Two programs that produced mental health outcomes each were tested in a single randomized controlled trial. The Family Bereavement Program was tested in a randomized controlled trial involving 156 families. Compared with a literature-only control, results for parents in the program included improved positive parenting, mental health, and coping and a reduction in stressful life events; for children, inhibition of expression of feelings was reduced. No effects were found on measures of children’s mental health (Sandler, Ayers, et al., 2003). At 11-month follow-up, the program participants continued to show improvement, and children who had greater internalizing problems when they began the program showed significant decreases. In addition, girls in the intervention condition showed a reduction in externalizing and internalizing problems compared with girls in the control condition (Schmiege, Khoo, et al., 2006).

Rotheram-Borus, Lee, and colleagues (2001) report on a randomized controlled trial of an intervention targeting adolescents living with a parent in terminal stages of HIV/AIDS. The program helped parents discuss their disease with their children, prepare them for the transition to a new caretaker, and facilitate their coping. Benefits were also found at two years (Rotheram-Borus, Stein, and Lin, 2001) and four years (Rotheram-Borus, Lee, et al., 2003) postintervention.

Child Maltreatment

Programs that target child maltreatment have the potential to prevent multiple MEB disorders and promote healthy development across several domains of functioning. One meta-analysis reviewed 40 evaluations of selective interventions providing early support (prenatal to age 3) to families at high risk for child maltreatment (Geeraert, Noortgate, et al., 2004). The authors found a significant decrease in abusive and neglectful acts and a significant risk reduction in such factors as child, parent, and family communication and functioning.

A meta-analysis by MacLeod and Nelson (2000) reviewed multiple programs designed to promote family wellness and prevent maltreatment of children up to age 12. Examples included home visiting; community-based, multicomponent interventions (providing services such as family support, preschool education or child care, and community development); media interventions; and intensive family preservation services (in-home support programs for families in which maltreatment had already occurred). The study concluded that most interventions designed to promote family wellness and prevent child maltreatment are successful. Effect sizes were largest for measures of family wellness and smaller for verified or proxy measures of child maltreatment. Differences were also reported between reactive interventions (in response to an incident of maltreatment), which had larger

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