Families in the Frontline 1.0: An Evaluation Study of Multi-Family Therapy (MFT) for Veteran Families

The negative influence of PTSD and more specifically deployment-related PTSD on
family relationships has been well documented. Despite this fact, there is a
dearth of empirically supported family programs addressing family functioning
and PTSD within veteran populations. In particular, interventions that are
tailored to the needs of veteran families are relatively new and under-studied.

1) To investigate the effectiveness of Multi-family therapy (MFT) versus
individual oriented treatment as usual (TAU) on end-of-treatment family
functioning of veteran families, as reported by the veteran. TAU consists of
supportive counselling or trauma-focused therapy, either individually or
group-based. TAU is individually oriented, targeting the veterans' PTSD
symptomatology, while MFT is system/contextual oriented, targeting the
veterans' family functioning through increasing parents' mentalization and
emotion regulation capacities. 2) To examine the effectiveness of MFT versus
TAU on other family indices (family functioning as reported by the veteran's
partner and the children (aged 12 years and older); child functioning as
reported by both parents and the children (aged 12 years and older); couple
adjustment as reported by both parents). PTSD symptom severity, emotion
regulation, and mentalization, are included indices on a veteran level.

This is a multisite study in which an observational design will be applied with
a two-arm model in which the intervention group/MFT+TAU will be
compared with the control group/TAU.

Multi-family therapy (MFT), part of the usual care at the participating sites,
is a comprehensive group intervention targeting families with children and aims
to elicit behavioural changes in family members through the restructuring of
interactional patterns in families. MFT provides a context of different
subsystems. The interactions and processes on different levels facilitate
change in individuals and families, as different perspectives and opportunities
to experiment with new behaviour are generated. Once families are able to share
their difficulties with other families, they can provide each other with
understanding, insight, perspectives and suggestions, and many resources. MFT
has been successfully applied to a whole range of problems and disorders.
Mentalization based family therapy (the Marlborough model) primarily focuses on
enhancing mentalizing strengths (i.e. the ability to understand emotions of
the self and the other) and thereby enhancing sensitivity. Therefore, the
Marlborough model of MFT seems particularly fit for treatment of the complex
consequences of trauma in families.

MFT is widely used and considered to be 'good practice'. MFT is part of the
standard care in the participating sites. Its effectiveness has been
established in a variety of populations. Therefore, it is not likely that this
therapy will be counterproductive. Besides one computer task, measurements
include questionnaires which are brief and some are even already part of the
routine outcome measurement. The assessments are not upsetting. The risk and
burden are therefore minimal. When this study ends, care/treatment is offered
to the couples when needed. In the long term this study adds to the evidence
for programs targeting family functioning among veteran families.