Publication year
2016
Citation Title
The effects of the family bereavement program to reduce suicide ideation and/or attempts of parentally bereaved children six and fifteen years later.
Journal Name
Suicide and Life-Threatening Behavior
Journal Volume
46
Issue Number
S1
Page Numbers
S32-S38
DOI
10.1111/12256
Summary
Youth who experience the death of a parent may be at increased risk for later suicide. Parentally bereaved youth and their caregivers completed a Family Bereavement Program, which teaches youth coping skills and caregivers positive parenting skills; youth suicidal ideation and suicide attempts were compared with controls at six and 15-year follow-ups. Teaching positive parenting and child coping skills may reduce risk for bereaved youth's suicidal ideation or suicide attempts many years later.
Key Findings
Parental causes of death were illness (67%), accident (20%), and homicide or suicide (13%).
The Family Bereavement Program decreased youth’s suicidal ideation and suicide attempts marginally at the six-year follow-up and significantly at the 15-year follow-up.
Approximately 10% of youth who received the Family Bereavement Program were prevented from experiencing suicidal ideation or suicide attempts across the 15-year follow-up period.
Implications for Military Professionals
Facilitate support groups for families of deceased Service members to teach healthy coping skills
Develop educational online modules for bereaved military family members who are parents to learn how to use positive parenting skills, even during bereavement
Implications for Program Leaders
Educate military parents about the risk and protective factors for suicidal ideation and mental health disorders for youth who have experienced the death of a parent
Offer workshops to military families to discuss when and where to find help for suicidal ideation or intent for themselves and their children
Implications for Policy Makers
Recommend education of professionals (e.g., mental health workers, educators, childcare workers) about suicide risk among parentally bereaved military youth
Continue to support programs that provide support groups, coping skills training, and mental health referrals for military families who have experienced the death of a Service member
Methods
Youth who had experienced the death of a parent within the past three to 30 months were recruited through community schools, agencies, and media advertisements.
Youth and caregivers were randomly assigned to the Family Bereavement Program, which taught positive parenting and effective coping skills, or the control group, which provided books and a study guide on grief.
Youth and their caregivers in the Family Bereavement Program completed measures of youths’ internalizing and externalizing problems, bereavement, and suicidal ideation and attempts.
Treatment groups were compared on levels of suicidal ideation and suicide attempts at pre- and postintervention and at six-year and 15-year follow-ups (14% attrition).
Participants
Participants included 244 youth (135 Family Bereavement Program, 109 control group), ages 8-16 years (M = 11.39, SD = 2.43) whose parent had died, and the youth’s caregivers.
Youth or caregivers who reported baseline suicidal ideation were excluded from the study.
Participants identified as White (67%), Latino (16%), Black (7%), and “other” races (10%).
Limitations
Measures of suicide plans or the duration or intensity of suicidal ideation were not included.
Measures of suicidal ideation and suicide attempts were combined and were only measured for the previous six months, decreasing clarity of results and potentially underestimating risk.
Participants were excluded for suicidal ideation at baseline, limiting generalizability.
Comparisons between control and treatment groups at pre- and post-intervention were not provided, and it is unclear whether groups had pre-existing differences at baseline.
Avenues for Future Research
Explore the effectiveness of the Family Bereavement Program for military families and youth in reducing long-term suicide risk following a parent’s death
Examine potential pathways through which the Family Bereavement Program may impact later youth suicide risk, including environmental factors such as positive parenting
Investigate whether positive parenting education improves parenting skills among bereaved spouses
Focus
Civilian
Target Population
Population Focus
Abstract
This study reports on the findings from a 6-year follow-up of a randomized trial of the Family Bereavement Program (FBP) on the outcomes for spousally bereaved parents. Spousally bereaved parents (N = 131) participated in the trial in which they were randomly assigned to receive the FBP (N = 72) or literature control (N = 59). Parents were assessed at four time points: pretest, posttest, and 11-month and 6-year follow-up. They reported on mental health problems, grief, and parenting at all four time periods. At the 6-year follow-up, parents reported on additional measures of persistent complex bereavement disorder, alcohol abuse problems, and coping efficacy. Bereaved parents in the FBP as compared to those in the literature control had lower levels of symptoms of depression, general psychiatric distress, prolonged grief, and alcohol problems, and higher coping efficacy (for mothers) at the 6-year follow-up. Multiple characteristics of the parent (e.g., gender, age, and baseline mental health problems) and of the spousal death (e.g., cause of death) were tested as moderators of program effects on each outcome, but only 3 of 45 tests of moderation were significant. Latent growth modeling found that the effects of the FBP on depression, psychiatric distress, and grief occurred immediately following program participation and were maintained over 6 years. Mediation analysis found that improvement in positive parenting partially mediated program effects to reduce depression and psychiatric distress, but had an indirect effect to higher levels of grief at the 6-year follow-up. Mediation analysis also found that improved parenting at the 6-year follow-up was partially mediated by program effects to reduce depression and that program effects to increase coping efficacy at the 6-year follow-up was partially mediated through reduced depression and grief and improved parenting. FBP reduced mental health problems, prolonged grief, and alcohol abuse, and increased coping efficacy of spousally bereaved parents 6 years later. Mediation pathways for program effects differed across outcomes at the 6-year follow-up.
Abstract Document
Attach