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Strengthening Family Coping Resources Open Trials (SFCR)

The safety and scientific validity of this study is the responsibility of the study sponsor and investigators. Listing a study does not mean it has been evaluated by the U.S. Federal Government. Know the risks and potential benefits of clinical studies and talk to your health care provider before participating. Read our disclaimer for details. Identifier: NCT01754610
Recruitment Status : Recruiting
First Posted : December 21, 2012
Last Update Posted : November 10, 2020
Substance Abuse and Mental Health Services Administration (SAMHSA)
Information provided by (Responsible Party):
Laurel J Kiser, University of Maryland, College Park

Brief Summary:

Strengthening Families Coping Resources (SFCR) Open Trials completes the second stage of the National Institute on Drug Abuse's intervention development model by testing a new family, skills-based intervention involving pre-post evaluation of families participating in multi-family groups. The purpose of this study is to gather practice-based evidence on the effectiveness of the manualized treatment, on the dynamics involved in the group format, and on implementation fidelity and feasibility. Analyses will involve initial exploration of the following hypotheses: 1) Families will show a significant increase in the constructive use of family coping skills and in general family functioning. 2) The target child will show a reduction in trauma-related symptoms and behavior problems. 3) Families will engage and participate in the treatment. 4) Providers will implement SFCR with fidelity.

Other outcomes of interest are the process measures that will be collected to monitor participation in the groups, cultural sensitivity and acceptability, clinician competence, and intervention integrity.

Condition or disease Intervention/treatment
Intervention Effectiveness Practice-based Evidence Posttraumatic Stress Disorder Behavioral: Strengthening Family Coping Resources (SFCR)

Detailed Description:

Strengthening Family Coping Resources (SFCR) is a manualized, trauma-focused, skills-based intervention that uses a multi-family group format. SFCR is designed for families living in traumatic contexts with the goal of reducing the symptoms of posttraumatic stress disorder (PTSD) and other trauma-related disorders in children and adult caregivers. Since most families living in traumatic contexts contend with on-going stressors and threats, SFCR is also designed to increase coping resources in children, adult caregivers, and in the family system to prevent relapse and re-exposure. SFCR provides trauma treatment within a family format. SFCR includes additional therapeutic strategies designed to improve the family's ability to cope with on-going stress and threats of re-exposure. Specifically, SFCR builds the coping resources necessary to help families boost their sense of safety, function with stability, regulate their emotions and behaviors, and improve communication about and understanding of the traumas they have experienced. The model includes family work on storytelling and narration, which builds to a family trauma narrative. SFCR is currently being implemented at University of Maryland Medical Center (UMMC), at sites that are part of the National Child Traumatic Stress Network (NCTSN), and at community agencies within the Baltimore Metro area and beyond.

500 families will participate in a multifamily version of the intervention. Multiple groups of 5-6 families will be conducted with pre-post data collected in addition to information on the feasibility of the intervention. Prior to beginning each group, families will be assessed using a structured assessment. This assessment will be repeated at the end of group (all groups) and approximately one year following the completion of the group (for UMMC groups only).

One child in each family will be designated as the research subject. The target child will be chosen according to age, aged 1 through 17 years old, and referral for services. If more than one child in the family meet these criteria, the primary caregiver will be given the option of how many children s/he would like to be assessed for inclusion in the study. Data on the parents will only be collected from mothers or female caregivers. If no female caregiver is available, the primary caregiver will complete the assessments.

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Study Type : Observational
Estimated Enrollment : 500 participants
Observational Model: Cohort
Time Perspective: Prospective
Official Title: Strengthening Family Coping Resources Open Trials
Study Start Date : February 2006
Estimated Primary Completion Date : September 30, 2021
Estimated Study Completion Date : September 30, 2021

Group/Cohort Intervention/treatment
Families participating in SFCR
Families who have experienced multiple traumas and high stress related to poverty
Behavioral: Strengthening Family Coping Resources (SFCR)

Trauma Version (15 weeks) and High Risk Version (10 weeks) are 2 hour sessions. Dinner will be provided at the start of group for all participants.

Activities will be conducted at each group to encourage family involvement. The treatment modules focus on family rituals and routine, strengthening families' collaborative coping, and resolution of the trauma(s) bringing the families to treatment. Activities will be both family-based and age-based.

Primary Outcome Measures :
  1. Pre-post Treatment Effects [ Time Frame: Change from baseline to end of 10 or 15 week group ]

    This is a large open-ended sample involving collection of practice-based evidence of intervention effectiveness related to broad dissemination. The sample size is not being constrained by a specific research question.

    Data analysis: Indications of change were assessed using pre-post measures. Post-intervention change will be assessed with t-tests for dependent samples. Cohen's d will be used to calculate effect size. Comparison of pre-post scores for the target child will be assessed on PTSD symptoms (UCLA-PTSD Reaction Index Parent and Child Versions) and on behavior problems (CBCL). Comparison of pre-post scores on standardized measures of family functioning (Family Assessment Device), family coping (F-COPES), and parental stress (PSI_SF), and scores on the Family Mealtime Q-Sort will be made.

