Fristad, M. A., Gavazzi, S. M., & Soldano, K. W. (1998). Multi-family psychoeducation groups for childhood mood disorders: Program description & preliminary efficacy data. Contemporary Family Therapy, 20(3), 385-402.
Type of Study: Non-randomized, within-group pre-/post-test design
Number of Participants: 9 families
Population:
- Age range — Not given; 3 children & 6 adolescents
- Race/Ethnicity — Not Specified
- Gender — Not Specified
- Status — All children/adolescents were prescribed one or more psychotropic
medications and all had participated concurrently in individual and/or
family therapy at the time of their participation in the MFPG program.
Location / Institution: Ohio State University
Summary: (To include comparison groups, outcomes, measures, notable limitations)
This article presents preliminary data regarding the efficacy of Multi-Family Psychoeducation Groups (MFPG, former name of Multi-Family Psychoeducational Psychotherapy (MF-PEP))
on treating mood disorders. Data were obtained from families who
participated in the first two groups to experience the pilot MFPG
program described in the article. The primary measure used was the Expressed Emotion Adjective Checklist (EEAC),
which assesses parents’ attitudes and behavior toward their children,
as well as their perceptions of their child’s attitudes and behavior
towards them. Additionally, parents and children/adolescents completed
an anonymous group evaluation form at the end of treatment. This form
included both rating scale and open-ended questions, in an attempt to
elicit feedback on the specific content of the group, as well as more
global positive and negative comments about group participation. To
assess changes in family emotional climate, data were obtained from one
parent per family in each of the 9 participant families (five mothers
and four fathers). Mothers and fathers each reported an increase in
positive attitude/behavior toward their child and a decrease in negative
attitudes/behaviors toward their child. Likewise, mothers and fathers
each reported increased positive attitude/behaviors of their child
toward them and decreased negative attitude/behaviors of their child
toward them. Limitations of the study include the small sample size and
the lack of a control group or randomization.
Length of post-intervention follow-up: 4 months.
Fristad, M. A., Goldberg-Arnold, J. S., & Gavazzi, S. M. (2002). Multi-family psychoeducation groups (MFPG) for families of children with bipolar disorder. Bipolar Disorders, 4, 254-262.
Type of Study: Randomized controlled trial
Number of Participants: 35 children, 47 of their parents
Population:
- Age range — (children) 8-11 years
- Race/Ethnicity — (families) 31 Caucasian, 1 African-American, 1 Hispanic/Caucasian, 1 Southeast Asian child with Caucasian adoptive parents, 1 Native American child with Caucasian adoptive parents
- Gender — 27 boys, 8 girls
- Status — Primary mood disorder diagnoses of the participating children included
Major Depressive Disorder (MDD, n = 13), Dysthymic Disorder (n=6),
Bipolar I Disorder (n=5), and Bipolar II Disorder (n=11). Participant
families were recruited from a variety of sources, including the
National Alliance for the Mentally Ill (NAMI), the Ohio State University
child inpatient and outpatient units, pediatricians, local school
psychologists, and local mental health providers.
Location / Institution: Ohio State University
Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study presents data from a pilot study of Multi-Family Psychoeducation Groups (MFPG, former name of Multi-Family Psychoeducational Psychotherapy (MF-PEP))
for families of children with mood disorders and addresses two questions:
Do families of children with Bipolar Disorder (BPD) and families of
children with Major Depressive Disorder/Dysthymic Disorder (MDD/DD): 1)
differ at treatment entry?; 2) benefit equally from intervention?
Measures included the Children’s Interview for Psychiatric Syndromes – Child and Parent Forms (ChIPS/P—ChIPS), which are structured psychiatric interviews to assess psychopathology; the Children’s Depression Rating Scale-Revised (CRS-R); the Mania Rating Scale (MRS), which assesses manic symptoms; the Children’s Global Assessment Scale (C-GAS), which documents the severity of illness; the Expressed Emotion Adjective Checklist (EEAC), which assesses parents’ perceptions of their child’s behavior toward them; the Social Support Scale, which determines the child’s perceived social support; and the Child and Adolescent Services Assessment (CASA),
which is a structured interview that assesses the use of physical
health, mental health, social service, etc, by children and adolescents
as a result of mental health or substance abuse problems, and also
examines attitudes toward treatment and barriers to service use. At
baseline, there was a trend toward parents in BPD families being more
knowledgeable about mood symptoms than parents in MDD/DD families (p
< 0.04). Additionally at baseline, children with BPD evidenced
greater mood severity historically and a trend toward more
hospitalizations, day treatment, outpatient treatment, medication
trials, and placement in special education classrooms than children with
MDD/DD. Immediately following and 4 months post-treatment, both BPD and
MDD/DD families described having gained knowledge, skills, support, and
positive attitudes during treatment. MDD/DD families increased their
knowledge of symptoms to the same level as BPD families. While BPD
families enter treatment with more impaired children and more extensive
treatment histories, both BPD and MDD/DD families benefit from
intervention. The clinical issues concerning combining families of
children with bipolar and depressive spectrum illnesses in groups are
discussed. Clinical impressions suggest that such combinations are
clinically feasible and potentially beneficial.
