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Table 3 Support and interventions

From: Community-based support for children who are next-of-kin for a parent experiencing illness or disability – a scoping review

Type of intervention Study Content of the intervention
To the children
 Group programme (TRAMPOLINE) 1 Bröning et al. (2012) This intervention included nine group modules for children, containing specific addiction-related themes, provided on a weekly basis and conducted by trained social workers. The aim of the intervention was to help children cope with stress and develop a positive concept of self.
 Equine-assisted therapy (EAT) 4 Dunlop & Tsantefski (2018) This intervention included an equine-assisted therapy programme for children, consisting of two-hour sessions per week over 9 weeks. It was led by a trained Equine-Assisted Growth Practitioner, as part of an alcohol and other drug treatment service for children whose parent has a substance abuse.
 Peer-support group 6 Gladstone et al. (2014) An eight-week, psycho-educational and peer-support programme for school-aged children. Children were expected to learn mental illness information because ‘knowledge is power’, and to express difficult feelings about being a child of a mentally ill parent. The group was led by an experienced facilitator and one who was in training.
 School holiday and school peer-support programmes (CHAMPS) 7 Goodyear et al. (2009) This intervention was offered in two formats; as school holiday programmes run over four consecutive days or school programmes which were carried out as two-hour sessions per week over one school term or fortnightly over two school terms. It was possible to participate in both formats of the programme.
The programmes aimed to provide the opportunity for children to meet regularly and offer a sense of belonging and acceptance, increase independence from parents and other adults and connectedness with peers. The programme assisted children to explore themes around the impact of hospitalization, children taking on caring responsibilities, and living with stigma.
 World café 15 McAndrew et al. (2012) This World Café event (one single occasion) had the goal of providing a platform to create important opportunities for collaboration between young carers, the volunteer sector, health and social care practice, and education. It aimed at better understanding the needs of the young people. The event was led by young service users and carers.
 Psychosocial group intervention Children’s Lives Include Moments of Bravery (CLIMB®) 16 O’Neill et al. (2019) This was a 6-week group psychosocial intervention for children, consisting of weekly 90-min sessions with art and play activities in small groups.
Sessions focused on sharing one’s cancer story with other children, increasing knowledge about cancer and its treatment, normalizing and coping with feelings of sadness, anxiety and anger, as well as identifying strengths and enhancing communication with the parent with cancer.
The programme was led by a professional with a health and social care background, who had completed 2 days of training in delivering the CLIMB programme.
 Wonders & Worries (W&W) intervention 17 Philips & Prezio (2017) This was a community-based psychosocial manual based intervention, designed to be individualized. It included 6 sessions (one 90-min session per week, except session 3, which was a tour of the cancer treatment centre).
 Youth Education and Support (YES) pilot intervention 20 Riebschleger et al. (2009) This was a psycho-educational support programme for youth that aimed to strengthen protective factors, help with accessing information and increase coping skills. It included six group meetings (2-h sessions) which covered different themes, such as learning, illness, effective rehabilitation, stigma, coping and hope. The sessions were led by the researcher and two professionals at two mental health agencies.
 Psychosocial group intervention Children’s Lives Include Moments of Bravery (CLIMB) 21 Semple & McCaugghan (2013) The psychosocial intervention CLIMB® was delivered at a cancer charity organization. It included 1.5 h group meetings for six consecutive weeks and were offered for children aged five to twelve years, who had a parent or a significant adult with cancer. Each week followed a similar format to help create a sense of structure and security through routine: the welcome, a team building activity, an educational component about cancer, different emotions discussed with a specific activity to help child acknowledge, express and cope with their feelings, and then a summary/closing. The goals of CLIMB® were to: [1] provide age-appropriate education about cancer, cancer treatment and the cancer experience [2]; normalize emotions that a child experiences when their parent has cancer [3]; support communication of complex emotions associated with parental cancer; and [4] improve coping by connecting children whose parents have cancer. The intervention was delivered by family-support workers.
 Innovative services for children and young people 24 Templeton et al. (2011) Three innovative programmes for children and young people living with parental substance misuse were described: Moving Parents and Children Together (M-PACT), Base Camp and Breaking the Cycle.
