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11-10-2019 | Original Paper

Clinically Significant and Reliable Change: Comparing an Evidence-based Intervention to Usual Care

Auteurs: Maria Michelle Vardanian, Amrita Ramakrishnan, Sarah Peralta, Yasmin Siddiqui, Suniti P. Shah, Elysha Clark-Whitney, Anil Chacko

Gepubliceerd in: Journal of Child and Family Studies | Uitgave 4/2020

Abstract

Objectives

Multiple Family Groups (MFG) is an evidence-based behavioral parent training developed with a specific focus on increasing engagement and decreasing treatment barriers for families of children with disruptive behavior problems within high-risk communities. Previous studies have demonstrated the effectiveness of MFG in improving oppositional behavior at the group-level compared to services as usual (SAU). However, information is lacking regarding intervention effectiveness on an individual-level (i.e., clinical significance).

Methods

The reliable change index and clinical cutoff score method was utilized to determine whether MFG produced clinically meaningful changes compared to SAU for both child- and parent-level outcomes in a sample of 320 youth aged 7 to 11-years-old.

Results

A significantly greater percentage of children in the MFG group experienced clinically meaningful change in problem behaviors compared to the SAU group, (p = 0.003, 95% [CI]: 1.610–18.481). A significantly greater number of parents in MFG also demonstrated clinically meaningful change in parental experience of stress compared to SAU, (p = 0.01, 95% [CI]: 1.255–14.704).

Conclusions

Findings suggested clinically significant and reliable improvements in child problem behaviors and decreases in parental perceived stress for families in MFG compared to SAU. Nevertheless, analyses demonstrated that both MFG and SAU resulted in few families obtaining clinically significant or reliable change in their functioning. Ongoing assessments and deeper understanding of intervention effect are needed to better service families in need. Both group- and individual-level comparisons should be considered when examining the effects of a treatment as they may provide a nuanced understanding of evidence-based interventions.

vorige artikel A Systematic Review of Psychological and Pharmacological Interventions for the Management of Trichotillomania in Children and Adolescents

volgende artikel Assessing and Treating Trauma in Detained Adolescents: A Pre–Post Within Subjects Evaluation

Abidin, R. R., & Brunner, J. F. (1995). Development of a parenting alliance inventory. Journal of Clinical Child Psychology, 24(1), 31–40.CrossRef

Acri, M., Chacko, A., Gopalan, G., & McKay, M. (2018). Engaging families in treatment for child behavior disorders: a synthesis of the literature. In J. E. Lochman & W. Matthys (Eds), The Wiley handbook of disruptive and impulse-control disorders (pp. 393–409). Hoboken, NJ: John Wiley & Sons Inc.

Adams, J. F. (2001). Impact of parent training on family functioning. Child & Family Behavior Therapy, 23(1), 29–42.CrossRef

Allan, C., & Chacko, A. (2018). Adverse events in behavioral parent training for children with ADHD: An under-appreciated phenomenon. The ADHD Report, 26(1), 4–9.CrossRef

American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5th ed.). Arlington, VA: American Psychiatric Publishing.CrossRef

Atkins, D. C., Bedics, J. D., Mcglinchey, J. B., & Beauchaine, T. P. (2005). Assessing clinical significance: does it matter which method we use? Journal of Consulting and Clinical Psychology, 73(5), 982–989.PubMedCrossRef

Barkham, M., Connell, J., Stiles, W. B., Miles, J. N., Margison, F., Evans, C., & Mellor-Clark, J. (2006). Dose-effect relations and responsive regulation of treatment duration: the good enough level. Journal of Consulting and Clinical Psychology, 74(1), 160–167.PubMedCrossRef

Bellamy, J. L., Gopalan, G., & Traube, D. E. (2010). A national study of the impact of outpatient mental health services for children in long-term foster care. Clinical Child Psychology and Psychiatry, 15(4), 467–479.PubMedPubMedCentralCrossRef

Bickman, L. (2008). Why don’t we have effective mental health services? Administration and Policy in Mental Health and Mental Health Services Research, 35(6), 437–439.PubMedCrossRef

