Comparing Child,Parent,and Family Characteristics in Usual Care and Empirically Supported Treatment Research Samples for Children with Disruptive Behavior Disorders
Restricted accessResearch articleFirst published online June, 2010
Comparing Child,Parent,and Family Characteristics in Usual Care and Empirically Supported Treatment Research Samples for Children with Disruptive Behavior Disorders
This study compared data from 34 research trials of five empirically supported treatments (ESTs) with one large usual care (UC) sample on child, parent, and family characteristics for children with Disruptive Behavior Disorders. Large variations were found within and across ESTs on sample characteristics during the past two decades. Most parent and family characteristics were not reported in EST studies. Statistical comparisons between UC and EST samples revealed that occurrences of child demographics and symptom severity levels were similar, but occurrences of most parent and family characteristics were different, with higher rates of problems for the UC sample. Results indicate that UC clients have complex needs, with multiple child, parent, and family issues. The findings are discussed in relation to the importance of acknowledging parent and family contextual variables in implementation efforts.
Achenbach, T.M. ( 1991). Manual for the CBCL/4-18 and profile. Burlington: University of Vermont Department of Psychiatry .
2.
Addis, M., & Waltz, J. ( 2002). Implicit and untested assumptions about the role of psychotherapy treatment manuals in evidence-based mental health practice. Clinical Psychology Science Practice, 9, 421-424.
3.
Alexander, J.F., & Parsons, B.V. ( 1973). Short-term behavioral intervention with delinquent families: Impact on family process and recidivism. Journal of Abnormal Psychology, 81(3), 219-225.
4.
American Psychiatric Association. (1994). Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: Author .
5.
Andrade, A.R., Lambert, E.W., & Bickman, L. ( 2000). Dose effect in psychotherapy: Outcomes associated with negligible treatment. Journal of the American Academy of Child & Adolescent Psychiatry, 39(2), 161-168.
6.
Armbruster, P., & Fallon, T. ( 1994). Clinical, sociodemographic, and systems risk factors for attrition in a children’s mental health
7.
clinic. American Journal of Orthopsychiatry, 64(4), 577-585. Arndorfer, R.E., Allen, K.D., & Aliazireh, L. (1999). Behavioral health needs in pediatric medicine and the acceptability of behavioral solutions: Implications for behavioral psychologists. Behavior Therapy, 30(1), 137-148.
8.
Atkins, M.S., Frazier, S.L., & Cappella, E. ( 2006). Hybrid research models: Opportunities for examining mental health in context. Clinical Psychology: Science and Practice , 13(1), 105-108.
9.
Bagner, D.M., & Eyberg, S.M. ( 2003). Father involvement in parent training: When does it matter ? Journal of Clinical Child and Adolescent Psychology, 32(4), 599-605.
10.
Baker-Ericzen, M.J., & McKeown, M. ( 2007). Prevalence and impacts of parent and family contextual factors in community child psychotherapy. Symposium presented at the 115th annual convention of the American Psychological Association , San Francisco, CA.
11.
Beauchaine, T.P., Webster-Stratton, C., & Reid, M.J. ( 2005). Mediators, moderators, and predictors of 1-year outcomes among children treated for early-onset conduct problems: A latent growth curve analysis. Journal of Consulting and Clinical Psychology, 73(3), 371-388.
12.
Bernal, M.E., Klinnert, M.D., & Schultz, L.A. ( 1980). Outcome evaluation of behavioral parent training and client-centered parent counseling for children with conduct problems. Journal of Applied Behavior Analysis, 13(4), 677-691.
13.
Bickman, L. ( 2002). The death of treatment as usual: An excellent first step on a long road. Clinical Psychology: Science and Practice , 9(2), 195-199.
14.
Borduin, C.M., Mann, B.J., Cone, L.T., Henggeler, S.W., Fucci, B.R., & Blaske, D.M., et al. (1995). Multisystemic treatment of serious juvenile offenders: Long-term prevention of criminality and violence. Journal of Consulting and Clinical Psychology, 63(4), 569-578.
