Family-based preventive interventions have strong potential for promoting family functioning and mental health in children. This chapter reports on one such intervention, the Family Strengthening Intervention (FSI), initially developed and tested in Rwanda to improve communication and parenting in HIV/AIDS-affected families with school-age children. Currently, an early childhood development version of the FSI is being piloted for delivery by lay workers with Rwandan families living in extreme poverty. Because of its flexible nature, the FSI has also been adapted for use with Bhutanese and Somali Bantu refugee families in the Greater Boston area, with overall aims to improve family functioning, improve caregiving practices, and positively impact the mental health of school-age refugee children. While highlighting the innovative nature of this intervention, issues related to feasibility, acceptability, sustainability, and do-no-harm protocols are presented. The chapter concludes with recommendations for future family-based programming.
