Preparation of the Family Bereavement Program for Adoption, and Sustained Implementation As a Community Service

This presentation will describe research that provided evidence for the efficacy of the Family Bereavement Program (FBP), studies to investigate the readiness of agencies to adopt the program and the development of consumer centered approach to our translational research. The FBP was designed to promote resilience of parentally bereaved children and their bereaved parents. Death of a parent is associated with an increased risk for multiple behavioral health problems for children and their bereaved parents. The FBP was designed as a manualized 12 session group, with components for children, adolescents and their caregivers. The program teaches parenting and child coping that research found to be associated with better outcomes for children. A randomized trial with 156 families and 244 children and adolescents found a broad range of short and long-term benefits of the program. At the six-year and fifteen year follow-ups the program was found to reduce mental health problems and persistent distressing grief for children. For bereaved parents the FBP led to a strengthening of positive parenting and reduction in their own mental health and substance use problems and persistent complex bereavement disorder six years later. Strengthened parenting partially mediated program benefits for children. Encouraged by these findings we conducted two pre-adoption translational research studies. A national survey of 122 agencies providing services to bereaved children (85% response rate) yielded several findings with important implications for FBP dissemination. Agencies primarily provided services for children, and felt very positively about these services. Although few programs provided services for parents, many were considering developing such services. A pilot study tested the implementation of the FBP in two bereavement agencies, and found that although the program could be delivered it was exhausting for the agency and could not be sustained. These experiences led to three decisions about our approach to translating the FBP from an experimental prototype into a sustainable community service. First, because improved parenting was a mediator of positive program effects, and there was community interest in developing services for parents we decided to focus on disseminating the parenting component. Second, the program would need to be redesigned to be a sustainable service that met the needs of parents, group leaders and agencies. Third, we would need to use a user-centered approach to redesign as a collaboration with parents, leaders and agencies to ensure that the program was acceptable and feasible for implementation.