About this trial
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 criteria
This trial does not accept healthy volunteersQualifiers
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
Disqualifiers
None
Trial design
Single group
Treatments tested in this trial
Brief Family Therapy Program
BehavioralThe 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.
Treatment groups
Trial outcomes
Primary outcomes
Referral Sources
Where participants heard about the program (e.g., social media, YUPC, employee, friend)
Participants Enrolled Per month
Number of participants enrolled per month
Service Enrollment Rate
Proportion of participants offered the service versus those who actually sign up
Reasons for Non-Enrollment
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.)
Secondary outcomes
Pre-Post Change in Parenting Stress
Using the Parental Stress Scale (PSS; Berry \& Jones, 1995). Minimum score=18, maximum score=90. Higher scores correspond to worse outcomes (i.e., more stress).
Pre-Post Change in Child Reported Coparenting Relationship
Using the Child Perspectives on the Coparenting Relationship - Revised (created based on McHale's 1999 Coparenting Scale - Revised). Minimum score=7, maximum score=21. Higher scores correspond to a greater frequency of outcomes.
Pre-Post Change in Parent and Child Family Adjustment
Using the Parenting and Family Adjustment Scale (PAFAS; Sanders \& Morawska, 2010). Minimum score=0, maximum score=90. Higher scores correspond to worse outcomes (i.e., higher levels of dysfunction).
Pre-Post Change in Child Emotional Distress (i.e., Anger, Anxiety, and Depressive Symptoms)
Using the subscales of the Emotion Distress scale of the Patient-Reported Outcomes Measurement Information System (NIH) Parent Proxy Domains (ages 5-17) or Early Childhood Parent Report (ages 1-5). Ages 5-17 minimum score = 19, maximum score = 120 Ages 1-5 minimum score = 24, maximum score = 120. Higher scores correspond to worse outcomes (i.e., more emotional distress).
Sponsors and contacts
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York University
Lead sponsor
University of Lausanne
Collaborator
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