Developing a Comprehensive Family-Based Intervention and Assessing its Effects on the Mental Health of the Parents of Children With Emotional and Behavioral Disorders

Mental and behavioral disorders are crucial issues in each community. This is because individuals’ early–life experiences form the foundation of their future mental health status. Emotional and behavioral disorders usually stem from the inappropriate interaction of children with the surrounding environment. Studies have suggested that the mental health status of the parents of children with emotional and behavioral disorders is at risk and they require skills to improve those. One of the ways to gain these skills is using family–based interventions. The present study aimed to design a comprehensive family–based intervention program and evaluate its effects on the mental health status of the parents of children with emotional and behavioral disorders.

This was a quasi–experimental study with a pretest–posttest and a control group design. The study population consisted of all the parents of children diagnosed with emotional and behavioral disorders living in Tehran City, Iran, in 2017–2018. The study sample consisted of 30 families (30 fathers & 30 mothers; N=60) referring to the Community Mental Health Center. They had children with emotional and behavioral disorders. They were selected by convenience sampling method; they were then randomly assigned to two intervention and control groups. The necessary data were collected by the General Health Questionnaire (GHQ) (Goldberg & Hillier, 1979). This 28–item questionnaire has 4 subscales of physical symptoms, anxiety and sleep disorders, social dysfunction, and depression. After sampling, the mental health questionnaire was distributed among all study participants, and under equal conditions, the pretest data were collected by an independent assessor. The control group received no intervention other than the pretest. The intervention group received a family–oriented treatment program. The intervention group received a family–based psychological intervention. The intervention was complementary and consisted of fifteen 90–minute weekly sessions of group consultations for 3 months. Next, the post–test results were analyzed by Multivariate Analysis of Covariance (MANCOVA) at a significance level of 0.01. In the present study, comprehensive family–centered interventions were educational and psychotherapeutic programs designed for parents in the form of individual and group counseling sessions. This program was developed based on a combination of family–centered intervention programs by Afrooz and Minoo (2015) and Mehri et al. (2016), as well as an intervention designed by McKay et al. (2017), as family–centered programs. Cognitive–Behavioral counseling methods were also used to modify the negative attitudes and beliefs of families, reduce stress, teach coping skills, and better adjustment of spouses in the intervention. Therefore, the presented program was an integrated protocol. To observe the ethical observations, after the completion of the study, the control group received the same treatment as well. Furthermore, the subjects of the two groups were tested by a posttest.

The MANCOVA results indicated that (considering pretest scores as a covariant variable), the difference between the treatment and control groups was significant concerning the total and all subscale scores of a mental health test. Thus, the provided family–based psychological intervention reduced the total score of mental health (p<0.001), physical disorders (p=0.008), anxiety and insomnia (p=0.001), social dysfunction (p=0.001), and depression (p=0.001) in the explored parents (p=0.05). Based on the Eta–Squared, 11%–86% of these differences were due to treatment.

The present study data indicated that the presented family–based psychological intervention designed by the researchers was effective in improving the mental health status of the studied parents of children with emotional–behavioral disorders. Accordingly, it is recommended to employ the above–mentioned intervention program in different clinical populations, e.g., hyperactive children, children with special disorders or chronic physical complications, and so on.