Family recovery from youth substance use related problems : a pilot study of the BEST plus program

Youth substance use related problems are increasingly common, and families experience considerable stress in attempting to cope with these problems. A pilot study of 34 Australian parents from 21 families (38% sole parent families) participating in an 8-week group program, designed to assist families recover from youth substance use related problems, provided the context to explore family change processes. Participants reported a number of significant improvements over the course of the four groups that ran from late 2003 and through 2004. Regression analyses found general support for the program logic model in identifying significant associations between program-targeted parent changes and post-program improvements in stress symptoms and cohesive family behaviors. The study's limitations are noted.

A multi-family group intervention for adolescent depression: the BEST MOOD program

Depression is the most common mental disorder for young people, and it is associated with educational underachievement, self-harm, and suicidality. Current psychological therapies for adolescent depression are usually focused only on individual-level change and often neglect family or contextual influences. The efficacy of interventions may be enhanced with a broader therapeutic focus on family factors such as communication, conflict, support, and cohesion. This article describes a structured multi-family group approach to the treatment of adolescent depression: Behaviour Exchange Systems Therapy for adolescent depression (BEST MOOD). BEST MOOD is a manualized intervention that is designed to address both individual and family factors in the treatment of adolescent depression. BEST MOOD adopts a family systems approach that also incorporates psychoeducation and elements of attachment theories. The program consists of eight multifamily group therapy sessions delivered over 2 hours per week, where parents attend the first four sessions and young people and siblings join from week 5. The program design is specifically aimed to engage youth who are initially resistant to treatment and to optimize youth and family mental health outcomes. This article presents an overview of the theoretical model, session content, and evaluations to date, and provides a case study to illustrate the approach.

New Strophalosiidae (Brachiopoda) from the early Permian of Argentina

New representatives of the family Strophalosiidae (Brachiopoda) are described from the Tupe Formation of the Paganzo Basin, Argentina. The genus Coronalosia Waterhouse & Gupta is reviewed and the new taxa Coronalosia argentinensis sp. nov. and Tupelosia paganzoensis gen. et sp. nov. proposed. The age of the Tupe Formation is reviewed and a middle to late Asselian (Early Permian) age is preferred.
The new genus Guadalupelosia from the mid-Permian of West Texas, USA, is also proposed.

Impact of an empowerment-based parent education program on the reduction of youth suicide risk factors

Purpose: To evaluate the impact of parent education groups on youth suicide risk factors. The potential for informal transmission of intervention impacts within school communities was assessed.

Methods: Parent education groups were offered to volunteers from 14 high schools that were closely matched to 14 comparison schools. The professionally led groups aimed to empower parents to assist one another to improve communication skills and relationships with adolescents. Australian 8th-grade students (aged 14 years) responded to classroom surveys repeated at baseline and after 3 months. Logistic regression was used to test for intervention impacts on adolescent substance use, deliquency, self-harm behavior, and depression. There were no differences between the intervention (n = 305) and comparison (n = 272) samples at baseline on the measures of depression, health behavior, or family relationships.

Results: Students in the intervention schools demonstrated increased maternal care (adjusted odds ratio [AOR] 1.9), reductions in conflict with parents (AOR .5), reduced substance use (AOR .5 to .6), and less delinquency (AOR .2). Parent education group participants were more likely to be sole parents and their children reported higher rates of substance use at baseline. Intervention impacts revealed a dose-response with the largest impacts associated with directly participating parents, but significant impacts were also evident for others in the intervention schools. Where best friend dyads were identified, the best friend’s positive family relationships reduced subsequent substance use among respondents. This and other social contagion processes were posited to explain the transfer of positive impacts beyond the minority of directly participating families.

Conclusions: A whole-school parent education intervention demonstrated promising impacts on a range of risk behaviors and protective factors relevant to youth self-harm and suicide.

Working with family to promote health adolescent development

In recent years a sea change has occurred in thinking about interventions for families with adolescent children. A range of intervention strategies has been proposed, including parent education, adolescent education, family therapy, and community change. These associations arise, in part, from a higher likelihood sole-parent families will experience traumatic conflict around family breakdown, lack of supervision due to the parent's work pressures, and limited family income resulting in higher exposure to community risk factors, which demonstrated reduced parental drug use and improved family management, and the Strengthening Families Program, which demonstrated increased children's protective factors, reduced substance use in both adolescents and parents, and improved parenting behaviours are currently investigating the impact of an integrated multi-level secondary school intervention, resilient families, which incorporates communication training for students, an information night for parents, sequenced parent education groups, and brief family therapy.