Bickman, L. (2000). The most dangerous and difficult question in mental health services research. Mental Health Services Research, 2(2), 71–72.CrossRef

Campbell, T. C. (2005). An introduction to clinical significance: an alternative index of intervention effect for group experimental designs. Journal of Early Intervention, 27(3), 210–227.CrossRef

Chacko, A., Alan, C., Uderman, J., Cornwell, M., Anderson, L., & Chimiklis, A. (2015a). Training parents of children with ADHD. In R. Barkley (Ed.), Attention deficit hyperactivity disorder: a handbook for diagnosis and treatment (pp. 513–536). New York, NY: Guilford Press.

Chacko, A., Fabiano, G. A., Doctoroff, G. L., & Fortson, B. (2018a). Engaging fathers in effective parenting for preschool children using shared book reading: a randomized controlled trial. Journal of Clinical Child & Adolescent Psychology, 47(1), 79–93.CrossRef

Chacko, A., Gopalan, G., Franco, L., Dean-Assael, K., Jackson, J., Marcus, S., & McKay, M. (2015b). Multiple family group service model for children with disruptive behavior disorders. Journal of Emotional and Behavioral Disorders, 23(2), 67–77.PubMedCrossRef

Chacko, A., Granski, M., Horn, E. P., Levy, M. D., Dahl, V., Lacks, R. S., & Ramakrishnan, A. (2018b). Prevention of disruptive behavior problems in children. In M. M. Martel (Ed.), Developmental pathways to disruptive, impulse-control and conduct disorders (pp. 347–380). London, UK: Academic Press.CrossRef

Chacko, A., Isham, A., Cleek, A. F., & McKay, M. M. (2016a). Using mobile health technology to improve behavioral skill implementation through homework in evidence-based parenting intervention for disruptive behavior disorders in youth: study protocol for intervention development and evaluation. Pilot and Feasibility Studies, 2(1), 57–68.PubMedPubMedCentralCrossRef

Chacko, A., Jensen, S. A., Lowry, L. S., Cornwell, M., Chimklis, A., Chan, E., & Pulgarin, B. (2016b). Engagement in behavioral parent training: review of the literature and implications for practice. Clinical Child and Family Psychology Review, 19(3), 204–215.PubMedCrossRef

Chacko, A., & Scavenius, C. (2018). Bending the curve: a community-based behavioral parent training model to address ADHD-related concerns in the voluntary sector in Denmark. Journal of Abnormal Child Psychology, 46(3), 505–517.PubMedCrossRef

Chacko, A., Scavenius, C., Rewitz, A. F., & Lydiksen, C. L. (2018c). Caring in chaos: a behavioral parent training model for resource-limited community providers. The ADHD Report, 26(4), 1–8.CrossRef

Chacko, A., Uderman, J. Z., & Zwilling, A. (2013). Lessons learned in enhancing behavioral parent training for high-risk families of youth with ADHD. The ADHD Report, 21(4), 6–11.PubMedPubMedCentralCrossRef

Chacko, A., Wymbs, B. T., Chimiklis, A., Wymbs, F. A., & Pelham, W. E. (2012). Evaluating a comprehensive strategy to improve engagement to group-based behavioral parent training for high-risk families of children with ADHD. Journal of Abnormal Child Psychology, 40(8), 1351–1362.PubMedCrossRef

Chacko, A., Wymbs, B., Rajwan, E., Wymbs, F., & Feirsen, N. (2017). Characteristics of parents of children with ADHD who never attend, drop out, and complete behavioral parent training. Journal of Child and Family Studies, 26(3), 950–960.CrossRef

Chacko, A., Wymbs, B. T., Wymbs, F. A., Pelham, W. E., Swanger-Gagne, M. S., Girio, E., & O’Connor, B. (2009). Enhancing traditional behavioral parent training for single mothers of children with ADHD. Journal of Clinical Child & Adolescent Psychology, 38(2), 206–218.CrossRef

Chavis, A., Hudnut-Beumler, J., Webb, M. W., Neely, J. A., Bickman, L., Dietrich, M. S., & Scholer, S. J. (2013). A brief intervention affects parents’ attitudes toward using less physical punishment. Child Abuse & Neglect, 37(12), 1192–1201.CrossRef

