An Integrated Analysis of the Impact of Spanish Family Support Programmes with Informed Evidence / Un análisis integrado del impacto de los programas españoles de apoyo familiar basados en la evidencia

A description is made of the quality of Spanish family support programmes, based on their impact, dissemination, scaling up in communities, and sustainability; 57 implemented programmes with informed evidence were selected by EurofamNet. Most of the programmes were shown to make a positive impact, using quantitative methodologies, and they were manualized, while about half of them defined the core contents and included professional training. From a cluster analysis of programmes with scaling up, those with a high and moderate level of systematization were identified, based on the existence of defined core contents, implementation conditions, institutional support, professional training, and reports of findings. The highly systematized programmes were characterized by a greater use of mixed methodologies, their scientific dissemination through different means, and their inclusion in services. A programme quality analysis is proposed, taking an integrated approach that relates the programme’s impact with its design, implementation, and evaluation of sustainability.(AU)

En este trabajo se presenta una descripción de la calidad de los programas españoles de apoyo a las familias, basándose en su impacto, difusión, diseminación institucional y sostenibilidad. En el marco de EurofamNet se seleccionaron 57 programas implementados con evidencia fundamentada. La mayoría de los programas mostraron un impacto positivo utilizando metodologías cuantitativas y estaban manualizados, mientras que cerca de la mitad de ellos definían los contenidos clave e incluían la formación de los profesionales. A partir de un análisis de conglomerados se identificaron los que tenían un nivel de sistematización alto y moderado, definidos los contenidos clave y las condiciones de implementación, apoyo institucional, formación profesional e informes de resultados. Los programas con alto nivel de sistematización se caracterizaron por un mayor uso de metodologías mixtas, su difusión científica a través de diferentes medios y su inclusión en las instituciones. Se propone un análisis de la calidad de los programas, con un enfoque integrado que relacione el impacto del programa con su diseño, implementación y la evaluación de la sostenibilidad.(AU)

Sistematización del programa preventivo para menores en situación de conflictividad en el ámbito familiar en la comunidad de Andalucía: Programa NAYFA / Systematization of the preventive program for minors in conflict situations in the family environment in the community of Andalusia: NAYFA Program

En este artículo se describe el proceso de investigación-acción llevado a cabo para la redefinición y el diseño de un programa destinado a niños, niñas y adolescentes con dificultades y/o situaciones conflictivas en el ámbito familiar. El diseño del nuevo programa NAYFA se ha realizado siguiendo los estándares de calidad de los programas basados en la evidencia y mediante un proceso colaborativo entre responsables políticos, profesionales e investigadores. Se utilizó la técnica DAFO para identificar las principales fortalezas y debilidades de las actuaciones previas desarrolladas en diferentes provincias andaluzas. Los resultados pusieron de manifiesto una importante falta de sistematización que se ha tratado de solventar definiendo, mediante un proceso colaborativo y de acuerdo con los criterios de calidad más consensuados, los componentes clave del nuevo programa: fundamentación teórica y metodológica, destinatarios, objetivos, contenidos, condiciones de implementación y diseño de la evaluación. El alto grado de acuerdo de profesionales y responsables con las características propuestas puede contribuir a que la implementación del programa se lleve a cabo con fidelidad al diseño original y, con ello, favorecer su efectividad (AU)

This article describes the action-research process carried out to redefine and design a program for children and adolescents with difficulties and/or conflictive situations in the family. The design of the NAYFA program has been carried out following the quality standards of evidence-based programs and through a collaborative process between policymakers, professionals and researchers. The SWOT technique was used to identify the main strengths and weak-nesses of the previous actions carried out in different Andalucía provinces. The results revealed an important lack of systematization that an attempt has been made to solve by defining, through a collaborative process and in accordance with the most agreed quality criteria, the key components of the new program: theoretical and methodological founda-tions, recipients, objectives, contents, implementation conditions and evaluation design. The high degree of agreement of professionals and managers with the proposed characteristics can contribute to the implementation of the program being carried out with fidelity to the original design and, thus, favor its effectiveness. (AU)

Family Functioning in Families of Adolescents with Mental Health Disorders: The Role of Parenting Alliance.

