Effectiveness of Functional Family Therapy in a Non-Western Context: Findings from a Randomized-Controlled Evaluation of Youth Offenders in Singapore.

This study is the first to evaluate Functional Family Therapy (FFT) in a non-Western culture. The effectiveness of FFT was examined in relation to three proximal outcomes relevant to youth offender rehabilitation: (i) mental well-being, (ii) family functioning, and (iii) probation completion. 120 youth probationers (Mage = 16.2, SD = 1.33) were randomly assigned to receive either standard probation services-Treatment-As-Usual (TAU; n = 57)-or FFT in addition to TAU (FFT; n = 63). Data on psychometric measures of mental well-being and family functioning were obtained at (i) preprogram, (ii) postprogram, and (iii) at the end of probation. Probation completion data were obtained from casefile records. Mean mental well-being scores of the FFT group improved from pre- to post-treatment, and gains were maintained at follow-up. However, there was a nonsignificant trend for the FFT group showing higher rates of reliable change and clinical recovery on the mental well-being scale. There were no group differences in family functioning scores over time. However, there was a significant trend for the FFT group showing higher rates of reliable change and clinical recovery on the family functioning scale. Probation completion rates were 88.9% and 70.2% for the FFT and TAU groups, respectively. Youth in the FFT group were significantly more likely to complete probation successfully. The results support FFT's effectiveness in Singaporean youth offenders. At a broader level, the study findings support the cross-cultural effectiveness of FFT in, and transportability to, a non-Western culture.

Este estudio es el primero en evaluar la Terapia Familiar Funcional (TFF) en una cultura no occidental. Se analizó la eficacia de la TFF en relación con tres resultados proximales relevantes para la rehabilitación de los delincuentes juveniles: (i) bienestar mental, (ii) funcionamiento familiar y (iii) término de la libertad condicional. Se distribuyeron aleatoriamente 120 jóvenes en libertad condicional (Edad Promedio = 16.2, Desviación Típica= 1.33) para recibir servicios de libertad condicional estándar-tratamiento habitual (TH; n = 57)-o TFF además del TH (TFF; n = 63). Se obtuvieron datos sobre las medidas psicométricas de bienestar mental y funcionamiento familiar en los siguientes momentos (i) antes del programa, (ii) después del programa y (iii) al final de la libertad condicional. Se obtuvieron datos del término de la libertad condicional de los expedientes judiciales. Los puntajes del bienestar mental promedio del grupo de TFF mejoraron desde antes a después del tratamiento, y se mantuvieron los avances en el seguimiento. Sin embargo, hubo una tendencia no significativa en el grupo de TFF que indicó índices más altos de cambio fiable y recuperación clínica en la escala de bienestar mental. No hubo diferencias entre los grupos en los puntajes de funcionamiento familiar en el transcurso del tiempo. Sin embargo, hubo una tendencia significativa en el grupo de TFF que indicó índices más altos de cambio fiable y recuperación clínica en la escala de funcionamiento familiar. Los índices de término de la libertad condicional fueron 88.9 % y 70.2 % en los grupos de TFF y de TH respectivamente. Los jóvenes del grupo de TFF fueron considerablemente más propensos a terminar la libertad condicional satisfactoriamente. Los resultados respaldan la eficacia de la TFF entre los delincuentes juveniles singapurenses. A nivel general, los resultados del estudio respaldan la eficacia intercultural de la TFF en una cultura no occidental y la transportabilidad hacia ella.

Virtual group Cognitive Stimulation Therapy (vCST) for dementia: mixed methods feasibility randomised controlled trial.

BACKGROUND AND OBJECTIVES: Cognitive Stimulation Therapy (CST) is an evidence-based group intervention for people with dementia , with benefits for cognition and quality of life when delivered face-to-face. Many people are unable to attend face-to-face groups for reasons including health and transport issues. This study aimed to assess the feasibility and acceptability of online or 'virtual' CST (vCST). RESEARCH DESIGN AND METHODS: Single-blind, randomised controlled feasibility design with qualitative interviews. 46 people with mild to moderate dementia were randomly allocated to attend either 14 sessions of twice-weekly vCST (n = 24) or treatment as usual (TAU, defined as usual care; n = 22) over seven weeks. Cognition, quality of life and depression were assessed pre and post-treatment. Qualitative interviews (n=16) with participants and carers were analysed using thematic analysis. RESULTS: High levels of attendance, adherence, fidelity to the manual and completion of outcomes were recorded. Recruitment appeared feasible although randomisation may not have been acceptable to some. There were no statistical differences noted between vCST and TAU in any of the outcomes evaluated, although both quantitative and qualitative data indicated acceptability, with qualitative reports of improved outcomes including cognition. DISCUSSION AND IMPLICATIONS: vCST appeared feasible to deliver but did not result in any changes in outcomes, as expected from an underpowered feasibility trial. CST is the main psychosocial intervention delivered for dementia in UK memory services and globally; with many services moving towards virtual CST delivery. Therefore, a fully powered RCT of the effectiveness of vCST is feasible and justified.