15.
Brannan, A.M., Heflinger, C.A., & Bickman, L. ( 1997). The Caregiver Strain Questionnaire: Measuring the impact on the family of living with a child with serious emotional disturbance. Journal of Emotional & Behavioral Disorders, 5(4), 212-222.
16.
Brestan, E.V., & Eyberg, S.M. ( 1998). Effective psychosocial treatments of conduct-disordered children and adolescents: 29 years, 82 studies, and 5,272 kids [Special issue: Empirically supported psychosocial interventions for children]. J ournal of Clinical Child Psychology, 27(2), 180-189.
17.
Chambless, D.L., Baker, M.J., Baucom, D.H., Beutler, L.E., Calhoun, K.S., Crits-Christoph, P., et al. (1998). Update on empirically validated therapies, II. Clinical Psychologist, 51, 3-16.
18.
Chambless, D.L., & Ollendick, T.H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of Psychology, 52, 685-716.
19.
Chronis, A.M., Chacko, A., Fabiano, G.A., Wymbs, B.T., & Pelham, W.E., Jr. (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.
20.
Cobham, V.E., Dadds, M.R., & Spence, S.H. ( 1998). The role of parental anxiety in the treatment of childhood anxiety. Journal of Consulting & Clinical Psychology, 66(6), 893-905.
21.
Cunningham, P.B., & Henggeler, S.W. (1999). Engaging multiproblem families in treatment: Lessons learned throughout the development of Multisystemic Therapy. Family Process, 38(3), 265-286.
22.
Cutrona, C.E., & Russell, D. ( 1987). The provisions of social relationships and adaptation to stress. In W. H. Jones & D. Perlman (Eds.), Advances in personal relationships (Vol. 1, pp. 37-67). Greenwich, CT : JAI Press.
Eisenstadt, T.H., Eyberg, S., Mcneil, C.B., Newcomb, K., & Funderburk, B. (1993). Parent-Child Interaction Therapy with behavior problem children: Relative effectiveness of two stages and overall treatment outcome. Journal of Clinical Child Psychology , 22(1), 42-51.
25.
Evans, M.E. ( 2001). Improving the quality of community-based services for children. Washington, DC: American Psychiatric Publishing.
26.
Eyberg, S.M., Boggs, S.R., & Algina, J. ( 1995). Parent-Child Interaction Therapy: A psychosocial model for the treatment of young children with conduct problem behavior and their families. Psychopharmacology Bulletin, 31(1), 83-91.
27.
Eyberg, S.M., Funderburk, B.W., Hembree-Kigin, T.L., Mcneil, C.B., Querido, J.G., & Hood, K.K. ( 2001). Parent-Child Interaction Therapy with behavior problem children: One and two year maintenance of treatment effects in the family . Child & Family Behavior Therapy, 23(4), 1-20.
28.
Eyberg, S.M., & Robinson, E.A. (1982). Parent-Child Interaction Training: Effects on family functioning. Journal of Clinical Child Psychology, 11(2), 130-137.
29.
Farmer, E.M.Z., Compton, S.N., Burns, J.B., & Robertson, E. ( 2002). Review of the evidence base for treatment of childhood psychopathology: Externalizing disorders. Journal of Consulting and Clinical Psychology, 70(6), 1267-1302.
30.
Firestone, P., Kelly, M.J., & Fike, S. ( 1980). Are fathers necessary in parent training groups? Journal of Clinical Child Psychology, 9(1), 44-47.
31.
Frick, P.J. ( 2001). Effective interventions for children and adolescents with conduct disorder. Canadian Journal of Psychiatry, 46(7), 597-608.
32.
Friedman, R.M., Kutash, K., & Duchnowski, A.J. (1996). The population of concern: Defining the issues. In B. A. Stroul (Ed.), Children’s mental health: Creating systems of care in a changing society (pp. 69-96). Baltimore: Brookes.
33.
