SAFE, a new therapeutic intervention for families of children with autism: a randomised controlled feasibility trial

Objectives To establish the feasibility of a definitive randomised controlled trial of Systemic Autism-related Family Enabling (SAFE), an intervention for families of children with autism.Design A randomised, controlled, multicentred feasibility study.Setting Participants were identified from three...

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Main Authors: Paul Ewings, Andy Barton, Rebecca McKenzie, Rudi Dallos, Jacqui Stedmon, Helen Hancocks, Tara Vassallo, Craig Myhill, Jade Chynoweth
Format: Article
Language:English
Published: BMJ Publishing Group 2020-12-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/10/12/e038411.full
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author Paul Ewings
Andy Barton
Rebecca McKenzie
Rudi Dallos
Jacqui Stedmon
Helen Hancocks
Tara Vassallo
Craig Myhill
Jade Chynoweth
author_facet Paul Ewings
Andy Barton
Rebecca McKenzie
Rudi Dallos
Jacqui Stedmon
Helen Hancocks
Tara Vassallo
Craig Myhill
Jade Chynoweth
author_sort Paul Ewings
collection DOAJ
description Objectives To establish the feasibility of a definitive randomised controlled trial of Systemic Autism-related Family Enabling (SAFE), an intervention for families of children with autism.Design A randomised, controlled, multicentred feasibility study.Setting Participants were identified from three National Health Service (NHS) diagnosing centres in Plymouth and Cornwall and a community pathway.Participants 34 families of a child with a diagnosis of autism severity level 1 or 2 between 3 and 16 years. Four families were lost to follow-up.Interventions SAFE is a manualised five-session family therapy-based intervention delivered over 16 weeks and designed for families of children with autism. SAFE involves families attending five 3-hour sessions led by systemic practitioners.Primary and secondary outcome measures The proposed primary outcome measure was the Systemic CORE 15 (SCORE-15). Proposed secondary outcome measures: Patient Health Questionnaire-Somatic Anxiety Depressive Symptoms, the Coding of Attachment-Related Parenting for use with children with Autism, the Child Behaviour Checklist (CBCL), the Reflective Functioning Questionnaire (RFQ) and the Caregiving Helplessness Questionnaire. Outcome measures were collected at baseline and 24 weeks post randomisation.Results All primary caregivers retained in the study completed the SCORE-15 at both time points. 34 of the target of 36 families were recruited and 88% of families were retained. Training for therapists was effective. Feedback revealed willingness to undergo randomisation. There was 100% attendance at appropriate sessions for core family members. The SCORE-15 showed reduction in scores for families receiving SAFE compared with controls suggesting positive change. Qualitative data also revealed that families found the study acceptable and families receiving SAFE experienced positive change. Feedback indicated that the SCORE-15 should be retained as a primary measure in a future trial, but secondary measures should be reduced.Conclusions This study indicates that a larger trial of SAFE is feasible. Findings suggest that SAFE can address current gaps in recommended care, can be confidently delivered by NHS staff and has potential as a beneficial treatment.Trial registration numbers ISCTRN83964946 and IRAS213527.
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spelling doaj-art-1c1b4559a6044f86a00e6cbbb4b3de0f2024-11-22T09:05:08ZengBMJ Publishing GroupBMJ Open2044-60552020-12-01101210.1136/bmjopen-2020-038411SAFE, a new therapeutic intervention for families of children with autism: a randomised controlled feasibility trialPaul Ewings0Andy Barton1Rebecca McKenzie2Rudi Dallos3Jacqui Stedmon4Helen Hancocks5Tara Vassallo6Craig Myhill7Jade Chynoweth8NIHR Research Design Service - South WestconsultantInstitute of Education, University of Plymouth, Plymouth, UK2 Department of Clinical Psychology, University of Plymouth, Plymouth, UK2 Department of Clinical Psychology, University of Plymouth, Plymouth, UK3 Peninsula Clinical Trials Unit, University of Plymouth, Plymouth, UK1 Institute of Education, University of Plymouth, Plymouth, UK1 Institute of Education, University of Plymouth, Plymouth, UKFaculty of Health, University of Plymouth, Plymouth, UKObjectives To establish the feasibility of a definitive randomised controlled trial of Systemic Autism-related Family Enabling (SAFE), an intervention for families of children with autism.Design A randomised, controlled, multicentred feasibility study.Setting Participants were identified from three National Health Service (NHS) diagnosing centres in Plymouth and Cornwall and a community pathway.Participants 34 families of a child with a diagnosis of autism severity level 1 or 2 between 3 and 16 years. Four families were lost to follow-up.Interventions SAFE is a manualised five-session family therapy-based intervention delivered over 16 weeks and designed for families of children with autism. SAFE involves families attending five 3-hour sessions led by systemic practitioners.Primary and secondary outcome measures The proposed primary outcome measure was the Systemic CORE 15 (SCORE-15). Proposed secondary outcome measures: Patient Health Questionnaire-Somatic Anxiety Depressive Symptoms, the Coding of Attachment-Related Parenting for use with children with Autism, the Child Behaviour Checklist (CBCL), the Reflective Functioning Questionnaire (RFQ) and the Caregiving Helplessness Questionnaire. Outcome measures were collected at baseline and 24 weeks post randomisation.Results All primary caregivers retained in the study completed the SCORE-15 at both time points. 34 of the target of 36 families were recruited and 88% of families were retained. Training for therapists was effective. Feedback revealed willingness to undergo randomisation. There was 100% attendance at appropriate sessions for core family members. The SCORE-15 showed reduction in scores for families receiving SAFE compared with controls suggesting positive change. Qualitative data also revealed that families found the study acceptable and families receiving SAFE experienced positive change. Feedback indicated that the SCORE-15 should be retained as a primary measure in a future trial, but secondary measures should be reduced.Conclusions This study indicates that a larger trial of SAFE is feasible. Findings suggest that SAFE can address current gaps in recommended care, can be confidently delivered by NHS staff and has potential as a beneficial treatment.Trial registration numbers ISCTRN83964946 and IRAS213527.https://bmjopen.bmj.com/content/10/12/e038411.full
spellingShingle Paul Ewings
Andy Barton
Rebecca McKenzie
Rudi Dallos
Jacqui Stedmon
Helen Hancocks
Tara Vassallo
Craig Myhill
Jade Chynoweth
SAFE, a new therapeutic intervention for families of children with autism: a randomised controlled feasibility trial
BMJ Open
title SAFE, a new therapeutic intervention for families of children with autism: a randomised controlled feasibility trial
title_full SAFE, a new therapeutic intervention for families of children with autism: a randomised controlled feasibility trial
title_fullStr SAFE, a new therapeutic intervention for families of children with autism: a randomised controlled feasibility trial
title_full_unstemmed SAFE, a new therapeutic intervention for families of children with autism: a randomised controlled feasibility trial
title_short SAFE, a new therapeutic intervention for families of children with autism: a randomised controlled feasibility trial
title_sort safe a new therapeutic intervention for families of children with autism a randomised controlled feasibility trial
url https://bmjopen.bmj.com/content/10/12/e038411.full
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