Is Family Therapy Effective, Acceptable, and Sustainable for Mothers and Children?: An Examination of Structural Family Therapy Implemented within a Semi-Rural Community Mental Health Setting

Weaver, Addie (2011) Is Family Therapy Effective, Acceptable, and Sustainable for Mothers and Children?: An Examination of Structural Family Therapy Implemented within a Semi-Rural Community Mental Health Setting. Doctoral Dissertation, University of Pittsburgh.

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Abstract

The gap between knowledge about psychotherapy generated in laboratory settings and its application in routine treatment settings prevents consumers from receiving state-of-the-art, evidence-based care, prolongs their suffering, and underutilizes economic resources supporting efficacy trials. Family therapy has strong evidence for treating children's behavioral health needs, yet few studies have examined its effectiveness in the real world. Further, family therapy provides an opportunity to address the demonstrated link between maternal and child mental health symptomatology in a way likely to engage untreated mothers and their presenting children. However, only one study has examined the impact of family therapy on maternal mental health symptomatology and very few have addressed maternal functioning.This mixed methods study examined the effectiveness, acceptability, and sustainability of Structural Family Therapy for mothers and their presenting children seeking care at a semi-rural community mental health clinic. Results suggest some support for the effectiveness of family therapy. Mothers' mental health symptomatology and mothers' ratings of children's impairment improved with time spent in family therapy; however, mothers' self-ratings of their functioning and children's ratings of their own mental health symptomatology did not change. Results also suggest that mothers found family therapy acceptable, as they reported gaining skills to more effectively manage their children's behavioral challenges as well as strategies for their own self-care. In addition, mothers' perceptions of family treatment glean insight to its sustainability in routine settings. Language used by mothers suggests that therapists adhered to core aspects of the Structural Family Therapy model. However, mothers indicated their children's severe behavioral challenges and the inconsistency of sessions influenced their treatment outcomes.Findings from this study suggest that family therapy may provide an innovative, empirically supported approach to engage and treat mothers with mental health needs whose children present for community treatment. Additionally, findings from this study offer insight to implementation challenges within this real world setting that may have impacted children's outcomes. Results of this study provide a number of implications for social work practice and suggestions for future research.

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