Category: Child / Adolescent - Anxiety

Symposium

A Family-Centered Preventive Intervention for Military Children and Families: Longitudinal Outcomes From Large-Scale Dissemination

Sunday, November 19
8:30 AM - 10:00 AM
Location: Sapphire Ballroom A, Level 4, Sapphire Level

Keywords: Dissemination | Prevention | Trauma
Presentation Type: Symposium

A trauma-informed, family-centered prevention program, FOCUS (Families OverComing Under Stress) developed to enhance resilience and reduce stress and anxiety within parents and children facing adversity has been implemented at scale for active duty military families.  Designed as a community-partnered, public health implementation of a suite of interrelated family prevention services, FOCUS includes core components:  a) cloud-based family check-in to support early identification of risk, personalized delivery and program quality improvement; b) psychoeducation and developmental guidance; c) family level cognitive behavioral skills training (emotional regulation, problem solving, goal setting, communication, and management of stress/loss reminders) & d) narrative timeline activity designed to enhance collaborative problem solving and shared meaning.  We present longitudinal program evaluation data from 2008-2014 for 3,499 parents and 3,810 children participating at 15 military installations in the United States and Japan.  Longitudinal regression models with family-level random effects were used to assess patterns of change in outcomes over time.  We found improvement in psychological health outcomes occurred in both service-member and civilian parents. Relative to intake, parental anxiety and depression symptoms were significantly reduced post-intervention, and these reductions were maintained at two subsequent follow up assessments. We identified a pattern of significant reductions in internalizing and externalizing symptoms and improvements in pro-social behavior over time for children. We observed reductions in the prevalence of clinically significant child anxiety symptoms, as well as parental posttraumatic stress symptoms from intake to follow-up.   Further, the FOCUS implementation provides a model for the delivery of family-centered preventive practices that can be integrated across multiple community and practice settings as a tiered public behavioral health strategy for children and families.  This large scale public health implementation indicates that strength-based, family level resilience approach to engaging highly stressed children and families within community systems provides an opportunity to identify increased risk for anxiety, provide early intervention outside of traditional care settings, and demonstrates the utility of multiple intervention platforms for delivering effective prevention. 

Patricia Lester

Professor-in-Residence
UCLA Division of Population Behavioral Health, Semel Institute for Neuroscience and Human Behavior

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