Funderburk, B.W., Eyberg, S.M., Newcomb, K., Mcneil, C.B., Hembree-Kigin, T., & Capage, L. ( 1998). Parent-Child Interaction Therapy with behavior problem children: Maintenance of treatment effects in the school setting. Child & Family Behavior Therapy, 20(2), 17-38.
34.
Garland, A.F., Hough, R., McCabe, K., Yeh, M., Wood, P., & Aarons, G. ( 2001). Prevalence of psychiatric disorders for youths in public sectors of care. Journal of the American Academy of Child and Adolescent Psychiatry, 40, 409-418.
35.
Griest, D.L., Forehand, R., Rogers, T., Breiner, J., Furey, W., & Williams, C.A. (1982). Effects of parent enhancement therapy on the treatment outcome and generalization of a parent training program . Behaviour Research & Therapy, 20(5), 429-436.
36.
Hanson, C.L., Henggeler, S.W., Haefele, W.F., & Rodick, J.D. ( 1984). Demographic, individual, and family relationship correlates of serious and repeated crime among adolescents and their siblings. Journal of Consulting and Clinical Psychology, 52(4), 528-538.
37.
Hawley, K.M., & Weisz, J.R. ( 2002). Increasing the relevance of evidence-based treatment review to practitioners and consumers. Clinical Psychology: Science and Practice, 9(2), 225-230.
38.
Henggeler, S.W., Melton, G.B., & Smith, L.A. ( 1992). Family preservation using Multisystemic Therapy: An effective alternative to incarcerating serious juvenile offenders. Journal of Consulting and Clinical Psychology, 60(6), 953-961.
39.
Henggeler, S.W., Rodick, J.D., Borduin, C.M., Hanson, C.L., Watson, S.M., & Urey, J.R. ( 1986). Multisystemic Treatment of juvenile offenders: Effects on adolescent behavior and family interaction. Developmental Psychology, 22(1), 132-141.
40.
Hoagwood, K., Burns, B.J., Kiser, L., Ringeisen, H., & Schoenwald, S.K. (2001). Evidence-based practice in child and adolescent mental health services. Psychiatric Services, 52(9), 1179-1189.
41.
Hood, K.K., & Eyberg, S.M. ( 2003). Outcomes of Parent-Child Interaction Therapy: Mothers’ reports of maintenance three to six years after treatment. Journal of Clinical Child and Adolescent Psychology, 32(3), 419-429.
42.
Hughes, R.C., & Wilson, P.H. ( 1988). Behavioral parent training: Contingency management versus communication skills training with or without the participation of the child . Child & Family Behavior Therapy, 10(4), 11-23.
43.
Ireland, J.L., Sanders, M.R., & Markie-Dadds, C. (2003). The impact of parent training on marital functioning: A comparison of two group versions of the Triple P-Positive Parenting Program for parents of children with early-onset conduct problems. Behavioural and Cognitive Psychotherapy , 31(2), 127-142.
44.
Kazdin, A.E. ( 1995). Scope of child and adolescent psychotherapy research: Limited sampling of dysfunctions, treatments, and client characteristics [Special issue: Methodological issues in clinical child psychology research]. Journal of Clinical Child Psychology, 24(2), 125-140.
45.
Kazdin, A.E., Bass, D., Siegel, T., & Thomas, C. ( 1989). Cognitive-behavioral therapy and relationship therapy in the treatment of children referred for antisocial behavior. Journal of Consulting and Clinical Psychology, 57(4), 522-535.
46.
Kazdin, A.E., Esveldt-Dawson, K., French, N.H., & Unis, A.S. ( 1987a). Effects of parent management training and problem-solving skills training combined in the treatment of antisocial child behavior. Journal of the American Academy of Child & Adolescent Psychiatry, 26(3), 416-424.
47.
Kazdin, A.E., Esveldt-Dawson, K., French, N.H., & Unis, A.S. ( 1987b). Problem-solving skills training and relationship therapy in the treatment of antisocial child behavior. Journal of Consulting and Clinical Psychology, 55(1), 76-85.
48.
