Assessing the Feasibility of Providing a Family Skills Intervention, “Strong Families”, for Refugee Families Residing in Reception Centers in Serbia

Abstract

War exposure and forced displacement threatens the wellbeing of caregivers and their children, leaving them at risk of negative outcomes, such as elevated rates of anxiety, depression and post-traumatic stress disorder. The importance of engaged, responsive and stable parenting for positive child wellbeing has been documented across diverse cultural and economic backgrounds. Despite the higher need for caregivers to be nurturing in challenging settings, they struggle to provide adequate support for their children due to lack of resources or their inability to deal with their own emotional challenges. A feasibility study was conducted of a new, open-access and light-touch family skills intervention, Strong Families (for families in humanitarian and challenged settings) on refugee families residing in Reception Centers in Serbia. Questionnaires and interviews were completed by participating caregivers and facilitators. Qualitative results indicated that the intervention was feasible to run in this humanitarian context, that caregivers viewed the intervention as culturally acceptable and complemented the quantitative results that showed promise for enhancing child behavior and family functioning tested indicators. Despite being a light intervention, Strong Families indicated improvement on child mental health, parenting practices and parent and family adjustment skills. Prioritizing family mental health and functioning as a primary need that parallels that of accessing physical medical care, sanitation and clean water must be the definitive next step in humanitarian aid.

Impact of a Brief Family Skills Training Programme (“Strong Families”) on Parenting Skills, Child Psychosocial Functioning, and Resilience in Iran: A Multisite Controlled Trial

“…This study further expands the knowledge cumulated from previous single arm pilots of the Strong Families programme pilot in Afghanistan and with Afghan refugees in Serbia [ 38 , 39 ]. The previous studies indicated positive feasibility and potential effectiveness of the programme on mental health, parenting and family adjustment indicators on families living in stressful situations.…”

“…The standardized FDQ had been previously used in other country contexts, such as Afghanistan [ 38 ], Uzbekistan, Zanzibar, Serbia [ 39 ], the Philippines, and the Dominican Republic, and only minor changes in some of the questions were made to reflect the Iranian context. Our aim to collect demographic questions was to perform stratified analyses, as indicated in the aims of our study.…”

“…The SDQ is widely used and now available in over 45 languages. It is commonly utilized in the family skills literature as pre- and post-intervention measures, both in short- and long-term follow ups [ 38 , 39 ]. The Persian version has been previously used in Iran and has shown good psychometric properties [ 61 , 62 , 63 ] in adolescents and their parents [ 64 , 65 ].…”

“…The Strong Families programme was first piloted in Afghanistan [ 38 ] and has since been implemented with families in seven additional countries, in four different continents. Research findings, so far, from single-arm implementation studies in Afghanistan [ 38 ] and Serbia [ 39 ], have indicated that the Strong Families programme was feasible in low-resource and challenged settings and can be delivered by trained lay facilitators.…”

“…The main aim of the current study was to expand the experience with the Strong Families programme, which had, so far, tested on its feasibility and effectiveness with one-arm research modality [ 38 , 39 ], through a two-arm intervention/control trial, that would further assess its impact on the different domains of its logical framework ( Figure 1 ). The dimensions of impact to be evaluated were, namely, child mental health, parenting, family adjustment skills, and child resilience.…”