Extrait

Background and study aims Children who grow up with a mentally ill or addicted parent are at high risk to develop problems themselves during their life. They are for instance at risk for various psychiatric disorders, such as depression and anxiety, but also for other problems like poor functioning in school and peer relations, suicide, and medical illnesses. The risk in these children is caused by a combination of inherited genes, biological processes caused by maternal stress during pregnancy, and environmental risk factors. With environmental risk factors we mean for instance problematic family functioning, a poor relationship between parent and child, and several child characteristics which make them more vulnerable for problems such as a low self-esteem. Since the environmental risk factors are malleable, over the years various preventive courses have been developed for these children to lower their risk and increase their strengths. In the Netherlands, nearly all mental health centres offer preventive support groups for the children of their adult patients. In the support groups, children meet, talk and play with other children of mentally ill or addicted parents. The groups aim to decrease the risk in these children by teaching them that other people that give them support. Children learn how they can ask for this social support, how to interact with their parent, how to cope with difficult situations, that they are not the only one with a mentally ill parent, and that they need not feel guilty or ashamed. This might lead to increases in self-esteem and feelings of social acceptance by peers. Although the support groups have been offered to the children for many years, until now, there is no information about whether the children who participate really learn the skills and have fewer problems afterwards. Therefore, this study will answer these questions. Who can participate? Twenty Dutch mental health centers that offer support groups for children aged 8 to 12 years old participate in the study. Children who are enlisted for a support group in one of these centers can participate. The children need to have a parent who is diagnosed with a mental disorder or substance use disorder. The children themselves have to be aged between 8 and 12 years old. What does the study involve? The children will be randomly assigned to one of two groups. One group will immediately start with the support group intervention. The support group intervention consists of eight weekly 90-minute sessions, each with a unique theme. Each session starts with an evaluation of the last week and a group discussion and is closed with a homework assignment. Children receive information (psycho-education), discuss topics and practice skills by doing role plays, games, creative activities and multimedia. Between the fourth and fifth session of the group there is a meeting for parents, and parents are also involved in a final family talk. Three months after the last session children meet again in a come back session (booster session). All sessions are supervised by a prevention and a child mental health expert. The other group will be put on a waiting list for 6 months. In order to prevent children from dropping out, the children on the waiting list are offered three pleasant activities, such as paintballing or watching a movie. After 6 months, when the study is finished, the groups change (children who first did the support groups now undertake three pleasant activities, and vice versa). The two groups will be compared in terms of the four goals of the support groups and their emotional and behavioural problems. The goals and their problems will be assessed by questionnaires that will be filled out by themselves and one of their parents. The questionnaires should be completed before start of the group, afterwards (3 months later), and 6 months after the start to see whether the effects are maintained. What are the possible benefits and risks of participating? The possible benefits are a reduction in risk and an improvement in strengths of the children. There are no risks. Where is the study run from? The study is conducted by the Radboud University Nijmegen (Netherlands) in cooperation with the Dutch National Institute for Mental Health and Addiction (Trimbos Institute). Twenty mental health centers are participating: Centrum Maliebaan, Context, De Jutters, Dimence, GGNet, GGZ Breburg, GGZ Friesland, GGZ Nijmegen, GGZ Oost Brabant, Indigo, Mediant, Mentrum, Mondriaan, Novadic Kentron, Optiment, Prezens, Reinier van Arkel Groep, Riagg Maastricht, Riaggzuid, Tactus. When is the study starting and how long is it expected to run for? The study ran from October 2007 to June 2010. Who is funding the study? The study is funded by ZonMw, which is the Dutch Organization for Health Research and Development. Who is the main contact? Ms Floor van Santvoort [email protected]

Critère d'inclusion

• Mental health problems in children at risk

Liens

• ictrp
• isrctn