Copyright Jan Nicholson, Kim Halford and Matt Sanders, 1996. One copy of this paper can be made for the purpose of personal, non-commercial use, subject to proper attribution to the author.



Prevention of Family Distress in Stepfamilies:
The StepPrep Project



Dr Jan M Nicholson
School of Public Health, Queensland University of Technology

Prof. Kim Halford
School of Applied Psychology, Griffith University

Assoc. Prof. Matt Sanders
Department of Psychology, The University of Queensland


November, 1996.

Acknowledgments

This research has been supported by the National Health and Medical Research Council (grants 920182 and 951290) and the Public Health Research and Development Council (fellowship 954213). The first author published previously as Jan M. Lawton. Correspondence should be directed to: Dr J.M. Nicholson, School of Public Health, QUT, Locked Bag No. 2, Red Hill, QLD 4059.




Stepfamilies: An 'At Risk' Group

Families exert a major influence on the wellbeing of family members. Historically, the 'traditional' Australian family contained 2-3 children living in the same household as both biological parents. This notion of the family is now considerably dated. Stepfamilies formed after parental divorce are becoming increasingly common. In 1992, 203,000 Australian families contained children born to a previous relationship (ABS, 1994).

Remarried couples face many difficulties which may place them at elevated risk of breakdown. The role of stepparents in the household, and relationships between stepparents and their partners' children are common problem areas. Longitudinal data reveal that 30% of stepfamilies end in separation within the first 2 years (compared to 6% of equivalent first marriage families), and 50% (compared with 15%) end in separation by 6 years (Fergusson, Horwood & Lawton, 1988). The presence of stepchildren in the household is one factor associated with the increased risk of breakdown (Anderson & White, 1986). Given the serious psychological, emotional and physical health consequences of marital breakdown, the high rates of divorce in stepfamilies is concerning.

Unfortunately living in a stepfamily also appears to be associated with poor outcomes for many children. When compared with their peers from intact two-parent families, children from stepfamilies have elevated rates of behavioural problems; peer relationship problems; academic difficulties; school discipline problems; and to a lesser extent, anxiety, depression and social withdrawal. Physical health also appears to be poorer, with these children reporting more physical health problems, accidental injuries and using health and mental health services to a greater extent than their peers (see Lawton & Sanders, 1994 for a review). While these difficulties may disappear with time, problems persist in 20% of cases and may be associated with early home leaving, drop out from formal education and troubled adult relationships.

Interventions for Troubled Stepfamilies: The Case for Prevention

The Stepfamilies Project was a randomised controlled trial of a tertiary intervention program for troubled stepfamilies. The intervention was designed to reduce the prevalence of clinically significant behaviour problems in a school aged children living in established stepfamilies. Parents and stepparents were provided with training in positive parenting skills, family problem solving and communication skills, and skills for supporting each other during difficult family interactions. Sixty one families were recruited from extensive media outreach and clinic referrals, and randomly assigned to wait list, therapist-directed intervention or self-directed intervention, with assessments at pre, post and 6-month follow-up.

The results of this trial indicated that a carefully designed tertiary clinical intervention for stepfamilies could result in significant reductions in child behaviour problems (Nicholson, 1995). Compared with pre-intervention, parents and stepparents who received either intervention, reported significantly fewer child behaviour problems at post-intervention, with evidence of maintenance to 6-month follow-up. This was associated with a significant reduction in the proportion of children from the intervention group who met diagnostic criteria. Additionally, active intervention resulted in significant improvements in other areas of family functioning such as reduced conflict over parenting.

Several limitations were noted during the course of the research. Firstly, it seems that many couples do not seek assistance for stepfamily-related problems. Recruitment took place over a 3 period and proved extremely difficult. This problem has been reported by other researchers, and it has been suggested that for a variety of reasons stepfamilies are reluctant to identify themselves as experiencing problems (Duncan & Brown, 1992).

A related area of concern was the level of distress evident in participating stepfamilies. In 10 of the 71 families who were initially assigned to the study, the couple decided either to separate (6 families) or to remove the child from the home (into state care in 2 cases, and to the other biological parent in 2 cases) before completion of therapy due to the severity of the problems experienced. It may be, that if stepfamilies are reluctant to admit to problems, by the time they do present for help, these difficulties are relatively entrenched, and resistant to change. The efficacy of clinical intervention is limited for severe cases (Miller & Prinz, 1990), and in this research, stepfamilies where child behaviour problems were comorbid with other difficulties (such as marital distress), or where the behaviour problems were long-standing and severe, appeared less likely to make gains.

These limitations indicate the need for greater consideration of alternative approaches to intervention. Early interventions with couples or families who have not yet developed clinically significant levels of distress show considerable promise for effective long term prevention (Behrens & Sanders, 1994; Hahlweg & Markman, 1988; Sanders & Markie-Dadds, 1992). An early intervention program to prevent child adjustment problems and marital distress in stepfamilies is described next.

The Stepfamilies Preparation (StepPrep) Program

StepPrep is a randomised controlled trial of an early intervention program which aims to prevent the breakdown of stepfamilies by providing remarried couples with key relationship skills; by promoting healthy couple and family relationships; and by providing couples with appropriate parenting skills for helping children to adjust to the stepfamily. Recruitment for the trial is ongoing, utilising media outreach and referrals. Participating couples are in a committed relationship of at least 6 months duration, with a child or children from a former relationship, and no evidence of current relationship distress. Couples are randomly allocated to a 7-week group intervention or self-help program, and assessed at pre, post and six monthly intervals.

