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

Condition(s) studied

Investigational drug(s) / intervention(s)

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.

Study summary

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.

Eligibility

Primary outcome measure(s)

• Referral Sources — Week 0
  Where participants heard about the program (e.g., social media, YUPC, employee, friend)
• Participants Enrolled Per month — Week 0
  Number of participants enrolled per month
• Service Enrollment Rate — Week 0
  Proportion of participants offered the service versus those who actually sign up
• Reasons for Non-Enrollment — Week 0
  Reasons for not joining the service for those who were offered it (e.g., scheduling multiple caregivers, desire for child-focused treatment, cost, time commitment, etc.)
• Waitlist Duration — Week 0
  Time in days from initial intake call to first phone call with clinician
• Participant Education — Week 1
  The percentage of participants with less than or equal to a high school degree.
• Geographic Reach — Week 0
  Cities/towns in Ontario families accessing the program reside
• Retention — Week 8
  The percentage of participants who remain in study until the end of the follow up session.
• Service Uptake — Week 8
  The percentage of participants reporting some reflection about coparenting outside of sessions.
• Client Acceptability — Week 8
  Looking for the percentage of participants reporting at least 'good' on 80 % or more indicators on an Implementation Acceptability Scale that will assess attitude, burden, perceived effectiveness, and ethicality. Minimum score=7, maximum score=35. Higher scores correspond to better outcomes.
• Clinician Acceptability — Week 8
  Looking for the percentage of clinicians reporting at least 'good' on 80 % or more indicators on an Implementation Acceptability Scale that will assess attitude, burden, perceived effectiveness, and ethicality. Minimum score=7, maximum score=35. Higher scores correspond to better outcomes.
• Working Alliance Inventory — Longitudinal change across week 1 to week 8
  Exploratory for pattern of scores across the intervention on a Working Alliance Inventory Scale that will assess client perceptions of goals, tasks, and bonds during intervention. Scores range from 12-60 with higher scores representing greater self-reported alliance.
• Pre-Post Change in Parent Reported Coparenting Relationship — Pre-post change from week 1 to week 8
  Using the Coparenting Scale-Revised (McHale, 1999; unpublished manuscript). Minimum score=18, maximum score=90. Higher scores correspond to a greater frequency of outcomes.

Trial sites (1)

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