The standard CPG^® is a 10-week manualized group program for parents of pre-teens and teenagers with serious behavioral and emotional problems. The program targets parenting factors that promote secure attachment, namely caregiver sensitivity, reflective functioning, shared mutuality, and dyadic affect regulation, which are crucial for supporting healthy adolescent development and autonomy while maintaining a positive emotional connection with their parents (Moretti and Obsuth, 2009; Moretti et al., 2015; Barone et al., 2020). Each weekly 90-min session is co-conducted in person by two trained group facilitators and introduces the principle of attachment. Sessions are designed to engage parents through role plays and reflection exercises that promote emotion-based learning (Barone et al., 2020). Research conducted over 15 years proved CPG^® as effective in building targeted parenting skills, reducing parental stress, increasing the attachment security of adolescents, and improving the quality of parent–adolescent relationships, as well as decreasing the levels of internalizing and externalizing problems in adolescents (Moretti and Obsuth, 2009; Moretti et al., 2015; Högström et al., 2017; Moretti et al., 2017; Osman et al., 2017a,b; Ozturk et al., 2019; Barone et al., 2020; Moretti et al., 2020; Pasalich et al., 2021; Pasalich and Palfrey, 2021), with positive outcomes up to 2 years after the intervention (Högström et al., 2017).

However, when the standard in-person CPG^® was used with foster parents, they did not find it as beneficial as biological parents. Therefore, based on foster parents’ suggestions, Moretti et al. developed a trauma-informed adaptation for foster parents of teens (Moretti et al., 2020; Pasalich et al., 2021). In this adaptation, each session integrates a part that can help caregivers understand the impact of pre-placement adverse experiences on adolescents’ behavior and deal with obstacles and feelings posed by the relationship with childcare services. For example, the first two sessions integrate psychoeducational information on how attachment can be affected by traumatic early childhood adversities, and the third session focuses on how trauma can distort adolescents’ behaviors in response to parent–adolescent conflicts. All sessions aim at enhancing the reflective engagement of the parents, considering the role of the attachment background of adolescents (their “attachment suitcase”) in shaping adolescents’ behavior, aiming at building parent skills of reflection, understanding, and sensitive response to adolescents’ behaviors. The pilot test of this trauma-informed adaptation of CPG^© with foster and kinship parents revealed promising results and positive feedback from parents and professionals working with them (Moretti et al., 2020; Pasalich et al., 2021), overall suggesting that this adaptation is recommended for foster and adoptive families.

Moreover, during the COVID-19 pandemic, Bao and Moretti (2023) adapted the standard intervention to be delivered online, i.e., e-Connect. In this adaptation, each participant follows the group through video calls on a personal device, a laptop, or a tablet, which enables them to see other participants and the facilitators who use digital flipcharts to work through exercises and reflections. Digital flipcharts contain prompts and are filled with participants’ responses, as would paper flipcharts in the in-person version. To prevent facilitators’ fatigue, unlike CPG^® in person, e-Connect is composed of smaller groups of a maximum of 10 participants and requires an additional assistant to manage the online flipcharts and provide technical support (Bao and Moretti, 2023). Role-playing has also been adapted to be performed by the two facilitators, each using their screen so parents can clearly observe facial expressions and non-verbal language. To facilitate participants’ attention and facilitators’ efficiency, for each e-Connect group, preferably no more than 10–12 video tiles should appear on the screen (Pasalich and Palfrey, 2021). Research with e-Connect conducted in Canada and Italy (Bao and Moretti, 2023; Benzi et al., 2023; Tracheggiani et al., 2023) suggests positive outcomes with this online adaptation as with the in-person one, suggesting its use is promising when parents can have difficulty accessing in-person programs. For instance, the online intervention could be fruitful for adoptive and foster families, often residing in decentralized areas, while adoption/foster services are usually in urban centers (Oldani and Pancino, 2017) and the overload of commitments partly resulting from adolescents’ problems can be a barrier to accessing support services (Golding, 2014; Leake et al., 2019).

To date, the trauma-informed adaptation of the CPG^® has been provided only in person and only to foster parents, and there is no information about how this adaptation might work if it were also delivered online, not only to foster parents but also to adoptive ones.

From the above, the utility of parent support tailored to the specific needs of adoptive and foster families emerged, particularly in trauma-informed attachment-based group programs such as CPG^®. The lack and potential of online intervention among these populations of parents also emerge. Therefore, the current study aimed to describe the outcomes of two pilot experiences where the trauma-informed adaptation of CPG^® for foster parents was delivered online, i.e., e-Connect for foster parents, to two groups of adoptive and foster parents of adolescents living in Italy. With descriptive purpose, we visually inspected trends of adolescents’ emotional-behavioral problems and affective regulation, caregivers’ strain, and quality of parent–adolescent relationships from the week before the intervention (T1) to the week after the intervention (T2), and we reported their feedback and suggestions about the program’s value, strengths, and limits.

