Mental health promotion and prevention interventions in families with parental depression: A randomized controlled trial

Giannakopoulos, George; Solantaus, Tytti; Tzavara, Chara; Kolaitis, Gerasimos

doi:10.1016/j.jad.2020.09.070

Cited by 30 publications

(80 citation statements)

References 35 publications

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“…Psychoeducational techniques were evaluated in nine trials (Catalano, Gainey, Fleming, Haggerty, & Johnson, 1999;Giannakopoulos, Solantaus, Tzavara, & Kolaitis, 2021;Jones et al, 2017;Kelley & Fals-Stewart, 2002;Lam, Fals-Stewart, & Kelley, 2008;Pella, Drake, Tein, & Ginsburg, 2017;Solantaus, Paavonen, Toikka, & Punamäki, 2010;Stein et al, 2018;Van Santvoort et al, 2014), sometimes associated with CBT approaches. Interventions targeted parents with mood disorders, substance use disorders (in association with behavioural couple therapy) or anxiety disorders.…”

Section: Psychoeducationmentioning

confidence: 99%

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Preventive interventions in offspring of parents with mental illness: a systematic review and meta-analysis of randomized controlled trials

et al. 2021

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Children with parents suffering from a psychiatric disorder are at higher risk for developing a mental disorder themselves. This systematic review and meta-analysis of randomized controlled trials aims to evaluate the efficacy of psychosocial interventions to prevent negative mental health outcomes in the offspring of parents with mental illness. Eight electronic databases, grey literature and a journal hand-search identified 14 095 randomized controlled trials with no backward limit to June 2021. Outcomes in children included incidence of mental disorders (same or different from parental ones) and internalizing and externalizing symptoms at post-test, short-term and long-term follow-up. Relative risks and standardized mean differences (SMD) for symptom severity were generated using random-effect meta-analyses. Twenty trials were selected (pooled n = 2689 children). The main therapeutic approaches found were cognitive-behavioural therapy and psychoeducation. A significant effect of interventions on the incidence of mental disorders in children was found with a risk reduction of almost 50% [combined relative risk = 0.53, 95% confidence interval (CI) 0.34–0.84]. Interventions also had a small but significant effect on internalizing symptoms at post-test (SMD = −0.25, 95% CI −0.37 to −0.14) and short-term follow-up (−0.20, 95% CI −0.37 to −0.03). For externalizing symptoms, a decreasing slope was observed at post-test follow-up, without reaching the significance level (−0.11, 95% CI −0.27 to 0.04). Preventive interventions targeting the offspring of parents with mental disorders showed not only a significant reduction of the incidence of mental illness in children, but also a diminution of internalizing symptoms in the year following the intervention.

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Section: Psychoeducationmentioning

confidence: 99%

“…3a). Another study (Giannakopoulos et al, 2021) reported two measures of internalizing symptoms (a, anxiety symptoms and b, depressive symptoms in Fig. 3a).…”

Section: Internalizing Symptoms (12 Trials)mentioning

confidence: 99%

Preventive interventions in offspring of parents with mental illness: a systematic review and meta-analysis of randomized controlled trials

et al. 2021

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“…The families' perspective most likely reflects their level of need (e.g., 76% were socially disadvantaged), as well as the general unavailability of mental health/family supports in the community, whereas the clinicians' perspective reflects working within a context of limited service resources for FFP. Most previous studies of FT have not mentioned the need for additional sessions or follow-on supports, but this may be due to their participants being largely middle class and relatively high functioning ( 12 – 14 , 51 , 52 ). There is evidence from two qualitative studies of FT that some parents with low-functioning psychosis and Borderline Personality Disorder may struggle to understand the impact of their illness on their children, and may require additional supports ( 31 , 47 ).…”