Family, school, peer and individual influences on early adolescent alcohol use: first-year impact of the Resilient Families programme

Introduction and Aims:  This study aimed to examine: (a) the influence of family factors relative to school, peer and individual influences on the development of adolescent alcohol use during the first year of secondary school; and (b) the feasibility of preventing adolescent alcohol use by modifying family factors. Design and Methods:  Twenty-four schools in Melbourne, Australia were randomly assigned to either the 'Resilient Families' intervention or a control condition. A baseline cohort of 2315 grade 7 students (mean age 12.3 years) were followed-up one year later (n = 2128 for longitudinal analyses). A sub-set of parents (n = 1166) also returned baseline surveys. Results: The prevalence of lifetime alcohol use in year 7 was 33% and rose to 47% by year 8. Student-reported predictors of year 8 alcohol use included baseline alcohol [Odds Ratio (OR) 3.64] and tobacco use (2.68), and school friend's alcohol (1.41) and tobacco use (1.64). After adjusting for other influences, student-reported family factors were not maintained as significant predictors of year 8 alcohol use. Parent-report predictors of student-reported alcohol use included allowing alcohol use in the home (2.55), parental alcohol use (1.88) and child hyperactivity (1.85). Protective factors included attendance at brief parent education (0.60) and parent involvement in school education (0.65). Discussion and Conclusions: The intervention appeared to benefit education-related outcomes, but no overall effect in reducing student alcohol use was found in year 8. Intervention effects on alcohol misuse may become significant in later secondary school once the entire program has been implemented. Considerable alcohol use was detected in early secondary school,   suggesting that interventions to reduce alcohol use may be usefully implemented prior to this period.

Financial, family, and social factors impacting on cardiac rehabilitation attendance

Background
Attendance in phase 2 cardiac rehabilitation program after acute myocardial infarction is poor.

Objective
To identify and explore the demographic factors that influence peoples’ decisions to attend cardiac rehabilitation programs.

Methods
A descriptive-interpretive design was used. Semi-structured interviews were conducted with 10 people post infarction in Victoria, Australia after their first scheduled appointment to attend outpatient cardiac rehabilitation. The interview transcripts were thematically analysed.

Results
The perceived relevance of cardiac rehabilitation related to the context of people’s lives, namely their financial, family and social situation, and how important program outcomes were seen to be relevant to this context.

Conclusion
The findings of this study suggest that there are a proportion of people unlikely to attend outpatient cardiac rehabilitation programs following an AMI despite encouragement to attend. It may be unrealistic to aim for 100% referral and uptake into cardiac rehabilitation programs and therefore an inappropriate endpoint by which to evaluate such programs.

Distributions of caregiving tasks among family members: the place of gender and availability.

To extend family-oriented approaches to caregiving, participants in 2 studies were asked to distribute tasks among a set of adult children, first with information only about gender and then with systematically varied information about commitments to paid work, marriage, and/or parenting. Making the distributions, using a computer-based program, were 2 groups of older adults (ages 60 to 90 years). In Study 1, gender composition was kept constant (2 sons and 2 daughters). In Study 2, it was varied. The results showed several ways in which people combine attention to gender and to availability. The results also pointed to the need to consider both the number and type of tasks allocated. The results are discussed in terms of implications for the way caregiving is regarded, the development of multiple-factor models for variations among family members, and the possible replications and extensions to other circumstances and populations.

The Resilient Families program: promoting health and wellbeing in adolescents and their parents during the transition to secondary school.

Resilient Families is a school-based prevention program designed to help students and parents develop knowledge, skills and support networks to promote health and wellbeing during the early years of secondary school. the program is designed to build within-family connectedness (parent--adolescent communication, conflict resolution) as well as improve social support between different families, and between families and schools. It is expected to promote social, emotional and academic competence and to prevent health and social problems in youth.

Change for the BEST: family changes for parents coping with youth substance abuse

This paper reports family changes for participants in a program for parents coping with youth substance abuse. The Behavioural Exchange Systems Training (BEST) program is a professionally-led, parent training intervention. During 1996 and 1997, six groups of parents participated in the program. High levels of depression were observed at intake and symptoms demonstrated a stable reduction in association with exposure to the program. Parents tended to achieve success in developing common strategies for assertively managing family problems, though couples from more complex blended families found this more difficult. Adolescent improvements were noted during the weeks observed. A two year follow up conducted with a subset of families revealed that parents continued to report that the intervention had helped them cope with youth drug abuse.

Including the siblings of youth substance abusers in a parent-focused intervention : a pilot test of the best plus program

Substance use is common among young people and can escalate into significant problems for affected individuals and their families. Family responses can influence the course of youth substance use and its consequences for family members, including parents and siblings. Family-level interventions developed to date have neglected the important role that siblings can play. This article describes a pilot test of an intervention designed to assist parents and siblings affected by youth substance use and related problems. The BEST Plus intervention consisting of professionally-led, multifamily groups sequenced over eight sessions is described with reference to the intended therapeutic processes. Professionally observed and self-reported changes for family participants including siblings suggested that the program had a beneficial therapeutic impact. This evaluation of early impacts suggests the BEST Plus program
offers a promising means of assisting families to respond to substance use problems in young people.