Randomised control trial (Pineda & Dadds, 2013, Pineda 2012)
The Resourceful Adolescent Program for Parents (RAP-P) has been evaluated in a randomised control trial with parents of suicidal adolescents in Western Sydney (Pineda 2012; Pineda & Dadds, 2013). This study evaluated the effectiveness of RAP-P in reducing suicidal behaviour and associated symptoms. Families received routine care only (treatment-as-usual) or routine care plus a 4-session interactive parent educational program. The first session aimed to enhance parents' understanding of youth suicidal behaviour and practical strategies to address this. RAP-P comprised the next three sessions.
While the Routine Care group showed no improvement across the study, significant improvements were seen in the RAP-P condition, including:
- Greater reductions in adolescents' suicidal behaviour
- Greater reductions in adolescents' psychiatric disability
- Greater improvement in family functioning
Benefits were maintained at both 3 and 6 month follow-up with strong overall effect sizes. Positive Changes in family functioning explained much of the reduction in adolescents' suicidality.
Recruitment and retention were high, with an attendance rate of over 90%.
Parents described RAP-P as very interesting, useful, and helpful. They reported that the resilience building approach of RAP-P was valuable in getting them “unstuck” and allowed them to engage in positive problem solving. Further, parents reported that they would strongly recommend this to other families.
This research is an exciting new development that provides support for using a strengths-based and family-focused approach to effectively prevent and treat youth suicidality. Although such systemic interventions might seem to be more resource-intensive, their effectiveness and lasting positive outcomes highlight their significant value.
Trials of RAP-P combined with RAP-A show no additive effect to RAP-A on its own. Evaluations of the program (Ham D., & Shochet I. 2006) show an improvement in parent perceptions of their efficacy as parents.
No positive effect on depression in adolescents was found, nor did the adolescents report an improvement in perception of family function.
Parent evaluations of the program have been very positive. An example of parent ratings on a 5 point Likert scale can be seen below:
|1.||How much value were the sessions to you as a parent of a teenage child?||3||5||4.41||0.64|
|2.||How much has the program helped your confidence in yourself as a parent?||3||5||4.41||0.64|
|3.||Will the program help you to deal with any stress as a parent?||3||5||3.89||0.64|
|4.||Do you think you feel more positive about parenting after doing the program?||3||5||4.26||0.66|
|5.||Will the program help you deal with any conflict with your teenager?||2||5||3.93||0.62|
|6.||Would you recommend the parent program to other parents of teenagers?||3||5||4.67||0.62|
|7.||Overall, how would you rate the usefulness of the RAP Parent Program?||3||5||4.48||0.70|
|8.||Overall, how enjoyable was the RAP Parent Program?||4||5||4.59||0.50|
What parents have said about the program
In response to the question “What did you like about the RAP Parent Program Workshops?” parents said;
“I liked the ability to exchange ideas with other parents of teenagers. It was nice to know that other parents share the same problems with their adolescents. The workbook was very well put together and I am sure it will be very useful in the future.”
“I was keen to participate every session and on the last one it seemed sad that it had been completed.”
“It gave me the opportunity to step back, reflect about my relationship with children and decide that with a little effort things go okay.”
“Reinforced my ideas and gave me some new ones and gave me hope for my children's future.”
“Made me realise that there are many ways to sort out issues and to look for ways to appreciate my children as they are and not how I'd like them to be.”
Parent examples of program use:
“When dealing with television and homework issues, we have tried to negotiate rather than dictate separate times and to involve our son in the process.”
“I’ve tried not to be too serious, and to use a sense of humour. I drive my daughter to school and she's often upset about something – I try to tell a joke about it or a humorous story from my own experience.”
“My daughter has quite a manipulative group of friends, and I've really tried to reinforce her expressing her own opinions. I tell her openly that her opinion is just as valid as anyone else's.”
“I use the ideas from the booklets all the time, always trying to be positive and encouraging.”
“We actually found the booklets helpful for managing our older son. We knew there was a situation where something was going on for him, but we didn't know what. Though we were tempted to go in with guns blazing, we decided to approach very softly making sure he knew that the door was open for him and that we were there to support him. It turned out that he had a drinking problem, which is now resolved because he felt comfortable approaching us.”
“I generally changed my methods, attitudes and perspectives to try to look at our teenager as an individual with feelings. The changes were gradual but they generalized over time.”