BEST-Foundations: a mixed methods exploration of the feasibility of a novel intervention treating internalising symptoms in children

ABSTRACT

Objective

Internalising disorders are one of the most common mental health problems in children under 12 years, yet mixed findings exist for current treatment options. This pilot involves a novel 10-session intervention, BEST-Foundations, to treat internalising symptoms in children using a family-inclusive model. Initial findings and feasibility using a mixed-methods approach are reported.

Method

Twenty-two participants from eight families (n = 8 children; n = 8 mothers; n = 6 fathers) participated in an uncontrolled single treatment design. Included children (aged 3–11 years) reported clinical-level internalising symptoms on the Child Behaviour Checklist. Data were collected across four timepoints: baseline, pre-intervention, post-intervention, and 4-weeks follow-up.

Results

As predicted, mothers reported large improvements in child internalising symptoms pre-post (SMD = −.83; 95% CI = 50.58–70.42) and maintained pre to follow-up (SMD = −.92; 95% CI = 50.14–69.11). Sustained improvements were also found in externalising problems and total problems. Qualitative analysis indicated families reported positive improvements in targeted areas including parent confidence and parent–child relationships.

Conclusions

Findings demonstrate initial feasibility data and effect size estimates comparable to previous trials using the “BEST” framework, and larger than CBT-based interventions. Results are considered preliminary due to the small sample. Further evaluation is warranted, showing the value of family-inclusive interventions to treat child internalising problems.

KEY POINTS

What is already known about this topic:

1. Modifiable family-based risk and protective factors influence internalising symptoms in children.

2. Currently, inconclusive support exists for targeted treatment options for child internalising symptoms, highlighting the need to explore novel, feasible, evidence-based approaches for children under 12 years.

3. Parental involvement in treatment is considerably heterogeneous, and the inclusion of fathers is lacking.

What this topic adds:

1. The BEST-Foundations intervention translates from theory to practice, demonstrating initial feasibility with families in improving internalising symptoms in children under 12 years.

2. Fathers may express initial hesitation, yet engaging them in treatment is important.

3. Parents reported improved confidence and perspective taking after taking part in the BEST-Foundations intervention.

KEYWORDS:

• Attachment
• child
• family-inclusive
• feasibility
• internalising symptoms
• intervention

Acknowledgements

This paper summarises research reported in Michelle L. Benstead’s thesis. Michelle Benstead was the recipient of an Australian Rotary Health Youth Mental Health scholarship for her PhD. Michelle would like to express gratitude to the Rotary Club of Richmond in conjunction with Motto Fashions, and Deakin University for their financial assistance. The authors would also like to thank the staff at Drummond Street Services for their contribution, as well as Deakin students Jo Hansen and Claire Joseph.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Data availability statement

Data are available by contacting Michelle L. Benstead.

Supplementary material

Supplemental data for this article can be accessed at https://doi.org/10.1080/00050067.2023.2282544.