M-PACT was a structured group programme with between three and eight families. Young people and/or their parents could join the programme.
Base Camp was an intervention for children of parents with alcohol problems. A professional worker worked with each child over a period of about 6 months, offering a range of individual and group support.
Breaking the Circle was an outreach service for families where the focal client was the parent with the alcohol or drug problem, but where other family members, including children were involved. A coordinator developed an individual care package and met with the family over a period of weeks or months.
 Support group 25 Van Santvoort et al. (2014) Support groups including eight weekly manual based 90-min sessions with different themes, and a booster session after 3 months. In addition, there was a meeting for parents and an individual family session. The aim of the intervention was to reduce negative cognitions; improve social support, competence, and parent–child interaction (direct intervention goals); and reduce emotional and behavioural problems (the ultimate aim of the intervention). The intervention was guided by two mental health or prevention experts (e.g. child psychologist, clinical social worker, psychiatric nurse).
 Online preventive course (Kopstoring) 27 Woolderink et al. (2015). This was an online weekly theme-based group course over 8 weeks supervised by two trained psychologists or social workers. The intervention aimed at preventing behavioural and psychological problems in children at risk.
For the family
 Culturally adapted family intervention (CAFI) 3 Davey et al. (2013) This intervention included five bi-monthly support group sessions (increasing fun activities, cognitive behavioural interventions, talking about feelings/cancer, improving attachment and communication), three group meetings with children only and two family group meetings. The intervention was provided by a trained therapist.
 Family-focused approach to care (theoretical model of support) 5 Foster et al. (2012) This was a theoretical model of family-focused care. Nurses can promote parent, child, and family well-being by supporting the internal and external protective factors and reducing the risk factors. Initial identification, assessment, education, and referral, through to supportive counselling and focused family interventions are included in the model. Nurses could offer this intervention, as well as other professionals.
 Family-focused psychoeducation DVD intervention based on Beardslee’s family talk intervention 8 Grove et al. (2015) This intervention included the use of a DVD—which provided children with age-appropriate and developmentally suitable information about parental depression and anxiety, and information about how the child could respond to their parent. It also provided the children with coping and help-seeking strategies. The DVD consisted of two sections: one for parents, and one for children.
 Parent-child group 11 Landry-Dattée et al. (2016) This was a support group for children and their parents, which aimed at helping parents to communicate with their child about their disease, increasing the child’s understanding about the disease and soothing the child. The sessions were conducted by a psychoanalyst and a doctor at the hospital in the format one 2-h session every 2 weeks. The reference frame for the intervention was psychoanalytical.
 A home visiting programme using a recovery planning model for families (NKC—OTCP) 13 Maybery et al. (2015) Family recovery planning model, where the programme involved setting goals for each child and parent according to 11 predetermined domains: family connectedness, mental health knowledge, child development, education, interpersonal skills, substance abuse, lifestyle, diet and exercise, community and social connectedness, finances, family health and well-being, and accommodation. The goals formed the basis of each family member’s case management plan, short- and long-term goals were reviewed three times every 4 months. The programme was led by a case manager.
 Beardslee’s family intervention (FI) 18 Pihkala et al. (2012) The main purpose of the manualized intervention was to prevent mental health problems for children of mentally ill parents by promoting resilience in children. It included two sessions with parents focusing on their experiences and the impact of the illness on themselves and on the children. Next, individual interviews were conducted with each child, focusing on the child’s experiences of the parent’s illness and protective risk factors. A family session then took place, focusing on parent–child communication, based on the children’s questions and experiences. Follow-up was conducted after one and 6 months. The intervention was provided by professionals with training in delivering the specific family intervention.
For the mothers
 Mother and toddlers’ programme 23 Suchman et al. (2011) The Mothers and Toddlers Program (MTP) was a 12-session of weekly individual parenting therapy aimed at enhancing maternal capacity for reflective functioning and softening harsh and distorted mental representations of parenting. An additional 12 weeks sessions were optional. The programme was an attachment-based individual parenting therapy for mothers involved in substance abuse treatment and caring for children from birth to 36 months. The programme was led by a MTP therapist.