The study was conducted with the support of “Fondo di Beneficenza di Intesa Sanpaolo” (protocol n. B/2021/0452).

Participants were enrolled with the collaboration of the project stakeholders, who signed a formal agreement sheet to collaborate. Full details about the study procedure (time and phases of data collection, dropout and attrition, and data collected and analyzed) are shown in the flowchart in Figure 1.

Participants reported on socio-demographic information during pre-intervention interviews, which are included in the Connect program and are designed to increase treatment motivation and address barriers to attendance. Socio-demographic information was also collected in the set of T1 pre-intervention questionnaires. This study included data from parents who completed both pre- and post-intervention questionnaires and at least 70% of sessions, which were all participants except one adoptive mother, who dropped at the second session for personal unresolvable reasons (5%). Therefore, this study included data of 9 adoptive parents (5 fathers, M_age = 51.30, SD_age = 5.75) of 6 adopted adolescents (60% males, M_age = 13.60, SD_age = 1.67; placed at M_age = 6.42 for M_lenght = 7.40; area of origin: 60% Italy, 40% Russia, 20% Colombia), and of 10 foster parents (four fathers, M_age = 55.30, SD_age = 4.29) of 8 adolescents in foster care (50% males, M_age = 14.13, SD_age = 3.04; placed at M_age = 6.42 for M_lenght = 7.88; area of origin: 87.5% Italy, 12.5% Pakistan). All parents had medium-high socio-educational levels. Only foster parents already had biological siblings (70%).

Data from the two samples were reported separately to highlight potential population specificities and because of different population characteristics, i.e., legal parenting in adoption vs. a temporary role in foster care.

This study includes data from T1 and T2, as the follow-up data collection (T3) is ongoing. Given the descriptive nature of the study and the limited sample sizes, no statistical analyses were performed. Scores in the two phases in each group were reported in a table, and results of the feedback session were narratively reported, grouped in themes of “program value,” “perceived changes,” and “suggestions to improve.”

Table 1 reports scores’ means [M] and standard deviations [SD] in both groups.

Scores on Table 1 seem to suggest decreasing trends regarding scores of parent-reported adolescents’ internalizing and externalizing problems and affective dysregulation and suppression, as well as in caregiving strain, while lines of quality parent–adolescent relationships appear quite stable on high scores (over 2.5 on a 4-point Likert scale).

This descriptive study has marked limitations to consider. First, because of the absence of data from follow-up assessment (under collection), this study was designed as a pilot preliminary description, and no statistical analyses were performed, so the statistical significance of the trends described was not empirically tested and should be verified by future studies. With the scope to describe pilot experiences and highlight possible population specificities, the small sample size groups were kept separate because they participated in the intervention separately and because of population characteristics, i.e., legal parenting in adoption vs. a temporary role in foster care. Furthermore, some parents were couples with only one child and referred to the same children, so the data were not independent of each other, and a larger, statistically based investigation should address this point. Third, adoptive and foster families have been fairly supported from the beginning, benefiting from psychological support and declaring a good-quality parent–adolescent relationship since T1. Therefore, this sample may not totally represent hard-to-reach adoptive and foster parents dealing with the plight of their children included in the previously mentioned CPG^® and e-Connect studies. Some families may be hard to reach due to their demanding childcare responsibilities that often occur as a result of problems in parenting adopted children (Moretti and Peled, 2004; Sánchez-Sandoval and Palacios, 2012; Golding, 2014; Oldani and Pancino, 2017; Leake et al., 2019; Hanlon et al., 2022) or because of their distant or remote geographical location. This online intervention is a promising option for overcoming these population-specific barriers to treatment. Furthermore, by working in partnership with formal and informal agencies and local services, we have found that barriers to the recruitment of population-specific and hard-to-reach populations (van der Ven et al., 2022) can be more easily resolved. Importantly, this recruitment strategy can build the engagement of trusted community professionals who can encourage and support parents in enrolling in online treatment (van der Ven et al., 2022).

However, having only one group of adoptive parents and one of foster parents, this study is configured more as the description of a pilot experience, and further experiences of other groups in these populations are necessary in order to reach the numbers necessary to substantiate these results with appropriate statistical tests.

Finally, because the aim was not a statistical pre- and post-change investigation, we did not report information from adolescent measurements or data from a control group, all limitations to be addressed in future study design.

Despite these limitations, and given the published findings supporting the effectiveness of Connect for alternate caregivers (Pasalich and Palfrey, 2021) and e-Connect in other countries (Bao and Moretti, 2023), our results appear encouraging and suggest further research on the feasibility of the trauma-informed version of e-Connect with adoptive and foster parents in Italy.