Effectiveness of a Preventive Parenting Program Combining Attachment and Behavioral Approaches in an Arab Context: a Cluster-Based Randomized Control Trial.

Parenting programs aim to help parents and carers enhance their skills and ameliorate infants' and toddlers' wellbeing. In Lebanon and other Arab countries, contextualized group-based parenting programs addressing parents' mental wellbeing, parenting styles, and child development are quite rare. Therefore, a Preventive Parenting Program consisting of 7 sessions has been designed by local experts for the local cultural context. This study aims to assess its effectiveness. Thirty-three sites were identified in Great Beirut: private firms, primary healthcare centers, and child daycares. Sixteen agreed to take part in the study and were randomly assigned to intervention and control arms. From these clusters, 191 mothers of typically developed children younger than three years were recruited to intervention (106) or control (85) groups. The Mental Health Inventory, Caregiver Knowledge about Child Development Inventory, Parent Authority Questionnaire, and a Demographic questionnaire were completed at pre-intervention and post-intervention and 3 months later by both groups of mothers. There were no significant differences between clusters with respect to all scales' scores at baseline as well as the 2 other data collection points. Despite the positive feedback collected from mothers who attended the sessions, no significant effects were detected. The design of the program, the expected outcomes, and the characteristics of the participants may have contributed to the limited results, hence the need for further research.

Building Emotional Resilience in Youth in Lebanon: a School-Based Randomized Controlled Trial of the FRIENDS Intervention.

In Lebanon, approximately one in four adolescents suffers from a psychiatric disorder. Alarmingly, 94% of adolescents with a mental disorder have not sought any treatment. This study assessed the effectiveness of an evidence-based school-based universal mental health intervention (the FRIENDS program) in reducing depression and anxiety symptoms in middle school students in Lebanon. A total of 280 6th graders aged 11-13 years were recruited from 10 schools in Beirut. Schools were matched on size and tuition and randomly assigned to intervention or control groups. The FRIENDS program was translated into Arabic, adapted, and then implemented by trained mental health professionals during 10 classroom sessions over 3 months. We assessed sociodemographic and relevant psychological symptoms by self-report, using the Scale for Childhood Anxiety and Related Disorders (SCARED), Mood and Feelings Questionnaire (MFQ), and Strengths and Difficulties Questionnaire (SDQ), at baseline. We re-administered these scales at 3 months post-intervention. There was a significant time × group interaction for the SDQ emotional score (p = 0.011) and total MFQ score (p = 0.039) indicating significant improvement in depressive and emotional symptoms in the intervention group. Subgroup analysis by gender showed a significant time × group interaction for the total SCARED score (p = 0.025) in females but not in males (p = 0.137), consistent with a reduction of anxiety symptoms in this stratum of the intervention group as compared with the control group. The FRIENDS program was effective in reducing general emotional and depressive symptoms among middle school students in this Lebanese study population. This intervention provides an opportunity for promoting mental health in Lebanese schools and reducing the treatment gap in mental health care.