The proposed project is a 6-year follow-up of 244 adolescents/young adults and their caregivers who participated in an experimental evaluation of a preventive intervention program for families who have experienced parental death. The evaluation involved comparing two randomly assigned conditions, the Family Bereavement Program versus a self-study comparison condition. The Family Bereavement Program works with caregivers and children/adolescents to improve risk and protective processes, such as parenting, family stability and child/adolescent coping. The program was implemented with a high degree of fidelity, and attendance in the program was excellent. The program was evaluated using multi-method, multi-reporter assessments. Attrition from assessment was very low and was not differential across experimental conditions. Intent-to-treat analyses of immediate posttest and 11 month follow-up data revealed positive effects on family functioning and child/adolescent coping and reductions in child/adolescent and caregiver mental health problems. At 11-month follow-up, the program reduced the rate of clinically significant internalizing problems for high risk children/adolescents. A pattern of interaction effects indicated that greater program benefits were often found for children/adolescents who were functioning more poorly at baseline and for girls. Effect sizes were generally in the moderate range at posttest and at 11-month follow-up. Program effects on mental health problems were stronger at 11-month follow-up than at immediate posttest. The proposed project has four specific aims: 1. To assess effects of the Family Bereavement Program six years following participation, on adolescents/young adults of ages 14- 22 and on their caregivers, 2. To assess factors that mediate program effects, 3. To assess whether program effects are moderated by baseline level of problems, gender or age, and 4. To assess cost-benefit of participation in the Family Bereavement Program. The proposal is consistent with NIMH priorities, to support long-term follow-up of prevention research (NIMH, 1998).
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