Dialogical Family Guidance in Families with a Child with Neurodevelopmental Disorders: Implementation and Outcomes

Diana Cavonius-Rintahaka

Research output: Book/ReportDoctoral thesisCollection of Articles

Abstract

The purpose of this study is to develop and implement a family intervention, Dialogical Family Guidance (DFG) and to evaluate the outcomes of the intervention regarding family functioning, health, and social support in families with a child with neurodevelopmental (neuropsychiatric) disorder (NDD). FAFHES-instrument (Family functioning, family health, and social support) was modified and tested in the study. Furthermore, parents` hopes and expectations regarding the support they receive from health care professionals are described.

The study aims to increase the knowledge and understanding concerning family functioning, health, and their experiences of received social support of families with a child with NDD. The summary of this dissertation integrates and synthesises findings from the three research publications included in this submission, including a Pilot study, DFG development- and implementation study, and a Randomized clinical study.

Data was collected in the Pilot study (2012-2014) using the modified FAFHES instrument. The participants included in the Pilot study (n=29) were families that had a child between 4-16 years old with NDD and who had a new referral to the Helsinki University Hospital (HUH) neurocognitive/neuropsychiatric unit. The modified FAFHES was found to be suitable for purpose. The data collected in the Pilot study was analyzed using statistical methods and open-ended questions were analyzed using inductive content analysis. The results of the Pilot study show a positive correlation between family functioning and family health. At baseline, there were no differences between mothers’ and fathers’ experiences regarding family functioning, health, or social support. No significant change was reported during the three-month follow up regarding family functioning, health or social support.

DFG development and implementation study included data collected from DFG training participants during 2015-2019 using a tailored questionnaire, on the last day of a threeday DFG training session. Twenty-six professionals (n=26) taking part in the DFG training programme filled the questionnaire. The data was analyzed by using statistical methods and open-ended comments were reported as a summary. Professionals reported high levels of satisfaction in the DFG training, and positively anticipated DFG being able to offer new ways to support families.

A modified FAFHES instrument and a tailored DFG instrument were used for data collection in the Randomized clinical study (2016-2018). Participants included in the Randomized clinical study (n=50) were families that had a child between 4-16 years old with NDD and who had a new referral to HUH neuropsychiatric unit. Randomization was achieved in the Randomized clinical study by placing alternate families into an intervention group (n=23) that received the DFG intervention immediately as well as ordinary clinical treatment, or a comparison group (n=19) that received only the ordinary clinical treatment. Parent questionnaires were completed by families taking part in the study before and immediately after they had received the DFG family intervention (intervention group). The DFG family intervention included six meetings within a three-month period. Parents in the comparison group filled out the FAFHES questionnaire twice, as baseline and three-month follow-up responses. The FAFHES and DFG questionnaires were analyzed by using statistical methods and the open-ended questions were analyzed by inductive content analysis.

The Randomized clinical study demonstrated that social support increased more in the intervention group than in comparison group. Managing in daily life and the relationship between parents were associated with family functioning and family health. However, while the experience of family health increased to some degree after DFG, family functioning did not. Parents reported high degrees of satisfaction and experienced the DFG intervention as empowering and needed. Importantly, DFG helped them to manage better in daily life with their child with NDD.

This dissertation concludes that the DFG intervention provides strength to the entire family and improved positive experiences of received social support for all family members. Furthermore, DFG offer support to both parenthood and the relationship between parents, along with providing an opportunity for all family members to discuss their concerns and to be heard.
Original languageEnglish
Place of PublicationTampere
ISBN (Electronic)978-952-03-2435-3
Publication statusPublished - 2022
Publication typeG5 Doctoral dissertation (articles)

Publication series

NameTampere University Dissertations - Tampereen yliopiston väitöskirjat
Volume615
ISSN (Print)2489-9860
ISSN (Electronic)2490-0028

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