None listed
Conditions
Brief summary
A cluster-randomised trial was conducted comparing two versions of delivery of the early primary school version of the Exploring Together program; one form had separate child and parent group sessions (Exploring Together-Adapted; ET-Adapted) and the other form included some parent-child group time in the intervention (Exploring Together; ET). The sample analysed consisted of 136 parents and their children (aged 5-10 years) with externalising and/or internalising problems, recruited from government (n = 20) and catholic (n = 4) primary schools from within the south east metropolitan suburbs of Melbourne and Mornington Peninsual region, Victoria. Child outcome measures included parent- and teacher-reported child externalising and internalising problems. Parent outcome measures included parent self-report of positive and negative parenting behaviour, parenting stress, satisfaction and efficacy. All outcomes were assessed post intervention and at 6- and 12-month follow ups. In regard to child outcomes, significant reductions in parent- and teacher-reported child externalising and internalising problems were evident across both treatment groups at post intervention. At the 6- and 12-month follow-ups significant reductions were maintained on parent-reported child externalising and internalising problems only. Change on all child outcome variables did not vary significantly between treatment conditions at any time point. In regard to parent outcomes, significant changes averaged across both treatment groups over time were found for parent-reported negative parenting practices at post intervention (maintained up to 12 month follow-up) and parenting efficacy at post intervention (maintained up to 6-month follow-up). Results showed non-significant changes averaged across both treatment groups over time for parenting stress, positive parenting practices and parenting satisfaction. There was evidence of a significant group (intervention) by time interaction for parenting efficacy at post intervention, with greater improvement for participants in the ET program. There was also evidence of a significant group (intervention) by time interaction for parenting satisfaction at 12-month follow-up, with greater improvements for participants in the ET-Adapted program. Overall, study results did not demonstrate that the inclusion of parent-child interactive groups (ET program) was associated with consistently greater improvements in child behaviour or parenting outcomes relative to the version (ET-Adapted program) that omitted the combined groups.
Interventions
Two versions of the early primary school version of the Exploring Together program were evaluated; one form had separate child and parent group sessions (Exploring Together-Adapted; ET-Adapted) and the other form included some parent-child group time in the intervention (Exploring Together; ET). The Exploring Together program (Littlefield et al., 2010) is a multi-group treatment program in that it involves children, their parent, and teachers. The original manualized version of the program consists of three group components, namely parent-child interactive groups, children’s group, and parent’s group. Additionally, two teacher’s meetings and two partner’s meetings are held throughout the program. The theoretical underpinning of the program is drawn from a number of psychological theories, including, cognitive-behavioral theory, attachment theory, and coercion theory. The program focuses on supporting parents, enhancing parenting practices, strengthening family units, reducing children’s problematic behavior, and developing children’s social skills. The ET-Adapted program consisted of separate concurrent groups for children (1.5 hours, 2 leaders) and parents (1.5 hours, 2 leaders). The ET program consisted of a parent-child interactive group (40 minutes, 4 leaders), followed by separate concurrent group sessions for parents and children (each 1 hour duration with 2 group leaders). Parents and children then came together for a final parent-child interactive group (20 minutes, 4 leaders). The programs were provided free to participants and consisted of nine (weekly) sessions, coinciding with school terms. It was a requirement that one parent be able to attend the nine-week group program. Intervention groups were conducted at the participating primary school during school hours. Each version of the program consisted of all of the content covered in the original manualized version of the early primary school edition of the Exploring Together program (Littlefield et al., 2010), including the distribution of weekly Mystery Mission (homework) tasks. Both versions of the program included two meetings for partners or support persons and two meetings for teachers. Additionally, both versions of the program incorporated teaching of Emotion Coaching principles (Gottman & DeClaire, 1997) to parents throughout the program. Parent participants from both intervention conditions were invited to attend a booster group to coincide with 6-month follow-up. Two teachers meetings (each 1-1.5 hours in duration) were held throughout both versions of the program (ET and ET-Adapted) and were usually held at the end of a school day. The teachers meetings aimed to provide information about the program and promote a consistent approach in how to discipline and nurture the children. Two group-based, face-to-face parent evenings (each 1-1.5 hours in duration) were held throughout both versions of the program (ET and ET-Adapted). The parent evenings aimed to elicit the partner’s expectations of the program and to involve the partners in the program and implementing strategies in the home. Parent participants from both versions of the program (ET and ET-Adapted) were invited to attend a group booster session (1-1.5 hours long) to coincide with completion of 6-month follow-up measures. The aims were to complete the 6-month follow-up measures and reinforce parenting strategies learnt during the program, and provide an opportunity to troubleshoot any problems that may have arisen. Monash Health mental health clinicians who completed a 2-day training workshop with the Exploring Together program authors or who were trained through co-leading a group with a trained Monash Health clinician led the groups. The clinicians completed fidelity checklists throughout the intervention period for a subsample of groups (16%) in order to elicit information about therapist adherence to group set-up and process. Gottman, J.M., & DeClaire, J. (1997). The heart of parenting: How to raise an emotionally intelligent child. London: Bloomsbury. Littlefield, L., Story, K., Woolcock, C., Trinder, M., Burke, S., & Reid, K. (2010). Exploring Together Preschool/Early Primary School Program: Program Manual. Princes Hill, Victoria: Exploring Together.
Sponsors
Study design
Eligibility
Inclusion criteria
Participants were children in Preparatory year to Grade Three with externalising and/or internalising behaviour problems and their parent/carer, recruited from consenting government and catholic primary schools in the south east metropolitan suburbs of Melbourne and Mornington Peninsula region, Victoria. Identification of externalising and/or internalising problems occurred through a population wide screening of children in Preparatory year to Grade Three at each participating school using Parent and Teacher versions of the Strengths & Difficulties Questionnaire (SDQ; Goodman, 1997). Children in Preparatory year to Grade Three were eligible for possible participation in the intervention group based on Parent and/or Teacher SDQ Total Difficulties Score in the borderline – abnormal range (greater than or equal to 14 or 12 respectively). Children were also eligible for the intervention group if they scored in the borderline – abnormal range on an Externalising score (combined Conduct Problems Score, Hyperactivity Score, & Peer Problems Score) of the Parent and/or Teacher SDQ (greater than or equal to 12 or 13 respectively), or if they scored in the borderline – abnormal range on an Internalising score (Emotional Symptoms Score) of the Parent and/or Teacher SDQ (greater than or equal to 4 or 5 respectively). Goodman, R. (1997). The Strengths and Difficulties Questionnaire: A research note. Journal of Child Psychology and Psychiatry and Allied Disciplines, 38(5), 581-586.
Exclusion criteria
Parent-child dyads excluded on the basis of: parent factors (i.e. unable to attend any or significant part of intervention program; recent or current significant transition or adjustment; significant mental health problems; intellectual disability; and insufficient English for group participation), and/or family factors (i.e. currently engaged in another group parenting program; active child protection case management). Children excluded if they had a pre-existing diagnosis of Autism Spectrum Disorder, intellectual disability, or behaviour disorder of such severity that it required government-funded specialist education support (Department of Education and Early Childhood Development, 1998). Children were also excluded for participation in the intervention group if they required prompt referral for assessment or treatment.