Kazdin, A.E., Holland, L., & Crowley, M. ( 1997). Family experience of barriers to treatment and premature termination from child therapy. Journal of Consulting & Clinical Psychology, 65(3), 453-463.
49.
Kazdin, A.E., Siegel, T.C., & Bass, D. ( 1992). Cognitive problem-solving skills training and parent management training in the treatment of antisocial behavior in children. Journal of Consulting and Clinical Psychology, 60(5), 733-747.
50.
Kazdin, A.E., & Crowley, M.J. ( 1997). Moderators of treatment outcome in cognitively based treatment of antisocial children. Cognitive Therapy & Research, 21, 185-207.
51.
Kazdin, A.E., & Wassell, G. ( 1998). Treatment completion and therapeutic change among children referred for outpatient therapy. Professional Psychology: Research and Practice, 29(4), 332-340.
52.
Kazdin, A.E., & Wassell, G. ( 1999). Barriers to treatment participation and therapeutic change among children referred for conduct disorder. Journal of Clinical Child Psychology, 28(2), 160-172.
53.
Kazdin, A.E., & Wassell, G. ( 2000a). Predictors of barriers to treatment and therapeutic change in outpatient therapy for antisocial children and their families. Mental Health Services Research, 2(1), 27-40.
54.
Kazdin, A.E., & Wassell, G. ( 2000b). Therapeutic changes in children, parents, and families resulting from treatment of children with conduct problems. Journal of the American Academy of Child & Adolescent Psychiatry, 39(4), 414-420.
55.
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.
56.
Liao, Q., Manteuffel, B., Paulic, C., & Sondheimer, D. (2001). Describing the population of adolescents served in systems of care [Special issue: The national evaluation of the Comprehensive Community Mental Health Services for Children and Their Families program]. Journal of Emotional & Behavioral Disorders , 9(1), 13-29.
57.
Lundahl, B., Risser, H.J., & Lovejoy, M.C. ( 2006). A meta-analysis of parent training: Moderators and follow-up effects. Clinical Psychology Review, 26(1), 86-104.
58.
Manteuffel, B., Stephens, R.L., & Santiago, R. ( 2002). Overview of the National Evaluation of the Comprehensive Community Mental Health Services for Children and Their Families Program and summary of current findings. Children’s Services: Social Policy, Research, &Practice, 5(1), 3-20.
59.
Maughan, D.R., Christiansen, E., Jenson, W.R., Olympia, D., & Clark, E. ( 2005). Behavioral parent training as a treatment for externalizing behaviors and disruptive behavior disorders: A meta-analysis. School Psychology Review, 34(3), 267-286.
60.
Mcneil, C.B., Eyberg, S., Eisenstadt, T.H., Newcomb, K., & Funderburk, B. (1991). Parent-Child Interaction Therapy with behavior problem children: Generalization of treatment effects to the school setting. Journal of Clinical Child Psychology , 20(2), 140-151.
61.
National Advisory Mental Health Council. ( 2001). Blueprint for change: Research on child and adolescent mental health. A report by the National Advisory Mental Health Council’s Workgroup on Child and Adolescent Mental Health Intervention Development and Deployment. Bethesda, MD: National Institutes of Health/ National Institute of Mental Health.
62.
National Advisory Mental Health Council Workgroup. ( 2006). The road ahead: Research partnerships to transform services: A report by the National Advisory Mental Health Council’s Workgroup on Services and Clinical Epidemiology Research. Bethesda, MD: National Institutes of Health/ National Institute of Mental Health.
63.
Nixon, R.D.V., Sweeney, L., Erickson, D.B., & Touyz, S.W. ( 2004). Parent-Child Interaction Therapy: One- and two-year follow-up of standard and abbreviated treatments for oppositional preschoolers. Journal of Abnormal Child Psychology, 32(3), 263-271.
64.
Norcross, J.C., Beutler, L.E., & Levant, R.F. ( 2006). Evidence-based practices in mental health: Debate and dialogue on the fundamental questions. Washington, DC: American Psychological Association.
65.
Ollendick, T.H., & King, N.J. ( 2000). Empirically supported treatments for children and adolescents . New York: Guilford Press.
