Children of Mentally Ill Parents-Network - CHIMPS-NET
Study Details
Study Description
Brief Summary
In order to identify psychological stress in children and adolescents of mentally ill parents as early as possible, four special intervention programs (CHIMPS-therapy, CHIMPS-Prevention-single, CHIMPS-prevention-group, iCHIMPS) have been developed. These four intervention programs are based on the initial medical situation, indication and need of the families. Thereby, an individually tailored counseling service will be provided. With this current project, the four counseling approaches will be tested at 20 study sites in 15 federal states in Germany. Moreover, the interventions long-term efficacy will be evaluated.
| Condition or Disease | Intervention/Treatment | Phase |
|---|---|---|
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N/A |
Detailed Description
The central objectives of the study at hand are the implementation, evaluation and transfer of three evidence-based innovative forms of care (CIMPS-Therapy, CHIMPS-Prevention-Group, CHIMPS-Prevention-Single) for children and adolescents (aged 3 to 18 years) with mentally ill parents at the 21 participating study cites in 15 federal states of Germany. In addition, iCHIMPS, an online intervention based on the CHIMPS concept for the whole family, will be developed.
The four innovative forms of care include diagnostic, prevention and - if needed - therapy in order to treat psychological symptoms of children and adolescents as early as possible. Thereby, chronification will be prevented and the cycle of transgenerational transmissions of psychiatric disorders will be broken. Each of the four interventions will be evaluated in a separate prospective, randomized-controlled trial (RCT); overall, four randomized-controlled trials will be performed. Each of the four control groups receives treatment as usual (TAU). Each of the four studies will include two groups: one intervention group (IG) and one control group (KG), i.e. CHIMPS-T vs. KG (TAU), CHIMPS-P-group vs. KG (TAU), CHIMPs-P-single vs. KG (TAU), iCHIMPS vs. KG (TAU). Central psychosocial outcomes will be assessed at four time points (t1, t2, t3, t4) at baseline as well as after six, 12 and 18 months. Due to a longer development period, iCHIMPS will have three times of measurement over a period of nine months (baseline, post-intervention after 2 months as well as six-months-followup) within the project term. Outcomes will be assessed from the perspectives of the mentally ill parent, the partner (if available), every child and adolescent (0 - 9 years only external assessment; from 10 years of age additional self-assessment) and the professionals. A special characteristic of the study at hand is the comprehensive accompanying evaluation of medical biometry, health economics and qualitative evaluation.
In addition, various sub-projects for systematic implementation will be conducted:
optimization of pathway to care, Knowledge and skills of professionals, development of a screening instrument and external quality assurance. In order to evaluate the effect of these three implementation strategies, an implementation study with a cluster-randomized trial was designed. Nineteen clinical centers are taking part in the implementation study. Nine of the nineteen clinical centers will receive the support of one of the three implementation strategies, the other ten clinical centers make up the control group and do not get a specific implementation support. The allocation is randomized. With three questionnaires in the investigator's implementation study we want to identify factors hindering or promoting implementation processes.
Study Design
Arms and Interventions
| Arm | Intervention/Treatment |
|---|---|
| Experimental: CHIMPS-T (Children of mentally ill parents) is a family-oriented lowfrequency brief therapy for diagnosis and treatment of mental disorders in children and adolescents. CHIMPS-T is based on a theory model, needs analyses and the pioneering studies of Williams Beardslee. The CHIMPS approach was tested, evaluated and manualized in an initial project (2007-2011). |
Behavioral: CHIMPS-T
CHIMPS-T (Children of mentally ill parents) is a family-oriented lowfrequency brief therapy for diagnosis and treatment of mental disorders in children and adolescents.
|
| Experimental: CHIMPS-P-single CHIMPS-P-single is a family-oriented prevention for children and adolescents without signs of mental disorders in the initial screening. These families will receive the 3 family sessions from the modular CHIMPS intervention. The sessions will be carried out by a social worker (based on the Finnish model "Let's talk about children (Solantaus), but in a family setting "Let's talk WITH children"). |
Behavioral: CHIMPS-P-single
CHIMPS-P-single is a family-oriented prevention for children and adolescents without signs of mental disorders in the initial screening. These families will receive the 3 family sessions from the modular CHIMPS intervention.
|
| Experimental: The CHIMPS-P-group The CHIMPS-P-group is a prevention with a multi-family setting based on the CHIMPS approach. The multi-family intervention comprises 8 sessions for children and adolescents without psychiatric disorders and their families: preliminary talk, one additional session with the family (if needed), multifamily group with three to six other families, concluding session. |
Behavioral: CHIMPS-P-group
The CHIMPS-P-group is a prevention with a multi-family setting based on the CHIMPS approach. The multi-family intervention comprises 8 sessions for children and adolescents without psychiatric disorders and their families.
