Nurturing Families Program

Problem: In humanitarian contexts, various stressors affect the family – displacement, poverty, increased violence, direct trauma, psychological distress. Caregivers are exposed to diverse stressors, can have high rates of distress, and may struggle to provide responsive and effective parenting. Families are a key protective or risk factor that are often overlooked. Programs working at the individual child or parent level, while important, do not address complex family challenges. Yet, family approaches are seldom conducted or evaluated.

Question: The main research question was “Does the mental health and psychosocial support (MHPSS) intervention enhance the well-being of persons affected by forced migration due to armed conflict?” Sub-questions were:

• Active ingredients: What factors make the MHPSS intervention effective?
• Enhancers of MHPSS effectiveness: Under which conditions can those factors best develop their full potential?
• Inhibitors of MHPSS effectiveness: What barriers can limit the effectiveness of the MHPSS intervention and how can they be mitigated?

Design & Methods: The intervention was developed through a series of workshops with local study advisors and community advisory boards, the research team, and expert review. The Core Module draws from a 6-session intervention developed by War Child in Lebanon. It was adapted to Jordan, with added child-focused and family sessions to identify remaining needs and optional Advanced Modules. The intervention was piloted with 12 families. Before the intervention, mid-way, immediately after the intervention, as well as 2 and 6 months after the end of sessions, the following outcomes were measured: parent distress, child distress, positive parenting, family relationships, parent ability to manage emotions, the impact of problems on the family, and child well-being.

To further test the intervention with a larger number of participants, a feasibility Randomized Control Trial was conducted with 60 families. Thirty families were randomized to receive the intervention (intervention group), and 30 were randomized to receive standard services at CRP, which included a financial literacy program (control group). Measures were mostly the same as the pilot, but parents were asked to also report on adolescent distress, and asked adolescents to also report on family relationships.