The 'Sawa Aqwa' study explores a brief family systemic intervention aimed at improving adolescent mental health in Lebanon. Researchers conducted a multi-site randomized controlled trial focusing on families residing in North Lebanon and Beqa'a governorates. These families often face significant risks of child protection concerns, such as child labor and neglect. Consequently, the study investigated whether non-specialists could effectively deliver this whole-family support model in humanitarian settings. The findings highlight the potential of systemic approaches to stabilize domestic environments during crises.

Effectiveness of the Family Systemic Intervention

The trial results showed significant improvements in family functioning and caregiver mental health. Furthermore, families in the intervention group reported more positive parenting practices compared to the waitlist control group. Notably, the researchers found that father attendance played a crucial role in enhancing adolescent well-being. Specifically, those who completed the intervention showed the greatest gains in overall life satisfaction. Therefore, engaging the entire family system appears highly beneficial for stabilizing the home environment and improving caregiver outcomes.

Outcomes for Adolescent Psychological Distress

However, the family systemic intervention did not significantly reduce adolescent-reported symptoms of psychological distress. Additionally, the initial benefits for family functioning and caregiver well-being dropped significantly by the three-month follow-up. This suggests that while systemic work strengthens family dynamics, adolescents may require more targeted clinical support for specific mental health symptoms. Future programs might need to combine systemic family work with specialized individual care to sustain long-term mental health gains. Consequently, clinicians should consider long-term monitoring for families in high-adversity contexts.

Key FAQs

Does the family systemic intervention reduce adolescent distress symptoms?

No, the trial did not find a significant reduction in specific psychological distress symptoms among adolescents. However, it significantly improved family functioning and parenting practices.

Why was father attendance important in this trial?

The study found that father attendance was associated with better outcomes for adolescent well-being in the intervention group. This underscores the value of including all primary caregivers in family-based therapies.

Disclaimer: This content is for informational and educational purposes only and does not constitute medical advice or a professional relationship. Always seek the advice of a physician or other qualified health provider with any questions regarding a medical condition. Refer to the latest local and national guidelines for clinical practice.

References

1. Bosqui T et al. 'Sawa Aqwa' (Stronger Together): A multi-site randomized controlled trial of a brief family systemic intervention for adolescent mental health in Lebanon. J Child Psychol Psychiatry. 2026 Jun 04. doi: 10.1111/jcpp.70174. PMID: 42241029.

2. Brown FL, Bosqui T, Elias J, et al. Family systemic psychosocial support for at-risk adolescents in Lebanon: study protocol for a multi-site randomised controlled trial. BMC Psychiatry. 2022;22(1):242.

3. Pederson AB, et al. Family-Based Youth Mental Health Interventions Delivered by Non-Specialist Providers in Low- and Middle-Income Countries: A Systematic Review. Front Psychiatry. 2022;13:831348.