Armed conflict and forced displacement can significantly strain nurturing family environments, which are essential for child well-being. Yet, limited evidence exists on the effectiveness of family-systemic interventions in these contexts. We conducted a two-arm, single-masked, feasibility Randomised Controlled Trial (fRCT) of a whole-family intervention with Syrian, Iraqi and Jordanian families in Jordan. We aimed to determine the feasibility of intervention and study procedures to inform a fully-powered RCT. Eligible families were randomised to receive the Nurturing Families intervention or enhanced usual care (1:1). Masked assessors measured outcomes at baseline and endline; primary outcome measures were caregiver psychological distress, family functioning, and parenting practices. Families and implementing staff participated in qualitative interviews at endline. Of the 62 families screened, 60 (98%) were eligible, 97% completed the baseline and 90% completed the endline. Qualitative feedback indicated specific improvements in adolescent well-being, caregiver distress and parenting, and family relationships. Data highlighted high participant engagement and adequate facilitator fidelity and competence. Outcome measures had good psychometric properties (most α > 0.80) and sensitivity to change, with significant changes seen on most measures in the intervention but not control group. Findings indicate the acceptability and feasibility of intervention and study procedures. Subsequent full-scale evaluation is needed to determine effectiveness.

Suicide remains an important public health problem worldwide. Many countries have developed national suicide prevention policies or guidelines, which often include family-based recommendations regarding suicide prevention, intervention or postvention. A recent systematic review, published in this journal, failed to find evidence of an impact of family-based recommendations in national guidelines on national suicide rates. In this editorial, we review other studies providing promising evidence of effectiveness of family-based interventions in the field of suicide prevention and postvention, and note that further studies are needed, especially in adult and older adult populations.

Despite a rapidly growing understanding of hoarding disorder (HD), there has been relatively limited systematic research into the impact of hoarding on children and adolescents. The goal of this paper is to suggest future research directions, both for children with hoarding behaviours and children living in a cluttered home. Key areas reviewed in this paper include (1) the need for prospective studies of children with hoarding behaviours and those who grow up with a parent with HD; (2) downward extensions of cognitive-behavioural models of adult HD that emphasise different information processing and behavioural biases in youth HD; (3) developmental research into the presentation of emerging HD in childhood compared with adulthood presentations of the disorder, with consideration of typical childhood development and unique motivators for childhood saving behaviours; (4) developmentally sensitive screening and assessment; and (5) the development of evidence-based treatments for this population. The paper concludes with a discussion of methodological suggestions to meet these aims.

Drawing upon the Trace method developed by Selma Sevenhuijsen (2004), this paper has traced the discourse constructed in two key Troubled Families Programme (TFP) policy documents through the lens of care ethics, highlighting tensions between ‘care’ and ‘justice’ orientations in the neoliberal family intervention model. It is argued that whilst the family intervention model advocated has the potential to provide families with support underpinned by an ethic of care, the TFP's managerialist tendencies also create challenges to the integration of care ethics within such services. Given that the programme's financial framework generates considerable opportunity for local variation in policy implementation, the ethics of care offer a valuable moral framework by which to evaluate local practice. Moreover, engaging with a distinctly feminist ethic of care renders visible to family support services the inequalities produced through the gendered distribution of ‘caring’ responsibilities, and highlights the need for interventions to address rather than reinforce these inequalities.

The Troubled Families Programme has provided an impetus for interventions with families with multiple disadvantages. This article identifies the prevalence of a government discourse of ‘empowerment’ around such interventions, which fails to reflect the contested nature of the term. Qualitative interviews with families supported by the programme and their keyworkers offer an insight into their experiences and a valuable alternative to government rhetoric. It is argued that government discourses equate ‘family empowerment’ with responsibilisation, seeking to reduce the resources deployed in supporting families whilst strengthening state power to define acceptable forms of family life. By contrast, family and keyworker discourses of ‘empowerment’ are founded in the redistribution of resources towards such families, advocacy strategies, psychological support and an understanding of power relations within and beyond families, which enable families to resist specific attempts at the exercise of professional power, albeit remaining subject to a more general exercise of state control.

Objective Description of burden, attitudes and received professional support in a sample of relatives of patients with schizophrenia, recruited in 8 Italian Mental Health Sservices (MHS), stratified by geographic areas and population density.Design - Cross-sectional study on key-relatives of clinically stable patients with a DSM-IV diagnosis of schizophrenia. Evaluation of: a) relationships of family burden with patient's clinical characteristics, family's sociodempgraphic variables, relative's attitudes toward the patient, professional and social support received by the family; b) differences in the levels of burden, attitudes and support received by the family with respect to geographical area and population density.Setting - 8 Italian MHS stratified by geographic areas (Northern, Central, Southern Italy) and population density (urban vs. rural areas).Main outcome measures - Patient's clinical status and social functioning: BPRS and ADC. Family burden, attitudes and support received by the family: FPQ.Results - Data on 144 patients and their key-relatives were collected. Higher levels of burden were found among relatives referring to Southern MHS. The burden was found positively correlated with the levels of patients' BPRS positive and manic/hostility symptoms and disability, and with the number of daily hours spent by the relative in contact with the patient, and negatively correlated with the levels of professional support received by the family. Conclusions - The results of this study highlight the need to provide rehabilitative programmes for patients with schizophrenia as well as informative and psychoeducational interventions for their families.