This study primarily examined the predictive role of emotional and behavioral disorders in family cohesion and the moderating role of parenting alliance. Adolescents' mental health issues are a major concern, with important implications for individuals and their families. However, the impact of mental disorders on family processes has been less widely studied. Participants in this study were 72 parents of adolescent beneficiaries of mental health services. Questionnaires assessed family cohesion, parenting alliance, and sociodemographic factors. Results indicated that emotional and behavioral disorders did not have an influence on family cohesion. They also suggested that parenting alliance may be a protective factor for family cohesion. This paper highlights the role of parenting alliance as a potential protective factor in positive family processes. These findings support the importance of focusing on the parental subsystem in therapy, and the need to incorporate a positive parenting perspective when working with these families.

Effectiveness of Scene-Based Psychodramatic Family Therapy (SB-PFT) in adolescents with behavioural problems.

Scene-Based Psychodramatic Family Therapy (SB-PFT) is a multiple-family intervention for adolescents with behavioural problems implemented by Child Welfare Services in Spain. This intervention is aimed at promoting adolescent well-being. The aim of this study was to evaluate the effectiveness of SB-PFT in 17 trials, measuring its impact on the emotional intelligence, parental attachment, peer attachment and antisocial behaviour of 216 adolescents (109 participating in the intervention and 107 in the control group). Repeated measures ANOVAs for pretest/posttest differences and long-term growth models were estimated. In the short term, the intervention had a positive impact on emotional intelligence and had a stabilising effect on parental attachment, whereas the long-term results showed significant logarithmic growth in emotional intelligence and exponential growth in parental attachment and a decrease in antisocial behaviour. However, no changes in peer attachment were shown. This study demonstrates SB-PFT to be a potentially effective intervention for adolescents with behavioural problems and emphasises the importance of fostering emotional intelligence.

Scene-Based Psychodramatic Family Therapy With Troubled Adolescents and Parents: A Pilot Study.

Scene-Based Psychodramatic Family Therapy (SB-PFT) is an innovative treatment used with troubled adolescents and their parents to improve family relationships and reduce adolescents' problematic behavior. It integrates the principles of family therapy, psychodrama, and multiple-family group methodology. This research is a pilot study to obtain empirical evidence on the SB-PFT therapeutic process by gauging the perception of change of troubled adolescents and their parents, and assess the perceived helpfulness of its methodology and techniques. Ten multiple-family intervention groups were drawn up, with 110 participants (63 adolescents and 47 parents), and we adopted a qualitative methodology with focus groups, using an inductive analysis of 290 active constructions of participant narratives. Concerning perception of change, the adolescents reported mainly gaining in social support, prosocial attitudes, keys to problem solving, and expression of emotions due to the treatment. The parents perceived improvement in social support, keys for educational practices, emotional well-being, and expression of emotions due to the treatment. Regarding the perceived helpfulness of methodology and techniques, both adolescents and parents highlighted the usefulness of the group methodology for gaining social support, relativizing the problem, and expressing emotions. Additionally, participants referred to role-playing and mirror techniques as the most useful techniques. In conclusion, this first study on SB-PFT presents and describes its treatment for troubled adolescents and their parents. The participants' positive perception of their personal and relational change after treatment should serve to promote further studies with quantitative methodology in order to verify the effectiveness of SB-PFT treatment.

La terapia familiar psicodramática basada en escenas (SB-PFT, por sus siglas en inglés) es un tratamiento innovador usado con adolescentes conflictivos y sus padres para mejorar las relaciones familiares y disminuir el comportamiento problemático de los adolescentes. Integra los principios de la terapia familiar, del psicodrama y de la metodología grupal multifamiliar. Esta investigación es un estudio piloto para obtener conocimiento empírico sobre el proceso terapéutico de la SB-PFT mediante la medición de la percepción de cambio de los adolescentes conflictivos y sus padres, y para evaluar la utilidad percibida de esta metodología y técnica. Se formaron diez grupos multifamiliares de intervención con 110 participantes (63 adolescentes y 47 padres), y adoptamos una metodología cualitativa con grupos focales utilizando un análisis inductivo de 290 construcciones activas de historias de los participantes. Con respecto a la percepción de cambio, los adolescentes informaron un aumento pricipalmente del apoyo social, de las actitudes prosociales, de las claves para resolver problemas y de la expresión de emociones debido al tratamiento. Los padres percibieron una mejora del apoyo social, de las claves para las prácticas educativas, del bienestar emocional y de la expresión de emociones debido al tratamiento. Con respecto a la utilidad percibida de la metodología y las técnicas, tanto los adolescentes como los padres destacaron la utilidad de la metodología de grupo para obtener apoyo social, relativizar el problema y expresar emociones. Además, los participantes se refirieron al juego de roles y a las técnicas del espejo como las más útiles. En resumen, este primer estudio sobre la SB-PFT presenta y describe su tratamiento para adolescentes conflictivos y sus padres. La percepción positiva de los participantes de su cambio personal y relacional después del tratamiento debería servir para promover más estudios con una metodología cuantitativa a fin de verificar la eficacia del tratamiento con la SB-PFT.

