Mental Health
Conditions
Brief summary
The goal of this feasibility study was to investigate a new intervention designed to help parents/carers of children aged 8-12 who have experienced adversities to build their child's resilience to mental health difficulties using a 'positive psychology' approach. The research questions concerned the acceptability, feasibility and safety of the intervention.
Detailed description
Background: Adverse Childhood Experiences (ACEs) are traumatic or stressful events before age 18 that have been linked to poor mental health across the life course. Resilience is the ability of an individual to maintain or return to a thriving state following adversity. As resilience is not a static trait, intervening to increase the resilience of children exposed to ACEs has the potential to decrease the risk of later mental health difficulties. Positive psychology interventions (i.e. interventions that aim to increase factors that have been identified as important to individual and community flourishing) have been shown to be effective in increasing resilience. However, there was not yet a positive psychology intervention designed to meet the needs of young people exposed to ACEs and their caregivers (parents/carers). Objectives: To investigate the acceptability, feasibility and safety of a co-produced caregiver-delivered positive psychology intervention to enhance the resilience to mental health difficulties of children who have experienced ACEs. Methods: The project was guided by a Stakeholder Research Team (SRT) comprising both adults and young people with relevant expertise-by-experience. The study was divided into two work packages. In work package 1, the researchers completed a component analysis of existing positive psychology interventions, and a qualitative study to understand the needs and preferences of young people, parents/carers and professionals. They then conducted a series of intervention development workshops to co-produce the intervention with the SRT, informed by the findings of the component analysis and qualitative study. In work package 2, the researchers carried out a waitlist-controlled feasibility study involving 12 families with a child aged 8-12 years who had experienced ACEs. Families were randomised to receive the intervention either immediately or after a 10-week waiting period and mixed methods data collected to enable us to assess the acceptability, feasibility and safety of the intervention.
Interventions
BEHAVIORALASPIRE support package
The ASPIRE support package has a modular structure with core modules that all participating families are encouraged to complete initially, followed by optional modules which the family is supported to select from according to their strengths and needs. Core modules provide psychoeducation for the caregiver and optional modules contain information on the selected positive psychology topic together with instructions for suggested activities to be completed by the caregiver with their child to implement evidence-based positive psychology strategies. All resources can be accessed both electronically via an online portal or via the printed resource pack. Each caregiver is supported through the programme by a trained practitioner who offers regular support sessions (up to 8 in total) to provide information, advice and encouragement. Support sessions can take place face-to-face, by video call or over the phone according to participant preference.
Sponsors
University of Oxford
University of Sussex
Norfolk and Suffolk NHS Foundation Trust
Study design
Allocation
RANDOMIZED
Intervention model
CROSSOVER
Primary purpose
PREVENTION
Masking
NONE
Intervention model description
Waitlist controlled
Eligibility
Sex/Gender
ALL
Age
8 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* The child's parent or carer identifies that their child has been significantly impacted by one or more Adverse Childhood Experience (ACE). * Child is aged 8 to 12 years. * Child is willing and able to provide informed assent to participate. * The child's parent or carer is willing and able provide parental consent for their child's participation. * At least one adult caregiver (aged 18+) is willing and able to provide informed consent to participate themselves.
Exclusion criteria
* Child is currently under the care of specialist child and adolescent mental health services (CAMHS). * There are ongoing safeguarding concerns that might have an impact on the family's ability to participate safely (e.g. ongoing abuse or neglect). * The child or their caregiver has a learning disability that would prevent them from accessing the intervention or completing outcome measures (reasonable adjustments will be made to allow families to participate wherever possible). In addition, professionals involved in supporting caregivers to deliver the intervention (ASPIRE facilitators) will be invited to participate as staff participants.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Intervention feasibility / fidelity of delivery | 10 weeks | ASPIRE intervention adherence checklist |
| Potential risks of the intervention | 10 weeks | Modified Edinburgh Adverse Effects of Psychological Therapy Scale |
| Intervention acceptability | 10 weeks | Qualitative acceptability of the intervention from the perspective of children, caregivers and professionals, assessed via interviews and focus groups |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Strengths and Difficulties Questionnaire (parent-report version) | Post intervention (10 weeks) & 20 week follow-up for immediate arm only | 25-item measure of caregiver perception of their child's emotional and behavioural difficulties (parent/carer completed) |
| Me and My Feeling Questionnaire | Post intervention (10 weeks) & 20 week follow-up for immediate arm only | 16-item measure of mental health difficulties with emotional and behavioural difficulties subscale (child completed) |
| Short Warwick Edinburgh Mental Wellbeing Scale | Post intervention (10 weeks) & 20 week follow-up for immediate arm only | 7-item measure of the parent or carer's mental wellbeing (parent/carer completed) |
| Me as a Parent | Post intervention (10 weeks) & 20 week follow-up for immediate arm only | 16-item measure of parental self-regulation, including their self-efficacy, personal agency, self-management and self-sufficiency as a parent (parent/carer completed) |
| The Student Resilience Survey | Post intervention (10 weeks) & 20 week follow-up for immediate arm only | 47-item measure measuring children's perceptions of their internal and external resilience (child completed) |
| Students' Life Satisfaction Scale | Post intervention (10 weeks) & 20 week follow-up for immediate arm only | 7-item measure of global life satisfaction (child completed) |
Countries
United Kingdom
Outcome results
None listed