|
| Experimental: iCHIMPS iCHIMPS is an online intervention. In terms of content, iCHIMPS is based on the CHIMPS program as well as on other evidence-based interventions of the study group. iCHIMPS will also be comprised of one module for children and adolescents as well as one module for parents; moreover; modules for the family system will be included. Overall, 8 consecutive online modules as well as elective modules will be included. These modules (e.g., dealing with difficult situations, emotion regulation, taboos and shame, self-worth) will be provided based on the specific constellation of children and adolescents of mentally ill parents. iCHIMPS will be completed by 2 booster session within a six months follow-up. |
Behavioral: iCHIMPS
iCHIMPS is an online intervention. In terms of content, iCHIMPS is based on the CHIMPS program as well as on other evidence-based interventions of the study group. iCHIMPS will also be comprised of one module for children and adolescents as well as one module for parents; moreover; modules for the family system will be included.
|
| No Intervention: Treatment as usual The treatment as usual implies that families of the control group receive the treatment that is customary in regular care. Thus, these families normally don't receive any post-treatment. If, however, a member of a control group family appears to have an urgent need for treatment (every family receives a comprehensive diagnostic investigation at the beginning of the study), the respective family will be placed in the ambulatory care system. |
Outcome Measures
Primary Outcome Measures
- Children's and adolescent's psychiatric symptomatology (CBCL) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Children's and adolescent's psychiatric symptomatology, assessed from the perspective of the parents by the Child Behaviour Checklist (CBCL 1,5-5; Achenbach & Rescorla, 2000), (CBCL 6-18R; Döpfner, Pflück, Kinnen, & Arbeitsgruppe Deutsche Child Behavior Checklist, 2014).
Secondary Outcome Measures
- Sociodemographic information [At baseline of the study]]
Sociodemographic information of the parents, assessed from the perspective of the parents.
- Psychiatric disorders of the children and adolescents (YSR) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Psychiatric disorders of the children and adolescents, assessed from the perspective of the parents by the "Youth Self Report" (YSR; Döpfner, Pflück, Kinnen & Arbeitsgruppe Deutsche Child Behavior Checklist, 2014).
- Psychiatric disorders of the children and adolescents (K-SADS-PL) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Psychiatric disorders of the children and adolescents, assessed from the perspective of an external rater by the Kiddie-SADS (K-SADS-PL) (Delmo, Weiffenbach, Gabriel, Stadler & Poustka, 2001).
- Psychiatric symptomatology of the children and adolescents (GAF) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Psychiatric symptomatology of the children and adolescents, assessed from the perspective of an external rater by the "Global Assessment of Functioning" (GAF; Saß, Wittchen, Zaudig & Houben, 2003).
- Mental health of the parents (BSI) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Mental health of the parents, assessed from the perspective of the parents by the "Brief Symptom Inventory" (BSI; Franke, 2000).
- Mental health of the parents (PHQ) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Mental health of the parents, Mental health of the parents, assessed from the perspective of the parents by the "Patient Health Questionnaire" (PHQ; PHQ; Löwe, Spitzer, Zipfel & Herzog, 2002).
- Mental health of the parents (GAF) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Mental health of the parents, assessed from the perspective of an external rater by the "Global Assessment of Functioning" (GAF; Saß, Wittchen, Zaudig & Houben, 2003).
- General anxiety of the parents (GAD-7) [Change from baseline of the study at 6,12 and 18 months after the randomization]
General anxiety of the parents, assessed from the perspective of the parents by the "Gerneralized Anxiety Disorder-7" (GAD-7; Kroenke, Spitzer, Williams, Monahan, & Löwe, 2007).
- Health-related quality of life of the parents (SF-12) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Health-related quality of life of the parents, assessed from the perspective of the parents by the "Short Form 12" (SF-12; Bullinger & Kirchberger, 1998)
- Health-related quality of life of the parents (EQ-5D) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Health-related quality of life of the parents, assessed from the perspective of the parents by the EQ-5D (EQ-5D; Brooks, Rabin & Charro, 2003; Hinz, Klaiberg, Brahler & Konig, 2006).
- Health-related quality of life of the children and adolescents (KIDSCREEN) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Health-related quality of life of the children and adolescents, assessed from the perspective of the child/adolescent (from 10 years of age) and from the perspective of the parents by the Kidscreen-27 (The KIDSCREEN Group Europe, 2006).
- Family functioning (GARF) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Family functioning, assessed from the perspective of an external rater by the "Global Assessment of Relational Functioning" (GARF; Saß, Wittchen, Zaudig & Houben, 2003).
- Family functioning (FB-A) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Family functioning, assessed from the perspective of the parents and the children and adolescents (from 10 years of age) by the "Allgemeiner Familienfragebogen" (FB-A; Cierpka & Frevert, 1995)
- Social support of the parents (OSSQ) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Social support of the parents, of the children and adolescents, assessed from the perspective of the parents, of the children and adolescents (from 10 years of age) by the "Oslo Social Support Questionnaire" (OSSQ; Dalgard, 2006).
