Conduct Disorders in Children, Depression / Major Depressive Disorder, Disruptive Behaviour in Children, Parenting Intervention
Conditions
Keywords
behavioural parent training, depression, parenting skills, child disruptive behaviour
Brief summary
Standard Behavioral Parent Training (BPT) is often less effective for parents experiencing depression. As such, the Addressing Depression and Positive Parenting Techniques (ADAPT) intervention is a novel BPT tailored to address the unique emotional and cognitive needs of depressed parents to improve treatment outcomes. The objective of this study is to determine the efficacy of ADAPT in reducing child emotional and behavioral difficulties compared to the gold-standard Incredible Years Parenting Program (IYPP). This study is a 4-year, individually-randomized group treatment (IRGT), parallel-group trial. We aim to recruit 180 caregivers and their children (aged 6-11 years) seeking treatment for their child's emotional and behavioral difficulties from multiple mental health centres across Toronto, including but not limited to the University of Toronto, Centre for Addiction and Mental Health (CAMH), and Women's College Hospital (WCH). Participants will be asked to complete research measures: * before randomization * post-treatment * 6 months after the end of treatment Participants will be randomized to either the experimental ADAPT intervention - A 10-session virtual program (1 individual, 9 group) focused on emotion regulation, distress tolerance, and cognitive restructuring, or the control intervention: Incredible Years Parent Program (IYPP) - A 12-session gold-standard BPT delivered virtually.
Interventions
BEHAVIORALADAPT Treatment
ADAPT is a 10-session virtual caregiver program (one individual engagement session and nine group sessions) that was developed with clinician and parent input. The initial engagement session is an individual meeting between the group facilitator and parent to build rapport and learn about the parent's unique challenges and parenting needs. Based on a motivational interviewing framework, this session is designed to gather information, discuss readiness for treatment and goals. The questions and tools used in this session help to build a collaborative understanding of unique child and parent needs that may be addressed through ADAPT and leave the parent with the hope that ADAPT can be helpful. The 9 virtual group treatment sessions that follow include modules to help parents understand the multiple potential contributions to their child's emotional/behavioral challenges, build their own emotion regulation skills, distress tolerance skills, and more helpful ways of thinking.
BEHAVIORALIncredible Years Parenting Program (IYPP)
The 12-session manualized treatment is considered a gold-standard treatment because it has shown efficacy in large-scale randomized and controlled trials and meta-analyses. Parents are helped to shift their children's emotional and behavioral difficulties through improved parental skills and competencies with behaviour management, and a parental problem-solving approach. IYPP will be delivered virtually.
Sponsors
University of Toronto
Centre for Addiction and Mental Health
Women's College Hospital
Study design
Allocation
RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. 18 years of age or above 2. has a child aged 6-11 years with clinically elevated emotional and behavioural disorders (Abnormal Range, 93rd percentile) on the Total Difficulties Scale of the Strength and Difficulties Questionnaire (SDQ) 3. parent shows clinical elevations for mild-moderate depression on the Patient Health Questionnaire-8 (PHQ-8) (\>4 and \<15) 4. capacity to tolerate a virtual group context assessed by clinical interview
Exclusion criteria
1. Parent shows active suicidal ideation, substance use disorder, or psychosis 2. they cannot communicate in English 3. child previously diagnosed with autism or an intellectual disability
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Changes in child emotional and behavioral difficulties | Baseline (pre-randomization), post-treatment (12-weeks post-randomization), and 6-month follow-up | Child emotional and behavioural difficulties are assessed using the Behaviour and Feelings Survey (BFS). |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in parental depression | Baseline (pre-randomization), post-treatment (12-weeks post-randomization), and 6-month follow-up | Parental depression is assessed using the Patient Health Questionnaire (PHQ-8). |
| Changes in parental quality of life | Baseline (pre-randomization), post-treatment (12-weeks post-randomization), and 6-month follow-up | Quality of life is assessed using the World Health Organization Disability Assessment 2.0 (WHODAS). |
| Changes in broad parenting practices | Baseline (pre-randomization), post-treatment (12-weeks post-randomization), and 6-month follow-up | Parenting practices are assessed using the Multidimensional Assessment of Parenting (MAPS). |
| Changes in parental stress | Baseline (pre-randomization), post-treatment (12-weeks post-randomization), and 6-month follow-up | Parental stress is assessed using the self-reported scores on items of the Stress subscale of the Depression, Anxiety, and Stress Scale (DASS-21). |
Countries
Canada
Contacts
CONTACTBrendan Andrade, PhD
Outcome results
None listed