Online and Hybrid Delivery of a Multi-Group Family Intervention for Families Living with Parental Mental Illness: Qualitative Evaluation Study

Abstract In the UK 1 in 4 children are exposed to parental mental illness (PMI). Families living with PMI are poorly provided for across social and mental health care settings. Whole-family interventions can reduce associated risks, enhance families’ overall functioning, mental health, and wellbeing. We evaluated how families experienced a modified version of KidsTime, a whole-family intervention for families living with PMI. KidsTime is normally delivered in-person, here we evaluated a modified version that was delivered online and in a hybrid approach throughout the COVID-19 pandemic. We used a qualitative research design involving semi-structured interviews and focus groups with parents/carers, children and intervention facilitators. We collected and analysed data from 22 families and 6 facilitators. Thematic reflexive analysis was used to analyse the data. The intervention was perceived as acceptable. The hybrid delivery approach was considered to cater for a wider range of families wanting to take part. We generated seven themes that reflect participants’ experiences with the intervention: (1) delivery modes, online, in-person and hybrid; (2) intervention content, structure and format; (3) families’ beliefs, attitudes and feelings; (4) learning; (5) social connection; (6) support and positivity; (7) observed changes and perceived impact. Based on participants’ feedback we provide insights into possible benefits and change mechanisms of the intervention. We give suggestions for clinical practice and how the intervention and its delivery can be improved. Future research should focus on: (1) co-design activities with families to help refine the intervention further and (2) confirming the intervention’s effectiveness in sufficiently powered trials.