Table 4 Summary of ad-hoc adaptation types and their alignment with intervention goals

Religion

• Faith, prayer suggested as strategies for coping with challenges

• Religious references (church/mosque, Bible) common for most counselors

• Encouraged to put trust in God

• Counselors, families prayed together

• Used religious texts to promote intervention content

• Mostly neutral but TP-interrupting 1/5 time

• TP-promoting: References to God, prayer to affirm and encourage families’ progress; encourage families to actively create change, rather than passively rely on God

• TP-interrupting: Tell families what to do (e.g., prayer as only solution), sometimes with religious justification

“I thank God because you have reached your goal. […] My prayer for you is that you will be able to build that goal to be the good foundation for you because you have decided on a good goal and will improve you in your marriage.” (Family 10)

Metaphors and proverbs

• Metaphors used to explain intervention content

• Mostly TP-promoting; only TP-interrupting in 10% instances

• TP-promoting: Metaphors effectively interwoven with eliciting problems, solutions or affirming family

• TP-interrupting: Sometimes become long lectures that prevent family from contributing, developing solutions

“When you want to plant vegetables, you can plant just a little bit of the vegetables, but you will harvest a lot from that. And so, what will you do in order to start this love, so that it can continue to flourish and grow?” (Family 12)

Incorporating community resources and dynamics

• Institutions (e.g., schools, businesses) and individuals (e.g., elders) discussed in relation to both possible help and harm (e.g., neighbors causing issues)

• Counselors encouraged families to seek out resources as potential emotional, problem-solving supports or material supports (e.g., for loans)

• Cultural dynamics rarely referenced; emphasized alignment of intervention, cultural values

• Mostly TP-promoting; only TP-interrupting in 10% instances

• TP-promoting: Encourage families’ active identification of solutions

• TP-interrupting: Tell families what to do; over-promise; become judgmental

“We say respect is powerful in Nandi; our people were not fools because you can see all these things that we use [in this program] are the things that our people used to do. [...] We need to consider it and put together our culture and what we have now.” (Family 1)

Examples and role models

• Examples of people in similar situations as families. Usually real people family or counselor knows. Sometimes famous people or hypothetical examples

• Mostly positive stories used to motivate; some negative examples used to warn

• Examples from previous families counseled to establish expertise, instill hope

• Mostly neutral but TP-interrupting 1/5 time

• TP-promoting: Encourage families through success stories or gentle warnings, while emphasizing necessity of effort; validate shared experiences

• TP-interrupting: Overstate possible improvements; examples sometimes long, confusing; offer solutions instead of family developing them; negative examples sometimes foreboding, heavy handed

“I had a [neighbor] and had the same problem as yours. They were quarreling and fighting all the time, and I had to sit down with them, and we talked, and they both listened to me, and we managed to solve their problem. […] Misunderstanding in a family is normal, but you have to look beyond that and see the future of your children.” (Family 15)

Self-disclosure

• Counselors shared own experiences (e.g., problem drinking, relationships, emotions)

• Sometimes hypothetical examples of how they would handle similar situation

• One of least frequent but used by widest range of counselors

• Most intervention-aligned type; large minority of instances neutral

• TP-promoting: Validate experiences; model active solutions; promote communication

• TP-interrupting: Become lecturing or judgmental; promote harmful behaviors

“Do not think we [counselors] do not have problems; we also have problems. I also love this program because it has helped me; when I pass through such challenges, I know that I need to do this and this.” (Family 1)