The Role of Parenting Styles on Behavior Problem Profiles of Adolescents.

Parental behavior is one of the most influential factors on the development of adolescent externalizing and internalizing behavior problems. These behavioral problems are closely related and often co-occur. The objectives of this work were: (i) to identify adolescents profiles according to their behavior problems; (ii) to explore individual, family, and social characteristics associated with these profiles; and (iii) to analyze the potential role of parenting styles in belonging to adolescents' profiles. A total of 449 Spanish adolescents (223 from families declared at-risk and enrolled in Child Welfare Services and 226 from families from the general population) participated in this study. The analyses revealed three profiles of adolescents based on external and internal behavior problems (adjusted, external maladjustment, and internal maladjustment). Parenting styles explained the adolescents' belonging to different profiles, in which the indulgent style was the most favorable in general terms. The distinctive role of parenting styles on two types of maladjustment profiles was confirmed. The relationship between parenting styles and adolescent adjustment is a key component that should be included in interventions according to adolescents' behavior problem profiles. Furthermore, the results shed light on the need that family interventions are complemented with individualized interventions with adolescents that accumulate stressful life events.

Effectiveness of Structural⁻Strategic Family Therapy in the Treatment of Adolescents with Mental Health Problems and Their Families.

Mental health problems during adolescence constitute a major public health concern today for both families and stakeholders. Accordingly, different family-based interventions have emerged as an effective treatment for adolescents with certain disorders. Specifically, there is evidence of the effectiveness of concrete approaches of systemic family therapy on the symptoms of adolescents and family functioning in general. However, few studies have examined the effectiveness of other relevant approaches, such as structural and strategic family therapy, incorporating parent⁻child or parental dyadic measurement. The purpose of this study was to test the effectiveness of a structural⁻strategic family therapy with adolescents involved in mental health services and their families. For this purpose, 41 parents and adolescents who participated in this treatment were interviewed at pre-test and post-test, providing information on adolescent behavior problems, parental sense of competence, parental practices, parenting alliance, and family functioning. Regardless of participants' gender, adolescents exhibited fewer internalizing and externalizing problems after the treatment. Parents reported higher family cohesion, higher satisfaction and perceived efficacy as a parent, and healthier parental practices (less authoritarian and permissive practices, as well as more authoritative ones). An interaction effect between parenting alliance and gender was found, with more favorable results for the mothers. In conclusion, this paper provides evidence of the usefulness of structural⁻strategic family therapy for improving family, dyadic, and individual facets in families with adolescents exhibiting mental health problems.

Family education and support for families at psychosocial risk in Europe: Evidence from a survey of international experts.

There is overwhelming consensus among policy makers, academics, and professionals about the need to support families in their childrearing tasks. Consequently, European countries have been encouraged to develop family support interventions aimed at guaranteeing children's rights, targeting particularly those children in situations of psychosocial risk. While a certain amount of evidence exists regarding how family support is generally delivered in certain European countries, with a particular focus on parenting initiatives, this paper aims to take existing evidence one step further by providing an updated review focusing on two core components of the Council of Europe's Recommendation on Positive Parenting: families at psychosocial risk as the target population, and family education and support initiatives as the delivery format. The scope of the study was therefore broad, in both geographical and conceptual terms. An online survey was conducted with experts from 19 European countries to gather information regarding how they perceive family education and support initiatives for families at psychosocial risk. Both quantitative and qualitative data were analysed by computing frequencies/percentages and by following a thematic synthesis method, respectively. The results revealed both similarities and disparities as regards provider profiles, intervention characteristics, and quality standards. Practical implications are discussed, such as the need to diversify initiatives for at-risk families in accordance with the tenets of progressive universalism, the ongoing need for an evidence-based, pluralistic approach to programmes, and the skills and qualifications required in the family support workforce. This study constitutes a first step towards building a common family support framework at a European level, which would encompass family support and parenting policies aimed at families at psychosocial risk.

The Role of Psychosocial Stress on a Family-Based Treatment for Adolescents with Problematic Behaviors.