In contrast to the tertiary intervention program, recruitment for StepPrep has proved less troublesome. Over a 12 month period, 43 families were recruited for this study. This compares favourably to the 61 families recruited over 3 years for the tertiary intervention study. On average, couples were in their late thirties (mean = 37.5 years, s.d. = 5.2 for parents; mean = 39.4 years, s.d. = 6.2 for stepparents), and had been in the relationship for around 2 years (mean = 24.2 months, s.d. = 19.4). At the start of therapy, 45.2% of couples were legally married, 35.5% cohabiting, 16.1% regularly stayed at each other's homes, and 3.2% were not cohabiting.

One quarter of the sample changed cohabitation/ marital status during the initial phase of the study. Three couples moved in together and 2 got married. However, 5 couples separated: 2 before commencing therapy, 1 each during the therapy group and self-help programs, and the fifth couple separated in the 6 month period after completing the therapy group. Pre- and post-intervention data are reported for 31 couples, 15 from the therapy groups and 16 from self-help.

At the completion of intervention, parents and stepparents reported satisfaction with the programs provided. Couples reported that the group program provided 'a valuable chance to talk about private issues using the group as a sounding board', that family relationships had been improved as a result of the program, and that 'new skills learnt as a parent and stepparent will be with me forever'. On a 7-point scale (1 = very dissatisfied to 7 = very satisfied) means of 4.6 and 4.9 were obtained for parents and stepparents from the self-help program, compared to 5.7 and 5.6 for parents and stepparents from the therapy group program.

While most participants receiving the self-help program appeared satisfied with this form of intervention, this was not the case for all couples. Dissatisfaction was related to difficulties discussing sensitive issues with each other, and lack of specific, concrete advice in the written materials (e.g. 'I felt that the at-home program was a little shallow for my situation'). These concerns were reflected in the significantly lower global ratings of satisfaction obtained from participants assigned to self-help compared to those assigned to the therapy group (parents: F(1,28)=4.5, p<.05; stepparents: F(1,28)=8.4, p<.01).

While pre-post data were available for only half of the projected sample at this time, preliminary analyses indicated that some improvements in family functioning have occurred. Significant time effects were obtained on measures of conflict over parenting, child-self reported depression and family stressful life events. The number of issues causing conflict between the remarried couples was significantly lower at post-intervention than pre-intervention according to parent report (F(1,28)=5.6, p<.05) and stepparent report (F(1,28)=4.1, p<.05). Depression as reported by the target child on the Child Depression Inventory was significantly lower at post intervention, (F(1,27)=6.2, p<.05), and parents reported fewer negative life events at post intervention (F(1,28)=7.0, p<.05). Significant time effects were not obtained on measures of relationship satisfaction, relationship stability or child behaviour problems. These results indicate that preparation programs may have some immediate positive impact on stepfamily functioning. The longitudinal follow-up to be undertaken in this study with a larger sample, will shed light on the longer term impact of such interventions.

Conclusions

There is a need to develop programs to assist modern families to deal with the challenges they face. In light of the rapidly changing nature of families, research which identifies the unique problems faced by non-traditional families will better enable professionals to assist those in trouble. Research demonstrates that carefully tailored interventions can result in improved functioning in many cases. However, tertiary interventions have significant limitations and there is a need for effective programs that prevent the development of problems in at risk families. Preliminary data from the StepPrep Program illustrate there are potential gains to be achieved from preventive approaches.

References

Anderson, J.Z., & White, G.D. (1986). An empirical investigation of interaction and relationship patterns in functional and dysfunctional nuclear families and stepfamilies. Family Process, 25, 407-422.

Australian Bureau of Statistics [ABS] (1994). Australia's families: Selected findings from the survey of families in Australia 1992. (Catalogue No. 4418.0). Canberra: ABS.

Behrens, B.C., & Sanders, M.R. (1994). Prevention of marital distress: Current issues in programming and research. Behaviour Change, 11, 82-93.

Duncan, S.F., & Brown, G. (1992). RENEW: A program for building remarried family strengths. Families in Society, 73, 149-158.

Fergusson, D.M., Horwood, L.J., & Lawton, J.M. (1988). The influence of family order and selection factors on the stability of first and second families. Christchurch Child Development Study, Christchurch School of Medicine, Christchurch, New Zealand.

Hahlweg, K., & Markman, H.J. (1988). Effectiveness of behavioral marital therapy: Empirical status of behavioral techniques in preventing and alleviating marital distress. Journal of Consulting and Clinical Psychology, 56, 440-447.

Lawton, J.M. & Sanders, M.R (1994). Designing effective behavioral family interventions for stepfamilies. Clinical Psychology Review, 14, 463-496.

Miller, G.E., & Prinz, R.J. (1990). Enhancement of social learning family interventions for child conduct disorder. Psychological Bulletin, 108, 291-307.

Nicholson, J.M. (1995). Child behaviour problems in stepfamilies: Assessment and intervention. PhD Thesis, The University of Queensland.

Sanders, M.R., & Markie-Dadds, C. (1992). Toward a technology of prevention of disruptive behaviour disorders: The role of behavioural family intervention. Behaviour Change, 9, 186-200.


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