Chronis, A., Chacko, A., Fabiano, G., Wymbs, B., & Pelham, Jr, W. (2004). Enhancements to the behavioral parent training paradigm for families of children with ADHD: Review and future directions. Clinical Child and Family Psychology Review, 7(1), 1–27.PubMedCrossRef

Dadds, M. R., Maujean, A., & Fraser, J. A. (2003). Parenting and conduct problems in children: Australian data and psychometric properties of the Alabama parenting questionnaire. Australian Psychologist, 38(3), 238–241.CrossRef

Deater-Deckard, K. (2008). Parenting stress. New Haven, CT: Yale University Press.

Deater-Deckard, K. D. & Panneton, R. (Eds) (2017). Parental stress and early child development. Cham, CH: Springer.

Devilly, G.J. (2005). ClinTools Software for Windows: Version 4 (computer programme). Psytek Ltd. www.clintools.com.

Eyberg, S. M., Nelson, M. M., & Boggs, S. R. (2008). Evidence-based psychosocial treatments for children and adolescents with disruptive behavior. Journal of Clinical Child & Adolescent Psychology, 37(1), 215–237.CrossRef

Fabiano, G. A., Pelham, W. E., Coles, E. K., Gnagy, E. M., Chronis-Tuscano, A., & O’Connor, B. C. (2009). A meta-analysis of behavioral treatments for attention-deficit/hyperactivity disorder. Clinical Psychology Review, 29(2), 129–140.PubMedCrossRef

Fabiano, G. A., Pelham, J., William, E., Waschbusch, D. A., Gnagy, E. M., Lahey, B. B., & Burrows-MacLean, L. (2006). A practical measure of impairment: psychometric properties of the impairment rating scale in samples of children with attention deficit hyperactivity disorder and two school-based samples. Journal of Clinical Child & Adolescent Psychology, 35(3), 369–385.CrossRef

Ferrer, R., & Pardo, A. (2014). Clinically meaningful change: false positives in the estimation of individual change. Psychological Assessment, 26(2), 370–383.PubMedCrossRef

Frazier, S. L., Chacko, A., Van Gessel, C., O’Boyle, C., & Pelham, W. E. (2012). The summer treatment program meets the south side of Chicago: bridging science and service in urban after‐school programs. Child and Adolescent Mental Health, 17(2), 86–92.PubMedCrossRef

Garland, A. F., Bickman, L., & Chorpita, B. F. (2010). Change what? Identifying quality improvement targets by investigating usual mental health care. Administration and Policy in Mental Health and Mental Health Services Research, 37(1–2), 15–26.PubMedCrossRef

Gerdes, A. C., Haack, L. M., & Schneider, B. W. (2012). Parental functioning in families of children with ADHD: evidence for behavioral parent training and importance of clinically meaningful change. Journal of Attention Disorders, 16(2), 147–156.PubMedCrossRef

Gopalan, G., Bornheimer, L. A., Acri, M., Winters, A., O’Brien, K. H., & Chacko, A. (2018). Multiple family group service delivery model for children with disruptive behavior disorders: Impact on caregiver stress and depressive symptoms. Journal of Emotional and Behavioral Disorders, 26(3), 182–192.PubMedCrossRef

Gopalan, G., Chacko, A., Franco, L., Dean-Assael, K. M., Rotko, L. E., Marcus, S. M., & McKay, M. M. (2015a). Multiple family groups for children with disruptive behavior disorders: Child outcomes at 6-month follow-up. Journal of Child and Family Studies, 24(9), 2721–2733.PubMedCrossRef

Gopalan, G., Fuss, A., & Wisdom, J. P. (2015b). Multiple family groups for child behavior difficulties retention among child welfare-involved caregivers. Research on Social Work Practice, 25(5), 564–577.PubMedCrossRef

Gopalan, G., Small, L., Fuss, A., Bowman, M., Jackson, J., Marcus, S., & Chacko, A. (2015c). Multiple family groups to reduce child disruptive behavior difficulties: Moderating effects of child welfare status on child outcomes. Child Abuse & Neglect, 46, 207–219.CrossRef

Gresham, F. M. (2015). Disruptive behavior disorders: evidence-based practice for assessment and interventions. New York, NY: Guilford Press.

