Family Functioning and Mental Health Changes Following a Family Therapy Intervention in Kenya: a Pilot Trial
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ORIGINAL PAPER
Family Functioning and Mental Health Changes Following a Family Therapy Intervention in Kenya: a Pilot Trial Eve S. Puffer
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Elsa Friis Healy1 Eric P. Green2 Ali M. Giusto1 Bonnie N. Kaiser2 Puja Patel2 David Ayuku3 ●
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© Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Family-based interventions offer a promising avenue for addressing chronic negative family interactions that contribute to lasting consequences, including family violence and the onset and maintenance of mental health disorders. The purpose of this study was to conduct a mixed-methods, single group pre-post pilot trial of a family therapy intervention (N = 10) delivered by lay counselors in Kenya. Results show that both caregivers and children reported reductions in family dysfunction and improved mental health after the intervention. Point estimates represent change of more than two standard deviations from baseline for the majority of primary outcomes. Treated families also reported a decrease in harsh discipline, intimate partner violence, and alcohol-related problems. These results were corroborated by findings from an observational measure of family functioning and in-depth qualitative interviews. This study presents preliminary evidence of pre-post improvements following a family therapy intervention consisting of streamlined, evidence-informed family therapy strategies to target family dysfunction and mental health. Keywords Family therapy Global mental health Child and adolescent mental health Kenya Low- and middle-income countries ●
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Highlights Families who received a family therapy intervention from lay providers in Kenya reported improvements in family functioning and mental health. ● Specific family improvements included reduced conflict, harsh discipline, intimate partner violence, and alcohol-related problems. ● Both caregivers and children reported improvements, and participants described changes in family interactions during in-depth interviews. ● Results are preliminary, but multiple improvements across data sources support conducting future studies on this intervention. ●
Supplementary information The online version of this article (https:// doi.org/10.1007/s10826-020-01816-z) contains supplementary material, which is available to authorized users. * Eve S. Puffer [email protected] 1
Department of Psychology and Neuroscience, Duke University, Box 90086417 Chapel Drive, Durham, NC 27708-0086, USA
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Duke Global Health Institute, 310 Trent Drive, Box 90519, Durham, NC 27708, USA
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Department of Behavioral Science, College of Health Sciences, School of Medicine, Moi University, Eldoret, Kenya
Chronic and negative family interactions pose major risks, leading to perpetration of family violence and the onset and maintenance of mental health disorders among children, adolescents, and adults (Repetti et al. 2002). These consequences are important global public health problems, as an estimated 10–20% of young people worldwide suffe
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