A Caregiver-Child Intervention for Mitigating Toxic Stress (The Resiliency Clinic): A Pilot Study

Introduction Primary care-based interventions that promote nurturing caregiving relationships and early relational health may help mitigate toxic stress and promote resilience in children. This pilot study aims to: (1) describe a novel group-based, psychoeducational primary care intervention for children experiencing adverse childhood experiences (ACEs) (The Resiliency Clinic), (2) assess program feasibility and acceptability, and (3) explore effects on child/caregiver behavioral health. Methods Intervention design centered on promoting supportive caregiving, caregiver/child self-regulation and co-regulation and teaching evidence-based stress management tools. Program feasibility and acceptability were assessed through attendance data and caregiver focus groups. Behavioral health measures were obtained at baseline and 8-month follow-up. Results Of 101 eligible families, 38 (37.6%) enrolled and attended a median of 3.00 (mean = 2.95, sd = 1.75) out of 6 sessions. Caregivers reported high satisfaction and benefits including stress management tools and connection with staff and other parents. There were modest, statistically non-significant improvements in caregiver stress (d = 0.23) and child executive functioning (d = 0.27). Discussion In conclusion, a group intervention teaching supportive caregiving and stress mitigation is feasible and acceptable for many families in an urban federally qualified health center (FQHC) with a signal for modest improvements in behavioral health. Future program iterations will seek to address participation barriers and expand the intervention's capacity to promote early relational health.

Automated summary

This pilot study aims to describe a novel group-based, psychoeducational primary care intervention for children experiencing adverse childhood experiences (ACEs), assess program feasibility and acceptability, and explore effects on child/caregiver behavioral health. The results show that this intervention is feasible and acceptable for many families in an urban federally qualified health center (FQHC) with modest improvements in behavioral health.