Kuhn and Liard coauthored Family support programs and adolescent mental health: review of evidence, which was published in the Journal of Adolescent Health, Medicine and Therapeutics in 2014. The principle focus of the review was to assess the efficacy of family support programs considering that they said to improve parenting, parent wellbeing, and adolescent behavioral and mental health. The authors found two major themes from their review of the extant literature. The first finding was that family support programs, which provide more support services are more effective than those that offered only a few forms of support. The second theme that the authors established is that family support programs are more effective when serving persons who are more in need of behavioral and mental health services in the community. Consequently, the authors highlight the potential contributions of the family socioeconomic status in dealing with adolescent mental health and behavioral issues. The objective of this paper is to critique the article It can be argued that bolstering family support programs might help America address the rising prevalence of mental health problems among adolescents, especially when they are developed with sensitivity to cultural diversity.
The incidence of mental health issues among American youth is high—trends suggest a continued rise—which suggests the need for family support programs in combating the problem. According to Kuhn and Liard (2014), an approximated twenty percent of American adolescents aged between twelve and seventeen years have experienced one or more forms of mental health problems. The authors suggest that because of the incidence of mental health problems among this group, they are more likely than those from other age groups to engage in risky behavior, as well as to experience other adverse consequences. The authors also cite ecological models of development, which propose that development happens within contexts of multiple socialized spheres, and principle sphere of influence is that which constitutes the everyday environment of the persons, especially the family. Consequently, in cementing their argument for the rationale of family support programs, the authors posit that these programs could offer parents the support and resources that enable them to interact effectively with their adolescent children, and to execute their parenting responsibilities. The researchers realized a possible critique to their contributions to the volume of literature explaining interventions for youth mental and behavioral health issues. For this reason, they were keen to not factor in the contributions of poor family backgrounds to the incidence of mental health problems among the youth. Precisely, the study reports that while poor family functioning many not be one of the requirements for adolescents to experience mental health issues, and that mental health issues may not always result in family dysfunction (Kuhn & Liard, 2014). However, the authors affirm that poor family functioning has a robust connection with poor mental health outcomes among adolescents. For instance, it is reported that high parental stress and psychopathology, poor practices of parenting, high rates of parent-adolescent conflicts, and minimal levels of perceived family support are connected with high rates of adolescent behavioral, social, and emotional problems. The idea expressed in the author’s first argument, therefore, explains the rationale for family support programs by underpinning the role of the family in combating teenage mental health issues. Because of the incidence of mental health issues among adolescents in the US, family support programs could be a well-thought solution for families who could be struggling with parenting.
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Family support programs have different characteristics, which ensure that they suit a cross section of youth and adolescents from different backgrounds. The reviewed article suggests that programs for supporting families vary according to their program delivery methods. For example, some of the programs are designed to work as preventive while others function as treatment interventions (Kuhn & Liard, 2014). The study further notes that the programs could be delivered by peer teams, parent peers, or professional interventionists. Some of the complex strategies, such as clinician-led interventions, the authors note, are primarily delivered by psychologists and clinicians, but they could further be delivered by school personnel, including teachers. The range of contexts in which family support programs can be delivered widens the range of the targeted people that can be accessed at a time. The study indentifies that one of the primary causes of failure for many strategies targeting the youth in the US is their insensitivity to diversity. Because of this insensitivity, the programs have disproportionately benefited the youth from some specific backgrounds at the expense of those from others. As one might expect, the authors identify that minority groups, despite the fact that they are disadvantaged in terms of resource endowment, do not benefit from family support programs at the same rate as do their counterparts from majority backgrounds. However, when delivered appropriately, family support programs could help address the disparities that have been reported in some of the programs around the country. For instance, preventive initiatives may reduce the probabilities of new mental health issues occurring through altering the underlying mechanisms that are implicated by the development and sustenance of the problem. The programs could be designed in consideration for the cultural implications of their success. One of the major issues that policymakers should always be aware is the need for their interventions to foster familial connections between the adolescents and their parents, which is a recognized cultural value across the different communities and ethnicities in the country. Consequently, the perceived efficacy of family support programs relies on their sensitivity to diversity indicators of the populations that they are designed to serve.