Length of post-intervention follow-up: 4 months.
Fristad, M. A., Goldberg-Arnold, J. S., & Gavazzi, S. M. (2003). Multi-family psychoeducation groups in the treatment of children with mood disorders. Journal of Marital and Family Therapy, 29(4), 491-504.
Type of Study: Randomized controlled trial (same sample as Fristad, Goldberg-Arnold, & Gavazzi, 2002)
Number of Participants: 35 children, 47 of their parents
Population:
- Age range — 8-11 years
- Race/Ethnicity — Children: 31 Caucasian, 1 African-American, 1 Hispanic/Caucasian, 1 Southeast Asian child with Caucasian adoptive parents, 1 Native American child with Caucasian adoptive parents
- Gender — 27 boys, 8 girls
- Status — Primary mood disorder diagnoses of the participating children included
Major Depressive Disorder (MDD, n = 13), Dysthymic Disorder (n=6),
Bipolar I Disorder (n=5), and Bipolar II Disorder (n=11). Participant
families were recruited from a variety of sources, including the
National Alliance for the Mentally Ill (NAMI), the Ohio State University
child inpatient and outpatient units, pediatricians, local school
psychologists, and local mental health providers.
Location / Institution: Ohio State University
Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study examined the impact of adjunctive Multi-Family Psychoeducation Groups (MFPG, former name of Multi-Family Psychoeducational Psychotherapy (MF-PEP))
on parental knowledge of mood disorders, family interaction patterns,
perceived social support, and subsequent utilization of clinical
services. Children and their families were randomly assigned to either a
6-week Multi-Family Psychoeducation Group plus treatment as usual (MFPG
+ TAU) or to a 6-month wait-list condition plus TAU (WLC + TAU).
Measures included the Children’s Interview for Psychiatric Syndromes – Child and Parent Forms (ChIPS/P—ChIPS), which are structured psychiatric interviews to assess psychopathology; the Children’s Depression Rating Scale-Revised (CRS-R); the Mania Rating Scale (MRS), which assesses manic symptoms; the Children’s Global Assessment Scale (C-GAS), which documents the severity of illness; the Expressed Emotion Adjective Checklist (EEAC), which assesses parents’ perceptions of their child’s behavior toward them; the Social Support Scale, which determines the child’s perceived social support; and the Child and Adolescent Services Assessment (CASA),
which is a structured interview that assesses the use of physical
health, mental health, social service, etc, by children and adolescents,
as a result of mental health or substance abuse problems, and also
examines attitudes toward treatment and barriers to service use. At the
6-month follow-up from baseline, families who received immediate
treatment reported: Increased parental knowledge about childhood mood
symptoms; increased positive family interactions as reported by the
parent; increased perceptions of parental support as reported by
children; and increased utilization of appropriate services by families.
The most notable limitation of the study is the small sample size.
Length of post-intervention follow-up: 4 months.
Fristad, M. A., Verducci, J. S., Walters, K. & Young, M. E. (2009). The impact of Multi-Family Psychoeducational Psychotherapy in treating children aged 8-12 with mood disorders. Archives of General Psychiatry, 66(9), 1013-1021.
Type of Study: Randomized controlled trial
Number of Participants: 165
Population:
- Age range — 8-11 years at baseline
- Race/Ethnicity — Immediate Treatment: 94% White; Wait-List Control: 89% White (rest unspecified)
- Gender — Immediate Treatment (n = 78): 76% male, 24% female; Wait-List Control (n = 87): 71% male, 29% female
- Status — Children were recruited from mental health and physical health care
providers, media contacts, and word of mouth. All had a major mood
disorder (major depressive disorder or dysthymic disorder, 30%, bipolar
disorder type I, type II, or not otherwise specified, 70%).