66.
Patterson, G.R., & Gullion, M.E. ( 1968). Living with children: New methods for parents and teachers . Champaign, IL: Research Press .
67.
Peed, S., Roberts, M., & Forehand, R. ( 1977). Evaluation of the effectiveness of a standardized parent training program in altering the interaction of mothers and their noncompliant children. Behavior Modification, 1(3), 323-350.
68.
Pekarik, G., & Stephenson, L.A. (1988). Adult and child client differences in therapy dropout research. Journal of Clinical Child Psychology, 17(4), 316-321.
69.
Prinz, R.J., & Miller, G.E. ( 1996). Parental engagement in interventions for children at risk for conduct disorder. Thousand Oaks, CA: Sage.
70.
Radloff, L.S. ( 1977). The CES-D Scale: A self-report depression scale for research in the general population. Applied Psychological Measurement , 1(3), 385-401.
71.
Reyno, S.M., & McGrath, P.J. ( 2006). Predictors of parent training efficacy for child externalizing behavior problem: A meta-analytic review. Journal of Child Psychology and Psychiatry, 47(1), 99-111.
72.
Schoenwald, S.K., Brown, T.L., & Henggeler, S.W. (2000). Inside Multisystemic Therapy: Therapist, supervisory, and program practices [Special issue: School safety: Part 1]. Journal of Emotional & Behavioral Disorders, 8(2), 113-127.
73.
Schoenwald, S.K., Halliday-Boykins, C.A., & Henggeler, S.W. (2003). Client-level predictors of adherence to MST in community service settings. Family Process, 42(3), 345-359.
74.
Schoenwald, S.K., Sheidow, A.J., Letourneau, E.J., & Liao, J.G. ( 2003). Transportability of Multisystemic Therapy: Evidence for multilevel influences. Mental Health Services Research, 5(4), 223-239.
75.
Schuhmann, E.M., Foote, R.C., Eyberg, S.M., Boggs, S.R., & Algina, J. ( 1998). Efficacy of Parent-Child Interaction Therapy: Interim report of a randomized trial with short-term maintenance. Journal of Clinical Child Psychology, 27(1), 34-45.
76.
Scott, S. ( 2005). Do parenting programmes for severe child antisocial behaviour work over the longer term, and for whom? One year follow-up of a multi-centre controlled trial. Behavioural and Cognitive Psychotherapy , 33(4), 403-421.
77.
Scott, S., Spender, Q., Doolan, M., Jacobs, B., & Aspland, H. ( 2001). Multicentre controlled trial of parenting groups for childhood antisocial behaviour in clinical practice. BMJ: British Medical Journal, 323(7306), 194.
78.
Shadish, W.R., Montgomery, L.M., Wilson, P., Wilson, M.R., Bright, I., & Okwumabua, T. ( 1993). Effects of family and marital psychotherapies: A meta-analysis . Journal of Consulting & Clinical Psychology, 61(6), 992-1002.
79.
Shaffer, D., Fisher, P., Lucas, C.P., Dulcan, M.K., & Schwab-Stone, M.E. (2000). NIMH Diagnostic Interview Schedule for Children Version IV (NIMH DISC-IV): Description, differences from previous versions, and reliability of some common diagnoses. Journal of the American Academy of Child & Adolescent Psychiatry, 39(1), 28-38.
80.
Shirk, S.R. ( 2001). The road to effective child psychological services: Treatment processes and outcome research. In J. N. Hughes, & A. M. La Greca (Eds.), Handbook of psychological services for children and adolescents (pp. 43-59). London: Oxford University Press.
81.
Silverman, W.K., & Hinshaw, S.P. ( 2008). The second special issue on evidence-based psychosocial treatments for children and adolescents: A 10-year update. Journal of Clinical Child and Adolescent Psychology, 37(1), 1-7.
82.
Southam-Gerow, M.A., Kendall, P.C., & Weersing, V.R. (2001). Examining outcome variability: Correlates of treatment response in a child and adolescent anxiety clinic . Journal of Clinical Child Psychology, 30(3), 422-436.
