Innovations in the Identification and Referral of Mothers at Risk for Depression: Development of a Peer-to-Peer Model

This paper describes a feasibility study of a peer-delivered prevention intervention to identify mothers at high risk for depression and facilitate engagement in mental health services for their emotional health. Sixteen family peer advocates and their supervisors partnered with academic researchers over a period of 6 months to develop a four-session intervention that focused on identifying symptoms of depression, providing education about depression and treatment, actively linking caregivers to treatment for their own emotional health, and assisting caregivers in becoming active participants in their mental health care. Collaborating with peers to develop the model enhanced its perceived relevance and utility, and resulted in an intervention that was complimentary to their roles and the mission of peer-delivered support services. Peer/professional partnerships may be beneficial for enhancing the feasibility and acceptability of research efforts; the impact of peers’ participation in the current project and the need for future research to develop and study peer-delivered models is discussed.     

Family Processes and Mental Health among Children and Caregivers in a Family Strengthening Program

Oppositional defiant disorder (ODD) is a common mental health concern and is particularly prevalent among children living in poverty-impacted communities. A family strengthening/parent management training (PMT)-based multiple family group (MFG) program entitled, the 4 Rs and 2 Ss for Strengthening Families, focuses on the following family process variables: rules, responsibilities, relationships, respectful communication, social support, and stress. While evidence supports effectiveness of this treatment program, less is known about the specific relationship between the family process variables and mental health outcomes of children and caregivers. The current study examined these relationships among a sample of 287 caregiver/child dyads who participated in a NIMH-funded Type II hybrid effectiveness-implementation study in New York City. Data were analyzed using SPSS 27 and Mplus 8. Results indicated that two of the six family process variables related to one or more child and caregiver mental health outcome. Caregiver stress significantly related to child inattention (b?=?0.034, SE?=?0.01, p?<?0.001), child ODD (b?=?0.053, SE?=?0.02, p?<?0.01), and caregiver depression (b?=?0.049, SE?=?0.02, p?<?0.01). Family rules significantly related to caregiver depression (b?=?0.228, SE?=?0.11, p?<?0.05) over time. Findings point towards the substantial role of caregiver stress in child and caregiver mental health, in addition to the impact of inconsistent discipline with difficulty establishing rules on caregiver depression. Examinations of treatment components in relation to improvements in child and caregiver mental health can guide practitioners towards utilizing models that result in positive therapeutic outcomes and/or making adaptations with added content that has been shown to be effective.

     

Peer-Delivered Models for Caregivers of Children and Adults with Health Conditions: A Review

Peer-delivered health models may hold important benefits for family members, yet their prevalence, components, and outcomes are unknown. We conducted a review of peer-delivered services for families of children and adults with serious health problems. Studies of interventions published between 2000 and 2016 were included if the intervention contained a component for family members. Of 88 studies that were assessed for their eligibility, five met criteria. Familial components included information about the health condition and management, strategies to enhance communication and stress, and the provision of emotional support. Outcomes were largely favorable, including reductions in distress and symptoms of trauma, enhanced quality of life, and positive perceptions of the peer therapeutic alliance. Peer-delivered services for family members may hold important benefits to caregivers; however, the research base remains thin. A research agenda to develop and examine these models is discussed.