Therapist alliance building behavior and treatment adherence for dutch children with mild intellectual disability or borderline intellectual functioning and externalizing problem behavior

BACKGROUND: Psychological interventions targeting children with mild intellectual disability or borderline intellectual functioning (MID-BIF) are suggested to be effective in reducing their externalizing problem behavior, but less is known about the specific treatment processes that may be associated with these effects. AIMS: The current study investigated whether the treatment processes of observed treatment adherence (i.e., the degree to which a therapist sticks to the protocol of a treatment and provides the treatment as intended) and observed therapist alliance-building behavior (TA-BB; i.e., behavior contributing to the affective bond between the therapist and the client) predicted treatment outcomes in a group behavioral parent training combined with group child cognitive behavior therapy targeting externalizing problem behavior in children with MID-BIF. METHODS AND PROCEDURES: Seventy-two children (aged 9-18; Mage = 12.1) and their parents in The Netherlands received the intervention program. They reported on children's externalizing behavior, parenting practices and the parent-child relationship by questionnaires at pre-test and post-test, and the observed treatment processes were coded by audio tapes of therapeutic sessions. OUTCOMES AND RESULTS: The results showed high levels of both treatment adherence (M = 2.49; SD = 0.20; range 1 - 3) and TA-BB (M = 4.11; SD = 0.32; range 1 - 5). Additionally, repeated measures analyses revealed that levels of treatment adherence significantly predicted the improvement of the parent-child relationship (F(1, 66) = 5.37; p = .024) and that levels of TA-BB significantly predicted the decrease of parent reported externalizing problem behavior (F(1, 66) = 9.89; p = .002). CONCLUSIONS AND IMPLICATIONS: The current study suggested that optimal treatment processes are important for treatment outcomes in an intervention targeting children with MID-BIF

An Outcome Evaluation of the Implementation of the Triple P – Positive Parenting Program in Hong Kong

The present study evaluated the effectiveness of the Positive Parenting Program (Triple P) with a sample of Chinese parents of children with early onset conduct related problems in Hong Kong. The participants consisted of 91 parents whose children attended maternal and child health centers and child assessment centers for service, and were between three to seven years old. Participants were randomly assigned to the intervention (TP) and a waitlist control group (WL. There was no significant difference in pre-intervention measures between the two groups. However, at post intervention, participants in the TP group reported significantly lower levels of child behavior problems, lower dysfunctional parenting styles, and higher parent sense of competence, compared to the WL group. Implications of these findings for the use of Triple P with families of Chinese descent are discussed

Psychosocial Treatment of Children in Foster Care: A Review

A substantial number of children in foster care exhibit psychiatric difficulties. Recent epidemiologi-cal and historical trends in foster care, clinical findings about the adjustment of children in foster care, and adult outcomes are reviewed, followed by a description of current approaches to treatment and extant empirical support. Available interventions for these children can be categorized as either symptom-focused or systemic, with empirical support for specific methods ranging from scant to substantial. Even with treatment, behavioral and emotional problems often persist into adulthood, resulting in poor functional outcomes. We suggest that self-regulation may be an important mediat-ing factor in the appearance of emotional and behavioral disturbance in these children

Impaired Neurocognitive Functions Affect Social Learning Processes in Oppositional Defiant Disorder and Conduct Disorder: Implications for Intervention

Item does not contain fulltextIn this review, a conceptualization of oppositional defiant (ODD) and conduct disorder (CD) is presented according to which social learning processes in these disorders are affected by neurocognitive dysfunctions. Neurobiological studies in ODD and CD suggest that the ability to make associations between behaviors and negative and positive consequences is compromised in children and adolescents with these disorders due to reduced sensitivity to punishment and to reward. As a result, both learning of appropriate behavior and learning to refrain from inappropriate behavior may be affected. Likewise, problem solving is impaired due to deficiencies in inhibition, attention, cognitive flexibility, and decision making. Consequently, children and adolescents with ODD and CD may have difficulty learning to optimize their behavior in changeable environments. This conceptualization of ODD and CD is relevant for the improvement of the effect of psychological treatments. Behavioral and cognitive-behavioral interventions that have been shown to be modestly effective in ODD and CD are based on social learning. Limited effectiveness of these interventions may be caused by difficulties in social learning in children and adolescents with ODD and CD. However, although these impairments have been observed at a group level, the deficits in reward processing, punishment processing, and cognitive control mentioned above may not be present to the same extent in each individual with ODD and CD. Therefore, the neurocognitive characteristics in children and adolescents with ODD and CD should be assessed individually. Thus, instead of delivering interventions in a standardized way, these programs may benefit from an individualized approach that depends on the weaknesses and strengths of the neurocognitive characteristics of the child and the adolescent

Therapist alliance building behavior and treatment adherence for Dutch children with mild intellectual disability or borderline intellectual functioning and externalizing problem behavior

BACKGROUND: Psychological interventions targeting children with mild intellectual disability or borderline intellectual functioning (MID-BIF) are suggested to be effective in reducing their externalizing problem behavior, but less is known about the specific treatment processes that may be associated with these effects. AIMS: The current study investigated whether the treatment processes of observed treatment adherence (i.e., the degree to which a therapist sticks to the protocol of a treatment and provides the treatment as intended) and observed therapist alliance-building behavior (TA-BB; i.e., behavior contributing to the affective bond between the therapist and the client) predicted treatment outcomes in a group behavioral parent training combined with group child cognitive behavior therapy targeting externalizing problem behavior in children with MID-BIF. METHODS AND PROCEDURES: Seventy-two children (aged 9-18; Mage = 12.1) and their parents in The Netherlands received the intervention program. They reported on children's externalizing behavior, parenting practices and the parent-child relationship by questionnaires at pre-test and post-test, and the observed treatment processes were coded by audio tapes of therapeutic sessions. OUTCOMES AND RESULTS: The results showed high levels of both treatment adherence (M = 2.49; SD = 0.20; range 1 - 3) and TA-BB (M = 4.11; SD = 0.32; range 1 - 5). Additionally, repeated measures analyses revealed that levels of treatment adherence significantly predicted the improvement of the parent-child relationship (F(1, 66) = 5.37; p = .024) and that levels of TA-BB significantly predicted the decrease of parent reported externalizing problem behavior (F(1, 66) = 9.89; p = .002). CONCLUSIONS AND IMPLICATIONS: The current study suggested that optimal treatment processes are important for treatment outcomes in an intervention targeting children with MID-BIF