AP

Evaluating the effectiveness of the Family Connections program for caregivers of youth with mental health challenges, part II: A qualitative analysis

Health Expectations Summary

Basic Information

  • Title: Evaluating the effectiveness of the Family Connections program for caregivers of youth with mental health challenges, part II: A qualitative analysis

  • Authors: Natasha Y. Sheikhan, Karen Wang, Tali Boritz, Lisa D. Hawke, Shelley McMain, Joanna Henderson

  • Journal: Health Expectations

  • DOI: 10.1111/hex.13220

  • Funding Source: Canadian Institutes of Health Research

  • License: Creative Commons Attribution License

Abstract

  • Background: Family Connections (FC) program is a 12-week support and skills training initiative originally focused on borderline personality disorder (BPD). It aims to improve outcomes for caregivers of youth with mental health challenges.

  • Objective: This study explores caregivers' experiences with the FC program and assesses its applicability beyond BPD.

  • Design: Conducted semi-structured interviews with 13 caregivers who participated in FC.

  • Results: Thematic analysis revealed three themes:

    1. Increased ability to manage youth's mental health challenges.

    2. Impact on caregivers' intra- and interpersonal relationships.

    3. Suggestions for program improvements.

  • Conclusion: FC is a valuable intervention for a broader spectrum of mental health issues and offers significant benefits for caregivers.

Introduction

  • Caregiver Mental Health: Caregivers of youth with mental health challenges experience higher rates of distress than the general population due to confusion, fear, and grief related to their loved ones' conditions.

    • Youth with a mental disorder: 18%-22% of ages 12-17 meet diagnostic criteria.

  • Intervention Models: Various models exist to support caregivers. Peer-based education programs significantly enhance self-reported empowerment, hope, and self-esteem.

  • Family Connections Details: Based on Dialectical Behavior Therapy (DBT) principles, the FC program aims to improve family functioning, coping skills, and provide social support. It has shown benefits in quantitative studies, but qualitative insights remain scarce, particularly for caregivers outside the BPD context.

Methods

Study Setting

  • Research Context: Part of the RAFT (Research and Action for Teens) study conducted in Ontario, Canada.

  • Participant Recruitment: Caregivers recruited from various community centers, and eligibility included being 18+, English literate, and family members of adolescents aged 14-18 with mental health concerns.

Sample Characteristics

  • Participants: 13 caregivers (Toronto = 10; Ottawa = 3); ages ranged from 40-55 years, evenly split between genders.

Intervention Details

  • Program Adaptation: The FC program was adapted for caregivers of youth and involved both peer-led and team-led sessions.

  • Session Details: Each group had manualized sessions lasting approximately 90 minutes, and facilitators underwent substantial training.

Data Collection Methods

  • Interviews: Semi-structured interviews were conducted post-treatment, focusing on caregivers' experiences and the impact of FC.

  • Analysis: Thematic analysis was conducted, followed by coding and discussion to develop themes.

Results

Major Themes Identified

  1. Increased Caregiver Management Ability

    • Caregivers developed a better understanding of their youth's mental health issues, leading to improved responses and skills in crisis management.

    • Subthemes:

      • New understanding of mental health challenges, leading to greater acceptance and hope.

      • Increased effectiveness in responding to mental health challenges through learned skills.

      • Positive shifts in caregiving experiences, including better communication and emotional validation.

  2. Enhancement of Inter- and Intra-personal Spheres

    • Improved relationships with youth facilitated by enhanced communication skills.

    • Caregivers reported feeling less isolated and recognized a sense of belonging within the group.

    • Focus on self-care strategies and personal control developed through the program.

  3. Program Improvement Suggestions

    • Feedback led to recommendations for enhanced materials, increased session duration, addition of mindfulness content, and the possibility of continued community support after program completion.

Discussion

  • The qualitative findings highlight the positive impact of the FC program on caregivers' experiences with youth mental health issues beyond BPD.

  • Programs like FC demonstrate the potential for significant emotional and functional improvements among caregivers.

  • The study emphasizes the necessity for broader implementation and evaluation of FC programs across caregiving contexts.

Strengths and Limitations

  • Strengths: Involvement of caregivers in program design and a diverse qualitative approach.

  • Limitations: Sample size and selection bias limit generalizability; findings may not represent caregivers in rural or less populated regions.

Conclusion

  • FC shows promise as a beneficial program for caregivers of youth with various mental health challenges, warranting its wider implementation and potential scalability. The study suggests future research must assess different facets of caregiver experiences within mental health contexts.