Haskett, M. E., Ahern, L. S., Ward, C. S., & Allaire, J. C. (2006). Factor structure and validity of the parenting stress-index-short form. Journal of Clinical Child & Adolescent Psychology, 35(2), 302–312.CrossRef

Health Resources and Services Administration [HRSA] (2016). National projections of supply and demand for selected behavioral health practitioners: 2013–2025. Department of Health and Human Services. https://bhw.hrsa.gov/sites/default/files/bhw/health-workforce-analysis/research/projections/behavioral-health2013-2025.pdf. Accessed 23 Jan 2019.

Heath, C. L., Curtis, D. F., Fan, W., & McPherson, R. (2015). The association between parenting stress, parenting self-efficacy, and the clinical significance of child ADHD symptom change following behavior therapy. Child Psychiatry & Human Development, 46(1), 118–129.CrossRef

Hoagwood, K., Cavaleri, M., Olin, S., Burns, B., Slaton, E., Gruttadaro, D., & Hughes, R. (2010). Family support in children’s mental health: a review and synthesis. Clinical Child and Family Psychology Review, 13(1), 1–45.PubMedCrossRef

Hoagwood, K., & Kolko, D. J. (2009). Introduction to the special section on practice contexts: A glimpse into the nether world of public mental health services for children and families. Administration and Policy in Mental Health and Mental Health Services Research, 36(1), 35–36.PubMedCrossRef

IBM Corp. (2017). IBM SPSS statistics for windows, version25.0. Armonk, NY: IBM Corp. Released.

Jacobson, N. S., & Truax, P. (1991). Clinical significance: a statistical approach to defining meaningful change in psychotherapy research. Journal of Consulting and Clinical Psychology, 59(1), 12–19.PubMedCrossRef

Kaminski, J. W., & Claussen, A. H. (2017). Evidence base update for psychosocial treatment of disruptive behaviors in children. Journal of Clinical Child and Adolescent Psychology, 46(4), 477–499.PubMedPubMedCentralCrossRef

Karpenko, V., Owens, J. S., Evangelista, N. M., & Dodds, C. (2009). Clinically significant symptom change in children with attention-deficit/hyperactivity disorder: Does it correspond with reliable improvement in functioning? Journal of Clinical Psychology, 65(1), 76–93.PubMedCrossRef

Kazdin, A. E. (1995). Child, parent and family dysfunction as predictors of outcome in cognitive-behavioral treatment of antisocial children. Behaviour Research and Therapy, 33(3), 271–281.PubMedCrossRef

Kazdin, A. E., & Whitley, M. K. (2003). Treatment of parental stress to enhance therapeutic change among children referred for aggressive and antisocial behavior. Journal of Consulting and Clinical Psychology, 71(3), 504–515.PubMedCrossRef

McCart, M. R., Priester, P. E., Davies, W. H., & Azen, R. (2006). Differential effectiveness of behavioral parent-training and cognitive-behavioral therapy for antisocial youth: a meta-analysis. Journal of Abnormal Child Psychology, 34(4), 525–541.CrossRef

McKay, M. M., Gonzales, J., Quintana, E., Kim, L., & Abdul-Adil, J. (1999). Multiple family groups: An alternative for reducing disruptive behavioral difficulties of urban children. Research on Social Work Practice, 9(5), 593–607.CrossRef

Newnham, E. A., & Page, A. C. (2010). Bridging the gap between best evidence and best practice in mental health. Clinical Psychology Review, 30(1), 127–142.PubMedCrossRef

Ogles, B. M., Lunnen, K. M., & Bonesteel, K. (2001). Clinical significance: history, application, and current practice. Clinical Psychology Review, 21(3), 421–446.PubMedCrossRef

