Elements that determine the effectiveness of interventions for families with multiple problems: towards more tailored care

This dissertation concerns the content and structure of eight interventions that appear to be effective for families with multiple and complex problems (FMP): which elements do these interventions consist of and which elements are helpful to FMP? It appears that the interventions differ hardly in terms of content and are equally effective. Many elements, such as learning parents parenting skills, are addressed in all interventions, but there are also elements that only occur in a part of the interventions or are hardly applied in practice. Parents and adolescents indicate that exactly these elements, such as activating the social network or focusing on the underlying cause of behavior, are helpful to them. Furthermore, the eight interventions mainly aim at the parent, while both adolescents and parents want children and adolescents to be involved in the intervention too. Adolescents and parents also find it important that the school and other professionals are involved in the care and that there are more options for follow-up care.

This dissertation also shows the importance of the framework within which the intervention is carried out. Regular intervision between professionals and regular telephone contact with the family appeared to make care more effective. This is where interventions distinguish themselves, because by no means all interventions have these elements.

We recommend to develop no new interventions for FMP, but to strengthen the valuable content of existing interventions. Taking the voice of FMP into account is essential in this respect so that interventions better matches their wishes and needs.