- Parental stress coping (EBI) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Parental stress coping, assessed from the perspective of the parents by the "Elterliches Belastungsinventar" (EBI; Tröster, 2010).
- Treatment evaluation (FBB) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Treatment evaluation, assessed from the perspective of the parents, the children and adolescents (from 10 years of age) as well as from the therapist by the "Fragebogen zur Behandlungsbeurteilung" (FBB; Mattejat & Remschmidt, 1999).
- Satisfaction with the treatment (ZUF-8) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Satisfaction with the treatment of the parents, of the children and adolescents, assessed from the perspective of the parents and from the perspective of the children/adolescents (from 10 years of age) by the "ZUF-8" (Schmidt, Lamprecht & Wittmann, 1989).
- Therapeutic activity and therapeutic processes (VPPS) [During the intervention]
Therapeutic activity and therapeutic processes, assessed from the perspective of the therapist by the "Vergleichende Psychotherapy Prozess Skalen" (VPPS; Beutel et al., 2016).
- Treatment costs (CAMHSRI-DE) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Treatment costs of the children and adolescents, assessed from the perspective of an external rater by the German version of the "Children and adolescent mental health services receipt inventory" (CAMHSRI-DE; Kilian, Losert, McDaid, Park, Knapp, Beecham, Kusakovskaja, Murauskiene & the CAMHEE Project, 2009).
- Treatment costs (CSSRI-DE) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Treatment costs of the parents, assessed from the perspective of an external rater by the German version of the "Client Socioeconomic and Services Receipt Inventory" (CSSRI-DE; Roick, Kilian, Matschinger, Bernert, Mory & Angermeyer, 2001).
- Family-oriented attitude (FFMHPQ) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Family-oriented attitude, assessed from the clinical employee's point of view by the German version of the "Family Focused Mental Health Practice Questionnaire" (FFMHPQ, Laser et al., 2019).
- Implementation components (ICQ) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Implementation components, assessed from the clinical employee's point of view by the German version of the "Implementation Components Questionnaire" (ICQ, Laser, Skogøy, Maybery & Wiegand-Grefe, 2019).
- Implementation Satisfaction (ISS) [Change from baseline of the study at 6,12 and 18 months after the randomization]
Implementation Satisfaction, assessed from the clinical employee's point of view by the German version of the "Implementation Satisfaction Scale" (ISS, Laser, Skogøy, Maybery & Wiegand-Grefe, 2019).
Eligibility Criteria
Criteria
Inclusion Criteria:
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Familiy with at least one psychiatrically ill parent (all F-diagnoses in ICD-10) and at least one child between the age of 3 and 18 years.
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Consent to participate in the study.
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Sufficient knowledge of the German language of parents and children.
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Insured with one of the participating insurance companies.
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Consent to data processing of the insurance companies.
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Consent to participation in special care (in case of interventions).
Exclusion Criteria:
Severe psychiatric disorders and impairments of parents or children with acute symptoms such as suicidal tendencies, severe depression, addictions, acute psychotic symptoms etc., which will not be sufficiently supplied by these new lowfrequency interventions.
Contacts and Locations
Locations
| Site | City | State | Country | Postal Code | |
|---|---|---|---|---|---|
| 1 | University Medical Center Universitätsklinikum Hamburg-Eppendorf, Klinik für Kinder- und Jugendmedizin | Hamburg | Germany | 20246 |
Sponsors and Collaborators
- Silke Wiegand-Grefe, Prof. Dr.
- Universitätsklinikum Hamburg-Eppendorf
- Charite University, Berlin, Germany
- University Medical Center Rostock
- Immanuel Klinik Rüdersdorf
- Evangelisches Klinikum Bethel
- Universitätsklinikum Köln
- University of Göttingen
- Ruhr University of Bochum
- University Hospital Tuebingen
- University Hospital Freiburg
- Josefinum Augsburg
- University Hospital Augsburg
- Klinikum der Universität München
- University Hospital, Saarland
- University of Magdeburg
- Helios Kliniken Schwerin
- Universitätsklinikum Marburg
- Universitätsklinikum Koblenz - Landau
- Pfalzklinikum
- Helios Klinikum Erfurt
- Bezirkskrankenhaus Günzburg
- DAK-Gesundheit Krankenkasse
- Techniker Krankenkasse
- BARMER
- BKK Mobil Oil
- KKH Kaufmännische Krankenkasse
- IKK Classic Krankenkasse
- AOK Hessen
- University of Ulm
- University Hospital Heidelberg
- aQua-Institut
- Leibniz Universität, Center for Health Economics Research Hannover
- AFET Bundesverband für Erziehungshilfe e.V.
- Dachverband Gemeindepsychiatrie
- AOK Baden-Württemberg
- LWL Klinik Gütersloh
Investigators
None specified.Study Documents (Full-Text)
None provided.More Information
Publications
None provided.- U1111-1244-6111