  2. McMaster Family Assessment Device (FAD) [ Time Frame: Change from baseline to end of 10 or 15 week group ]
    The McMaster Family Assessment Device (FAD) (Epstein et al., 1983; Miller, Epstein, Bishop, & Keitner, 1985) is a 60-question, Likert scale instrument designed to measure family functioning based upon the McMaster Model. Items are scored on a 4-point scale from 1 "healthy" to 4 "unhealthy." The instrument provides scores for seven scales, including problem-solving, communication, roles, affective responsiveness, affective involvement, behavior control, and overall functioning.

  3. Child Behavior Checklist (CBCL) [ Time Frame: Change from baseline to end of 10 or 15 week group ]
    The CBCL/1½-5 and 6-18 (Achenbach & Rescorla, 2001)requires a caregiver to rate, on a three-point scale from 0 (not true) to 2 (often true), each of 118 problems as they are perceived to reflect the child's behavior over the past six months. The instrument has 8-9 subscales that can be collapsed into broadband scales: Internalizing, Externalizing, and a Total Score.

  4. UCLA PTSD Reaction Index [ Time Frame: Change from baseline to end of 10 or 15 week group ]
    This instrument measures exposure to and symptoms of trauma in school-age children and adolescents. Symptoms assessed are tied to Diagnostic and Statistical Manual criteria for Posttraumatic Stress Disorder (PTSD). The UCLA PTSD-RI can be used as either a self-report or clinician-administered instrument. Reliability and validity are fairly robust (Steinberg et al., 2004). It has been used in many research designs and, importantly for the purposes of this study, among children exposed to community stress and violence.

Secondary Outcome Measures :
  1. SFCR Facilitator Competence and Fidelity [ Time Frame: Completed after each session ]
    These are short self-report measures of each facilitators' impressions of their competence during the group and their adherence to the session guidelines.

  2. Parent Symptoms of PTSD [ Time Frame: Change from baseline to end of 10 or 15 week group ]
    Measured using the PTSD Checklist for DSM-5, a 20-item self-report measure that assesses the 20 DSM-5 symptoms of PTSD (Blevins, Weathers, Davis, Witte, & Domino, 2015). The PCL-5 was developed to assess symptom change during and after treatment, to screen for clinically significant PTSD symptoms, and to make provisional PTSD diagnoses.

  3. Parent General Symptoms [ Time Frame: Change from baseline to end of 10 or 15 week group ]
    Brief Symptom Inventory-18 item (BSI) (Derogatis, 2000) is an 18-item self-report inventory of adult (18 years and older) psychological symptoms.

Other Outcome Measures:
  1. Family Mealtime Q-Sort [ Time Frame: Change from baseline to end of 10 or 15 week group ]
    The Family Mealtime Q-Sort provides a methodology for examining mealtime practices. The results of formative research on the measure demonstrate that coders could rate family mealtimes with adequate inter-rater reliability, construct validity was satisfactory, and family mealtimes could be compared to an independently derived, culturally appropriate standard.

Information from the National Library of Medicine

Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Learn About Clinical Studies.

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Ages Eligible for Study:   1 Year to 17 Years   (Child)
Sexes Eligible for Study:   All
Accepts Healthy Volunteers:   Yes
Sampling Method:   Non-Probability Sample
Study Population
community sample

Inclusion Criteria:

  • Children aged 1 through 17 years old at the time of recruitment
  • Child and family exposed to multiple traumas
  • a partial diagnosis of PTSD (15-week treatment version)
  • currently in the custody of a caregiver who agrees to participate in the study.
  • a stable caregiving system as defined by a recent history of stability and unlikely to change in the next 6 months.

Exclusion Criteria:

  • Children will be excluded only if they have active suicide ideation, an imminent risk for re-exposure due to their living environment, active psychosis, severe mental retardation or brain injury
  • Parent/caregiver has active psychosis or is a danger to self/others.

Information from the National Library of Medicine

To learn more about this study, you or your doctor may contact the study research staff using the contact information provided by the sponsor.

Please refer to this study by its identifier (NCT number): NCT01754610

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United States, Maryland
University of Maryland, School of Medicine, Department of Psychiatry, Divsion of Services Research Recruiting
Baltimore, Maryland, United States, 21201
Contact: Laurel J Kiser, Ph.D.    410-706-2490   
Principal Investigator: Laurel J. Kiser, Ph.D.         
Sponsors and Collaborators
University of Maryland, Baltimore
Substance Abuse and Mental Health Services Administration (SAMHSA)
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Principal Investigator: Laurel J Kiser, Ph.D. University of Maryland, Baltimore
Publications of Results:
Kiser, LJ., Backer, PM., Winkles, JK., Medoff, D. Strengthening Family Coping Resources (SFCR): Practice-Based Evidence for a Promising Trauma Intervention. Couple and Family Psychology: Research and Practice 4:49-59, 2015. Doi:10/1037/cfp0000034

Other Publications:
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Responsible Party: Laurel J Kiser, Prinicipal Investigator; Associate Professor, University of Maryland, College Park Identifier: NCT01754610    
Other Study ID Numbers: HP-00040466
First Posted: December 21, 2012    Key Record Dates
Last Update Posted: November 10, 2020
Last Verified: November 2020
Keywords provided by Laurel J Kiser, University of Maryland, College Park:
family trauma
multi-family therapy
Posttraumatic Stress Disorder
Additional relevant MeSH terms:
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Stress Disorders, Traumatic
Stress Disorders, Post-Traumatic
Trauma and Stressor Related Disorders
Mental Disorders