Location / Institution: Ohio State University
Summary: (To include comparison groups, outcomes, measures, notable limitations)
Eleven sets of 15 families were recruited, 1 set every 3 months. Within
each set, 7 families were assigned to immediate treatment (IMM) with Multi-Family Psychoeducational Psychotherapy (MF-PEP)
and 8 families to a 1-year wait-list control (WLC) group. All families
were encouraged to continue treatment as usual (TAU, i.e., any other
psychosocial, psychopharmalogical, and educational interventions the
family desired) on their own during the study. Over an 18-month period,
four assessments were conducted. After the 12-month assessment, WLC
families participated in MF-PEP. Measures included the Children’s Interview for Psychiatric Syndromes and the Children’s Interview for Psychiatric Syndromes—Parent Version, which are structured psychiatric interviews designed to assess psychopathology according to Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) criteria. Additionally, the Children’s Depression Rating Scale—Revised (CDRS-R) was used to measure the severity of depressive symptoms; the Mania Rating Scale (MRS) was used to measure the severity of manic symptoms; and the Mood Severity Index (MSI) was used to assesses the total severity of both manic and depressive symptoms. Results showed that MF-PEP
treatment in the IMM group was associated with improvement in mood
symptom severity compared with the WLC group over a 1-year follow-up.
Additionally, IMM participants maintained their rate of mood symptom
improvement through the 18-month assessment. When WLC participants
received MF-PEP treatment after 12 months,
they showed a similar pattern of improved mood symptoms. Limitations of
this study include the sample consisting primarily of white males (and
their families) and the use of a wait-list control group rather than a
placebo control group.
Length of post-intervention follow-up: Immediate treatment families (intervention group) were assessed at Month 0 (Time 1). Intervention occurred between Time 1 and Time 2 (Month 6). Follow-up occurred at Time 3 (Month 12) and Time 4 (Month 18). Wait-list treatment families (control group) wer
Mendenhall, A. N., Fristad, M. A. & Early, T. (2009). Factors influencing service utilization and mood symptom severity in
children with mood disorders: Effects of Multi-Family Psychoeducation
Groups (MFPG). Journal of Consulting and Clinical Psychology, 77(3), 463-473.
Type of Study: Secondary analyses of Randomized controlled trial (same sample as Fristad, Verducci, Walters & Young, 2009)
Number of Participants: 165
Population:
- Age range — 8-11 years at baseline
- Race/Ethnicity — Immediate Treatment: 94% White; Wait-List Control: 89% White (rest unspecified)
- Gender — Immediate Treatment (n = 78): 76% male, 24% female; Wait-List Control (n = 87): 71% male, 29% female
- Status — Children were recruited from mental health and physical health care
providers, media contacts, and word of mouth. All had a major mood
disorder (major depressive disorder or dysthymic disorder, 30%, bipolar
disorder type I, type II, or not otherwise specified, 70%).
Location / Institution: Ohio State University
Summary: (To include comparison groups, outcomes, measures, notable limitations)
This study investigated the impact of psychoeducation on service
utilization and mood symptom severity in children with mood disorders.
Parents’ knowledge of mood disorders, beliefs about treatment, and
perceptions of children’s need for treatment were hypothesized to
mediate the relationship between psychoeducation and service utilization
and between psychoeducation and mood symptom severity. Linear mixed
effects modeling and joint significance test for mediation were used in
secondary data analyses of the Multi-Family Psychoeducation Group (MFPG,
former name of Multi-Family Psychoeducational Psychotherapy (MF-PEP))
study, a randomized controlled trial of 165 children ages 8 to 12 years
with mood disorders. A majority of those sampled were male (73%) and
White, non-Hispanic (90%), and the median range of family income was
$40,000 –$59,000. Participation in MFPG significantly improved quality
of services utilized, mediated by parents’ beliefs about treatment.
Participation in MFPG also significantly improved severity of child’s
mood symptoms, mediated by quality of services utilized. MFPG appears to
be a psychoeducational intervention that helps parents to become better
consumers of the mental health system who access higher quality
services. Children’s symptom severity decreases as a result.
Length of post-intervention follow-up: 6 months (for treatment group; no post-intervention follow-up for wait-list control).
