An Evidence-Based Family Support Program for Parents and Children in Palestine: A Theory-Based Intervention

Families living amid chronic sociopolitical violence face stressors that extend beyond discrete traumatic events. Ongoing exposure to instability, loss, and uncertainty can shape daily family interactions, potentially altering emotional climates within the home. Adolescents in these contexts are navigating normative developmental tasks—identity formation, autonomy, peer relationships—against a backdrop of collective threat. Understanding how to support family systems under such conditions requires interventions that move beyond individual symptom reduction toward strengthening relational security.

In the MRI-funded project that provides critical co-funding support for an ongoing trial at the National Institute of Mental Health, An Evidence-Based Family Support Program for Parents and Children in Palestine: A Theory-Based Intervention, Dr. Laura Miller-Graff and Dr. E. Mark Cummings (University of Notre Dame) evaluates Promoting Positive Family Futures (PPFF), a culturally responsive, family-centered program designed for parents and adolescents in Palestine. The project advances a systemic premise: enhancing emotional security within the family can buffer adolescents from the psychological impacts of chronic sociopolitical violence and promote adaptive coping across development.

The intervention is theoretically grounded in three complementary frameworks. Emotional Security Theory provides the central organizing lens, emphasizing adolescents’ need for stability, protection, and predictability in family relationships—particularly during periods of external threat. Social-ecological resilience theory situates coping within nested relational systems, recognizing that family functioning interacts with broader community and sociopolitical contexts. Finally, cognitive-behavioral strategies contribute practical skills for emotion regulation, cognitive flexibility, and constructive conflict management, linking relational processes with evidence-based tools for distress management.

PPFF consists of eight 90-minute sessions delivered primarily in multi-family group formats, supplemented by two targeted in-home sessions: one focused on the couple relationship and one engaging the full family triad. The structure reflects prior local consultation and adaptation. Fathers participate in parallel groups separate from mother–adolescent groups while covering equivalent core material—an intentional response to longstanding gaps in father inclusion within intervention research. The comparison condition mirrors a common real-world alternative: adolescent-only weekly support groups with limited parental involvement, allowing for evaluation of the added value of systemic family engagement.

The evaluation employs a randomized controlled trial design with approximately 300 families. Participants are assessed at baseline, post-intervention, and at 6- and 12-month follow-ups, permitting examination of both immediate and sustained effects. Outcome domains include adolescent internalizing and externalizing symptoms, posttraumatic stress, resilience, and prosocial skills, alongside parent psychological well-being and global family functioning.

Critically, the project incorporates observational assessments of family problem-solving and conflict discussions. By coding interactional behavior during structured tasks, the study moves beyond self-report measures to capture enacted relational processes—how families negotiate disagreement, express support, and regulate affect in vivo. This multimethod approach strengthens inference regarding whether improvements in adolescent adjustment are mediated by observable shifts in family emotional security and communication patterns.

If PPFF demonstrates efficacy, the implications extend beyond symptom reduction. The intervention may provide a scalable, theory-driven model for strengthening family systems in contexts of chronic collective adversity. By integrating emotional security, ecological resilience, and cognitive-behavioral tools, the program offers a framework adaptable to other conflict-affected settings.

At its core, this project reframes adolescent mental health in environments of sociopolitical violence as inseparable from family relational processes. By reinforcing safety and cohesion within the home, PPFF seeks to create relational conditions in which adolescents can pursue development not solely defined by threat—but supported by connection, stability, and shared coping.