The success of family support programs, apart from being sensitive to diversity, should be led by properly trained personnel who would be tasked with choosing the right combination of different components. The authors report that most of the family support programs are a combination of one or several components, but the specific combinations of components varies according to the manner in which the programs are delivered. Because of the need to combine the different components, the authors argue that clinician-led interventions are the most common around the US. In their review, the authors divided their clinician-led interventions into three groups, which different according to their program components. They noted that the combination of informational and instructional clinician-led models is the most commonly described in literature and that those that combine advocacy, instructional, and support are the second most commonly adopted by practitioners. When delivered by properly trained personnel, it should be noted that the programs may yield a series of benefits for the families and adolescents. For instance, they reported that the strategies may yield bolstered parental self-esteem, more positive cognitions concerning their adolescent children, and an increase in their levels of engagement and satisfaction with the type of treatment that they receive. Concerning child outcome, the authors reported that family support programs, which combine informational and instructional components delivers benefits, which may include reduced symptoms identified with anxiety disorders. The researchers also suggested in their review that in some cases, family support programs alone could be more useful than when medication was combined with family support initiatives. The implications of component combinations on the success of family support programs suggest that some regions may not realize the benefits of the programs, especially if they do not have sufficient personnel in their regions.
Apart from treatment methods, family support initiatives could also be attained through the application of family support prevention programs. The latter programs, as the study notes, could be classified into four levels, which are multilevel, indicated, selective, and universal. The authors report that the universal prevention programs target to lower the prevalence of new incidences of mental health disorders through hindering its onset (Kuhn & Liard, 2014). On the other hand, selective prevention programs target to lower the incidence of disorders through early identification and thorough treatments for subclinical problems while indicated interventions intervene with persons who display symptoms of mental health disorders, but who do not meet the full diagnostic criteria for the conditions. Usually, the focus of the interventions is to hamper the development of further negative consequences. Lastly, universal support programs are those that combine any of the initiatives. The latter programs appear to be the most favored by interventionists since they emphasize on the value of education in informing decisions. For example, interventionists seeking to reduce the likelihood of the occurrence of specific mental health disorders among a group of adolescents with the high risk of contraction may educate parents and their children about the prognosis of the condition in addition to using strategies that would hinder the development of the identified condition. In this review, the authors identify that the success of any strategy adopted relies on its suitability to specific persons, which again highlights the need for the interventions to be sensitive to diversity issues.
In conclusion, the authors argue that family support initiatives could have significant levels of effectiveness in the improvement of mental health and behavioral outcomes of adolescents in addition to bettering the parenting approaches of their parents. The study stresses the need for the interventionists to consider cultural diversity in the choice of their interventional approaches. For instance, among the treatment programs, clinician-led programs that offer of advocacy, informational, and instructional support are reported to have the most profound influence on the desired outcomes. Further study, as the authors note, is required to appraise the efficiency of some other programs, especially those that do not employ effectively trained personnel, such as peers. This argument draws from the realization that family support strategies that have been described in the reviewed literature emphasize the role that the family plays as a social institution in the prevention of mental health problems among the youth. Furthermore, among the prevention interventions multilevel programs are the most widely applied because of their reported levels of effectiveness compared to other strategies. The efficacy of the strategy, as reported in the study, is founded on the educational perspective that it inclines on to obtain its objectives. Overall evidence reviewed by the researchers indicates that when family support initiatives are riveted to offer one form of support for the target population, they have the potential of shutting out probable solutions to meeting the family needs of the targeted groups. It is imperative noting, therefore, that practitioners should always strive to use combined approaches to dealing with mental health and behavioral issues among the youth.
Reference
Kuhn, E. S., & Laird, R. D. (2014). Family support programs and adolescent mental health: review of evidence. Adolescent health, medicine and therapeutics , 5 , 127.
