Evidence map›Paper›PMID 42241029›Full record

Trial reportJournal of child psychology and psychiatry, and allied disciplines2026

'Sawa Aqwa' (Stronger Together): A multi-site randomized controlled trial of a brief family systemic intervention for adolescent mental health in Lebanon.

Tania Bosqui, Felicity L Brown, Sally Farah, Joseph Elias, Maliki E Ghossainy, Anas Mayya, Diana Abo Nakkoul, Bryony Walsh, Sarah Chreif, Ahmad Einein and 12 more

Abstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Journal of child psychology and psychiatry, and allied disciplines, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Tania BosquiDepartment of Psychology, American University of Beirut, Beirut, Lebanon.ORCID https://orcid.org/0000-0002-7376-5405
Felicity L BrownResearch and Development Department, War Child Alliance, Amsterdam, The Netherlands.
Sally FarahDepartment of Psychology, American University of Beirut, Beirut, Lebanon.
Joseph EliasWar Child Alliance, Beirut, Lebanon.
Maliki E GhossainyWheelock College of Education and Human Development, Boston University, Boston, MA, USA.
Anas MayyaDepartment of Psychology, American University of Beirut, Beirut, Lebanon.
Diana Abo NakkoulTerre des Hommes Italy, Beirut, Lebanon.
Bryony WalshDanish Refugee Council, Beirut, Lebanon.
Sarah ChreifDanish Refugee Council, Beirut, Lebanon.
Ahmad EineinTerre des Hommes Italy, Beirut, Lebanon.
Bassel MeksassiWar Child Alliance, Beirut, Lebanon.
Roula Abi SaadChild Protection, United Nations Children's Fund (UNICEF), Beirut, Lebanon.
Hady NaalGlobal Health Institute, American University of Beirut, Beirut, Lebanon.
Michael DonnellyCentre for Public Health, School of Medicine, Queen's University Belfast, Belfast, UK.
Theresa S BetancourtBoston College School of Social Work, Chestnut Hill, MA, USA.
Alan CarrSchool of Psychology, University College Dublin, Belfield, Dublin, Republic of Ireland.
Eve S PufferDepartment of Psychology & Neuroscience, Duke Global Health Institute, Duke University, Durham, North Carolina, USA.
Estefania HannaDepartment of Psychology, American University of Beirut, Beirut, Lebanon.
Hasan MansourDepartment of Psychology, American University of Beirut, Beirut, Lebanon.
Farah SemaanDepartment of Psychology, American University of Beirut, Beirut, Lebanon.
Rabih El ChammayMinistry of Public Health, Beirut, Lebanon.
Mark J D JordansResearch and Development Department, War Child Alliance, Amsterdam, The Netherlands.

Funding

Arts and Humanities Research Council AH/T007419/1
6 · The paper itself

Abstract

backgroundThere are no evaluated family-based mental health and psychosocial support (MHPSS) interventions for adolescents in Southwest Asia (known as the Middle East), and few whole-family interventions in low- and middle-income countries, despite consistent evidence for the impact of family support on mental health and well-being. This study aims to evaluate the effectiveness of a brief family systemic mental health intervention, deliverable by non-specialists in mental health.

methodsWe conducted an assessor-blind type I hybrid effectiveness-implementation multi-site randomized controlled trial comparing the locally developed family intervention to a waitlist control group for randomly allocated families residing in North Lebanon and Beqa'a governorates. Eligible families presented with medium-to-high risk for child protection concerns (abuse, neglect, child labor, early marriage) and had at least one adolescent aged 12-17 who demonstrated psychological distress. Outcomes at the family, caregiver, and adolescent level were measured pre- and post-intervention, and at 3-month follow-up.

resultsIntent-to-treat analyses found a significant between-group effect of the intervention on adolescent-reported family functioning, caregiver mental health, and parenting. No change was found for adolescent psychological distress. Further analyses found effects on adolescent well-being for those who completed the intervention, and that father attendance was associated with better outcomes for adolescent well-being in the intervention group. No other significant moderators were found. At the 3-month follow-up for the intervention condition, family functioning and caregiver well-being significantly dropped from endline.

conclusionsThe study demonstrates mixed results for a non-specialist-delivered family-systemic intervention developed in the context of humanitarian crises in Lebanon. While the intervention did not result in benefits in adolescent-reported symptoms of psychological distress, the intervention group did show greater improvements than the control group on a number of other outcomes, showing the potential impact of working with the wider family system to support adolescents in humanitarian settings.

Indexed as

Family TherapyPsychological DistressAdolescentAdolescent HealthChildFamily SupportFemaleHumansLebanonMaleOutcome Assessment, Health Careadolescentsarmed conflictfamilyHumanitarianLebanonlow‐ and middle‐income (LMIC) countriesmental health and psychosocial supportrandomized controlled trialrefugees

Identifiers

PMID42241029
PMCPMC13535759

What OpenQuestion holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.