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Dissemination of an evidence-based intervention to parents of children with behavioral problems in a developing country

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Abstract

This project describes the dissemination of an evidence-based parenting skills intervention by training social and health workers with little or no mental health background so that they themselves train mothers of children with behavioral problems in impoverished communities in a developing country. The Strengths and Difficulties Questionnaire was completed by mothers to screen for children with behavioral problems and was repeated at the end of the intervention. Pre- and post-tests of knowledge and parenting attitudes were administered to mothers. Mental health workers trained social and health workers in social development centers and dispensaries. Each social and health worker trained mothers of children with behavioral problems under supervision utilizing an Arabic adaptation of the treatment manual for externalizing disorders “Helping Challenging Children” developed by the Integrated Services Taskforce of the World Psychiatric Association Child Mental Health Presidential Programme. A total of 20 workers and 87 mothers participated in the training. The proportion of children who obtained an SDQ total difficulties score in the abnormal range decreased from 54.4 to 19.7% after the training. Whereas 40.2% of mothers used severe corporal punishment with their children before the intervention, this decreased to 6.1% post-intervention. Three-fourths of mothers related that the program helped them develop new parenting skills. This pilot project demonstrated the feasibility of dissemination of a manual-based intervention and training of workers who have little background in mental health to offer effective services to families in impoverished communities who otherwise would have not received them. Successful replication in other developing countries would pave the way to incorporating such programs in national policies given their potential sustainability and cost-effectiveness.

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Acknowledgments

We thank Dr. Mohammad Kanaan and Mrs. Wafaa Kanaan from the Lebanese Ministry of Public Health, Mrs. Viviane Haddad and Mrs. Salam Chreim from the Lebanese Ministry of Social Affairs and Dr. Elie Mikhael and Mrs. Sanaa Awada from the Lebanese Higher Council for Children (HCC) for their coordination and collaboration to implement this project. We also wish to thank all the social and health workers from the various centers affiliated with the Ministries of Public Health and Social Affairs for their work on the field and their collaboration with the IDRAAC team. Finally, we would like to thank Dr. Peter Jensen and Dr. Ahmad Okasha for their valuable comments on the manuscript, as well as all the members of the Integrated Services Program Task Force for their work on bringing the manual to life. This project was supported by a grant from Oxfam-Quebec, in association with the Canadian Fund for Social Development (CFSD) and Canadian International Development Agency (CIDA) as well as the Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut, Lebanon.

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Authors and Affiliations

  1. Department of Psychiatry and Clinical Psychology, Faculty of Medicine, Balamand University, PO Box 166227, Ashrafieh, Beirut, 1100 2110, Lebanon

    John A. Fayyad, Youmna Cassir & Elie G. Karam

  2. Department of Psychiatry and Clinical Psychology, St Georges Hospital University Medical Center, PO Box 166227, Ashrafieh, Beirut, 1100 2110, Lebanon

    John A. Fayyad, Youmna Cassir & Elie G. Karam

  3. Institute for Development Research Advocacy and Applied Care (IDRAAC), PO Box 166227, Ashrafieh, Beirut, 1100 2110, Lebanon

    John A. Fayyad, Lynn Farah, Youmna Cassir, Mariana M. Salamoun & Elie G. Karam

  4. Medical Institute for Neuropsychological Disorders, Beirut, Lebanon

    John A. Fayyad, Lynn Farah, Youmna Cassir & Elie G. Karam

Authors
  1. John A. Fayyad
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  2. Lynn Farah
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  3. Youmna Cassir
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  4. Mariana M. Salamoun
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  5. Elie G. Karam
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Correspondence to John A. Fayyad.

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Fayyad, J.A., Farah, L., Cassir, Y. et al. Dissemination of an evidence-based intervention to parents of children with behavioral problems in a developing country. Eur Child Adolesc Psychiatry 19, 629–636 (2010). https://doi.org/10.1007/s00787-010-0099-3

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  • DOI: https://doi.org/10.1007/s00787-010-0099-3

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