Oruche, U. M., Draucker, C. B., Robb, S. L., Aalsma, M. C., Pescosolido, B. A., & Brown-Podgorski, B. (2017). Developing a multiple caregiver group for caregivers of adolescents with disruptive behaviors. Archives of Psychiatric Nursing, 31(6), 596–601.PubMedCrossRef

Owens, J. S., Johannes, L. M., & Karpenko, V. (2009). The relation between change in symptoms and functioning in children with ADHD receiving school-based mental health services. School Mental Health, 1(4), 183–195.CrossRef

Pelham, W. E., & Fabiano, G. A. (2008). Evidence-based psychosocial treatments for attention-deficit/hyperactivity disorder. Journal of Clinical Child & Adolescent Psychology, 37(1), 184–214.CrossRef

Pelham, W., Gnagy, E., Greenslade, K., & Milich, R. (1992). Teacher ratings of DSM-III-R symptoms for the disruptive behavior disorder. Journal of The American Academy of Child & Adolescent Psychiatry, 31(2), 210–218.CrossRef

Rajwan, E., Chacko, A., Wymbs, B., & Wymbs, F. (2014). Evaluating clinically significant change in mother and child functioning: comparison of traditional and enhanced behavioral parent training. Journal of Abnormal Child Psychology, 42(8), 1407–1412.PubMedCrossRef

Sheldrick, R. C., Kendall, P. C., & Heimberg, R. G. (2001). The clinical significance of treatments: a comparison of three treatments for conduct disordered children. Clinical Psychology: Science and Practice, 8(4), 418–430.

Shelton, K. K., Frick, P. J., & Wootton, J. (1996). Assessment of parenting practices in families of elementary school-age children. Journal of Clinical Child Psychology, 25(3), 317–329.CrossRef

Stoltz, S., Deković, M., van Londen, M., Orobio de Castro, B., & Prinzie, P. (2013). What works for whom, how and under what circumstances? Testing moderated mediation of intervention effects on externalizing behavior in children. Social Development, 22(2), 406–425.CrossRef

Warren, J. S., Nelson, P. L., & Burlingame, G. M. (2009). Identifying youth at risk for treatment failure in outpatient community mental health services. Journal of Child and Family Studies, 18(6), 690–701.CrossRef

Warren, J. S., Nelson, P. L., Mondragon, S. A., Baldwin, S. A., & Burlingame, G. M. (2010). Youth psychotherapy change trajectories and outcomes in usual care: community mental health versus managed care settings. Journal of Consulting and Clinical Psychology, 78(2), 144–155.PubMedCrossRef

Waschbusch, D., & Willoughby, M. (2008). Parent and teacher ratings on the IOWA Connors Rating Scale. Journal of Psychopathology and Behavioral Assessment, 30(3), 180–192.CrossRef

Weeland, J., Chhangur, R. R., van der Giessen, D., Matthys, W., de Castro, B. O., & Overbeek, G. (2017). Intervention effectiveness of The Incredible Years: new insights into sociodemographic and intervention-based moderators. Behavior Therapy, 48(1), 1–18.PubMedCrossRef

Weisz, J. R. (2004). Psychotherapy for children and adolescents: Evidence-based treatments and case examples. Cambridge, UK: Cambridge University Press.CrossRef

Weisz, J. R., Kuppens, S., Ng, M. Y., Eckshtain, D., Ugueto, A. M., Vaughn-Coaxum, R., & Weersing, V. R. (2017). What five decades of research tells us about the effects of youth psychological therapy: a multilevel meta-analysis and implications for science and practice. American Psychologist, 72(2), 79–117.PubMedCrossRef

Titel: Clinically Significant and Reliable Change: Comparing an Evidence-based Intervention to Usual Care
Auteurs: Maria Michelle Vardanian
Amrita Ramakrishnan
Sarah Peralta
Yasmin Siddiqui
Suniti P. Shah
Elysha Clark-Whitney
Anil Chacko
Publicatiedatum: 11-10-2019
Uitgeverij: Springer US
Gepubliceerd in: Journal of Child and Family Studies / Uitgave 4/2020
Print ISSN: 1062-1024
Elektronisch ISSN: 1573-2843
DOI: https://doi.org/10.1007/s10826-019-01621-3

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