участия

Критерии включения

• Both primary caregivers are over age 18 years
• Families living in Ontario, Canada
• Primary caregivers endorses caring for a child between 2 to 9 years old with a mental health challenge (e.g., anxiety, low mood, behavioural challenges) or mild/moderate levels of family distress
• Both caregivers and child agree to participate
• Family must have access to a screen (phone, tablet, computer) and internet for virtual services and recording.

Критерии исключения

\- Families seeking care for child who is at imminent risk of harm to self or others

Критерии приведены из реестра в оригинале (на английском). Окончательную оценку соответствия проводит исследовательский центр.

Здоровые добровольцы: Нет

Дизайн исследования

Распределение

Не применимо

Модель

Одна группа

Маскирование

Открытое

Основная цель

Лечение

Центры проведения

Канада · 1 центр

• York University — Toronto

Публикации

• Schleider JL, Weisz JR. Little Treatments, Promising Effects? Meta-Analysis of Single-Session Interventions for Youth Psychiatric Problems. J Am Acad Child Adolesc Psychiatry. 2017 Feb;56(2):107-115. doi: 10.1016/j.jaac.2016.11.007. Epub 2016 Nov 25. PMID 28117056
• Graziano PA, Ros-Demarize R, Hare MM. Condensing parent training: A randomized trial comparing the efficacy of a briefer, more intensive version of Parent-Child Interaction Therapy (I-PCIT). J Consult Clin Psychol. 2020 Jul;88(7):669-679. doi: 10.1037/ccp0000504. Epub 2020 Apr 30. PMID 32352803
• Philipp DA, Prime H, Darwiche J. An ultra-brief systemic intervention to address child mental health symptomatology. Fam Process. 2023 Jun;62(2):469-482. doi: 10.1111/famp.12875. Epub 2023 Mar 23. PMID 36959726
• Carr, A. (2019). Family therapy and systemic interventions for child-focused problems: the current evidence base. Journal of Family Therapy, 41(2), 153-213. https://doi.org/10.1111/1467-6427.12226
• Karam, E. A., Blow, A. J., Wampler, K. S., Seedall, R. B., & Miller, R. B. (2020). Common Factors Underlying Systemic Family Therapy. In The Handbook of Systemic Family Therapy (pp. 147-169). John Wiley & Sons, Ltd. https://doi.org/10.1002/9781119438519.ch7

Идентификаторы

NCT: NCT07161063 · e2025-244

Первоисточники (государственные реестры)

• ClinicalTrials.gov (NIH, США)

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