Session: Unpacking the Black Box of Family Interventions to Improve Our Understanding of How They Work, and How to Improve Them (Society for Prevention Research 26th Annual Meeting)

Family intervention is a key prevention strategy to reduce children’s mental health problems. Yet, many questions remain about the processes underlying how family intervention works. This knowledge is vital, first, to learn more about the nature and magnitude of the impact of changes in family dynamics on child development, and second, to guide efforts to optimize the effectiveness and efficiency of family intervention as a prevention strategy. This symposium brings together researchers committed to shed light on these issues.

Most intervention evaluation research relies on trials comparing a “package-deal” intervention to a control condition. These trials are invaluable for informing prevention workers on interventions that are less or more effective. These trials cannot, however, inform us on why a family intervention does or does not work; they leave unanswered which family intervention components actually drive intervention effects, and the mechanisms through which they operate.

The first presentation provides an overview of research strategies (e.g., testing associations between intervention components and intervention effects and microtrials) that prevention scientists can use to identify the effective components of interventions. It includes examples of how these strategies are currently applied to family intervention, and how their findings have improved our understanding of how family interventions work. The second presentation applies several of these strategies to the field of family intervention. In meta-analyses of immediate and longer-term effects of family interventions, researchers identified discrete intervention components associated with intervention effects. Findings include evidence that different components matter for treatment versus prevention settings, highlighting the need for interventions developed or adjusted for prevention purposes specifically. The third presentation addresses underlying mechanisms of change of a family intervention in Kenya. They authors use a novel combination of methods to disentangle the processes by which families change and the components of the intervention and implementation that drive those changes. Findings include that changes in marital communication and violence play a key role in triggering sequences of change leading to improved child mental health. Intervention components associated with change included communication skills training and facilitating solution-focused communication during sessions.

In sum, these presentations use novel methods to unpack the “black box” of family interventions: they help identify the intervention components that drive intervention effects, and the mechanisms underlying these effects. Findings help improve our understanding of how family intervention works, and provide sound guidance on how to optimize intervention delivery and benefit.