The stressful life events experienced by adolescents with problematic behaviors, should be considered for implementing effective interventions. This study aimed to examine the adjustment of adolescents with problematic behaviors, and to assess the effectiveness of a family-based treatment, namely Scene-Based Psychodramatic Family Therapy (SB-PFT), according to different stress profiles. Ten SB-PFT sessions, over 17 trials were implemented. Stressful life events and adolescent adjustment were evaluated at pretest and posttest, for the SB-PFT participants (n = 104 adolescents) and a control group (n = 106). The adolescents were categorized into three profiles depending on the nature of the stressors: family stress profile, individual and family stress profile, and low stress profile. The individual and family stress group showed worse adjustment. Effectiveness analyses revealed improvements in SB-PFT participants' emotional intelligence, but not in anger and hostility. Furthermore, adolescents with low and family-related stress profiles showed enhancements in parent attachment. In conclusion, interventions involving adolescents with problematic behaviors must be tailored to the stressful life events experienced. Specific treatments should be used alongside SB-PFT, when adolescents are met with individual-related stress. Nevertheless, SB-PFT seemed to promote emotional intelligence and parent attachment, particularly in adolescents with problematic behaviors that experienced only family stressors.

Análisis factorial de las escalas FACES (Family Adaptability and Cohesion Evaluation Scales) con familias en situación de riesgo psicosocial / Factor analysis of FACES (Family Adaptability and Cohesion Evaluation Scales) with Families at Psychosocial Risk

Resumen En este artículo se presenta un análisis factorial de las escalas FACES III con una muestra de familias en situación de riesgo psicosocial (N= 324). Los resultados no replican la estructura bidimensional original de la prueba, e indican que solo la escala de cohesión (prescindiendo de tres ítems) obtiene propiedades psicométricas aceptables en esta muestra. Las significativas relaciones de las puntuaciones de esta escala con las de otras dimensiones relevantes del microsistema familiar ofrecen algunas evidencias de la validez de esta solución. Se discute la necesidad de revisar la escala de adaptabilidad propuesta por los autores y reformularla para poder evaluar empíricamente este constructo formulado teóricamente desde el modelo circumplejo del funcionamiento familiar.

Abstract In this article a factor analysis of FACES III with a sample of families at psychosocial risk (N= 324) is presented. The original two-factor structure is not found, and only the cohesion scale (deleting three items) shows adequate psychometric properties with this sample. Significant correlations between the obtained scale and other dimensions of family dynamics (i.e., family self-esteem, parenting alliance and marital satisfaction) evidence validity. The need for reviewing and reformulating the adaptability scale proposed by the authors is discussed, in order to empirically evaluate this theoretical construct from the circumplex model of family functioning.

"Family Education and Support" program for families at psychosocial risk: The role of implementation process / El programa de "Formación y apoyo familiar" para familias en situación de riesgo psicosocial: el papel del proceso de implementación

This paper analyses the implementation characteristics of the Family Education and Support program, a theory-driven, needs-based, and evidence-based positive parenting program originally developed for the Andalusian family preservation services. The implementation process of 34 trials of the FAF program with 155 participants was analyzed. Cluster analyses were also performed to explore variability in implementation conditions from a comprehensive perspective. Results showed different implementation profiles that moderated the FAF effectiveness (namely lengthier interventions, higher program fidelity, and practitioners' positive perceptions and satisfaction with the program). The relevance of examining implementation process across several trials is discussed in order to distinguish core and non-core FAF components, as well as the need for combining faithful and adaptable implementations that guarantee the ecologic validity of evidence-based positive parenting programs

Este artículo analiza las características de implementación del programa de 'Formación y apoyo familiar' (FAF). A partir de un análisis de necesidades, con una sólida fundamentación teórica y cumpliendo con los criterios de los programas basados en evidencias, el FAF se aplica en los servicios de preservación familiar de Andalucía para la promoción de la parentalidad positiva. En este artículo se analiza el proceso de implementación de 34 aplicaciones del programa FAF en las que participaron 155 madres. Desde una aproximación integral, se realizó un análisis de clústeres para explorar la variabilidad en las condiciones de implementación. Los resultados mostraron diferentes perfiles de implementación que moderaban la efectividad del programa FAF. Los grupos que mostraron mejores resultados fueron los de más duración, mayor tamaño y los que fueron aplicados con más fidelidad y por profesionales que valoraban muy positivamente el programa. Se discute la utilidad de examinar el proceso de implementación de diferentes aplicaciones del programa para identificar los elementos centrales del mismo y que necesitan ser respetados. Asimismo, se concluye con la necesidad de combinar fidelidad y flexibilidad para asegurar la validez ecológica de los programas de parentalidad positiva basados en la evidencia