Outcomes and Mechanisms of Change of the Strengthening Families Program in a Clinical Sample of Children and Their Families in Austria

Family context and parenting behavior have the greatest influence on children's mental health and well-being, and interventions that take the whole family system into account are promising. This study aims to evaluate the outcomes, i.e., family strength, parenting behavior, and child behavior, of the Strengthening Families Program (SFP), developed by Kumpfer which was implemented in an outpatient clinic of a community-based non-governmental organization in Austria between 2012 and 2018. Furthermore, the program's mechanism of change as formulated by the program authors (i.e., to what extent parenting behavior mediates the relationship between family strength and child behavior) was tested in this clinical sample. Instruments measuring family strength, parenting behavior, and child behavior were administered before, immediately after, and 6 months after participation in the SFP. To test the mechanisms of change, a half-longitudinal model was applied with two measurement points (before and after). A total of 62 families (50 boys, 24 girls, and 69 parents) participated in the culturally adapted SFP. Regarding the outcomes of the program, all variables yielded significant improvement in all variables. With respect to the mechanism of change, no significant association between the variables could be found. Implications for the implementation of the SFP in a clinical population and how further adaptation of the program could enhance the adherence of this target group are discussed.