Section: Discussionmentioning

confidence: 99%

A Family-Focused Intervention for Parental Mental Illness: A Practitioner Perspective

et al. 2021

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Background: Parental mental illness (PMI) is common and can lead to children developing mental disorders. Family Talk (FT) is a well-known and widely implemented intervention designed to reduce the risk of transgenerational psychopathology. However, given the research to practise “gap,” very little qualitative research, to date, has investigated practitioner experiences in implementing FT. This study aimed to explore the practitioner-perceived barriers and facilitators to the implementation and sustainability of FT within mainstream mental health settings.Methods: This qualitative study was nested within a randomised controlled trial (RCT) of Family Talk [N = 86 families (139 parents, 221 children)] within 15 adult (AMHS), child (CAMHS), primary care mental health, and child protection sites in Ireland. Semi-structured interviews and focus groups were undertaken with a purposive sample of clinicians (n = 31) and managers (n = 10), based on their experiences of implementing FT. Interview data were transcribed verbatim, analysed using constructivist grounded theory, and informed by Fixsen's implementation science framework.Results: Service providers highlighted a number of benefits for approximately two thirds of families across different diagnoses and mental health settings (AMHS/CAMHS/primary care). Sites varied in their capacity to embed FT, with key enablers identified as acquiring managerial and organisational support, building clinician skill, and establishing interagency collaboration. Implementation challenges included: recruitment difficulties, stresses in working with multiply-disadvantaged families, disruption in delivery due to the COVID-19 global pandemic, and sustainability concerns (e.g., perceived fit of FT with organisational remit/capacity, systemic and cultural barriers to change).Conclusion: This study is only the second qualitative study ever conducted to explore practitioner experiences in implementing FT, and the first conducted within the context of an RCT and national research programme to introduce family-focused practise (FFP) for families living with PMI. The findings illuminate the successes and complexities of implementing FFP in a country without a “think family” infrastructure, whilst highlighting a number of important generalisable lessons for the implementation of FT, and other similar interventions, elsewhere.

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“…The records highlight that the emerging evidence-base of LTC is derived from a set of discrete research endeavors in diverse settings beginning in Finland and now including Greece, Japan, Australia and USA. The variety of settings included adult mental health settings both clinical and Non-government, general hospital psychiatry, child and family services and universal settings (12,20,21,25,27,(34)(35)(36). The range of populations studied included families where a parent has depression, bipolar disorder, life threatening cancer, schizophrenia, schizoaffective disorder, borderline personality disorder, anxiety, Post-traumatic stress disorder, gambling and other co-occurring issues.…”

Section: Findings Recordsmentioning

confidence: 99%

“…LTC is described as a "low threshold public health intervention" (23) because it is brief, low resource-intensive and has been applied in different settings and with different populations (12,24). It has been translated, adapted and utilized across a range of countries and cultures including Estonia, Norway Sweden, Greece (25), Japan (26), Australia (27)(28)(29) and the USA (30,31).…”

Section: Introductionmentioning

confidence: 99%

An Evidence-Based Practice Developed in-situ: Let's Talk About Children and a Consolidation of Its Evidence Base

Allchin

Solantaus

2022

Front. Psychiatry

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BackgroundTraditional models of evidence-based practice assume knowledge is developed in research settings before being installed in practice settings. The role practice settings can play in enhancing effectiveness and enabling sustainability is not therefore acknowledged. Developing interventions in-situ alongside developing their evidence base, provides another pathway to evidence-based practice. One example is Let's Talk about Children (LTC), a brief family-focused intervention that promotes parent, family and child wellbeing. Let's Talk about Children has been developed and adapted to respond to the context into which it has been established, leading to different descriptions reported in its 20 year collection of evidence. Collating the diverse literature on LTC, this paper showcases an evidence-based practice developed in-situ in order to guide future innovation.MethodUsing an integrative review, key literature using LTC were identified through electronic databases and snowballing techniques. Constant comparison analysis synthesized the data to develop patterns and themes.FindingsFrom the 26 records, three forms of LTC were identified and outcomes related to parents, family and child wellbeing, implementation and sustainability were collated. Consolidated outcomes show overall agreement in effectiveness and acceptability outcomes across different settings and populations. Implementation and sustainability impacts are entwined with the context, and influenced by its development in-situ.ConclusionsThe study documents that the in-situ model is effective at developing sustainable evidence-based practice. In consolidating the evidence, the review clarified LTC's forms and outcomes, and draws attention to the importance of research on mechanisms of change.

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Mental health promotion and prevention interventions in families with parental depression: A randomized controlled trial

Cited by 30 publications

References 35 publications

Preventive interventions in offspring of parents with mental illness: a systematic review and meta-analysis of randomized controlled trials

Preventive interventions in offspring of parents with mental illness: a systematic review and meta-analysis of randomized controlled trials

A Family-Focused Intervention for Parental Mental Illness: A Practitioner Perspective

An Evidence-Based Practice Developed in-situ: Let's Talk About Children and a Consolidation of Its Evidence Base

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