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Mental Health Care Mental Health Projects

Talking Therapy after Family Separation

Family separation and relationship breakdown can be a traumatic experience for all parties involved, especially the children. If there is parental conflict around the child arrangements then this can exacerbate the conflict resulting in the poor mental health of both the adults and children. Talking therapy after family separation can help.

Mental Health after Family Separation. Illustration of two parents and a child with a broken heart above the family.

From the child’s perspective, they may internalise feelings or externalise feelings. A downturn in their mental health can impact on their education, can impact on their behaviour, and can have a negative effect on how they perceive themselves and positive relationships.

The impacts can be multi-generational as the effects on the child are taken into their own adult relationships and parenting ability.

Does Talking Therapy help after Family Separation?

A UK based charity, Dads Unlimited, deliver a multi-pronged approach to supporting separated parents (91.3% Male, 7.4% Female, 0.6% Non-binary ​(Colthorpe, 2020)​). This includes one-to-one mentoring, a co-parenting programme, family law support, and talking therapy following family separation.

This mental health project review looks at how they deliver the talking therapy, how they measured the results, and what the results found.

Evaluation Method

To evaluate the effectiveness of the talking therapy, initially, they considered the PHQ-ADS scale which is a combination of the PHQ-9 (Patient Health Questionaire – Depression) and GAD-7 (Generalised Anxiety Disorder) scales.

The PHQ-ADS scale has been shown to be a reliable and valid composite measure of depression and anxiety ​(Kroenke et al., 2016)​​.

In turn, the GAD-7 is a valid and efficient tool for screening for GAD and assessing its severity in clinical practice and research ​(Spitzer et al., 2006)​, and evidence supports reliability and validity of the GAD-7 as a measure of anxiety in the general population ​(Löwe et al., 2008)​.

The PHQ‐9 is also a reliable and valid measure of depression severity ​(Kroenke et al., 2001)​ and a useful tool to recognise not only major depression but also subthreshold depressive disorder in the general population ​(Martin et al., 2006)​.

In line with the charity’s underlying approach based on Solution-focused Brief Therapy, the Warwick Edinburgh WEMWBS was found to be more appropriate as a measure of mental well-being focusing entirely on positive aspects of mental health ​(Tennant et al., 2007)​, and with their ambition to develop further services for the children of separated families, the WEMWBS has also been shown to be a psychometrically strong population measure of mental well-being, which can be used for this purpose in teenagers aged 13 and over ​(Clarke et al., 2011)​.

The client’s mental well-being is measured using the full WEMWBS 14-question questionnaire at their registration with the charity, and then again at each therapy session or at regular intervals during their engagement with the charity if they have not entered the talking therapy support programme.

As per the WEMWBS instructions, only surveys that have been taken at least two weeks apart can be used for evaluation, but the extra surveys are taken in case the client drops out of the process.

A second group is then established with the clients who are registered with the charity but only utilising the one-to-one mentoring service and not undergoing the talking therapy.

It is already known that there are significant differences in WEMWBS scores across levels of marital status, with widowed, divorced or separated respondents reporting low scores ​​(Tennant et al., 2007)​​.

Results

Full results of the project are still pending and are expected in Summer 2021, however early results from the in-therapy group show an average positive improvement of +8 on the WEMWBS with an average starting score of 40.9 and an average latest score of 48.8.

Baseline comparison scores from the general population ​(Braunholtz et al., 2007)​ are:

  • Total population: 50.7
  • Male: 51.3
  • Female: 50.3
  • Widowed/Divorced/Separated: 47.8

Read more

For more information visit 5 Steps to Co-parenting Success.

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  2. Clarke, A., Friede, T., Putz, R., Ashdown, J., Martin, S., Blake, A., Adi, Y., Parkinson, J., Flynn, P., Platt, S., & Stewart-Brown, S. (2011). Warwick-Edinburgh Mental Well-being Scale (WEMWBS): Validated for teenage school students in England and Scotland. A mixed methods assessment. BMC Public Health. https://doi.org/10.1186/1471-2458-11-487
  3. Colthorpe, A. (2020). Client Information Dashboard (p. 1). Dads Unlimited.
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