Family Processes in the Year Following Brief and Virtual Emotion-Focused Family Therapy Groups: Child and Family Trajectories and Mental Health Service Utilization

Abstract

Brief Emotion-Focused Family Therapy (EFFT) is associated with numerous putative benefits across the domains of child mental health and caregiver psychosocial well-being. Despite promising findings to date, there remains limited research examining the interrelationships across multilevel family process for those seeking this intervention, cutting across child, caregiver, family-wide, and service-system levels of analysis. To address this research gap, the present dissertation provides an empirical application of family systems theory while exploring family-wide trajectories following a brief and virtual two-day EFFT intervention. Three studies involved a sample of N=159 caregivers, representing 124 families and 264 children. This included an analysis of both children’s mental health and family functioning, alongside child- and caregiver-specific predictors that characterize families with ongoing mental health service utilization. Across these three studies, the findings of the present dissertation demonstrated that: (1) Variance in post-intervention trajectories was attributable to both stable differences between children, and families, alongside within-child and within-family change, (2) Families experienced consistent post-intervention trajectories of recovery, with a horizontal “s-shaped” pattern over time, across the domains of family functioning and children’s anger, anxiety, and depressive symptoms, (3) The associations within child and family well-being are multiple, consistent, and cut across layers of family organization, (4) Out of the variables considered, there were relatively few predictors of mental health service utilization beyond the levels of child symptom impairment and family economic situation, the latter operating differently for caregivers and children. Altogether, these results provide a fulsome evaluation of the interrelationships among family processes implicated in child and family-wide well-being for families seeking a short-term, caregiver-focused EFFT intervention. Overall implications are discussed, including the empirical basis for a family-wide lens within both EFFT research and emotion-focused caregiver interventions for children’s mental health care more broadly.