Caregiver Support Intervention

Caregivers living in war bear a heavy burden of stress - one shared with the children in their care

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Driving caregiver support forward

Research Lead
“Our guiding assumption is that chronically high stress can stop parents using the knowledge and skills they already possess. We therefore developed the Caregiver Support Intervention to strengthen parents’ own psychosocial wellbeing - layering on positive parenting sessions only after participants have gained some mastery of stress management.”

Kenneth E. Miller Ph.D., Research Lead

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Want to learn more or ask a question? Contact Kenneth via email or LinkedIn


Treatment gap

  • Caregivers in conflict-affected communities can face high levels of stress. Stressors such as poverty, insecure housing, separation from support networks and a compromised ability to protect their family compound their worries.
  • These emotions take the form of depression, anxiety and uncertainty.
  • This stress burden can make it harder to be a loving caregiver.
  • Interventions to date have focused primarily on positive training techniques - not the wellbeing of individual caregivers.



Providing individual support

The Caregiver Support Intervention directly addresses the psychosocial wellbeing of parents and caregivers - in addition to developing positive parenting techniques. The nine session programme sees small groups of caregivers meet for sessions conducted by trained facilitators - with the overall aim of reducing stress and improving psychosocial wellbeing.


Postive impact

Preliminary testing in Lebanon and Gaza has found a high utilization of the relaxation and stress management exercises - among both women and men. Participants gave positive evaluations of the impact of these exercises on anxiety, sleep, anger management and conflict with children and spouses. Initial results suggest an improvement in both caregiver wellbeing and parenting skills.

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This intervention is delivered by non-specialized professionals to target the treatment gap prevalent in settings affected by conflict.

Key evidence

Pilot study (2019)

79 families (or 151 caregivers) took part in the pilot randomized control trial located in North Lebanon. The participants of the study were caregivers of children between the ages of 3-12 years old who were Syrian refugees based in Lebanon. Participants of the pilot who received the CSI sessions showed significant changes in parenting, improved psychosocial wellbeing, and improved stress management.

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Source: Miller, K.E., Arnous, M., Tossyeh, F., Chen, A., Koppenol-Gonzalez, G., Nahas, N., & Jordans, M.J.D. Supporting Syrian families displaced by armed conflict: A pilot randomized controlled trial of the Caregiver Support Intervention. (revision under review)

Randomized control trial (2020)

In total 240 families and 480 caregivers are currently participating in the full RCT – also set in North Lebanon with Syrian refugees. This sample size is powered, meaning we can decisively test for effectiveness. The RCT has been adapted for remote modalities amid restrictions to combat the COVID-19 pandemic.

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Source: Miller, K.E., Arnous, M., Tossyeh, F., Chen, A., Bakolis, I., Koppenol-Gonzalez, G., Nahas, N., & Jordans, M.J.D. (2020) Protocol for a randomized controlled trial of the Caregiver Support Intervention with Syrian refugees in Lebanon. Trials, 21:277

Want to know more about the CSI’s study design? Read the full academic publication here.


Our partners

The Caregiver Support Intervention is driven through collaboration with partners from the humanitarian sector and beyond.

These partners include the Bernard van Leer Foundation, the Open Society Foundation, and the Fred Foundation.



The Caregiver Support Intervention has been adapted following small-scale testing in Gaza and Lebanon. Further testing is continuing in Lebanon.

Next steps

our research agenda

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The curriculum of the CSI has two focal areas: caregiver wellbeing and positive parenting. These will be further explored during the ongoing development of the intervention.

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Meet our Research and Development Team

Kenneth Miller Ph.D. is Senior Researcher at War Child Holland - where he leads efforts to develop and evaluate mental health interventions for conflict-affected children and families.