83.
Southam-Gerow, M.A., Weisz, J.R., & Kendall, P.C. ( 2003). Youth with anxiety disorders in research and service clinics: Examining client differences and similarities. Journal of Clinical Child & Adolescent Psychology, 32(3), 375-385.
84.
Spaccarelli, S., Cotler, S., & Penman, D. ( 1992). Problem-solving skills training as a supplement to behavioral parent training. Cognitive Therapy & Research, 16(1), 1-17.
85.
Straus, M.A., Hamby, S.L., Boney-McCoy, S., & Sugarman, D.B. (1996). The Revised Conflict Tactics Scales: Development and preliminary psychometric data. Journal of Family Issues, 17(3), 283-316.
86.
Taylor, T.K., Schmidt, F., Pepler, D., & Hodgins, C. ( 1998). A comparison of eclectic treatment with Webster-Stratton’s parents and children series in a children’s mental health center: A randomized controlled trial. Behavior Therapy, 29(2), 221-240.
87.
Webster-Stratton, C. ( 1982). Teaching mothers through videotape modeling to change their children’s behavior. Journal of Pediatric Psychology , 7(3), 279-294.
88.
Webster-Stratton, C. ( 1984). Randomized trial of two parent-training programs for families with conduct-disordered children. Journal of Consulting and Clinical Psychology, 52(4), 666-678.
89.
Webster-Stratton, C. ( 1990). Enhancing the effectiveness of self-administered videotape parent training for families with conduct-problem children. Journal of Abnormal Child Psychology, 18(5), 479-492.
90.
Webster-Stratton, C. ( 1994). Advancing videotape parent training: A comparison study . Journal of Consulting and Clinical Psychology, 62(3), 583-593.
91.
Webster-Stratton, C., & Hammond, M. ( 1990). Predictors of treatment outcome in parent training for families with conduct problem children. Behavior Therapy, 21(3), 319-337.
92.
Webster-Stratton, C., & Hammond, M. ( 1997). Treating children with early-onset conduct problems: A comparison of child and parent training interventions. Journal of Consulting and Clinical Psychology, 65(1), 93-109.
93.
Webster-Stratton, C., Kolpacoff, M., & Hollinsworth, T. (1988). Self-administered videotape therapy for families with conduct-problem children: Comparison with two cost-effective treatments and a control group. Journal of Consulting and Clinical Psychology, 56(4), 558-566.
94.
Weersing, V.R., Iyengar, S., Birmaher, B., Kolko, D.J., & Brent, D.A. ( 2006). Effectiveness of cognitive-behavioral therapy for adolescent depression: A benchmarking investigation. Behavior Therapy , 37, 36-48.
95.
Weersing, V.R., & Weisz, J.R. ( 2002). Community clinic treatment of depressed youth: Benchmarking usual care against CBT clinical trials. Journal of Consulting and Clinical Psychology, 70(2), 299-310.
96.
Weisz, J.R. ( 2004). Psychotherapy for children and adolescents: Evidence-based treatments and case examples. New York: Cambridge University Press.
97.
Weisz, J.R., Doss, A.J., & Hawley, K.M. ( 2005). Youth psychotherapy outcome research: A review and critique of the evidence base. Annual Review of Psychology, 56, 337-363.
98.
Weisz, J.R., Jensen-Doss, A., & Hawley, K.M. ( 2006). Evidence-based youth psychotherapies versus usual clinical care: A meta-analysis of direct comparisons. American Psychologist , 61(7), 671-689.
99.
Westen, D., Novotny, C.M., & Thompson-Brenner, H. (2004). The empirical status of empirically supported psychotherapies: Assumptions, findings, and reporting in controlled clinical trials. Psychological Bulletin, 130(4), 631-663.
100.
Wiltz, N.A., & Patterson, G.R. (1974). An evaluation of parent training procedures designed to alter inappropriate aggressive behavior of boys. Behavior Therapy, 5(2), 215-221.
